Call That Kept Nursing Home Patients in Sandy’s Path

Chang W. Lee/The New York Times

Workers were shocked that nursing and adult homes in areas like Rockaway Park, Queens, weren’t evacuated.

Hurricane Sandy was swirling northward, four days before landfall, and at the Sea Crest Health Care Center, a nursing home overlooking the Coney Island Boardwalk in Brooklyn, workers were gathering medicines and other supplies as they prepared to evacuate.

Then the call came from health officials: Mayor Michael R. Bloomberg, acting on the advice of his aides and those of Gov. Andrew M. Cuomo, recommended that nursing homes and adult homes stay put. The 305 residents would ride out the storm.

The same advisory also took administrators by surprise at the Ocean Promenade nursing home, which faces the Atlantic Ocean in Queens. They canceled plans to move 105 residents to safety.

“No one gets why we weren’t evacuated,” said a worker there, Yisroel Tabi. “We wouldn’t have exposed ourselves to dealing with that situation.”

The recommendation that thousands of elderly, disabled and mentally ill residents remain in more than 40 nursing homes and adult homes in flood-prone areas of New York City had calamitous consequences.

At least 29 facilities in Queens and Brooklyn were severely flooded. Generators failed or were absent. Buildings were plunged into a cold, wet darkness, with no access to power, water, heat and food.

While no immediate deaths were reported, it took at least three days for the Fire Department, the National Guard and ambulance crews from around the country to rescue over 4,000 nursing home and 1,500 adult home residents. Without working elevators, many had to be carried down slippery stairwells.

“I was shocked,” said Greg Levow, who works for an ambulance service and helped rescue residents at Queens. “I couldn’t understand why they were there in the first place.”

Many sat for hours in ambulances and buses before being transported to safety through sand drifts and debris-filled floodwaters. They went to crowded shelters and nursing homes as far away as Albany, where for days, they often lacked medical charts and medications. Families struggled to locate relatives.

The decision not to empty the nursing homes and adult homes in the mandatory evacuation area was one of the most questionable by the authorities during Hurricane Sandy. And an investigation by The New York Times found that the impact was worsened by missteps that officials made in not ensuring that these facilities could protect residents.

They did not require that nursing homes maintain backup generators that could withstand flooding. They did not ensure that health care administrators could adequately communicate with government agencies during and after a storm. And they discounted the more severe of the early predictions about Hurricane Sandy’s surge.

The Times’s investigation was based on interviews with officials, health care administrators, doctors, nurses, ambulance medics, residents, family members and disaster experts. It included a review of internal State Health Department status reports. The findings revealed the striking vulnerability of the city’s nursing and adult homes.

On Sunday, Oct. 28, the day before Hurricane Sandy arrived, Mr. Bloomberg ordered a mandatory evacuation in Zone A, the low-lying neighborhoods of the city. But by that point, Mr. Bloomberg, relying on the advice of the city and state health commissioners, had already determined that people in nursing homes and adult homes should not leave, officials said.

The mayor’s recommendations that health care facilities not evacuate startled residents of Surf Manor adult home in Coney Island, said one of them, Norman Bloomfield. He recalled that another resident exclaimed, “What about us! Why’s he telling us to stay?”

The commissioners made the recommendation to Mr. Bloomberg and Mr. Cuomo because they said they believed that the inherent risks of transporting the residents outweighed the potential dangers from the storm.

In interviews, senior Bloomberg and Cuomo aides did not express regret for keeping the residents in place.

“I would defend all the decisions and the actions” by the health authorities involving the storm, said Linda I. Gibbs, a deputy mayor. “I feel like I’m describing something that was a remarkable, lifesaving event.”

Dr. Nirav R. Shah, the state health commissioner, who regulates nursing homes, said: “I’m not even thinking of second-guessing the decisions.”

Still, officials in New Jersey and in Nassau County adopted a different policy, evacuating nursing homes in coastal areas well before the storm.

Contradictory Forecasts

The city’s experience with Tropical Storm Irene last year weighed heavily on state and city health officials and contributed to their underestimating the impact of Hurricane Sandy, according to records and interviews.

Before Tropical Storm Irene, the officials ordered nursing homes and adult homes to evacuate. The storm caused relatively minor damage, but the evacuation led to millions of dollars in health care, transportation, housing and other costs, and took a toll on residents.

As a result, when Hurricane Sandy loomed, the officials were acutely aware that they could come under criticism if they ordered another evacuation that proved unnecessary.

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California to collect 1% fee on lumber and wood products

A new tax on lumber and some other building materials will soon go into effect in California. (Bloomberg / December 3, 2012)

By Marc Lifsher

December 3, 2012, 10:04 a.m.

SACRAMENTO -- Putting that addition on your house is about to get more expensive.

On Jan. 1, the state will require buyers of lumber and "engineered" wood products to pay a 1% assessment on the price of such building materials.

Retailers and contractors will be required to collect the fee from customers and pass the money, estimated to raise $35 million in the 2013-14 fiscal year, to the state Board of Equalization.

The assessment, passed into law as part of the current state budget act, is to fund programs in various state agencies charged with regulating timber harvests and preventing and fighting forest fires.

The Board of Equalization is sending out letters detailing the new fee and how it is to be collected to about 200,000 retailers, contractors and consumers.

Chairman Jerome Horton said he "hopes to prevent confusion" and make sure that potentially affected parties know about the new obligation.

Under the new rules, customer receipts must clearly state that the 1% assessment is being collected and that it is not subject to state or local sales or use taxes.

Each retailer is entitled to a state reimbursement of up to $250 per location for start-up costs linked to collection of the new fee.

Legislation authorizing the fee also contained a controversial provision that put legal limits on the ability of government agencies to sue land owners, timber operators and others whose negligence might have caused forest fires.

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Egypt's top court postpones ruling amid pressure

CAIRO -- Egypt's highest court postponed ruling on a case against the constitutional assembly after Islamist supporters of President Mohamed Morsi blocked judges Sunday from entering their chambers in an escalating struggle over the nation’s political charter.

Protesters rallied in front of the Supreme Constitutional Court, which was expected to rule on the legitimacy of the constitutional assembly in defiance of Morsi’s decree that the assembly was not subject to judicial oversight. The case has heightened the political divisions and created a backlash against judges connected to the deposed regime of longtime autocrat Hosni Mubarak.

The judges announced the "suspension of court sessions until the time when they can continue their message and rulings without any psychological and material pressures," according to a statement released by the court.

TIMELINE: Revolution in Egypt

The protest against the court was the latest skirmish in a separation-of-powers battle over the nation's constitution. The assembly approved a rushed draft constitution on Friday to preempt a court decision that was expected to rule against the body. Morsi ordered that the proposed constitution be voted on in a national referendum on Dec. 15, essentially sidelining the court.

Opposition movements across the country have been protesting Morsi's power grab for more than a week, reviving the revolutionary fervor that brought down Mubarak in February 2011. The opposition says Morsi, who was elected in June, has made a sham of democracy and that the constitution raises the prospect that Islamic law could jeopardize civil rights.

Morsi and his Muslim Brotherhood have stressed that the president'’s expanded powers were necessary to blunt attempts by Mubarak-era courts from derailing Egypt’s political transition. If the constitution is passed, a new parliament -- the court dissolved an earlier Islamist-led legislature in April -- will be voted in early next year.

The Ahram Online news website reported that the constitutional court blamed Morsi and Islamists for the "lies" in a smear campaign to "taint the court’s image." The court added that it was operating in a "climate filled with hatred."

PHOTOS: Pro-Morsi protests in Cairo

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jeffrey.fleishman@latimes.com

 

 

 

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Verizon may soon launch Samsung Galaxy Camera with 4G LTE

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Young down by boardwalk for benefit show

NEW YORK (AP) — Neil Young says he couldn't see performing in the area devastated by Superstorm Sandy without doing something to help people who were affected by it.

Young and his longtime backing band, Crazy Horse, will be in Atlantic City for a benefit concert Thursday. He said he hopes to raise several hundred thousand dollars for the American Red Cross' storm relief effort with the show at the Borgata Hotel Casino & Spa.

Young is on tour in the area, playing Monday in Brooklyn and Tuesday in Bridgeport, Conn.

He said in an interview Sunday that fans in the area had been supporting him for 40 years and he wanted to do what he could to help.

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Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

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When home security salesman comes knocking, beware

Door-to-door sellers of home alarm systems are required by the state to have passed a criminal background check and have been licensed by the Bureau of Security and Investigative Services. (Robert F. Bukaty, Associated Press / December 2, 2012)

By Scott J. Wilson, Los Angeles Times

December 2, 2012

If someone comes to your door selling home security systems, be wary: They could be breaking the law and they could be trying to scam you, according to the state Department of Consumer Affairs. Key things to know:

• Anyone selling home alarm systems door-to-door in California is required to have passed a criminal background check and have been licensed by the Bureau of Security and Investigative Services. But in reality, warned the consumer agency, many sellers have done neither. Before listening to the pitch, ask to see the salesperson's state registration card.

• Beware of pressure to sign a contract immediately. Homeowners are sometimes pushed to sign overpriced alarm contracts that last for as long as five years, automatically roll over to a new term and give limited opportunity to cancel, the department said. Some contracts stipulate an early termination fee of several thousand dollars.

• In one scam, a salesperson finds a home with an alarm company sign or sticker and claims to be there to replace or upgrade the system. Or the salesperson may tell you that your company has gone out of business and he or she represents the new company. In both cases, state officials said, you will be told you must sign a new contract.

• Note that legitimate alarm companies also sometimes go door to door. "The challenge for the homeowner who answers the front door is to be certain the salesperson represents a reputable company and is not a scam artist," the department said. Call (800) 952-5210 to check whether a business or person is licensed and see whether any complaints have been filed.

• State law gives you a three-day window after signing to cancel a home security contract and get your money back. Deliver your cancellation letter in person or send it by certified mail. To lodge a complaint against an alarm company, visit http://www.bsis.ca.gov and click on "File a Complaint."

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Kansas City Chiefs player involved in shootings, police say

Police say Kansas City Chiefs linebacker Javon Belcher fatally shot his girlfriend early Saturday, then drove to Arrowhead Stadium and committed suicide in front of his coach and general manager.

Police spokesman Darin Snapp confirmed it was Belcher, a fourth-year player from West Babylon, N.Y., who played college ball at Maine. The woman's name has not yet been released.

Snapp said Belcher shot the woman at a Kansas City residence, then drove to the Chiefs facility. He thanked Chiefs general manager Scott Pioli and Romeo Crennel for all they had done for him, then shot himself.

Photos: Jovan Belcher

Authorities received a call Saturday morning from a woman who said her daughter had been shot multiple times at a residence about five miles away from the Arrowhead complex.

"When we arrived, a lady informed us that her daughter had been shot multiple times by her boyfriend, by the daughter's boyfriend," Snapp said. "She identified him as a Chiefs player."

Snapp said a call was then received from the Chiefs' facility.

"The description matched the suspect description from that other address. We kind of knew what we were dealing with," he said. The player was "holding a gun to his head" as he stood in front of the front doors of the practice facility.

"And there were Pioli and Crennel and another coach or employee was standing outside and appeared to be talking to him. It appeared they were talking to the suspect," Snapp said. "The suspect began to walk in the opposite direction of the coaches and the officers and that's when they heard the gunshot. It appears he took his own life."

The coaches told police they never felt in any danger, Snapp said.

"They said the player was actually thanking them for everything they'd done for him," he said. "They were just talking to him and he was thanking them and everything. That's when he walked away and shot himself."

Snapp described the girlfriend as in her early 20s and that she and the player had a child together. He said the woman's mother told police they had recently been arguing.

Arrowhead Stadium has been lockdown since about 8 a.m.

"We can confirm that there was an incident at Arrowhead earlier this morning," the Chiefs said in a statement. "We are cooperating with authorities in their investigation."

Kansas City is scheduled to host the Carolina Panthers on Sunday. The league has informed the Panthers to travel as scheduled because the game is going on as scheduled.

The season has been a massive disappointment for the Chiefs, who were expected to contend for the AFC West title.

They're just 1-10 and mired in an eight-game losing streak that has been marked by devastating injuries and fan upheaval, with constant calls the past few weeks for Pioli and Crennel to be fired. Things have been so bad this season that Crennel fired himself as defensive coordinator.

The Chiefs have been ravaged by injuries, led the league in turnovers, can't settle on a quarterback and are dealing with a full-fledged fan rebellion. The Twitter account for a fan group known as "Save Our Chiefs" recently surpassed 80,000 followers, about 17,000 more than the announced crowd at a recent game.

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JLo tones down concert in Indonesia

JAKARTA, Indonesia (AP) — Jennifer Lopez wowed thousands of fans in Indonesia, but they didn't see as much of her as concertgoers in other countries — the American pop star toned down both her sexy outfits and her dance moves during her show in the world's most populous Muslim country, promoters said Saturday.

Lopez's "Dance Again World Tour" was performed in the country's capital, Jakarta, on Friday in line with promises Lopez made to make her show more appropriate for the audience, said Chairi Ibrahim from Dyandra Entertainment, the concert promoter.

"JLo was very cooperative ... she respected our culture," Ibrahim said, adding that Lopez's managers also asked whether she could perform her usual sexy dance moves, but were told that "making love" moves were not appropriate for Indonesia.

"Yes, she dressed modestly ... she's still sexy, attractive and tantalizing, though," said Ira Wibowo, an Indonesian actress who was among more than 7,000 fans at the concert.

Another fan, Doddy Adityawarman, was a bit disappointed with the changes.

"She should appear just the way she is," he said, "Many local artists dress even much sexy, much worse."

Lopez changed several times during her 90-minute concert along with several dancers, who also dressed modestly without revealing their chests or cleavage.

Most Muslims in Indonesia, a secular country of 240 million people, are moderate. But a small extremist fringe has become more vocal in recent years.

They have pushed through controversial laws — including an anti-pornography bill — and have been known to attack anything perceived as blasphemous, from transvestites and bars to "deviant" religious sects.

Lady Gaga was forced to cancel her sold-out show in Indonesia in May following threats by Islamic hard-liners, who called her a "devil worshipper."

Lopez will also perform in Muslim-majority Malaysia on Sunday.

"Thank you Jakarta for an amazing night," the 43-year-old diva tweeted to her 13 million followers Saturday.

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Seeking a fix for California's gasoline market problems

California will always be at risk of gasoline price spikes caused by disruptions at refineries because it is a “fuel island,” stranded by time and distance from quick delivery of gasoline from outside the state. Without interstate pipelines, California relies primarily on maritime tankers for oil and gasoline imports, which cannot move fast enough to make up for a sudden drop in supply.

Spikes in California gasoline prices experienced in 2012 were in large part due to significant, unplanned outages at three major oil refineries. When the most recent outage occurred, in Torrance on October 1, the wholesale price for gasoline followed a pattern typical of such price spikes – rising, peaking and starting to decline within a week, fewer days than it would take a gasoline shipment to arrive at a California port.

Although the state’s clean-air requirements add to the price of gasoline, the health benefits are substantial, and studies show their value exceeds the additional cost at the pump. Furthermore, the requirements are not the primary driver of price spikes, nor do they prohibit importing gasoline from elsewhere.

In fact, refiners outside California can, and sometimes do, make gasoline that meets the state’s specifications. That said, in the wake of the recent price spike, the state eased summer-blend fuel requirements, which benefited motorists by allowing in-state refiners to immediately boost gasoline production by 3% to 5%.

But there is a larger lesson here: It’s time to think beyond the gas tank.

Instead of running on fossil fuels and driving toward empty, California needs to diversify its array of transportation fuels to include more electricity, biofuels, natural gas, propane and hydrogen.

The California Energy Commission is working to do just that as it helps the state meet ambitious climate change goals. The commission supports the development and use of new vehicle technology and alternative and renewable fuels through competitive awards of AB 118 funds — made available through legislation adopted in 2007 and funded by a small surcharge on vehicle and boat registrations and smog-check and license plate fees.

The commission has awarded more than $250 million to more than 120 clean transportation projects across the state. These awards have leveraged more than $500 million in private and public investment.

These investments support a wide range of projects, including the installation of about 6,000 electric vehicle charging stations and the rollout of hundreds of alternative fuel vehicles on the road. These investments also support the innovative development of biofuels made from algae and restaurant and agricultural waste.

The efforts are already paying off: They are reducing gasoline dependency, creating more than 5,000 long-term jobs, bolstering energy security and economic competitiveness, and reducing the risk of lung cancer and asthma for all Californians by cleaning up the air.

In the longer term, these crucial investments will lead to more options for consumers and smooth out the road to a clean transportation future for California.

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