The Centers for Medicare & Medicaid Services should do more to help states fully implement background checks for long-term care employees, recommends a report released Thursday by the Department of Health and Human Services Office of Inspector General.

CMS concurred with the recommendation.

Enacted by legislation in 2010, the National Background Check Program provides grants to states to develop systems to conduct background checks of state and federal criminal history records for prospective long-term-care employees for nine types of long-term-care facilities or providers:

The OIG reviewed grant-monitoring documents and financial reports and collected additional information to determine the extent to which the 10 states that concluded participation between 2013 and 2016 had implemented certain program requirements.

According to the 40-page report:

Lawmakers in several states are trying to ban a widely used pesticide that the Environmental Protection Agency is fighting to keep on the market.

The pesticide, chlorpyrifos, kills insects on contact by attacking their nervous systems.

Several studies have linked prenatal exposure of chlorpyrifos to lower birth weights, lower IQs, attention deficit hyperactivity disorder and other developmental issues in children. But the EPA in 2017 ignored the conclusions of its scientists and rejected a proposal made during the Obama administration to ban its use in fields and orchards.

Hawaii was the first state to pass a full ban last year. Now California, Oregon, New York and Connecticut are trying to do the same.

Should California succeed, the rear-guard action could have a big impact.

“If California is successful, that’s a big deal because it’s such a big state — the biggest agricultural state,” said Virginia Ruiz, director of occupational and environmental health at the Washington, D.C.-based nonprofit Farmworker Justice.

Earlier this year, congressional Democrats also introduced bills to ban the pesticide nationally, but experts believe states are more likely to succeed than Congress. Sen. Kirsten Gillibrand (D-N.Y.), who is running for president, introduced a separate bill last week that would prohibit schools from serving fruits and vegetables sprayed with the pesticide.

“I don’t see this as something we should still be debating,” said Irva Hertz-Picciotto, an epidemiologist and director of the Environmental Health Sciences Center at the University of California-Davis.

Every pediatrician knows that it’s important to diagnose autism when a child is as young as possible, because when younger children get help and intensive therapy, their developmental outcomes improve, as measured in everything from improved language, cognition and social skills to normalized brain activity.

“The signs and symptoms for most children are there between 12 and 24 months,” said Dr. Paul S. Carbone, an associate professor of pediatrics at the University of Utah and a co-author of “Autism Spectrum Disorder: What Every Parent Needs to Know,” published by the American Academy of Pediatrics. “If we can get them in for evaluation by then, the therapies are available as young as those ages, you can easily start by 2,” he said. “We’d like to give kids the benefit of getting started early.”

That means taking parents seriously when they bring up concerns about what they regard as strange behaviors and interactions on the part of babies and toddlers, and it also means that we try to screen all our patients, often with a checklist for parents to complete, like the Modified Checklist for Autism in Toddlers, or M-CHAT. Children whose

Cases involving starvation, neglect and sexual abuse targeting developmentally disabled clients in California are not being addressed thoroughly or going unchecked altogether, according to a former North Bay care employee who worked with patients.

Roberto Franco, an ex-employee of the North Bay Regional Center in Napa, said he is blowing the whistle on the multi billion dollar care industry that he believes is overwhelmed with cases and allowing serious incidents to fall through the cracks.

“It’s crazy because I’ve been trying to tell people about these things I’ve seen,” he told 2 Investigates.

As the number of clients increases each year so does the amount of public money budgeted to DDS. This year, the governor budgeted $7.8 billion to the state department, $435.2 million more than the previous year. 

Despite the increase in funds for services, numerous misconduct cases are not being properly reported or investigated, according to Franco. If even seemingly small issues go unchecked, he said, they can turn into serious cases of abuse and neglect that fly under the radar of the proper authorities for years. 

Franco was fired from the North Bay Regional Center (NBRC) in January 2018 for being “unprofessional and insubordinate,” according to his termination letter. But he believes regional center management penalized him for being

In a series of letters sent to legislators, members of Washington’s health care community have come together to oppose cuts to the state’s Medicaid program in both the House and Senate operating budget proposals.

The letters stem from a cut in excess of $300 million to the Health Care Authority (HCA) that’s included in both the House and Senate proposals. The budgets cut $101.8 million in general funds and $351.5 million in total funds, based on the assumption that Managed Care Organizations (MCOs) will be able to save this money though “program integrity activity recoveries.”

In July 2018, CMS identified areas of concern with MCO oversight, and in a January 2019 report, recommended program integrity activities to save money by combatting provider fraud, waste, and abuse.

An April 8 letter to legislators from Medicaid Director MaryAnne Lindeblad outlines HCA’s concerns with relying on program integrity activities to save the state over $300 million.

“While it is certainly true CMS recently identified areas of concern with managed care program integrity oversight after a focused review of Washington and select MCOs in July 2018, along with similar efforts across the nation, the audit in no way indicated a level of budget savings that could be achieved congruent with the budget,” reads the letter.

“Recovered dollars related to program integrity activities can vary from year to year and are difficult to forecast” as they are based on provider billing behaviors, refunded federal match, and timeliness of the recovery, Lindeblad wrote.

If the $300 million in savings aren’t achieved through these measures, Lindeblad writes that the budget will result in real cuts to the Medicaid program.

Continued

Gov. Doug Ducey on Wednesday signed the first bill meant to better protect vulnerable adults like the woman who was victimized in a center charged with her care last year.

Sen. Heather Carter, R-Cave Creek, introduced Senate Bill 1211 to close a loophole in state law that allowed centers like Hacienda HealthCare to operate without a state license since the 1990s.

Her bill also strengthened background check requirements for intermediate care centers serving people with intellectual disabilities.

Ducey had long indicated his support for the bill and signed it without comment yesterday.

A new, non-profit Phoenix dental clinic is hoping to help train aspiring dentists and offer a vital resource for patients with physical or intellectual disabilities.

“We’re here to just be a starting point,” said Dr. Jacob Dent, a dentist at the Pacific Dental Services Foundation’s ‘Dentists for Special Needs’ clinic off Bell Road near Tatum Boulevard.

PDSF estimates there are around 52 million people in the U.S. living with a disability, including 600,000 in Arizona. From their research, “only about 10 percent of [dentists] are actually willing to see someone with special needs,” Dent said, especially patients with a condition like autism or Asperger's syndrome.

The clinic, which just opened late last month, allows new patient families to spend an hour becoming acclimated to the environment with no other patients in the office. Younger patients begin their visit in a “sensory room” filled with toys and items to help them adjust. The clinic has a special x-ray machine that can scan a patient’s mouth without them having to put anything inside.