Tag Archives: FOIA

Investigations spotlight workplace safety

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Workplace safety got plenty of attention last week, from a public radio investigation in Seattle to a series by the Center for Public Integrity that includes plenty of opportunities for localizing.

KUOW’s John Ryan conducted hit the topic from all sides, with a five-part series on workplace safety in Washington. His story selection ranges from stats-directed investigations to features focusing on unique cases.

Chris Hamby did a two-part investigation in the Center for Public Integrity’s iWatch News on OSHA’s Voluntary Protection Programs, which exempt “model workplaces” from regular inspections (Part 1, Part 2).

Over the course of his eight-month investigation, Hamby pored over thousands of pages of documents which revealed, among other things, that “Since 2000, at least 80 workers have died at these sites, and investigators found serious safety violations in at least 47 of these cases.”

Workers at plants billed as the nation’s safest have died in preventable explosions, chemical releases and crane accidents. They have been pulled into machinery or asphyxiated. Investigators, called in because of deaths, have uncovered underlying safety problems — failure to follow recognized safety practices, inadequate inspections and training, lack of proper protective gear, unguarded machinery, improper handling of hazardous chemicals.

Yet these companies have rarely faced heavy fines or expulsion from the program. In death cases in which OSHA found at least one violation, VPP companies ultimately paid an average of about $8,000 in fines. And at least 65 percent of sites where a worker has died since 2000 remain in VPP today.

The program, with its emphasis on cooperation between regulators and industry, began under the Reagan administration and greatly expanded under the most recent Bush regime. There are some success stories, Hamby found, but he also uncovered a hearty helping of dirty laundry. Those included preventable deaths traced to OSHA violations, failures to self-police and an emphasis on expanding program participation at the expense of quality and safety.

In the second installment, Hamby spotlights oil refineries to illustrate what became a familiar pattern.

Recognition of “model workplace” status, missed opportunities to detect and fix hazards, a serious mishap or fatal accident, detection of safety violations and, ultimately, continuation of the government’s stamp of approval.

Hamby backs up these strong words with even stronger numbers. Here’s just one sample:

During 2009 and 2010, at least 21 of 55 fires at refineries falling under federal jurisdiction occurred at VPP sites, an iWatch News analysis of regulatory and news media reports found. VPP sites make up about 30 percent of these refineries, so these government-recognized sites have experienced more than their proportionate share of fires.

Reporters have already produced local versions of Hamby’s story throughout the country, particularly in Florida and Louisiana.

Related: OSHA lists 147 employers as “Severe Violators” of worker safety standards

Hot pipes lead reporter to radioactive aquifer

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Mark Greenblatt, reporter for KHOU-Houston, reports that officials in Central Texas have been alarmed to discover high levels of radiation in the pipes and related systems that provide much of the region’s drinking water.

According to local officials, the contamination comes from years of exposure to drinking water that already tests over federal legal limits for radioactive radium. Of even more concern, they say, is that any water quality testing is done before the water runs through the contaminated pipes that could be adding even more radiation.

Almost as remarkable as the waterborne radiation itself? The fact that it was only discovered when city workers dug up old piping, brought it to the recycling center and were rejected because they were “too radioactive” to recycle.

Through his sources, Greenblatt knew the documents and tests proving the connection between a radioactive aquifer and “hot” pipes existed, but getting his hands on them was a different matter.

The call (with sources) was prompted by internal documents from the Texas Commission on Environmental Quality, which identified a main source of the region’s water as radium contaminated. The TCEQ had initially refused to release the paper after a public-records request, and only did so under order from the Attorney General of Texas.

Greenblatt’s story runs much deeper, and it’s worth taking the time to appreciate the scope of his dense, document-rich investigation.

Reporter FOIA’s database further exposing the toll war takes on returning vets

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Writing for the Bay Citizen and The New York Times, Aaron Glantz brings a new, data-based take on the mental and physical toll the wars in Iraq and Afghanistan have taken on returning veterans, thanks to what he calls “an obscure government database called the Beneficiary Identification Records Locator Subsystem death file,” which he obtained via FOIA.

The database, which reveals a high rate of suicide and fatally risky behavior, lists all veterans who earned Veterans Affairs benefits since 1973.

Records from that database, provided to The Bay Citizen under the Freedom of Information Act, show that the VA is aware of 4,194 Iraq and Afghanistan veterans who died after leaving the military. More than half died within two years of discharge. Nearly 1,200 were receiving disability compensation for a mental health condition, the most common of which was post-traumatic stress disorder.

Names were redacted, but Glantz nonetheless managed to identify a number of veterans, including a troubled 26-year-old man who threw himself under a train just three days after being turned away by the VA. In the course of his investigation, Glantz has managed to fill in some of the gaps in the federal records, a process which has shown just how lacking the VA’s data can be.

In October, The Bay Citizen, using public health records, reported that 1,000 California veterans under 35 died from 2005 to 2008 — three times the number killed in Iraq and Afghanistan during the same period. At the time, the VA said it did not keep track of the number of Iraq and Afghanistan veterans who died after leaving the military.

The VA database does not include veterans who never applied for benefits or who were not receiving benefits at the time of their death, according to the agency. The VA said it also did not keep track of the cause of death.

When confronted with his agency’s shortcomings, a VA representative responded in a manner that belied his agency’s lack of focus on recordkeeping.

David Bayard, a VA spokesman, said the agency was working hard to treat veterans with mental health issues. “VA has some pretty fine programs,” Mr. Bayard said, “but unfortunately we aren’t always successful.”

Emails show Texas council’s disregard for EPA regs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Thanks to an order from the Texas Attorney General, Mark Greenblatt, of KHOU-Houston, obtained emails (2-page PDF) which demonstrate the state water advisory council’s conscious effort to effectively defy certain EPA water quality regulations related to radionucleotide content.

Texas Commission on Environmental Quality accomplished this trick by subtracting the counting error from otherwise dangerous test results, thus successfully dropping them below necessary thresholds. With the numbers below the threshold, there was no formal violation and authorities could get away with not warning residents about their potentially harmful water supply. The dodge continued until 2008, when it was caught by federal auditors.

The health highlights of two years of Guardian data

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In two years, the Guardian’s data blog has published more than 600 data sets. I know this because, thanks to their nifty summary post, I just browsed the full list. In addition to more than a few UK analogues to the sort of stuff we see from AHRQ and NCHS, such as UK life expectancy, birth rates and aging populations and public spending, they’ve also got the sort of global health stuff that any journalist or blogger could pull out and use in a post tomorrow. I’ve collected some of my favorites and tried to strike a good balance between unique stuff and broad-spectrum, widely available global health data.

And finally, for no particular reason, here’s the outcome of every freedom of information request ever filed by the BBC. Also in the category of “data for curious journalists/insiders”? Several years of UK libel cases.

Nonprofit hospitals pay country club dues for execs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In what would seem a logical follow up to last year’s piece on hospital salaries, KUOW’s John Ryan has used public records to look at the top salaries at Seattle-area nonprofits this year.

This time, he focuses on the job perks given to nonprofit executives as much as he does their paychecks. Among them, Ryan writes, “Eight hospital systems in our region reported paying membership dues for their executives at clubs like the Columbia Tower Club and the Kitsap Golf and Country Club.”

A PDF of the salaries is also available. For more on how Ryan puts it all together, see the how-to he posted with last year’s edition.

ProPublica releases ratings of 5,000 dialysis providers

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

On the heels of a successful FOIA request related to Robin Fields’ dialysis investigation, ProPublica has published a database evaluating dialysis clinics on 15 different measures. The information has been available to state health agencies for years, but this is the first time it’s been released for general public consumption, Fields writes.

Patients have long chosen dialysis clinics based only on location or physician recommendation, even though the data shows a wide variation in quality among the 5,000-plus such facilities nationwide.

In more than 200 counties nationwide, the data show, the gap between facilities with the best and worst patient survival, adjusted for case-mix differences, is greater than 50 percent. In areas such as Allegheny County, Pa., or Franklin County, Ohio, each with upwards of two dozen clinics, the differences are even more substantial, exceeding 200 percent.
There is also wide variability in how often patients at different clinics are hospitalized for septicemia. Although septicemia cases can be unrelated to dialysis, it is a significant risk for patients, who typically have their blood cleaned of toxins three times a week. Nationally, the rate was about 12 percent a year for 2006 to 2008. But in dozens of counties, the spread between facilities with the highest and lowest rates was more than 25 percentage points.

Like Dollars for Docs, this new database should provide plenty of ready localizations of of the story.

WSJ explains why Medicare data is hidden

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In The Wall Street Journal, reporters Mark Schoofs and Maurice Tamman have pulled off an impressive feat, weaving a tale of freedom of information and databases so compelling that it’s already attracted hundreds of comments and attention from all over. At its heart, it’s the tale of why public Medicare payment data does not identify the doctors and individual providers who receive about an eighth of its annual disbursements. If the practitioners were identified, the authors argue, the public and press would be better equipped to expose and deter fraud.

The Medicare claims database, partially available for around $18,300 a year, is one of the most powerful health data resources in the world. It’s also hamstrung:

While the services and earnings of hospitals and other institutional providers can be publicly identified, such information is kept strictly confidential for doctors and other individual providers. The reason is that the American Medical Association, the doctors’ trade group, successfully sued the government more than three decades ago to keep secret how much money individual physicians receive from Medicare. The AMA has continued to defend this ruling, including in two cases in which federal appeals courts issued decisions last year.

This time around, The Wall Street Journal and the Center for Public Integrity took the AMA on. For health journalists, their description of what followed is really the crux of the story:

The Wall Street Journal, in conjunction with the nonprofit Center for Public Integrity, attempted for nearly a year to obtain the database. As part of the effort, the CPI filed a lawsuit against the Department of Health and Human Services, which houses the Medicare program. The Journal and CPI wanted the data at no cost; the government wanted $100,000 for eight years of data. In a settlement, The Journal and CPI obtained the requested data at a substantially reduced fee. They later obtained a decryption key to identify individual providers but signed a contract agreeing not to publish such identities in most cases.

The database, technically known as the Carrier Standard Analytic File, focuses on doctors and others paid on a fee-for-service basis. It contains 5% of all beneficiaries, and includes all doctor claims that Medicare paid directly in association with their care.

There’s far more to the story including information about the Consumers’ Checkbook lawsuit and the penultimate paragraphs on just how clear-cut fraud cases can be, once you know what to look for. An article on the Center for Public Integrity’s website promises more reporting, presumably based on the database, of “some of the questionable spending that occurs in the Medicare program.”

Related

Physician Panel Prescribes the Fees Paid by Medicare

VA pays for Agent Orange-related illnesses despite lack of evidence

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Hundreds of thousands of Vietnam veterans are being compensated by the U.S. Department of Veterans Affairs for illnesses the agency says are related to Agent Orange, as Associated Press reporter Mike Baker found. On the face of it, that might not be particularly surprising. Agent Orange has been convincingly linked to cancer and a number of other ailments. But, and here’s the interesting bit, the illnesses most Agent Orange-exposed veterans are being compensated for – things like diabetes and erectile dysfunction – have never been authoritatively linked to the defoliant.

Because of worries about Agent Orange, about 270,000 Vietnam veterans — more than one-quarter of the 1 million receiving disability checks — are getting compensation for diabetes, according to Department of Veterans Affairs records obtained by The Associated Press through the Freedom of Information Act.

More Vietnam veterans are being compensated for diabetes than for any other malady, including post-traumatic stress disorder, hearing loss or general wounds.

Tens of thousands of other claims for common ailments of age — erectile dysfunction among them — are getting paid as well because of a possible link, direct or indirect, to Agent Orange.

Not only that, but the list is growing. The VA has announced it will add chronic B cell leukemias, Parkinson’s and ischemic heart disease to the list of conditions that it will “presume to be related to Agent Orange and other herbicide exposures.” This means even more common, aging-related illnesses will be covered by the VA, an expensive proposition.

The agency estimates that the new rules, which will go into effect in two months unless Congress intervenes, will cost $42 billion over the next 10 years.

Related

Ethics audits of health-related agencies available

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Every year, the federal Office of Government Ethics audits ethics programs at a few federal agencies and departments. The targeted agencies are all over the map – in fiscal 2010 they’ve already hit the Broadcasting Board of Governors and NASA’s Johnson Space center, among others – but include plenty that will interest health care journalists. The audit reports are about eight to 10 pages long and can be obtained with a FOIA request.

The Project on Government Oversight commented recently on the reports:

The Office of Government Ethics (OGE) used to publish these periodic reviews of agency ethics programs, but now only releases them in response to Freedom of Information Act (FOIA) requests. Given recent concerns about certain agencies’ ethics programs (we’re looking at you, Interior), now might be a good time for agencies to take a more proactive approach.

Here’s a selection of some offices that have been audited in recent years:

2010

  • National Transportation Safety Board
  • United States Nuclear Regulatory Commission

2009

  • Rural Development (USDA)
  • Naval Hospital Pensacola
  • HHS Office of the Secretary and Office of General Counsel
  • HHS Centers for Medicare and Medicaid Services
  • HHS Health Resources and Service Administration
  • USDA – Food Safety and Inspection Service

2008

  • Department of Veteran’s Affairs
  • Armed Force Retirement Home

2006

  • Centers for Disease Control
  • U.S. Army Medical Command

2005

  • Food and Drug Administration