grist for the mill
A not-so-secret research cacheTuesday, June 24, 2003
Monday, June 23, 2003
Sunday, June 22, 2003
Excerpt: The current system embodies struggle, control, and a survival of the fittest mentality. It is based on dialectic, right/wrong, either/or patterns that originated in Aristotelian logic. Even though we live in a densely populated, rapidly changing technological world that cries out for systems that foster collaboration, individuals and institutions tenaciously cling to old habits.
Saturday, June 21, 2003
The DMC has lost more than $350 million during the past five years, mostly caring for uninsured patients, or those with government-funded health plans that don't fully cover the costs. DMC leaders have threatened to close Receiving and Hutzel hospitals this year without more public funding.
The DMC has lost more than $350 million during the past five years, mostly caring for uninsured patients, or those with government-funded health plans that don't fully cover the costs. DMC leaders have threatened to close Receiving and Hutzel hospitals this year without more public funding.
Friday, June 20, 2003
By ERIC LICHTBLAU
Los Angeles Times Staff Writer
June 1, 2000
Excerpts: Bush said in a written statement that while lawlessness by police cannot be tolerated, "I also do not believe that the federal government should instruct state and local authorities on how police department operations should be conducted, becoming a separate internal affairs division."
Ironically, FOP is now moving to endorse Gore, even though the vice president generally supports the Justice Department's police misconduct investigations. Union leaders consider the probes political "blackmail."
One union source said that in his in-person interview with union leaders, the governor appeared "ill-prepared" to discuss the critical issue. And he came across as somewhat flippant when asked what he had done to help state troopers in Texas get more bargaining rights.
"He said, 'Well, we make sure they have a heck of a Christmas party.' That went over pretty poorly," the source said.
Thursday, March 13, 1997
City officials check out popular system used in San Jose, Calif., to
review complaints made by citizens
By Julie Wallace
Beacon Journal staff writer
Wednesday, June 18, 2003
Excerpt: City Council created the Citizen Complaint Authority as part of a package of police reforms following the shooting of Timothy Thomas by a police officer in Over-the-Rhine in 2001. A U.S. Justice Department investigation and the settlement of a racial profiling lawsuit, known as the collaborative agreement, recommended a stronger, more independent police oversight agency.
Tuesday, June 17, 2003
Detroit Free Press - March 12, 2003
Excerpt: Between 1997 and 2001, the City Council authorized more than $123 million in lawsuit damages against police.
Personal Comment: It would seem then that City Council has a compelling interest in being involved in consent decrees.
PARC regularly publishes reports and articles concerning police oversight. Some of these reports detail monitoring activities in various jurisdictions where PARC has been engaged as a consultant to the monitor. Others were articles produced by the PARC staff. On a monthly basis, PARC publishes the Best Practices Review , a newsletter containing up-to-date news, interviews and events ... This page also contains other publications and websites of interest to those concerned with police reform and oversight.
In other matters, the Sewerage and Water Board submitted its first written reports to the City Council, as required by the Council?s adoption of Resolution R?02-761 on December 5, 2002. Written reports regarding the status of the Consent Decree must be presented to the Council on a monthly basis, as part of an ongoing effort to retool the agency and provide proof of goal fulfillment prior to requesting any additional rate increases.
A RESOLUTION of the Council of the City of Salisbury, Maryland approving the Consent Order in Civil Case No. 22-C-02-0011217;
Harvey Grossman, director of the ACLU’s legal arm, commended Highland Park’s Mayor and City Council for its work in reaching this national model to prevent racial profiling and called on other communities to follow Highland Park’s lead.
The City afterwards moved to set aside the consent order on the ground that its attorneys lacked the authority to bind the municipality to the agreement without the prior approval of the City Council. The primary focus of the objection was the provision for payment of monetary damages to the plaintiffs in the amount of $37,500.00.
"There's things in that consent decree I really appreciate and like, such as the monetary value of the computers,'' the chief said. "The things I appreciate the most is the schooling and education. In the past it was always a problem getting the money. Now, since the consent decree, it's a must.''
The money comes from a city council that had been reluctant in the past to approve such funds for training, he said.
POLICE ACCOUNTABILITY - Civilian review comes a step closer
BY STEVEN STYCOS
FEBRUARY 22, 2002
MINNEAPOLIS CITY COUNCIL
OFFICIAL PROCEEDINGS
Oakland City Council Approves Consent Decree Requiring Discussion of Citizens' Police Review Board Matters in Open Session
Monday, June 16, 2003
Excerpt:The Detroit-based St. John and Henry Ford Health systems want to build new hospitals in Novi and West Bloomfield, if state lawmakers waive state rules that limit such expansion. [They already have. See related article below.] They'd like to do more business in the suburbs to offset losses in Detroit.
Late last year, the state Legislature passed changes to the laws that restrict hospitals' ability to build new hospitals, add beds and expand services. At the urging of the three Detroit hospital systems, the legislature agreed to let health systems add bed capacity in locations where they already have a presence.
As a result, St. John plans to build a hospital in Novi that Joseph said could generate $10 million in operating profit when it is fully operational.
Excerpt: Last year's losses resulted from lower-than-expected patient volume and unexpected costs associated with delays in relocating Hutzel Women's Hospital.
Thursday, June 12, 2003
Excerpt:The coalition's study predicts that rising prices will increase the number of uninsured Americans -- now 41 million -- to at least 51 million and as many as 54 million by 2006.
Excerpt:"Recent evidence from our site visits suggests hospitals continue to use their formidable negotiating leverage to seek large payment rate increases from health plans—in part to reverse the effect of discounted hospital payment rates in the mid-1990s," said Bradley C. Strunk, an HSC research analyst and study coauthor.
Hospitals also may be seeking to pass through higher wage increases granted in response to labor shortages, particularly for nurses. Growth in hospital wage rates slowed in 2002 but continued to be high, growing 5.5 percent, down from 6.1 percent in 2001
Excerpts:But Leon Atchison, former board member of Receiving Hospital, told the council that money was being taken out of Receiving Hospital's reserve accounts and transferred to other DMC operations without approval of Receiving's board. He claimed the money was not being repaid, nor was the DMC paying interest on the "loans" made by Receiving.
"We recognize our responsibility to support the viability of the whole system, but I get questions about what is happening to our (reserve) account," Atchison said.
Atchison said Receiving's unrestricted cash reserves fell from $225 million three years ago to $37 million today "and even that might be gone now," he said.
The DMC has said it cannot continue to operate all of its hospitals without some form of public funding from the local, county, state or federal government. The DMC has identified Receiving as one of its most vulnerable hospitals because of the volume of free care it delivers to poor and uninsured people. Systemwide, DMC delivered $130 million in free care in 2002 with Receiving delivering $78 million alone.
[DMC Chief Executive Arthur] Porter said all reserves belong to the DMC since the separate hospitals formed an "obligated group" in 1986. He said money is transferred among the hospitals to help cover costs of operations and is used to pay interest on DMC's collective debt.
"Detroit Receiving and its financials are within the DMC organization," Porter said. "All monies are owned jointly and severally by all the DMC organizations . . . all DRH money was made for the entire institution."
Excerpts: Her [Granholm's]reluctance to seek Band-Aid cash infusions for DMC has some political appeal. Outstate legislators always resent doling out subsidies to southeastern Michigan institutions, be they Detroit museums or the Pontiac Silverdome.
Therefore, Granholm wins points from the anti-Detroit crowd with her suggestion -- echoed in recent days by state health director Janet Olszewski and even by Detroit Mayor Kwame Kilpatrick -- that DMC needs to resolve its own "structural issues" and not expect a blank check.
OK, I get it, I understand the political need to stress fiscal discipline as you try to herd Republicans, Democrats and competing health care systems together to forge a solution to the hospital crisis.
But the vague reference to "structural issues" at DMC is a smoke screen. Or worse, this implication that DMC is inefficient or mismanaged becomes the first step in a blame game, where key players start to duck responsibility for a public policy failure that becomes almost pre-ordained.
But there's enough evidence to conclude that DMC President Arthur Porter and his management team aren't idiots. They have cut employment from 15,500 to 12,000 since 1999, cut accounts receivable in half, and reduced the cost per discharged patient three years in a row. DMC is well below the national average in the cost of supplies per patient and ranks above national hospital firms HCA and Tenet in revenue generated per employee from paying customers, says Nick Vitale, DMC's chief operating officer.
Some DMC doctors have suggested a total shutdown of Receiving to spark a full-blown crisis if the city's only top-level trauma center closes and its 87,000 patients a year are diverted to other hospitals. Granholm said Wednesday that she will not allow Detroit to be without a Level One trauma center, but she didn't elaborate.
If there's confusion about DMC's structure because some Detroit City Council members are ranting about promises made -- or not -- in 1978 when the city's public hospital was closing, forget about it. It's silly. DMC's current financial structure has been in place since 1985 and has been no big secret.
by Arthur T. Porter
Exerpt: Recent announcements of layoffs and consolidation shouldn't have surprised anyone. For months, we have been appealing to city, county, state and federal officials to help us work out a solution that will allow us to continue our services at full strength. And while the DMC made progress in getting on government agendas, no dollars have come our way. Therefore, the DMC needed to act immediately or risk the financial health and well-being of the system's other jewels, including Children's Hospital of Michigan, Sinai-Grace Hospital and the six other DMC hospitals that make budget.
Kilpatrick said he understands that the DMC has other funding issues, and that a Granholm task force will continue to work toward establishing a public authority for better long-term care of the region's indigent and uninsured.
"But my mission at this time is to save Receiving Hospital," he said. "It's a burn center; it's a Level 1 trauma center; it's the bio-terrorism center. These things touch a lot of stuff -- the Super Bowl, pope visits . . . You can't have any of those things if you don't have a Level 1 trauma center."
Porter understands the urge to keep Receiving afloat. "Receiving stands for a lot in this community and appropriately so, but I really do feel we really need to think about obstetric care and mental health on an urgent basis," he said
Tuesday, June 03, 2003
PDF format. Lists accomplishments of DMC turnaround plan, pg 17-23.
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