Next Door helps women in crisis

By Nicole Young • THE TENNESSEAN • November 30, 2009 Cynthia Stovall credits her daughter with saving her life after she was released from a federal prison three years ago and began doing drugs again. "She came in my room and made me watch Intervention," Stovall said. "And she told me she wasn't going to watch me die." Contina Stovall, now 23, told her mother she would call her probation officer and report the drug abuse if she refused to stop. A few days later, Cynthia Stovall, 47, said her daughter made that call. After a 28-day drug rehabilitation program and a 60-day stay at a federal halfway house, Cynthia Stovall came to The Next Door, a nonprofit agency dedicated to helping women in crisis. In the five years it has been open, The Next Door has helped 566 women like Cynthia Stovall recover from incarceration, drug addiction, homelessness and more, said CEO Linda Leathers. "It's a place where they can find out how to live," Leathers said. "When they come to us, they literally have nothing." More than 40 women live at The Next Door, which is downtown. An additional 20 women and their families are staying at an apartment facility off Charlotte Avenue, Leathers said. During the program, the women complete counseling and job training while living at the treatment centers. Most women stay for six months, but there are some exceptions. "It's very individualized," Leathers said. "Our goal is to get them into apartments of their own, but we become a family. Anyone who needs us can always call home and we'll be there for her." Cynthia Stovall has called the downtown center home since she completed the program in 2006. Today, the former inmate and addict is the resident coordinator at The Next Door, helping other women meet their goals. She often draws on her experiences, the 10 years she spent in federal prison for bank robbery and the eight years she spent addicted to crack cocaine, as a way to reach out to others. "I remember being so afraid when I got out of prison," she said. "It was like I had been kicked out into the world and I didn't know what to do. I felt like I didn't know my family and they didn't know me. "This program was a struggle. I didn't think I needed to be here, but I did. I can relate to everything these ladies go through, because I've been there."

New toilets meet ADA and environmental needs

Posted 11/27/2009 4:05 AM ET USA Today GATLINBURG, Tenn. (AP) — Visitors to the highest point in the Great Smoky Mountains National Park will find better toilet facilities next year. The National Park Service will close the Clingman's Dome Road next Tuesday as part of the winter routine. But during the winter, the old restrooms -- built more than six decades ago by the Civilian Conservation Corps -- will be replaced. The agency said three sets of toilets that meet standards of the Americans with Disabilities Act will be installed. Park officials said the vault toilets also meet more stringent water quality standards; the old system was overwhelmed by increasing use. Vault toilets have holding tanks that are periodically pumped.

Children living in poverty increases in Middle TN

Ability to learn, lifetime health can be affected By Janell Ross • THE TENNESSEAN • November 27, 2009 While new U.S. Census Bureau figures show poverty has dropped in most of Middle Tennessee between 2007 and 2008, the area's children remain disproportionately affected. Poverty for the population overall increased in Davidson and Wilson counties during the period but declined in nearby Rutherford, Sumner and Williamson counties. But children living in almost every part of the region were more likely than other age groups — including senior citizens — to live in poverty. In Davidson County, poverty rose from 15.2 percent of residents in 2007 to 16.9 percent last year. The same rate for children grew from 24.2 to 25.7 percent. "When you see these kinds of gaps in poverty, this many children living in poverty compared to the rest of the population, it is directly related to public policy choices being made in this state," said Gordon Bonnyman, executive director of the Nashville-based Tennessee Justice Center. In the 1970s, the federal government assumed the responsibility of providing basic needs of disabled individuals and senior citizens through Social Security payments, Bonnyman said. The welfare of children has generally been left to the states, he said. The problem isn't necessarily parents' employment. A full 49 percent of the parents of children living in poverty or near it across the United States are employed part or full time. And in Tennessee, 56 percent of children living in poverty or near it have parents who are employed, but they don't earn enough to exceed federal poverty guidelines. Poverty can affect children's ability to learn and lifetime health, which can hamper their educational attainment level, limit their income and perpetuate the cycle of poverty, according to the National Center for Children in Poverty at Columbia University. Janice L. Cooper, the center's interim director, said the Census numbers show just how far the nation has to go to meet the needs of its youngest citizens. "This kind of widespread economic hardship impact child and adolescent development, health and ultimately has the potential to hinder our nation's competitiveness in the global economy," she said in a statement. Nationwide, poverty rose from 12.5 percent in 2007 to 13.2 percent in 2008, its highest level in more than a decade. Federal poverty measures the share of residents who earn less that the census bureau's poverty threshold . Those figures vary based on household size and composition. For example, a family of two adults under age 65 and two children is living in poverty if it collectively earns less than $21,834. Contact Janell Ross at 615-726-5982 or jross1@tennessean.com.

Stolen BlueCross hard drives lead to credit watch

USA TODAY CHATTANOOGA, Tenn. (AP) — BlueCross BlueShield of Tennessee will provide free credit monitoring for any customers whose personal information could be at risk after 57 computer hard drives were stolen from an office at the state's largest health insurer. BlueCross spokeswoman Mary Thompson said work is continuing to determine how many of the Chattanooga-based insurer's 3.1 million customers are affected. She could not provide an estimate Tuesday. The hard drives were taken Oct. 2 from a closet at the BlueCross Eastgate Town Center training center, where employees are preparing to relocate to the insurer's new state headquarters in downtown Chattanooga. BlueCross earlier reported that 68 hard drives were taken. The insurer on Friday notified companies and group administrators that the stolen hard drives contain customers' personal information such as Social Security numbers and birth dates. Thompson says BlueCross is assisting in the continuing criminal investigation and has bolstered security at all facilities by adding video surveillance, reviewing card access readers and increasing security personnel. She said hundreds of employees and temporary staff are retrieving and reviewing backup files, combing through 300,000 screen images and reviewing 50,000 hours of audio to determine what data was stolen. Letters to affected customers will offer free Equifax credit monitoring for a year. BlueCross also will set up a telephone hotline for questions. Thompson said BlueCross has insurance to cover related costs. Police said the equipment is highly specialized and investigators are looking for any hint of it being offered for exchange or for sale. BlueCross BlueShield of Tennessee: http://www.bcbst.com/

Nashville convention center groups take fight to the public

Calls, Twitter try to sway opinion By Michael Cass • THE TENNESSEAN • November 25, 2009 Bellevue resident Jim Pfeiffer was surprised and annoyed by a midafternoon phone call he received last week. The caller claimed to be working on a survey about Nashville's downtown convention center proposal but kept saying taxes would go up if the $585 million facility were built, said Pfeiffer, a businessman who supports the proposal. "I said, 'I don't know that,' " Pfeiffer said. "I said, 'This isn't much of an opinion poll, is it?' It was just a push poll. You could tell it was scripted. It reminded me of something we'd sit down in Shoney's and write up in three minutes." The convention center opposition group Nashville's Priorities acknowledges that it's behind the calls, but denies it is running a misleading poll and disputed Pfeiffer's account. This much is clear: The final battle over the convention center is fully engaged. With a financing plan due from Mayor Karl Dean next week and a final Metro Council vote tentatively scheduled for Jan. 19, both sides of the debate are trying to influence public opinion and, by extension, the council. Ron Samuels, chairman of the Music City Center Coalition, said his group will keep doing the traditional things it's been doing for some time: speaking to neighborhood and community groups and talking to council members about the importance of the project. But the coalition could use other communication techniques as well. "If it's necessary to do advertising, I'm sure we'll find some money and go about that," Samuels said. Nashville's Priorities has been using new media like Twitter and YouTube to draw attention to problems in the convention business, highlight previous council deliberations and point to various Dean administration statements on the topic. The group's president, Kevin Sharp, said it also has been advertising in print and online media and is planning a direct mail campaign. It also might go on the radio but won't try to pay for TV ads. "It just depends on what we need to do and can afford to do," he said. 'Not pushing anything' Sharp, an attorney, acknowledged paying for a survey about the convention center project but denied that it was a push poll designed to influence the results with leading questions. Sharp said he wants to see if the opposition that he is hearing from "everybody" he talks to is widespread. "We're not pushing anything," he said. "We'll see where the numbers are. But my sense is that I'm right." Nashville's Priorities, which has been raising questions about the convention center plan since September, hired an out-of-town contractor to make the calls. Sharp said the callers have been asking Davidson County voters who say they support the project if they would still favor it "if there was a pledge of taxes" and if it would put education funding at risk. Metro officials have said the city probably would have to pledge non-tax revenues from the general fund to make up any shortfalls in the visitor taxes and fees that are supposed to pay for the project. They've also said they don't expect any shortfalls, however. Critics have said that if non-tax revenues were tapped, the city would have to raise property taxes to keep funding city services at the same levels. The critics also have said they're worried about a provision in state law that would let Metro use revenue from any source to help its convention center authority pay debts or cover operating expenses. That could put sales tax dollars for schools at risk, they say. Metro Finance Director Rich Riebeling has said sales tax revenues wouldn't be used to pay for the convention center. Misrepresentation? Samuels, president of Avenue Bank, said Nashville's Priorities was misrepresenting the facts. "We are disappointed that Nashville's Priorities has resorted to a massive campaign to spread misinformation about the proposed new convention center," he said in a written statement. "What they are saying is simply not true. Taxes will not be increased to pay for this project. Tax revenue will not be diverted from our schools. What they are doing is deceitful and inappropriate." Nashville's Priorities received $8,500 earlier this year from Gaylord Entertainment Co., which owns Opryland Resort & Convention Center in Donelson. Sharp, a veteran of Democratic political campaigns, declined to say what the poll would cost or talk about the organization's finances or fundraising. "There's nothing sinister here," he said. "This is about as straight up as it gets."

Neighborhood clinics may not get state support

WKRN Channel 2 Posted: Nov 23, 2009 5:35 PM CST Budget cuts could close some neighborhood clinics NASHVILLE, Tenn. - Neighborhood clinics would see a cut in state funding, and the Tennessee Bureau of Investigation says its forensics won't be free anymore. These are the latest scenarios played out in Governor Phil Bredesen's budget hearings if the TBI and Tennessee Department of Health must cut 9% from their budgets. The state money for neighborhood clinics came into being as a safety net after nearly 200,000 people off the Tennessee's Medicaid program TennCare. But $4 million from the health department to help dozens of neighborhood health clinics around state would go away under a plan presented to the governor late Monday. "It's likely these reductions will result in many Tennesseans going without basic care, and many of these faith-based and neighborhood clinics may close," Health Commissioner Susan Cooper told the governor. She called the choice "the hardest decision I have had to make" mainly because she says the state worked so hard to find clinics and primary care facilities to help create a "temporary" safety net for those who were cut from TennCare to help balance the state budget in the governor's first term. Monday, TBI director Mark Gwyn told the governor he, too, has made a tough decision. A primary part of his presentation was to say his agency would start charging local law enforcement for use of the TBI forensics lab. Gwyn says it could cost a small agency an extra $2,000 a year, while it could cost a medium-sized agency up to $6,000 extra each year. With that move, the TBI could raise about $2 million yearly and avoid laying off 58 agents. Gwyn said such layoffs, "would basically paralyze the criminal justice system and the entire state, so the only alternative that I see to that is to start charging a nominal fee for our forensic services." The TBI says lab use would stay free if not for the budget cuts. The TBI plans to introduce a bill in the upcoming legislative session to allow it to charge for the forensic lab.

Volunteers give others a reason to give thanks

By Nicole Young • THE TENNESSEAN • November 24, 2009 For thousands of Nashvillians, the Thanksgiving holiday is a time for family, but it's also a time to volunteer. As of Friday, Don Worrell, president and CEO of the Nashville Rescue Mission, said more than 1,000 volunteers had signed up to work Thanksgiving Day serving food to about 1,000 people at the downtown shelter for the homeless. "This is a tradition for some families," Worrell said. "We literally have generations of families, grandparents, parents and grandchildren, that come out and spend their Thanksgiving with us." For more than 55 years, the mission has provided a Thanksgiving dinner for the needy. "We try to turn this into Grandma's house," he said. "We tell our volunteers that it's just not about serving food here. It's about the feeling of family and togetherness. "Our volunteers become these people's surrogate family." Check out these contacts to volunteer on Thanksgiving: • Assumption Catholic Church parishioner Gerry Searcy is organizing Thanksgiving dinner for about 2,000 people. Volunteers are needed to help prepare and deliver meals. To help, call Gerry Searcy at 615-733-1478 or 615-406-7446, or e-mail her at gjsearcy@aol.com. • The United Way of Nashville's Call United Way 2-1-1, Middle Tennessee's referral help line, is an option to connect volunteers with organizations. 2-1-1 is free, confidential and available 24 hours a day. Callers are connected with real people who can check the organization's database for volunteer opportunities. • The Community Foundation of Middle Tennessee's GivingMatters.com offers detailed information about a wide range of nonprofits. • The Community Resource Center's Web site, www.crcnashville.org, includes a weekly wish list and volunteer list.

Crime UpDate from Metro Nashville Police

FOR IMMEDIATE RELEASE November 19, 2009 Metro Police and the FBI’s Violent Crimes Task Force are asking for the public’s assistance in identifying the man believed responsible for robbing the Fifth Third Bank branch at 2326 Murfreesboro Pike late this afternoon. He approached the teller and demanded money at gunpoint at 5 p.m. He fled on foot. The suspect is described as a black man in his 20’s who is approximately 5’7” tall with a medium build. At the time of the robbery, he wore all black clothing and a ski mask. Anyone with information about the bank robber is urged to contact Detective Keith Sutherland with the FBI Violent Crimes Task Force at 232-7500 or Crime Stoppers at 74-CRIME. Citizens can also send an electronic tip to Crime Stoppers by texting the word “CASH” along with their message to 274637 (CRIMES) or online at www.nashvillecrimestoppers.com. Persons who contact Crime Stoppers by phone or text message can remain anonymous and qualify for a cash reward.

Nonprofit Dispensary of Hope pharmacy serves needs of uninsured

By Christina E. Sanchez • THE TENNESSEAN • November 19, 2009 A local nonprofit drug assistance program will expand to give more uninsured Tennesseans access to critical medications at a time when many prescriptions are 9 percent more costly than they were a year ago. The Dispensary of Hope has partnered with three national pharmaceutical companies — Merck, Novartis and AstraZeneca — to make sure there is a consistent, plentiful supply of medications for people who cannot afford them. Other companies are expected to sign on. The pharmaceutical companies already have drug assistance programs, but patients have to apply directly to each company, which can take longer. Under the new Continued Access Program, the Dispensary will become a central order-and-fill pharmacy location for thousands of people in Tennessee and across the country. "This simplifies distribution," said Scott Cornwell, chief operating officer for the Dispensary. "It adds more resources but also gives us a consistent supply of medication that patients need." An estimated 800,000 Tennesseans were uninsured in 2008. With the recession, that number is expected to reach 1 million in the next year. "There is typically the belief that if you are uninsured, you are unemployed," Cornwell said. "We are seeing more uninsured working people." At the same time, the prescription drugs that people need are getting more expensive, an AARP study showed recently. Many popular brand-name prescription prices had increased by about 9 percent from October 2008 to September 2009. The average annual cost for one brand-name medication was about $2,045, according to the advocacy group for seniors. How program works More than 20,000 Tennesseans accessed the drug aid program in 2008, and with this initiative, the staff hopes the Dispensary will serve that many more. The Dispensary has 47 medications for chronic conditions that include diabetes, heart disease and neurological disorders. The Dispensary gets its supply from physicians' offices, distributors and manufacturers that send donated medications to the program's distribution center. Often the medications are brand names. Partner sites send prescription orders to the Dispensary and then distribute the medicine to patients. The Continued Access Program could benefit many people who don't know about each pharmaceutical company's aid efforts. "It's unfortunate that many people who would otherwise utilize these resources don't simply because they don't know they exist," said Jennifer McGovern, director of patient assistance programs for AstraZeneca. Since it was founded in 2003 in Nashville, the Dispensary has expanded from one site to more than 49 sites across the country. The program grew out of trips that health officials took to local clinics where they found the biggest need was prescription assistance. More than 200,000 people have been served since its inception. "It is truly a model of care for the nation," said state health commissioner Susan Cooper. "What we saw in one little clinic has morphed into a program that has helped tens of thousands of Tennesseans."

First-of-its-kind registry matches volunteers with medical studies

ResearchMatch.org boosts health research By Christina E. Sanchez • THE TENNESSEAN • November 20, 2009 In the age of the World Wide Web, people are a click away from finding old friends, meeting potential soul mates, and now, helping to discover cures or treatments for diseases. Some of the nation's leading research institutions, including Vanderbilt University and Meharry Medical College, have teamed up to create the first national research study recruitment registry. ResearchMatch.org pairs volunteers who want to participate in research with the best studies that might be a good fit for them. The nonprofit site is designed to increase the chances that studies translate into cures, treatments and preventions for diseases. As things stand now, limited funding forces researchers to find participants by word-of-mouth, short radio spots, newspaper advertisements or supermarket bulletin boards. Some trials never get up and running due to few volunteers. ResearchMatch is free, and it connects volunteers and researchers nationally. People who sign up are not obligated. "Clinical research is often stymied by finding the right patient who wants to volunteer," said Dr. Gordon Bernard, associate vice chancellor for research at Vanderbilt. "We don't think it's because people don't want to volunteer." According to the National Institutes of Health, about 4 percent of the nation's population has participated in a research study. Because of low participation rates, about 85 percent of trials don't finish on time, and about 30 percent never enroll a single patient. Currently, the only comparable registry is Clinicaltrials.gov, which is run by the National Institutes of Health. The site puts the burden on volunteers to choose which studies might work for them. Vanderbilt University spearheaded the development of the new match site with a $200,000 grant from the National Center for Research Resources.The site launched Nov. 10 after a year of planning. More than 52 institutions will participate in the first year. Kristin Woody Scott, Vanderbilt's liaison for the program, said the site is supposed to complement other recruitment tactics to boost recruits. "There is potentially a research opportunity for everyone," Scott said. "This is a disease-neutral site, meaning it doesn't matter your background. The only limitation is you must be in the U.S." To join, people give their name and contact information and answer several questions. If a trial match is found, they will receive an e-mail. They can choose to proceed or turn it down. No information is released without consent. Thousands of clinical studies are happening at any given time. Right now, there are more than 80,000 trials in 170 countries, including almost 5,000 in Tennessee. But some trials never get started because there are not enough volunteers. "At the most basic level, one of the difficulties with doing research with humans is to be able to enroll enough people in a study so the results will have meaning from a statistical standpoint at the end of the day," said Jared Elzey, research liaison at Meharry Medical College. Often, the same people may volunteer repeatedly, or researchers may overuse the same groups, Elzey said. Meharry, which does a lot of studies on health disparities among minorities, often comes across the same people willing to help science. "It's difficult to enroll enough people," he said. "People (we need for our studies) have a lot of other pressures on their time, lack understanding about the research, or perhaps there is an organizational distrust. This (site) will allow us to interact with a much broader community." Doctors routinely ask patients who may fit the prototype for a study if they are willing to sign up. That's how Mary and Phillip Hill joined a Vanderbilt study two years ago. Phillip Hill, who has age-related macular degeneration, an eye disorder that can cause vision loss, was asked by his doctor to participate. His wife also joined as the control — a person without the disease who has lived a similar life. They have been married 50 years. Phillip Hill, who had a heart transplant, also has been in a study on heart disease for six years. He also signed up after his doctor asked. "We have enjoyed some benefits; we felt like it was important for us to give back," Phillip Hill said. "This could help our children or our grandchildren or even your grandchildren," Mary Hill said

TN budget cuts could close longtime institution for people with severe disabilities

Nashville's Clover Bottom Development Center shutdown would save the state $36 million a year, By Chas Sisk • THE TENNESSEAN • November 20, 2009 The only state institution in Middle Tennessee for people with severe intellectual disabilities could be closed under a plan introduced Thursday to cut spending. The Clover Bottom Development Center, an 86-year-old Donelson institution that at its peak housed more than 1,500 residents, could be targeted for closure in the next fiscal year if Gov. Phil Bredesen were to go forward with plans to slash the state budget by as much as 9 percent. The closure would save the state $36 million a year, officials from the Division of Intellectual Disabilities Services said. But it would also mean moving the 108 people who still live at the facility on short notice into another state institution in East Tennessee or into private facilities. "There must be great care taken in how we transition a person," said Debra Payne, the division's director. "I think we've been looking to downsize Clover Bottom, but I don't think the planning process has fully developed a plan." The plan was revealed on the third day of public hearings in which government officials presented suggestions for how to close a state budget gap that could reach as much as $1.5 billion next year. Previous suggestions have included releasing as many as 4,000 nonviolent felons and curbing benefits for people enrolled in TennCare, the state insurance program for the poor, pregnant women and children. Bredesen has not yet said which of those proposals he intends to take up, but at Thursday's hearing, he appeared to show some interest in closing Clover Bottom. "Closing a very old state facility and putting them in another facility … would seem to be a good thing," he said. Mary Schaffner, an attorney for the Clover Bottom Parent-Guardian Association, said her group would not be opposed to closing Clover Bottom, if its residents were transitioned safely into another state-run facility. The residents of Clover Bottom have disabilities that are too severe to be placed in group homes, and the care they need is too intensive to be trusted to privately operated facilities, she said. "With state-run, you always have a system of providing good care," she said. "Private ones go up and down in terms of making money." The plan would cut about 3.8 percent from the division's budget. Officials offered no other spending cut proposals, so Bredesen asked that they consider renegotiating contracts for other services, pointing out that only three states spend more per patient than Tennessee to care for people with intellectual disabilities. "I need you to go back and at least tell me if I really have to go there, what do I have to do, he said. "I don't think I'm imposing an impossible challenge." Safety cuts discussed In another hearing, Bredesen also heard officials from the Department of Safety describe possible cuts to that agency. Officials said they would have to remove 25 troopers from the state's highways, leaving 13 small counties without a trooper assigned to them, if Bredesen were to ask them to cut their budget by the full 9 percent. Safety officials also said they would have to close six driver license offices and cut staffing at others, increasing the expected wait time for a driver license to as long as two hours from the current 45 minutes.

Nashville Metro Council may hear convention hall, hotel financing plans separately

Some expect one vote on financing By Michael Cass • THE TENNESSEAN • November 20, 2009 A new study says Nashville could afford a $585 million convention center, relying in part on an adjacent hotel that would help generate the expected revenue. But questions remain about whether the city will build a 750-room hotel — an assumption used by HVS Consulting in its feasibility study that was unveiled this week. Mayor Karl Dean's administration has struggled to find private financing for the hotel, and officials have started saying a hotel financing plan might not be ready at the same time as the plan for the center itself. That concerns some Metro Council members, who will have the ultimate say on whether the convention center gets built. After hearing for so long that the center and hotel would depend on each other to drive business, they've been expecting to consider the financing plans as a single deal. We need to review them together," said Councilman Sam Coleman of Antioch. "If we're going to have half a chance with the citizens we represent, we don't need to do it in a two-part package. We need to have all the facts on the table and be square with people." Dean declined to say Thursday if the plans would arrive simultaneously. He said he's looking at a variety of hotel options and would make an announcement in early December, around the same time his administration is expected to share the convention center proposal with the council. But Dean and Marty Dickens, chairman of Metro's convention center authority, said the question to ask about the hotel is when, not if. "There will certainly be a hotel," Dean said in an interview after his keynote address to a Nashville hospitality industry summit. "The issue is the size, how it's financed. "As I've said several times, we're not going to build anything we can't afford. I'm not going to force the issue. I'm going to go about this protecting the taxpayers." Better off with hotel At an authority meeting earlier in the day, Dickens said the hotel wouldn't take as long to build as the convention center. "It's not about yea or nay on the hotel," he said. "It's the timing of the financing package." Tom Hazinski, managing director of HVS, said the average event at the proposed convention center would be smaller if the sales staff couldn't promise a large hotel next door. The hotel's presence would have a "cascading effect" on the visitor taxes and fees that would pay off the convention center debt. "My guess is you're better off financially with a hotel than without," Hazinski told the authority. In his speech Thursday about the need for the convention center, Dean urged about 150 people at the hospitality summit to help push the project "over the goal line." His administration is hoping to present the financing package for the center to the council in an informational session on Dec. 3.

Meds can interfere with blood thinner Plavix

Blood thinner used by millions By Matthew Perrone • ASSOCIATED PRESS • November 18, 2009 WASHINGTON — Federal health officials said Tuesday a popular variety of heartburn medications can interfere with the blood thinner Plavix, a drug taken by millions of Americans to reduce risks of heart attack and stroke. The Food and Drug Administration said the stomach-soothing drugs Prilosec and Nexium cut in half the blood-thinning effect of Plavix, known generically as clopidogrel. Regulators said the key ingredient in the heartburn medications blocks an enzyme the body needs to break down Plavix, muting the drug's full effect. Procter & Gamble's Prilosec OTC is available over-the-counter, while AstraZeneca's Nexium is only available with a prescription. "Patients at risk for heart attacks or strokes who use clopidogrel to prevent blood clots will not get the full effect of this medicine," the agency said in a statement. Plavix is marketed by Sanofi-Aventis and Bristol-Myers Squibb. With global sales of $8.6 billion last year, it's the world's second-best selling drug behind Pfizer's cholesterol drug Lipitor. Because Plavix can upset the stomach, it is often prescribed with stomach acid-blocking drugs. The FDA says patients who need to reduce their acid should take drugs from the H-2 blocker family, which include Johnson & Johnson's Mylanta and Boehringer Ingelheim's Zantac. FDA scientists say there is no evidence those drugs interfere with Plavix's anti-blood clotting action.

Seniors are likely to see Medicare insurance costs rise, benefits fall

Review options during enrollment, experts advise By Getahn Ward • THE TENNESSEAN • November 18, 2009 For next year, 67-year-old Anna Nickerson plans to stick with a HealthSpring private Medicare plan for medical and prescription drug coverage, preferring to ignore a heated marketing battle as rival health plans jockey to sign new members over the next six weeks of enrollment here. "I'm very pleased with everything I have," said the Nashville resident, who sat through pitches from two other plans last year and had a choice among 46 Medicare prescription drug plans available statewide when annual enrollment kicked off Sunday. Health insurance experts, however, say most seniors would do well to at least review their options. Careful study could be even more critical this year as consumers probably will see higher premiums and reduced benefits, including from many of the Medicare Advantage plans on the market. "This is probably going to be the wildest open enrollment period for Medicare since the launch of the drug benefit in 2006," said John Gorman, chief executive of Medicare consulting firm Gorman Health Group. Reimbursements fall Gorman estimates that Medicare Advantage plans, on average, had to reduce benefits or increase members' out-of-pocket costs by $40 to $80 a month to make up for a 4.5 percent reduction in federal reimbursements. The health plans are paid a set monthly fee by Medicare for each enrollee. HealthSpring didn't make any major changes for next year to its HealthyAdvantage plan in which Nickerson is enrolled, a spokeswoman said. But beneficiaries in the Franklin-based managed-care company's plans overall should see the value of added benefits drop about $60 a month or see their share of costs increase by that much, said Chief Executive Herb Fritch. "If they give us less, we can't provide the same level of benefits," Fritch said, adding that HealthSpring still offers some zero-premium options. Services that could face cuts include free transportation to doctors' offices, he said. Meanwhile, HealthSpring no longer offers separate "special needs" plans for people with high cholesterol levels and hypertension, after a mandate from Medicare's overseer seeking an overall reduction in the number of such plans. Beneficiaries in some plans from BlueCross BlueShield of Tennessee, meanwhile, should see premiums rise and expect to pay more when they're hospitalized or undergo CAT scans and MRI tests. Rob Slattery, vice president and general manager for the insurer's senior care division, estimates a 10 percent to 15 percent adjustment on average through a combination of changes in benefits and pricing. He attributes the changes to the federal reimbursement cuts and patterns of usage by patients in the affected plans. On the other hand, BlueCross has expanded its lower-cost plan offerings, including rolling out a zero-premium plan in northeast Tennessee. And next year 45 more counties statewide — including several in Middle Tennessee — would have access to the insurer's Medicare Advantage PPO network. Slattery said that move would give beneficiaries a lower-premium option in anticipation of the end to such so-called private-fee-for-service products in 2011 for any county with two or more HMOs or PPOs. Extra benefits available During open enrollment through year-end, Medicare beneficiaries can switch to one of the private alternatives to traditional Medicare and/or enroll in a Medicare prescription drug benefit plan. Nationwide, 11 million people are in Medicare Advantage plans. Many seniors are drawn to the extra benefits offered by many such plans. But as with other HMOs, prior approval is needed for some services, and members are limited to certain doctors and hospitals for others. HealthSpring, for instance, added dental benefits to the HealthyAdvantage HMO plan in which Nickerson is enrolled. But there are restrictions on which dentists can be used. Helen Lee of Nashville is among seniors who have decided to stay on traditional Medicare, under which the federal insurance program for the elderly and disabled reimburses providers a fee for services. "It's like everything: It sounds good, but if you get down to the bottom of it, it doesn't," Lee said, expressing her suspicion of extra-benefit plans. Lee has a supplemental policy that costs about $330 a month to pick up expenses Medicare doesn't cover. For seniors, the variety of choices can create confusion. One mistake many make is thinking only about premiums, paying too little attention to such important topics as making sure their drugs are covered and that their key providers accept the plan, said Paul Precht, a spokesman for the Medicare Rights Center in Washington, D.C. Seniors can call 1-800-Medicare to get help searching among various plans for those that may best meet their needs and budgets.

Metro picked for jail analysis

By Travis Loller • ASSOCIATED PRESS • November 18, 2009 For the next two years, national consultants will be looking closely at how Davidson County jail inmates fare when they leave confinement and how Nashville's sheriff's office prepares inmates to be released. Eventually, officials hope the pilot project can help them do a better job of providing inmates with services like drug treatment, anger management and job placement that can help keep them from re-offending and eventually make their communities safer. The U.S. Department of Justice's National Institute of Corrections and The Urban Institute Justice Policy Center are sponsoring the pilot project. They began their work in Nashville on Tuesday. Local agencies in California, Michigan and Wisconsin were also selected to participate. Agencies in Colorado and Kansas were selected for the pilot program last year. Davidson draws praise Davidson County Sheriff Daron Hall said his jail has about 3,200 people behind bars on any given day and releases about 100 a day. The sheer volume of people entering and exiting the system can make intervention difficult, but it also provides a lot of opportunities. Humphries said one goal is to get social service agencies and community nonprofits to do "in-reach" into the jails, something Davidson County has already begun to do. Those agencies can then continue to work with the offenders after they are released. Humphries praised David son County for the work it has already done, calling it "far advanced over most jurisdictions." Jail programs director Paul Mulloy said the sheriff's office looked at recidivism rates in 2007 and found that 64 percent of those who did not receive help had returned to jail within a year while only 36 percent of those who received help re-offended in that period. Since then, he said, the jail has improved its interventions and is redoing its statistical research to see if recidivism rates have also improved.