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Posts published in May 2015

Low-income senior costs

This is from a report by the Oregon Health Care Association, about a Portland State University study which shows needs of Oregon seniors have risen while Medicaid reimbursement rates decreased in community-based care settings.

The number of Oregon seniors who depend on Medicaid has risen considerably since 2008, but the Legislature’s funding of reimbursement rates for services has declined in the same time period, according to a new report by Portland State University’s Institute on Aging.

The report – “Oregon Community-Based Care: Resident and Community Characteristics” – offers a unique look at Oregon’s long-term care landscape, and includes data from 243 community-based care (residential care and assisted living communities) providers across the state. Findings indicate the proportion of Oregon seniors who depend on Medicaid to afford care has risen by ten percent since 2008, but Medicaid reimbursement rates have decreased by three percent when adjusted for inflation.

“The findings from this study fill an important gap in our understanding of Oregon’s senior population, staff and caregivers, and community-based care settings as a whole,” said Paula Carder, PhD, Associate Professor, Portland State University Institute on Aging. “The demand for community-based care is expected to increase as our population ages, and we hope this report will be used to inform policy decisions that ultimately improve the lives of aging Oregonians.”

The report indicated that nearly half (47%) of all residents in community-based care settings have some form of dementia, including Alzheimer’s disease. This staggering figure represents a five percent increase from 2008 in the number of seniors with dementia living in community-based care settings, and points to higher overall acuity rates and service needs among Oregon seniors. According to a 2010 report by the Alzheimer’s Association, the number of Oregonians with Alzheimer’s disease is expected to double by 2025.

In March, the Oregon Health Care Association released data that shows more than 31,000 low-income seniors in Oregon depend on Medicaid reimbursements to afford care each month, but Medicaid rates have not kept pace with rising costs. In state after state, studies demonstrate that investments in long term care for low-income seniors ultimately improve health outcomes by allowing providers to offer better quality care. A 2011 study showed that states that increased Medicaid reimbursements the most improved quality outcomes for low-income seniors in long term care settings.

Commissioned by the Department of Human Services (DHS), the report was a collaboration between DHS, Portland State University Institute on Aging, the Oregon Health Care Association, SEIU, and LeadingAge Oregon.

First take

Leonard Pitts has a strong blast at social conservatism out today that ought to generate some discussion. (He makes the point that he's not talking here about small-government, fiscal or foreign policy conservatism.) By way of description, he notes, "Always, social conservatism defined "them" as something faceless and frightening against which the rest of "us" must struggle with everything we had, or else be overrun. It is an ideology that has contributed virtually nothing of value to the life of the nation - unless you count mindless panic as a good thing." And he points out polling showing that for the first time since such polling has been done, as many Americans now call themselves social liberals as social conservatives - when the polling was first done, in the 90s, the sc side outnumbers the lc side about two to one. He wrote, "Gallup's numbers suggest more Americans are seeing through this con job, this appeal to their basest selves. They suggest the GOP, held in willing thrall to this dead-end thinking for years, may now have a chance to break free." The polling has been pretty clear on this for a while, and the next few elections may tell quite a story.

About the Washington state second special session: What we have here is a failure to compromise. No new facts are needed; a little bit of give is. The call of a third would be cause for serious complaint.

‘Sovereignty’ in 1890

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As the seemingly endless chatter about how “sovereign” Idaho is continues, and another anniversary of statehood approaches, let’s look back on how it looked leading up to the moment of statehood.

You could say that Territorial Delegate Fred T. Dubois’ wire back to Boise, upon approval, to “Turn the Eagle loose!”, was more emblematic of his emotions than of what he had experienced along the way.

Idaho territory had already gone through, and narrowly evaded, a number of proposals to break it up and combine it with other jurisdictions. Idaho activists wanted to establish some legitimacy for their request, so they called for a constitutional convention to write a state constitution – which met, and drafted the constitution (albeit amended) Idaho still has. The convention had no legal authority to meet,not only because - unlike the four previous states to be admitted – Congress had not approved any such convention but also because the territorial legislature hadn’t done so either.

The convention did take care to say, in the third section of the first article, that “The state of Idaho is an inseparable part of the American Union, and the Constitution of the United States is the supreme law of the land.”

The legitimacy of the convention was only a minor problem in Congress, where a resolution approving statehood had to pass both the House and Senate. Democrats, though in the minority, were not eager to admit Idaho, since that would mean yet another Republican state (as everyone knew Idaho would be), especially after recently admitting the Republican Dakotas, Montana and Washington (as it was then).

The Idaho bills – more than one of them – reached consideration point early in 1890, at a critical juncture. Congress’ action was sure to turn on a case before the U.S. Supreme Court, Davis v. Beason. Samuel Davis was a Mormon who had voted after taking the “test oath” - a territorial law requirement that the voter not adhere to certain principles of the Church of Jesus Christ of Latter Day Saints – and was charged and convicted of perjury. Davis’ case before the Supreme Court was based on the idea that the test oath was unconstitutional.

Dubois, the Idaho territorial delegation who spearheaded the statehood effort, wrote to an ally in Idaho that “If their decision is adverse, of course we are done . . . I shall not ask for statehood unless we can keep the Mormons out of our politics.”

When the Supreme Court ruled against Davis, in favor of the Test Oath, the bills began to move through Congress, but amid raucous debate, a lot of it having to do with Mormons. Then a fierce debate erupted over “free silver” (a coinage question that would become much more intense in the coming decade). After anti-climactic floor votes, the admission bill was signed by President Benjamin Harrison on July 3.

Conditions were attached. For example, 3.5 million acres of the new state specifically were set aside to be used as an education endowment, and the use of them was closely regulated. The subject of how to use those Idaho lands has been back in Congress from time to time, notably in 1998 when then-Representative Mike Crapo proposed a loosening of the rules.

If it’s an immaculate sovereign conception anyone is looking for, Idaho’s isn’t it.

First take

Wonder what implications this may have for the new Wisconsin 20-week abortion ban: Idaho's ban on abortions after the 20th week of pregnancy was tossed by the 9th Circuit Court of Appeals on Friday. It said the law "is facially unconstitutional because it categorically bans some abortions before viability. Section 18-608(2) is facially unconstitutional because it places an undue burden on a woman’s ability to obtain an abortion by requiring hospitalizations for all second-trimester abortions." All of which was intended, of course, as a feature of the law, not a bug.

Wind turbines and birds

A guest opinion, by Michael Parr, Vice President and Chief Conservation Officer, of the American Bird Conservancy.

When the Department of Energy released a report last week championing the construction of larger, more-powerful wind turbines, the wind industry unsurprisingly greeted the news with enthusiasm.

By extending the “hub-height” of turbines up to 360 feet, the chief executive of the American Wind Energy Association said, wind energy could expand to all 50 states.

Less ardent was the association’s response to well-documented concerns over the half-million birds that die each year from collisions with existing turbines: Some migrating birds, a spokesman said, fly too high to be harmed by rotor blades.

Indeed. Some birds do fly very high in the sky. But far more travel at the very altitudes that would put them at greatest risk of colliding with these taller turbines. The risk is especially high during spring and fall, when migrating birds take to the skies in billions, many traveling vast distances between their wintering and breeding grounds.

A new report this month from the U.S. Fish and Wildlife Service calls into question the wind industry’s assertion that birds fly well above wind turbines’ rotor blades. Using radar, researchers examined fall migration at two locations in Michigan. They found that the greatest density of birds and bats migrating at night occurred from 300 to 500 feet above ground. That’s almost directly at hub-height for the new generation of giant turbines.

Birds and bats “don’t have fixed lanes up there in the sky,” says Jeff Gosse, regional energy coordinator for the U.S. Fish and Wildlife Service in Bloomington, Minn., and the report’s principal investigator. For instance, during poor weather, birds tend to fly lower. “As conditions change, they will change their altitude, also. As the report indicates, many birds and bats are flying within the current rotor swept zone.”

Before we rush to build thousands of turbines taller than many skyscrapers, with blade tips that often spin in excess of 100 miles per hour, we should pause to examine what we already know about turbines’ impacts on wildlife. Concerns about birds — and bats, which turbines also kill in large numbers — have not gone unnoticed. (The Department of Energy report euphemistically acknowledges the need to address “additional interactions with wildlife.”)

Yet we already know what these “interactions” are. While existing wind turbines kill hundreds of thousands of birds annually, the projections are even more sobering: scientists have estimated that as the number of turbines increases, they could kill more than a million birds each year by 2030.

Meanwhile, a new analysis released last week by American Bird Conservancy based on federal data found that more than 30,000 turbines have been installed in areas critical to the survival of federally protected birds — with an additional 50,000 turbines planned for construction in similar areas.

But there are steps we can take. Building wind turbines away from heavily traveled bird migration routes such as the Atlantic coastline or in the Great Lakes region would help to lessen the fatal collisions. So would temporary shutdowns of turbines during peak migration periods in the spring and fall.

Keeping turbines away from core habitat where imperiled birds breed is also important. Another new study shows that Greater Prairie-Chickens — rare birds that gather each year for mating displays — are more likely to abandon these courtship grounds when they are close to wind turbines.

These are all realistic goals. The Federal Aviation Administration, for instance, already uses a database to make sure wind farms aren’t built in places where they would interfere with aircraft. The U.S. Fish and Wildlife Service is well-equipped to do for birds and other wildlife what the FAA does for planes. The agency’s biologists know where birds occur, how they migrate, and which areas harbor protected species such as the California Condor and Whooping Crane.

Developing renewable energy sources is important. But right now, our policies treat birds and other wildlife as collateral damage in that quest. As the wind industry prepares to take turbines to new heights, the death toll for birds will only intensify.

Science tells us our current approach to wind development is killing hundreds of thousands of birds each year. The good news is that we also have the tools to do better.

First take

An impressive group, including a couple of former national secretaries of Health and Human Services (Mike Leavitt and Kathleen Sebelius) and a roomful of medical professionals, turned up at the Idaho Healthcare Summit at Fort Hall this week. The idea was to educate Idaho officials on the subject of health care, and a few leading Idaho officials - Senate President pro tem Brent Hill, House Democratic leader John Rusche (a physician) and House health committee chair Fred Wood (also a physician), among them. They were among the Idaho legislators who probably were least in need of the education; according to news reports, just one other legislator (Representative Julie VanOrden, R-Pingree) showed up. The facts apparently didn't matter to many others Today's editorial in the Idaho Falls Post Register suggests, "As for the rest, we can only assume they are content to remain uninformed, place greater stock in talking points than actual data, and continue to appease GOP primary votersby tossing around perjoratives such as 'Obamacare' while lamenting 'federal dependency.'"

Not all of the "Patriot Act" (you have to know there's something wrong when legislation is wrapped in the flag like that) is bad; it included a number of needed updates and upgrades in the law. But the bad stuff, such as the authorization of mass surveillance, was really bad, and support for it has diminished over the years, both on the left and right. Now, on Monday, it may be wiped out - sunset. And that could be important, because simply reauthorizing what's already on the books may be a lot different, politically, than specifically authorizing a new bill. A new, cleaner, better proposal might still pass. But at least a lot of the garbage soon may be taken out.

First ladies

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e have all heard the cliches which describe the influence mothers and wives exercise over the men in their lives who hold public office or positions of prominense. Phrases such as “the hand that rocks the cradle,” “the power behind the throne,” and the ambiguous “pillow talk,” come to mind.

Most successful male political practitioners have around them either a strong mother, or a strong wife, or both.

In Idaho, some of her more successful governors either had or still have spouses that were critical elements in helping win elections and govern. Some First Ladies were or are key advisors to their husbands. Others saw or see their role as that of being a protective mother hen whose purpose is to fight for “get away time” for their spouse, for relaxation and recharging the batteries. Many First Ladies have exercised their influence by controlling the schedule.

None of these primary roles are mutually exclusive. Several First Ladies in Idaho functioned in several capacities for their spouse.

One of the best First Ladies in Idaho history, Lola Evans, was laid to rest in the Malad cemetary last week, next to her beloved husband, John V., who served as governor for ten straight years, from 1977 to 1987.

Lola Evans ranks in the top tier along with Carol Andrus and Grace Jordan. All three of these First Ladies made significant contributions to the success and well-being of their husbands, as did most of Idaho’s First Ladies. These three, though, were adept politicians in their own right. All three governors recognized their spouse had unerringly good instincts.

None were or are demure wall flowers hesitant to tell the governor of a “miscalculation.” All, though, kept their counsel in the home for all three share another quality---fierce loyalty to the spouse and zealous protection of the spouse and the family.

Early in my journalism career when I was the political reporter for the Idaho State Journal I made a passing reference to one of then State Senator Cecil Andrus’ daughters giving him an “in” with students at ISU because the daughter was dating the student body president.

Mrs. Andrus was not pleased and made certain I should have known references to candidate or officeholders spouse or children was “off limits” unless they were directly injected into a campaign. She wa absolutely correct. There was a reason why she learned her husband had hired me to be his press secretary only by reading the Idaho Statesman.

What made Lola Evans stand out was her fine sense of humor and her sense of adventure. One can learn much about another if they have to travel with them. Some call it “the four-day raft trip” test. Was the person a good traveling companion? Did one encounter an unexpected challenge that required poise and presence?

Mrs. Evans passed that test with flying colors. In 1975 I accompanied then Lt. Governor John Evans and Mrs. Evans on a week-long trade mission to Japan. Two nights before we left to return home I switched all of us from our five-star western hotel to a three-star genuine ryoken, a Japanese Inn.

From a soft queen-size bed to sleeping on the tatami mats; from western food to Japanese fare and no utinsels, just chop-sticks; from waitresses who spoke English to servers who spoke only Japanese---it was a stunning change.

Most First Ladies could not or would not have agreed to such a total change. Lola Evans took it in stride, thoroughly enjoyed herself and thanked me afterwards for taking the group out of a transplanted, homogenized faux wertern experience and instead providing them with a true cross-cultural experience.

When one recognizes that the spouse of an officeholder often has to carry almost all the child rearing responsibilities, keep the home presentable, be ready to prepare fine meals when the hubby suddenly brings home an unannounced guest, often do all the shopping and pay all the bills, and still is expected to stand by the guy at countless receptions and accompany him on the “rubber chicken” circuit, all while maintaining the right appearance, only then can one begin to appreciate what valuable asssets First Ladies like Lola Evans can be and were for their husbands.

Multi-tasking does not begin to describe the skill.

John Evans only lost one political race in his life (the last one). A full partner in his success was Lola Daniel Evans - the sine qua non of his career. May God’s angels convey her swiftly to the bosum of the Lord and a joyful reunion with her governor amidst the communion of Saints.

First take

I wondered what the acronym for BASE, as in BASE jumping, was. Turns out it refers to the places from which you would be able to jump: a building, antenna, span, or Earth. It is highly dangerous, without doubt, far more than skyjumping. Twin Falls, with its high Perrine Bridge to the immediate north, has become a favored spot, and people have died. Local officials have become concerned, as they should be, and have been trying to get a handle on the situation. Today, however, front-page news reports around Idaho highlight a BASE community (if that's what it is) that seems to be looking toward spreading out, moving to more widespread and less regulated locations. Is that better than having them do their thing in one place? No easy answers here.

Traditionally, the line not crossed by most political people who were on the pro-life side of the abortion was to call for bans on abortion in the case of rape and incest. There's political reason for that; while many of the time-related decisions about abortion deeply split the American public, abortion in the case of rape and incest does not, in a meaningful way: About 70% favor allowing it in those cases. In Wisconsin, likely presidential candidate Governor Scott Walker has said he will sign a bill banning abortion in the 20th week - which in itself will be controversial but likely not overwhelmingly so - even in cases of rape or incest, which may be another matter. (A 20-week bill recently passed by the U.S. House did include those exceptions.) For decades now the pro-choice public (as opposed to the activists) have been the proverbial frog in the pot of water brought to a slow boil, never quite hitting the peice of legislation or administrative action that rouses them to action. Might this one be it, when signed into law by a presidential candidate? Keep a close look.

Open for business

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ATTENTION Washington, California, Idaho, Utah, Canada, et al: The Pacific Ocean is OPEN.

Traditionally, Memorial Day is the start of “the season” and, equally traditionally, it runs through Labor Day. I’m not so sure that holds true now as much as it used to since we’ve gotten more mobile and have the ol’ I-net to keep us connected for business, education or “reality.” To me, it seems to run from Spring Break to about mid-October. At least from traffic on our little piece of shoreline. But tradition is - well, tradition.

Life for we “locals” changes during the extended summer. Lots of little things visitors don’t see. For one thing, when driving Highway 101 through the downtown of any Oregon coastal community “in season,” locals learn to drive only in the right hand lane. That’s because there are always - ALWAYS - tourists who will try to make a left hand turn off 101 to get to the ocean. Typically, they do so at the intersection where the big “NO LEFT TURN” sign is posted. Above the painted arrow. Next to the flashing light.

If you live here all year, you spend some of your time researching alternate driving routes to get around town. May mean 10 or more stop signs from one end to the other but you stay off the main drag as much as possible. So, for half the year, local commutes to church or shopping - or the bar - take us a bit longer.

Locals hit the grocery stores during earlier hours in the summer. That’s because tourists who shop, do so later in the afternoon. After a day in surf, sand, wind and sunburns. We don’t usually shop Monday-Wednesday since many restaurants are closed those days. When visitors find those doors locked, grocery stores get crowded as people line up in late afternoon at Safeway and Fred Meyer for the usual vacation health foods - chips, Ding-Dongs and beer. Others travel in RV’s so they do much of their own cooking.

In our part of the central Oregon coast, the license plates we see most are from Washington and California. My guess is that’s because Oregon is the only West Coast state with an “open beach” law. Took the late Gov. Tom McCall two terms in office and all his political capital to get that mandate on the books despite voter and legislative opposition. Hilton, Marriott, Holiday Inn, Red Lion and many other “biggies” have tried to bust through. So far, the Oregon Supreme Court has rejected all comers. And McCall is revered for his perseverance.

Washington and California people either understand that or have unknowingly taken advantage of what Gov. Tom labored so hard to get into law. In those two states - and all but one other on the East and West coasts - unfettered access to the ocean is available only with city-county-federal land ownership or other designated public space. Hotels, tribes and folks with deep, deep pockets have bought up most of it and locked the rest of us out. Not so Oregon. Doubt it ever will be.

The next most seen license plates in our neighborhood are Canadian - British Columbia and Alberta. Lots of ‘em. Especially when their dollar buys more in the U.S. than at home. We’ve met many in the winter. Oregon is “snowbird” territory for them with December-January temperatures here 30-40 degrees warmer than their native land. I’ve found them - on the whole - to be friendlier than a lot of American tourists. And generally better stewards of the areas where they recreate or park their RV’s.

You don’t need a calendar to know when Memorial Day arrives near the Pacific. Just watch prices at gas stations. We pay more per gallon than anywhere else in the state year ‘round. But, end of May, add 20-30-cents per gallon. And don’t give me any B.S. about “refinery shortages” or “drops in oil reserves” or “prices at the wellhead.” In the local paper, some weeks ago, the largest wholesaler on the coast was asked why our prices are always higher - especially in the Summer months. His ballsy answer - “Because we can.”

Summer on the Oregon Coast is also a time to “get-out-of-Dodge” for a lot of locals. Many rent their homes May-September and head inland. Or South. Income at home to offset expenses on the road.

Nothing brings strangers to the Oregon coast more than weather forecasts. In Spring and Fall, it’s the ones with blue skies and temps in the 60's-70's. In the Winter, nothing swells the local population like a really good storm prediction. Thunder, lightening and high winds - coupled with a good Oregon wine and a fire - seem to be magnetic to lots of folks East of the Cascades and in the Portland area.

November through March, you see lots of empty storefronts or seemingly permanent “Closed” signs on the coast. Two reasons for that. First, some operate on a part-time basis like candy, small restaurants or novelty shops with their wind socks and kites. Tourists come - they open. Tourists go - they close.

Second, we get a lot of folks who’ve saved money for retirement so they could go into business turning a hobby into a second career or even something entirely new. Living the American dream. Unfortunately, when the summer is over, so is the income it takes to stay in business 12 months a year. A lot of ‘em don’t plan for that or find year-round expenses higher here than they’re used to. Happens a lot.

We locals have a few other little secrets for living with the seasonal interlopers. I can’t share ‘em all. Local privilege, don’t you know. Besides, we all take an oath when we start paying local taxes.

But the “OPEN” sign is out. Y’all come. We’ll deal with it.

First take

Larry Kenck, who has been Idaho state Democratic chair for about three years, is departing for health reasons. Personable but also fair quick with sharp responses to Republicans, he's been a sound enough leader for the Idaho Democrats, but if he's found a way to make a dent in the overwhelming Republican machine in the state, it isn't visible yet. Not that it seems to have impinged his efforts, but - will the party go for a Boise-based chair next time?

What, Gandhi less than a saint? A contributor even now, more than 60 years after his death, to the enduring bitterness and conflict between India and Pakistan? An insightful piece in Foreign Policy today gets too exactly that, in compelling fashion. India's population, while majority Hindu, long has included a large minority of Muslims, but in the runup to independence Gandhi and the pro-indepedence Congress group he fostered was dominated by Hindus, and he countenanced a number of anti-Muslim efforts and rulings. Muslims feared that with independence (even once Pakistan was broken off from India) that Hindus would overwhelm the new country's power structure, and Muslims would be sidelined at best. Gandhi spoke repeatedly in favor of religious pluralism, but his approach to the independence movement was heavily grounded in Hinduism, and he made no secret of it. Critics (including no less than Leo Tolstoy) blasted Gandhi back in the day for mixing religion into the pro-independence movements. A piece well worth reading.