Tag Archives: prescribed

Ethics complaints filed by Republicans against Sen. Baldwin are dismissed

The Senate ethics panel has dismissed three complaints filed by Republicans against Democratic U.S. Sen. Tammy Baldwin over her firing of a top-level staff member and handling of allegations at the Tomah Veterans Affairs Medical Center.

Baldwin on Thursday released an Aug. 14 letter from the U.S. Senate Select Committee on Ethics notifying her that the ethics complaints had been dismissed because they lacked merit. All three related to the firing of Baldwin’s former deputy state director Marquette Baylor and allegations that Baldwin mishandled a whistleblower’s reports of abuse at the VA hospital.

“It should be clear to everyone that these frivolous allegations are false and were nothing more than political smears,” Baldwin’s spokesman John Kraus said in a statement. “Senator Baldwin has not let these political attacks distract from the important work she has done working with Wisconsin veterans and their families to bring reform to the VA.”

Baylor, the Republican Party of Wisconsin and the Foundation for Accountability and Civic Trust in April requested an investigation into Baldwin’s handling of abuse allegations at the Tomah Veterans Affairs hospital and Baylor’s firing in January.

Baylor alleged in her complaint that Baldwin used her as a scapegoat in the office’s mishandling of reports of overprescribing of narcotics and retaliatory behavior at the hospital.

Baldwin said in February that Baylor was terminated due to long-term performance issues that weren’t exclusive to her dealing with concerns about the Tomah hospital. The senator later admitted responsibility for her staff’s mishandling of reports.

The committee told Baldwin the complaints lacked substantial merit and did not sufficiently allege facts or provide evidence of a violation of law, Senate rule or regulation. The committee plans to take no further action and closed the complaints, its lead attorney Deborah Sue Mayer told Baldwin.

“It is up to the people of Wisconsin to determine whether Senator Baldwin’s actions were appropriate,” Baylor’s attorney Todd Graves said in an email in reaction to the dismissal.

Messages left with the Wisconsin Republican Party and FACT were not immediately returned.

A VA report in March month concluded that patients at the Tomah facility were more likely than patients at other VA hospitals to receive high doses of pain killers. The report also said there was an atmosphere of fear among staff members that affected patient care.

In August, the VA’s inspector general said deficiencies in care led to the mixed drug toxicity death last year of Jason Simcakoski, a 35-year-old Marine Corps veteran from Stevens Point. The director of the Tomah facility was fired in September.

Illinois issues medical marijuana licenses

Illinois Gov. Bruce Rauner awarded licenses this week to dozens of medical marijuana businesses across the state after conducting an internal review that found flaws in the never-completed license award process under former Gov. Pat Quinn.

Letters to 18 winning cultivation centers and 52 retail shops were sent out, Rauner spokesman Lance Trover told The Associated Press. In eight districts, Rauner delayed the licenses for further review, leaving those jurisdictions awaiting word on which companies will be able to join what could be a $36 million industry in 2016.

“I believe the right companies were rewarded,” said Tim McGraw, CEO of ACE Revolution Cannabis, which won licenses to build marijuana-growing facilities in the Illinois cities of Delavan and Barry. “We’re excited to get to work to bring safe medicine to the patients of Illinois.”

Letters sent to the cultivation center winners from the Department of Agriculture inform them of a number of conditions. Businesses will need to pay a license fee, for example, and they’ll be subject to ongoing oversight during the startup process.

The license awards follow many weeks of uncertainty after the Quinn administration failed to meet its own deadline of issuing the permits by the end of 2014. The Democrat announced the morning of Rauner’s inauguration that he would leave the issue for the Republican to decide. 

The Associated Press reported last week, based on documents obtained in a Freedom of Information Act request, that Quinn’s office was scrambling to decide whether to issue licenses on the eve of him leaving office. The Rauner administration launched its review of the process almost immediately.

Medical patients had been pushing Quinn to issue the licenses. Rauner’s action this week means that Illinois’ first legal marijuana crop could be harvested this year. It’s not immediately clear how long it will be before patients will have access to the first legal cannabis. 

State Rep. Lou Lang, the Skokie Democrat who sponsored the legislation that created the pilot program, praised Rauner for issuing the licenses. He said although the Republican governor inherited a program with several problems and has indicated he is not a big fan of medical cannabis, his office managed to carefully review the process and issue licenses with only three weeks of delay. 

“Gov. Rauner deserves a lot of credit here,” Lang said. “It’s great for patients.”

Rauner’s general counsel, Jason Barclay, released a statement Monday listing problems in the Quinn process that had created “a risk of substantial and costly litigation” to the state.

Barclay said that the teams reviewing the applications imposed arbitrary cut-offs in scores “that were not expressly contemplated or provided by law that effectively eliminated certain applicants from consideration.”

He said the state agencies involved conducted a character and fitness review of the applicants only after the blind scoring process had been completed. That character and fitness review resulted in several applicants being disqualified “without clear procedures and standards for disqualification and without offering the prospective applicants an opportunity to respond to the information that was relied upon to make the disqualification decisions.”

Finally, the Rauner administration faulted Quinn for deciding “to award no more than one cultivation center license to applicants who were the high point scorers in more than one district.”

Barclay said the review was shared with Attorney General Lisa Madigan’s office, which also reviewed the findings. Natalie Bauer, a spokeswoman for the attorney general, wouldn’t elaborate.

One dispensary applicant still under review in two districts, Health Central LLC, had hired former Quinn chief of staff Jack Lavin to lobby for medical marijuana licenses. 

Matthew Hortenstine, an attorney representing Health Central, said he’s “confident the Rauner administration will be fair-minded about this and give an adequate and proper review.” Other companies also had politically connected lobbyists, Hortenstine said.

Lang, the sponsor, said he’s believed from the beginning that the process would result in litigation, and that a lawsuit was likely regardless of how Rauner handled it. 

Lang said he spoke with some patients after hearing the news. “They are thrilled and ready to go,” he said.

Quinn made no decisions because he “felt the process was incomplete,” Quinn spokesman George Sweeney said in an email Monday. “He refused to rush the licenses out the door and instead left the licensing decisions to the next administration, as was done with many contracting decisions at other state agencies.”

Material released last week by Rauner’s administration “was preliminary and never approved” by Quinn, Sweeney said.

Smartphone apps remind patients to take meds

Medicine only helps if you take it properly. And adhering to an exact schedule of what to take, and when, can be challenging for patients who are forgetful or need to take several medications.

Doctors warn about the consequences and urge patients to use various techniques, such as using divided pill boxes or putting their pill bottles beside their toothbrush as a reminder to take their morning and bedtime medicines.

Still, only about half of patients take medication as prescribed, resulting in unnecessary hospital admissions and ER visits that cost the U.S. health care system an estimated $290 billion a year.

To help combat the problem, many doctors are trying a more high-tech approach: They’re recommending smartphone apps that send reminders to patients to take their medications and record when they take each one.

“I think it’s going to become pretty standard” for doctors to recommend them, said Dr. Michael A. Weber, a cardiologist at SUNY Downstate Medical Center. Weber began recommending apps to patients a few months ago and already has seen better lab results from a few using them.

“Some people say, `That’s a great idea,'” Weber said. “Even ones who claim they’re conscientious, like the reminders.”

He said the apps are particularly helpful for patients with symptomless conditions, such as high blood pressure or high cholesterol. Those patients are less likely to regularly take their medications than someone with pain or an infection.

“I don’t think they’re going to change the world,” Weber said, though he recognizes benefit of apps. Even so, he said smartphone apps won’t do much to help people who simply don’t like taking medicine, fear side effects or can’t afford their prescriptions.

It’s too soon to tell how well the apps keep patients compliant or how long they keep using them.

Darrell West, director of the Center for Technology Innovation at the independent public policy group Brookings Institution, said some doctors have reported better medication adherence, but there haven’t been large scale studies on the effectiveness of such apps.

The apps began appearing a few years ago and now there are dozens.

Available functions include providing more detailed information on the patient’s medication and illness, prompts to refill prescriptions, email alerts about possible drug interactions, doctor locators and more.

Some have symptom checkers, and one called iPharmacy can identify pills when patients enter their shape, color and imprinted text. Others are just for women on birth control pills or patches (myPill) or patients with complex chronic diseases, such as cancer (CareZone Cancer), diabetes (Diabetes Pacer, which also tracks blood sugar and exercise) or HIV (My Health Matters, from drugmaker Merck & Co.). For those patients, getting off schedule or ignoring symptoms can have particularly serious consequences.

Still more apps take distinct approaches. For instance, Mango Health lets users earn points for complying with their medication schedule. Those points can be turned into gift cards or charitable donations.

CEO and founder Jason Oberfest, formerly head of game platforms at MySpace, said Mango Health partners with doctors and health insurers who are recommending its app to patients and customers.

The app, featured in Apple’s iTunes store, gives a history showing users daily results and point total, plus graphs comparing an individual’s adherence to other app users.

According to the company, 46 percent of its monthly visitors use the app daily and 60 percent are still using it after four months. For widely used classes of drugs for depression, diabetes, high cholesterol and high blood pressure, the company claims at least 80 percent of its users take their meds as prescribed. That’s compared to 59 percent or less in independent studies of overall patient adherence for those drug classes.

“We’ve heard from people using the application as old as their mid-’70s and older,” Oberfest said, but it’s especially popular with the 35-to-55 age group, people familiar with video games.

Here are some tips for choosing an app:

-Check whether it’s available for your smartphone’s operating system. Some are only available for one system or haven’t been updated for the latest phones.

-Ask your doctor’s opinion. Some may not be up on the different apps but have staff members who can help patients pick and install apps.

-Start with one of the many free or low-cost apps. Search your app store for “medication reminder.”

-Think about what you’ll really use. If you only want reminders to take your pills, that’s all you need. If you’re taking multiple drugs or change medications often, you might prefer an app with information on your condition, drug interactions and other details.

-To protect your privacy, pick one with password protection.

-If your life is hectic, consider one with a snooze function.