Wednesday, January 23

Health Care and OSHA

If you are an employer, you are likely familiar with OSHA, or should be. Most employees or individuals in general are not going to know much about this government agency. However, OSHA, which stands for Occupational Safety and Health Administration, is the government watchdog at the federal level that oversees workplace safety. So, if you are in human resources, or a business owner, you are going to hear from them or about them.

According to www.OSHA.gov, the Occupational Safety and Health Act (OSH Act) was passed to prevent workers from being killed or seriously harmed at work. The law requires employers to provide their employees with working conditions that are free of known dangers. The Act created the Occupational Safety and Health Administration (OSHA), which sets and enforces protective workplace safety and health standards. OSHA also provides information, training and assistance to workers and employers. Workers may file a complaint to have OSHA inspect their workplace if they believe that their employer is not following OSHA standards or that there are serious hazards.

Who OSHA Covers:

1.) Private Sector Workers -- Most employees in the nation come under OSHA's jurisdiction. OSHA covers private sector employers and employees in all 50 states, the District of Columbia, and other U.S. jurisdictions either directly through Federal OSHA or through an OSHA approved state program. State-run health and safety programs must be at least as effective as the Federal OSHA program.

2.) State and Local Government Workers -- Employees who work for state and local governments are not covered by Federal OSHA, but have OSH Act protections if they work in a state that has an OSHA-approved state program. Four additional states and one U.S. territory have OSHA approved plans that cover public sector employees only. This includes: Connecticut, Illinois, New Jersey, New York, and the Virgin Islands. Private sector workers in these four states and the Virgin Islands are covered by Federal OSHA.

3.) Federal Government Workers -- Federal agencies must have a safety and health program that meet the same standards as private employers. Although OSHA does not fine federal agencies, it does monitor federal agencies and responds to workers' complaints. The United States Postal Service (USPS) is covered by OSHA.

Not covered by the OSH Act:

--Self-employed;
--Immediate family members of farm employers that do not employ outside employees; and
--Workplace Hazards regulated by another Federal agency (for example, the Mine Safety and Health Administration, the Federal Aviation Administration, the Coast Guard).

Also, according to www.OSHA.gov, employers have the responsibility to provide a safe workplace. Employers MUST provide their employees with a workplace that does not have serious hazards and follow all relevant OSHA safety and health standards. Employers must find and correct safety and health problems. OSHA further requires employers to try to eliminate or reduce hazards first by making changes in working conditions rather than just relying on masks, gloves, ear plugs or other types of personal protective equipment (PPE). Switching to safer chemicals, enclosing processes to trap harmful fumes, or using ventilation systems to clean the air are examples of effective ways to get rid of or minimize risks.

Employers MUST also:

--Inform employees about hazards through training, labels, alarms, color-coded systems, chemical information sheets, and other methods.
--Keep accurate records of work-related injuries and illnesses.
--Perform tests in the workplace, such as air sampling required by some OSHA standards.
--Provide hearing exams or other medical tests required by OSHA standards.
--Post OSHA citations, injury and illness data, and the OSHA poster in the workplace where workers will see them.
--Notify OSHA within 8 hours of a workplace incident in which there is a death or when three or more workers go to a hospital.
--Not discriminate or retaliate against a worker for using their rights under the law.

Much more detailed information can be found at this website: www.osha.gov .

A safety program is a set of policies and work practices specifically designed by your company for your company. It addresses not only the OSHA regulations and ways to reduce the exposure to hazards in your work areas, but also organizes a performance driven framework for continued focus and improvement on safety, according to www.AllAboutOSHA.com.

When you think about the term “safety program”, you probably think about the OSHA regulations and procedures for handling fire extinguishers or ladders, for example. This is only partly true. A safety program is more than canned procedures on how to comply with OSHA regulations. An effective safety program is designed around the work processes or tasks normally assigned to employees and integrates safety and health related decisions and precautions into them. A significant amount of information about this solution can be found at this site: http://www.allaboutosha.com/safety-programs .

There are online courses for OSHA training and certification. One of the better websites is www.OSHA.com, and is not affiliated with any government agency. With on-demand training courses designed by authoritative experts, OSHA.com delivers immediate and cost-effective educational solutions that improve your safety, compliance and risk management initiatives.

Another web portal for OSHA training can be found at www.osha-pros.com . For two decades, OSHA-Pros USA has become synonymous with quality OSHA training and risk avoidance. Founded by Certified Safety Professionals, OSHA-Pros USA provides both online and group onsite courses, including the OSHA 10 Hour Construction Training, OSHA 30 Hour Construction Training, OSHA 10 Hour General Industry Training and the OSHA 30 Hour General Industry Training. All courses are accepted by OSHA in all 50 states and result in the Department of Labor Wallet Card. Established in 1971, OSHA’s Outreach Training program teaches workers about their rights, employer responsibilities, and how to file a complaint as well as how to identify, abate, avoid and prevent job related hazards.

Workplace safety and health is a very important issue, and the OSHA programs at both the federal and state levels mandate how employers must comply. If you feel that you need more help, the resources listed in this material can assist you in getting up to speed, and help you stay out of trouble. Organizations are subject to heavy fines if violations are reported and verified. Be careful to follow OSHA guidelines as an employer; and if you have problems as an employee with workplace safety, and your company is not responsive to your issue, you have adequate resources at your disposal to help with a resolution. Follow the rules, and be vigilant about protecting yourself, your business, and your employees and co-workers.

Until next time.

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Wednesday, January 16

Health Care and Double Dosing Meds

Have you ever been guilty of taking too much of your prescription medications? Have you ever double dosed? It’s a common problem with people who are on maintenance medications or who may be responsible for dosing others under their care. Children especially may be vulnerable, and it’s absolutely critical to be as careful as possible when giving medication to kids.

According to The Centers for Disease Control and Prevention Division of Healthcare Quality Promotion, more than 70,000 visits to emergency rooms each year are for accidental medication overdoses, some of which are ultimately fatal. Most cases occur when a child accesses prescription medication while a parent or childcare provider is distracted or in another room, though there are incidents involving medication poisoning resulting from inadvertent double or incorrect doses. If your doctor has prescribed medication or recommended an over-the-counter drug for treatment and symptom management, these tips may help you prevent an ill-timed second dose, as found on www.becomeananny.org , and here is the detailed information: http://www.becomeananny.org/blog/preventing-double-dosing-when-children-are-prescribed-medication/ .

As children that are prescribed daily medication for a chronic condition begin to get older and accept responsibility for their own dosage, it’s imperative that parents take the time to explain the importance of scheduling each and every dose properly, as well as the many intricacies of taking a powerful chemical. Instituting a “when in doubt, don’t” policy, which means that your child always opts not to take medication if they aren’t sure about the last dose without speaking to an adult, can help to prevent kids that are eager to grow up from overdosing themselves with their medication, according to www.BecomeaNanny.org.

According to Southwestern Medical Center in Lawton, Oklahoma, every day, people play Russian roulette with their prescription drugs, herbal and over-the-counter or OTC medications and vitamins. Mixing these medications and remedies can result in serious or even fatal health consequences. It is common for doctors to tell (patients) to bring in their medications; most of the time they don’t. Many patients don’t know for sure what they are taking. If they do know the name, then they don’t know the strength or dosage, or they know what the pill looks like but not what it is.

Sometimes people bring in a list, but it is usually an older list without their current medications listed or changes in strength. When patients actually bring them in, very often physicians find that they have two bottles of the same thing or they have two different medications within the same class which results in double dosing. Many people not only have more than one doctor now, they also use more than one pharmacy; so duplicate or overlapping drugs for the same health issue can’t even be caught by the pharmacist. More details can be found at this site: http://www.southwesternmedcenter.com/2012/news/if-you-want-to-avoid-double-dosing-brown-bag-it/ .

With insurance companies mandating the use of generic drugs whenever they're available, it's all too common for patients to get confused and end up with bottles of a brand-name drug and a generic version at the same time without realizing it, according to www.Caring.com. "For example, a common diuretic is Furosemide. The brand name is Lasix. A patient might have a bottle of Furosemide and a bottle of Lasix and not know they're the same thing," says internist Bruce Mann, M.D. "In essence, the patient is taking twice the dose." Since generic drugs don't list the equivalent brand name on the label, you might not spot this unless your brand-name version lists the generic name in the fine print.

How to avoid it: When your doctor prescribes a new medication, make sure you have a chance to go over all the details you might need to know later. Have the doctor write down the name of the drug (brand and generic, if available), what it's for, its dosage, and how often and when to take it. Try to remember both names for future reference. Also, look up the generic names for each of your brand-name prescriptions and vice versa; then line up all of your medicine bottles and see if you have any duplications. The numbers are simply staggering: Every year 1.5 million people are sickened or severely injured by medication mistakes, and 100,000 die. And yet all of those deaths are preventable. Much more info about medication mistakes can be found at this site: http://www.caring.com/articles/medication-mistakes .

Seniors are especially vulnerable to double dosing medications. According to www.CareFamily.com, proper medication management is vitally important for seniors’ daily care, over-all health and well-being. According to the Federal Drug Administration, medication misuse often causes falls, moodiness, loss of appetite and weakness. Seniors should take their medicine in the exact amount and at the time when their doctor prescribes. Some seniors, if they miss a day’s dose, will double-dose the next day. Others may take a medication in the evening that should be taken in the morning. Another common thing seniors may do is cut pills in half to extend the quantity, in an effort to save money. Consider using a medication planner or pill case to organize the medications in a daily format, or even chart them on paper or a calendar. More advanced medication dispensing equipment is also available. More information about tips on taking medication can be found at this site: https://www.carefamily.com/Articles/health-medicine/managing-your-medications/ .

Seniors having trouble understanding or remembering or whose health is declining are particularly vulnerable to medication errors, according to www.MedicineOnline.com. Research shows the average senior takes four prescription medications daily and fills 18 a year. Of course, people with multiple chronic conditions may take many more medicines each day. And, when you add in any over-the-counter remedies or nutritional supplements that seniors rely on to relieve symptoms or improve their health, it's no wonder they sometimes get confused or have drug interactions that could pose serious health threats. Complicated dosing regimens don't help matters.

People taking the blood thinner Coumadin, for instance, must be constantly monitored to ensure they're getting enough of the drug to keep their blood from clotting but not so much that they experience any unusual bleeding. Physicians may fine-tune the dosing by switching patients, say, from one tablet daily to one tablet four days a week and one-and-a-half tablets three days a week. Plus, there's also the risk that patients being treated by more than one physician will be prescribed a double dose of the same active ingredient or two drugs that interact negatively with one another. More details can be found at this website: http://www.medicineonline.com/news/10/97/Help-Seniors-Sidestep-Medication-Mishaps.html .

The probability of double dosing is common, and the best options to avoid it can be found with the sources quoted in this article. The most important aspect of taking medications is to follow the directions, and talk with your doctor about any and all medications you take regardless of type, including vitamins, supplements, and all prescriptions. Prevent tragic consequences by paying attention to what you are doing, and also have someone you can trust to help you if you experience difficulty with your medications. Be safe, not sorry.

Until next time.
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Wednesday, January 9

Health Care and State Health Exchanges 2013

As a result of the Affordable Care Act of 2010 becoming law, individual states have been provided an option to develop a health care exchange. These public entities have been in development over the past three years and are in various stages of implementation. The ACA mandates that states provide a mechanism for individuals and employer groups be given an opportunity to purchase health insurance on an open exchange basis.

According to the Kaiser Family Foundation (KFF), states have the option of operating their own exchange or partnering with the federal government to run an exchange. States choosing neither option will default to a federally-facilitated exchange. All exchanges, regardless of how they are administered, must be ready to begin enrolling consumers into coverage on October 1, 2013 and must be fully operational on January 1, 2014. While many states have already announced their intentions, several remain undecided as to which exchange approach they will take.

The Department of Health and Human Services (HHS) recently extended the deadlines for states to make their decisions, giving states until December 14, 2012 to decide whether to run a state-based exchange, and until February 15, 2013, to opt for a partnership exchange. Even with the additional time for decision making, states opting for a state-based or partnership exchange will face challenges to making the necessary policy and implementation decisions, according to the KFF. Much more detail can be found at this site: http://www.kff.org/healthreform/upload/8213-2-2.pdf .

You can also go to the Kaiser Foundation site that talks specifically about the state exchanges. Go in-depth and learn more about each state’s progress in setting up exchanges including the legislative process and the next steps: http://healthreform.kff.org/state-exchange-profiles-page.aspx . Additionally, state by state analysis can be found at this Kaiser hosted site: http://www.statehealthfacts.org/comparemaptable.jsp?ind=962&cat=17 .

According to USA Today, the federal government conditionally approved eight additional states to run health exchanges on January 4, 2013, bringing the total to 20 states that will have the programs that were authorized by the 2010 federal health care law. The newly approved states that will run their own exchanges are California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah. Arkansas will partner with the federal government for its exchange. Although states with Republican governors have fought the law, such as Texas, four of them -- Idaho, Nevada, New Mexico and Utah -- have created the exchanges.

The conditional approvals follow those issued previously granted to Colorado, Connecticut, the District of Columbia, Kentucky, Massachusetts, Maryland, Minnesota, New York, Oregon, Rhode Island and Washington to operate State-based Exchanges and to Delaware to operate a State Partnership Exchange, according to the US Department of Health & Human Services (HHS). To date, 20 states including DC have been conditionally approved to partially or fully run their marketplaces – with the remaining states having until February 15, 2013 to apply for a State Partnership Exchange. More details can be found at this site: http://www.hhs.gov/news/press/2013pres/01/20130103a.html .

Because the law known informally as “Obamacare” is politically controversial, many Republican governors and legislatures have declined to prepare for the exchanges, which go live in 2014, according to Government Executive magazine online. Conditional approval, said Gary Cohen, director of HHS’ Center for Consumer Information and Insurance Oversight, means the state’s plan is “neither approved nor denied” while the department continues overseeing each state’s ongoing activities in managing the marketplaces and helping consumers. Individuals, families and businesses who seek insurance under the law may be eligible for tax credits. “There will be future opportunities to become a state-based exchange,” Cohen added, describing an annual process that means states could apply by this November to stand up an exchange by 2015. States that opt for the hybrid approach could pursue full exchanges later on, the guidance says, according to this site: http://www.govexec.com/management/2013/01/hhs-ushers-eight-more-states-health-exchanges/60456/ .

According to the National Conference of State Legislatures, HHS also on January 4, 2013, issued new guidance to states on marketplaces that will be operated in partnership with the federal government. This guidance outlines the various options that states have to provide input and guidance, and take ownership over significant components of the operation of a FFE. The State Partnership Exchange (SPE) options provide states with a high level of participation in plan management and consumer assistance/ outreach either on a permanent basis or as they work toward a goal of running a State-based Exchange. With an SPE, states can continue to serve as the primary point of contact for issuers and consumers, and will work with HHS to establish an exchange.

The guidance outlines state functions, activities, and responsibilities for a "State Plan Management Partnership Exchange," and the "State Consumer Partnership Exchange." To operate an SPE in 2014 a state must complete the relevant portions of the Exchange Blueprint and be approved or conditionally approved by HHS for the functions and activities the state will perform. States may receive funding for the start-up year expenses for activities related to establishing an SPE. After grant funding set aside in the Affordable Care Act (ACA) for this purpose has been depleted, HHS anticipates that continued funding under a different funding vehicle will be available to support these activities. The new guidance also describes how HHS plans to integrate traditional state regulatory functions and activities into FFE operations in the absence of a partnership. More details can be found at this site: http://www.ncsl.org/issues-research/health/american-health-benefit-exchanges.aspx .

Regardless of your opinion about Obamacare, Health Exchanges, or insurance in general, the cost and complexity of finding affordable quality health care coverage is definitely increasing this year and into 2014. You’ll need very expert guidance to help navigate your way through whatever choices are in your state. Now is the time to start researching what you plan to do starting in 2014. Individuals and companies face challenges for finding the best coverage at the best price. Do your homework early, and avoid the year end rush. It’s going to be crunch time the closer you get to next year, and you’ll need to know your options before the end of this year.

Until next time.

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