Read Text On October 12, 2017 Healthcare Executive Order

President Trump today (October 12, 2017) issued the following that he promised will provide invaluable Obamacare relief  for consumers, employers and others by promoting healthcare choice and competition.

Language of Executive Order

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1. Policy.

(a) It shall be the policy of the executive branch, to the extent consistent with law, to facilitate the purchase of insurance across State lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people. The Patient Protection and Affordable Care Act (PPACA), however, has severely limited the choice of healthcare options available to many Americans and has produced large premium increases in many State individual markets for health insurance. The average exchange premium in the 39 States that are using http://www.healthcare.gov in 2017 is more than double the average overall individual market premium recorded in 2013. The PPACA has also largely failed to provide meaningful choice or competition between insurers, resulting in one-third of America’s counties having only one insurer offering coverage on their applicable government-run exchange in 2017.

(b) Among the myriad areas where current regulations limit choice and competition, my Administration will prioritize three areas for improvement in the near term: association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements (HRAs).

(i) Large employers often are able to obtain better terms on health insurance for their employees than small employers because of their larger pools of insurable individuals across which they can spread risk and administrative costs. Expanding access to AHPs can help small businesses overcome this competitive disadvantage by allowing them to group together to self-insure or purchase large group health insurance. Expanding access to AHPs will also allow more small businesses to avoid many of the PPACA’s costly requirements. Expanding access to AHPs would provide more affordable health insurance options to many Americans, including hourly wage earners, farmers, and the employees of small businesses and entrepreneurs that fuel economic growth.

(ii) STLDI is exempt from the onerous and expensive insurance mandates and regulations included in title I of the PPACA. This can make it an appealing and affordable alternative to government-run exchanges for many people without coverage available to them through their workplaces. The previous administration took steps to restrict access to this market by reducing the allowable coverage period from less than 12 months to less than 3 months and by preventing any extensions selected by the policyholder beyond 3 months of total coverage.

(iii) HRAs are tax-advantaged, account-based arrangements that employers can establish for employees to give employees more flexibility and choices regarding their healthcare. Expanding the flexibility and use of HRAs would provide many Americans, including employees who work at small businesses, with more options for financing their healthcare.

(c) My Administration will also continue to focus on promoting competition in healthcare markets and limiting excessive consolidation throughout the healthcare system. To the extent consistent with law, government rules and guidelines affecting the United States healthcare system should:

(i) expand the availability of and access to alternatives to expensive, mandate-laden PPACA insurance, including AHPs, STLDI, and HRAs;

(ii) re-inject competition into healthcare markets by lowering barriers to entry, limiting excessive consolidation, and preventing abuses of market power; and

(iii) improve access to and the quality of information that Americans need to make informed healthcare decisions, including data about healthcare prices and outcomes, while minimizing reporting burdens on affected plans, providers, or payers.

Sec. 2. Expanded Access to Association Health Plans. Within 60 days of the date of this order, the Secretary of Labor shall consider proposing regulations or revising guidance, consistent with law, to expand access to health coverage by allowing more employers to form AHPs. To the extent permitted by law and supported by sound policy, the Secretary should consider expanding the conditions that satisfy the commonality‑of-interest requirements under current Department of Labor advisory opinions interpreting the definition of an “employer” under section 3(5) of the Employee Retirement Income Security Act of 1974. The Secretary of Labor should also consider ways to promote AHP formation on the basis of common geography or industry.

Sec. 3. Expanded Availability of Short-Term, Limited‑Duration Insurance. Within 60 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, consistent with law, to expand the availability of STLDI. To the extent permitted by law and supported by sound policy, the Secretaries should consider allowing such insurance to cover longer periods and be renewed by the consumer.

Sec. 4. Expanded Availability and Permitted Use of Health Reimbursement Arrangements. Within 120 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, to the extent permitted by law and supported by sound policy, to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.

Sec. 5. Public Comment. The Secretaries shall consider and evaluate public comments on any regulations proposed under sections 2 through 4 of this order.

Sec. 6. Reports. Within 180 days of the date of this order, and every 2 years thereafter, the Secretary of Health and Human Services, in consultation with the Secretaries of the Treasury and Labor and the Federal Trade Commission, shall provide a report to the President that:

(a) details the extent to which existing State and Federal laws, regulations, guidance, requirements, and policies fail to conform to the policies set forth in section 1 of this order; and

(b) identifies actions that States or the Federal Government could take in furtherance of the policies set forth in section 1 of this order.

Sec. 7. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

DONALD J. TRUMP

THE WHITE HOUSE,

October 12, 2017

Implications & Actions

The impact of the Executive Order depends upon what actions, if any, the agencies determine they are allowed by law to take and how those changes are implemented.  Concerned persons and organizations should begin preparing input to the agencies and monitoring and commenting on proposals and other guidance to help shape the outcome.

Solutions Law Press, Inc. is preparing initial analysis of this Executive Order and will be closely monitoring and updating this analysis.  Follow up to learn more and stay abreast of new developments.

About The Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: Erisa & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for management work, coaching, teachings, and publications.

Ms. Stamer works with businesses and their management, employee benefit plans, governments and other organizations deal with all aspects of human resources and workforce, internal controls and regulatory compliance, change management and other performance and operations management and compliance. Her day-to-day work encompasses both labor and employment issues, as well as independent contractor, outsourcing, employee leasing, management services and other nontraditional service relationships. She supports her clients both on a real-time, “on demand” basis and with longer term basis to deal with all aspects for workforce and human resources management, including, recruitment, hiring, firing, compensation and benefits, promotion, discipline, compliance, trade secret and confidentiality, noncompetition, privacy and data security, safety, daily performance and operations management, emerging crises, strategic planning, process improvement and change management, investigations, defending litigation, audits, investigations or other enforcement challenges, government affairs and public policy.

Well-known for her extensive work with health, insurance, financial services, technology, energy, manufacturing, retail, hospitality, governmental and other highly regulated employers, her nearly 30 years’ of experience encompasses domestic and international businesses of all types and sizes. Author of numerous works on privacy and data security, Ms. Stamer‘s experience includes involvement in cyber security and other data privacy and security matters for more than 20 years.

A Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her thought leadership, experience and advocacy on these and other concerns by her service as a management consultant,  business coach and consultant and policy strategist as well through her leadership participation in professional and civic organizations such her involvement as the Vice Chair of the North Texas Healthcare Compliance Association; Executive Director of the Coalition on Responsible Health Policy and its PROJECT COPE: Coalition on Patient Empowerment; former Board President of the early childhood development intervention agency, The Richardson Development Center for Children; former Gulf Coast TEGE Council Exempt Organization Coordinator; a founding Board Member and past President of the Alliance for Healthcare Excellence; former board member and Vice President of the Managed Care Association; past Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; a member and policy adviser to the National Physicians’ Council for Healthcare Policy; current Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee; current Vice Chair of Policy for the Life Sciences Committee of the ABA International Section; Past Chair of the ABA Health Law Section Managed Care & Insurance Section; ABA Real Property Probate and Trust (RPTE) Section former Employee Benefits Group Chair, immediate past RPTE Representative to ABA Joint Committee on Employee Benefits Council Representative, and Defined Contribution Committee Co-Chair, past Welfare Benefit Committee Chair and current Employee Benefits Group Fiduciary Responsibility Committee Co-Chair, Substantive and Group Committee member, Membership Committee member and RPTE Representative to the ABA Health Law Coordinating Council; past Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee; a former member of the Board of Directors, Treasurer, Member and Continuing Education Chair of the Southwest Benefits Association and others.

Ms. Stamer also is a widely published author, highly popular lecturer, and serial symposia chair, who publishes and speaks extensively on human resources, labor and employment, employee benefits, compensation, occupational safety and health, and other leadership, performance, regulatory and operational risk management, public policy and community service concerns for the American Bar Association, ALI-ABA, American Health Lawyers, Society of Human Resources Professionals, the Southwest Benefits Association, the Society of Employee Benefits Administrators, the American Law Institute, Lexis-Nexis, Atlantic Information Services, The Bureau of National Affairs (BNA), InsuranceThoughtLeaders.com, Benefits Magazine, Employee Benefit News, Texas CEO Magazine, HealthLeaders, the HCCA, ISSA, HIMSS, Modern Healthcare, Managed Healthcare, Institute of Internal Auditors, Society of CPAs, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other symposia and publications. She also has served as an Editorial Advisory Board Member for human resources, employee benefit and other management focused publications of BNA, HR.com, Employee Benefit News, InsuranceThoughtLeadership.com and many other prominent publications and speaks and conducts training for a broad range of professional organizations and for clients on the Advisory Boards of InsuranceThoughtLeadership.com, HR.com, Employee Benefit News, and many other publications.

Want to know more? See here for details about the author of this update, attorney Cynthia Marcotte Stamer, e-mail her here or telephone Ms. Stamer at (469) 767-8872.

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FEMA Shares Info On Federal Aid Programs for Texas Hurricane Harvey Victims

President Trump’s Texas National Disaster Declaration in anticipation of Hurricane Harvey last week gave FEMA pre-disaster lead time to begin rolling out its disaster response services for Texas victims. As passed disaster victims have discovered, the FEMA and other government and private relief programs and resources are an imperfect panacea for solving the losses and disruptions disaster victims suffer. However many of the FEMA programs are an indispensable part of the usually complex puzzle of personal insurance, government, charitable and private relief disaster victims rely upon as they work to restore their lives to a new normal following the disaster.Some of the key federal disaster aid programs that FEMA can make available as needed and warranted under President Donald J. Trump’s disaster declaration include a broad array of programs to assist individuals and families on a short or longer-term basis including:

  • Rental payments for temporary housing for those whose homes are unlivable.  Initial assistance may be provided for up to three months for homeowners and at least one month for renters.  Assistance may be extended if requested after the initial period based on a review of individual applicant requirements.  (Source: FEMA funded and administered.)
  • Grants for home repairs and replacement of essential household items not covered by insurance to make damaged dwellings safe, sanitary and functional.  (Source: FEMA funded and administered.)

  • Grants to replace personal property and help meet medical, dental, funeral, transportation and other serious disaster-related needs not covered by insurance or other federal, state and charitable aid programs.   (Source: FEMA funded at 75 percent of total eligible costs; 25 percent funded by the state.)
  • Unemployment payments up to 26 weeks for workers who temporarily lost jobs because of the disaster and who do not qualify for state benefits, such as self-employed individuals.  (Source: FEMA funded; state administered.)
  • Low-interest loans to cover residential losses not fully compensated by insurance.  Loans available up to $200,000 for primary residence; $40,000 for personal property, including renter losses.  Loans available up to $2 million for business property losses not fully compensated by insurance.  (Source: U.S. Small Business Administration.)
  • Loans up to $2 million for small businesses, small agricultural cooperatives and most private, non-profit organizations of all sizes that have suffered disaster-related cash flow problems and need funds for working capital to recover from the disaster’s adverse economic impact.  This loan in combination with a property loss loan cannot exceed a total of $2 million. (Source: U.S. Small Business Administration.)
  • Loans up to $500,000 for farmers, ranchers and aquaculture operators to cover production and property losses, excluding primary residence.  (Source: Farm Service Agency, U.S. Dept. of Agriculture.)
  • Other relief programs: Crisis counseling for those traumatized by the disaster; income tax assistance for filing casualty losses; advisory assistance for legal, veterans’ benefits and social security matters.

How to Apply for Assistance:

Individuals and business owners who sustained losses in the designated area can begin applying for assistance by registering online at www.DisasterAssistance.gov or by calling 1-800-621-FEMA (3362).  Disaster assistance applicants, who have a speech disability or hearing loss and use TTY, should call 1-800-462-7585 directly; for those who use 711 or Video Relay Service (VRS), call 1-800-621-3362. The toll-free telephone numbers will operate from 7 a.m. to 10 p.m. (local time) seven days a week until further notice. 

Assistance for the State and Affected Local Governments Can Include as Required:

• Payment of not less than 75 percent of the eligible costs for debris removal and emergency protective measures taken to save lives and protect property and public health.  Emergency protective measures assistance, including direct federal assistance is available to state and eligible local governments on a cost-sharing basis (Source: FEMA funded, state administered.)

• Payment of not less than 75 percent of the eligible costs for repairing or replacing damaged public facilities, such as roads, bridges, utilities, buildings, schools, recreational areas, and similar publicly owned property, as well as certain private non-profit organizations engaged in community service activities. (Source: FEMA funded, state administered.)

• Payment of not more than 75 percent of the approved costs for hazard mitigation projects undertaken by state and local governments to prevent or reduce long-term risk to life and property from natural or technological disasters.  (Source: FEMA funded, state administered.

Victims interested in assistance Application procedures for state and local governments will be explained at a series of federal/state applicant briefings with locations to be announced in the affected area by recovery officials. Approved public repair projects are paid through the state from funding provided by FEMA and other participating federal agencies.

Victims and others interested in updates and other information about these briefings, programs and other FEMA disaster relief activities should consider following FEMA online at www.fema.gov/blog, www.twitter.com/fema, www.facebook.com/fema and www.youtube.com/fema.

See FEMA Release Number: HQ-17-060-FactSheet

Houston Convention Center Medical Clinic for Hurricane Harvey Victims Opening Wednesday; Other HHS Relief Announced

Thousands of Texans sheltering at the George R. Brown Convention Center in Houston will have access to on-site medical care at a 250-bed Federal Medical Station established by the U.S. Department of Health and Human Services (HHS)

scheduled to be operational Wednesday.

According to Secretary of Health and Human Services Tom Price, M.D., the Federal Medical Station will provide vital care to Texans affected by Hurricane Harvey. The Federal Medical Station at the convention center will be staffed by members of HHS’ National Disaster Medical System and U.S. Public Health Service Commissioned Corps. 

HHS has more than 500 personnel on the ground to assist those affected by Hurricane Harvey and 1,300 more on standby.

Beyond the team deploying to mean the Houston Convention Center, HHS has additional Federal Medical Stations available for patient care in Texas, and has positioned two 250-bed Federal Medical Stations in Baton Rouge ready to be deployed in Louisiana should state officials determine they are needed.

HHS also has activated its Disaster Distress Helpline, a toll-free call center, that is available at 1-800-985-5990 to aid people in coping with the behavioral health effects of the storm and help people in impacted areas connect with local behavioral health professionals.

HHS is opening the Federal Medical Stations are part of HHS disaster relief efforts initiated in connection with Secretary Price’s declaration of public health emergency in Texas on Saturday and in Louisiana yesterday in response to Hurricane Harvey. See

The HHS Centers for Medicare & Medicaid Services’ (CMS) beneficiaries and their health care providers greater flexibility to provide Medicare-covered health care to meet emergency health needs under his authority in the Public Health Service Act and Social Security Act.

Many Medicare beneficiaries have been evacuated to neighboring communities where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person’s status as a Medicare beneficiary. Due to the emergency declaration and other actions taken by HHS, CMS is able to waive certain documentation requirements to help ensure facilities can deliver care.

These actions and flexibilities will become effective at 12:00 P.M. Eastern Standard Time on August 28, 2017, but will have retroactive effect to August 25, 2017.

Additional public health and safety information for Hurricane Harvey can be found here.  

 

Practice Pool Safety

Summertime means pool time.  

Splashing around in the water provides a wonderful opportunity to stay cool and have fun … as long as everyone stays safe.

News reports of an Ohio lifeguard saving a toddler the first day on the job is a timely  reminder of the importance of knowing and constantly practicing pool safety when you or someone near you is in or near a pool or other water.

Downing & Near Drowning Very Common

Centers for Disease Control (CDC) data shows the importance of water safety and vigilance:

  • Drowning ranks fifth among the leading causes of unintentional injury death in the United States.
  • 10 people die from unintentional drowning every day on average.
  • Children are particularly African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites. are children 14 and younger.
  • For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.
  • More than 50% of drowning victims treated in emergency departments (EDs) require hospitalization or transfer for further care (compared with a hospitalization rate of about 6% for all unintentional injuries).
  • Near drownings are a leading cause of permanent brain injury.  These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (e.g., permanent vegetative state).

While anyone in or around the water may get into trouble under the right circumstances, the victims overwhelmingly tend to be young children and are mostly males.  According to the CDC:

  • Children ages 1 to 4 have the highest drowning rates. In 2014, among children 1 to 4 years old who died from an unintentional injury, one-third died from drowning, most of which occur in home swimming pools.
  • Male and minorities have a higher likelihood of becoming victims.  CDC statistics show:
    • Nearly 80% of people who die from drowning are male; and
    • African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites.

Factors Influencing Drowning Risk

CDC data also reveals the main factors that affect drowning risk:

  • Lack of swimming ability,
  • Lack of barriers to prevent unsupervised water access,
  • Lack of close supervision while swimming,
  • Location,
  • Failure to wear life jackets,
  • Alcohol use, and
  • Seizure disorders.

Preventing Drowning Injuries

CDC data also provides helpful tips about steps people can take to reduce the risk of drowning or near drowning deaths and injuries including the following key safety measures:

  • Close supervision and vigilance is critical whether or not an individual can swim. Drowning can happen quickly and quietly anywhere there is water (such as bathtubs, swimming pools, buckets), and even in the presence of lifeguards.
  • Swimming lessons are a key tool to reduce the risk of drowning in young children.  The CDC reports participation in formal swimming lessons can reduce the risk of drowning among children aged 1 to 4 years.
  • Barriers, such as pool fencing, prevent young children from gaining access to the pool area without caregivers’ awareness. A four-sided isolation fence (separating the pool area from the house and yard) reduces a child’s risk of drowning 83% compared to three-sided property-line fencing.

CDC demonstrates that age or location may increase the need for added diligence and supervision.  The data shows that people of different ages drown in different locations.

  • Most children ages 1-4 drown in home swimming pools.
  • The percentage of drownings in natural water settings, including lakes, rivers and oceans, increases with age.
  • More than half of fatal and nonfatal drownings among those 15 years and older (57% and 57% respectively) occurred in natural water settings.
  • In 2010, the U.S. Coast Guard received reports for 4,604 boating incidents; 3,153 boaters were reported injured, and 672 died. Most (72%) boating deaths that occurred during 2010 were caused by drowning, with 88% of victims not wearing life jackets.
  • For persons with seizure disorders, bathtub drowning is not uncommon.  Drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk.

The data also makes clear drinking and water sports are a dangerous cocktail.   According to the CDC, among adolescents and adults:

  • Alcohol use is involved in up to 70% of deaths associated with water recreation;
  • Nearly 1/4 of emergency room visits for drowning; and
  • About 1/5 of reported boating deaths.

Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat. Of course alcohol consumption by others around a swimmer who has been drinking undermine the awareness of those that would be available to rescue and impaired swimmer too.
The bottom line:  Alcohol and water don’t mix.

Water Safety To-Do List

In light of the known risks, Americans, and their employers, health plans, health care providers, and communities should take steps to keep themselves and others safe while enjoying pools, lakes and other rivers this Summer.

Practice water safety and urge others to do the same by taking the following common sense steps:

  • Supervise When in or Around Water 

Designate a responsible adult to watch young children while in the bath and all people swimming or playing in or around water.

Supervisors of preschool and other young children should  be close enough to reach the child at all times (@touch supervision”).

Because drowning occurs quickly and quietly, supervising adults should not be involved in any other distracting activity (such as drinking, reading, playing cards, talking on the phone, or mowing the lawn) while supervising children, even if lifeguards are present.

Parents considering authorizing swimming field trips led by childcare providers or allowing their children to swim under the supervision of others should investigate the adequacy and training of staff to meet these guidelines.

  • Use the Buddy System. 

Always swim with a buddy. 

  • Lifeguards

Select swimming sites that have lifeguards when possible.  When hosting a social or workplace event near or involving swimming or other water activities, consider hiring one or more lifeguards to monitor the activity and be prepared to respond in case of an emergency.

  • Seizure Disorder Safety

If you, a worker or a family member has a seizure disorder, provide one-on-one supervision around water, including swimming pools. Consider taking showers rather than using a bath tub for bathing. Wear life jackets when boating.

  • Learn to Swim & Make Sure Others In Or Near The Water Can Swim

Formal swimming lessons can protect young children from drowning. However, even when children have had formal swimming lessons, constant, careful supervision when children are in the water, and barriers, such as pool fencing to prevent unsupervised access, are still important.

  • Learn Cardiopulmonary Resuscitation (CPR)

In the time it takes for paramedics to arrive,  CPR skills could save someone’s life. Many free or low-cost options for learning CPR are readily available from the American Red Cross and others.  If you host people around your pool or other water related event, consider hosting a CPR training at one of your upcoming gatherings.

  • Use Life Jackets, Not Air-Filled or Foam Toys.

Provide an wear Coast Guard approved life jackets in good condition as needed.

Don’t use air-filled or foam toys, such as “water wings”, “noodles”, or inner-tubes, instead of life jackets. These toys are not life jackets and are not designed to keep swimmers safe.

  • Don’t Mix Water & Alcohol

Avoid drinking alcohol before or during swimming, boating, or water skiing.  Do not drink alcohol while supervising children.  Do not serve or control the consumption of alcohol by guests when hosting events involving boating, swimming or other water sports.

  • Guard Against “Hypoxic Blackout”

Teach your children and don’t let swimmers hyperventilate before swimming underwater or try to hold their breath for long periods of time. This can cause them to pass out (sometimes called “hypoxic blackout” or “shallow water blackout”) and drown.

  • Prevent Recreational Water Illnesses

Learn how to and act to prevent recreational water illnesses by following the CDC’s recommended 12 Steps for Prevention of Recreational Water Illnesses.

  • Watch For Hazardous Weather And Conditions

Know the local weather conditions and forecast before swimming or boating. Strong winds and thunderstorms with lightning strikes are dangerous.

  • Practice and Maintain Home Pool Safety

If you have a swimming pool at home, consider the following special safeguards:

  • Install a four-sided pool fence at least four feet high with that completely separates the pool area from the house and yard. The fence should be at least 4 feet high with self-closing and self-latching gates that open outward with latches out of reach of children. Also consider additional barriers such as automatic door locks and alarms to prevent access or alert you if someone enters the pool area.
  • Remove floats, balls and other toys from the pool and surrounding area immediately after use so children are not tempted to enter the pool area unsupervised.
  • Stay vigilant at all times.  Supervise your family and guests.  Require adult guests to provide touch supervision for their children in the pool.   Hire a lifeguard during parties or at other times when your ability to provide touch supervision isn’t sufficient.
  • Don’t swim or allow others to swim after or while consuming alcohol.

Keep in mind that a drowning or near drowning of a family member or guest in your pool presents both a substantial legal exposure as well as risks an irreversible personally devastating experience for all involved.  Don’t let fun get ahead of common sense or safety.

  • Practice Natural Water Safety

If you are in and around natural water settings:

  • Use U.S. Coast Guard approved life jackets regardless of the distance to be traveled, the size of the boat, or the swimming ability of boaters.
  • Know the meaning of and obey warnings represented by colored beach flags. .
  • Watch for dangerous waves and signs of rip currents such as water that is  discolored  choppy, foamy, or filled with debris and moving in a channel away from shore.
  • If you are caught in a rip current, swim parallel to shore. Once free of the current, swim diagonally toward shore.

Also plan ahead and take some common sense steps to prepare for the possible need for a timely rescue before pushing off the boat from the shore or entering the water. Among other things:

  • Let at least a couple people not participating know where you are, where you are going, what you plan to do and when you should be back or checkin;
  • Confirm that at least one cellphone has service and keep it with you and working;
  • Consider using the share my location or other feature on your cellphone or other device to help emergency or other rescue personnel find you in the event of an emergency;
  • Discuss safety rules with all participants before getting started;and
  • Enforce safety throughout the activity.

Remember and remind guests that a drowning or near drowning isn’t worth the risk.

  • Be Prepared: Know CPR & Plan Ahead

Since seconds matter when a drowning or near drowning happens, be prepared for a possible emergency before anyone gets in the water.  At minimum:

  • Know CPR and encourage others to do the same;
  • Prominently your address and keep a telephone available in your pool area; Drop a locator pin on your cell phone or otherwise take note of your location if you were on natural water.

Cooling off in the pool or lake can be a fun way to stay comfortable in the summer. Plan ahead and practice water safety as you and your friends enjoy the fun.

When A Loved One Needs Assistance With Daily Living

While living in a well-run assisted-living or other support of residential living arrangement can provide many positive social, safety and healthcare benefit for patients with declining physical or cognitive abilities, most elderly and disabled individuals dread and resist moving from their home to an assisted living or other supportive care living environment.

When transitioning a patient to an assisted living or other care environment, caregivers often must override and understand what preference by the patient to live independently in order to provide support to patient needs to be safe.

Like the surrender of driving privileges, the loss of choice that results from compulsory relocation to a new living environment for an elderly or disabled person forces the patient concurrently to confront his declining functionality and his declining self-determination.

Recognizing this, caregivers should seek to involve the patient as much as possible in making the new living arrangements.

Talking about the possibility of a future need her assisted living care well in advance at the onset of disabling condition can help.

Planning ahead can help patients and their families to be prepared to pick up a facility where the patient may already have friends for siding will be familiar with the staff or the facility reputation.

Many assisted-living providers also sponsor social or other community out reach events for members of the community living independently.  Others offer daycare or other intermittent care opportunities.  Still others may offer temporary assisted-living or stay arrangements following episodes of chemotherapy or other intensive inpatient care.  Participation in these opportunities for involvement gives a patient an opportunity to try out the facility in their services before the patient actually needs to relocate as well as gives the family and the patient the opportunity to check out the facility before making a choice.

When relocating the patient to an assisted living or other facility, careful planning can help ensure that the patient’s room and other living quarters are as home like as possible.  To the extent that space allows, try to bring to the facility some furniture, photographs and other special possessions that will make the new living space feel more like home.

It often also helps if family members participate in the daily flow of activities such as going to lunch or dinner or participating in social gatherings often on for the first few weeks to help encourage the patient to participate in acclimatize them to the new opportunities and friendships.

The best way to head off problems is to detect issues early and intervene.  Even after the patient as well settled family members and friends should drop by often and at varying times to check on the patient’s physical and emotional status, keep the patient engaged and to check up on the care and service that the patient is receiving.

Family members and friends should learn and watch for signs of abuse or neglect.  Many excellent sources of education and resources are available through state Agency responsible for oversight in care of the aging and disabled like this list of elder neglect warning signs  published by the State of Idaho.

To help safeguard your loved one, make sure you and others with a close relationship to the patient check in on the patient regularly.  Set aside time to check in on the patient as well as to talk to the patient to detect signs of abuse, neglect, deterioration in the patient’s physical, cognitive or emotional status or other signs of possible concern.  Even something so seemingly minor as a recurrent failure at the facility staff timely to assist the patient to make her bed or with other schedule services should be monitored and addressed.  Beyond the actual assistance with the performance of the designated chores, the interactions scheduled with staff to perform these chores are critical monitoring activities for the facility.  Failing to timely perform the services means the facility is not keeping on top of their monitoring and other care duties for the patient and should be addressed.

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Despite an endless stream of well-meaning market and governmental reforms over the past 25 years, the U.S. health care system is in crisis. American patients, their families and other caregivers, their employers, their health benefit programs, their health care providers, the communities and even our federal health care budget increasingly are burdened and overwhelmed by the mounting obstacles to caring for our ill, disabled, and aging citizens within our health care system and the extraordinary expense of maintaining and using that system.

As Congress takes up reform again, it is critical that Americans act to protect their own and their families’ health care and control the financial burdens of health care by getting informed, providing clear and consistent direction to Congress and other reformers and taking other actions to empower and care for themselves and their loved ones within our evolving health care system.

©2017 Cynthia Marcotte Stamer. Non-exclusive right to republish licensed to Solutions Law Press, Inc. For information about republication of this or other materials and programs of the author, email the author here.   All rights reserved.