Archive for the ‘State News’ Category

Cavalier Greed And Cruelty In Minnesota

Wednesday, September 21st, 2022

Yesterday, Federal authorities charged 47 people in Minnesota with conspiracy and other counts in what prosecutors said is, to date, the largest fraud scheme of the COVID-19 pandemic, a scheme that stole at least $250 million from a federal program that provides meals to low-income children.

According to the Justice Department, “The 47 defendants are charged across six separate indictments and three criminal informations with charges of conspiracy, wire fraud, money laundering, and bribery.”

Government prosecutors allege the defendants created companies that claimed to be offering food to tens of thousands of children across Minnesota — nearly all of whom did not exist, — then sought reimbursement for those meals through the U.S. Department of Agriculture’s food nutrition programs. Because the need was so great, some standards were waived and oversight was often minimal. The USDA allowed for-profit restaurants to participate, and allowed food to be distributed outside educational programs. The charging documents say the defendants exploited such changes “to enrich themselves.”

A non-profit called Feeding Our Future was central to the scheme.

The Federal Child Nutrition Program is used to feed low income children in daycare and afterschool organizations. It spends $4 billion a year to feed needy children across the country. Feeding Our Future received hundreds of millions of dollars from the program from 2019 through 2021.

Here’s how it worked.

The government alleges Feeding Our Future, a sponsor in the Federal Child Nutrition Program, established sponsorship contracts with nearly 200 federal child nutrition program sites throughout the state, knowing that the sites intended to submit fraudulent claims. The sites would submit the claims to Feeding Our Future, which would then submit them to the Minnesota Department of Education, which has historically administered the programs, primarily through school programs. With schools closed for the pandemic the rules of the nutrition programs were changed to allow for all of the new entrant providers and the relaxed rules.

Feeding Our Future became a sort of Third Party Administrator for the sham sites and collected 15% of the charges as its fee. It went from receiving and disbursing approximately $3.4 million in federal funds in 2019 to nearly $200 million in 2021.

According to the indictments, “The sites fraudulently claimed to be serving meals to thousands of children a day within just days or weeks of being formed and despite having few, if any, staff and little to no experience serving this volume of meals.”

The massive fraud was allegedly headed up by Aimee Bock, Feeding Our Future’s founder and executive director. The indictments also allege she and some of her employees received additional kickbacks, which were often disguised as “consulting fees” paid to shell companies Bock created.

Andy Luger, the U.S. Attorney for Minnesota, said the fraudsters billed the government for more than 125 million fake meals. He displayed one Form For Reimbursement that claimed a site served exactly 2,500 meals each day Monday through Friday — with no children ever getting sick or otherwise missing a meal.

Luger said, “These children were simply invented.”

Earlier this year, the U.S. Department of Justice made prosecuting pandemic-related fraud a priority. The department has already taken enforcement actions related to more than $8 billion in suspected pandemic fraud, including bringing charges in more than 1,000 criminal cases involving losses in excess of $1.1 billion.

In this case, one of the indictments offered a beyond-brazen example of the fraud. It described a small storefront restaurant in Willmar, in west-central Minnesota, that typically served only a few dozen people a day. Two defendants offered the owner $40,000 a month to use his restaurant, then billed the government for some 1.6 million meals through 11 months of 2021. They listed the names of around 2,000 children — nearly half of the local school district’s total enrollment — and only 33 names matched actual students. And where did the defendants get the names of the children they said the program fed? From a website that randomly provides the names of mythical children. That’s where.

As usual in these kinds of fraud schemes the defendants used the stolen money to buy homes, exotic cars, vacation junkets and expensive clothes and jewelry.

And what did Minnesota’s low income children get? They got hunger.

 

 

 

Paid Sick Leave: Public Policy That Makes Ethical And Economic Sense

Tuesday, August 23rd, 2022

Mississippi: America’s Third World Country

Wednesday, May 11th, 2022

Although I have been there only once, I can’t help thinking about Mississippi.

Mississippi has recently been in the news, of course, because its 2018 Gestational Age Act will be upheld in the same Supreme Court decision overruling Roe v. Wade, which we discovered from Justice Samuel Alito’s leaked first draft opinion for the majority.

This is not Mississippi’s first foray into restricting abortion. In 2007, the state passed its version of an abortion Trigger Law, which “bans all abortions unless necessary to save the life of the pregnant woman or if the pregnancy was caused by rape and charges have been filed with law enforcement,” and which takes effect immediately following the state attorney general certifying the Supreme Court has overturned Roe v. Wade. The Trigger law had 19 male legislative sponsors and zero female sponsors. Regardless, Mississippi has been ready for this for 15 years.

But has it been ready for what comes next?

Matthew Walther, editor of The Lamp, a Roman Catholic literary journal, and a person who will never be accused of favoring abortion, sees predictable and unpleasant consequences after Roe is no longer the law of the land. In his 10 May 2022 guest essay for the New York Times, “Overturning Roe will disrupt a lot more than abortion. I can live with that,” Mr. Walthern acknowledges what very few anti-abortionists want to admit.

Research over the years has suggested that an America without abortion would mean more single mothers and more births to teenage mothers, increased strain on Medicaid and other welfare programs, higher crime rates, a less dynamic and flexible work force, an uptick in carbon emissions, lower student test scores and goodness knows what else.

But Mr. Walther, despite envisioning a gloomy horizon, “can live with that.” I cannot restrain myself from pointing out that Mr. Walther is of the male persuasion and, consequently, faces little likelihood of ever having to “live with” personal pregnancy.

Nonetheless, he makes a good argument, which brings us back to Mississippi.

A few points worth considering:

  • Poverty: According to the Department of Agriculture, 20.29% of Mississippi’s adults and 27.6% of its children live below the poverty line. This is the highest poverty rate in America where the national average is 11.4%.
  • Income: The median family income in Mississippi is $45,081. This is the lowest in the nation. According to the National Census Bureau, the national average in 2019 was $65,712.
  • Education: Only Texas, at 84%, ranks lower than Mississippi, at 85%, for the percentage of high school graduates. The national average is 89.6%. Only West Virginia, at 21%, ranks lower than Mississippi’s 22% for the percentage of college graduates. The national average is 31.28%.
  • Life Expectancy: At 74.4 years, Mississippi has the lowest life expectancy rate in the nation. Of note, the life expectancy rate for Mississippi’s men is 71.2 years.
  • Fetal Mortality: Mississippi’s fetal mortality rate, the number of deaths at 24 or more weeks of gestation per 1,000 live births, is 6.6. This is the highest in the nation. The national average is 3.68. If that isn’t enough, fetal deaths have lately doubled among unvaccinated pregnant women who suffer COVID-19 infections, State Health Officer Dr. Thomas Dobbs said during a Mississippi State Department of Health press conference in September, 2021.
  • Infant Mortality: The Infant Mortality Rate is the number of infant deaths per 1,000 live births. At 8.27, Mississippi’s is the highest in the nation, far exceeding Louisiana’s rate of 7.53, which is the second highest.
  • Maternal Mortality: According to the Centers for Disease Control and Prevention (CDC), Mississippi’s maternal mortality rate is 20.8, again, the highest in the country, where the national average is 17.4, which is the highest among all members of the Organization for Economic Co-operation and Development (OECD). A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”
  • Maternity Leave: Mississippi has no guaranteed Maternity or Sick Leave in its state laws.
  • Smoking: According to the CDC, 20.4% of Mississippians smoke. This is the fourth highest in the nation.
  • Autopsies: Something you probably have never have considered until now: Autopsy backlogs. According to the National Association of Medical Examiners (NAME), 90% of all autopsies should be completed within 60 days of death. The NAME has never accredited Mississippi, which has the highest backlog in the nation. The Mississippi State Medical Examiner’s Office was waiting for about 1,300 reports from as far back as 2011, records sent to the Associated Press in early April show. Around 800 of those involve homicides – meaning criminal cases are incomplete.
  • Abortion: According to the Mississippi Department of Public Health, the state has about 3,500 abortions annually. This represents 4.3 abortions per 1,000 women of reproductive age.
  • Finally: Mississippi ranks highest in the nation for Percent of Births to Unmarried Mothers, Cesarean Delivery Rate, Preterm Birth Rate, and Low Birthweight Rate.

Reading the above, one might be forgiven for thinking  there is a significant population in Mississippi who are actual victims of the state’s inability, or outright refusal, to carry out its first responsibility: to provide for the security and safety of its citizens.

Thinking about this, I have to ask: Given how well it’s doing now, how in the world is Mississippi going to cope with 3,500 new births per year? On CNN this past Sunday, Jake Tapper interviewed the state’s Republican Governor, Tate Reeves. That interview offered a glimpse of what is likely coming, a catastrophe becoming worse than it already is, which is considerable.

Tapper: Mississippi, as you know, has the highest rate of infant mortality in the United States. You have the highest rate of child poverty in the United States. Your state has no guaranteed maternity leave that’s paid. The legislature in Mississippi just rejected extending post-partum Medicaid coverage. Your foster care system is also the subject of a long-running federal lawsuit over its failure to protect children from abuse. You say you want to do more to support mothers and children, but you’ve been in state government since 2004. Based on the track record of the state of Mississippi, why should anyone believe you?

Reeves: I believe in my heart that I was elected, not to try to hide our problems, but to try to fix our problems. We are focusing every day on fixing the challenges that are before us.

Good luck, Governor. You and all those “unborn” children who are about to be “saved” are going to need a lot of it. And so are the Mississippi women who are about to become the state’s newest victims.

 

 

 

 

How Much Does Truth Matter In America Today?

Friday, March 18th, 2022

In 399 BCE, the Greek philosopher Socrates was accused of corrupting the youth of Athens and impiety, in that he “failed to acknowledge the gods that the city acknowledges.” He was tried, found guilty on both charges by a jury of male Athenians chosen by lot, and condemned to death.

Socrates real crime was in challenging his students to think critically. He asked political and philosophical questions and did not accept trite answers. Athenian leaders and other intellectuals resented his elenctic method of questioning, because it threatened their own credibility.

The trial of Socrates is an early example of a state restricting the knowledge its citizens can access and debate, and ever since then autocrats have done exactly that to get and maintain power.

In the 20th century, Adolph Hitler rose to power by building his own falsity factory and feeding the German people only a single version of “the truth.” And today, Vladimir Putin, a modern-day a devil disguised in a bespoke suit of skin, has imposed a crude and draconian crackdown on anyone who doesn’t toe the company line. I find it interesting that yesterday Kremlin spokesman Dmitry Peskov, defending Putin from nearly worldwide condemnation, called him a, “very wise, prescient, and cultured international figure.” That’s rich.

Here in America, we daily face similar attempts, some subtle, some not, to package lies and sell them as gospel truth. They pummel us from all sides. The tragedy is that so many of us open wide and swallow.

A case in point can be found in many states that are now restricting what teachers can teach and what books their students can read. Right now, in eleven states, teachers and librarians can be prosecuted for violating restrictions recently enshrined in law by their legislators and governors.

Reading these laws (I did), one gets the impression they were mostly written by the same person. Their focus is race and sex. They all contain the the following language taken from Texas that prohibits teachers from introducing a concept by which:

(vii)  an individual should feel discomfort, guilt, anguish, or any other form of psychological distress on account of the individual’s race or sex;

Right on page one, in South Dakota’s summary of its new law it says it aims to “protect students and employees at institutions of higher education from divisive concepts.” Whatever they are.

Similar versions of these restrictive laws have been passed in Arizona, Florida, Idaho, Iowa, North Dakota, Oklahoma,. South Carolina, Tennessee, Texas, Utah and Mississippi.

FutureEd has done a good job of cataloguing both the enacted legislation and the bills currently under consideration devoted to racism and sex. You might want to visit. There are 96 of them, nearly all of them in red states.

Imagine yourself a history teacher in any of these states. How do you cover The Mud Sill speech of South Carolina Senator James Henry Hammond, delivered in the U.S. Senate on 4 March 1858, without causing some “discomfort”? That’s the speech in which Hammond said:

In all social systems there must be a class to do the menial duties, to perform the drudgery of life. That is, a class requiring but a low order of intellect and but little skill. Its requisites are vigor, docility, fidelity. Such a class you must have, or you would not have that other class which leads progress, civilization, and refinement. It constitutes the very mud-sill of society and of political government; and you might as well attempt to build a house in the air, as to build either the one or the other, except on this mud-sill. Fortunately for the South, she found a race adapted to that purpose to her hand. A race inferior to her own, but eminently qualified in temper, in vigor, in docility, in capacity to stand the climate, to answer all her purposes. We use them for our purpose, and call them slaves.

Or, how do you discuss the Cornerstone speech of Alexander Stevens, Vice President of the Confederacy, former U.S. Representative from Georgia, and future Governor of Georgia in 1882? In the Cornerstone speech, he said:

Our new government is founded upon exactly the opposite idea; its foundations are laid, its corner-stone rests, upon the great truth that the negro is not equal to the white man; that slavery subordination to the superior race is his natural and normal condition.

It seems to me a violation of all that’s sacred to sugar-coat this stuff. In discussing it with intellectual honesty, a teacher is probably going to offend somebody somewhere, be it a student, a parent or a politician. The truth requires honest discussion of all of America’s history, both the good and the awful. An open discussion in the safety of a classroom where students are free to think critically, and are led by a teacher drawing out the best their brains have to give in the manner of Socrates is good for the students and for the future of America.

Painful though it may be, truth matters.

 

 

 

Zelenskyy’s Heroism, Women’s Long March To Equality, And Then There’s Ron DeSantis

Tuesday, March 8th, 2022

“Be not afraid of greatness. Some are born great, some achieve greatness, and others have greatness thrust upon them.” — William Shakespeare, Twelfth Night

Ukraine update

Last night, Ukriane’s president, Volodymyr Zelenskyy, posted a nine-minute video from the Presidential Office Building on Bankova Street in central Kyiv.

Zelenskyy opened from a window looking out over Kyiv at night (a nice way to show everyone he was really there), and then selfied his way down corridors to his office where he sat at his desk to address the world, as well as the people of Ukraine. His fierce determination not only to defend Ukraine, but, more than that, prevail against a barbaric enemy was on full display. Speaking for all Ukrainians, he said, “I’m here, it’s mine, and I won’t give it away. My city, my community, my Ukraine.”

He closed his address by letting the nation know he had earlier in the day bestowed medals for bravery on 96 “heroes.” He then singled out five and described what they had done to earn the medals. Brilliant stuff.

Zelenskyy continues to unite his country and keep its spine stiff. His leadership, his rhetoric, his example are sharp enough to slice bread. He must be setting Putin’s hair on fire.

International Women’s Day

Today is International Women’s Day, and The Economst has released it’s annual glass-ceiling index, which measures the role and influence of women in the workforce across the countries of the Organization for Economic Cooperation and  Development (OECD).

According to The Economist:

A country’s performance on the index is measured along ten metrics, including the gender pay gap, parental leave, the cost of childcare, educational attainment and representation in senior management and political jobs.

We give more weight to the indicators which affect all women (such as labour-force participation) and less to those which affect only some (such as maternity pay). Paternity pay is also included. Studies show that where fathers take parental leave, mothers tend to return to the labour market (emphasis added), female employment is higher and the earnings gap between men and women is lower.

That “return to the labour market” point is important, given the tremendous difficulty American women are having right now in returning to the labor market due to the ridiculous cost of child care.

It is unfortunate that, in this year’s glass-ceiling index, the United States continues to rank lower in how it treats its women than the OECD average, 20th out of 29 countries.

You may notice the top four countries in the rankings, Sweden, Iceland, Finland and Norway, are Nordic countries so often ridiculed by conservatives as prime examples of “totalitarian socialism.” Actually, these countries have combined successful capitalism with, yes, welfare state benefits that allow their citizens to have a high standard of living, universal health care, and life expectancies higher than most other countries, certainly higher than the U.S.

But all is not Panglossian with the Nordic Model. These countries have large challenges, most notably what to do about an aging population and an influx of immigrants. Time will tell whether they’ll be able to marshal the political will to deal successfully with these significant headwinds.

That said, on International Women’s Day it seems fitting to suggest that, due to the collective culture the Nordics have fostered, their women are much better positioned for success than their peers in America. It pains me to write that.

DeSantis continues to be…well, DeSantis

Yesterday, at the conclusion of a 90-minute virtual video forum (make that show) in West Palm Beach, Florida’s Governor Ron DeSantis and his Surgeon General Joseph Ladapo announced a new state policy that will recommend against giving a coronavirus vaccine to healthy children, regardless of their age.

Sitting in front of what could have been mistaken for an IMAX screen where hundreds of forum participants were pictured, Ladapo enthusiastically proclaimed, “Florida is going to be the first state to officially recommend against the covid-19 vaccination for healthy children.”

Let’s hope it’s the last one, too. National data from the Centers for Disease Control and Prevention show more than 40 Florida children, from birth to age 17, have died from COVID-19. Nationally, the number is nearly1,600.

In an interview reported in today’s Washington Post, Peter Hotez, a professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and a leading expert on the virus, said, “To be at such distinct variance from the hundreds of physicians and scientists at the CDC and the FDA is reckless at best and dangerous at worst.”

Look, we get it that Governor DeSantis features himself as the next president of the United States and that he’ll say or do just about anything to get there. This is the man who just last week bullied a group of high school students for wearing masks at an event at the University of South Florida. “You do not have to wear those masks. I mean, please take them off. This is ridiculous,” he told the teens just before slamming his folder on a lectern.

These folks are playing with kids’ lives, all for their own opportunistic and hypocritical ends. I can only hope there’s a special place in hell reserved for such people.

I’ll leave you today with this question: How do you think DeSantis would do in Zelenskyy’s chair on Bankova Street? Or, would he have skedaddled to safety before the fun began?

Just a thought.

 

 

North Carolina And Ohio: Worlds Apart

Friday, January 14th, 2022

Law requires all the states to redraw their state and congressional districts in the year following the decennial census of the country. Once they do that their legislatures approve the new maps, and the maps become enacted law. Then the lawsuits begin.

Yesterday, I wrote about a State Court Panel of the North Carolina Superior Court’s decision, rendered on Tuesday of this week, to uphold that state’s recently enacted election redistricting maps, maps the Court strongly affirmed were examples of extreme partisan gerrymandering in every respect in every district. Why? Because the Court said history had shown that’s the way the legislature and the state’s electorate wanted it regardless of which Party was in power.

It’s about 480 miles from Raleigh, capitol of North Carolina, to Columbus, capitol of Ohio. But from yesterday’s ruling on the same subject by the Ohio Supreme Court, you’d think they were on separate planets.

The three signers of the North Carolina decision are Republicans, and in the Ohio Supreme Court there is also a Republican majority. But on a 4-3 vote, with Chief Justice Maureen O’Connor, a Republican, siding with the three Democratic Justices, the Court invalidated the GOP’s recently-drawn legislative maps.

The Ohio Constitution requires mapmakers to attempt to match the statewide voting preferences of voters over the past decade. That amounts to 54% for Republican candidates and 46% for Democratic candidates. According to the decision, “The commission is required to attempt to draw a plan in which the statewide proportion of Republican-leaning districts to Democratic-leaning districts closely corresponds to those percentages.” The Court ruled that did not happen. What did happen was extreme partisan gerrymandering.

Until November 2015, Article XI of Ohio’s constitution specifically allowed, and the Court upheld, partisan gerrymandering. However, in that year Ohio voters overwhelmingly approved an amendment to the constitution repealing Article XI and replacing it with a new version, which established a new process for creating General Assembly districts. The amendment provided for the creation of a seven-member Ohio Redistricting Commission, composed of elected officials, such as the Governor and other legislative leaders. The Ohio Redistricting Commission that drew up the new maps under dispute consisted of five Republicans and two Democrats.

The Ohio commission is responsible for redistricting the boundaries of the 99 districts of the House of Representatives and the 33 Senate districts in the year immediately following the release of the federal decennial census. This is the same procedure followed in North Carolina and in every other state. However, Section 6 of Ohio’s new Article XI mandates: “No general assembly district plan shall be drawn primarily to favor or disfavor a political party.” Further, “The statewide proportion of districts whose voters, based on statewide state and federal partisan general election results during the last ten years, favor each political party shall correspond closely to the statewide preferences of the voters of Ohio.”

And that’s not all. The Court’s majority, interpreting the state’s constitution, wrote, “To adopt a plan under Section 1(C) (of Article XI), at least two members of each of the two largest political parties represented in the General Assembly must be in the majority voting for the plan.” Wow! The Ohio Supreme Court’s interpretation of the state’s constitution is requiring Republicans and Democrats to work together to establish state voting districts. With respect to gerrymandering, the Court has handcuffed the partisan Commission.

The Ohio Supreme Court’s decision is 146 pages (Thank you very much; North Carolina’s was 260.). The beginning of it gives a highly readable history of the drawing up of the maps. Anyone interested in an application of the quote about laws and  sausages misattributed* to Germany’s Iron Chancellor Otto von Bismarck should read pages 6 through 21. Enough said.

Because 2 February 2022 is the deadline in Ohio for candidates for legislative offices to submit petitions and declarations of candidacy, the Court ordered the Commission to meet, draw up, and submit new redistricting maps to the Court within ten days of its decision.

In yesterday’s column I wrote about North Carolina’s two decade charade in which the Party out of power repeatedly calls for an Independent Commission to formulate map redistricting, rather than elected officials. That is, until they come to power, when it suddenly doesn’t seem like such a good idea. In Chief Justice O’Connor’s concurring opinion she begins by saying she agrees with everything in the Court’s decision and order. But then she goes into depth about how Ohio’s voters might want to amend the Constitution again in order to create such an Independent Commission in an attempt to stop all the partisanship, or at least slow it down. She analyzes Arizona’s decision to do just that. In my next column, I’ll examine the Arizona change and report on its results thus far.

But for the moment, ask yourself this: Are we one country, or are we fifty countries? Are the shenanigans that go on every ten years in every state capitol what we really want for America? Or, do we want one, unified system that insures all elections, at least at the federal level, are governed by the same rules?

I’d love to know how America’s voters, not America’s legislators, would answer those questions.

*The true author is now  believed to have been American poet John Godfrey Saxe, who said it in 1869, 25 years before Bismarck. Saxe’s exact quote is, “Laws, like sausages, cease to inspire respect in proportion as we know how they are made.”

 

 

 

Reflections On WCRI’s Recent Virtual Annual Conference: In A Word, It Was Excellent

Tuesday, March 30th, 2021

COVID-19 impact analysis

Last year, the Workers’ Compensation Research Institute held its Annual conference in Boston at the Westin Hotel on 5 and 6 March. The ballroom was full. COVID-19 was talked about in the conference and on the breaks, but it was too new to be on the Agenda. Everyone was doing elbow bumps instead of hand shaking. Four days after the conference wrapped, Governor Charley Baker declared a Massachusetts State of Emergency. The WCRI conference was likely the last one held in the City before everything shut down.

At that time, per the Johns Hopkins University COVID-19 Dashboard, the nation had seen ~139,000 cases and 2,425 deaths. In Massachusetts, where the conference was held, there had been 4,955 cases and 48 deaths.

The following month, the National Council on Compensation Insurance (NCCI) issued a Research Brief titled, COVID-19 and Workers’ Compensation: Modeling Potential Impacts. 

NCCI’s analysis projected a best case scenario, in which loss costs would increase $2 billion, and a worst case scenario, in which they would increase $81.5 billion, or 250% more than then current total loss costs. Willis Towers Watson also released a scenario-based analysis that suggested pretty much the same thing.

Also in April, the California Workers’ Compensation Insurance Rating Bureau (WCIRB) projected loss costs if conclusive (rebuttable) presumptions were provided to front line workers, something Governor Gavin Newsom actually did through Executive Order one month later, so the “if” became a “done.” The WCIRB report concluded costs would range “from $2.2 billion to $33.6 billion with an approximate mid-range estimate of $11.2 billion, or 61% of the annual estimated cost of the total workers’ compensation system prior to the impact of the pandemic.

A year later, at this week’s virtual annual conference, WCRI Economist Olesya Fomenko, Ph.D., reported results from her analysis of workers’ compensation claims in WCRI study states for Q1 and Q2, 2020. This period, ending 30 June, encompassed the pandemic’s first of what has been up to now three surges.*

Her data and presentation slides are preliminary, but more than likely will stand up to future scrutiny. Her findings confirmed what most students of COVID-19 were intuitively thinking. To wit, it does not appear that, at least through the study period of two quarters, COVID-19 would deal a death blow to the workers’ compensation industry. Claims in her analysis of 27 study states are plentiful, but relatively inexpensive. There is wide variation in the geographic distribution of claims, probably because COVID-19 surged at different times in different states. New York is not among the WCRI study states, but during the period of Fomenko’s analysis, it was the state with more COVID problems than any other. A lot more.

During the study period, Massachusetts, Connecticut and New Jersey had the most reported claims. Massachusetts claims were 42% of all reported claims in the study states and 59% of all lost time claims. Dr. Fomenko suggested that the presence of presumption laws, pay without prejudice (in the case of Massachusetts) and other compensability issues (in New Jersey) might is some way contribute to the high numbers in those states.

Looking at Massachusetts for a moment might be instructive.

At the top of this column we showed Massachusetts with relatively few cases as of early March, two-thirds of the way through Q1. Let’s look at Massachusetts now, at the end of Q1 a year later. The state has been hit hard, but has also rebounded. Here’s a look at the state by county:

As you can see, no county has had less than 3,000 infections, and three have had more than 10,000. But what came of those infections? How did the patients make out medically? Here is a look at cumulative cases from 9 March 2021 through yesterday, 29 March 2021.

There have been 17,130 total deaths since the beginning of the pandemic, but 97% of infected patients have recovered. Deaths are at 3%, which is less than the 5% predicted by the CDC one year ago. And this is the case for most of the country, and is one of the reasons Dr. Fomenko’s data shows claims to be relatively inexpensive.

NCCI Analysis

The WCRI studies define the concept of “early days.” So do those from the National Council on Compensation Insurance (NCCI). The point is, however, that analyses from both organizations appear to be congruent and complementary.

The lasting costs of COVID-19 to the workers’ compensation industry, aside from deaths, are going to come from permanent total and permanent partial disability awards. To that end, in October, 2020, NCCI published a Research Brief updating the Brief cited earlier in this column and titled, COVID-19 And Workers’ Compensation: Permanent Disability. These costs will be significant. NCCI’s analysis determined the average age of hospitalized COVID-19 patients at 49.5 years old. Average life expectancy allows for about 30 more years of benefits. The organization writes:

Given that severe cases are expected to have a higher likelihood of permanent disability, particularly PTD injuries, NCCI
assumed that all PTD claims would occur in this symptom grouping (infections and lung claims). Adjusting our PTD rate to between 0.0% and 1.5% to be applicable to only severe cases, we observe a PTD rate between 0% and 10% (= 1.5% / 15%) using the default Critical Care Rate from the NCCI Hypothetical Scenarios Tool.

Permanent Partial Disability cases are another matter. Here the frequency will be higher as well as the costs:

One interpretation of this assumption could be that moderate cases behave more like infection claims which tend to have a
near-zero PTD rate. If we compare the lung and infection PPD rates, we observe that lung claims have about twice the
likelihood of a PPD injury compared to infection claims. To the extent that moderate cases of COVID-19 behave like
infection claims and severe cases behave like lung claims, then a similar difference in the PPD rate may be expected. Under
this view, the Severe PPD rate would range between 40% and 50% with an implied Moderate PPD rate ranging between
20% and 25%.

With assumptions it clearly states contain wide variability, NCCI suggests the following COVI-19 benefits by injury type:

We’ll continue to follow the NCCI analyses as well as WCRI’s ongoing research.

Interview by John Ruser, PhD, with John Howard, MD, MPH, JD, LLM, MBA

John Howard is the longest serving Director of the National Institute for Occupational Safety and Health, three terms and counting. He is a legend in the field, and WCRI attendees got a good look at why during this wonderful interview by John Ruser. Howard, who has more letters after his name than there are years in elementary and high school combined, put on quite a show.

Some people are one inch wide and ten miles deep; others ten miles wide and one inch deep. Howard seems to know no inch or mile boundaries.  His subject was The Future of Work, and he made a number of highly interesting and prescient points, even going so far as to describe Aristotle’s concerns about automation in the ancient world of 350 BCE.

Asked about fears of jobs disappearing because of Artificial Intelligence and automation, Dr. Howard pointed to a study showing that in 2018 there were 60% more jobs than existed in 1940. Jobs have always gone away, but they’ve been replaced, and then some, by new jobs.

He’s concerned about a safety ergonomic vacuum employers are going to have to manage somehow. He believes employers are facing a “real challenge” adjusting to the new Work From Home paradigm.

My question is: How do employers deal with, let alone manage, workers’ compensation claims bound to occur while working in the home. You’re at your desk or dining room table working, get up for lunch, fall down the stairs and break an arm. Is that compensable? Is your employer going to make you prove it actually happened while you were actually working, and not just taking Junior out to the back forty for a little tag football?

And what responsibility does an employer have with respect to OSHA’s General Duty Clause, the one about providing a safe and healthful workplace?

If anyone can figure this stuff out, my money’s on John Howard.

Conclusion

Under trying circumstances, WCRI did an admirable job of hosting its 2021 Annual Conference. I’m told attendees gave it high marks, as well they should have. At the end of the second day, Dr. Ruser announced next year’s conference as being back in Boston’s Copley Westin Hotel on 15 and 16 March 2022. And I have a suggestion: After this ridiculously stressful year, it would be helpful and probably appreciated to devote a session to the impact of COVID-19 on employee mental health. A lot has happened in the last year to the field of Behavioral Health. It seems to have fitted in quite well to the new paradigm called Telehealth. It would be interesting to learn about that.

 

* Yesterday, CDC Director Dr. Rochelle Walensky said, “We do not have the luxury of inaction. For the health of our country, we must work together now to prevent a fourth surge. I so badly want to be done. I know you all so badly want to be done. We are just almost there, but not quite yet.” Walensky said she is now feeling a sense of “impending doom.”

**The Future of Work: The Economist is presenting a discussion on 8 April, at 4 pm, EST. To reserve a place, go here.

The Georgia Election Integrity Act: A Desperate Attempt By The Republican Party To Retain Power

Monday, March 29th, 2021

There was already a perfectly fine election statute in the state of Georgia. Perfectly fine. Chapter 2 of Title 21 of the Official Code of Georgia Annotated had just completed governing the November election for President and the January election for two US Senate seats. The Presidential election had withstood lawsuits and multiple audits and been judged to have been exemplary on all counts. It was a perfectly fine statute, except for one thing: The wrong people won. And they were Democrats.

The Republican elites, who currently hold the key to the Governor’s office, as well as majorities in both the Georgia House of Representatives and Senate, could not abide that. Something had to be done. And something was. Senate Bill 202 amended the perfectly fine Chapter 2 of Title 21 of the Official Code of Georgia Annotated. It became the Election Integrity Act.

The Election Integrity Act was signed into law last Friday by Governor Brian Kemp behind locked doors, no reporters allowed, in the presence of six other aging white guys (and a photographer, for whose presence and work we are grateful) and in front of a painting of the Calloway Plantation, where, in the mid-19th century, more than 100 Black Slaves toiled day and night to make the very white Calloway family ever so comfortable and rich.

As Governor Kemp, who, ironically, served as Georgia’s Secretary of State from 2010 to 2018, was getting ready to sign this obviously much-needed legislation, State Representative Park Cannon, who is Black, knocked on the locked door asking to be let in to observe. For her trouble, she was arrested by three burly state troopers and hauled off in handcuffs, and now faces two charges: willful obstruction of law enforcement officers by use of threats or violence and preventing or disrupting general assembly sessions. Video taken at the time showed none of that.

After the unfortunate interruption, Kemp signed the amended legislation, shook hands with the six aging white guys, and that was that.

That was that, that is, until certain people, including the current President of the United States, upset with the whole thing, noticed the wording in lines 1,872 through 1,881, which is this:

So, unless you have a 26 foot pole with a drink on the end of it, you’re not giving water to anyone standing in the Georgia Sun patiently waiting to cast a ballot. If you do, you’ll share Representative Cannon’s fate. In his nationally broadcast press conference, President Biden called this provision of the law, “sick.”

A new national study led by economist Keith Chen of the University of California, Los Angeles, found voters in predominantly black neighborhoods waited 29 percent longer, on average, than those in white neighborhoods. They were also about 74 percent more likely to wait for more than half an hour.

The new food and drink prohibition quite understandably got a lot of press attention. It oozes racism. But throughout the amended statute one will find other instances of intentional voter suppression. For example:

  • Drop boxes: Created by emergency rule due to the pandemic, these proved extremely popular during the two elections in question. In heavily democratic Fulton County, alone, 146,000 votes were made by absentee ballots placed in drop boxes. Republicans noticed immediately.

“As soon as we may constitutionally convene, we will reform our election laws to secure our electoral process by eliminating at-will absentee voting,” the Georgia Senate Republican Caucus wrote in an 8 December email. “We will require photo identification for absentee voting for cause, and we will crack down on ballot harvesting by outlawing drop boxes.”

The result in the Election Integrity Act: No more than one drop box per county. Officials, at their discretion, may place others, but no more than one per every 100,000 voters.

  • Voter challenges: In Georgia, voters are called “electors.” Prior to the new legislation, any elector could challenge the qualifications of anyone applying to register to vote or could challenge anyone whose name appeared on a list of registered electors. The Election Integrity Act added the following sentence: There shall not be a limit on the number of persons whose qualifications such elector may challenge. One can imagine an entire group of people being challenged.
  • Mobile Voting Buses: Under the old legislation, groups could use buses, approved by the Secretary of State, as mobile voting centers. Two were used in predominantly minority Fulton County (I cite Fulton County again, because in his infamous call with Secretary of State Raffensperger, President Trump mentioned the County 11 times in his quest to get Raffensperger to find him 11,780 votes). The Election Integrity Act prohibits Mobile Voting Buses.
  • Absentee Ballots: The Election Integrity Act, which is 2,427 lines long, devotes more than 1,450 to redesigning Georgia’s entire absentee ballot system. It is obvious Georgia’s Republican Party abhors the very thought of absentee ballots, even though a significant number of Republicans vote by absentee ballot. The law prohibits no-excuse absentee ballot application, as well as the universal sending of absentee ballot applications to all registered voters. Absentee ballot violations are considered felonies by the new legislation.
  • The Secretary of State: Until Brian Kemp signed the Election Integrity Act, the Secretary of State, as in most U.S. states, was responsible for conducting elections. But Raffensperger and those in his office angered many fellow Georgia Republicans during the presidential and senate races, because, after exhaustive audits, they found no fraud significant enough to change anything. The new law strips him of his authority by creating an Elections Board, whose chairperson will be elected by the legislature. The Secretary of State is now an ex-officio, non-voting member of the Board.

It is understandable why Georgia republicans are going to such lengths to suppress minority voting. Consider this from statistics from Georgia’s Secretary of State:

  • Since 2000, the percentage of white voters in Georgia has decreased from 68% to 58%. At the same time, the Black voting percentage has increased from 27% to 33% of total voters.
  • From 2000 through 2019, Georgia’s eligible voting population grew by 1.9 million; 48% were Black. White growth was only 26%.
  • The majority of single-race Blacks live in the South – 59%

As the proportion of white voters in the nation continues to shrink, the Republican Party is shrinking right along with it. It is unmovably the Party of Barry Goldwater and his small tent, Ronald Reagan and his “welfare queen,” and, of course, Donald Trump and his racist white supremacy. It is exhibiting all the characteristics of the self-cannibalistic rat snake that cannot stop itself from eating itself. Georgia’s Election Integrity Act is nothing more than a desperate attempt by the aforementioned aging white guys to blunt the impact of an irresistible demographic force.

In the end, it will fail.  Democracy will prevail.

Seven Days

Tuesday, October 27th, 2020

A diversion

How about a break from anything having to do with COVID-19 or the election? Would you like that? Then let me tell you a story.

Long ago, in a galaxy far away, a 23-year-old, newly-minted, Infantry 2nd Lieutenant airborne ranger with my name spent two-plus years in a little country in Southeast Asia called Vietnam. I think if Donald Trump had foregone the fake bone spurs and taken his chances over there he might have learned a lot.

But that’s another story, and not the point of this one. Couldn’t help myself.

Three months before rotating home to the U.S., I had been pulled from the field, that is, taken out of the jungle, and given a staff job on Firebase Vegel in northern South Vietnam.

With two months to go, I decided to begin keeping a Short-timer’s Calendar.

My Short-timer’s Calendar consisted of the centerfold of the June, 1971, Playboy magazine. My Battalion Commander, Lt. Colonel  Bulldog Carter (that’s right, Bulldog), and my partner, Buck Kernan (who went on to become a Lieutenant General, like his father before him), marked up the luscious photo into 60 puzzle-like areas numbered from 60 down to one. The trajectory of the progression became increasingly lascivious.

Thereafter we held a nightly, candle-lit ceremony in the bunker occupied by Buck and me.

But before I describe the ceremony, I have to tell you about the Macadamia nuts.

During Vietnam  the army  allowed soldiers a ten-day R&R (Rest and Relaxation) vacation. As a two-year guy I got two of them, which I spent in Honolulu, Hawaii, with my wife, Marilyn. One day, during the second R&R, we went to the PX (Post Exchange) at Scofield Army Barracks to pick up a couple of things. While we were there we bought a large bottle of Macadamia nuts for me to take back to Vietnam. In Vietnam, little things became luxurious delicacies.

Back to the ceremony.

Our bunker had a single bunk bed. There was only one bed, because Buck and I took 12-hour shifts in the Op Center keeping the world safe for democracy. One of us would end his shift, wave to the other and crash into the bed.

Every night, at 2000 hours, 8:00 pm to you, the three of us would gather in the bunker. There was a small table to the side of the bed.  I had pinned the centerfold to the wall above the table. At the appointed hour, I would light two candles and place them on each side of the table under the pin-up. I would open the bottle of Macadamia nuts, which occupied a special spot in the center of the table, and hand each of my comrades one nut, taking one for myself. We would then have a moment of quiet reflection, after which I would, with a red marker purloined from the Op Center, X-out the next descending number on Miss June.

We would then eat the nuts.

We did that all the way down to ONE! On that night, we held a special ceremony, inviting the Battalion XO, the other six staff officers and the Battalion Sgt. Major into the bunker, which became almost as crowded as the stateroom scene in Night at the Opera. We gave everyone a Macadamia nut that night, and, in a service worthy of priestly ordination, I passed the bottle of Macadamia nuts to Buck, who, because he still had six weeks to go, later on would replace my centerfold with his centerfold and continue the tradition. We retired my centerfold to a place of prominence on the side wall of the Op Center, where Bulldog could see it every day all day. Six weeks later, Buck’s would be hung beside it.

The next day, I choppered south, boarded a chartered Pan Am plane with about three-hundred other happy guys and flew home to what we called “the world.”

OK. Break’s over

If it weren’t so stupidly tragic and delusional, one might be forgiven for viewing Donald Trump’s campaign swan song as comical. “We’ve turned the corner.” “It will go away.” “On November 4th, you won’t hear about it anymore.” And the list goes on.

But if you really want to know how we’re doing, there are, actually, reliable places to look. Johns Hopkins Coronavirus Resource Center and the New York Times COVID Tracker, for example.

And now there is this website, which tracks the Rt factor for each state, daily. Rt represents the effective reproduction rate of the virus calculated for each locale. It lets us estimate how many secondary infections are likely to occur from a single infection in a specific area. Values over 1.0 mean we should expect more cases in that area, values under 1.0 mean we should expect fewer. As of today, only one state, Mississippi, of all places, is below 1. You can see what infection rates are like today, two weeks ago, one, two and three months ago. It confirms what all of us, except the aforementioned Mr. Trump, his minions and cult-like followers, know to be true.

If we’ve “turned the corner” it is only to enter Dante’s Ninth Circle of Hell. You remember that one, don’t you? It’s the final, deepest level of hell, reserved for traitors, betrayers and oath-breakers. Up until now, it’s most famous occupant had been Judas Iscariot.

Up until now.

And finally…

Seven days to go.

The number seven comes up a lot in Roman Catholicism. There are seven Cardinal Virtues, called by the church, “Gifts of the Holy Spirit.” They are wisdom, understanding, counsel, fortitude, knowledge, piety, and fear of the Lord.

There are seven Corporal Works of Mercy. They are feed the hungry, shelter the homeless, clothe the naked, visit the sick and imprisoned, bury the dead, and give alms to the poor.

And there are seven Spiritual Works of Mercy. They are instruct, advise, console, comfort, forgive, and bear wrongs patiently.

Judge, now Justice, Amy Coney Barrett is a devout Roman Catholic. I’m sure she is also a very smart person and probably a pretty good lawyer, too.

But for a month now, I’ve been bothered by something about her, and with seven days to go, I’m bothered even more.

For the life of me I cannot get over that, at her super-spreader Rose Garden introduction and follow-on reception in the White House, she did not wear a mask to protect herself and others. I understand everyone else who attended had swallowed the Kool-Aid, but she should have known better. And last night, in the White House Blue Room and outside on its balcony, she was still unmasked.

There are only three possibilities for this behavior.

  1. She doesn’t believe masks protect us and others from the virus, which I don’t believe for a minute;
  2. She is ignorant about masks and doesn’t understand their importance, which I don’t believe for a second;
  3. She was influenced by Trump’s behavior, as well as that of everyone else’s, and just went along to get along.

I’m voting for door #3, and that is a scary thought for our future.

Seven days.

 

 

It’s Been Quite A Week — Here Are Some Things You Might Have Missed

Saturday, October 24th, 2020

From the Department of There’s No Accounting For Stupidity

Since 1980, the population of Idaho has grown from about one million to nearly 1.8 million, considerably outstripping the rate of growth of its neighbors Montana and Wyoming. Over the last 14 days, all three states have seen large spikes in Covid-19 cases, according to the New York Times’s Covid Map and Case Count. And they’re not alone. All the Midwest and Pacific region states are seeing similar surges. Their governors are faced with balancing increased restrictions with the personal freedom inherent in pioneering individualism.

Nowhere did this daunting task become more evident than Thursday in Idaho, a state that has seen a 55% rise in cases in the last two weeks and where, minutes after hearing local hospitals were approaching full capacity necessitating moving patients to Seattle, of all places, the regional health board voted to repeal the local mask mandate.

The regional board, composed of seven appointed members with no requirement to have any medical experience, voted 4-3 to end the mandate. Health District epidemiologist Jeff Lee had just finished describing how the state’s hospitals were becoming “overwhelmed” by the surge in cases. For example, even after doubling up patients in rooms and buying more hospital beds, the hospital in Coeur d’Alene had reached 99% capacity. But, not to worry, it’s just an eight hour, 493 mile ambulance ride from Boise to Seattle.

“We’re facing staff shortages, and we have a lot of physician fatigue. This has been going on for seven months — we’re tired,” Lee said.

He introduced several doctors who testified about the struggle COVID-19 patients face, the burden on hospitals and how masks reduce the spread of the virus. But that didn’t matter to the Board’s majority who just did not see the sense in masks, no matter what the experts said.

To put a period on the “Health” Board’s meeting, member Allen Banks got to the heart of the matter by denying the existence of Covid-19. Lecturing the medical professionals who testified, he said, “Something’s making these people sick, and I’m pretty sure that it’s not coronavirus, so the question that you should be asking is, ‘What’s making them sick?”

That penetrating question came from a gentleman with a Ph.D. in chemistry from the University of Colorado, who for 30 years has worked in medical research in biotechnology and pharmaceutical development.

Dr. Banks would make a wonderful addition to the White House Coronavirus Task Force.

How cold is cold enough?

Have you stopped to consider the logistics of delivering upwards of 200 million doses of a future Covid-19 vaccine? That’s a lot of syringes. If you laid them end to end they would stretch from the North Pole to the South Pole, about 13,000 miles.

And the vaccine would have to be kept cold, very cold. Just how cold you ask? Try minus 103 Fahrenheit. That’s nearly four times colder than your home freezer, colder even than Antarctica in the dead of winter.

This is a complex challenge. For months, manufacturers, federal and state governments, and large health care systems have been quietly planning how to navigate this ultra “cold chain” that stretches from vaccine manufacturers to hospitals, nursing homes, doctors’ offices, and many far-flung clinics. Now that Pfizer has announced it plans to apply for emergency-use authorization designation in late November for its vaccine currently in Phase 3 trials, solving the cold problem becomes more urgent.

The nation’s governors wrote the Trump Administration last Sunday expressing concerns about the supply of ultracold freezers and dry ice — already experiencing shortages. Pfizer says it has developed specially designed, temperature-controlled shipping packages, using dry ice, to keep its vials at roughly minus 103 below Fahrenheit for up to 10 days. But what happens if the doses are not used in ten days? This is what is confounding the governors.

This issue is even more difficult than it appears, because the vaccines of both Pfizer and Moderna, another leading vaccine developer in Phase 3 trials, require two shots within 21 and 28 days, respectively. The situation is eased somewhat, because Moderna’s vaccine, at around minus 4 Fahrenheit, does not require the same ultra-cold storage temperature as Pfizer’s.

Might be a good time to buy stock in a maker of dry ice.

High Deductibles: Another nail in the rural hospital coffin

Since 2010, more than 130 rural hospitals have closed, 15 thus far in 2020. One mostly overlooked reason is the health insurance deductible. Depending on the plan (employer-sponsored, ACA Marketplace, etc.) a family deductible can range from $0 (but the out-of-pockets are huge) to well over $8,000.

Families in rural communities often face deductibles in the $2,000 to $4,000 range. And when family members require hospitalization, it often happens they cannot pay the deductible. Rural hospitals are forced to eat this less than tasty bill, send it to a collections company, or set up a payment plan with the patient. They prefer the payment plan route, but this significantly delays getting the money, and the bill is often reduced because of the patient’s economic circumstances. So, the hospital goes further in the red and its patients go further in debt. The pandemic has only exacerbated this problem.

Just another example of our nation’s dysfunctional health care “system.”

How to get rid of an irritating federal employee

Despite a great swath of the public thinking otherwise, federal employees can be fired, although it is true that this happens rarely. Of the 2.1 million federal employees about 10,000 are terminated annually, according to the Merit Systems Protection Board (MSPB).

Firing a federal worker is similar to what would occur in the private sector, with one twist. In both settings, best practice recommends, and the federal system requires, the three step verbal warning, written warning, termination process. The twist comes after that. Federal employees can appeal to the MSPB, and the appeals can take a long time to adjudicate.

This past week, the Trump administration threw an interesting log on the fire when the President issued an Executive Order stripping long-held civil service protections from employees whose work involves policymaking. This will affect tens of thousands of workers, and will reduce them to being, for all practical purposes, “at will” employees, meaning they can be fired for cause or not for cause at a moment’s notice.

Under this order, federal scientists, attorneys, regulators, public health experts and many others in senior roles would lose rights to due process and in some cases, union representation, at agencies across the government.

These are not politically appointed employees who require confirmation to their positions, whom the president can terminate or have terminated by whim. Rather, they are professionals who serve as a cadre of subject-matter experts for every administration. I will let you consider the possible ramifications of this Executive Order, which to me seem profound. The Order, while not affecting a majority of the government, could upend the foundation of the career workforce by imposing political loyalty tests.

It is possible, with less than two weeks before election day, this may be more symbolic than real, because the Order requires agencies to indicate employees who would be affected by 19 January 2021, a day before the next inauguration. If Joe Biden wins the election he would be unlikely to follow through on the president’s order. But if Donald Trump is re-elected, this tectonic Order will monumentally reshape the federal service.

Think about that. Please.