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New From the GAO

May 21, 2013 Comments off

New GAO Reports and Testimonies

Source: Government Accountability Office

Reports

1. Homeland Security: An Overall Strategy Is Needed to Strengthen Disease Surveillance in Livestock and Poultry. GAO-13-424, May 21.
http://www.gao.gov/products/GAO-13-424
Highlights – http://www.gao.gov/assets/660/654750.pdf
Podcast – http://www.gao.gov/multimedia/podcasts/654743

2. Funding for 10 States’ Programs Supported by Four Environmental Protection Agency Categorical Grants. GAO-13-504R, May 6.
http://www.gao.gov/products/GAO-13-504R

Testimonies

1. Immigration Enforcement: Preliminary Observations on DHS’s Overstay Enforcement Efforts, by Rebecca Gambler, director, homeland security and justice, before the Subcommittee on Border and Maritime Security, House Committee on Homeland Security. GAO-13-602T, May 21.
http://www.gao.gov/products/GAO-13-602T
Highlights – http://www.gao.gov/assets/660/654753.pdf

2. Telecommunications Networks: Addressing Potential Security Risks of Foreign-Manufactured Equipment, by Mark L. Goldstein, director, physical infrastructure issues, before the Subcommittee on Communications and Technology, House Committee on Energy and Commerce. GAO-13-652T, May 21.
http://www.gao.gov/products/GAO-13-652T
Highlights – http://www.gao.gov/assets/660/654764.pdf

3. Fiscal Year 2014 Budget Request: U.S. Government Accountability Office, by Gene L. Dodaro, Comptroller General of the United States, before the Subcommittee on Legislative Branch, Senate Committee on Appropriations. GAO-13-617T, May 21.
http://www.gao.gov/products/GAO-13-617T
Highlights – http://www.gao.gov/assets/660/654758.pdf

Teens, Social Media, and Privacy

May 21, 2013 Comments off

Teens, Social Media, and Privacy

Source: Pew Internet & American Life Project

Teens are sharing more information about themselves on social media sites than they have in the past, but they are also taking a variety of technical and non-technical steps to manage the privacy of that information. Despite taking these privacy-protective actions, teen social media users do not express a high level of concern about third-parties (such as businesses or advertisers) accessing their data; just 9% say they are “very” concerned.

The Geography of Student Debt

May 21, 2013 Comments off

The Geography of Student Debt

Source: Federal Reserve Bank of New York

This morning, the New York Fed released its Quarterly Report on Household Debt and Credit for 2013 Q1. The report uses the FRBNY Consumer Credit Panel to show that outstanding household debt declined approximately $110 billion (about 1 percent) from the previous quarter. The drop was due in large part to a reduction in housing-related debt and credit card balances. Meanwhile, delinquency rates for each form of consumer debt declined, with the overall ninety-plus day delinquency rate dropping from 6.3 percent to 6.0 percent.

One of the unique aspects of the FRBNY Consumer Credit Panel, which is itself based on Equifax credit data, is the detail we obtain for each kind of household debt. This quarter, we have taken advantage of the geographic information available in the data set and are introducing a set of maps of our student loan data, which indicate regional variation in several dimensions of student debt. They depict:

  • Student loan borrowers as a share of the population. The population with active student loan debts, or “SL borrowers,” as a share of the population with a credit record varies substantially over space. For example, in Hawaii, less than 12 percent of people with a credit report have student debt, while in the District of Columbia over 25 percent do.
  • Student loan balances per SL borrower. Student indebtedness is significant for SL borrowers in virtually all states. Educational indebtedness per SL borrower ranges from a low of just under $21,000 in Wyoming to a high of over $28,000 in Maryland. Again, Washington, D.C., stands out: the average SL borrower there owes over $40,000. In general, we find SL-borrower debt levels are highest in California and along the Atlantic and Gulf coasts.
  • Percent of balance ninety-plus days delinquent. Delinquency rates show a distinct regional pattern, with states in the south and southwest having generally higher rates than those in the north. The lowest delinquency rate is South Dakota, at just over 6.5 percent, while the highest is in West Virginia, at nearly 18 percent.

Student loan indebtedness and delinquency continue to generate intense interest and we look forward to sharing data and perspectives that help define the scope of this important issue.

Incidence of Childhood and Adolescent Melanoma in the United States: 1973–2009

May 21, 2013 Comments off

Incidence of Childhood and Adolescent Melanoma in the United States: 1973–2009

Source: Pediatrics

OBJECTIVE:

Childhood and adolescent melanoma is rare but has been increasing. To gain insight into possible reasons underlying this observation, we analyzed trends in melanoma incidence diagnosed between the ages of 0 and 19 years among US whites by gender, stage, age at diagnosis, and primary site. We also investigated incidence trends by UV-B exposure levels.

METHODS:

By using Surveillance, Epidemiology, and End Results (SEER) program data (1973–2009), we calculated age-adjusted incidence rates (IRs), annual percent changes, and 95% confidence intervals for each category of interest. Incidence trends were also evaluated by using joinpoint and local regression models. SEER registries were categorized with respect to low or high UV-B radiation exposure.

RESULTS:

From 1973 through 2009, 1230 children of white race were diagnosed with malignant melanoma. Overall, pediatric melanoma increased by an average of 2% per year (95% confidence interval, 1.4%–2.7%). Girls, 15- to 19-year-olds, and individuals with low UV-B exposure had significantly higher IRs than boys, younger children, and those living in SEER registries categorized as high UV-B. Over the study period, boys experienced increased IRs for melanoma on the face and trunk, and females on the lower limbs and hip. The only decreased incidence trend we observed was among 15- to 19-year-olds in the high UV-B exposure group from 1985 through 2009. Local regression curves indicated similar patterns.

CONCLUSIONS:

These results may help elucidate possible risk factors for adolescent melanoma, but additional individual-level studies will be necessary to determine the reasons for increasing incidence trends.

Mental Health Surveillance Among Children — United States, 2005–2011

May 21, 2013 Comments off

Mental Health Surveillance Among Children — United States, 2005–2011

Source: Morbidity and Mortality Weekly Report (CDC)

Mental disorders among children are described as "serious deviations from expected cognitive, social, and emotional development" (US Department of Health and Human Services Health Resources and Services Administration, Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999). These disorders are an important public health issue in the United States because of their prevalence, early onset, and impact on the child, family, and community, with an estimated total annual cost of $247 billion. A total of 13%–20% of children living in the United States experience a mental disorder in a given year, and surveillance during 1994–2011 has shown the prevalence of these conditions to be increasing. Suicide, which can result from the interaction of mental disorders and other factors, was the second leading cause of death among children aged 12–17 years in 2010. Surveillance efforts are critical for documenting the impact of mental disorders and for informing policy, prevention, and resource allocation. This report summarizes information about ongoing federal surveillance systems that can provide estimates of the prevalence of mental disorders and indicators of mental health among children living in the United States, presents estimates of childhood mental disorders and indicators from these systems during 2005–2011, explains limitations, and identifies gaps in information while presenting strategies to bridge those gaps.

Attention-deficit/hyperactivity disorder (6.8%) was the most prevalent parent-reported current diagnosis among children aged 3–17 years, followed by behavioral or conduct problems (3.5%), anxiety (3.0%), depression (2.1%), autism spectrum disorders (1.1%), and Tourette syndrome (0.2% among children aged 6–17 years). An estimated 4.7% of adolescents aged 12–17 years reported an illicit drug use disorder in the past year, 4.2% had an alcohol abuse disorder in the past year, and 2.8% had cigarette dependence in the past month. The overall suicide rate for persons aged 10–19 years was 4.5 suicides per 100,000 persons in 2010. Approximately 8% of adolescents aged 12–17 years reported ≥14 mentally unhealthy days in the past month.

Future surveillance of mental disorders among children should include standard case definitions of mental disorders to ensure comparability and reliability of estimates across surveillance systems, better document the prevalence of mental disorders among preschool-age children, and include additional conditions such as specific anxiety disorders and bipolar disorder. Standard surveillance case definitions are needed to reliably categorize and count mental disorders among surveillance systems, which will provide a more complete picture of the prevalence of mental disorders among children. More comprehensive surveillance is needed to develop a public health approach that will both help prevent mental disorders and promote mental health among children.

Faded Colors: From the Homeland Security Advisory System (HSAS) to the National Terrorism Advisory System (NTAS)

May 21, 2013 Comments off

Faded Colors: From the Homeland Security Advisory System (HSAS) to the National Terrorism Advisory System (NTAS) (PDF)

Source: Naval Postgraduate Center

After the events of 9/11, Homeland Security Presidential Directive – 3 (HSPD – 3) established the Homeland Security Advisory System (HSAS) to provide a comprehensive and effective means to di sseminate information regarding the risk of terrorist acts to federal, state, and local authorities and the American people. Under HSAS, threat levels were raised or lowered 16 times, but never below Threat Level Yellow (Elevated Condition). HSAS should ha ve been straightforward and easy to understand. What evolved was confusion over alerts, lack of specific threat information, concerns over costs to institute and maintain protective measures, and questions regarding what was expected of citizens. Governmen t agencies, the private sector, and the general population became immune with the threat level remaining at or above Yellow.

HSAS was woefully misunderstood not just by the general population, but also within federal, state, and local governments. Ridicul ed by comedians, HSAS gradually began to disappear, to the point where it was necessary to search to find the current threat level, whereas it had once been prominently posted. The purpose of this thesis is to review HSAS and the associated problems, look at comparable international systems, and present an alternative recommendation to provide timely and informative warnings of terrorist threats, and restore credibility by merging HSAS with the already existing DoD force protection conditions.

Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness

May 21, 2013 Comments off

Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness

Source: U.S. Department of Veterans Affairs (via Federal Register)

This document amends the Department of Veterans Affairs (VA) regulation authorizing tentative eligibility determinations to comply with amended statutory authority concerning minimum active-duty service requirements. This document also codifies in regulation statutory presumptions of medical care eligibility for veterans of certain wars and conflicts who developed psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis within 2 years after service and within 2 years after the end of the Persian Gulf War period.

Country Analysis Brief: Algeria

May 21, 2013 Comments off

Country Analysis Brief: Algeria

Source: Energy Information Administration

Algeria is the largest natural gas producer and second largest oil producer, after Nigeria, in Africa. It became a member of the Organization of the Petroleum Exporting Countries (OPEC) in 1969, shortly after it began oil production in 1958. Currently, the country is heavily reliant on its hydrocarbon sector, which accounted for almost 70 percent of government budget revenue and grants and about 98 percent of export earnings in 2011, according to the International Monetary Fund.

In recent years, crude oil production has been stagnant, while natural gas production has gradually declined, because new production and infrastructure projects have repeatedly been delayed. Additionally, in the last three licensing rounds there has been limited interest from investors to undertake new oil and gas projects under the government’s current terms. As a result, the Algerian parliament recently approved amendments to the current hydrocarbon law and introduced fiscal incentives to entice foreign companies to take on new ventures, particularly exploration in offshore areas and in areas onshore that contain shale resources.

The recent militant attack on the In Amenas gas facility prompted security concerns about operating in Algeria’s remote areas, particularly in the south. Any major disruption to Algeria’s hydrocarbon production would not only be detrimental to the local economy but, depending on the scale of lost production, could affect world oil prices. Also, since Algeria is the fourth largest natural gas supplier to Europe, unplanned cuts to natural gas output could affect some European countries. Natural gas and oil account for almost all of Algeria’s total energy consumption, and the country consumes very small amounts of hydro power, coal, and traditional biomass.

New NOAA report examines national oil pollution threat from shipwrecks

May 21, 2013 Comments off

New NOAA report examines national oil pollution threat from shipwrecks
Source: NOAA

NOAA presented to the U.S. Coast Guard today a new report that finds that 36 sunken vessels scattered across the U.S. seafloor could pose an oil pollution threat to the nation’s coastal marine resources. Of those, 17 were recommended for further assessment and potential removal of both fuel oil and oil cargo.

The sunken vessels are a legacy of more than a century of U.S. commerce and warfare. They include a barge lost in rough seas in 1936; two motor-powered ships that sank in separate collisions in 1947 and 1952; and a tanker that exploded and sank in 1984. The remaining sites are 13 merchant marine ships lost during World War II, primarily along the Atlantic Seaboard and Gulf of Mexico. To see a list of the ships and their locations, visit: http://sanctuaries.noaa.gov/protect/ppw/.

The report, part of NOAA’s Remediation of Underwater Legacy Environmental Threats (RULET) project, identifies the location and nature of potential sources of oil pollution from sunken vessels. Knowing where these vessels are helps oil response planning efforts and may help in the investigation of reported mystery spills–sightings of oil where a source is not immediately known or suspected.

Memo: Offshore Profit Shifting and the U.S. Tax Code – Part 2 (Apple Inc.)

May 21, 2013 Comments off

Memo: Offshore Profit Shifting and the U.S. Tax Code – Part 2 (Apple Inc.) (PDF)

Source: U.S. Senate Permanent Subcommittee on Investigations

From press release (Sen. Carl Levin (D-MI):

Apple Inc. has used a complex web of offshore entities – including three foreign subsidiaries the company claims are not tax resident in any nation – to avoid paying billions of dollars in U.S. income taxes, a bipartisan investigation by the Senate Permanent Subcommittee on Investigations has found.

The subcommittee will spotlight Apple’s extensive tax-avoidance strategies at a Tuesday hearing. Witnesses will include Apple CEO Tim Cook, other Apple executives, Treasury Department officials and outside experts. Sen. Carl Levin, D-Mich., and Sen. John McCain, R-Ariz., subcommittee chairman and ranking member, respectively, will also issue a 40-page memorandum with findings and recommendations.

The subcommittee, which previously explored tax avoidance by other multinational corporations using offshore subsidiaries, found similar practices at Apple. In addition, the subcommittee review discovered an unusual tax scheme: Apple’s claim that two key offshore companies are not tax residents of Ireland, where they are incorporated, or of the United States, where Apple executives manage and control the companies. One of those Irish subsidiaries has paid no income taxes to any national tax authority for the past five years.

See also: Offshore Profit Shifting and the U.S. Tax Code – Part 1 (Microsoft & Hewlett-Packard)

Retirement Security Across Generations: Are Americans Prepared for Their Golden Years?

May 20, 2013 Comments off

Retirement Security Across Generations: Are Americans Prepared for Their Golden Years?

Source: Pew Charitable Trusts

This report explores how the Great Recession affected the wealth and retirement security of baby boomers relative to younger and older age groups.

It also explores the retirement security of each group by calculating replacement rates, or the extent to which retirees can use their accumulated wealth and savings to replace preretirement income.

This research reveals that younger age groups face the greatest prospect of downward mobility in their golden years.

New From the GAO

May 20, 2013 Comments off

New GAO Report and Press Release

Source: Government Accountability Office

Report

1. Prescription Drugs: Comparison of DOD and VA Direct Purchase Prices. GAO-13-358, April 19.
http://www.gao.gov/products/GAO-13-358
Highlights – http://www.gao.gov/assets/660/654020.pdf

Press Release

1. GAO Fills Vacancy on Health Information Technology Policy Committee May 20.
http://www.gao.gov/press/gao_fills_vacancy_hit_committee.htm

International Religious Freedom Report for 2012

May 20, 2013 Comments off

International Religious Freedom Report for 2012

Source: U.S. Department of State

Fifteen years ago, the U.S. Congress took a momentous step in support of religious freedom when it passed the International Religious Freedom Act, establishing within the Executive Branch the position of Ambassador at Large for International Religious Freedom. With this measure, the U.S. government made a bold statement on behalf of those who were oppressed, those who were persecuted, and those who were unable to live their lives at the most basic level, for the simple exercise of their faith. Whether it be a single deity, or multiple deities, or no deities at all, freedom to believe–including the freedom not to believe–is a universal human right.

Freedom of religion and belief and the right to worship as one chooses fulfill a deep and abiding human need. The search for this freedom led the Pilgrims to flee Europe for America’s shores centuries ago, and is enshrined in our own Constitution. But it is by no means exclusively an American right. All states are committed to freedom of thought, conscience and belief in the Universal Declaration of Human Rights, which has been the touchstone and the global standard for the protection of human rights around the world since 1948.

The right to religious freedom is inherent in every human being. Unfortunately, this right was challenged in myriad ways in 2012. One of the basic elements of the International Religious Freedom Act is the requirement that the Department of State publish an annual report on the status of religious freedom in countries around the world, and the record of governments in protecting–or not protecting–this universal right.

This year’s report tells stories of courage and conviction, but also recounts violence, restriction, and abuse. While many nations uphold, respect, and protect religious freedom, regrettably, in many other nations, governments do not protect this basic right; subject members of religious minorities to violence; actively restrict citizens’ religious freedom through oppressive laws and regulations; stand by while members of societal groups attack their fellow citizens out of religious hatred, and fail to hold those responsible for such violence accountable for their actions. The immediate challenge is to protect members of religious minorities. The ongoing challenge is to address the root causes that lead to limits on religious freedom. These causes include impunity for violations of religious freedom and an absence of the rule of law, or uneven enforcement of existing laws; introduction of laws restricting religious freedom; societal intolerance, including anti-Semitism and lack of respect for religious diversity; and perceptions that national security and stability are best maintained by placing restrictions on and abusing religious freedom.

This comprehensive report comprises almost two hundred individual reports on countries and territories. Each report sets forth the laws, policies, and practices of governments; describes the nature of societal respect for religious freedom; and highlights the specific efforts that the U.S. government made in each country to promote respect for religious freedom. Some reports document religious bigotry, hatred, and oppression. Others describe examples of religious freedom, societal respect, and interfaith dialogue. Whatever the case, the Secretary of State has been clear that these reports should be accurate, objective, detailed, and frank.

For 2012, some common themes regarding the status of religious freedom around the world emerged. In general, these themes reveal negative trends, and often cut across national and regional boundaries. The individual reports provide the details, but these worrying trends–and the authoritarian governments that restrict their citizens’ ability to practice their religion–merit highlighting.

Alleviating Poverty: Mobile Communications, Microfinance and Small Business Development Around the World

May 20, 2013 Comments off

Alleviating Poverty: Mobile Communications, Microfinance and Small Business Development Around the World

Source: Brookings Institution

Poverty is one of the most pressing problems around the world. According to statistics from the World Bank, nearly one-quarter of the global population lives at or below the poverty line of $1.25 per day.[i] With so many people struggling for basic subsistence, it is hard for those affected to get out of poverty, gain access to capital, or develop small firms or businesses that help them build a better life.

Yet with the growth of mobile technology, there are new opportunities for individuals and small businesses to lift themselves up. People can use handheld devices to make monetary transfers, arrange for microfinance loans, establish small enterprises, and improve their economic circumstances. This helps them alleviate poverty and create a better situation for themselves and their families.

Jeffrey Sachs, director of Columbia University’s Earth Institute, said that wireless communication is a breakthrough technology that helps to solve the worst problems associated with health care, poverty, and educational access. "Now in every village where I go, someone’s got a cell phone, somebody can make an emergency call, someone can find out the price on the market, someone can start a business empowered by the fact that they can reach a customer or a supplier, someone can drive a taxi or a truck for that reason as well. Everything is changing," said Sachs.[ii]

In this Mobile Economy Project report, Darrell West looks at the growth of handheld devices and investigates the barriers to doing business in the developing world. In particular, West explores how mobile devices enable individual entrepreneurship and small business development. Despite the presence of barriers such as corruption, lack of transparency and capital, and poor infrastructure in many parts of the developing world, there are successful ventures enabled by mobile technology.

The report details some of the cases which illustrate emerging possibilities for alleviating poverty in different countries including:

  • The growth of mobile devices
  • Mobile money transfer services
  • Mobile tools for small businesses
  • Microfinance applications

The Evolving Role of Emergency Departments in the United States

May 20, 2013 Comments off

The Evolving Role of Emergency Departments in the United States

Source: RAND Corporation

From press release:

Hospital emergency departments play a growing role in the U.S. health care system, accounting for a rising proportion of hospital admissions and serving increasingly as an advanced diagnostic center for primary care physicians, according to a new RAND Corporation study.

While often targeted as the most expensive place to get medical care, emergency rooms remain an important safety net for Americans who cannot get care elsewhere and may play a role in slowing the growth of health care costs, according to the study.

Emergency departments are now responsible for about half of all hospital admissions in the United States, accounting for nearly all of the growth in hospital admissions experienced between 2003 and 2009.

Despite evidence that people with chronic conditions such as asthma and heart failure are visiting emergency departments more frequently, the number of hospital admissions for these conditions has remained flat. Researchers say that suggests that emergency rooms may help to prevent some avoidable hospital admissions.

"Use of hospital emergency departments is growing faster than the use of other parts of the American medical system," said Dr. Art Kellermann, the study’s senior author and a senior researcher at RAND, a nonprofit research organization. "While more can be done to reduce the number of unnecessary visits to emergency rooms, our research suggests emergency rooms can play a key role in limiting growth of preventable hospital admissions."

New From the GAO

May 20, 2013 Comments off

New GAO Report

Source: Government Accountability Office

1. DOD Business Systems Modernization: Further Actions Needed to Address Challenges and Improve Accountability. GAO-13-557, May 17.
http://www.gao.gov/products/GAO-13-557
Highlights – http://www.gao.gov/assets/660/654734.pdf

The Religious Affiliation of U.S. Immigrants: Majority Christian, Rising Share of Other Faiths

May 20, 2013 Comments off

The Religious Affiliation of U.S. Immigrants: Majority Christian, Rising Share of Other Faiths
Source: Pew Forum on Religion & Public Life

Over the past 20 years, the United States has granted permanent residency status to an average of about 1 million immigrants each year. These new “green card” recipients qualify for residency in a wide variety of ways – as family members of current U.S. residents, recipients of employment visas, refugees and asylum seekers, or winners of a visa lottery – and they include people from nearly every country in the world. But their geographic origins gradually have been shifting. U.S. government statistics show that a smaller percentage come from Europe and the Americas than did so 20 years ago, and a growing share now come from Asia, sub-Saharan Africa and the Middle East-North Africa region.

With this geographic shift, it is likely that the religious makeup of legal immigrants also has been changing. The U.S. government, however, does not keep track of the religion of new permanent residents. As a result, the figures on religious affiliation in this report are estimates produced by combining government statistics on the birthplaces of new green card recipients over the period between 1992 and 2012 with the best available U.S. survey data on the religious self-identification of new immigrants from each major country of origin.

While Christians continue to make up a majority of legal immigrants to the U.S., the estimated share of new legal permanent residents who are Christian declined from 68% in 1992 to 61% in 2012. Over the same period, the estimated share of green card recipients who belong to religious minorities rose from approximately one-in-five (19%) to one-in-four (25%). This includes growing shares of Muslims (5% in 1992, 10% in 2012) and Hindus (3% in 1992, 7% in 2012). The share of Buddhists, however, is slightly smaller (7% in 1992, 6% in 2012), while the portion of legal immigrants who are religiously unaffiliated (atheist, agnostic or nothing in particular) has remained relatively stable, at about 14% per year.

Unauthorized immigrants, by contrast, come primarily from Latin America and the Caribbean, and the overwhelming majority of them – an estimated 83% – are Christian. That share is slightly higher than the percentage of Christians in the U.S. population as a whole (estimated at just under 80% of U.S. residents of all ages, as of 2010).

These are among the key findings of a new study by the Pew Research Center’s Forum on Religion & Public Life examining recent trends in the geographic origins and religious affiliation of immigrants to the United States.

Sequestering Meals on Wheels Could Cost the Nation $489 Million per Year

May 20, 2013 Comments off

Sequestering Meals on Wheels Could Cost the Nation $489 Million per Year

Source: Center for Effective Government

Sequestering Meals on Wheels funds could cost taxpayers far more than it saves. While across-the-board spending cuts that began March 1, called sequestration, are expected to reduce spending on Meals on Wheels programs this year by an estimated $10 million, these savings will be dwarfed by at least $489 million per year in increased spending on Medicaid, both this year and in each subsequent year that sequestration remains in place.

Outside of Washington, waiting lists for Meals on Wheels enrollees have received media attention, but the expected savings have remained largely unquestioned. In reality, cutting Meals on Wheels will very likely increase the federal deficit by increasing the overall cost burden and shifting it to Medicaid, local charities, and other programs.

Overall, Meals on Wheels saves the federal taxpayers money by helping participants live at home instead of living in comparatively expensive nursing homes. The average cost to Medicaid of nursing home care per patient is approximately $57,878 annually.

By contrast, the cost to Medicaid of home care is much lower, approximately $15,371 annually, or $42,507 less than nursing home care. Nationally, according to a survey by the Administration on Aging, as many as "92% [of enrollees] say Meals on Wheels means they can continue to live in their own home."

Based on these estimates, our analysis suggests that sequestering Meals on Wheels funds will actually cost the U.S. taxpayer $479 million dollars over the seven months it will be implemented during this federal fiscal year, which ends September 30 (see the appendix for details of this estimate). Moreover, because sequestration-related cuts are expected to increase in FY 2014 and beyond, if sequestration is not reversed, Medicaid-related costs will increase even more in those years.

CRS — Multilateral Development Banks: U.S. Contributions FY2000-FY2013

May 20, 2013 Comments off

Multilateral Development Banks: U.S. Contributions FY2000-FY2013

Source: Congressional Research Service (via Federation of American Scientists)

This report shows in tabular form how much the Administration requested and how much Congress appropriated for U.S. payments to the multilateral development banks (MDBs) since 2000. It also provides a brief description of the MDBs and the ways they fund their operations. It will be updated periodically as annual appropriation figures are known. The title of this report will also change annually, as new yearly appropriation figures are added.

For FY2013, the Administration has requested funds for several of the non-concessional lending facilities at the MDBs. Several of the MDBs are in the process of increasing the size of their nonconcessional lending facilities, a process frequently called a “general capital increase” (GCI). GCIs are relatively unusual, particularly for so many institutions at the same time. Contributions to the GCIs are expected to be spread out over a five- to eight-year period, depending on the institution. For most of the institutions, the funds appropriated in FY2012 were the first annual payment. In addition to funds for the GCIs, the Administration has requested for FY2013 funds for several MDB concessional lending facilities and more targeted MDB funds, such as those dedicated to environmental issues. The total Administration’s request for the MDBs is smaller than its requests in FY2011 and FY2012.

For further information about the MDBs, the GCIs, and relevant U.S. policy process, see:

• CRS Report R41170, Multilateral Development Banks: Overview and Issues for Congress, by Rebecca M. Nelson;

• CRS Report R41672, Multilateral Development Banks: General Capital Increases, by Martin A. Weiss; and

• CRS Report R41537, Multilateral Development Banks: How the United States Makes and Implements Policy, by Rebecca M. Nelson and Martin A. Weiss.

Microbes in Pool Filter Backwash as Evidence of the Need for Improved Swimmer Hygiene — Metro-Atlanta, Georgia, 2012

May 19, 2013 Comments off

Microbes in Pool Filter Backwash as Evidence of the Need for Improved Swimmer Hygiene — Metro-Atlanta, Georgia, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

Filters physically remove contaminants, including microbes, from water in treated recreational water venues, such as pools. Because contaminants accumulate in filters, filter concentrates typically have a higher density of contamination than pool water. During the 2012 summer swimming season, filter concentrate samples were collected at metro-Atlanta public pools. Quantitative polymerase chain reaction (qPCR) assays were conducted to detect microbial nucleic acid. Pseudomonas aeruginosa was detected in 95 (59%) of 161 samples; detection indicates contamination from the environment (e.g., dirt), swimmers, or fomites (e.g., kickboards). P. aeruginosa detection underscores the need for vigilant pool cleaning, scrubbing, and water quality maintenance (e.g., disinfectant level and pH) to ensure that concentrations do not reach levels that negatively impact swimmer health. Escherichia coli, a fecal indicator, was detected in 93 (58%) samples; detection signifies that swimmers introduced fecal material into pool water. Fecal material can be introduced when it washes off of swimmers’ bodies or through a formed or diarrheal fecal incident in the water. The risk for pathogen transmission increases if swimmers introduce diarrheal feces. Although this study focused on microbial DNA in filters (not on illnesses), these findings indicate the need for swimmers to help prevent introduction of pathogens (e.g., taking a pre-swim shower and not swimming when ill with diarrhea), aquatics staff to maintain disinfectant level and pH according to public health standards to inactivate pathogens, and state and local environmental health specialists to enforce such standards.

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