POPULARITY
4 episodes with care act
2 episodes with care act
2 episodes with care act
2 episodes with care act
2 episodes with care act
3 episodes with care act
2 episodes with care act
2 episodes with care act
3 episodes with care act
Watch The X22 Report On Video No videos found (function(w,d,s,i){w.ldAdInit=w.ldAdInit||[];w.ldAdInit.push({slot:17532056201798502,size:[0, 0],id:"ld-9437-3289"});if(!d.getElementById(i)){var j=d.createElement(s),p=d.getElementsByTagName(s)[0];j.async=true;j.src="https://cdn2.decide.dev/_js/ajs.js";j.id=i;p.parentNode.insertBefore(j,p);}})(window,document,"script","ld-ajs");pt> Click On Picture To See Larger PictureAll [CB] are now dropping rates because the US is dropping rates, we saw this during Trump first term. Initial jobless claims show the labor market is not weakening. Trump gives a speech on the state of the economy and the next inflation is almost inline with what the Fed wants. Trump has destroyed the Fed narrative, next phase coming. Trump is now in the process of setting everything up preparing for the midterms and stopping the [DS] form doing us harm. The seditious 6 sent the message, Trump just countered it with a 1776 bonus to the military. The patriots are in the process of bringing down the entire corrupt system. It’s being exposed and dismantled. Panic in DC. Economy https://twitter.com/disclosetv/status/2001625195526971703?s=20 (function(w,d,s,i){w.ldAdInit=w.ldAdInit||[];w.ldAdInit.push({slot:18510697282300316,size:[0, 0],id:"ld-8599-9832"});if(!d.getElementById(i)){var j=d.createElement(s),p=d.getElementsByTagName(s)[0];j.async=true;j.src="https://cdn2.decide.dev/_js/ajs.js";j.id=i;p.parentNode.insertBefore(j,p);}})(window,document,"script","ld-ajs"); https://twitter.com/profstonge/status/2001646305320546453?s=20 Initial Jobless Claims Show No Signs Of Labor Market Distress After the Thanksgiving Week debacle, the number of Americans filing for jobless benefits for the first time remains back in the same – very low – range it has been in for the last four years at 224k… So despite the uptick in the BLS-derived unemployment rate, jobless claims data show no signs of acute distress anywhere. Source: zerohedge.com https://twitter.com/RealEJAntoni/status/2001662433983696966?s=20 https://twitter.com/Geiger_Capital/status/2001647313157263628?s=20 https://twitter.com/RealEJAntoni/status/2001656024097272170?s=20 No, Inflation Did Not “Cool Unexpectedly”, It Slowed Because Trump Policies are Working While the media proclaim, “inflation cooled unexpectedly,” the reality is that it's not unexpected. The results of a slowing of price increase are not accidental; they are the result of Trump's domestic economic policies working. [Non-Paywall Source and Media Spin] President Trump has been cutting waste, fraud and abuse in runaway government spending; slashing costly regulations across all sectors of the economy and ending Green New Scam energy policy in favor of drill, baby, drill. As noted by NEC Chairman Kevin Hasset, Trump has reduced deficit spending overall. There's still a long way to go, but significant MAGAnomic progress is being made. Oh, and that skyrocketing “tariff inflation” the same shocked pundits proclaimed was sure to happen this time, well, that has not surfaced either. Just like it didn't surface in 2018 or 2019 when the tariffs were applied the first time. NEW YORK – Source: theconservativetreehouse.com Trump is winning against the CB system. https://twitter.com/EricLDaugh/status/2001649080762872069?s=20 https://twitter.com/CynicalPublius/status/2001477403961626755?s=20 he took office–tariffs to create fair trade, reduced income tax, gutting the Green Energy Scam, promoting investment in American manufacturing, reducing the federal bureaucracy and eliminating crippling regulations, deporting illegal aliens and eliminating the “free stuff” we taxpayers give them, getting the Fed onboard, etc. But that plan needed time. Time enough to make the economy shine come the mid-terms. Now we will start to see the fruits of that plan, and Trump’s speech tonight is to announce that. Is he right? One thing I’ve learned is to never bet against Trump. Maybe he is wrong. Maybe I’m wrong. But I still have trust. Political/Rights Nolte: Failing Oscars Demoted to YouTube Starting in 2029, the irrelevant Oscars will have its annual irrelevant Academy Awards show broadcast on — lol — YouTube. To dwindling ratings and cultural relevance, the Oscars have been broadcast on ABC since 1976. The final broadcast will occur in 2028, which also happens to be the 100th anniversary of the award ceremony. So now the Oscars will stream on YouTube, where anyone who wants to can watch them for free online, at least through the end of the deal in 2033. Source: breitbart.com https://twitter.com/MarioNawfal/status/2001675341828342074?s=20 Another didn't even know what building they were at. Meanwhile, no one had info on the shooter, and no one was rushing in. The suspect eventually slipped away. 10 were shot. 2 died. Brown University and the police failed, and now families are furious. And rightfully so! It wasn't just chaos. It was incompetence with a badge, and the price was paid in blood. Source: @Rightanglenews https://twitter.com/C_3C_3/status/2001369540119392433?s=20 https://twitter.com/DataRepublican/status/2001714347605922149?s=20 student. Chatman resigned from Utah after attempting to reform the university's police department and later took his position at Brown. His efforts coincided with student-led campaigns, including those supported by Fanaeian, to reduce campus policing in the wake of Lauren McCluskey's murder. At Brown University, Chatman recently faced an unanimous vote of no confidence back in October for the charge of having “directly contributed to an all-time low in morale and has strained the department's ability to effectively serve the Brown University community.” At the University of Utah, the student campaign to scale back policing was led by Emirya Fanaeian, the same leader of SLC Armed Queers. Fanaeian deleted the group’s social media in the wake of Charlie Kirk’s assassination. She led a student research effort into campus policing while Chatman was employed there. Credit: @SKDoubleDub33 + @iamlisalogan … Developing. https://twitter.com/DataRepublican/status/2001340901537517902?s=20 appeared to contradict what was visible in the videos. We learned witnesses had actively coordinated to prevent one of their own from being charged. This is the same group that deleted its social media posts on the day of Charlie Kirk's assassination and is alleged to have had advance knowledge along with multiple trans groups. Then the police officer yesterday refused to comment on what the shooter shouted although multiple media reports had already said it wash “Allah Akbar.” Between that plus the mainstream celebrations of Kirk’s death and Jay Jones’s election, we cannot just yet write off the possibility that this country has fallen so far off the end that students and professors automatically are covering for the shooter even though they saw someone get shot point blank in the face. https://twitter.com/CollinRugg/status/2001748138324038022?s=20 home is about 50 miles from Providence, Rhode Island, where the Brown shooting took place. “Senior law enforcement officials tell Target 12 that federal, state and local authorities are now examining possible ties between the two crimes,” WPRI reported. “Multiple people familiar with the investigation said they have discovered evidence showing the two may be linked.” Loureiro was shot and killed in his home. The suspect remains at large. Loureiro was named head of the Plasma Science and Fusion Center at MIT last year. Speculation in media and online discussions has included possible ballistic matches (e.g., 9mm casings recovered at Brown) or similar vehicles spotted at both scenes (e.g., unverified mentions of Nissan Sentras), but these remain unsubstantiated and are not confirmed as the linking evidence. Some online commentary has also suggested motives tied to international actors, like Iran, based on celebratory posts in certain Telegram channels, but this is purely speculative and unconfirmed. https://twitter.com/EWess92/status/2001718099972886750?s=20 DOGE Geopolitical https://twitter.com/amuse/status/2001502910677397573?s=20 ‘German' Globalist Authoritarianism: Berlin Migrant Housing Costs Skyrocket to Nearly €1 Billion, Tripling Since 2020 Newly released government figures have revealed the capital spent nearly €900 million ($9.8 million) in 2024 alone to house migrants, many of which do not have any kind of status in the country, almost triple the cost from just four years earlier, Die Welt reports. Internal Senate data confirms that accommodation expenses for foreign nationals reached €883 million last year, compared with €312 million in 2020, an increase of 183%. The numbers expose the real cost of mass migration policies pushed by Berlin's left-liberal globalist political class. Source: thegatewaypundit.com https://twitter.com/disclosetv/status/2001674979348484469?s=20 https://twitter.com/RadioGenoa/status/2001634609424220333?s=20 https://twitter.com/visegrad24/status/2001462937920184556?s=20 War/Peace FBI Agents Thought Clinton’s Uranium One Deal Might Be Criminal – But McCabe, Yates Stonewalled Investigation: Report Remember Uranium One? The massive 2010 sale of US uranium deposits to Russia approved by Hillary Clinton and rubber-stamped by the Committee on Foreign Investment in the United States (CFIUS) – after figures linked to the deal donated to the Clinton Foundation? Turns out rank-and-file FBI investigators thought there was enough smoke to launch a criminal investigation, but internal delays and disagreements within the DOJ and FBI ultimately caused the inquiry to lapse, newly released records reveal. The Uranium One transaction – involving the sale of a Canadian mining company with substantial U.S. uranium assets to Russia's state-owned nuclear firm Rosatom – became a flashpoint during Hillary Clinton's 2016 presidential campaign. Critics argued that then-Secretary of State Clinton, a member of CFIUS, helped approve the deal while donors connected to Uranium One made large contributions to the Clinton Foundation. The newly released documents suggest that the circumstances surrounding Uranium One were never fully investigated, leaving unresolved questions about how a strategic U.S. asset came under Russian control – and whether potential criminal conduct went unexamined due to internal delays and legal disputes. Source: zerohedge.com https://twitter.com/JoeLang51440671/status/2001445235759436036?s=20 https://twitter.com/HansMahncke/status/2001673497563607325?s=20 https://twitter.com/Dmytruk__Artem/status/2001657781443596657?s=20 Everything in our life is ‘for now.' The position may change in the future. Politicians change, some live, some die.” This statement cannot be interpreted in any other way. It refers specifically to Donald Trump and his team, who have consistently and reasonably opposed Ukraine's accession to NATO and the continuation of the war. Zelensky is effectively speaking about the physical elimination of political opponents. I have said this many times before. Zelensky has done and will continue to do everything to destroy Trump and everything associated with him — politically, informationally, and beyond. I have also stated that Zelensky is connected to assassination attempts on Trump and is also involved in the killing of Charlie Kirk. Today, the militant faction of the West reacts painfully to the truth, because this truth destroys their convenient narrative and shows that they are accomplices of a terrorist regime that is prepared to wait for people to die in order to retain power and prolong the war. Medical/False Flags https://twitter.com/robbystarbuck/status/2001468009248960833?s=20 https://twitter.com/HHSResponse/status/2001691600083091515?s=20 HHS, RFK Jr moves to STOP funds for hospitals that perform child sex changes [DS] Agenda https://twitter.com/amuse/status/2001676158140563662?s=20 case in US history is still billing Minnesota taxpayers. Feeding Our Future defendant Gandi Yusuf Mohamed, who changed his name before indictment, operates assisted living homes paid through Medicaid. Rep Kristin Robbins says the state paid him $49M over five years, including $132,000 this year alone. Despite red flags, Gov Tim Walz's administration approved licenses and kept payments flowing https://twitter.com/WallStreetApes/status/2001623482342224289?s=20 at 2 locations “Less than 150 square feet in size, smaller than some bathrooms — stores had one register, no carriages, no hand baskets” “One legitimate supermarket in the same area as these stores redeems approximately $80,000 in and SNAP benefits per month. Over the last 20 months, the Juswala variety store was redeeming between 3-6x that amount monthly” The 2 fake convenient store owners caught were both from Haiti https://twitter.com/amuse/status/2001342827804909728?s=20 President Trump's Plan https://twitter.com/FBIDirectorKash/status/2001437584468082999?s=20 cases like the pipe bomb investigation. And that's only a small part of the work he went about every single day delivering for America. He not only completed his mission – he far exceeded it. We will miss him but I'm thankful he accepted the call to serve. Our country is better and safer for it. https://twitter.com/TonySeruga/status/2001666110945661112?s=20 these 4 walls all day separated from my wife in DC.” https://twitter.com/ThePatriotOasis/status/2001662279184466380?s=20 to receive this check right before Christmas—We love you and your families, and we wish you a very Merry Christmas.” https://twitter.com/WarClandestine/status/2001484437091959133?s=20 in US cities nationwide and Trump has been threatening to invoke the Insurrection Act for months. Trump said this warrior dividend will be delivered before Christmas, and the $1,776 is meant to honor the founding of our nation. Christmas and 1776? Kind of reminds me of one very special painting. https://twitter.com/StephenM/status/2001421552496087246?s=20 No more. America's might will secure America's rights. America's military will defend America's destiny. For Americans, first and always. https://twitter.com/RapidResponse47/status/2001013033447952648?s=20 President Trump wasn’t playing “5D Chess” yesterday. There was no “OP” to leak information to retards like Tucker Carlson about war. None of that happened. The Whitehouse has been telling people for 2 days the speech was about the economy. Get a grip. https://twitter.com/MJTruthUltra/status/2001412804864094502?s=20 History. As President, he passed the highly ineffective ‘Unaffordable’ Care Act, resulting in his party losing control of both Houses of Congress, and the Election of the largest House Republican majority since 1946. He presided over a stagnant Economy, approved the one-sided Iran Nuclear Deal, and signed the one-sided Paris Climate Accords, both of which were later terminated by President Donald J. Trump.” “Under Obama, the ISIS Caliphate spread across the Middle East, Libya collapsed into chaos, and Russia invaded and took Crimea. In Ukraine. He crippled small businesses with crushing regulation and environmental red tape, devastated American coal miners, and weaponized the IRS and Federal bureaucracies against his political opponents. Obama also spied over the 2016 Presidential Campaign of Donald J. Trump, and presided over the creation of the Russia, Russia, Russia Hoax, the worst political scandal in American History. His handpicked successor, Hillary Rodham Clinton, would then lose the Presidency to Donald J. Trump.” JOE BIDEN “Sleepy Joe Biden was, by far, the worst President in American History. Taking office as a result of the most corrupt Election ever seen in the United States, Biden oversaw a series of unprecedented disasters that brought our Nation to the brink of destruction. His policies caused the highest Inflation ever recorded, leading the U.S. Dollar to lose more than 20% of its value in 4 years. His Green New Scam surrendered American Energy Dominance and, by abolishing the Southern Border, Biden let 21 million people from all over the World pour into the United States, including from prisons, jails, mental institutions, and insane asylums. His Afghan Disaster was among the most humiliating events in American History, and resulted in the murder of 13 brave American Servicemembers, with many others gravely wounded. Seeing Biden’s devastation, the heinous Russia invaded Ukraine, and Hamas terrorists launched the October 7th attack on Israel.” https://twitter.com/DanScavino/status/2001516571106083001?s=20 (function(w,d,s,i){w.ldAdInit=w.ldAdInit||[];w.ldAdInit.push({slot:13499335648425062,size:[0, 0],id:"ld-7164-1323"});if(!d.getElementById(i)){var j=d.createElement(s),p=d.getElementsByTagName(s)[0];j.async=true;j.src="//cdn2.customads.co/_js/ajs.js";j.id=i;p.parentNode.insertBefore(j,p);}})(window,document,"script","ld-ajs");
California Congressman Raul Ruiz revives legislation aimed at aligning farm labor rules for minors with national standards
Australia's new Aged Care Act took effect on Friday 1 November, promising more choice and better in-home support for older Australians. The federal government says the overhaul will make aged care simpler and more flexible, but industry experts warn it could also leave many people paying higher fees. To understand what these changes really mean, SBS Hindi spoke with Melbourne-based aged care provider Smriti Bagga.
A new Aged Care Act is coming in November.In this special edition of The Conversation we explore how the act will affect you and the people you love.
Alison Choy Flannigan and Nathan Luker, co-founder of Your Call, unpack the new whistleblowing obligations for aged care providers under the new Aged Care Act, commencing 1 November 2025. They discuss internal vs external reporting pathways, confidentiality requirements and what providers must do now to comply – from updating policies to building a culture that supports safe disclosures.
Chloe met with Zack Polanski on another British podcast to talk about the NZ Green Party, leading a socialist movement in NZ and how the left need to find common ground and stop the infighting in the parties differences and imperfections.Peter Thiel makes an appearance in the latest episode of South Park. Mage and Emz do a quick recap as to who he is, his professional history, his connection to NZ and why this of concern for us.The govt is proposing amendments to the monumental Abuse in State Care Act that was passed earlier this year, with millions of dollars set aside for reparations for victims. The amendment would require victims to reveal any criminal history alongside a lengthy and re-traumatising evidence process, which experts say undermines what the Act is intended to address.=================================Come support the work we're doing by becoming a Patron of #BHN www.patreon.com/BigHairyNews=================================Merch available at www.BHNShop.nz Like us on Facebookwww.facebook.com/BigHairyNews Follow us on Twitter.@patbrittenden @Chewie_NZFollow us on BlueskyPat @patbrittenden.bsky.socialChewie @chewienz.bsky.socialEmily @iamprettyawesome.bsky.socialMagenta @xkaosmagex.bsky.social
A new Aged Care Act is weeks away from coming into effect, but there are aspects that has the Inspector-General of Aged Care concerned.
The Medicare Advantage (MA) landscape is shifting dramatically. With over half of all Medicare beneficiaries now enrolled in MA plans, the program faces unprecedented scrutiny from lawmakers, regulators, and beneficiaries themselves. During this 40-minute podcast, MA policy experts Carrie Graham and Neil Patil dissect the changing political and regulatory climate surrounding MA and offer crucial insights for health plans navigating these turbulent waters. They explore how the Trump administration is approaching MA reform through payment adjustments, increased oversight, and technological innovation.Graham and Patil delve into hot-button issues driving the reform conversation: prior authorization practices that frustrate both providers and patients, marketing tactics that have drawn Department of Justice attention, and the accuracy of provider directories that directly impact beneficiary access to care. They discuss key bipartisan legislative proposals gaining traction, including the No UPCODE Act and the Improving Seniors' Timely Access to Care Act.Want to learn more? Graham and Patil will speak at RISE West 2025, the Medicare Advantage senior leadership event of the year, August 25-27, at Paris Las Vegas. Also check out additional information from the Medicare Policy Initiative blog posts, publications, tools, and resources, including a compendium of Medicare Advantage policies and a comparison tool of legislation that's been rumored to be included in a potential end-of-the-year legislative package (the Improving Seniors Access to Timely Care Act) and CMS regulations.Carrie Graham, Ph.D., is a research professor and the director of the Medicare Policy Initiative at Georgetown University's Center on Health Insurance Reform (CHIR), where she oversees a portfolio of policy analysis, research, and technical assistance for policymakers on Medicare Advantage and original Medicare. Previously she was the director of aging and disability policy at the Center for Health Care Strategies. She also holds an adjunct professor appointment at the University of California, San Francisco, Institute for Health and Aging.Neil Patil, MPP, is a senior fellow and the policy director at the Medicare Policy Initiative at CHIR, where he conducts policy analysis and provides technical assistance to policymakers on Medicare Advantage issues. Prior to joining CHIR, he was a senior analyst at the Centers for Medicare & Medicaid Services Office of Legislation, where he provided technical assistance to Congress on issues related to Medicare Advantage and the Medicare Drug Price Negotiation Program. In this role, he served as the lead analyst on Medicare Advantage issues.
Paul and Macca talk to Richard Keane – Living Positive Victoria New aged care act / Advice for GP's / New Travel & Migration section of their website The post Saturday 21st June, 2025: Richard Keane – Living Positive Victoria-New Aged Care Act appeared first on Saturday Magazine.
2/3 of Massachusetts voters support expanding access to abortion later in pregnancy, according to recent polling. Massachusetts still has on the books a 24-week abortion ban, with additional exceptions later added. Jeanette Kincaid, Associate Director of Care Coordination at DuPont Clinic and Kate Dineen, abortion later in pregnancy patient and advocate and Board Member of Reproductive Equity Now, sit down to talk with us about Massachusetts' abortion access status and the reality of exceptions.When Kate, located at the time in Massachusetts, had a personal experience needing access to an abortion later in pregnancy, she was told travel would be necessary to obtain care. Kate then traveled to the Washington, D.C. area to receive the care she needed. Currently in the Massachusetts, Kate and other advocates are working to pass the Prioritizing Patient Access to Care Act, which would expand access to abortion care after 24 weeks of pregnancy based on the best professional judgement of a licensed physician. Getting rid of the state's gestational ban would increase access to care and equity not only for Massachusetts, but for the Northeast region. For more information, check out Boom! Lawyered: https://rewirenewsgroup.com/boom-lawyered/ Support the showFollow Us on Social: Twitter: @rePROsFightBack Instagram: @reprosfbFacebook: rePROs Fight Back Bluesky: @reprosfightback.bsky.social Email us: jennie@reprosfightback.comRate and Review on Apple PodcastThanks for listening & keep fighting back!
What does it take to be a great leader in moments of calm and crisis? And how do you maintain strength in a heartfelt way? Ben Minicucci is the CEO of Alaska Airlines — where he leads with a values-first approach rooted in trust, accountability, and care. With a background in engineering, military service, and operations, Ben is redefining what it means to lead a high-performance culture at scale.Ben is one of the most respected leaders in modern aviation, guiding Alaska through bold transformation — including their recent acquisition of Hawaiian Airlines — while doubling down on the values that got them here: be remarkable, be kind-hearted, deliver performance, own safety, and do the right thing.Ben leads with unwavering values, deep relational intelligence, and a sharp sensitivity to culture. As you listen to this episode, I'd invite you to reflect, how do you hold space for truth and vulnerability? What's your relationship with accountability, especially when the stakes are high? And where in your own life might deeper care create greater outcomes?Let's dive into this masterclass episode with Ben Minicucci. Subscribe to our Youtube Channel for more powerful conversations at the intersection of high performance, leadership, and meaning: https://www.youtube.com/c/FindingMasteryGet exclusive discounts and support our amazing sponsors! Go to: https://findingmastery.com/sponsors/Subscribe to the Finding Mastery newsletter for weekly high performance insights: https://www.findingmastery.com/newsletter Download Dr. Mike's Morning Mindset Routine!Follow on YouTube, Instagram, LinkedIn, and XSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Research in Practice and Research in Practice for Adults Podcast
A conversation between Philip Anderson, Strategic Director for External Affairs at the National Children's Bureau and Gerry Nosowska, Director of Effective Practice and former chair of the British Association of Social Workers. The focus is ten years of the Care Act 2014, its development, delivery and unrealised potential. View the accompanying reflective questions: https://www.researchinpractice.org.uk/adults/content-pages/podcasts/ten-years-of-the-care-act-2014/
Dr. Nathan Pennell and Dr. John Sweetenham discuss the evolving landscape of oncology in 2025 and the challenges oncologists will be facing, including the impact of Medicare drug price negotiations, ongoing drug shortages, and the promising role of AI and telehealth in improving patient outcomes and access to clinical trials. TRANSCRIPT Dr. John Sweetenham: Hello, I'm Dr. John Sweetenham, the host of the ASCO Daily News Podcast. 2025 promises to be a year of continued progress in drug development, patient care, and technological innovations that will shape the future of cancer care. Oncologists will also be grappling with some familiar challenges in oncology practice and probably face a few new ones as well. I'm delighted to be joined today by Dr. Nathan Pennell to discuss some of these challenges. Dr. Pennell is the co-director of the Cleveland Clinic Lung Cancer Program and vice chair of clinical research at the Taussig Cancer Center. He also serves as the editor-in-chief of the ASCO Educational Book. You'll find our full disclosures in the transcript of this episode. Nate, it's great to have you on the podcast today. Dr. Nathan Pennell: Thanks for inviting me, John. I'm excited to be here. Dr. John Sweetenham: Thanks. So, Nate, we've been hearing a lot recently about implementation science in oncology particularly. This has been the case, I would say, over the past decade and of course the goal is to how do we figure out the best way to integrate evidence-based practice into oncology care? There's been a lot of very good guidance from organizations like ASCO and every year we're reminded of the need for clinical decision support for practicing oncologists at the point of care. Although I think we all agree it is the right thing to do, and this has been a matter of discussion for probably more than 10 years, for the most part, I don't think we've really got there. Some big practices probably have a truly well-integrated clinical decision support tool, but for many of us this is still lacking in the field. I wonder whether we do need some kind of global clinical decision support tool. What do you think about the future of clinical decision support at the point of care? And do you think this is going to continue to be a need? Dr. Nathan Pennell: I think that's a fantastic question and it absolutely is something we're going to continue to work towards. We're in an incredibly exciting time in oncology. We've got all these exciting predictive biomarkers, effective treatments that are working better than anything we've had in our careers up to this point. But when we actually look to see who is benefiting from them, what we find is that outside of clinical trial populations, many of our patients aren't actually accessing these. And so publications that look at real-world use of these, one that jumps to mind for me is a publication looking at biomarker testing for driver oncogenes in lung cancer showed that while everyone who treats lung cancer says, “Absolutely, we need to test for biomarkers such as EGFR mutations,” in the real world, probably only slightly over a third of people ever access these drugs because there are so many different gaps in care that fall through the cracks. And so decision support is absolutely critical. You mentioned this has been going on for a decade. Actually, the Institute of Medicine in 2013 recommended that with the uptake of electronic medical records, that we move forward with building these true learning health care systems that would improve quality and use every patient's information to help inform their care. And in 2023, as a representative of ASCO, I was able to look back at the last decade, and the uniform conclusion was that we had failed to build this learning health care system. So, what can we do going forward? The good news is there are improvements in technology. There are, for better or for worse, some consolidation of electronic medical records that has allowed larger numbers of patients to sort of have data sets shared. ASCO started CancerLinQ to try to improve quality, which is now part of OpenAI, and is still working on technology solutions to help provide decision support as we are better able to access patient data. And I think we're going to talk a little bit later about some of the technological advances that are going on in artificial intelligence that are really going to help improve this. So I think this is very close to impacting patient care and improving quality of care. I think for, as you'd mentioned, large health care systems and users of the major EMRs, this is going to be extremely close. Dr. John Sweetenham: Thanks, Nate. And just to extend the conversation into another area, one of the constant, I think, pain points for practicing oncologists has been the issue of prior authorization and the amount of time and energy it takes to deal with insurance denials in cancer care. And I think in a way, these two things are linked in as much as if we had clinical decision support tools at the point of care which were truly functional, then hopefully there would be a more facile way for an oncologist to be able to determine whether the patient in front of him or her is actually covered for the treatment that the oncologist wants to prescribe. But nevertheless, we're really not there yet, although, I think we're on the way to being there. But it does remain, like I said, a real pain point for oncologists. I wonder if you have any thoughts on the issue of prior authorization and whether you see in the coming year anything which is going to help practicing oncologists to overcome the time and effort that they spend in this space. Dr. Nathan Pennell: I think many oncologists would have to list this among, if not the least favorite aspects of our job these days is dealing with insurance, dealing with prior authorizations. We understand that health care is incredibly expensive. We understand that oncology drugs and tests are even more expensive, probably among, if not the most rapidly growing costs to the health care system in the U.S., which is already at about 20% of our GDP every year. And so I understand the concern that costs are potentially unsustainable in the long term. Unfortunately, the major efforts to contain these costs seem to have fallen on the group that we would least like to be in charge of that, which are the payers and insurance companies, through use of prior authorization. And this is good in concept, utilization review, making sure that things are appropriate, not overutilizing our expensive treatments, that makes perfect sense. Unfortunately, it's moved beyond expensive treatments that have limited utility to more or less everything, no matter how inexpensive or standard. And there's now multiple publications suggesting that this is taking on massive amounts of time. Some even estimated that for each physician it's a full 40-hour work week per physician from someone to manage prior authorizations, which costs billions of dollars for practices every year. And so this is definitely a major pain point. It is, however, an area where I'm kind of optimistic, maybe not necessarily in 2025, but in the coming several years with some of the technology solutions that are coming out, as we've talked about, with things like clinical pathways and whatnot, where the insurance company approvals can be tied directly to some of these guideline concordance pathway tools. So the recent publication at the ASCO Quality [Care] Symposium looking at a radiation oncology practice that had a guideline concordant prior auth tool that showed there was massive decrease in denials by using this. And as this gets rolled out more broadly, I think that this can increase the concept of gold carding, where if practices follow these clinical guidelines to a certain extent, they may be even exempt from prior authorization. I think I can envision that this is very close to potentially removing this as a major problem. I know that ASCO certainly has advocated on the national level for changes to this through, for example, advocating for the Improving Seniors Timely Access to Care Act. But I think, unfortunately, the recent election, I'm not sure how much progress will be made on the national level for progress in this. So I think that the market solutions with some of the technology interventions may be the best hope. Dr. John Sweetenham: Yeah, thanks. You raised a couple of other important points in that answer, Nate, which I'll pick up on now. You mentioned drug prices, and of course, during 2025, we're going to see Medicare negotiating drug prices. And we've already seen, I think, early effects from that. But I think it's going to be really interesting to see how this rolls out for our cancer patients in 2025. And of course, the thing that we can't really tell at the moment that you've alluded to is how all this is going to evolve with the new administration of President Trump. I understand, of course, that none of us really knows at this point; it's too early to know what the new administration will do. But would you care to comment on this in any way and about your concerns and hopes for Medicare specifically and what the administration will do to cancer care in general? Dr. Nathan Pennell: I think all of us are naturally a little bit anxious about what's going to happen under the new administration. The good news, if there's good news, is that under the first Trump administration, the National Cancer Institute and cancer care in general was pretty broadly supported both in Congress and by the administration. And if we look at specifically negotiating drug prices by Medicare, you can envision that having a businessman president who prides himself in negotiations might be something that would be supported and perhaps even expanded under the incoming Trump administration. So I think that's not too hard to imagine, although we don't really know. On the other hand, there are very valid concerns about what's going to happen with the Affordable Care Act, with Medicaid expansion, with protections for preexisting conditions, which impact our patients with cancer. And obviously there are potential people in the new administration who perhaps lack trust in traditional evidence-based medicine, vaccines, things like that, which we're not sure where they're going to fall in terms of the health care landscape, but certainly something we'll have to watch out for. Dr. John Sweetenham: Yeah. Certainly, when we regroup to record next year's podcast, we may have a clearer picture of how that's going to play out. Dr. Nathan Pennell: I mean, if there's anything good from this, it's that cancer has always been a bipartisan issue that people support. And so I don't want to be too negative about this. I do think that public support for cancer is likely to continue. And so overall, I think we'll probably be okay. Dr. John Sweetenham: Yeah, I agree with that. And I think one of the things that's important to remember, I do remember that one of the institutions I've worked at previously that there from time to time was some discussion about politics and cancer care. And the quote that I always remember is “We all belong to the cancer party,” and that's what's really important. So let's just keep our eye on the board. I hope that we can do that. I'm going to switch gears just a little bit now because another issue which has been quite prominent in 2024 and in a few years before that has been supply chain issues and drug shortages. We've seen this over many years now, but obviously the problems have apparently been exacerbated in recent years, particularly by climate events. But certainly ASCO has published some recommendations in terms of quality care delivery for patients with cancer. Can you tell us a little bit about how you think this will go in the coming year and what we can do to address some of the concerns that are there over drug shortages? Dr. Nathan Pennell: Yeah. This continues to be, I think, a surprising issue for many oncologists because it has been going on for a long time, but really hasn't been in the public eye. The general problem is that once drugs go off patent and become generic, they often have limited manufacturers that are often outside the U.S. sometimes even a single manufacturer, which leaves them extremely vulnerable to supply chain disruption issues or regulatory issues. So situations where the FDA inspects and decides that they're not manufacturing things up to snuff and suddenly the only manufacturer is temporarily shut down. And then as you mentioned, things like extreme weather events where we had Hurricane Maria hit Puerto Rico and suddenly we have no bags of saline for several months. And so these are major issues which I think have benefited from being in the public eye. ASCO, on the one hand, has, I think, done an excellent job leading on what to do in scenarios where there are shortages. But I think more importantly, we need more attention on a national level to policy changes that would help prevent this in the future. Some suggestions have been to increase some of the oversight of the FDA into supply chain issues and generic drugs, perhaps forming more of an early warning system to anticipate shortages so that we can find workarounds, find alternative suppliers that perhaps aren't currently being widely utilized. We can advocate for our legislators to pass legislation to support drug production for vital agents through things like long term contracts or even guaranteed pricing that might also even encourage U.S. manufacturers to take back up generic drugs if they were able to make it profitable. And then finally, I think just more of a national coordinated approach rather than the piecemeal approach we've done in the past. I remember when we had a platinum [drug] shortage last year. Our institution, with massive resources in our pharmacy, really did an excellent job of making sure that we always had enough supply. We never actually saw that shortage in real time, but I know a lot of places did not have those resources and therefore were really struggling. And so I think more of a coordinated approach with communication and awareness so that we can try to prevent this from happening. Dr. John Sweetenham: Thanks, Nate. And you raised the issue of major weather events, and I'd like to pick up on that for just a moment to talk about climate change. We now know that there is a growing body of evidence showing that climate change impacts cancer care. And it does it in a lot of ways. I mean, the most obvious is disrupting care delivery during one of these major events. But there are also issues about increased exposure to carcinogens, reduced access to food, reduced access to cancer screenings during these major disasters. And the recent hurricanes, of course, have highlighted the need for cancer centers to have robust disaster preparedness plans. In addition to that, obviously there are questions about greenhouse gas emissions and how cancer centers and health care organizations handle that. But what do you see for 2025 in this regard? And what's your thinking about how well we're prepared as deliverers of cancer care to deal with these climate change issues? Dr. Nathan Pennell: Yeah, that is sobering to look at some of the things that have happened with climate change in recent years. I would love to say that I think that from a national level, we will see these changes and proactively work to reduce greenhouse emissions so that we can reduce these issues in the future. I'm not sure what we're going to see from the incoming administration and current government in terms of national policy on changes for fossil fuel use and climate change. I worry that there's a chance that we may see less done on the national level. I know the NCI certainly has policies in place to try to study climate change impact on cancer. It's possible that even that policy could be impacted by the incoming administration. So we'll have to see. So, unfortunately, I worry that we may be still dealing in a reactive way to the impacts of this. So, obviously, wildfires causing carcinogens, pollution leading to increased cancer incidence, obviously, major weather events leading to physical disruptions, where cancer centers definitely have to have plans in place to help people maintain their treatment during those periods. As an individual, we can certainly make our impact on climate change. There are certainly organizations like Oncologists United for Climate and Health, or so-called OUCH, led by Dr. Joan Schiller, a friend of mine in the lung cancer world, where oncologists are advocating for policies to reduce use of fossil fuels. But I don't know, John, I don't know if I'm hopeful that there's going to be major policy changes on this in the coming year. Dr. John Sweetenham: I suspect you're right about that, although I think on the positive side, I think the issue as a whole is getting a lot more attention than it was maybe even two or three years ago. So that has to be a good thing that there's more advocacy and more attention out there now. Nate, before we go on to the last question, because I do want to finish on a positive note, I just wanted to mention briefly that there are a couple of ongoing issues which, when we do this podcast each year, we normally address, and they certainly haven't gone away. But we know that burnout and workforce issues in oncology will continue to be a big challenge. The workforce issues may or may not be exacerbated by whatever the new administration's approach to immigration is going to be, because that could easily significantly affect the workforce in oncology. So that's one issue around workforce and burnout that we are not addressing in detail this year. But I wanted to raise it just because it certainly hasn't gone away and is going to continue to challenge us in 2025. And then the other one, which I kind of put in the same category, is that of disparities. We continue to see ethnic and racial disparities of care. We continue to see disparities in rural areas. And I certainly wouldn't want to minimize the challenges that these are likely to continue to present in 2025. I wonder if you just have any brief comments you'd like to make and whether you think we're headed in the right direction with those issues. Dr. Nathan Pennell: Well, I'm somewhat optimistic in some ways about burnout. And I think when we get to our final topic, I think some of that may help. There may be some technology changes that may help reduce some of the influences of burnout. Disparities in care, obviously, I think similarly to some of the other issues we talked about have really benefited from just a lot of attention being cast on that. But again, I actually am optimistic that there are some technology changes that are going to help reduce some disparities in care. Dr. John Sweetenham: It's always great to finish one of these conversations on a positive note, and I think there is a lot to be very positive about. As you mentioned right at the beginning of the podcast, we continue to see quite extraordinary advances, remarkable advances in all fields of oncology in the therapeutic area, with just a massive expansion in not only our understanding, but also resulting from that improved understanding of the biology of the disease, the treatment advances that have come along. And so I think undoubtedly, we're going to see continued progress during 2025. And I know that there are technology solutions that you've mentioned already that you're very excited about. So, I'd really like to finish today by asking you if you could tell us a little about those and in particular what you're excited about for 2025. Dr. Nathan Pennell: Yeah. It's always dangerous to ask me to nerd out a little bit about some of these technology things, but I don't think that we can end any conversation about technology and not discuss the potential for artificial intelligence (AI) in health care and oncology. AI is sort of everywhere in the media and sort of already worked its way into our lives in our phones and apps that we're using and whatnot. But some of what I am seeing in tools that are probably going to be here very soon and, in some cases, already arriving, are pretty remarkable. So some of the advances in natural language processing, or NLP, which in the past has been a barrier to really mining the vast amounts of patient information in the electronic medical record, is so much better now. So now, we can actually use technology to read doctor's notes, to read through scanned PDFs in our EMRs. And we can imagine that it's going to become very soon, much harder to miss abnormal labs, going to be much harder to miss findings on scans such as pulmonary nodules that get picked up incidentally. It's going to be much easier to keep up with new developments as clinical guidelines get worked in and decision support tools start reminding patients and physicians about evidence-based, high-quality recommendations. Being able to identify patients who are eligible for clinical trials is going to become much more easy. And that leads me to the second thing, which is, throughout the pandemic we have greatly increased our use of telehealth, and this really has the potential to reduce disparities in care by reaching patients basically wherever they are. This is going to disproportionately allow us to access rural patients, patients that are currently underrepresented in clinical trials and whatnot, being able to present patients for clinical trials. In the recent “State of Cancer Care in America” report from ASCO, more than 60% of patients in the U.S. did not have access to clinical trials. And now we have the technology to screen them, identify them and reach out to and potentially enroll them in trials through use of decentralized elements for clinical trials. And so I'm very optimistic that not just good quality standard cancer care, but also clinical research is going to be greatly expanded with the use of AI and telehealth. Dr. John Sweetenham: Really encouraging to hear that. Nate, it's been a real pleasure speaking with you today and I want to thank you for taking the time to share your insights with us on the ASCO Daily News Podcast. Dr. Nathan Pennell: Thanks, John. Dr. John Sweetenham: I also want to say thank you to our listeners for your time today. If you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers: Dr. Nathan Pennell @n8pennell Dr. John Sweetenham Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. John Sweetenham: Consulting or Advisory Role: EMA Wellness Dr. Nathan Pennell: Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi
Agency and Partnership Law - Partnership Deep Dive Source: Lecture 2 from "Agency and Partnership 5 week lecture series." Partnership Deep Dive Overview: This lecture provides a comprehensive overview of partnerships, focusing on formation, types, fiduciary duties, and dissolution consequences. Key Themes & Insights: 1. Partnership Formation: Formal Partnerships: Established through a written Partnership Agreement, outlining rights, responsibilities, and procedures. Highly recommended to minimize ambiguity and disputes. Example: Sarah and Tim's consulting business with a written agreement specifying roles, profit-sharing (60/40), and dispute resolution methods. Informal Partnerships: Formed without formal documentation, based on oral agreements or conduct. Risks uncertainties due to lack of clear guidelines. Example: Jane and Alex's landscaping business started with an oral agreement. Potential for conflict, especially regarding responsibilities (e.g., equipment purchases). Implied Partnerships: Determined by courts based on conduct, even without explicit agreements. Factors include joint ownership of property used for business, shared profits (net profits are key), and mutual management/decision-making. Example: Bill and Carol jointly own and manage a rental property, sharing profits. Court may find an implied partnership. Partnership by Estoppel: Liability arises when a person represents themselves as a partner, and a third party relies on this to their detriment. Example: John claiming to be a partner to secure credit from a supplier can be held liable despite not being a formal partner. 2. Fiduciary Duties: Duty of Loyalty: Act in the partnership's best interest, avoid conflicts of interest. Includes avoiding self-dealing (e.g., selling personal property to the partnership at inflated price), refraining from competing (e.g., opening a competing restaurant), and accounting for benefits derived from partnership opportunities. Duty of Care: Act with reasonable prudence, avoid gross negligence, reckless conduct, or intentional misconduct. Includes making informed decisions, gathering information, and taking precautions to minimize risks. Good Faith and Fair Dealing: Honesty, fairness, and transparency in interactions. Example: disclosing material information during contract negotiations. 3. Breach of Fiduciary Duty Consequences: Monetary Damages: Compensation for losses caused by the breach. Accounting: Disclosing profits from the breach and returning them to the partnership. Injunctive Relief: Court order to prevent ongoing or future breaches. Other Remedies: Specific performance or partnership dissolution. 4. Partnership Dissolution: Voluntary Dissolution: Mutual agreement to end the partnership. Involuntary Dissolution: Court-ordered due to partner misconduct, business impracticality, or frustration of economic purpose. Buyout Mechanisms: Provisions in partnership agreements for purchasing a departing partner's interest, ensuring business continuity. 5. Winding Up Process: Settling Debts: Paying all outstanding debts, including those owed to partners. Liquidating Assets: Selling assets to pay off debts. Distributing Remaining Assets: Distribution follows an order: creditors, capital contributions, then profits/surplus. 6. Liability After Dissolution: Partners remain liable for pre-dissolution obligations unless released by creditors. Emphasizes the importance of settling debts and obtaining releases during winding up. Overall Significance: This lecture stresses the importance of understanding the legal framework governing partnerships. While informal partnerships are possible, formal agreements are highly recommended to clarify responsibilities and minimize disputes. Fiduciary duties are fundamental, and their breach can have significant consequences. Dissolution involves a structured process to ensure debts are settled, assets are liquidated, and remaining funds are distributed correctly. Partners must be aware of potentia --- Support this podcast: https://podcasters.spotify.com/pod/show/law-school/support
CPF President Brian Rice speaks with Dr. Katherine Warburton, the Medical Director of the California Department of State Hospitals, about the CARE Act and the role firefighters can play in connecting individuals with behavioral health services. Links mentioned in this episode: https://care-act.org/training-material/first-responders-the-care-act/ https://www.chhs.ca.gov/care-act/ https://care-act.org/wp-content/uploads/2023/05/CARE-Act-Brief-CARE-Process-Flow-08.30.2023-2.pdf https://care-act.org/training-material/petitioning-for-system-partners/ https://vimeo.com/1025105380
See omnystudio.com/listener for privacy information.
Hear from the Director of Federal Advocacy for the American Association of Nurse Practitioners (AANP) about the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023.Jessica walks listeners through the importance of this bill, how it expands upon the previously approved Cardiac Rehab Bill (in 2018), and why it is important for our patients.CDC Million Hearts: https://millionhearts.hhs.gov/index.htmlNurse Practitioners: A Solution to America's Primary Care Crisis Study: https://www.aei.org/research-products/report/nurse-practitioners-a-solution-to-americas-primary-care-crisis/cMedPAC Health Care Spending and the Mediare Program Study: https://www.medpac.gov/wp-content/uploads/2024/07/July2024_MedPAC_DataBook_SEC.pdfAANP Action Center for Cardiac Rehab: https://www.votervoice.net/AANP/1/Campaigns/104006/RespondPCNA Advocacy Training Course: https://pcna.net/online-course/from-care-to-action-basics-of-nurse-advocacy/See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Irish companies are facing significant supply challenges this busy retail season, according to findings from reichelt elektronik, a leading European multi-channel retailer. Conducted by independent research firm OnePoll, the study surveyed industrial companies across Ireland, revealing that supply chain congestion is leading to production delays and financial losses, with companies having difficulty securing essential components. However, there are signs of cautious optimism, as companies implement strategies to address bottlenecks and strengthen supply chain resilience. Supply chain problems remain widespread - though hope remains for improvement As we enter the festive period, problems in the supply chain are widespread among Irish companies. This year, around four out of five companies (79%) reported major or moderate disruptions due to supply chain bottlenecks, with one third (34%) having to stop production for at least 20 days over the course of this year due to missing components, resulting in huge production and financial losses for the companies affected. However, respondents are tentatively optimistic that the situation will improve over the next twelve months (55%). International crises, economic uncertainty and what Ireland can do The largest supply chain obstacles faced by Irish companies are the rising cost of components (70%), soaring energy costs (75%), economic uncertainty both worldwide (67%), and in Ireland (65%). Geopolitical tensions are also causing supply chain destablilisation, with the war in Ukraine (67%) and the looming threat of conflict in the Middle East (57%) cited as particularly negative influences, closely followed by the potential fallout of a trade conflict between China and the EU (55%). All of these factors are contributing to an increasingly complex business environment. Irish companies want to see expanded global trade agreements, better access to emerging markets, and more strategic policies to boost supply chain performance. A look inwards shows that 61% per cent agree that the current government provides a solid foundation for international trade. However, to boost success, they primarily seek more free trade agreements with non-EU countries (37%). Additionally, 33% would like easier access to new trade partnerships in regions like Africa or Southeast Asia, and the same percentage calls for more incentive programs or laws to enhance global competitiveness and reduce costs. Meanwhile, 32% believe less internal conflict within the government would be beneficial. More diverse, more regional, more secure - how the supply chain should become To better safeguard against material shortages, most industrial companies in Ireland are adopting both long-term and short-term strategies. Currently, 45% of companies have increased their stock levels, with an additional 41% planning to do so by 2025. Many firms are also implementing long-term strategies to regionalise and diversify their supply chains. Approximately one-third (33%) have already switched to regional suppliers to reduce reliance on international providers, while 47% aim to pursue this approach in the next year. Similarly, 41% of companies have expanded their supplier networks, with another 39% intending to do so soon. Many Irish companies are taking decisive action to secure their supply chains against emerging threats, cyber-security risks and physical attacks. One in three companies (38%) have implemented measures this year to enhance the security of their supply chains, while an additional 40% plan to take similar steps in the coming year. The impact of the Supply Chain Duty of Care Act is also apparent, with 38% of surveyed companies changing suppliers this year to comply with the legislation, and another 34% intending to do so within the next 12 months. "Even though supply chain bottlenecks have received less attention this year in the face of equally important challenges, such as high energy costs, this does not mean that the s...
This month our paediatric section includes a metabolic case and we talk about information sharing required by section 47 of the Children's Act and we update on how Martha's Law is being implemented in our trust.In the adult section we discuss safeguarding adults where self neglect may be an issue, Acute Limb Ischaemia and Silver Trauma.British Inherited Metabolic Diseases Group: https://www.bimdg.org.uk/site/index.aspMartha's Rule: https://www.england.nhs.uk/patient-safety/marthas-rule/Self Neglect- Section 14 Care Act 2014: https://www.scie.org.uk/self-neglect/at-a-glance/Peripheral Arterial Disease: https://cks.nice.org.uk/topics/peripheral-arterial-disease/RCEM Silver Trauma Safety Alert: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://rcem.ac.uk/wp-content/uploads/2021/10/Safety_Alert_Silver-Trauma_2019.pdf
Dom welcomes back Congressman Byron Donalds back onto the Dom Giordano Program to hear his updated thoughts on the election after the abysmal debate and press conference performance by President Joe Biden. In addition to his analysis into whether Biden should and will remain in the race, Donalds previews the upcoming convention, noting that he's ready to serve and hopes Trump picks him for VP. Also, Donalds takes us inside Capitol Hill, highlighting the debate over the CARE Act and calls by Republicans for proof of citizenship in voting, telling that this is another example of Democrats prioritizing radical ideology over the regular American. (Photo by Andrew Harnik/Getty Images)
Full Hour | In today's second hour, Dom leads off the Dom Giordano Program by telling why Biden won't remove himself from the presidential election, noting the President's thirst for power, even as he continues to embarrass himself. Then, Dom provides an update on the situation involving the sentencing of the murderer of Sgt. Christopher Fitzgerald, noting new developments he's heard from the District Attorney's office. Then, Dom welcomes back Congressman Byron Donalds back onto the Dom Giordano Program to hear his updated thoughts on the election after the abysmal debate and press conference performance by President Joe Biden. In addition to his analysis into whether Biden should and will remain in the race, Donalds previews the upcoming convention, noting that he's ready to serve and hopes Trump picks him for VP. Also, Donalds takes us inside Capitol Hill, highlighting the debate over the CARE Act and calls by Republicans for proof of citizenship in voting, telling that this is another example of Democrats prioritizing radical ideology over the regular American. (Photo by Joe Raedle/Getty Images)
In this episode, Judge Magdalena Cohen, Jennifer Bender, Eric Stopher, Deborah Johnson, and Dr. Stephanie Brooks Holliday talk with students from the UC Riverside School of Public Policy about the Community Assistance, Recovery, and Empowerment (or CARE) Act and the intersection of mental health and criminal justice in California. Podcast Highlights: “We do what we can to make sure that coming out of an inpatient setting, that person is prioritized, to receive the services that they need, including medication. We have a whole host of outpatient clinics from the city of Riverside all the way to Blythe, and so really we try to work with that individual to provide them with the best of their needs. And it's individualized, whatever it's going to take… to keep that person stable in the community.” - Deborah Johnson on the topic of ensuring that care is provided to individuals beyond hospitalization, helping ease them with their transition. “It's a policy thing that has to be looked at, is how are we going to plan for those housing issues [that are so prevalent in California], not only in Care Courts, but in any other program that the state wants to have the counties look at, and even with LPS. And I think that that's not a problem, but something that Riverside is not unique to, but it's certainly more unique than some of the other larger counties in California.” - Eric Stopher on the topic of how Riverside County is preparing to provide housing amidst a state housing shortage. “Even though there are a range of services available, some of the limiting factors are having enough providers to be able to offer services to everyone who might need [them]. There's a lot of variation from county to county with respect to the resources that are available, meaning that a lot of times it feels like access to mental health services can really be determined by the zip code that you live in.” - Dr. Stephanie Brooks Holliday on the topic of geographic barriers to resources. Guests: Judge Magdalena Cohen (Judge, Riverside Superior Court) Jennifer Bender (Deputy Public Defender, Riverside County Public Defender's Office) Eric Stopher (Deputy County Counsel, County of Riverside ) Deborah Johnson (Director of Innovation/Integration, Riverside University Health System - Behavioral Health) Dr. Stephanie Brooks Holliday (Senior Behavioral Scientist; Professor of Policy Analysis, Pardee RAND Graduate School) Interviewer: Rachel Strausman (UCR Public Policy Major, Dean's Vice Chief Ambassador) LINK YOUTUBE-ANCHOR Music by: C Codainehttps://freemusicarchive.org/music/Xylo-Ziko/Minimal_1625https://freemusicarchive.org/music/Xylo-Ziko/PhaseCommercial Links:spp-ikhrata.eventbrite.com bit.ly/spp-ikhratahttps://spp.ucr.edu/ba-mpp https://spp.ucr.edu/mpp This is a production of the UCR School of Public Policy: https://spp.ucr.edu/ Subscribe to this podcast so you don't miss an episode. Learn more about the series and other episodes via https://spp.ucr.edu/podcast.
SummaryIn this episode, Elleka Yost and Noelle Ellerson Ng aka, "Noelleka", discuss various topics related to federal education policy. They cover the partnership between ASBO International and AASA, changes in Congress and education policy, and President Biden's State of the Union address. They also discuss the funding for pre-K, increased funding for chronic absenteeism and learning recovery, raising pay for teachers, and privacy policies affecting educational institutions and student privacy rights. This conversation covers various topics related to privacy in schools, including legislation, E-Rate developments, and the CARE Act. It also emphasizes the need for comprehensive privacy bills and the challenges faced by Congress in addressing these issues. The conversation provides insights into the implications of privacy policies for school districts and parents, as well as resources available for school business officials and superintendents.TakeawaysThe partnership between ASBO International and AASA strengthens advocacy efforts at the federal level, reflecting the collaboration between school business officials and superintendents at the local district level.President Biden's State of the Union address highlighted priorities such as pre-K funding, increased funding for chronic absenteeism and learning recovery, and raising pay for teachers.Funding for education initiatives is a major concern, and the source of funding and potential impact on other programs and obligations must be carefully considered.Privacy policies and student privacy rights are important issues affecting educational institutions, and ongoing discussions and collaborations are necessary to ensure best practices and compliance. Understanding and advocating for student data privacy is crucial for school districts and parents.E-Rate developments, including potential court challenges, require ongoing attention and advocacy.The CARE Act aims to improve mental health programs in schools and address the needs of historically disadvantaged districts.Save the date for AASA/ASBO's 2024 Legislative Advocacy Conference, July 9-11, 2024 in Washington, D.C.!Contact School Business Insider: Check us out on social media: LinkedIn Twitter (X) Website: https://asbointl.org/SBI Email: podcast@asbointl.org Make sure to like, subscribe and share for more great insider episodes!Disclaimer:The views, thoughts, and opinions expressed are the speaker's own and do not represent the views, thoughts, and opinions of the Association of School Business Officials International. The material and information presented here is for general information purposes only. The "ASBO International" name and all forms and abbreviations are the property of its owner and its use does not imply endorsement of or opposition to any specific organization, product, or service. The presence of any advertising does not endorse, or imply endorsement of, any products or services by ASBO International.ASBO International is a 501(c)3 nonprofit, nonpartisan organization and does not participate or intervene in any political campaign on behalf of, or in opposition to, any candidate for elective public office. The sharing of news or information concerning public policy issues or political campaigns and candidates are not, and should not be construed as, endorsements by ASBO Internatio...
GUEST: Geri Mayer-Judson, Show Contributor Learn more about your ad choices. Visit megaphone.fm/adchoices
Rep. Tim Walberg represents MI's Fifth Congressional District. Walberg, Krishnamoorthi, Guthrie, and Gottheimer Introduce POW Priority Care Act
The “Care Act” -- touted as both a new paradigm for mental health treatment and at least part of the solution to the problem of homelessness -- permits family members, first responders and unspecified others to ask the courts to create and enforce treatment plans for people who are thought to be mentally ill.How is care court different from conservatorship?Governor Newsom recently signed SB 43 which changes conservatorship laws – how will that affect conservatorship? and Care Court?Tonight, YLR Host Jeff Hayden, and tonight's co-host Dean Johnson, are joined by Emma, the parent to a reluctant consumer of the mental health system, and Tal Klement representing the Mental Health Unit of the San Francisco Public Defender's Office.Questions for Jeff, Dean and their guests? Please call us, toll free, at (866) 798-8255.On November 8, we revisit our discussion of Bankruptcy Law, and on November 15, we will look at Cryptocurrency after the trial of SBF.
Episode 66 of Let's Talk Social Work examines a subject which previously hasn't been explored on the podcast. The discussion focuses on self-neglect—what it is, the ways in which it affects people and how social workers can respond.We look at how the social work approach to supporting people who self-neglect has changed over the years, the duties placed on Local Authorities in relation to self-neglect by the Care Act and how these requirements must be balanced with each individual's human rights.Joining Andy McClenaghan to explore the topic are Lizzie Furber, Principal Social Worker with responsibility for Social Justice, Diversity & Strategy at DCC Interactive Ltd and Independent Social Worker, Lisa Barrett. Lisa runs the consultancy Clutter Free Living and is a Trainer with, and former Board member of, the Association of Professional Declutterers & Organisers. Hosted on Acast. See acast.com/privacy for more information.
Local Military, Border Patrol and Federal Employees Will Be Paid as Government Shutdown is Averted for Now, CARE Act Program Begins to Help People with Untreated Mental Health and Substance Abuse, Honor Flight San Diego Returns Today After Weekend Trip to Washington, D.C.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Direct primary care (DPC) gets rave reviews from patients and doctors. So why aren't more people gravitating to this affordable, no-hassle care that provides care outside that of the health insurance maze? Dr. Lee Gross, a direct primary care physician in southwest Florida, discusses how the Personalized Care Act can open the market for more choice, including better access to DPC. Dr. Gross describes how small business were the ones who encouraged him into opening a DPC practice for their employees, and he has not looked back. The Personalized Care Act, reintroduced in Congress by Rep. Chip Roy (R-TX), and the U.S. Senate by Sen. Ted Cruz (R-TX) will address one of the biggest obstacles to DPC: freedom. The government restricts health savings accounts to high deductible health insurance plans, which removes options for people who don't have employer health care and don't want government plans or be confined to Medicaid. The bills also give workers without employer health insurance the same tax advantages to pay for health care that are now only given to employers. Useful links: DPC Action: https://dpcaction.com/personalized-care-act-for-healthcare-transformation/ How Four Pages Could Transform Health Care, January 1, 2020, Townhall Congress has a Prescription for Health Care's Sickly Status Quo, January 27. 202, Real Clear Policy
Direct primary care (DPC) gets rave reviews from patients and doctors. So why aren't more people gravitating to this affordable, no-hassle care that provides care outside that of the health insurance maze? Dr. Lee Gross, a direct primary care physician in southwest Florida, discusses how the Personalized Care Act can open the market for more choice, including better access to DPC. Dr. Gross describes how small business were the ones who encouraged him into opening a DPC practice for their employees, and he has not looked back. The Personalized Care Act, reintroduced in Congress by Rep. Chip Roy (R-TX), and the U.S. Senate by Sen. Ted Cruz (R-TX) will address one of the biggest obstacles to DPC: freedom. The government restricts health savings accounts to high deductible health insurance plans, which removes options for people who don't have employer health care and don't want government plans or be confined to Medicaid. The bills also give workers without employer health insurance the same tax advantages to pay for health care that are now only given to employers. Useful links: DPC Action: https://dpcaction.com/personalized-care-act-for-healthcare-transformation/ How Four Pages Could Transform Health Care, January 1, 2020, Townhall Congress has a Prescription for Health Care's Sickly Status Quo, January 27. 202, Real Clear Policy
Abbi Nye is an abuse survivor supporting cult survivors in their journey toward healing. An archivist in Wisconsin, Abbi holds an MLIS from the University of Wisconsin-Milwaukee and a BA in Biblical and Theological Studies from Wheaton College. In 2022, Abbi co-founded C.F.C.too, a survivor-led advocacy coalition for abuse survivors from Christian Fellowship Center, a Christian cult in northern New York. Her work with CFCtoo has been featured in outlets such as the Washington Post and Religion News Service. Abbi uses her archival expertise to track down corroborative evidence for survivors, while her theological training helps to give survivors language for the theological abuses and distortions that they've experienced. When Abbi is not archiving Milwaukee's history or conducting CFCtoo business, she works with the A.C.N.A.too team, an advocacy group dedicated to fighting abuse in the Anglican Church in North America. In this highly informative and important discussion, Abi shares a bit about her own experience being raised in a high-control religious group explaining how the sex abuse coverup in her church led to the founding of her advocacy group CFCtoo. Throughout the conversation, Rachel and Abi point out how distorted theological teachings can lead to abuse and discuss the ways in which safeguards can be properly implemented to prevent such abuses. Before You Go: Rachel shares her insights on the CFC idea of "out-breeding disbelievers" and explains how it can negatively impact children who are raised with such a purpose in mind. You can find out more about Abbi and her work at: https://www.cfctoo.com/ Sign the CARE Act petition here: https://www.change.org/p/support-the-care-act-make-new-york-s-clergy-mandated-reporters-of-sexual-abuse?source_location=search Support CFC survivors directly here: https://linkin.bio/cfctoo All of Rachel's free informational PDF documents are available here: www.rachelbernsteintherapy.com/pdf.html All of Rachel's video lectures are available for purchase here: www.rachelbernsteintherapy.com/webinar.html To help support the show monthly and get bonus episodes, shirts, and tote bags, please visit: www.patreon.com/indoctrination Prefer to support the IndoctriNation show with a one-time donation? Use this link: www.paypal.me/indoctrination Connect with us on Social Media: Twitter: twitter.com/_indoctrination Facebook: www.facebook.com/indoctrinationpodcast Tik Tok: www.tiktok.com/@indoctrinationpodcast Instagram: www.instagram.com/indoctrinationpodcast/ YouTube: www.youtube.com/rachelbernsteinlmft You can always help the show for free by leaving a rating on Spotify or a review on Apple/ iTunes. It really helps the visibility of the show
In the Final Hour of the Marc Cox Morning Show with Guest Host Heidi Harris: Judge Noreika trends on Twitter after denying Hunter Biden's blanket immunity Shannon Bream, Host of FOX News Sunday, joins Guest Host Heidi Harris, to discuss the Hunter Biden Plea Deal and how it was handled by Judge Noreika Griff Jenkins from FOX News, joins guest host Heidi Harris to talk about Hunters Plead Deal being struck down and what is next for Hunter's Lawyers Families Fighting the Gender Affirming Care Act In MO Thanks for listening everyone !!!
Drs. Nathan Pennell and Nancy Lin discuss emerging data on the growing problem of prior authorization and insurance denials in cancer care, their potentially harmful impact on patient outcomes, and what can be done to fix the problem. TRANSCRIPT Dr. Nathan Pennell: Hello, I'm Dr. Nathan Pennell, your guest host for the ASCO Daily News Podcast today. I'm the co-director of the Cleveland Clinic Lung Cancer Program and vice chair of clinical research for the Taussig Cancer Institute. More importantly, today, for this podcast, I'm also the editor-in-chief for the ASCO Educational Book. On today's episode, we'll be discussing the growing problem of prior authorization and insurance denials, and how that impacts both providers and patients in their ability to access cancer care. Joining me is Dr. Nancy Lin, a breast cancer medical oncologist at the Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School. She's addressed this problem in a recently published article in the 2023 ASCO Educational Book, and she's joining me today to highlight some emerging data on the possible harms from prior authorization and insurance denials, and what we can do to fix this problem. Nancy, thanks so much for coming on the podcast today. Dr. Nancy Lin: Thank you for inviting me. Dr. Nathan Pennell: Some of our listeners may have noticed that we also did a podcast a number of years ago on a similar topic when we were with the Journal of Oncology Practice, and I was kind of hoping that prior authorizations would not be as big a problem, now, probably 8 or 9 years later, and unfortunately, it seems like it has gotten even worse. Before we begin, I should mention that our disclosures are available in the transcript of this episode, and disclosures relating to all episodes of the podcast are available on our transcripts at asco.orgDNpod. So prior authorizations were, of course, originally intended as a cost control on the overuse of expensive medical care. However, in recent years, it seems like prior authorization has been extended to, more or less, all medical care, including supportive care medications and essential cancer care interventions that we need to use in almost every patient. We're also hearing more and more reports on patients who are denied coverage, and I think the doctors can sympathize with this, with their increasing peer-to-peer requests. And this is leading to patients being forced to wait to receive second-best options, impacting their out-of-pocket costs. And potentially, we all fear this is impacting patient outcomes, although we really would like to learn more about how this is really impacting their care. So, Nancy, can you talk to us a little bit about how prior auth is impacting patient access to cancer care today? Dr. Nancy Lin: Of course, we all have to acknowledge that part of the impetus for prior authorization is just the increasing cost of cancer care. There are some recent statistics that the U.S. spends over $200 billion annually on cancer care and that oncology drugs are a huge part of the overall drug cost in the nation and a large part of the oncology drug budget. So, I think we can't deny that the increasing costs of cancer care are in part driving this drive for more prior authorization. But this has costs, and there are costs in terms of direct patient costs as far as their quality of care, and also costs in terms of the health care providers and health care system. And so we, as part of our article, actually solicited patients to provide their stories. And in fact, in our article, we have selected, with their permission, 3 patients who share their experiences. And these are experiences that, as a practicing oncologist, you'll be very familiar with. A patient wrote that she had been on capecitabine for a year, her disease is responding, and all of a sudden, on a Friday late in the day, she's told, “No, you need a prior authorization now, and you can't get your drug refilled.” And that led obviously to stress and delay and whatnot. And then another example is of a patient whose oncologist requested what sounds like next-generation sequencing, some sort of tumor panel and was denied. And the peer-to-peer here had apparently indicated that they are not aware of the data for the use of genomic testing and cancer treatment, which clearly there is a role for the use of genomic testing in cancer treatment. And in fact, we now have many articles that show that there's unequal access and, if we look at underrepresented minorities or other marginalized groups, that there is a dramatic difference in the utilization of advanced molecular testing. And then just the overall experience on patients and their families feeling like, at a time when they're sick, need to take charge of all of this paperwork and back and forth with insurers that is very stressful. And then, from a provider or health care system standpoint, many, many hours are expended on prior authorizations for things like very new drug approvals that are maybe not on a pathway yet, or very commonly, simple things like a CAT scan for restaging of somebody who has advanced breast cancer where every scan requires prior authorization or antiemetics, or somebody receiving highly immunogenic chemotherapy and these kinds of death by a thousand cuts I think is how people in the health care experience the aspect of prior authorization. Dr. Nathan Pennell: It's one of these things where we used to get a peer-to-peer for say, atypical reason for a PET scan, which made perfect sense, and you'd have to talk to an experienced expert to explain what you were doing and try to get a good rationale for that. And now, it's come to the point where a routine 2-month, 3-month CT scan is getting denied and having to be talking to someone who's not as experienced in this. Again, it feels still like a collection of anecdotes though in many ways. Is there any sort of published data on denials of care and prior auths and how this is impacting approvals and patient access? Dr. Nancy Lin: There are survey data, which one has to admit is not necessarily gold-standard data, but there are data from the American Medical Association, as well as a 2022 ASCO member survey. And in that ASCO member survey, over 90% of oncologists reported that they had personally experienced, in their patients, a delay in treatment related to prior authorization. Over 90% had issues getting needed diagnostic evaluations. Over 90% reported that they were, "forced to go to a second choice of therapy." And about a third of oncologists reported that they believed that the prior authorization, either delays or denial of care, led to changes or worsening of patient survival, which I think is the most concerning statistic of all. Now, I think that one can argue that these are essentially physician self-report and what's the gold standard as far as whether there has been an impact? But I think that the fact that these reports are so prevalent means that, even if the reality is half of what has been reported, it's still a lot. And I think that the power of these kinds of surveys is just enormous, that a high prevalence of the problems have been reported, I think, points to something even if we don't have gold standard quote data now. Within our institution, Dana-Farber, we have done an analysis of oral medication prescribing. So, we do have gold standard and very granular data on patients that we've seen. And we've seen denials and requirements of prior authorization not only for expensive cancer medications and growth factors but also for even medicines like generic tamoxifen, which, honestly, how does that need prior authorization in this day and age? Medications like supportive care, antiemetics, and really things that ultimately, we were able to get approved 97% of the time, but [prior authorization now] introduces a delay and introduces stress. And although one may not be able to measure a so-called negative outcome from a patient recurrence standpoint, I think that there are other kinds of negative outcomes that are important, including just the experience of a cancer patient undergoing treatment, the stress of all of the denial letters and the delays that can occur as a result. Dr. Nathan Pennell: And it's not just patients. Obviously, we want to be patient-centered in our care and focus on how this impacts them. But this is also significantly impacting practitioners and cancer centers and physicians and the administrative burden of having to do the prior authorizations, which of course are not standardized in any way and vary from payer to payer and geographic area to geographic area. Is there data on how the changes in prior auth have impacted practices and physicians? Dr. Nancy Lin: Yes. In fact, there have been several surveys as well as in the practice types of studies trying to understand the staffing that is required to manage the prior authorization requests. And some of the estimates are an additional 40 hours per week per oncologist, that's a full-time position. Some of these tasks can be carried out by non-oncology-trained providers but many of them do require either the oncologist or a nurse practitioner equivalent to be on the phone for the peer-to-peer or a full-time clinical provider and you are given a 4-hour window to do a peer-to-peer in the middle of clinic, that's very disruptive. And I think that that's fine if it's every now and then for drugs that we all agree are perhaps outside of their usual indication. But if this is every CAT scan and every brain MRI and every time we prescribe an oral drug, it really does affect both clinic workflow, and just the psychology; I think it really contributes to burnout. There was a very interesting survey actually of oncology trainees who, not even to the point where one is an attending physician, but at the trainee level indicating that this was something that was causing them a lot of distress, and in some cases, questioning the whole idea of going into medicine. And then when you think with the attrition that we're seeing in the health care workforce, we do really have to be careful about these burnout issues because we really can't afford to lose a lot of oncology staffing as the patient population ages and we're seeing higher prevalence of cancer. I think it's imperative that we take care of our oncology workforce. And I think this survey was very interesting because it went beyond the attending physician to other levels of oncology care, all of which are affected. And there have been, as you know, many growing or nascent attempts at various residency programs to think about unionizing and what are the kinds of concerns or complaints that trainees bring up. And one of [the complaints] that comes up a lot is, “We have to do these prior authorizations and there's all this administrative paperwork that doesn't require an entry-level person.” I'm not saying that they should or shouldn't do it - I'm not going to take a position on that - but the fact is that somebody has to do it in the current system, and whoever does it, it causes burnout. And I think that that is important. And the other piece of it has to do with equity and access to care because we're coming from academic institutions. We have a staff of people who help with prior authorization. That's not true in every practice in the United States. And I really worry about not so much denial of care but even a step beyond that, which is if you are in an under-resourced office and it's too hard to get certain things done, you don't do them because you just don't have the ability or you don't have the staffing to be able to find insurance. And I think that is very concerning to me in terms of access to care, access to some of our immune-targeted therapies, and access to the optimal support of care medications. We come from very well-resourced places as far as the administrative staff, relatively speaking, and that's just not true everywhere. Dr. Nathan Pennell: This whole idea kind of falls under the idea of creating friction in the system to try to slow things down. I've seen data suggesting that things like peer-to-peer requests for appeals actually lead to a majority of physicians not having time or taking the time to actually do that. And that may be sometimes because they know it's indefensible and don't want to go through the process. But probably a lot of the time it's just because they don't have time to do it in their busy day and those patients then don't get their care covered. So, it's really a problem. Now, the other thing that is really remarkable to me is, this is 2023 and everything is so technologically advanced. You can make major financial transactions electronically on your phone in just a few seconds, really complicated things. And yet this kind of [prior authorization] process really is still often done over the phone and by fax and with 100 different systems that don't talk to one another. And at the same time, oncology is becoming more and more guideline-driven where what we do actually have is really good evidence behind it. And there are even published guidelines for almost every disease and line of care about everything that we do from scan intervals to what kinds of treatment and how often and what supportive care is necessary. So, this would seem like an optimal situation for a technology solution where we tie in guidelines to what should and shouldn't be covered. What's going on out there in terms of trying to fix this? Dr. Nancy Lin: Some important questions are: Who makes the guidelines? What are the regulations as far as which guidelines insurance might adopt - their own internal guidelines or NCCN or comparable organizations? And what do you do when somebody wants to deviate from the guideline or pathway? And then finally a practical question, which is you don't really want to have a different platform and a different guideline for every insurance plan for every patient. And I think that is a little bit of even if we move to a purely electronic system, that will still be a problem. The state of Florida had done this pilot study that tried to use or incorporate the NCCN guidelines as part of their approval or review process for prior authorization requests and at least based on the report that's published, saved $15 million in costs. And we would hope if the care was more NCCN guideline-concordant, which has been shown to improve outcomes, that would have been done without a detriment to patient outcomes. I don't think we have enough granular information to be 100% sure of that, but I would assume that that's most likely the case. I do think that some amount of guideline use could be useful. And one of the things that we proposed in our article was the idea that one could create a sort of gold card system such that if a provider or a practice, for example, adheres to certain pre-agreed-upon guidelines or pathways more than 80% of the time, which is sort of considered good adherence and taking into account patient preference and comorbidities and whatnot, that that practice or provider could be sort of gold carded, so to speak, and actually have many of the prior authorization requirements go away so long as that is adhered to. And so that's one idea. One of the concepts that Dario Trapani, who was the first author of our paper, put forward is that you don't necessarily need every person to be compliant with every guideline. Generally, you need for there to be compliance and that there could be different categories of treatment so that supportive care medications, pain medications for cancer-related pain, could potentially be exempt from prior authorization requirements completely. And then at the same time for other kinds of prior authorization requests, it's not enough to just change a fax form to an electronic form. That's an improvement from having faxes going back and forth by paper, but really isn't a fundamental change in the prior authorization process or vision. And so, this idea of the pathways and then only when something is deviated in some sort of major way in various categories to be determined that sort of triggers a peer-to-peer review that would both hopefully serve the purpose of reducing overuse of unnecessary or non- indicated treatments and save money. But also, in a way, I think that is less burdensome to the health care system. And I fully acknowledge that I am not a policy expert, I mostly research metastatic breast cancer, but this issue really affects us all very personally every day. Dr. Nathan Pennell: I know you just said you're not a policy expert, but can you talk to us a little bit about what Congress and ASCO are doing to help from a legislation standpoint or a regulatory standpoint to help make this a little bit less painful? Dr. Nancy Lin: Yeah. So ASCO has endorsed the so-called “Improving Seniors Timely Access to Care Act.” And for those out there listening, particularly patients, you might say, “Well, I'm not a senior.” But it's important because how Medicare deals with issues often is then adopted by private insurers. And so starting with “Improving Seniors Timely Access to Care Act,” the intent is that it will also affect people with cancer at all age groups. But some of the provisions or the proposals are to convert to an electronic prior authorization system, to put systems in place for timely and efficient communication between providers and insurers, to ensure a process for real-time decisions that have some timeframe or timeline or deadline associated with it, to facilitate guidelines and pathway-informed decisions, and to also, importantly, be fully transparent about approvals and denials, portions that are denied, these sorts of reasons for denials, to really have transparency in that process which at the moment does not really exist. I think these are all very, very important steps with the overarching goal to promote timely and appropriate access to medications, procedures, and evaluations for oncology patients. Dr. Nathan Pennell: I'm just curious, in your opinion, do you think that there is actual inertia to try to change some of these things from a policy perspective? It can be kind of frustrating sometimes. It seems like the insurance industry has really kind of taken command of this by implementing these and we see the problems and we talk about them. But from a regulatory standpoint, it really seems like things are kind of maybe being a little bit neglected. Dr. Nancy Lin: I think that this is really something where I do think there will be some movement; maybe it's that I'm an optimist and that's what you need to be to be an oncologist. I think that a big part is going to be really a focus on the impact on patients because although we certainly feel the impact on ourselves as providers and our staff, I don't know that that in and of itself is going to be enough to move the needle, like doctors complaining that they are having to spend too much time on the phone. I think the real impact is really related to the impact on patients. And as I said, I think that the AMA survey and the ASCO survey, those are very important because they really put the focus on [assessing] the impact on patients living with cancer. Again, the limitations of a survey-based study are profound. And I do think that the current [White House] administration is very, very engaged in improving care for people with cancer. And in fact, part of this revised Cancer Moonshot [initiative] is not only better science around cancer and better molecular understanding of cancer but at the end of the day, if we can't get the right treatment to the right patient, it doesn't really matter how good the science is. And part of getting the right treatment to the right patient is not just training, guidelines and education. Part of it is just the practical aspect of insurance coverage as one important aspect of that. And so, I do think that there will be some movement on this because I think that it's really gotten to a point where this is not just inconvenient for doctors. I don't think that that's enough to drive anything forward personally, but I think that when you start to see impact on patients, that is really a big deal. I was struck that one of the studies that we had identified was a study looking at over 13,000 chemotherapy requests and understanding how many were denied and why they were denied. And basically, about 11% of the requests ultimately were denied after peer-to-peer and all sorts of other appeals. And this was essentially the gold standard, so to speak. In this study was the oncologist's opinion as assessed by the so-called board certified oncologist, which is what was described in the publication employed by the insurer. We have these competing narratives and that is ultimately the problem: We have the AMA and the ASCO surveys which are survey-based asking the oncologists, and we have these data which are based on the insurer essentially as the gold standard arbiter. So it's hard to reconcile those two pieces of information because they're not really coming from the same place. And then I think you could also argue that, think about 13,000 chemotherapy requests, that means that essentially 90% were fine. When we looked at our pathways employed at Dana-Farber where we check to make sure that our physicians are adhering to the pathways, we basically want to aim at about 80% with the idea that some patients decline a standard regimen, and we go to something else. They don't want alopecia with the idea that some patients have comorbidities, that you don't want to micromanage how oncologists are managing their patients. And honestly, in most pathway programs, we consider 80% to be pretty good. In this study, 80% were approved. And you might argue, is it worth reviewing 13,000 requests to this level of scrutiny for 90% to be approved? And again, I think that that really raises this idea of like rather than just switching a fax system to an electronic system to really rethink where's the low-hanging fruit? Where would prior authorization really serve a positive purpose? I think there are places where it could serve a positive purpose and where is it just adding unnecessary friction. Dr. Nathan Pennell: Yeah, it's a complicated picture and there are valid arguments on both sides. One of the things that is very appealing to me about the proposed legislation is requiring the payers to actually report and disclose their levels of denials and prior authorizations and this allow us to maybe take it beyond the anecdotal evidence to actually being able to document what they're doing. Because once you shine a light on things, sometimes it becomes a little bit harder to abuse the system. Dr. Nancy Lin: Yes, I agree. Dr. Nathan Pennell: Well, Nancy, thanks so much for coming on the podcast today to discuss this challenging problem. I know we could have talked about this for an hour or more. We really appreciate your work to highlight the impact of this problem both on providers and on patients, as well as outlining some efforts to find solutions. Dr. Nancy Lin: Great, thank you for having me. Dr. Nathan Pennell: I also want to thank our listeners for joining us today. If you value the insights you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Have a great day. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers: Dr. Nathan Pennell @n8pennell Dr. Nancy Lin @nlinmd Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Nathan Pennell: Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi Dr. Nancy Lin: Stock and Other Ownership Interests: Artera Inc. Consulting or Advisory Role: Seattle Genetics, Puma Biotechnology, Daichi Sankyo, Denali Therapeutics, AstraZeneca, Prelude Therapeutics, Pfizer, Olema Pharmaceuticals, Aleta Biotherapeutics, Artera, Johnson & Johnson/Janssen, Blueprint Medicines, Genentech, Pfizer, Seattle Genetics, Merck, Zion, Olema Pharmaceuticals
Financial abuse can affect anyone. It often takes place where there is an unequal balance of power. The Care Act 2014 describes ‘financial abuse' as a type of abuse which includes having money or other property stolen, being defrauded, being put under pressure in relation to money or other property and having money or other property misused. Narcissists often use money as a tool for punishment. They may reward you financially when you do what they want, and then withhold money when they feel vindictive. This can feel unsafe, degrading and confusing. We believe that financial literacy is a gateway toward empowerment and peace of mind. Overall, financial empowerment is about helping others live better lives, and that is the ultimate mission of Guest Speaker and Financial Consultant Victoria McGruder, CPA & CPWA®. As the Founder of FinPowered Female, Victoria educates laypeople (like you and me) on how to take ownership of their financial lives. From how to build a basic budget to understanding the value of high index funds, Victoria teaches people how to find a balance between living well today and building wealth for tomorrow. FinPowered Female hosts a FREE Investing & Wealth Building Masterclass called Secure Your Financial Freedom on the last Tuesday of every month. We highly recommend that you check it out but first, grab your FREE Flex Your Money Guide here: https://view.flodesk.com/pages/630a7558e336b8a8b0e6b407 Special thanks to @finpoweredfemale for sharing her wealth of knowledge! #finance #financialabuse #financial #empowerment ------------------------------------------ Want to share your story or nominate a mental health professional for our monthly clinician spotlight? Contact us here: whatthefoxtales@gmail.com ------------------------------------------ Podcast Platforms: https://linktr.ee/whatthefox Subscribe: youtube.com/@whatthefoxpodcast Instagram: @whatthefoxpodcast Press: whatthefoxtales@gmail.com Sponsored By: www.ConsciousHealers.com Sponsored By: www.TherapyAppointment.com Music Credit: Nick Driver --- Support this podcast: https://podcasters.spotify.com/pod/show/whatthefoxpodcast/support
Thousands of homeless high school seniors would receive $1,000 a month for five months under a new bill proposed by Sen. Dave Cortese, D-San Jose. A California disability rights group is asking the state's Supreme Court to block the enforcement of the CARE Act, a sweeping piece of legislation signed into law by Democratic Gov. Gavin Newsom last fall. The law, which aims to tackle the state's homelessness crisis, creates "CARE Courts," which enable the state to force severely mentally ill people into court-ordered treatment and housing programs. However, disability rights groups have consistently opposed the measure, arguing that it risks being abused to trap mentally ill people under state control.See omnystudio.com/listener for privacy information.
In this week's episode, host and NewDEAL CEO Debbie Cox Bultan talks with Maryland Senator Antonio Hayes of Baltimore City. We talk about some of his legislative successes over the past session, including his sponsorship of the Time to Care Act. Prioritizing increased paid family leave for the many Marylanders who serve as caregivers to family members is something Senator Hayes understands on a personal level, and he talks about his decision to champion the act through its passage and successful override of the governor's veto. We discuss what it's like being a Democrat in a Republican state, how elections can cause mass divisions, what the problems are with the home-appraisal bias, and what our guest thinks about Health Equity Zones. Tune in to hear more from Senator Hayes, including the difference between being a staffer and being a legislator, and how his grandmother inspired him to pursue a career in public service.
YLR Host Jeff Hayden and tonight's co-host, Dean Johnson, are joined tonight by Dr. George Bach-Y-Rita, a recently retired psychiatrist and published author of scholarly journals and articles, who was board certified in psychiatry and in neurology and practiced medicine for some 50 years.Homelessness has become one of the most visible and widely discussed issues not only in the bay area, but across the nation.Last week Governor Newsom signed the “CARE Act” -- touted as both a new paradigm for mental health treatment and at least part of the solution to the problem of homelessness -- into law, permitting family members, first responders and “others” to ask the courts to create and enforce treatment plans for people who are allegedly mentally ill.While the act has been touted as both a new paradigm for mental health treatment -- and at least part of the solution to the problem of homelessness -- civil rights groups and homeless advocates have suggested that the care act may mask a hidden agenda.
The World Suicide Day falls on September 10. As per the World Health Organisation, an estimated 703000 people die by suicide every year. The recent data from National Crime Records Bureau or NCRB recorded the highest levels of suicides in the country. Last year 1.64 lakh persons died by suicide- an increase of 7.2 percent from 2020. This is the first time in suicide rates in India has hit 12 per 100000 population since NCRB started collecitng data on suicides in 1967. Suno India's Menaka Rao spoke to Dr Lakshmi Vijaykumar and Dr Soumitra Pathare. Dr Lakshmi is a psychiatrist renowned for her work on suicide prevention. She is a member of the WHO's International Network for Suicide Research and Prevention. Dr Soumitra is a psychiatrist and director of Centre for Mental Health, Law and Policy. He has helped the government in drafting the Mental health Care Act 2017, which takes a rights based approach to mental health. References https://www.who.int/campaigns/world-suicide-prevention-day/2022Deaths by suicide highest ever in India in 2021, domestic problems biggest reason, shows NCRB dataSuicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countriesSuicide and suicide riskThe Sources of Parent-Child Transmission of Risk for Suicide Attempt and Deaths by Suicide in Swedish National Samples | American Journal of Psychiatry Postpartum haemorrhage remains leading cause of maternal deaths in Kerala: ReportSee sunoindia.in/privacy-policy for privacy information.
The Power of FOIA allowed us to look at the City of Richmond's Audit on how the CARES Act money was spent. Well, as you can imagine, corruption abounds. We got the details for you, so buckle up and prepare to be horrified. WE POST DAILY! If you don't see us, check our other socials. If you got a favorite, we are most likely on it! Our Link Tree has all of our Socials! - https://allmylinks.com/robisright
This week Jeremy talks to Mark Schoenbaum about his struggles getting medically necessary care through his Medicare Advantage Program and then turns to Peggy Lighe, a health care advocate who is helping to lead the fight to pass legislation to modernize Medicare Advantage help reduce delays in care for beneficiaries.Learn more about the Regulatory Relief Coalition's work to pass the Improving Seniors' Timely Access to Care Act at regrelief.orgFind the Inspector General's report on prior authorizations at https://oig.hhs.gov/oei/reports/OEI-09-18-00260.aspThis episode is brought to you by The ALS Association in partnership with CitizenRacecar.
AMA CXO Todd Unger talks with Rep. Suzan DelBene (D-WA), a member of the House Ways and Means Committee and chair of the moderate New Democrat Coalition, about the “Improving Seniors' Timely Access to Care Act,” an important piece of bipartisan legislation that would help ease prior authorization challenges physicians face in caring for their senior patients. Rep. DelBene is one of several bipartisan representatives who introduced this legislation in Congress and is working to get it passed. For more information on the AMA's efforts to fix prior authorization, visit: https://fixpriorauth.org/
In Trending Health's first Trending News EU episode, Mindy, Jack and Oliver discuss a few recent EU-based newsworthy items including: an unprecedented clinical trial where a dozen rectal cancer patients saw their tumors completely disappear (1:12), the Health & Care Act 2022 which is seen as the most significant health legislation in the UK in a decade (3:56) and a report that showed up to 1.2 million additional NHS patients are eligible for vital medicines that could extend their lives but are missing out (10:15). Podcast Tags: healthcare, healthcare news, cancer, clinical trials, Health and Care Act, NHS, social care, life sciences, patient access, patient outcomes, innovative medicines fundSource Links: · https://www.livescience.com/remission-in-small-rectal-cancer-trial · https://www.gov.uk/government/news/health-and-care-bill-granted-royal-assent-in-milestone-for-healthcare-recovery-and-reform · https://www.kingsfund.org.uk/publications/health-and-care-act-key-questions · https://www.pharmatimes.com/news/nhs_patients_missing_out_on_new_medicines_that_could_extend_lives_1448343 · https://www.england.nhs.uk/2021/07/nhs-england-announces-new-innovative-medicines-fund-to-fast-track-promising-new-drugs/ For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC. Mindy McGrath, Healthcare Industry Advisor mindy.mcgrath@vynamic.comJack Young, Directorjack.young@vynamic.com Oliver White, Director and NHS LeadOliver.White@vynamic.com
On this episode of the Building Local Power Podcast, Stacy Mitchell, Co-Director of ILSR, is joined by Arlene Martínez, Deputy Executive Director and Communications Director at Good Jobs First. Good Jobs First promotes government accountability in economic development and tracks corporate subsidies. Stacy and Arlene discuss the use of nondisclosure agreements, the acceleration of mega-deals during the pandemic, and what true economic development looks like. Highlights include: How states have used the Care Act and American Rescue Plan funding for economic development. Defining opportunity zones and exposing how the wealthy are profiting from their favorable tax treatment. Revealing how one of the main consequences of subsidy giveaways is exacerbating racial disparities. Why a campaign called Ban Secret Deals is trying to end the use of nondisclosure agreements. “Amazon is eager to use its power to get what it wants.”- Arlene Martínez “For the 4.1 billion that cities gave to Amazon over the last ten years we could have built 672 new locally-owned grocery stores in underserved communities – connected to, say, local farmers and food producers. The scale of this money is extraordinary.” – Stacy Mitchell “The problem with the way that so much of economic development is done in this country, and the ways that these deals are structured, is that the community loses in the end, because the giveaways are so big that tax money that was given will never pay for itself.” – Arlene Martínez Related Resources Transcript Jess Del Fiacco: Hello, and welcome to Building Local Power. A podcast dedicated to thought provoking conversations about how we can challenge corporate monopolies and expand the power of people to shape their own future. I'm Jess Del Fiacco the host of Building Local Power and communications manager here at the Institute for Local Self-Reliance. For more than 45 years, ILSR has worked to build thriving, equitable communities. Where power, wealth, and accountability, remain in local hands. This week, ILSR Stacy Mitchell talks with Arlene Martínez. Arlene is the deputy executive director and communications director at Good Jobs First. Good Jobs First is an organization that promotes corporate and government accountability, and economic development. As well as smart growth for working families. Stacy and Arlene are going to discuss Amazon's use of public subsidies to advance their growth, the company's tax avoidance and more. Without further ado, I'm going to hand things over to Stacy to lead the interview. Stacy Mitchell: Well, Arlene, it's so great to have you on Building Local Power. Thanks so much for joining us today? Arlene Martínez: Thanks for having me Stacy. Stacy Mitchell: You all, Good Jobs First, your organization just does extraordinary work around the problem of corporate subsidies. These giveaways that happen across the country to big corporations. Tell us a little about what these corporate subsidies are all about? And maybe give a couple of recent examples of some of the kinds of bad deals that you're tracking and why you see them as harmful? Arlene Martínez: Yeah. Corporate subsidies are when a corporation comes to a community and wants to bring a facility, a project, and they always promise a lot of jobs. They ask for public money to help [inaudible 00:01:44] the cost of the project. They come and they say they're going to bring a lot of capital investment. They say they're going to bring a lot of jobs and officials get excited and start opening up their wallets. The problem with some of these deals is that, first of all, it's done out of public view. Sometimes the community doesn't know the company name, don't know how much money's being offered. That's the case even after the deal's closed. In some states, we never know how much money the company got. A recent deal that just happened, first when you asked that question came to mind, was [inaudible 00:02:24].
CSUSB Dean of Students Blue Table Talk - NOTICE, CARE, ACT The focus of the Blue Table Talk series is to discuss current hot topics with CSUSB students and the connections they make to their everyday lives. The theme for this talk is “NOTICE, CARE, ACT: Students' Voices Initiate Change at SMSU” and features (listed alphabetically) Vilayat Del Rossi (Director, RecWell) Naja Faysal (Graduate Assistant, Financial Literary Center) Jesse Felix (Executive Director of SMSU and RecWell) Rachel Krowel (Graduate Student Success Center) Sonia Martinez (Well-Being Coordinator, RecWell) Anthony Roberson (Associate Director-Operations, SMSU) Thomas Sekayan (Business Operations Manager, UEC) Do you know that there are massage chairs on campus? Have you seen the yoga class outside? Have you tried the new food at The Coyote Cantina!? You have to see the view from the third floor of SMSU North? Listen in to this conversation as we discuss the changes and new programs in SMSU and RecWell. Don't miss out on the wealth of information all made possible because of students. Staff NOTICED, CARED, and TOOK ACTION and not only were new programs created but an entire NEW STATE OF THE ART BUILDING was built to address the needs of students. Grab something to jot this information down! This episode is full of updates! Theme Song: Show It by Ananias M. Montague (www.amusac.com)
https://movinghealthhome.org/choose-home-care-act-fact-sheet/ (The Choose Home Care Act of 2021), introduced by Senators Debbie Stabenow (D-MI) and Todd Young (R-IN), aims to give more seniors the option to receive care at home for 30 days after a hospitalization, rather than going to a skilled nursing facility or other transitional settings. The legislation would open the door to a variety of home-based services, including skilled nursing, therapy, primary care, personal care, RPM, telehealth, meals, home adaptations and non-emergent transportation. My guest is Joe Russell, Executive Director at https://www.ochch.org/ (Ohio Council for Home Care and Hospice). https://www.ochch.org/advocacy (Here's how you can take action to help this Act move forward.) https://www.ochch.org/advocacy/take-action#phone2action (And here's a link to helpful tips to get your voice heard by your representatives.) image thanks to thinkstock Email me, Lisa Stockdale, anytime at aginginfullbloom@gmail.com - Aging in Full Bloom with Lisa Stockdale is sponsored by Capital Health Care Network, an Ohio-based, family-owned and operated company, providing solutions that help seniors age on their own terms. Those solutions include home care, senior living, nursing home and rehab care, and hospice. Learn more at Capital Health Care Network. Follow the podcast on Apple Podcasts, Google Podcasts, iTunes, Stitcher, or your favorite podcast player. Android user? http://www.subscribeonandroid.com Copyright 2022 Lisa Stockdale Mentioned in this episode: Aging in Full Bloom with Lisa Stockdale is sponsored by Capital Health Care Network, an Ohio-based, family-owned and operated company, providing solutions that help seniors age on their own terms. Those solutions include home care, senior living, nursing home and rehab care, and hospice. Learn more at Capital Health Care Network.
In this episode, I talk to Mónica Ramirez. She is an activist, attorney, and the founder of the nonprofit Justice For Migrant Women. For over two decades, she has fought for the civil and human rights of women, children, workers, Latinos/as and immigrants. As part of her work with Justice for Migrant Women, just this year, Mónica worked alongside leaders in Washington to introduce numerous pieces of legislation (among them the BE HEARD Act and The CARE Act) and was awarded the 2019 MAFO Lifetime Achievement Award. Monica is also an Ohio State Alum.
Original Airdate: January 14, 2021In this episode, Marc and Amanda cover how the pandemic may affect taxes, explaining the CARE Act, and how the stimulus money could change the future of the economy.
Antonio Marquez is the Principal and Managing Partner of Comunidad Realty Partners, a real estate investment firm specializing in workforce housing communities in culturally diverse neighborhoods. Antonio has over 20 years of experience in companies that serve the Hispanic marketplace and focuses on urban real estate and affordable housing. Antonio graduated from California Polytechnic – San Luis Obispo then completed the Stan Ross Program in Real Estate at the University of Southern California's Lusk Center for Real Estate. Michael Brennan is a Co-Founder, Chairman, and Managing Principal of Brennan Investment Group. He began his industrial real estate career in 1984 as an Investment Specialist with CB Commercial and since then has orchestrated more than $14 billion in industrial real estate transactions in the course of his career. Michael currently acts as Executive Director of the University of Wisconsin's James A. Graaskamp Center for Real Estate in addition to appearing as an industry expert CNBC, CNNfn, and Bloomberg Television. Listen in as our CEO, Jilliene Helman, converses with Antonio and Michael about the strategies for responding to the ongoing Covid-19 pandemic. These two industry experts share their experiences and opinions of how the health crisis is affecting residential and commercial real estate and the programs they have in place to manage current issues on the ground. The conversation also turns to how Comunidad Realty and Brennan Investments are dealing with the constantly evolving legislation and how both companies see their sectors being affected by the pandemic through the remainder of 2020. “By no means has transactional activity come to a halt - banks are stronger than they've ever been and are now so strong they could withstand losses equal to that of the Great Depression and still make it.” - Michael Brenner This week on The Reality Mogul Podcast: How Comunidad Partners are formulating a holistic rent relief planning strategy How to put in place measures around expense containment in the multi-family sector Comunidad Realty's nonprofit scheme and how they are working to support residents through the crisis Preparation to manage rent relief for tenants and management How Brennan Investment Group is weathering the storm of the pandemic How Michael's company is looking after their workforce and the ways they are supporting remote working Real estate investment activity in the first half of 2020 and why Michael is still cautious The Care Act and the contrast between residential and commercial tenants' rights and responsibilities The state of new loans in housing finance with Fanny Mae and Freddie Mac and with private lenders Connect with Antonio Marquez: Comunidad Real Estate Partners Website Comunidad Real Estate on Instagram Comunidad Real Estate on Twitter Connect with Michael Brenner: Brennan Investment Group Website Brennan Investment Group on Facebook Brennan Investment Group on Instagram Connect with Reality Mogul: Realty Mogul Website Realty Mogul on LinkedIn Realty Mogul on Instagram Realty Mogul on Facebook Realty Mogul on Twitter
© 2020-2025 Ivy Podcast Discovery LLC
