I want to continue one more day on private non-profits and commissions and health care in Maryland. Remember, large sectors of Marylanders are not accessing health care----having a longevity 30 years less than affluent communities shows this. Having the worse VA system in the nation shows this. The clinic care system built to keep Marylanders out of hospitals offer almost no access to basic medical procedures.
IT IS A DISASTER AND IT IS BECAUSE PEOPLE HAVING NO MORALITY OR ETHICS ARE CREATING THESE POLICIES ONLY AIMED AT MAKING A FEW EVER MORE RICH.
The average citizen working for these organizations are not bad people----they just want jobs. Each time you create a private non-profit or commission for health care you have eliminated the public sector employees that would do that job. You eliminate the public's ability to see what is happening and the accountability tasked to our government to serve and protect.
DO YOU HEAR YOUR POLITICIANS SHOUTING THIS? IF NOT, THEY ARE NEO-LIBERALS WORKING FOR WEALTH AND PROFIT AND NOT YOU AND I!
Yesterday we saw the commissions filled with the health executives writing the law and regulating themselves. Let's look at the front lines where the health care is delivered----or, in Maryland, not delivered. This is where the fraud and corruption fills the system. Again, it is not the average staff doing this---they are being told to do this. I spoke at length about the dismantling of the VA to private non-profits and showed they were receiving the money and doing nothing. Medicaid and Medicare is handled just the same. Remember, in Maryland Medicaid and Medicare is handled the same as private insurance so none of the requirements of coverage or accountability have occurred for a few decades. Billions of dollars are lost as fewer Medicare patients enter the hospital but Medicare bills per patient climb.....THAT IS FRAUD CAUSING THOSE BILLS TO CLIMB.
Below you see the private non-profit that took over yet another duty of public health and it has been at it for 15 years---the very years that gave Baltimore the 30 year longevity difference. If you look today health access has never been worse so we know this organization is not doing its job! Remember, the people affected are not only black and brown or unemployed and impoverished or working poor. Middle-class families with expenses that take money that would go for health care are included in these stats.
DO NOT ALLOW PREJUDICE OF CLASS OR RACE SKEW YOUR THOUGHTS ON HEALTH ACCESS----THIS AFFECTS EVERYONE.
Our Organization Enroll In Benefits
HealthCare Access Maryland (HCAM)
is a nonprofit agency that plays a critical role in strengthening Maryland’s health care delivery system. Working with both government and private-sector support, HCAM helps residents enroll in public health care coverage, navigate the complex health care system and connect to educational and other resources.
HCAM was established in 1997 as Baltimore HealthCare Access to initially assist with the Medicaid transition to managed care. What began as a small organization with 40 employees, a $3 million budget and two core grants has grown steadily.
- Funding has grown to $23 million and the agency has earned more than 30 major grants, including a $7.9 million grant from the Maryland Health Benefit Exchange (MHBE) as part of the State’s efforts to implement health care reform in Maryland and help uninsured residents gain access to affordable health care.
- The number of programs offered has grown from the original two to 19, allowing HCAM’s 200 employees to help connect over 125,000 clients each year to health insurance and care and to vital community resources through a variety of programs serving the uninsured, under-insured and vulnerable populations of the state.
- Eligibility and enrollment
- Navigation of the health care system
- Care coordination
- Education and advocacy
The agency’s ability to help people live healthier lives has been recognized by others in our field. The agency is the proud recipient of Maryland Nonprofits’ Seal of Excellence, a designation that recognizes HCAM’s reputation for delivering high-quality programs and services in a fiscally responsible way.
Although HCAM specializes in health care access, we continue to serve the needs of our clients beyond just helping them obtain an insurance card. We serve children, pregnant women, parents, childless adults and youth in foster care, as well as those with addiction issues, immigrants, individuals recently released from jail and the homeless.
HCAM’s work to implement health care reform in Maryland
Throughout its 15-year history, HCAM has become a critical player in strengthening Maryland’s health care delivery system, earning a spot as a public health leader in the state and working with policymakers, nonprofit organizations and elected officials on innovative approaches to improving the health of all Marylanders.
In the Spring of 2013, HealthCare Access Maryland (HCAM) received a $7.9 million grant from the Maryland Health Benefit Exchange (MHBE) as part of the State’s consumer assistance program to implement the Affordable Care Act and help uninsured residents learn about, apply for and enroll in health insurance. HCAM was selected as the State’s Central Region Connector, serving Baltimore City, Baltimore County and Anne Arundel County.
As the Central Region Connector, HCAM will organize services across the region and has partnered with 17 organizations to provide outreach, education and eligibility determinations and to facilitate enrollment of the nearly 217,000 uninsured residents in the region into Medicaid, the Maryland Children’s Health Program (MCHP) and subsidized and non-subsidized qualified health plans.
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Baltimore is ground zero for Medicaid and Medicare spending and as we know the money is not getting to the people. Johns Hopkins and University of Maryland Medical Center are handling many of these groups so that is where you start your search. Since Johns Hopkins has captured all public policy and creates all the private non-profits that are then funded to work in these low-income communities----that is who is charged with overseeing this distribution only THERE IS NO OVERSIGHT! THERE IS THE PROBLEM. If we had a public health department filled with employees whose job it is dispensing money and providing oversight and reporting to the citizens of Baltimore----this would not be happening.
If you have followed me these few years you know I do not like Sharfstein and Barbot. They were appointed to dismantle all public health and build more of these private non-profits and
THEY HAVE BEEN VERY BUSY! NO WONDER SHARFSTEIN COULDN'T ROLL OUT THE STATE HEALTH EXCHANGE----HE'S TOO BUSY MAKING SURE MARYLAND HAS NO PUBLIC HEALTH. Slander you say----no, all you have to do is look at who is doing the work of public health and you see nothing but private non-profits. The people supposedly served all complaining they cannot access care. The money is flowing but not where its supposed to------
DID YOU KNOW THAT JOHNS HOPKINS BUILT A GLOBAL CORPORATE EMPIRE THESE FEW DECADES THAT MEDICARE AND MEDICAID FRAUD WAS THE WORSE-----just saying there's likely a link!
This should anger everyone as this looted Medicare Trust is now being addressed by limiting more access to most people....you and I!
Tuesday, May 10, 2011
Healthy Baltimore 2015 Last month, the Robert Wood Johnson Foundation issued the second annual County Health Rankings. As it did last year, Baltimore City ranked last in the state.
One statistic in particular stuck out: 14,887. That’s the number of years of potential life lost before the age of 75. Put simply, far too many Baltimore City residents are dying before their time.
Statistics like these give great urgency to the work we do to improve the health of our city, our neighborhoods and our residents. It also makes clear that traditional medical or public health approaches aren’t working and it’s time to try something different.
That conversation starts today with the release of Healthy Baltimore 2015.
This comprehensive health policy agenda highlights 10 priority areas that account for the greatest morbidity and mortality in Baltimore. These areas were chosen because there are evidence-based interventions proven to make a difference. The plan looks at the relevance of where we live, work and play on health outcomes, as oftentimes they play as significant a role in making us sick as they do in keeping us healthy.
The city has set ambitious, yet reachable, improvement goals for the following priority areas:
1. Promote access to quality health care for all.
2. Be tobacco free.
3. Redesign Communities to Prevent Obesity.
4. Promote Heart Health.
5. Stop the spread of HIV and other STIs.
6. Recognize and Treat Mental Health Disorders.
7. Reduce Drug Use and Alcohol Abuse.
8. Encourage early detection of cancer.
9. Promote Healthy Children and Adolescents.
10. Create Health Promoting Neighborhoods.
For more information on the specific indicators we will use to measure progress in these areas, please view the full Healthy Baltimore 2015 report.
As you can see, there is much work to be done. Healthy Baltimore 2015 makes clear that we all play a role in improving the health of our city.
Over the course of the next several weeks to months, we will work with partners throughout the city to flesh out a 3-pronged approach to moving the needle for each of the leading indicators, including policy development; prevention, quality, and access; and community engagement. Later this spring, senior leaders within the department will visit communities around the city to share this plan and the updated neighborhood health profiles. We hope communities will put this information to use in designing new strategies and interventions for tackling the top priorities they identify for creating health promoting environments.
Let me be clear: the health department alone cannot successfully execute Healthy Baltimore 2015. We welcome all motivated neighborhood leaders, individual citizens, academic institutions, community-based organizations, business owners and the media to join us in this effort as partners in health.
Partners can contribute to the success of Healthy Baltimore 2015 in many ways. These varying levels of engagement include, but are not limited to:
- Communication – displaying or distributing health information materials within each of the ten priority areas.
- Facilitation – actively participating in interventions such as incorporating wellness at work programs into the business day.
- Integration – actively considering the potential health impacts of pending business or policy decisions.
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Using Maryland for the divide between wealthier counties and poor counties we need to be clear-----while the poorest were excluded from accessing health in Maryland these last decades it is now coming higher up the economic scale....The Affordable Care Act is designed to make preventative care the only care 80% of Americans can afford and percentage is rising soon to 90%. We will see with these forced re-negotiations of corporate and public sector health benefits that the middle-class will now be the ones forced out of care because they cannot afford co-pays and deductibles or once they pay the health insurance premiums they have no money for the health care itself. THAT IS THE GOAL....
IT'S LIKE AUTO INSURANCE....YOU PAY AND PAY FOR COVERAGE AND IF YOU USE IT, THEY HIKE YOUR RATES OR CANCEL YOUR POLICY.
That is what is coming. Below you see the other factor that will keep most people out of basic medical care----the need for a primary care doctor to access specialists and their care. Activists have tried for decades to have medical school training be made free. Get rid of the medical grads high tuition debt and you get lots of people in doctoring less motivated to earn $500,000 or more. THIS ONE POLICY HAS CREATED THIS SHORTAGE AND AGAIN---IT IS DONE DELIBERATELY. If corporations and the rich are paying no taxes and receive all revenue that is collected as corporate subsidy----where does all that free money for medical schools come from? No, say corporations its better to simply exclude most people from health care access to maximize corporate profits.
FREE MEDICAL SCHOOL PAID FOR BY SIMPLY RECOVERING TRILLIONS OF DOLLARS IN HEALTH INDUSTRY FRAUD AND STOPPING IT IN THE FUTURE FLOODS THE MARKET WITH PRIMARY CARE DOCTORS.
But then say health corporations we cannot pretend to need to bring third world doctors to the US that are used to high levels of fraud and corruption and not bothering with the Hippocratic Oath and HIPAA regulations and who have no rights as citizens so as to be exploited by these growing US global health systems!
What is being said here is nothing new----we have been shouting it for decades----they simply are pretending they are working on this solution as they dismantle all the avenues to address this.
Primary care access a key to health disparities among counties ■ An annual ranking of counties based on health status found that gaps between the healthiest and unhealthiest regions of states are wide — and getting wider.
By Jennifer Lubell — Posted April 1, 2013 AMED NEWS.com
Washington If you're a resident of Howard County, Md., chances are fairly high that you have insurance, enjoy good health and have relatively easy access to a primary care physician. Take a short car ride to Baltimore, however, and the situation for residents is much more grim.
In Howard County, ranked as Maryland's healthiest in the most recent County Health Rankings and Roadmaps survey, only 9% of residents are uninsured, and just 8% are considered in poor health. There's one primary care physician for every 577 patients. In Baltimore City, the unhealthiest county in the state, the uninsured rate is nearly twice as high, and there's only one primary care doctor for every 985 patients — a combination that means a significant access-to-care problem.
The comparison underscores a key finding in the 2013 survey: Gaps between the healthiest and unhealthiest counties in individual states are large and continue to grow. The survey highlighted the fact that residents in the healthiest counties are 1.4 times more likely to have access to a primary care physician than those in the least healthy counties. Unhealthy areas also had higher rates when it came to a host of other negative indicators of overall health, including child poverty, teen pregnancy and premature death.
This is the fourth year that the Robert Wood Johnson Foundation and the University of Wisconsin School of Medicine and Public Health have surveyed the health of every county in the U.S., ranking them on a state-by-state basis to gauge the factors determining the health of residents. All survey measures use figures or percentages that take population into account so that a county such as Howard, with a population of less than 300,000, can be compared with Baltimore City's population of more than 600,000.
The rankings are set up so that every state has a healthiest and unhealthiest county despite the overall health of the state. But health outcomes can vary widely within a state, said Patrick Remington, MD, MPH, professor and associate dean at the University of Wisconsin School of Medicine and Public Health, during a teleconference to discuss the 2013 rankings. Louisiana and Mississippi are two states that often rank last in the nation on overall health. But when researchers dig into each state, they find as much variability among individual counties in Louisiana and Mississippi as they do in Vermont, a state that ranks relatively high nationally on patient health outcomes, he said.
Competition drives improvement Dr. Remington said promoting the results of county rankings has made a difference, “sparking action all over the country as people from all sectors join forces to create new possibilities in health — county by county.”
One of those areas is New Orleans, which has been trying to rebuild its infrastructure after Hurricane Katrina in 2005, said Karen B. DeSalvo, MD, New Orleans health commissioner and senior health policy adviser to the city's mayor. Orleans Parish typically has ranked in the 60-62 range in a state that has 64 counties, Dr. DeSalvo said. “So we've been at the bottom of the pack in one of the more unhealthy states in the country. What we're excited about this year is we've jumped up to number 48, so that's a big leap.”
In addition to overhauling its education system and making improvements to parks and playgrounds, the city has spent seven years on an initiative to develop its primary care infrastructure.
“We had essentially no neighborhood-based primary care before Katrina. People were reliant upon hospital-based services, especially those who were uninsured and underinsured,” Dr. DeSalvo said.
Since then, the city has responded by working with 25 organizations, ranging from small clinics to large hospital systems, to build access to primary care and outpatient mental care, with a particular focus on patient-centered medical homes and health information technology. The initiative has received financial support from philanthropic sources as well as some federal demonstration program funding to expand access to primary care rapidly. “This is a true public-private partnership,” she said.
Dr. DeSalvo said the renewed focus on building strong primary and preventive care at the neighborhood level probably has reduced unnecessary hospitalizations and led to improvements in screening rates for such conditions as diabetes and breast cancer.
Improving patient-reported measures and clinical outcomes is one of the strategic goals recently adopted by the American Medical Association. The AMA is focusing on promoting quality and safety, reducing unwarranted variation in care, and fostering appropriate use of limited health care resources.
Other factors leading to poor health The fact that fewer physicians and dentists practice in certain communities obviously contributes to poorer health in those areas, said Bridget B. Catlin, PhD. She's a senior scientist at the University of Wisconsin Population Health Institute and director of the County Health Rankings and Roadmaps survey. But, as she and other health care observers pointed out, lack of access is just one of many problems that go hand in hand with poor health among residents. In addition to measuring clinical care outcomes, the survey analyzes health behaviors, social and economic statistics, morbidity, and such physical environment elements as air and water quality.
“Other key factors that influence the health of a community are education, employment, income, and whether people smoke or have access to healthy foods and places to exercise. Some of these factors probably also influence physicians' decisions about where to practice,” Catlin said. “In particular, there is a widespread need for health care providers in rural areas.”
At least in Maryland, the health gap between the highest- and lowest-ranking counties largely comes down to socioeconomic conditions, said Brian Avin, MD, a neurologist and the president of MedChi, the Maryland State Medical Society. Howard County, a suburb of Washington, is one of the most affluent areas of the nation, “so whatever social factors you want to create, Howard is going to be the highest and Baltimore City is going to be the lowest,” he said. There's much more poverty and unemployment in Baltimore, as well as more people on Medicaid or going without insurance, generating more uncompensated care cases. “Obesity, smoking, any individual feature you're going to look at is going to be worse when you're not getting basic care.”
Howard County also has been trying to get all of its population insured, whereas no such strategic initiative exists in Baltimore City, Dr. Avin said.
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Baltimore has a policy of replacing school athletic courts and community center athletic courts with 'greening' development moving all of this to private non-profits like YMCA located too far for most to reach. I literally had to fight for an athletic court for an elementary school of 300 students----Johns Hopkins Homewood wanted to make it a park. Parks and playgrounds across the city have been neglected as the city dismantled its Parks department and handed the funding to a private non-profit. So school grounds have grass up to your knees, broken glass all because the city does not collect revenue from corporations and the rich and any that is collected go to projects connected to the same. Baltimore City schools often have no recess and most schools have no athletic teams. The tiered funding leaving these low-income schools run as businesses make it impossible to address these disparities so NOTHING is being done to actually address health issues ------they simply say they are doing so.
Private wellness non-profits are going into poor neighborhoods telling people to eat better and scolding when people explain that living in poverty places survival over preparing a good meal or even having a living space that allows it. So, we are seeing these national private non-profits coming in to talk the talk of better health to communities now being kept from accessing any health care but preventative care.
There are some good programs-----Food stamps being used at Farmers Markets is a good thing. If you are creating an environment of deeper and wider poverty as neo-liberals and neo-cons are doing today----none of this will end in data having better results and THEY KNOW THIS.
EXPANDED AND IMPROVED MEDICARE FOR ALL SIMPLY ALLOWS EVERYONE TO GET ALL THE CARE THEY NEED AND THAT IS THE BEST PREVENTATIVE MEDICINE AND YOU PAY FOR IT BY ENDING HEALTH INDUSTRY FRAUD AND PROFITEERING.
Below you see the vestige of a city no caring for families and with that goes health. Day care is where children receive healthy exposure and access is critical to a family working and having low-incomes. So, if you do not provide a system of day care-----and you are closing and defunding parks and playgrounds-----YOU DO NOT CARE ABOUT WELLNESS. None of this information is new and Johns Hopkins is behind the redirecting of money and the lack of oversight and accountability and is the one charged now with the most responsibility in these Maryland health care reforms....THE OPPOSITE OF WHAT IS NEEDED FOR REAL CHANGE.
Below you see middle-class families saying OMG!!!!! and it is all centered on the corporations/ rich taking all the revenue through fraud and corruption in the City of Baltimore and this expands across the State of Maryland.
Day care shortage frustrates parents in Baltimore. Costs can top tuition at University of Maryland, College Park
In five months, the downtown Baltimore day care attended by Celine Plachez's youngest son is slated to close, yet she's not looking for a backup. She can't stomach it.
She searched before he was born, calling about a dozen places, some of which said they wouldn't have an opening in the foreseeable future. Others were so expensive, they cost more than tuition at the University of Maryland, College Park. And a handful were just plain unacceptable in terms of quality.
So she's devoting her energy to finding a way to keep open the Children's Choice Learning Center, housed in the Social Security Administration building on North Greene Street.
"Call me crazy — I refuse to look. I want to fight," said Plachez, a scientist who lives in Federal Hill. "We can make it happen. It's not impossible, it's not unrealistic."
Plachez's response to the center's planned closure highlights a frustrating reality: At a time when the city is trying to attract and retain families — and more women work than ever before — there's a lack of high-quality, affordable, regulated child care in Baltimore.
The shortage is particularly pronounced for children younger than 2, like Plachez's son, who require a higher, 3-1 ratio of children to staff under state law, making their care cost-prohibitive for many facilities.
For some who live or work in the city, the situation has significant consequences.
Rachel Winer Sticklin of Canton is postponing having a second child until the first is out of day care because her family can't afford to pay for two at once.
Judy O'Brien of Otterbein started looking for a spot two years before her newborn needs it, knowing she faced long waiting lists at many places.
And Jana Gauvey of Federal Hill brings her kids to Baltimore County, where she works in marketing, for their care.
"There weren't that many options close to our home," Gauvey said.
Others, particularly those with low incomes, are putting their kids in informal, unregulated city settings — often in the homes of neighbors operating babysitting businesses — in the hope that the financial savings won't equate to inadequate care.
Not enough spaces
Roughly 13,300 Baltimore children younger than 2 have mothers who work, and many of them need some kind of child care, from relatives, hired sitters or centers, according to a Baltimore Sun analysis of state data. Licensed facilities can accommodate at most 20 percent of them.
The surrounding counties face a similar issue, though only Anne Arundel County's case is as severe. In Howard County, for example, licensed facilities can handle up to 35 percent of the children under 2 who might need care; in Baltimore County up to 27 percent can be accommodated.
The quality of care is also thought to be less variable in the counties. A greater percentage of children enter kindergarten fully prepared in the counties than in Baltimore.
"In most cities, there is always a shortage of infant and toddler care, mainly because it's expensive to do it right," and Baltimore is no exception, said David W. Andrews, dean of the Johns Hopkins University School of Education. "The ratios of adults to children [here] just don't make it a very profitable scenario unless you're able to charge upward of 17, 18, 19 thousand per kid."
There are also a "number of consequences associated with" doing it wrong, Andrews said.
Studies increasingly show that the early years are crucial to a person's development. Ninety percent of brain growth happens before age 5, and the first three years of life are particularly important. Young children and infants are primed for learning, educators said, and their environment has a lasting impact.
Studies show that while parents have a strong influence on young children, day care effects can linger. Children in the highest-quality programs — where kids feel comfortable, stimulated and cared for by a stable staff — do the best years later in terms of social and academic development, and even health and economic prospects. Those who receive poor care are more likely to wind up in the criminal justice system, act out or drop out of school.
Yet early childhood education in the United States receives the least public investment of any schooling, leaving parents to bear much of the financial burden.
The average cost of full-time infant care at a Baltimore center, as opposed to a home-based site, is about $11,560, according to data from the Maryland Family Network, a private nonprofit that advocates for children and families.
That figure, which factors in the highest- and lowest-quality care options, is 40 percent higher than the average cost of tuition and fees at a state university — $8,220 in 2012. And it's roughly 30 percent of the median household income in the city before taxes.
"It's a real struggle for most parents," said Steve Rohde, the network's deputy director of child care resource and referral services.
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This article shows the mechanism that creates all this disparity and dysfunction. A Baltimore global corporation headquartered in the Enterprise Zones that allow corporations to pay no taxes starve Baltimore's coffers for a few decades causing all of the crumbling of infrastructure and closing of facilities geared towards keeping citizens healthy. All money is directed to boosting profits for this global corporation that adds almost nothing to the economy of Baltimore.
IT IS A HUGE SUCKING MACHINE AND CORPORATE SUBSIDY IS ITS BEST ACHIEVEMENT.
So, here we have our Baltimore media giving this global corporation recognition for 'donating' a playground so it can write the costs of donation from any taxes that might be left to pay again starving government coffers. Rather than consistently paying taxes so general funds can be distributed equitably across the city-----we have corporation simply selecting where they want their tax deduction to go.
THIS IS JOHNS HOPKINS DRIVING THESE POLICIES AND HOPKINS IS NEO-CONSERVATIVE WORKING FOR GLOBAL CORPORATE WEALTH WITH POLITICIANS RUNNING AS DEMOCRATS CREATING ALL THESE POLICIES.
The point is this-----the structures in place that have the public sector dismantled and complete control of policy given to corporations will never end with health policy that does what they say it will do. They will simply create private non-profits that for the most part pretend to be doing something. Remember, more and more people are falling into this abyss so we need the middle-class to WAKE UP and care about where these policies lead.
The taxes this corporation should have paid for a decade or so would have built dozens of playgrounds across the city.
If city employees were being paid to build this playground they could afford to live more healthily!
press release
June 10, 2014, 7:13 p.m. EDT
Baltimore-Based Global Education Company Builds New Playground for Local School
BALTIMORE, June 10, 2014 /PRNewswire/ -- Laureate Education, Inc., the world's largest higher education network, today built and donated a playground at The Historic Samuel Coleridge-Taylor Elementary School in Baltimore. Nearly 300 of Laureate's most senior executives from around the world came to Baltimore to build the playground. Laureate, formerly known as Sylvan Learning Systems, relocated its global headquarters to Baltimore in 1996, the first company to do so in more than twenty years. Laureate was the first company in the Harbor East neighborhood, a key part of Baltimore's federally designated empowerment zone. In the 18 years since moving to Baltimore, the company has grown from employing 300 people at the headquarters to more than 2,700.
More than 100 local volunteers joined Laureate executives and students to build the playground, in partnership with KaBOOM!. The playground will be accessible to nearby residents.
"It's a great honor to give back to the community that has given me -- and Laureate Education -- so much," said Douglas L. Becker, Laureate's founder, chief executive officer, and a Baltimore native. "We are committed to doing work that is here for good in every community in which we operate."
"The Historic Samuel Coleridge-Taylor Elementary School really is the center of this community and this new playground will help foster that sense of community that we cherish," said the school's principal, Dr. Harold A. Barber.
"Congratulations to Baltimore's own Doug Becker and Laureate Education on their 15th anniversary," said Mayor Stephanie Rawlings-Blake. "I'm so grateful that this Baltimore-based global company continues to invest in the local community in ways that benefit the people of this great city. The students of the historic Samuel-Coleridge Taylor Elementary School and members of the neighboring community will truly enjoy the new playground more than you will ever know. Thank you."