Tag Archives: texas

Texas psych clinics take Medicare’s millions without oversight

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.

The Houston Chronicle‘s Terri Langford reports that for-profit outpatient psychiatric clinics in the state, most located around Houston, are collecting millions in Medicare dollars yet “require no license to operate in Texas.”

She writes that, despite access to significant federal funds, the clinics are subject to little oversight from any level of government, especially when it comes to patient care.

…other than a one time inspection conducted by Medicare when clinics start operating – these programs have no detailed standards or “conditions of participation,” that must be met before filing claims and collecting taxpayer money.

The U.S. Department of Health and Human Services flagged the problem earlier this year, saying “no regulatory basis exists to ensure basic levels of quality and safety” for CMHC care.

The loopholes, including the lack of an established means to kick poorly performing centers out of the medicare system, apply nationwide, but their exploitation remains localized.

Records show that in 2009, Medicare paid $287 million on these programs nationwide, 74 percent of them located in the three states that have no state licensing requirements: Florida, Louisiana and Texas.

Hospital sues to block release of records

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Parkland Memorial Hospital in Dallas, the subject of recent reports that patients were at risk, has sued the Texas attorney general in an attempt to prevent the release of records requested by The Dallas Morning News.

Brooks Egerton reports:

Parkland filed the latest lawsuit — its fifth against the AG related to the newspaper — on Monday. This time the goal is to block release of Parkland police department records dealing with the psychiatric emergency room. The News is not seeking medical records.


Reports detail Dallas hospital on brink of losing federal funds

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.

Late Friday, a damning federal report declaring that patients were at risk at Parkland Memorial Hospital in Dallas was released. Even later that same day, Dallas Morning News reporters Miles Moffeit, Sue Goetinck Ambrose, Reese Dunklin and Sherry Jacobsen published their first report online (available to subscribers only).

The reporters write that the inspectors’ findings were released in response to a reform plan the hospital submitted just before its Friday deadline, a plan they report “involves hiring new nurses; rewriting some policies; retraining staff; retiring outdated medicines, supplies and equipment; and launching an intensive series of daily or weekly performance audits over at least the next five months.” According to those who have viewed the 600-page release, they have a lot to overcome.

“It appears safety was routinely relegated to a lower priority by other pressures,” said Vanderbilt University professor Ranga Ramanujam, a national expert in health care safety. “The CMS action is extraordinary. I am hard-pressed to think of an example of a similarly high-profile hospital facing the very real possibility of losing their CMS funding as a result of safety violations.”

The paper’s speedy, thorough response to the release shouldn’t be entirely surprising, considering that they’ve been out ahead of the story from the very beginning.

The top-to-bottom July inspection of Parkland was sparked by a News report of the death of a Parkland psychiatric patient in February. The hospital didn’t report the death to the Texas Department of State Health Services or to CMS, both of which then investigated the case. CMS regulators later determined that the rights of the patient, George Cornell, had been violated repeatedly by Parkland.

The hospital has until Sept. 2 to get its correction plan approved by CMS and to pass inspections, otherwise it could lose the Medicare and Medicaid funds on which it so heavily depends.

Reporter predicts Houston to emerge as global health hub

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.

Jaclyn Schiff, writing for the UN Dispatch, makes the case that journalists should look to Houston as the emerging hub of the global health universe, predicting that it may even supplant hotspots like Washington, D.C. and Seattle.

The foundation for Houston’s emergence, she writes, will be built on its already powerful medical community, built on Baylor College of Medicine, the mammoth Texas Medical Center and the MD Anderson Cancer Center, all of which are stepping up their global health efforts.


Photo by Houston TranStar via Flickr

Beyond that pedigree, the particular catalyst for her story is Dr. Peter Hotez’ move from D.C. to work with Baylor and the Texas Children’s Hospital. Hotez is a bit of a global health rock star (Wikipedia bio), known for his work with vaccines and tropical diseases, and he’s bringing his work to Houston with him.

Part of his nonprofit organization, the Sabin Vaccine Institute, is also moving down to Houston, which Hotez calls a “gateway to Latin America.” Hotez will also be the founding dean of the first U.S.-based school of tropical medicine. Its exclusive mandate and Hotez’s track record of achievement are likely to attract some of the brightest physicians with an interest in global health, which is huge for creating a bustling global health community.

Schiff finishes with another prediction, writing that “the Houston Chronicle hasn’t traditionally been a major source of global health news, but I’d start paying closer attention. There’s too much going on for there not to be a story.” For the record, reporters interested in adding the Chronicle to their regular health reading lists can subscribe to its RSS at http://feeds.chron.com/houstonchronicle/health.

As an alternative or supplement to the Chronicle‘s coverage, Carrie Feibel covers the Houston health beat for the local NPR affiliate, and you can keep up with her reporting by following her on Twitter at @KUHFHealth.

The UN Dispatch is sponsored by the United Nations Foundation, a private organization which supports UN efforts worldwide, particularly in the public health arena.

America’s border towns are often health care black holes

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.

Colonias, underserved, poverty-riddled communities along America’s southern border populated mostly by American citizens of Mexican descent, have long remained uncomfortably disconnected from mainstream government and social services. In a two-part series in the Texas Tribune, Emily Ramshaw takes stock of life in the colonias, then focuses on the health issues created by their unique circumstances.

Ramshaw paints a vivid picture of these forgotten settlements, home to at least 400,000 folks in Texas alone, and no summary would do her writing justice. Here’s an excerpt from the first installment.

In Del Mar Heights, on the outskirts of Cameron County, residents live on a devastated stretch of scrubland littered with dilapidated trailers and dotted with listing telephone poles. There are no paved streets or sewers, basic infrastructure that developers promised the Mexican immigrants who purchased land here 30 years ago and often live three families — and several bleating goats — to a lot. Floodwaters and wayward hurricanes routinely sweep through the area, battering roofs patched with tarps and campaign signs.

Despite hundreds of millions of dollars of local, state and federal investment in infrastructure and services in the colonias, they still clearly lag behind much of the country. As a curious aside, some of the areas Ramshaw profiles happen to sit just miles from the notorious health care consumers of McAllen, Texas, yet the care they are offered could hardly be any more different.

At last count, nearly 45,000 people lived in the 350 Texas colonias classified by the state as at the “highest health risk,” meaning residents of these often unincorporated subdivisions have no running water, no wastewater treatment, no paved roads or solid waste disposal. Water- and mosquito-borne illnesses are rampant, the result of poor drainage, pooling sewage and water contaminated by leaking septic tanks. Burning garbage, cockroaches, vermin and mold lead to high rates of asthma, rashes and lice infestations. And the poor diet so intrinsically linked to poverty contributes to dental problems, diabetes and other chronic conditions, which residents of the colonias rarely have the health insurance, money or access to regular health care to treat.

Ramshaw writes that cultural and geographic barriers, as well as a general distrust of the federal government in a community where not all residents are legal migrants, have hampered adoption of available programs, but there have been signs of improvement in recent years.

The series was made possible by a grant from the Dennis A. Hunt Fund for Health Journalism, and produced as part of the California Endowment Health Journalism Fellowships, a program of the Annenberg School for Communication & Journalism at the University of Southern California.

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.

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.