Monthly Archives: May 2016

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Pennsylvania voters cast their vote on a constitutional amendment question on April 26– but their vote doesn’t officially count.

Commonwealth Court Judge Kevin Brobson rejected an injunction request seeking to stop House Resolution 783, which implements a last-minute election ballot change to remove from the April 26 ballot a constitutional amendment question on mandatory judicial retirement. The question will be placed on the Nov. 8 general election ballot.

The resolution was upheld but, given the close proximity to the April 26 primary election, state and county election officials weren’t able to physically remove the question from the ballot. Because the resolution stands, Brobson said, Secretary of the Commonwealth Pedro Cortes has no authority to “canvass and compute” votes cast on a question that is not before the electorate.

“In light of H.R. 783, Proposed Constitutional Amendment 1 was, but is no longer, a question before the electorate, regardless of its presence on a ballot,” Brobson wrote. “Thus, the Secretary is under no legal obligation to ‘canvass and compute’ votes cast on Proposed Constitutional Amendment 1 during the April 2016 Primary Election.”

The traditional posting of election night results on the Department of State’s website is done as a public service. The official “canvassing, computing and tabulating return” does not occur until days after the election.

However, due to the complexity of testing and coding the election night returns system, the results of votes cast regarding the ballot question could appear publicly on the department’s website. Any changes to publicly posting the election night results of the ballot question will be left up to the discretion of the secretary.

H.R. 783 moves the ballot question to the fall general election ballot and directs Cortes to re-word the question asking voters to approve or disapprove increasing the mandatory retirement age of judges to 75. Judges currently must retire at the end of the year in which they turn 70 years old.

Three Democrats who filed the preliminary injunction request argued H.R. 783 disenfranchises voters, particularly absentee voters who have already cast ballots on the question, or others who intended to vote on the question on primary election day.

Brobson rejected that argument. He also rejected limitations the Democrats sought on the General Assembly’s exclusive authority under the Pennsylvania Constitution to dictate the “time” and “manner” in which a question will appear on the ballot.

The judge said the close proximity of the resolution’s passage to the primary election might place hardships on state and county election officials, but those do not reach the level of “harms” that could be remedied by the court.

“Even if the Court were to consider them harms for purpose of preliminary injunctive relief, greater harm of a constitutional dimension would result if this Court were to enjoin enforcement of the otherwise lawful action of a coordinate branch of government,” Brobson wrote.

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donatucci

By Angelique H. Caffrey

Bobby Rydell.  Frankie Avalon.  Fabian.  They were more than just household names for PA Representative Maria Donatucci.  They were literally friends of the family.  Growing up in the Philadelphia area, her father, whose given name was Phil Patelmo, but who entertained under the name of Phil Jaye, was one of the comedy/singing duo known as the Jaye Brothers.  They sang, they released an album, and they even toured America and Europe.  It was a unique life, and one Donatucci didn’t realize was quite out-of-the-ordinary.  “It was fun growing up,” she says with a laugh.  “I was an only child, and I had great parents.  All my friends loved my parents!”

Donatucci didn’t hear much talk about politics at home; however, she began to develop her own leanings and at 16 she became involved in local campaigns. “I either wanted to be in the arts or in politics,” she explains. Perhaps it’s no surprise that she married a State Representative, Robert Donatucci.  “We lived a block away from each other and went to same class at Temple,” she notes.  “I used to date him in between boyfriends… he was a perennial bachelor and much more introverted than I am!”

Together, they had two children, a boy and a girl.  She supported her husband’s political career, working alongside him and the same time fostering her own work life, which included being an adjudicator for the Philadelphia Bureau of Administrative Adjudication.  Then, everything changed when he suddenly died of complications of obstructive sleep apnea in November 2010.  “They didn’t know what it was,” she says in reference to his medical team.  “He had a [sleep apnea] attack three months earlier, and was testing different masks and CPAP machines.  In the meantime, he had a second attack.”

The shock of losing her husband was followed by something she couldn’t have expected: suggestions that she consider trying for his seat in the House.  “People asked me to run.  I took a deep breath… and won it [during a special election].”  Looking back, she’s sure that her colleagues weren’t expecting her to jump in with both feet.  She explains, “When I went in it, they thought, ‘We didn’t expect this out of you!’ Maybe it came naturally after living with a State Rep.”

Donatucci tends to follow her heart on all legislation, something about which she’s unapologetic.  “I serve three distinct districts that are very diverse.  When I’m voting, it can get hard.  I try to be as bipartisan as I can, and I’m always open to listen.  I may not agree, but I will listen.”  She has a passion for bringing women together to discuss issues, which she feels opens a tremendous amount of dialogue.  “I’m very pro-woman, especially on equal pay,” she says.  “I’m told I’m controversial, but I don’t think it’s controversial in 2016.”  At her office, she offers shadowing opportunities for two young women every year to expand her mentoring of the next generation.

Although she hasn’t followed in her father’s footsteps, she has a bit of the performing bug and loves to read to children in elementary schools, especially her favorite book, Green Eggs and Ham.  “I have a ball with that one!”  She uses another Dr. Seuss classic, Yertle the Turtle, to begin conversations with kids about government.  “I open the dialogue and ask them, ‘Would you want this person to be your mayor?  Is this the way a leader should be?’  These kids are going to be making decisions for us in our old age, and education is so important.”

Rep. Maria Donatucci, a Democrat, represents the 185th District.

 

 

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Rep. Steve Bloom

By Angelique H. Caffrey

 

Steve Bloom has faith in young people, so much faith that he entrusted his first House of Representatives run to two 19-year-olds from Messiah College in Grantville.  The result?  He was elected in 2010, and is grateful to them for their unwavering service as his campaign managers.  “They did a tremendous job,” Bloom avers.  “They impressed me.  We beat some candidates who were well-established in the public realm.”

Taking the path not traveled was a gamble that paid off, and it represents his grassroots, open-minded approach to politics.  To save money during his campaign, he asked his oldest daughter to design his posters and door hangers.  His youngest daughter accompanied him as he traveled around the district, lamenting when the election process was over because she found it so enjoyable.

Since entering the Pennsylvania legislature during his 2011 swear-in, Bloom has sought ways to give high school and college students an opportunity to see and experience politics.  In some cases, their schools offer credits for a practicum or unpaid internship with his office.  “They end up being excited about making a difference,” he explains.

Bloom’s own road to the House was anything but predictable.  A husband and father of three children, as well as an attorney living and working in the Carlisle area, he was always willing to volunteer to benefit his neighbors and friends.  Yet he never wanted to run for public office because he felt it would take time away from his familial responsibilities.  However, in 2009, he had an epiphany.

“I was concerned about the direction the country was taking… something more needed to happen.  The gentleman who was state rep for [the 199th] district announced that he wasn’t running for reelection.  I felt it was the right time.”  After talking to his wife, pastor and trusted friends, the lawyer who had his own practice and was an adjunct professor at Messiah College dove into an intense, seven-way primary.  He admits, “It wasn’t part of my life plan, but I always wanted to make a positive difference.  It’s the right thing for me now.”

Ironically, his children are fine with his incredibly busy schedule.  Each is an adult with his or her own interests, so he has time to focus on serving the public.  It’s as time-consuming as he expected… and more.  “I knew conceptually it would be a busy lifestyle, but until I lived it, I didn’t realize it,” he says.  He has especially been surprised at the importance of the ceremonial aspects of the job, such as showing up at an Eagle Scout ceremony or giving a public speech during a 9/11 event at the Army War College.  The latter made him feel “inadequate and blessed”, having never served in the military.  “I was so warmly received,” he recalls.  “It was such an encouragement.”

To counterbalance the tremendous pace of the job, Bloom tries to set aside Sundays as a source of “space, sanity and perspective”, although those plans don’t always come to fruition.  On the occasions when he’s not working, he reads, which has been his number one downtime pursuit since the first grade.   Books on Lyndon Johnson, Abraham Lincoln, Alexander Hamilton and Ulysses S. Grant highlight his significant interest in politics and history.  A self-professed ideologically-driven individual, he describes how he reads to better understand those who are more driven by power than dogma.  “I’m trying to understand how to deal with those types of people.”

Bloom may have a passion for reading and writing, but he also carries a dark secret: he didn’t inherit his father’s mathematics gene.  Fortunately, Algebra is a little-needed requirement for legislators.

Rep Stephen Bloom, a Republican, represents the 199th District.

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House GOP leaders are considering running a cigarette tax increase to kickstart budget talks this spring, according to Republican sources.

One Republican source with knowledge of a private leadership conference call on Monday said a cigarette tax increase, which the source described as a “low-hanging fruit” revenue increase, probably enjoys the widest support in the House, as opposed to tougher votes like increasing broad-based taxes or a severance tax.

Details of the proposal are scarce. But a tobacco levy package proposed by Gov. Tom Wolf this year could generate upwards of $618.9 million, according to the Independent Fiscal Office. Gov. Wolf’s $1 per cigarette pack increase would generate $472.2 million, with additional revenues coming from a 40-percent tax on the wholesale price of other tobacco products, including smokeless tobacco, large cigars, loose tobacco, and e-cigarettes, which would generate another $146.7 million.

But the Republican source suggested the cigarette tax proposal, which was brought by House Speaker Mike Turzai, R-Allegheny, also could be seen “as a way to say we passed a revenue increase” and then undercut what is likely to be a push – from Gov. Wolf and allies – for greater tax increases in upcoming budget negotiations.

Steve Miskin, spokesman for House Majority Leader Dave Reed, R-Indiana, downplayed that claim, saying the proposal was mentioned along with other revenue proposals. He stressed the leadership doesn’t support broad-based tax increases, such as a personal income tax or sales tax hike. He also said he was unaware of a plan to run a tax code bill next week.

On April 25, during his Pennsylvania Press Club appearance, House Appropriations Committee Majority Chairman Bill Adolph, R-Delaware, said it’s not easy to get a revenue bill approved, but it’s likely to be necessary for the 2016-17 budget.

“You need 103 votes in the House and 26 votes in the Senate to get a bill with revenue to the governor’s desk,” said Adolph.

“If it’s $1.3 billion, $1.4 billion or $1.5 billion … for the structural deficit, you’re going to need some revenue,” Adolph continued.

“Does it have to be a broad-based tax, meaning an increase in PIT or an increase in sales tax?” Adolph asked rhetorically, then noting internet gaming could be a source of “a couple hundred million dollars” in revenue. GOP and Democratic leaders in the Senate have yet to warm to such an idea, however.

“You may see some cigarette taxes – I know there are some folks here from the heart and cancer societies that support increased tobacco taxes,” added Adolph.

In early December during the impasse, when House Republicans proposed their own $30.3 billion budget, they also proposed a combination of tobacco and gaming taxes that they said would have generated a bit more than $600 million in additional recurring revenue.

“You may be able to get there [covering the structural deficit] without a broad-based tax,” Adolph said. “I do believe – it’s just my opinion – that there’s going to be some type of revenue increase in order to balance the budget this year.”

Of course, that also assumes a budget with a spend number that increases at no more than 3 to 3.5 percent (or no more than about $1 billion) over the 2015-16 budget ($30.031 billion), said Adolph.

Adolph acknowledged such a spending increase wouldn’t leave much room for new expenditures, instead covering, for the most part, mandatory spending increases for things like pensions, corrections and Medicaid.

Gov. Wolf’s 2016-17 spending plan offered in February – based on the assumption he would get $30.8 billion in spending for 2015-16 – proposed $33.3 billion in expenditures and $2.72 billion in new recurring revenue derived from a variety of tax changes, including a PIT hike, an expansion of the sales tax, tobacco taxes and a severance tax.

Budget talks are expected to pick up in earnest during the next few weeks as all sides have said they would like to avoid another drawn out budget fight.

 

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After four years and 28,000 public comments, a controversial set of oil and gas drilling regulations narrowly won approval from the Independent Regulatory Review Commission

Ultimately, Commissioners Murray Ufberg and Dennis Watson joined IRRC Chairman George Bedwick in a 3-2 vote to approve the regulations, all agreeing the Department of Environmental Protection had done its best to strike a balance between the drilling industry and those who bemoan drilling’s impact on the environment.

“I think consensus in a situation such as this is difficult, if not impossible, to achieve,” Ufberg said before casting his vote April 22. “I believe the department has addressed this regulation as earnestly and honestly as it claims that it has and it appears that it has.”

Ufberg said he “fully understands the industry representatives do not feel that balance.” Those representatives delivered more than half of the nearly eight hour meeting’s public comments.

“But it is not, in my judgment, responsible to say the current regulations are adequate,” Ufberg added.

“I believe the process was transparent,” Watson said. “There may be people who felt they didn’t get their way … but it does not negate the fact that for four years there was considerable effort to get as many people involved as possible.”

Commissioners John Mizner and W. Russell Faber voted to disapprove the regulations.

“I’m not certain the DEP has met its burden to show why the stringent regulations for the conventional drilling industry are needed,” Mizner said. “There’s been a lot of discussions, issues and concerns, but I’m not sure, from my perspective, that these regulations are an answer to those concerns.”

DEP Secretary John Quigley, who characterized the regulations as “the most important rulemaking” since the founding of the oil and gas industry in Pennsylvania, released a statement applauding the IRRC’s vote.

“I am pleased that IRRC moved these important regulatory updates closer to the finish line,” he said. “The Chapter 78 and 78A regulations have been written with an unprecedented amount of public participation, including from the conventional and unconventional drilling industries. This final regulatory package will improve protection of water resources, add public resources considerations, protect public health and safety, address landowner concerns, enhance transparency, and improve data management.”

Now all eyes turn to Republicans in the House and Senate to see if either of the environmental resources and energy standing committees report out a concurrent resolution to their chambers’ full membership to stop the regulations from taking effect. Those committees have 14 days from the receipt of the IRRC’s action to move the resolution of disapproval — something Gov. Tom Wolf could still ultimately veto.

Jenn Kocher, spokeswoman for the Senate Republican Caucus said it’s “a little too premature to speculate on what the committee will do.”

“But it’s important to note the outstanding issues raised by members of the committee remain the same,” she said. “A disapproval resolution is a definite option moving forward.”

Whether a veto override would be possible remains unclear, though Rep. Greg Vitali, D-Delaware, told IRRC commissioners House Republicans could pursue it.

 

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Bob Fayfich, executive director of the Pennsylvania Coalition of Public Charter Schools, believes while the iFiscal Code doesn’t directly impact the state’s 170-plus charter schools, tensions between the administration and the school choice movement haven’t subsided.

“Absolutely we are still at war,” he said. “Our biggest challenge is the unstated, but very real attack on charters and school choice in Pennsylvania.”

Fayfich cited nearly a dozen instances since Gov. Tom Wolf assumed office that he says undermine existing charter school policy and leave organizations like PCPCS playing defense — constantly. As of this month, the coalition is party to at least three pending lawsuits involving the state, two of which have hearings scheduled for June.

Former Philadelphia School Reform Commission Chairman Bill Green’s announcement that he would file suit against Wolf to get his job back after being ousted in March 2015 joins this growing list of grievances, Fayfich said.

“Gov. Wolf defied the law by removing me from office for purely political purposes,” Green said. “The powerful teachers’ unions that gave $1.6 million to Gov. Wolf’s election campaign oppose charter school expansion. Our students deserve better, and they deserve options. To protect the integrity and independence of the SRC and the office of chair from political manipulation, I am suing the governor.”

Green, who stepped down from Philadelphia City Council in 2014 to join the five-member SRC, is described in legal documents as the local teachers’ union chosen “whipping boy” because of his role in the cancellation of their expired contract with the city’s school district and his public support of charter school expansion. Gov. Wolf removed him from the commission just weeks after he voted to approve applications for five new charter schools — a turn of events Green’s general counsel, David Osborne of the Fairness Center, claims is no coincidence.

“Gov. Wolf exceeded his authority in firing Bill Green,” Osborne said. “The statute clearly says an SRC member may be removed from office only because of wrongdoing and with written justification. Neither was present here. Like the Arneson case, Gov. Wolf acted arbitrarily for partisan reasons. We expect the court to reinstate Bill to his former position as chair of the School Reform Commission.”

Jeff Sheridan, an administration spokesman, said “misguided and poor decisions” in Harrisburg are the root of the School District of Philadelphia’s woes and Green’s removal offered a chance for new leadership.

“Gov. Wolf used his authority, as provided by statute, to appoint the chair of the School Reform Commission and to bring new leadership to the school district, which has been devastated by education cuts,” Sheridan said. “Even now, after the governor has fought for greater investment in education at all levels and started to restore the funding Philadelphia lost, the district is in dire financial straits and our children are at a disadvantage. Due to misguided and poor decisions made by Harrisburg politicians, the district has been forced to lay off educators, cut important programs and slash transportation, security and other vital services. Gov.  Wolf will continue fighting for more funding for education and to provide a new path forward for Philadelphia’s schools.”

Sheridan did not directly address the “war” against charters. He most recently denied that characterization  in January.

Despite the Wolf administration’s denials, Fayfich said the administration only continues its onslaught and, with a 2016-17 budget impasse likely, payment disputes between charters, districts and the state will get worse.

Last fall, as Gov. Wolf and Legislative Republicans negotiated a slew of failed budget deals, cash-strapped districts got creative when it came to paying their charter school tuition bills. Which meant, in some dire cases, not paying anything at all.

Fayfich said the Department of Education’s announcement in January that it would no longer mediate payment disputes between districts and charters for any money owed beyond the current school year means that charters have only one avenue left to collect the payments: through the courts.

“PDE saying they are no longer going to do that leaves tens of millions on the table,” he said. “They are saying they are going to renege on their legally-mandated responsibility to act in this way and there’s nothing we can do about it.”

PDE cited a 2012 Commonwealth Court decision regarding a $7 million underpayment dispute between Chester Upland School District and Chester Community Charter School that found the department should only redirect money from a school district’s state subsidy to a charter school it owes if the payment is due in the current school year.

PDE spokeswoman Nicole Reigelman said the text of the memo sent to charter schools back in January regarding the policy change reads: “In 2012, the Pennsylvania Commonwealth Court [Chester Community Charter School v. Pennsylvania Department of Education, 44 A. 3d 715, 722] determined that the mandatory withholding requirements of section 1725-A (a)(5) of the Charter School Law apply only to claims on current year funding. The prior administration delayed the implementation of the court’s decision. PDE cannot contravene the law, and therefore will cease the end-of-year reconciliation process. Instead, charter schools may work directly with resident school districts to reconcile each school year’s tuition payments based on the number of days that each student was enrolled in the charter school.”

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By Tony May

It’s a non brainer that another budget debacle serves no one – not the beneficiaries of state programs, not school districts reliant on state funding or local governments who share in the Commonwealth’s tax collection and distribution functions.  And certainly not legislators up for re-election who need to be home campaigning and not the governor who has been feeling the heat from both friends and foes over last year’s budget mess.

So, at last, after more than a year of seemingly petty bickering and in-fighting, we seem to be agreed on something: getting out of town by June 30.  So how do we do it?

There are a number of ways this can go but here is the cleanest and the fairest:

  1. Gov. Tom Wolf agrees to accept a budget for 2016-17 that is funded without an increase in the personal income tax or major changes to the state sales tax in return for a pledge from at least some Republican leaders to work cooperatively on addressing broad-based tax and spending needs in a comprehensive package in 2017.
  2. The General Assembly finds a way to pump some additional funds into Pennsylvania public schools in 2016-2017 with the recognition that urban schools need special attention and funding.
  3. The leadership of both political parties in the legislature names delegates from the private sector and the community to sit with nominees to be named by the governor to a special blue ribbon panel on Pennsylvania’s future program and revenue needs (kudos to my colleague and friend, George Wolff, for proposing this initiative). The commission should be tasked with producing an interim report by December 2016 and a long-term blue print by summer 2017.

Normally, commissions and study panels are created to avoid confronting major areas of disagreement.  In this case, the panel would provide a new – and less partisan – perspective on where the state is and where it is heading.

The current problem with today’s General Assembly is a wide rift not between Democrats and Republicans but between Republicans who believe that government has a legitimate role in the lives of citizens and a growing element in the GOP that wants to kill government at most any cost short of insurrection.

Nowhere is the chasm between the two wings of the GOP more evident than in the current debate over the operation of bricks and mortar and cyber charter schools.

The most basic tenets of Republican fiscal responsibility have been thrown out the window in favor of ideological purity – the blind acceptance  of the belief that any private school is preferable to a public (or :”government”) school.  Charters – both cyber and traditional – are given the same state funding as public schools without regards to actual costs.  It’s a more flawed policy than the federal government’s cost-plus contracts with defense contractors.  In the case of charter schools, you can spend your per student allocation any way you want and make as much of a profit as you’re able.  There’s not much academic oversight and even less fiscal oversight.

The result is charter schools that perform all over the lot – some better than their public counterparts and many that do not.

Looking for a place to find waste, fraud and abuse?  The charter movement may be the biggest source of waste and abuse in state government today.  Notice, I didn’t say “fraud” because the charters do what is required of them.  We’re just not calling them to account the way that we should.

Charters do provide parents – at least in some parts of the state – with choices.  The fair question to ask is it worth the cost?

Maybe it’s an issue that requires its own blue ribbon panel but at least if could be addressed in a general way by the ways and means panel proposed above.

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By Ann Culp

 

Most patients don’t know about certified registered nurse anesthetists (CRNAs) until they need one. Yet, when the time comes, these advanced practice nurses never leave your side. No matter the procedure, from open-heart surgery to pain management to basic outpatient treatments, CRNAs are with you every step of the way in any setting where you need anesthesia care.

CRNAs are the main hands-on provider of anesthesia care, practicing in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; and pain management centers. More than 49,000 CRNAs safely administer well over 34 million anesthetics nationwide each year.

CRNAs have a well-established tradition of administering anesthesia, and that culture of care continues to this day. CRNAs were the first professional group to provide anesthesia in the United States and are the oldest recognized group of advanced practice registered nurse specialists in the country, with a history that spans back to the Civil War.

Training and education programs are rigorous.

In Pennsylvania, nurse anesthetists must obtain a bachelor’s degree, graduate with a minimum of a master’s degree from a nurse anesthesia accredited program, complete additional hours of clinical work (the average student nurse anesthetist completes almost 2,500 clinical hours) and pass a national exam in order to be able to practice.

CRNAs also must be a Registered Nurse (RN), and they must be recertified every four years. Nurse anesthetists’ recertification includes meeting advanced practice requirements and obtaining a minimum of 40 continuing education credits.

Because of this training and experience, numerous medical studies show there is no statistical difference in patient outcomes when a nurse anesthetist provides treatment. In fact, these studies by nationally recognized health-care policy and research organizations prove that CRNAs provide high-quality care, even for rare and difficult procedures.

As health-care demands continue to grow, increasing the number of CRNAs will be a key to containing costs while maintaining quality care. The Federal Trade Commission recently cautioned states against policies that restrict advanced-practice nurses’ work.

Pennsylvania is a leader in the field. Our commonwealth ranks among the top states for drawing certified registered nurse anesthetist students for education and training — there are 12 nurse anesthetist programs spread out across our state.

The General Assembly currently is considering legislation that would create an official CRNA designation in statute. Defining CRNA in Pennsylvania law not only helps with students and advanced practice nurses here, but it also would carry across borders, helping us maintain our professional leadership in educating and training CRNAs from across the country.

CRNAs are skilled practitioners who increase access to care, reduce cost and ensure quality.

CRNAs also are the primary anesthesia providers in rural America. In fact, more than two-thirds of all rural hospitals rely on CRNAs to provide anesthesia care in these medically underserved areas. Without these advanced practice nurses, some 1,500 facilities would not be unable to maintain trauma stabilization and surgical and obstetrical capabilities, forcing many rural Americans to travel long distances for such services.

In today’s changing health-care environment, patients want health care delivered with personal care, at a lower cost, with a high degree of confidence. CRNAs deliver all of these by staying with their patients throughout the entire procedure; they ensure that the whole of the patient is cared for, physically, mentally and emotionally.

The bottom line is this: CRNAs are highly-skilled advance practice nurses who ensure the highest level of care and pain management to those they serve, using all anesthetic techniques and practicing in every type of setting in which anesthesia is delivered.

Know about nurse anesthetists before you need one. Visit www.PANAforQualityCare.com.

Ann Culp, CRNA, DNP, is president of the Pennsylvania Association of Nurse Anesthetists (PANA) which represents more than 3,000 CRNAs and students in the Commonwealth.

 

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By Pat Toomey and Sherrod Brown

Pat Toomey sherrod Brown

 

Often, the image of opioid addiction in America today is that of a working-age adult who first turned to painkillers for relief from a back injury. Or it is the young person who was introduced to oxycodone as a party drug, and now, with pills having become too expensive, has turned to heroin.

Forgotten in the national conversation are the hundreds of thousands of senior citizens who are unwittingly being given duplicative and unsafe prescriptions of opioids and other controlled substances. These seniors face elevated risks for cognitive impairment, falls and fractures, and even overdose deaths. Between 1993 and 2012, inpatient hospital stays related to opioid overuse by Medicare beneficiaries rose more than ten percent annually.

While nearly one-third of all Medicare beneficiaries will receive at least one opioid prescription each year, finding those at highest risk for adverse outcomes from painkillers is fairly easy. The Medicare Payment Advisory Commission estimates that less than one percent of Medicare beneficiaries account for 70 percent of all spending on pain pills.

Opioids can help to quickly control intense pain, but long-term use is known to become less effective in many patients. In fact, seniors who are receiving the most opioids aren’t likely to be any healthier.

Medical specialty societies are developing new guidelines that reduce both the dosage and the length of time prescription opioids can safely be taken. For instance, the American Academy of Neurology recently found that the risks of opioids outweighed any benefits for treating headaches, lower back pain, and fibromyalgia.

Seniors with chronic pain and illnesses, who are visiting multiple specialists and physicians, can find it difficult to manage many prescriptions. Their physicians may be unaware they are prescribing duplicative opioid painkillers due to the fragmented nature of care. Adding to the problem, those prescriptions can then be filled at multiple pharmacies. To address this gap in treatment and deliver higher quality coordinated care to seniors, we introduced the bipartisan Stopping Medication Abuse and Protecting Seniors Act (S. 1913).

Recently passed by the Senate as an amendment to the Comprehensive Addition and Recovery Act, our proposal will ensure that the small number of seniors who receive high doses of addictive opioids, get those painkillers only from a single provider and a single pharmacy. The legislation not only helps individuals who are battling addiction get treatment, it also saves taxpayers nearly $100 million over the next decade by helping to reduce overprescribing and to stop outright fraud.

“Locking in” at-risk individuals to a single prescriber and pharmacy is not a new idea. Commercial insurance plans and Medicaid already successfully use it. States such as Iowa, Oklahoma, and Washington have all seen fewer emergency room visits, opioid prescriptions, and millions in savings from “lock-in” programs.

 

The Stopping Medication Abuse and Protecting Seniors Act will deliver better care to seniors, and help to reduce a significant source of pills for the narcotics black market. The nonpartisan Government Accountability Office has found there are more than 170,000 Medicare enrollees actively engaged in “doctor shopping” for physicians who will unknowingly write redundant opioid prescriptions. Some of these individuals are likely feeding their own addiction. Others are selling significant quantities of these powerful narcotics to criminal gangs and entities, providing fuel to the burning epidemic.

In the last two budget requests, the Administration has requested Congress grant it authority to initiate a “lock-in” program for Part D. The HHS Inspector General routinely recommends “lock-in,” and the House of Representatives has already passed similar legislation as part of its 21st Century Cures package.

Our bipartisan proposal, which has been endorsed by the Pew Charitable Trusts, Medicare Rights Center, Academy of Managed Care Pharmacy, and numerous law enforcement groups, should be part of any final legislative package addressing opioid abuse that goes to the president for his signature.

Ending the epidemic of opioid addiction will require a multi-faceted approach, and our proposal is one step we can take right now that will also help seniors get better coordinated care. While it is terrific that the Senate has passed this measure, we must continue working to ensure that this sensible, bipartisan effort to protect our nation’s senior citizens becomes the law of the land.

Sherrod Brown, a Democrat, is the senior United States Senator from Ohio. A Republican, Pat Toomey is the junior United States Senator for Pennsylvania.

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Democrat Katie McGinty, made it through to the general election,ending Joe Sestak’s hope of a rematch of the 2010 contest.

McGinty, who just two years ago placed last in the gubernatorial primary, received financial support and endorsements from organized labor, Democratic-aligned groups, and the party’s senatorial campaign arm, trounced former U.S. Rep. Sestak, the party’s U.S. Senate nominee in 2010, according to unofficial results with nearly 99 percent of Pennsylvania’s statewide precincts reporting.

Braddock Mayor John Fetterman, an outsider whose politics aligned with presidential hopeful Bernie Sanders, said he had an impressive showing considering “we’ve been outspent 15-to-1.” McGinty will face incumbent Republican U.S. Sen. Pat Toomey.

Sestak, who rebuffed Democratic Party leaders in 2010 and defeated the late U.S. Sen. Arlen Specter but then lost to Toomey, eschewed traditional support this time around.

In another heated primary, Democratic and Republican voters tapped politicians over prosecutors as their standard-bearers to replace Attorney General Kathleen Kane.

Montgomery County Commissioner Josh Shapiro defeated Allegheny County D.A. Stephen Zappala Jr. and Northampton County D.A. John Morganelli. Shapiro will face fellow Montgomery Countian, Sen. John Rafferty, who defeated former federal prosecutor Joe Peters, in November.

Shapiro and Rafferty, who did work for the Office of Attorney General from 1988 to 1991 primarily investigating and prosecuting Medicaid fraud, both pledged to clean up the Office of Attorney General following Kane’s turbulent tenure.

As expected, Democrat Hillary Clinton defeated Sanders by a wide, double-digit margin. Republican frontrunner Donald Trump ran away with the popular vote over U.S. Sen. Ted Cruz, R-Texas, and Ohio Gov. John Kasich.

For Trump, the popular vote secures 17 of Pennsylvania’s 71 GOP delegates. And of the other 54 unbound delegates that were up for election (three delegate slots available in each of the state’s 18 congressional districts), it appears at least half of those elected are backing Trump (maybe as many as 31).

Congress

State Rep. Dwight Evans of Philadelphia defeated long-time incumbent U.S. Rep. Chaka Fattah in a four-way primary race by more than 10,000 votes. The district, which covers Philadelphia and parts of Montgomery County, is predominantly Democratic.

In the 16th congressional district, state Sen. Lloyd Smucker defeated Chet Beiler in the Republican bid to replace U.S. Rep. Joe Pitts.

In the 8th congressional district, Republican U.S. Rep. Mike Fitzpatrick’s brother, Brian, won a three-way primary race. Rep. Fitzpatrick isn’t seeking re-election. He’ll face State Rep. Steve Santarsiero, who defeated Shaughnessy Naughton.

In the 9th district, U.S. Rep. Bill Shuster defeated Art Halverson.

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