Unemployed natives available for work: Report finds huge number of less-educated Americans not working
The Center for Immigration Studies (CIS) has released a new study detailing the U-6 unemployment rates among native born workers. U-6 is a broader measure of employment that includes the unemployed, people who would like to work but who have not looked for a job recently, and those involuntarily working part-time. A look at these numbers shows the situation is particularly bad for minorities, the young, and less-educated Americans. These are the workers who face the most competition from immigrants – legal and illegal.
The study, “A Huge Pool of Potential Workers: Unemployment, Underemployment, and Non-Work Among Native-Born Americans,” is authored by CIS Director of Research Steven A. Camarota and Demographer Karen Jensenius. The report is available online at: http://cis.org/UnemploymentAmongNativeWorkers.
Among the findings:
– As of the third quarter of 2009, there are 12.5 million unemployed native-born Americans, but the broader U-6 measure shows 21 million natives unemployed or underemployed.
– There are 6.1 million natives with a high school education or less who are unemployed. Using the U-6 measure, it is 10.4 million.
– In addition to those less-educated natives covered by U-6, there are another 18.7 million natives with a high school education or less not in the labor force, which means they are not looking for work.
– The total number of less-educated (high school education or less) natives who are unemployed, underemployed, or not in the labor force is 29.1 million.
– To place these numbers in perspective, there are an estimated seven to eight million illegal immigrants holding jobs.
– As of the third quarter of 2009, the overall unemployment rate for native-born Americans is 9.5 percent; the U-6 measure shows it as 15.9 percent.
– State with the highest U-6 rates for less-educated natives are Michigan, California, Arizona, Florida, Tennessee, South Carolina, North Carolina, Nevada, Illinois, and Georgia.
– Nationally, the unemployment rate for natives with a high school degree or less is 13.1 percent. Their U-6 measure is 21.9 percent.
– The unemployment rate for natives nationally with less than a high school education is 20.5 percent. Their U-6 measure is 32.4 percent.
– Nationally, the unemployment rate for young native-born Americans (18-29) who have only a high school education is 19 percent. Their U-6 measure is 31.2 percent.
– Nationally, the unemployment rate for native-born blacks with less than a high school education is 28.8 percent. Their U-6 measure is 42.2 percent.
– The unemployment rate for young native-born blacks (18-29) with only a high school education is 27.1 percent. Their U-6 measure is 39.8 percent.
– Nationally, the unemployment rate for native-born Hispanics with less than a high school education is 23.2 percent. Their U-6 measure is 35.6 percent.
– The unemployment rate for young native-born Hispanics (18-29) with only a high school degree is 20.9 percent. Their U-6 measure is 33.9 percent.
– Nationally, the overall unemployment rate for immigrants (legal and illegal) is 9.9 percent. Their U-6 measure is 19.6 percent, which is significantly higher than the rate for natives.
– The unemployment rate for immigrants with less than a high school education is 12.3 percent. Their U-6 measure is 27.4 percent. The unemployment rate for young immigrants (18-29) with only a high school education is 12.2 percent. Their U-6 measure is 25.2 percent.
The Center for Immigration Studies is an independent research institution that examines the impact of immigration on the United States.
Source: Center for Immigration Studies
New report warns against Bubble economic recovery
A new report released today by Bread for the World Institute warns that unless the triple threats of hunger, unemployment, and climate change are addressed, any economic recovery will only lead to another bubble.
“To blunt the surge of hunger, unemployment, and the long-term effects of climate change, we need a just and sustainable economic recovery,” said Rev. David Beckmann, president of Bread for the World Institute. “If we do not reshape our economy with jobs that allow low-income workers to feed their families and move out of poverty, our recovery will not be sustainable. Like a bubble, it will only collapse again.”
According to the new report, Hunger 2010: A Just and Sustainable Recovery, more than 1.02 billion people are hungry every day — an increase of more than 100 million from a year ago. In the United States, the number of people who struggle to put food on the table has surged to 49.1 million. “It’s deeply disturbing to think that nearly one in four children live on the brink of hunger in this country,” said Rev. Beckmann. “It’s a scandal for us as the richest country in the world.”
Unemployment is also on the rise, with one in ten Americans out of a job. The report stresses that for a sustainable economic recovery, we need to put people back to work. It argues that dollar for dollar, one of the best investments the United States can make is to create green jobs focused on lowering carbon emissions. “The jobs that will help us convert our economy from reliance on fossil fuels to alternative energy sources could more than surpass the 4 million manufacturing jobs lost since the start of the recession,” Rev. Beckmann added.
“Climate change is real and we have to deal with it,” said Rev. Beckmann. “Governments negotiating a new climate treaty must make concrete commitments at the climate change conference in Copenhagen in early December. The world’s economic recovery will remain fragile if we do not take steps to address climate change. Hungry and poor people are the most vulnerable. More than anyone else, they are bearing the brunt of the effects of climate change.”
The report analyzes the issues that need to be addressed in order for the U.S. and global economies to recover from the worst economic crisis since the Great Depression. It highlights the opportunity to put in place policies that reduce inequality, help low-income families to save and build assets for the future, and revitalize neglected communities throughout the country.
Hunger 2010: A Just and Sustainable Recovery also makes the case for U.S. leadership in reducing hunger and poverty around the world and in addressing climate change. “The economic crisis has given us an unprecedented opportunity to rebuild our economy and to put people and the planet at the center of our decisions,” said Rev. Beckmann. “It is important that the economic recovery be measured by how many of the world’s poorest people are able to lift themselves out of chronic hunger and poverty.”
Hunger 2010: A Just and Sustainable Recovery is available online at www.bread.org/hungerreport.
Source: Bread for the World Institute
Only five States have plans to address the Health Impact of Climate Change, new report finds
Trust for America’s Health (TFAH) released a new report that finds only five states have published a strategic climate change plan that includes a public health response. This includes planning for health challenges and emergencies expected to develop from natural disasters, pollution, and infectious diseases as temperatures and sea levels rise.
The Health Problems Heat Up: Climate Change and the Public’s Health report examines U.S. planning for changing health threats posed by climate change, such as heat-related sickness, respiratory infections, natural disasters, changes to the food supply, and infectious diseases carried by insects.
“The changing environment has serious ramifications for our health,” said Jeff Levi, PhD, Executive Director of TFAH. “In the near future, more extreme weather events, rising temperatures, and worsening air quality mean we’ll see an upswing in climate-related illnesses and injuries. As countries around the world work to address climate change, federal, state, and local governments around the United States need to ramp up activities to protect people from the health harms it poses.”
“States are already overwhelmed by existing public health responsibilities, so we face a serious challenge as we see these new climate change related problems on the horizon. States and communities will need more resources to effectively plan and prepare for them,” Levi continued.
The five states with public health response plans included in their larger climate change plans are California, Maryland, New Hampshire, Virginia, and Washington. Twenty-eight states have published strategic climate change plans that do not include a public health response, and seventeen states and the District of Columbia have not published a strategic climate change plan.
Other key findings from the report include that:
– Only 12 states have established climate change commissions that include a representative from the state’s public health department;
– Twenty-two states and New York City have received grants from the U.S. Centers for Disease Control and Prevention (CDC) for Environmental
Health Tracking, to track connections between health problems and the environment;
– Thirty-three states have received CDC funds for state asthma control programs; and
– Every state except Alaska has received funds to track diseases spread through mosquitoes and other insects.
According to Health Problems Heat Up, communities across the United States are at risk for negative health effects associated with climate change. Urban communities face natural disasters, such as floods and heat waves. Rural communities may be threatened by food insecurity due to shifts in crop growing conditions, reduced water resources, heat, and storm damage. Coastal and low-lying areas could see an increase in floods, hurricanes, and tropical storms. Mountain regions are at risk of increasing heat and vector-borne diseases due to melting of mountain glaciers and changes in snow melt. And communities around the country could experience new insect-based infectious diseases that used to only be affiliated with high temperature regions.
“The health threats from climate change are very real,” said Phyllis Cuttino, Director of the Pew Environment Group’s U.S. Global Warming Campaign. “That is one more reason the U.S. Congress should enact legislation to address global warming. Passing climate legislation that includes provisions to help states prepare for and respond to the projected health impacts of climate change is a measure in helping to protect the long term health of the American people. The sooner we act on global warming the healthier we’ll all be.”
The report contains a series of policy recommendations, including:
– Congress should provide funding for state and local health departments to conduct needs assessments and strategic planning for public health
considerations of climate change;
– The White House and the federal interagency working group on climate change should take into account the potential health implications of
policies and programs under consideration;
– Congress should increase support for tracking of environmental effects on health and research into health effects of climate change;
– CDC should set national guidelines and measures for core public health functions related to climate change, and in exchange for federal funding for climate change planning and response, CDC should require states and localities to report the findings to both the public and the federal government;
– All state and local health departments should include public health considerations as part of climate change plans, including conducting needs assessments, developing strategic plans, and creating public education campaigns; and
– Special efforts must be made to address the impact of climate change on at-risk and vulnerable communities.
The U.S. Senate is in the process of developing comprehensive climate change legislation. The U.S. House of Representatives recently passed a climate change bill that includes language to direct the U.S. Secretary of Health and Human Services to create a national strategic action plan to assist health professionals to prepare for and respond to the impact of climate change on public health in the United States and globally. The House bill also includes a Climate Change Health Protection and Promotion Fund to provide the funds needed to develop and carry out the strategic plan.
The full Health Problems Heat Up report, including state-specific information, is available on TFAH’s web site www.healthyamericans.org. The report was supported by The Pew Environment Group, which is the conservation arm of The Pew Charitable Trusts.
Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.
Source: Trust for America’s Health
Report: Same-sex couples face significant disadvantages in retirement
New Study Released During National Save for Retirement Week Documents How Lack of Federal Recognition for Same-Sex Couples Reduces Their Retirement Income and Survivor Benefits
A new study released details the inequalities faced by same-sex couples in employer-sponsored retirement plans. Without legal recognition of their relationships under federal law, the report concludes, lesbians and gay men have less retirement income and are disadvantaged in their ability to pass on savings to their families after their death.
The study, “The Impact of Inequality for Same-Sex Partners in Employer-Sponsored Retirement Plans,” provides the first detailed demographic portrait of older same-sex couples. It was released by the Williams Institute at the UCLA School of Law with funding support from Merrill Lynch in conjunction with National Save for Retirement Week.
“The findings show that, in particular, female same-sex couples have far less retirement income than different-sex married couples,” says study author Naomi Goldberg. Key findings of the report include:
– Female same-sex couples over 65 have almost 20% less income than different-sex married couples.
– Only 50% of female same-sex couples have at least one member eligible for an employer-sponsored retirement plan. That compares to 56% of different-sex married couples and 79% of male same-sex couples.
– Older female and male same-sex couples receive less income from traditional retirement sources–retirement, survivor, and disability pensions–than older different-sex married couples.
– Men in same-sex couples earn less than their heterosexual counterparts, but appear to work for more years.
The study also analyzes the ways in which elderly lesbians and gay men are disadvantaged when their partner or spouse dies. Upon death, unlike married different-sex couples, 401k balances and remaining assets cannot be passed tax-free to the surviving same-sex spouse or partner. In particular, these studies conclude:
– Even in states where same sex couples can marry, private employers can discriminate against same-sex married couples for the purpose of welfare and pension plans because of the reach of the federal Defense of Marriage Act (DOMA); thus, same-sex couples typically cannot avail themselves of pension survivor benefits.
– Surviving same-sex spouses or partners are unable to access social security spousal or survivor benefits. As a result, they lose out on an estimated $5,700 each year in benefits.
– Because same-sex surviving spouses cannot have the balance of their dead spouse’s 401k transferred directly to them, they must begin making withdrawals immediately- often resulting in a higher tax rate and missing out on potential earnings and the ability to withdraw when they are really needed.
“The bulk of these inequalities are a direct result of the Defense of Marriage Act, which forces the federal government to treat same-sex couples differently than married couples when it comes to retirement savings or estate taxes after death,” said Goldberg.
“Even without repealing DOMA, Congress could address these inequalities similar to the way it allowed same-sex partners to rollover the balance of their dead spouse’s 401ks in 2006. While not perfect, the Pension Protection Act has at least moved same-sex couples closer to equality in the treatment of their retirement assets.”
The full report is available at http://www.law.ucla.edu/williamsinstitute/home.html.
New report shows states can save hundreds of millions by abolishing the death penalty
National Poll of Police Chiefs Ranks the Death Penalty Last Among Crime-Fighting Priorities and Least Efficient Use of Taxpayers’ Money
A report released by the Death Penalty Information Center concludes that states are wasting hundreds of millions of dollars on the death penalty, draining state budgets during the economic crisis and diverting funds from more effective anti-violence programs. A nationwide poll of police chiefs conducted by RT Strategies, released with the report, found that they ranked the death penalty last among their priorities for crime-fighting, do not believe the death penalty deters murder, and rate it as the least efficient use of limited taxpayer dollars.
Read “Smart on Crime: Reconsidering the Death Penalty in a Time of Economic Crisis.”
“With many states spending millions to retain the death penalty, while seldom or never carrying out an execution, the death penalty is turning into a very expensive form of life without parole. At a time of budget shortfalls, the death penalty cannot be exempt from reevaluation alongside other wasteful government programs that no longer make sense,” said Richard C. Dieter, Executive Director of the Death Penalty Information Center and the report’s author.
“The death penalty is a colossal waste of money that would be better spent putting more cops on the street. New Jersey threw away $250 million on the death penalty over 25 years with nothing to show for it. The death penalty isn’t a deterrent whatsoever. New Jersey’s murder rate has dropped since the state got rid of the death penalty. If other states abolished the death penalty, law enforcement wouldn’t miss it and the cost savings could be used on more effective crime-fighting programs,” said Police Chief James Abbott of West Orange, New Jersey. Abbott, a Republican, has served 29 years on the police force and was a member of the state commission that recommended the death penalty be abolished.
Key findings from the poll of police chiefs include:
– The death penalty was ranked last when the police chiefs were asked to name one area as “most important for reducing violent crime,” with only one percent listing it as the best way to reduce violence. The death penalty came in behind more police officers; reducing drug abuse; better economy and more jobs; longer prison sentences; and technological innovations such as improved laboratories and crime databases.
– The police chiefs ranked the death penalty as the least efficient use of taxpayers’ money. They rated expanded training and more equipment for police officers; hiring more police officers; community policing; more programs to control drug and alcohol abuse; and neighborhood watch programs as more efficient uses of taxpayers’ dollars.
– Almost 6 in 10 police chiefs (57%) agreed that the death penalty does little to prevent violent crimes because perpetrators rarely consider the consequences when engaged in violence. Although the police chiefs did not oppose the death penalty in principle, less than half (47%) would support it if a sentence of life without parole with mandatory restitution to the victim’s family were available.
“We need to stop wasting money on a broken death penalty and instead spend our limited resources on solving more homicides. My brother’s murder has remained unsolved for more than six years. The death penalty won’t bring my brother back or help to apprehend his murderer. We need to start investing in programs that will actually improve public safety and get more killers off the streets,” said Judy Kerr of Albany, California.
The extra costs of the death penalty, beyond life sentences, are often $10 million per year per state. If a state spent that $10 million on hiring new police officers (or teachers) at $40,000 per year, it could afford to hire 250 additional workers.
California spends $137 million per year on the death penalty and has not had an execution in almost four years, even as the state pays its employees in IOUs and releases inmates early to address overcrowding and budget shortfalls. In Florida, where the courts have lost 10 percent of their funding, the state spends $51 million dollars per year on the death penalty or $24 million for each execution.
Executions themselves are not expensive; it is the pursuit of the death penalty that carries a high price tag. The higher costs of the death penalty process — including the costs of higher security on death row — are unavoidable and likely to increase in light of all the mistakes that have been made in capital cases.
In 2009, 11 state legislatures (Colorado, Connecticut, Illinois, Kansas, Maryland, Montana, Nebraska, New Hampshire, New Mexico, Texas and Washington) considered abolition bills. New Mexico abolished the death penalty and Maryland narrowed its application with costs as an issue in both states.
Both houses of the Connecticut legislature voted to end the death penalty and one house of the Montana and Colorado legislatures (where cost savings were to be allocated to solving cold cases) passed abolition bills. The trend of states reexamining the death penalty in light of the economic crisis is expected to continue.
The poll of 500 randomly-selected police chiefs was conducted from October 29 to November 14, 2008 by RT Strategies with a margin of error of +/- 5.1 for all elites. The results of the poll were publicly released for the first time today.
The Death Penalty Information Center is a non-profit organization serving the media and the public with analysis and information on issues concerning capital punishment. The Center was founded in 1990 and prepares in-depth reports, issues press releases, conducts briefings for journalists, and serves as a resource to those working on this issue. The Center is widely quoted and consulted by all those concerned with the death penalty.
Source: Death Penalty Information Center
Geothermal power could top 10 Gigawatts, new industry report shows
A new report by the Geothermal Energy Association (GEA) shows strong growth in new geothermal power projects continuing through 2009. U.S. Geothermal Power Production and Development Update, September 2009 identifies 144 new geothermal projects under development in fourteen states that could represent as much as 7,100 MW of new baseload power capacity. When added to the 3,100 MW of existing capacity, 10 Gigawatts of geothermal power appears to be feasible.
“It is great to see that between March 2009 and September 2009 there was a continued increase in new geothermal projects,” remarked Dan Jennejohn, the report’s author. “Interest in geothermal development continues to grow, with the number of projects up 50% and megawatts under development nearly doubling over the past two years.” He added, “In 2009, we are seeing new power projects being initiated as well as new applications, such as geothermal-hydrocarbon coproduction, being pursued.”
The report found a total of 144 projects under development that could add between 4,699.9 and 7,109.9 MW of power to the U.S. geothermal energy output. At the high end, that would be enough baseload power to supply about 20% of California’s total electric power in 2008 — or enough generating capacity to supply the power needs of about 7.2 million people.
On a state-by-state basis the GEA report found: (state, number of projects/potential MW) — Alaska, 6/70-115 MW; Arizona 1/2-20 MW; California, 37/1841.8-2435.8 MW; Colorado, 1/10 MW, Florida 1/0.2-1 MW; Hawaii, 2/8 MW; Idaho 5/238-326 MW; Louisiana 1/.05 MW; Mississippi 1/.05 MW; Nevada, 64/1876.4-3473.4 MW; New Mexico, 1/20 MW, Oregon, 13/317.2-368.2 MW, Utah, 10/272.4-332.4 MW; Washington 1/Unspecified.
The number of states with geothermal projects under development also increased, from 12 to 14 over the past six months, with the addition of two oil-field co-production projects in Louisiana and Mississippi. “Despite the recession, geothermal power projects continue to move forward,” observed Karl Gawell, Executive Director of GEA.
While the report shows generally good news, it also shows a decline in projects currently listed in “phase 4,” or under construction. According to GEA this was due to 4 new geothermal power projects moving to completion, but also reflects difficulty obtaining final permits and difficulty obtaining financing.
The recession, as the report confirms, is having an impact on the industry, according to GEA. “Financing is expensive and scarce, and available lenders are requiring much more work be done before they will finance projects,” noted Gawell. “We hope the tax, loan guarantee, and DOE spending provisions of the stimulus bill will help turn this around, but there have been delays implementing these initiatives by the federal agencies.”
“It also appears that some projects seeking final construction permits are having difficulty acquiring them because of the tremendous demands being placed on federal, state, and local agencies by a wave of renewable energy project applications,” Gawell noted. “These geothermal projects would otherwise be ‘ready to go’ bringing new jobs and spurring economic growth,” he stressed. “So it’s important that federal and state agencies don’t neglect the needs of geothermal projects.”
Copies of the report will be available at the GEA booth at the Geothermal Energy Expo in Reno, Nevada, which takes place from October 4-7, 2009. (For information on the Expo go to: http://www.geothermalenergy2009.com/.) There will be a presentation on the report at the Expo on Tuesday, October 6 at 10 a.m. which will be webcast. Also, copies of U.S. Geothermal Power Production and Development Update, September 2009 are available to download free of charge from the GEA Web site at: http://www.geo-energy.org/.
Source: Geothermal Energy Association
Hoffa: Government report shows border should remain closed
Trucking Pilot Program Diverted Inspections From Buses, Inspector General Reports
Teamsters General President Jim Hoffa said today that an inspector general report shows once and for all that the border should remain closed to unsafe Mexican trucks.
A pilot program to allow Mexican trucks on U.S. highways began in September 2007 and ended in March 2009 when Congress, with bipartisan support, cut off funding for it.
The inspector general reported that states aren’t consistently reporting Mexican drivers’ traffic convictions. That “could result in Mexican Federal CDL (commercial driver’s license) holders continuing to drive in the United States after incurring a disqualifying traffic offense,” the report said.
“This new report raises even more alarms about opening our border to unsafe trucks from Mexico and endangering the lives of drivers in the United States,” Hoffa said.
The inspector general also reported that the program diverted border officials from inspecting passenger buses. In El Paso, for example, the number of bus inspections fell by 80 percent.
At some California and Texas crossings, passenger buses are still not inspected when they cross the border on evenings, weekends or holidays because there are no inspectors working those shifts.
“This report shows without a doubt that opening the border to Mexican trucks and buses puts an unacceptable strain on our border resources,” Hoffa said. “Federal officials couldn’t keep up with inspections when there were only 118 trucks in the pilot program. If the border were opened to all Mexican trucks, border inspection stations would be completely overwhelmed.”
The report, dated Aug. 17, said that the shift in border inspectors should “call into question whether FMCSA’s (Federal Motor Carrier Safety Administration) border staff could meet the bus inspection demands that may occur if the border were to open to a large number of Mexican long-haul trucks and buses.”
Hoffa said that Mexican trucks should not be allowed to travel on U.S. highways until the United States implements a comprehensive inspection program and the Mexican government ensures that hours-of-service rules are enforced, that Mexican drivers meet the same qualifications as U.S. drivers and that drug and alcohol testing facilities are brought up to U.S. standards.
The Mexican government slapped tariffs on $2.4 billion worth of goods after the pilot program was shut down. Hoffa said the retaliatory tariffs are unfair and disproportionate.
“Anyone who drives on U.S. roads should be required to obey U.S. safety laws,” Hoffa said. “The Mexican government is wrong if it thinks NAFTA should give it the right to send dangerous trucks onto our highways. Mexico must meet its end of the bargain. For the last 15 years, it hasn’t even tried. The U.S. Trade Representative should be challenging these unfair tariffs.”
Founded in 1903, the International Brotherhood of Teamsters represents 1.4 million hardworking men and women in the United States, Canada and Puerto Rico.
Source: International Brotherhood of Teamsters
New report: Sustainable climate strategies must create not destroy wealth
Responsible development of forest lands reduces emissions, offers economic returns up to 8-times greater than CO2 farming
The NGO World Growth International released a new report, cautioning U.N. officials and World leaders that efforts to tackle climate change will fail unless they create rather than destroy wealth — a critical fact ostensibly disregarded by some environmental organizations.
The analysis entitled “Forestry and the Poor: How forestry reduces poverty” reveals that forestry generates up to 7% of GDP in poor countries, creating much-needed jobs and prosperity. The report goes on to compare the value of these established uses of forest land with the economic return of using trees solely for carbon storage — the strategy being pushed by “green” NGO’s like Greenpeace and WWF.
“The value of established development of forest land is at least four times – and can easily be – eight times greater than carbon farming,” explained World Growth Chairman Alan Oxley. “This contradicts claims that poor countries can enjoy greater economic returns by halting forestry and conversion of wooded land for agriculture and other more productive purposes.”
In the midst of a global economic recession, policy makers and legislators around the globe are desperate to promote economic growth. “Consequently,” continued Mr. Oxley, “any proposal on climate change that undermines growth just won’t fly.
“This reality is clearly not understood by a few environmental NGO’s like Greenpeace and WWF. In fact, rather than stimulating economic development, their recently-released model for a climate treaty would actively destroy wealth in rich and poor countries alike.
“It would effectively establish global ‘green’ welfare. The plan calls for imposition of a five-year US$760 billion tax on rich countries. Those revenues would then be directed to developing countries as aid — on dubious condition that they close down wealth-producing industries like forestry.”
Previous research by World Growth demonstrated that expansion of carbon sinks in forests of developing countries provides one of the most effective ways to reduce emissions. This expansion entails running sustainable forestry operations in natural forests as well as establishing plantations and commercial crops.
Due to unfavorable economic circumstances and vast differences among leading nations, Mr. Oxley explained that the chances of agreement on a new treaty at Copenhagen this year are poor: “Unless strategies that protect and even encourage economic development are advanced in the future, a new global strategy will elude negotiators this year and for many years to come.”
Click here to read the entire World Growth Report
Source: World Growth
National Report ranks Oklahoma as a Top State for Mental Health Services
Ranking Featured Oklahoma’s Innovative SoonerPSYCH Program
Over the past three years, Oklahoma has risen from a “D” to a “B” grade in the 2009 National Alliance on Mental Illness’ Grading the States Report — a state-by-state assessment of the nation’s public mental health care system.(1) Oklahoma showed the greatest improvement in the nation and is heads above the national average grade of “D.”(1)
Oklahoma’s report card featured several of the state’s innovations in mental health services, including SoonerPSYCH (Sooner Prescription Solutions for Your Cognitive Health) – a Medicaid prescription management program.(1) An analysis of 2007 data from SoonerPSYCH shows the program has helped increase the quality of care for Oklahoma residents with severe mental illness while helping lower health care costs.(2)
SoonerPSYCH was developed by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) and Oklahoma Health Care Authority (OHCA) in collaboration with clinical research firm Comprehensive NeuroScience, Inc. Lilly, an Indianapolis-based pharmaceutical company, provides funding for this program to promote excellence in patient care. Operation and implementation of the program is done solely by the states and Comprehensive NeuroScience, Inc.
Improving Quality of Care
The four goals of SoonerPSYCH are to improve continuity of patient care, eliminate redundant treatments, coordinate care among health care providers, and decrease risks associated with inappropriate medication use. An analysis(2) of the program’s provider outreach in 2007 showed a:
- 72 percent decrease in the number of patients who were prescribed the same mental health medications from multiple doctors;
- 61 percent decrease in the number of patients who were on two or more antipsychotics for 45 or more days; and
- 52 percent decrease in the number of multiple prescribers of any psychotropic for 45 or more days.
The same analysis showed that, between August 2004 and December 2007, Oklahoma may have avoided $12.3 million in behavioral health pharmacy costs that would have been incurred had the state not intervened.(2)
“OHCA is pleased that the SoonerPSYCH collaboration with ODMHSAS was specifically cited in the NAMI report card. Our ongoing partnership continues to result in positive outcomes for our members,” said Dr. Lynn Mitchell, Oklahoma Medicaid director.
How the Program Works
First launched in 2004, the SoonerPSYCH program evaluates Medicaid pharmacy claims on more than 400 mental health medications. It identifies prescribing patterns that are inconsistent with national, evidence-based best practice guidelines, including those published in peer-reviewed medical journals. When there is an inconsistency with what is considered best prescribing practice, SoonerPSYCH sends an educational mailing that highlights the research and best practice information in a concise document for the physician’s review and consideration at the next visit with the patient.
Some of the inconsistent patterns the program has identified include premature discontinuation of a medication, rapid switching from one medication to another, prescribing above or below recommended dosing levels, and prescribing multiple medications from the same therapeutic class.
SoonerPSYCH also alerts physicians when patients receive the same medication from two different doctors, and informs physicians when their patients have not refilled their prescriptions. This is a health care concern because poor compliance or non-compliance with medication treatment is strongly linked to relapse, rehospitalization, poor outcomes, and high economic costs.(3)
SoonerPSYCH is entirely voluntary for doctors. All decisions regarding treatment and medications are made privately between the physician and the patient and are completely individualized.
“Physicians will change their prescribing practice patterns to be in keeping with best practice, when they know what the best practice is. They use the educational information from the program’s mailings and, when they do, the overall care of the patient is improved, and we see overall reduction in health care costs,” said Carol D. Clayton, Ph.D., vice president, Operations, Comprehensive NeuroScience, Inc.
National Results and Awards
Twenty-seven other states have run similar programs, based in part on the increasing awareness that disease management and coordination of care programs are effective health care reform solutions.
Nationwide, these programs have resulted in 2 million patient care improvement interventions.(4) On average, states that have run the program have seen a behavioral health pharmacy cost avoidance of almost $800 each year per patient whose physician received an educational mailing compared with those patients whose physician has not yet received an educational mailing.(5)
“We’re pleased to see how this program is helping improve care for Oklahoma Medicaid patients with mental illness, who represent some of our most vulnerable citizens,” said Alex M. Azar II, vice president of business-to-business, LillyUSA. “We congratulate the state on the success of this program and its dedication to delivering high quality health care to patients.”
Because of its success, the program has been highlighted by leading organizations and received several national awards, including:
- Substance Abuse and Mental Health Services Administration Science and Service Award;
- URAC Silver Award for Best Practices in Consumer Empowerment and Protection;
- American Psychiatric Association Bronze Achievement Award; and
- Disease Management Association of America Gold Award.
(1) Aron L, Honberg R, Duckworth K et al. Grading the States 2009: A Report on America’s Health Care System for Adults with Serious Mental Illness, Arlington, VA: National Alliance on Mental Illness. Available at: http://www.nami.org/gtsTemplate09.cfm?Section=Overview1&Template=/ContentManag ement/ContentDisplay.cfm&ContentID=75090. Accessed on April 13, 2009.
(2) Data provided by Comprehensive NeuroScience Inc.
(3) Perkins DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry. December 2002; 63(12):1121-1128.
(4) Data provided by Comprehensive NeuroScience Inc.
(5) Data provided by Comprehensive NeuroScience Inc.
Source: Eli Lilly and Company
Patients spent an average of four hours and three minutes in U.S. Emergency Departments in 2008
Authoritative Report on Emergency Department Experiences Released Today, Available at www.ImproveMyER.com
Press Ganey Associates, Inc. released the 2009 Emergency Department Pulse Report: Patient Perspectives on American Health Care. According to the report, patients now spend an average total time of 4 hours and 3 minutes in the emergency room (ER), also known as the emergency department (ED). That is a 27-minute increase in the nationwide average time since 2002.
Press Ganey’s Emergency Department Pulse Report analyzed the experiences of nearly 1.4 million patients treated at 1,725 emergency departments nationwide in 2008.
Notable findings from the 2009 pulse report include:
- South Dakota has the lowest total time spent in the emergency department (3 hours, 52 minutes) while Utah had the highest total time (6 hours, 48 minutes).
- Two states showed notable improvement in their emergency department average total times over the year. Virginia patients spent 23 fewer minutes in the emergency department in 2008 than they had in 2007, while patients in Maryland spent 14 fewer minutes in the ED last year.
- The metro areas with the highest patient satisfaction in the emergency department for 2008 were, in order, Miami, Detroit, Philadelphia, Pittsburgh, Boston, Chicago, Baltimore, Houston, Dallas/Ft. Worth and New York/Long Island. Miami moved up from third on last year’s list, while Detroit moved up from fourth. Philadelphia was a new entry in the top 10.
- Patients who arrive in the emergency department between 7:00 a.m. and 3:00 p.m. report higher satisfaction than those who arrive in the evening or overnight hours. Lowest satisfaction was reported among those who are in the emergency department between 3:00 p.m. and 11:00 p.m.
- While average total times have increased since data was first collected in 2002, patient satisfaction is improving as many hospitals are communicating better with patients about delays.
- The economy is having a significant impact as the proportion of emergency department patients without insurance is increasing. Fewer patients are seeking inpatient and elective services.
“Today’s health care landscape, shaped by quality initiatives, transparency, and consumer choice, gives patients the ability to decide for themselves where to receive care,” says Richard Siegrist, president and chief executive officer of Press Ganey Associates. “Improving patient satisfaction in the emergency department is particularly critical for health care leaders because it is often the most visible public face of a hospital or health care system.”
The report, along with “Press Ganey Solutions for Consumers” and “Press Ganey Tips for Hospital Administrators,” is available at www.ImproveMyER.com. The site offers resources on emergency departments and improvement solutions for both consumers and administrators.
The findings and observations of the Emergency Department Pulse Report highlight progress being made in hospitals, emphasize areas for improvement, and explore the path to improving the quality of health care in the United States. Press Ganey works with emergency department administrators to assist them with best practices such as implementation of “fast tracks” or hiring dedicated staff charged with improving communication about delays in the ED. Other consultation tactics include:
- Analyze and interpret patients’ perception of care
- Identify priorities for improvement specific to each institution
- Assist with goal setting for improvement initiatives
- Recommend specific best practices
- Facilitate change management within the hospital
“No patient wants to visit an emergency department; but when they do, Press Ganey’s goal is to help hospitals treat the patient as quickly and efficiently as possible,” said Siegrist. “Keeping the patient moving through the right phases of the hospital — and communicating with them along the way — is beneficial to the patient and the hospital.”
Source: Press Ganey Associates, Inc.