Intensive Care For Rural Hospitals

Source: Ronald A. Wirtz, Fedgazette, Vol. 19 no. 2, March 2007

Critical access program brings life, hope back to some rural hospitals. But if access is the goal, it may be overmedicating.

For rural hospitals, many of which have been gasping financially for years, the answer has been the federal Critical Access Hospital (CAH) program. This Medicare-based program gives rural hospitals the organizational equivalent of CPR because it purposefully pays rural hospitals more to care for Medicare patients than urban institutions receive. These higher reimbursement rates have improved profit margins and offered the possibility of upgrading long-neglected facilities.

Old Promises, Emerging Bills: Considering OPEB in Public Finance Ratings

Source: Fitch Ratings, March 22, 2007
(subscription required)

As the first deadline for implementation of Governmental Accounting Standards Board Statement No. 45 (GASB 45) approaches, Fitch Ratings has further developed its thinking on the credit implications for state and local governments of providing long-term funding for other post-employment benefits (OPEB). This report follows up on Fitch Research in June 2005 titled “The Not So Golden Years (Credit Implications of GASB 45)” (available on Fitch’s web site at www.fitchratings.com). It focuses on how the various approaches to managing and funding the liability will affect Fitch’s credit analysis, rather than on meeting the reporting deadlines set forth by GASB 45, as Fitch expects such compliance from issuers it rates. Failure to comply will be considered a weak management practice. This report also examines several governments that have taken prudent actions related to OPEB.

Questions and Answers About Health Care Workers and the Americans With Disabilities Act

Source: U.S. Equal Employment Opportunity Commission, February 2007

Health care is the largest industry in the American economy, and has a high incidence of occupational injury and illness. Though they are “committed to promoting health through treatment and care for the sick and injured, health care workers, ironically, confront perhaps a greater range of significant workplace hazards than workers in any other sector.” Health care jobs often involve potential exposure to airborne and bloodborne infectious disease, sharps injuries, and other dangers; many health care jobs can also be physically demanding and mentally stressful. Moreover, health care workers with occupational or non-occupational illness or injury may face unique challenges because of societal misperceptions that qualified health care providers must themselves be free from any physical or mental impairment.

Although the rules under Title I of the ADA and Section 501 of the Rehabilitation Act are the same for all industries and work settings, this fact sheet explains how the ADA might apply to particular situations involving job applicants and employees in the health care field.

The Long Gray Line: Older Workers and the Correctional Workforce

Source: Joyca Fogg, Charles J. Kehoe, and Timothy O. Kestner, Corrections Today, Vol. 69 no. 1, February 2007

If projections come true, more workers will reach retirement age with fewer younger workers to take their place. One option will be to see older workers as a resource. Many in this age group want to continue to work, but would like less stress, flexible hours, the feeling of making a difference and enjoyment from performing the work. Boredom, nothing to look forward to and no feeling of self-worth drive many boomers back into the workplace.

Health Savings Accounts in National Compensation Survey Data

Source: Alan Zilberman, Bureau of Labor Statistics, November 29, 2006

The Bureau of Labor Statistics (BLS) recently reported that 6 percent of private industry workers have access to a health savings account (HSA), a relatively new kind of employer-provided health benefit. These data were published in the summary National Compensation Survey: Employee Benefits in Private Industry in the United States, March 2006. Data on HSAs currently are available for 2005 and 2006. BLS plans to continue to collect HSA data on workers in private nonagricultural industries.

The States Step Up

Source: Marilyn Werber Serafini, National Journal, Vol. 39 no. 11, March 17, 2007
(subscription required)

The ink was barely dry on then-Gov. Mitt Romney’s bold new plan to achieve nearly universal health coverage for Massachusetts residents when Vermont Gov. James H. Douglas signed similar legislation into law last year. “We have a goal of 96 percent coverage within the next three years, and I think we can do that,” Douglas recently boasted to National Journal. “We’re going to be quite aggressive with enrollment.”

Other state officials had been closely watching this pair of Republican governors as they steered away from the safe political path to push plans requiring employers to either offer their employees health insurance or pay a compensating fee to the state. The Massachusetts Legislature went a controversial step further when it decided to require all residents to certify on their state income tax forms that they had health insurance — or face a penalty. Before Massachusetts and Vermont took the plunge, most politicians had spoken only in muffled tones about health care mandates, fearful of a backlash from constituents — voting constituents.

Libraries Key to Building Local Economic Base

Source: PA Times, Vol. 30 no. 3, March 2007
(subscription required)

Evanston, IL-Public libraries build a community’s capacity for economic activity and resiliency, says a new study from the “Urban Institute. Making Cities Stronger: Public Library Contributions to Local Economic Development” adds to the body of research pointing to a shift in the role of public libraries-from a passive, recreational reading and research institution to an active economic development agent, addressing such pressing urban issues as literacy, workforce training, small business vitality and community quality of life. The study was commissioned by the Urban Libraries Council (ULC) and funded by the Bill & Melinda Gates Foundation and Geraldine R. Dodge Foundation.