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Medicaid Officials Target Home Health Aides’ Union Dues Medicaid home care aides — hourly workers who help the elderly and disabled with daily tasks like eating, getting dressed and bathing — are emerging as the latest target in the ongoing power struggle between conservatives and organized labor. About half a million of these workers belong to the Service Employees International Union, a public-sector union that represents almost 1.9 million workers in the United States and Canada. The union is an influential donor to liberal politicians and boasted strong ties to the Obama administration. A proposed rule from the federal Centers for Medicare & Medicaid Services would prohibit home health aides paid directly by Medicaid from

having their union dues automatically deducted from their paychecks, though it doesn’t name the fees explicitly. Blocking these direct Medicaid payments means the workers — especially those who don’t work in a single, centralized office, or don’t have a credit card or a bank account — are far less likely to pay dues, diminishing the union’s potential influence. CMS’ language affects only “individual providers” — that is, those who aren’t employed by the private, for-profit agencies that dominate this industry. Individual providers, who are technically state employees, are far more likely to be unionized. The directive, which would overturn an Obama

administration policy put in place to ease the collection of union dues and pay for other fees, such as health benefits, could take effect by the end of this year. A month-long comment period, ending Monday, has attracted more than 3,300 responses. “This is just another way to make life more difficult for public-sector unions,” said Jake Rosenfeld, an associate professor of sociology at Washington University in St. Louis, who studies unions and their influence. The proposed rule comes on the heels of June’s landmark Supreme Court ruling, in which a 5-4 majority held that publicsector workers don’t have to pay unions for the cost of collective bargaining, calling it a violation

of their free speech. That decision expanded on the Supreme Court’s 2014 ruling in Harris v. Quinn, in which the high court found that home care workers must explicitly state their desire to be in a union before the organization can collect dues. But because these workers are not attached to a single office or meeting point, organizing them into a collective unit poses a distinct challenge; collecting membership dues, even more so. As union membership has waned in other sectors, organized labor has doubled down on home care, lobbying liberal governors to declare thousands of workers as state employees, rendering them eligible to organize and engage in collective bargaining….Read More

Telling doctors their patient died from overdose could prevent some opioid abuse The form letters from the San Diego County Medical Examiner's Office were supportive but grim. “This is a courtesy communication to inform you that your patient (Name, Date of Birth) died on (date). Prescription drug overdose was either the primary cause of death or contributed to the death,” said the letters, sent to hundreds of doctors who in the past 12 months had prescribed opioids to patients who later died. “…

We hope that you will take this as an opportunity to join us in preventing future deaths from drug overdose.” The notices were a simple but unusual experiment — part of a growing research effort aimed at finding solutions to the opioid epidemic that is estimated to have killed almost 50,000 people from overdoses last year. They also addressed an almost astonishing gap in the

American health-care system — the gulf between the care doctors provide and their knowledge about the consequences for patients. Many doctors who prescribe painkillers may believe that addiction is a problem that happens to other doctors' patients, because they never learn about their own patients who died of an overdose. The letters were successful,

although the effects were modest. Doctors who were informed of their patients' deaths were 7 percent less likely to start new patients on opioids and issued fewer high-dose prescriptions over the next three months, compared with those who did not receive a letter. In total, there was a 9.7 percent reduction in the total amount of opioids they prescribed, according to results published Thursday in the journal Science...Read More

AP FACT CHECK: Trump's economic fiction: 'record' GDP, jobs President Donald Trump is distorting the truth on U.S. economic growth and jobs, pointing to record-breaking figures that don't exist and not telling the full story on black unemployment. He cites the highest-ever gross domestic product for the U.S. that's not there and predicts a spectacular 5 percent annual growth rate in the current quarter that hardly any economist sees.

On black joblessness, he boasts of a "new" record low, but the numbers in fact have recently ticked upward, with greater declines seen during the Obama administration. The statements marked a week of fiction in which Trump also made erroneous claims about the California wildfires and the Russia investigation and falsely declared that his tariffs on

foreign goods will help erase $21 trillion in national debt. Meanwhile, Sen. Bernie Sanders skimmed over the facts in asserting that his "Medicare for all" plan would reduce U.S. health spending by $2 trillion. A look at the claims: ECONOMY AND JOBS TRUMP: "One new and great FACT — African American

unemployment is the lowest ever recorded in the history of our Country. So honored by this." — tweet Friday. TRUMP: "I am proud to have fought for and secured the LOWEST African American and Hispanic unemployment rates in history." — tweet Saturday. THE FACTS: Not exactly. He omits important caveats….Read More

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RI ARA August 19, 2018 E-Newsletter  

RI ARA August 19, 2018 E-Newsletter  

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