The recording for this webinar is now available.
During the question-and-answer session, the issue of increasing a medical or hospital library’s visibility among physicians, beyond having library staff serve on institutional committees, was raised. Attendees suggested the following approaches.
–Ask physicians what their specific research needs are; particularly if an evidence-based approach is necessary, an “evidence-based toolkit” in the research guides or elsewhere on the library’s website can be helpful
–Keep track of publications by physicians and send notes of congratulations
–Assist in searches for personnel, particularly nurses, since much research done by doctors involves collaboration with nurses
–Present at local meetings of medical organizations
–Hold library “office hours” in a doctors’ lounge, or another area of the hospital or medical center in which doctors are likely to congregate
–Distribute packets of library information during orientation for new employees, including physicians and administrators; if possible, including a nifty freebie, such as an ALA “READ” mug
–Also at orientation, try to schedule time for a library staff member to speak; even if can’t fit in speaker, ask for slides on library services to be included in presentations on organization
The recording for this webinar is now available.
For anyone who might be interested, the National Network of Libraries of Medicine, Middle Atlantic Region, will be holding a symposium on the role that libraries of all types (medical and hospital, public, and academic) can play in promoting awareness of the Patient Protection and Affordable Care Act. The full-day event, titled “The Affordable Care Act / Access to Care – Libraries Making a Difference”, will take place on April 24, at the Sonesta Hotel in Philadelphia. Topics to be covered include what library staff need to know about the Affordable Care Act, the challenges in explaining enrollment policies and procedures to library users, privacy issues associated with enrolling patrons by using public computers, and the best strategies for partnering with community organizations to promote understanding of, and access to, the Health Insurance Marketplace.
To view the agenda for the day, go here. To register for the event, go here. The deadline is April 10. Note, however, that priority will be given to members of the Middle Atlantic Region (New York, Pennsylvania, New Jersey, and Delaware).
There is no indication, at this point, whether or not any of the sessions will be broadcast live or will be made available for viewing afterwards. If that information does become available, I will pass it along.
The Governor’s proposed budget, which is intended to overcome a projected $6 billion budget deficit for FY 2016 (on top of a $1.6 billion deficit for the current fiscal year), includes $1.5 billion in cuts to Medicaid, making the program one of the main targets of the Governor’s cost-cutting efforts. The program currently covers more than 3 million Illinois residents. The belief by some lawmakers is that eliminating the services provided by Medicaid will simply make associated costs disappear. This mindset does not take into account, however, that Medicaid beneficiaries will still need to seek health services in other forms, such as emergency-room visits, that could actually increase costs. Furthermore, as the Illinois Hospital Association’s “talking points” below emphasize, it is not just Medicaid recipients who will be affected by decreases in funding for it.
* Any cuts to Medicaid in the current FY 2015 Illinois budget need to be opposed.
* Any proposals that would grant Governor Rauner unilateral authority to make cuts in the Illinois budget need to be stopped.
* Hospitals play a major role in providing health care to residents of their communities.
o Not only that, but they also provide good-paying jobs and promote economic growth.
* Statewide, 40 percent of hospitals are already operating at a loss.
* Illinois hospitals and health systems have already borne the burden of substantial cuts in recent years, including $380 million in Medicaid reductions and almost $1.9 billion in federal Medicare cuts
o Additionally, any further Medicaid cuts to hospitals would result in the loss of services for patients, including those who do not receive Medicaid, and would hinder ongoing efforts to reform Medicaid and health care more broadly.
o Also, reductions in Medicaid would increase the cost of health insurance for less-affluent individuals and their families, particularly through higher premiums, co-pays, and deductibles.
* Illinois hospitals have already played a key role in alleviating the state’s budget woes.
o Hospitals have worked with Illinois government to reform Medicaid and the delivery of health care, in the process saving the state over $1 billion since 2012.
o Hospitals have agreed to pay the state an assessment fee of more than $1 billion annually. This has resulted in a significant reduction in the proportion of Medicaid payments that the state must provide (25%), as the rest are covered by the assessment fee and matching funds from the federal government.
Also, the IHA has released a 2015 advocacy agenda for Illinois that covers issues beyond just Medicaid funding. The agenda can be accessed here.
The agenda includes the following key issues.
* Ensuring adequate funding, via the state budget and Medicaid
* Maintaining fairness in contracts by insurers and health plans
* Streamlining the health-planning process through regulatory reforms
* Reforming medical liability
* Reforming workers’ compensation
* Preserving health coverage for Illinois residents
* Bringing in additional funding via the 1115 Medicaid waiver
* Supporting rural health care
Two weeks ago, House Bill 2689–the Internet Screening in Public Libraries Act–was introduced in the Illinois General Assembly. The Act would require that all public libraries in the state put into place a “technology protection measure”, such as a filter, that would prevent library users from viewing material that could be construed as obscene or pornographic (particularly if such material is harmful to minors). Libraries that do not currently have filtering software would have to pay for it on their own, which would put pressure on less-affluent libraries that are already stretched to the limit financially. Also, although libraries would be able to remove the filtering restrictions at a patron’s request, the guidelines for what constitutes “legitimate research” are very vague.
This past Monday, the bill was assigned to the Judiciary-Civil Committee. The Illinois Library Association is asking for a concerted effort to stop this legislation at the committee stage, due to the far-reaching implications if it were to become law, including preventing public libraries from fulfilling one of their main missions–making information as broadly accessible to the public as possible. The ILA has identified the following individuals as “key players” in determining whether the legislation moves past the committee stage.
Representative Ron Sandack (Republican, 81st District–Downers Grove)
Representative Pamela Reaves-Harris (Democrat, 10th District–Chicago)
Representative Andre M. Thapedi (Democrat, 32nd District–Chicago)
Representative Dwight Kay (Republican, 112th District–Edwardsville)
Representative John E. Bradley (Democrat, 117th District–Marion)
To view their contact information, go here.
To track the current status of the legislation, click here.
For more background information on the impact and effectiveness of Internet filters in libraries, Internet Filters: A Public Policy Report is a good source. The report, an updated version of which was released in 2006, discusses the types of terms that are most likely to be filtered. Among those that would likely be the most relevant to Internet searches by patrons in hospital and medical libraries are terms related to substance abuse or human sexuality (including gay issues).
The report can be downloaded here.
House Bill 2689, the Internet Screening in Public Libraries Act, was introduced in the Illinois General Assembly on February 19. (So far, no action has been taken on the legislation since it was referred to the Rules Committee that same day.) The sponsor is Representative Peter Breen (Republican—48th District, Lombard), who just started his first term in the General Assembly. The Act would mandate that every public library in the state implement a “technology protection measure”. Such a measure would prevent patrons from viewing, on a public computer, any visual representation that could be construed as obscenity, child pornography, or anything else harmful to minors. Although libraries would be allowed to disable the protection measures so that adults can partake in “legitimate research”, the term is not defined, leaving it open to broad interpretation. Also, even if libraries do not already have filtering software that can meet the Act’s requirements, those libraries would not be reimbursed for the cost of buying or updating the necessary equipment.
To check the bill’s current status, click here.
The Illinois Library Association has voiced strong opposition to this legislation, with the largest objection being that the Act would impose a “one-size-fits-all” approach to determining whether filters are appropriate for a specific library and its clientele and, if so, how access to content should be managed. In the process, the Act undermines local control by library staff, trustees, and other community stakeholders who play a role in decisions affecting a library.
Even though the legislation does not impact academic and research libraries, the issue of filters is still quite pertinent, especially in the case of medical and hospital libraries, as content on anatomy, for instance, could be interpreted by a filter as being “obscene”. The ILA has drawn up a list of “talking points” on the issue.
Filters Hurt Libraries—they take decision-making abilities away from those most familiar with the needs and resources of an individual library
Filters Don’t Work—numerous studies have documented that filters often block useful information on many topics, while still allowing material that could be considered inappropriate to get through, presenting libraries with liability issues
Filters are Expensive—library budgets are already stretched to the limit, and forcing libraries to spend money on filters that may or may not be effective prevents those libraries from investing money in other technology, such as additional computers and high-speed Internet access, that are far more crucial
Filters Hurt the Poor—on a related note, filters prevent patrons in less-affluent communities, who may not have Internet access at home, from viewing government or health information that might be crucial to one’s work or personal well-being
Filters are Inflexible—a filter works the same way, regardless of whether the individual using a library computer is a grade-schooler, a college student, or a senior citizen, and users are not always aware that they are being prevented from accessing particular types of material, meaning that those individuals won’t know when to request that a filter be turned off
Filters are Biased—the companies that design filters determine what kinds of materials the filter will recognize as inappropriate, meaning that what kinds of materials get blocked could reflect the ideology or personal biases of the designers.
Earlier this month, President Obama announced his priorities for the FY 2016 federal budget. Part of the budget is devoted to improving health care for Americans, through the Patient Protection and Affordable Care Act, and through other reforms. The specific areas being targeted, and the goals under each one, are listed below.
Supporting Implementation of the Affordable Care Act
- Preserving coverage through CHIP (Children’s Health Insurance Program)
Strengthening Medicare and Medicaid
- Expanding health coverage by improving access to Medicaid, in addition to CHIP coverage and services
- Promoting access to Medicaid long-term care services and supports (LTSS)
- Improving care delivery for low-income beneficiaries under Medicare and Medicaid
- Encouraging high-quality, efficient care among providers of Medicare
- Improving health outcomes for children and youth in foster care
- Reducing cost growth by encouraging beneficiaries to use high-value services
- Improving quality, and decreasing drug costs, for federal health programs
- Lowering Medicaid drug costs for both states and the federal government
- Reducing fraud, waste, and abuse in Medicaid and Medicare
- Requiring prior authorization for power mobility devices and advanced imaging
- Directing states to track high prescribers and utilizers of prescription drugs in Medicaid
- Backing efforts to investigate and prosecute allegations of abuse or neglect of Medicaid beneficiaries, specifically in non-institutional health care settings and in the U.S. territories
Reforming Health Care Delivery System
- Modifying health care payment structures to reward providers for optimal care
- Supporting practice redesign and creating better capacity to improve care delivery
- Improving access to information, in order to encourage date-driven decision-making by providers, consumers, and businesses
Improving Public Health, Safety, and Security
- Increasing funding to combat abuse of prescription drugs and heroin
- Modernizing the country’s food-safety system
- Investing in Native American health care
- Undertaking a CARB (Combating Antibiotic-Resistant Bacteria) initiative
- Increasing efforts to prevent, detect, and respond to infectious diseases, both at home and abroad
- Strengthening preparedness for all health threats, including naturally-occurring dangers and intentional attacks
Strengthening Health Centers and the Health Workforce
- Improving access to health care services
- Improving access to providers of high-quality health care
To view the FY 2016 budget, click here. The initiatives that are specific to health care are in the “Investing in America’s Future” section, on pages 60-67.
The Illinois Library Association’s Executive Board has taken the following general positions on legislation that has already been introduced, or is likely to be introduced, during the current session of the Illinois General Assembly.
–Opposes any legislation cutting funding, for counties and municipalities, that comes from the Local Government Distributive Fund
–Is against legislation reducing the amount of funding that units of local government receive from the Corporate Personal Property Replacement Tax
–Opposes any legislation that would restrict the power that local libraries have to levy or collect taxes on real property
The ILA has also reiterated its past stances on the issue of pensions, while adding a fourth one.
–Is against legislation that would modify pension benefits an employee has already accrued
–Backs legislation that promotes genuine choice for employees
–Supports legislation that would apply any proposed pension reform uniformly across all local and state plans
–Opposes any mandatory reform that would move the burden of pensions costs from the State to local governments or institutions (new statement)
To give some background on the first point (maintaining levels of funding from the Local Government Distributive Fund), the Fund consists of net revenue that the State draws from personal and corporate income taxes. (The money is transferred from the General Revenue Fund to the Distributive Fund.) The proportion of those taxes that has been earmarked for the Fund has declined in recent years, from 10 percent to about 6 percent. The reduction went into effect in 2011, when the State temporarily increased the tax rates on corporate and personal income but did not correspondingly raise the amount set aside for the Fund. That the tax increase has not been renewed complicates the issue further. As of FY 2014, the Fund brought in $1.095 billion.
Legislation to increase the proportion of money transferred from the General Revenue Fund to the Local Government Distributive Fund has been introduced in this session of the General Assembly. House Bill 0365 would raise the amount back to 10 percent by February 1, 2019. (The increases would come in increments over a three-year period, beginning in February of next year.) The bill was referred to the Rules Committee on January 28. To track the status of the bill, click here.
Yesterday (February 3), the United States House of Representatives made yet another attempt to start the process of repealing the Patient Protection and Affordable Care Act. House Resolution 596 passed by a vote of 239 to 186, with the tally split almost entirely along party lines. (No Democrat voted for it, although three new Republican members did join the Democrats in voting against it.) The legislation now moves on to the Republican-controlled Senate. Even if it is put to a vote there and passes, it is unlikely that the resolution will become law, at least in the near future, as President Obama is certain to veto the legislation.
H.R. 596 represents the 56th time that the House has voted to repeal the Affordable Care Act, either entirely or in part. (Several similar pieces of legislation have already been introduced in either house during the current session, but H.R. 596 represents the first time that such legislation has actually been put to a vote.) Due to the lack of success in formally repealing the Affordable Care Act, the latest attempt represents more of a symbolic effort to draw public attention to what some consider the law’s flaws.
Even with their consistent efforts to repeal the Affordable Care Act, Republicans have not actually offered an alternative. That could change, however, since H.R. 596 includes a provision tasking House committees with creating a health-care law that would take Act’s place. Based on the guidelines laid out in the provision, the alternative law should promote economic expansion and private-sector job creation, while lowering health premiums and increasing the number of Americans with health insurance. Committees would need to report back within six months. Also, Republican leaders in the House have put together a task force to create proposals for reforming health care.
These moves are coming in response to an upcoming U.S. Supreme Court case, King v. Burwell, that could result in 6 million Americans across 30 states losing the federal subsidies that enable them to purchase health insurance. (For more background on the case, click here.) Republicans would need to take such changes into account when crafting an alternative to the Affordable Care Act.
Yesterday, an amendment to the “Firearm Concealed Carry Act” was introduced by Representative Ed Sullivan, Jr. (Republican, 51st District–Mundelein), and the bill was referred to the Rules Committee this morning. The amendment would affect the section of the legislation covering the removal of a weapon from a vehicle, specifically if the vehicle is parked in a lot in which concealed carry is not allowed. As the Act stands now, an individual who is licensed to carry a firearm may remove the weapon from his or her vehicle, if the vehicle is parked in a lot not covered by concealed carry, only to store the firearm in the vehicle’s trunk or to remove it from the trunk. Also, the weapon must be unloaded before one takes it out of the vehicle. The amendment would remove the segment of the Act mandating that the weapon be unloaded before it is removed from the vehicle.
For information on House Bill 0319, including its current status, click here.
If you are planning to attend one of the Legislative Meet-ups, this might be a good issue (along with the impact of Governor Rauner’s fiscal policies) to raise with your elected officials.
Also, for an overview of the ongoing impact of the concealed-carry legislation, please see this page from the Illinois Hospital Association’s website. The page focuses, in particular, on the requirements for reporting to the Department of Human Services that an individual is developmentally disabled or poses a danger to one’s self or to others (so that, in certain instances, the Department may determine whether such an individual owns a firearm).