WBEZ | Health Care http://www.wbez.org/tags/health-care Latest from WBEZ Chicago Public Radio en Immigrants face barriers on health care site http://www.wbez.org/news/immigrants-face-barriers-health-care-site-109698 <img typeof="foaf:Image" src="http://llnw.wbez.org/main-images/ACA immigrants_web.jpg" alt="" /><p><p>More than two months after the Obama administration declared <a href="https://www.healthcare.gov/">healthcare.gov</a> working &ldquo;smoothly for the vast majority of users,&rdquo; immigrants who try to sign up are still encountering serious glitches.</p><p>On Wednesday, federal officials <a href="http://www.hhs.gov/news/press/2014pres/02/20140212a.html">trumpeted</a> the fact that more than 1 million people signed up for private insurance in January, with Illinois accounting for nearly 89,000 of those enrollees. With fewer than 40 days until the deadline to enroll without incurring a penalty, much of the attention has turned to so-called &ldquo;young invincibles,&rdquo; a term for young, healthy people who will likely have lower health care costs.</p><p>There&rsquo;s no similar focus on immigrants, WBEZ has found, who continue to face significant hurdles with identity and citizenship verification, and faulty determinations of eligibility for Medicaid. In Illinois, the task of finding and navigating around those barriers often falls to scrappy enrollment specialists who work directly with those clients at community health centers. On top of their jobs, they are finding themselves tasked with bringing the glitches to the attention to state and federal authorities, and lobbying for them to be fixes.</p><p>Illinois, which is one of seven states to engage in a state-federal partnership, relies on the federal site to handle the enrollment function for plans offered on the state&rsquo;s insurance marketplace. Under the Affordable Care Act, immigrants are required to have insurance if they reside lawfully in the U.S. &ndash; even if they are not citizens.</p><p>&ldquo;Since November I have frequently made visits, and every time I made a visit I&rsquo;ve stayed at least 3-4 hours,&rdquo; said Zejna Belko, a 51-year old Bosnian immigrant who described her attempt to enroll in the healthcare exchange with the help of enrollment counselors at the Hamdard Center on Chicago&rsquo;s far North Side. &ldquo;We&rsquo;ve also had individuals from other agencies try to help us out.&rdquo;</p><p>Belko, who&rsquo;s lived in the U.S. with a green card for 16 years, said she&rsquo;s spent up to 30 hours working with enrollment specialists. Still, they haven&rsquo;t even been able to start her application because the system cannot verify her identity. So far, Belko has twice mailed identifying documents, such as copies of her green card and social security card, to the Department of Health and Human Services, to no avail.</p><p>&ldquo;My blood pressure rises,&rdquo; she said through a translator. &ldquo;I get very frustrated and angry because I&rsquo;m an honest person and I&rsquo;m not hiding anything, and I don&rsquo;t understand what the problem is. I just want to get health care coverage.&rdquo;</p><p>In a small health center in Wicker Park, Graciela Guzman said she sees these cases all the time. Most frequently, the issues with identity verification is done via checking an applicant&rsquo;s credit history &ndash; something Guzman said many newer immigrants don&rsquo;t yet have.</p><p>&ldquo;They haven&rsquo;t been here long enough to be considered &lsquo;bankable,&rsquo;&rdquo; she said. &ldquo;Like a lot of them have been paid by cash. Maybe they don&rsquo;t have banks. Maybe they don&rsquo;t own property. So the system has a harder time just finding them.&rdquo;</p><p><strong>The Morning Shift: How an ACA enrollment specialist is helping immigrants in Chicago</strong></p><p><iframe frameborder="no" height="166" scrolling="no" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/134626873&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_artwork=true" width="100%"></iframe></p><p>Guzman works with a team of five enrollment specialists at <a href="http://www.primecarechi.org/">PrimeCare Community Health</a>, a small clinic based in St. Elizabeth&rsquo;s Hospital in Chicago&rsquo;s Wicker Park neighborhood. About half of their clients are immigrants. Her team encounters hurdles to enrollment so frequently, they&rsquo;ve managed to cobble together a complicated flow sheet of workarounds. For identity verification problems, they&rsquo;ve found that calling the federal Health Insurance Marketplace Call Center, and later uploading or mailing a client&rsquo;s identification documents, usually helps to get an application started</p><p>But there are other barriers. Through trial and error, they found success in ignoring the site&rsquo;s directions to fill out information completely, and instead repeatedly clicking &ldquo;continue and save&rdquo; when they get an error on citizenship verification. The most significant challenge, however, appears not to have a workaround.</p><p>&ldquo;Most of our clients receive incorrect eligibility determinations, that tell them that they&rsquo;re eligible for Medicaid,&rdquo; said Guzman.</p><p>This is the case for lawful permanent residents whose incomes would qualify for Medicaid, but who are barred from enrolling in that program because they&rsquo;ve lived in the U.S. less than five years. Once the site directs an enrollee to apply for Medicaid, it does not allow them back onto the private healthcare exchange, where these clients should be.</p><p>&ldquo;We have brought this to the attention of our federal counterparts,&rdquo; said a state spokesman, &ldquo;and we believe they have been working to address it by adding new questions to <a href="https://www.healthcare.gov/">healthcare.gov</a> late last week that will allow people to get through to the Marketplace once they have been issued a denial.&rdquo;</p><p>In other words, immigrants are advised to apply for Medicaid even when they know they are ineligible for it, just to receive a denial. But since Medicaid eligibility was expanded under the Affordable Care Act, a backlog in applications has led to significantly longer processing times.&nbsp;</p><p>Guzman and her team of so-called &ldquo;navigators&rdquo; say, as they discover glitches, they&rsquo;ve relayed them to state and federal officials. So far, they have enrolled more than 600 immigrants to the healthcare exchange. In addition to the discoveries they&rsquo;ve made about getting through the technical difficulties, the team is also working out ways to handle the unexpected emotional impact of the job.</p><p>&ldquo;On our days off, we&rsquo;re constantly thinking about patients, which is like ludicrous,&rdquo; said Martin Jurado, who works with Guzman at PrimeCare. &ldquo;I don&rsquo;t think anybody else does that. You know? Somebody that you&rsquo;ve barely met, you barely know, yet you know everything about their life, what they&rsquo;re going through, and you&rsquo;re carrying that, and a lot of people didn&rsquo;t tell you that, starting off the bat.&rdquo;</p><p>Guzman found that <a href="http://guzmangraciela.wordpress.com/">blogging </a>helps her process their experiences. She writes of frustrations with the healthcare exchange website, but also about clients that stick in her head.</p><p>&ldquo;People really weren&rsquo;t hearing the complexity of the website, they weren&rsquo;t hearing people&rsquo;s fears and difficulties in getting through the website,&rdquo; she said. &ldquo;And so we wanted to share some of what&rsquo;s going on.&rdquo;</p><p>Together, she said, they have come to realize they are witnessing a moment: droves of people are coming out of the shadows because the law requires them to &ndash; and they&rsquo;re coming with needs that extend far beyond just health care.</p><p>&ldquo;We get them comfortable and primed, hopefully, for enrollment,&rdquo; she said, &ldquo;but then they&rsquo;ll turn around and kind of like almost offhandedly be like, &lsquo;so you helped me with this, can you help me with housing? Can you help me with food stamps? I have some domestic stuff going on, where do I go?&rsquo;&rdquo;</p><p>Guzman said she believes they&rsquo;re on the frontier of a new phase. She, Jurado, and the rest of their team will stick around after the crush of enrollment ends March 31st, helping people change or update their health plans. But she said they&rsquo;ll also continue to serve as access points to community resources when immigrants don&rsquo;t know where to go.</p><p><em>Odette Yousef is WBEZ&rsquo;s North Side Bureau reporter. Follow her <a href="https://twitter.com/oyousef" style="text-decoration:none;">@oyousef</a> and <a href="https://twitter.com/WBEZoutloud" style="text-decoration:none;">@WBEZoutloud</a></em></p></p> Thu, 13 Feb 2014 12:29:00 -0600 http://www.wbez.org/news/immigrants-face-barriers-health-care-site-109698 Conservative conference draws lawmakers, picketers http://www.wbez.org/news/conservative-conference-draws-lawmakers-picketers-108356 <img typeof="foaf:Image" src="http://llnw.wbez.org/main-images/repubs.png" alt="" /><p><p>CHICAGO &mdash;More than a thousand conservative lawmakers and business executives from across the nation are gathering in Chicago to craft policy proposals that could be pushed in state capitols next year.</p><p>Attendees at the annual meeting of the American Legislative Exchange Council were countered Thursday by a roughly equal number of protesters upset by the close ties between big businesses and lawmakers.</p><p>The council has backed model legislation passed in Republican-led states that has sought to invalidate key portions of the federal health care law, reduce union powers and cut taxes. Participants discussed ways Thursday of injecting more private-sector involvement in state Medicaid programs and pushing laws that bar union membership from being a requirement for employment.</p><p>Protesters outside the meeting accused the organization of corporate greed and union busting.</p></p> Thu, 08 Aug 2013 13:49:00 -0500 http://www.wbez.org/news/conservative-conference-draws-lawmakers-picketers-108356 Limbo on Illinois health marketplace disappoints consumer and business advocates http://www.wbez.org/news/limbo-illinois-health-marketplace-disappoints-consumer-and-business-advocates-107582 <img typeof="foaf:Image" src="http://llnw.wbez.org/main-images/health market_060613_lw.jpg" alt="" /><p><p>Illinois&rsquo; new health insurance marketplace will be run jointly with the federal government for the foreseeable future, which has disappointed consumer advocates.</p><p>The marketplace, also known as the insurance exchange, is where people without health insurance will go to shop under the Affordable Care Act or Obamacare. States had the option to pass legislation establishing state-run marketplaces, or leave it to the feds.</p><p>Several such bills made their way through the Illinois General Assembly without passing by the end of the legislative session in May. As it stands, Illinois&rsquo; marketplace will be jointly run with the federal government for the foreseeable future.</p><p>&ldquo;We&rsquo;re not gonna have the ability to really have any oversight of the federal exchange,&rdquo; said Jim Duffett, Executive Director of the Illinois Campaign for Better Healthcare. He says the bill would have established a regulatory board representing a broad swath of consumer interests including small businesses, communities of color and people with disabilities, calling the proposed body &ldquo;a very broad-based independent pro-consumer board.&rdquo; It would also have given the state the ability to regulate rates.</p><p>The bill, HB 3227, was passed in the Illinois state senate, but never came to a vote in the house. While it could still progress in the fall legislative veto session, the current limbo means the exchange will be run jointly with the federal government in 2014 based on previous legislation. The future of the exchange in 2015 remains unclear.</p><p>Healthcare and small business advocates had also hoped for a bill to pass this year.</p><p>Danny Chun, spokesperson for the Illinois Hospital Association (IHA), says hospitals supported HB 3227 because they, too, would have had representation on the regulatory board. And IHA supports requiring the insurance industry to cover the costs of managing the marketplace, another provision of the stymied bill. But he said he was not too worried.</p><p>&ldquo;The marketplace is happening,&rdquo; Chun said. &ldquo;Just because they didn&rsquo;t pass it in the spring session doesn&rsquo;t mean the issue isn&rsquo;t going to be called again.&rdquo;</p><p>The Illinois Chamber of Commerce supported a different version of the bill, but had hoped another version would pass this session -- one without the same requirements for insurance companies to fund the exchange.</p><p>&ldquo;Ultimately what ended up passing the Senate we were neutral on,&rdquo; said Laura Minzer, head of the healthcare council for the ICC. &ldquo;But it reflected a lot of the provisions and the principles we wanted to see captured.&rdquo;</p><p>Other key legislation did pass the Illinois General Assembly, including a bill to expand Medicaid in Illinois to low-income adults and a bill to establish licensed Illinois Insurance Navigators. Navigators will help consumers make their way in the new marketplace.</p><p>Beginning January 1, 2014, all Americans will be required to get health insurance or pay a fine. At least 17 states have already opted to create their own insurance exchanges, while 26 states will likely leave it to the federal government. Illinois is among the seven that are currently planning a jointly-run exchange. The federal marketplace, including the one in Illinois, is set to open October 1.</p><p><em>Lewis Wallace is a WBEZ Pritzker Journalism Fellow. Follow him <a href="http://twitter.com/lewispants" target="_blank">@lewispants</a>.</em></p></p> Fri, 07 Jun 2013 07:55:00 -0500 http://www.wbez.org/news/limbo-illinois-health-marketplace-disappoints-consumer-and-business-advocates-107582 The story of Dunning, a 'tomb for the living' http://www.wbez.org/series/curious-city/story-dunning-tomb-living-106892 <p><p><iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/g3l7YoGhlbM" width="560"></iframe></p><p><iframe frameborder="no" height="166" scrolling="no" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/109749351&amp;color=ff6600&amp;auto_play=false&amp;show_artwork=false" width="100%"></iframe></p><p>For a long time, Chicagoans were scared of Dunning. The very name &ldquo;Dunning&rdquo; gave them chills. People were afraid they would end up in <em>that </em>place.</p><p>Today, the Chicago neighborhood, out on the city&rsquo;s Far Northwest Side, looks like a middle-class suburb. &ldquo;If peace and quiet are what you seek, look no further than Dunning,&rdquo; the Chicago Tribune wrote in 2009. Some of the area&rsquo;s younger residents have no idea what used to be there: an insane asylum, a home for the city&rsquo;s poorest people, and cemeteries where the poor were buried.</p><p>&ldquo;I grew up in this area,&rdquo; says Michael Dotson, who is 29. &ldquo;I&rsquo;ve passed by this vicinity a hundred times, and never knew anything about it.&rdquo; Dotson recently stumbled across a website that mentioned the old Dunning asylum. And then he saw a headline claiming that 38,000 bodies might be lying underneath the old Dunning grounds, their burial places unmarked.</p><p>That prompted Dotson to pose this question to Curious City:</p><p dir="ltr"><em>What&rsquo;s the history behind Cook County&rsquo;s former Dunning Insane Asylum and the people buried near there?</em></p><p>It&rsquo;s a long history with many dark chapters. Curious City can&rsquo;t detail the entire history, so we focused on finding out who lived at Dunning &mdash;&nbsp;and who is still lying in Dunning&rsquo;s unmarked graves. In both life and death, the people who ended up at Dunning were some of Chicago&rsquo;s least fortunate residents.</p><p dir="ltr">Here&rsquo;s how historian Perry Duis describes Dunning&rsquo;s reputation in his 1998 book &ldquo;<a href="http://www.press.uillinois.edu/books/catalog/57zms8wb9780252074158.html">Challenging Chicago</a>&rdquo;:</p><p><em>For many generations of Chicago children, bad behavior came to a halt with a stern warning: &ldquo;Be careful, or you&rsquo;re going to Dunning.&rdquo; The prospect sent shivers down the spines of youngsters, who regarded it as the most dreaded place imaginable.</em></p><p>Chicago resident Steven Hill, who is 60, recalls: &ldquo;It was a term used in the &rsquo;50s and &rsquo;60s &mdash; &lsquo;If you and your brothers and sisters don&rsquo;t behave, we&rsquo;ll send you to Dunning.&rsquo; And that used to scare kids, because they knew that it was a mental institution.&rdquo;</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/1800s-asylum.jpg" style="margin: 5px; float: right; height: 194px; width: 285px;" title="The Cook County Insane Asylum at Dunning in the late 1800s." />Mundelein resident Ross Goodrich, who is 81, heard a similar expression growing up on the West Side in the 1930s and &rsquo;40s. &ldquo;Whenever anyone would act a little nutsy, any of the kids, we&rsquo;d say, &lsquo;Oh, gotta send them to Dunning.&rsquo; It was a pretty common expression,&rdquo; he says.</p><p>Hill and Goodrich are interested in the history of Dunning because both of them had great-grandparents who died in the institution in the early 1900s.</p><p>The complex occupied 320 acres of land between Irving Park Road and Montrose Avenue, stretching west from Naragansett Avenue to Oak Park Avenue.</p><p>It was never actually named Dunning. But the property just south of it was owned by the Dunning family &mdash; so when the Chicago, Milwaukee &amp; St. Paul Railway extended a line to the area in 1882, the stop was named Dunning Station. And then people started calling the institution &ldquo;Dunning.&rdquo; (In its early years, people sometimes called it &ldquo;Jefferson,&rdquo; since it&rsquo;s part of Jefferson Township.)</p><p>When it opened in 1854, it wasn&rsquo;t an insane asylum. The Cook County Infirmary was a &ldquo;poor farm&rdquo; and almshouse. County officials opened its doors to people who had fallen on hard times and found themselves unable to earn a living.</p><p>&ldquo;They didn&rsquo;t provide very many services,&rdquo; says Joseph J. Mehr, a Springfield clinical psychologist who wrote about Dunning in his 2002 book, &ldquo;<a href="http://www.amazon.com/Illustrated-History-Illinois-Services-1847-2000/dp/1553952154">An Illustrated History of Illinois Public Mental Health Services</a>.&rdquo;</p><p>&ldquo;What they really provided were a place to sleep and food,&rdquo; he says. &ldquo;And that was pretty much the extent of it.&rdquo;</p><p>But from the very beginning, many of the poor people who were sent to live at the almshouse had mental illnesses. &ldquo;In some ways, it&rsquo;s almost similar to what we have today,&rdquo; Mehr says, &ldquo;in that we have a lot of people who are homeless and living on the streets, and a significant portion of them are people who are mentally ill.&rdquo;</p><p>So the county added an &ldquo;Insane Department&rdquo; at the almshouse. And then, in 1870, it built a separate Cook County Insane Asylum on the grounds.</p><p>&ldquo;The feeling was it&rsquo;s better to isolate the population of the mentally handicapped, the indigent, and keep them far away from the city proper,&rdquo; Chicago historian Richard C. Lindberg says.</p><p>But Mehr sees another motivation behind the asylum&rsquo;s location, far from downtown Chicago. &ldquo;The idea was to get people who were disturbed out of stress-inducing situations,&rdquo; he says. &ldquo;Asylums were built out in the country, and they were really pastoral, bucolic places where people could relax.&rdquo;</p><p>That was the idea, anyway. In reality, Dunning was chronically overcrowded, and patients were neglected and abused.</p><p>&ldquo;You could think of this place as the prototypical evil dark asylum of literature,&rdquo; Mehr says. &ldquo;There wasn&rsquo;t much treatment. People &hellip; weren&rsquo;t fed well. The food was terrible &mdash; weevil-filled. &hellip; People didn&rsquo;t get the kind of medical care that they ought to get. &hellip; For many, many years, it was really a terrible place.&rdquo;</p><p dir="ltr"><strong>Abuse and corruption</strong></p><p>In 1874, a Tribune reporter described Dunning&rsquo;s poorhouse as &ldquo;a shambling, helter-skelter series of wooden buildings&rdquo; where dejected-looking people with matted hair and tattered clothing were &ldquo;crowded and herded together like sheep in the shambles, or hogs in the slaughtering-pens.&rdquo;</p><p>&ldquo;The rooms swarm with vermin,&rdquo; an attendant told the reporter. &ldquo;The cots and bed-clothing are literally alive with them. We cannot keep the men clean, and we cannot drive the parasites away unless they are clean.&rdquo;</p><p>The reporter couldn&rsquo;t take the smell in the room, exclaiming: &ldquo;For Heaven&rsquo;s sake let us get out; this stench is unbearable.&rdquo;</p><p>Political corruption was part of the problem at Dunning. County officials treated it as a patronage haven, hiring pals and cronies who had no expertise in handling mental patients. Employees got drunk on duty, partying and dancing late at night in the asylum. Some of the asylum&rsquo;s top authorities used taxpayer money to decorate their offices and hold lavish parties while patients were suffering in squalor.</p><p dir="ltr">&ldquo;Everybody was a political hiree,&rdquo; says Al Opitz, a neighborhood historian. &ldquo;So consequently, they had nobody to report to other than the political boss.&rdquo;</p><p>In an 1889 court case, Cook County Judge Richard Prendergast described Dunning as &ldquo;a tomb for the living.&rdquo; He criticized the asylum for squeezing 1,000 patients into a space better suited for 500. &ldquo;The presence of so many lunatics in a room irritates all,&rdquo; Prendergast said. &ldquo;Fighting among the patients at night is frequent.&rdquo;</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/dunning-residents-01091898-chicago-inter-ocean.jpg" style="margin: 5px; float: left; height: 263px; width: 200px;" title="An artist’s depiction of residents inside Dunning, published in 1898 in the Chicago Inter Ocean newspaper." />That same year, two attendants at the Dunning asylum were charged with murdering patient Robert Burns. They&rsquo;d kicked him in the stomach and given him a gash on the head. A defense attorney claimed these &ldquo;blows and kicks &hellip; were beneficial to the insane man, as they were a sort of stimulus or tonic,&rdquo; according to the Tribune. Jurors acquitted the attendants, blaming Dunning&rsquo;s overcrowding rather than the actions of individual employees.</p><p>Even under the best of conditions, doctors didn&rsquo;t have many effective treatments for people suffering from mental illness. The only drugs they had at their disposal were sedatives. &ldquo;If a person was terribly agitated, they might dose them with chloral hydrate, which would pretty much knock them out,&rdquo; Mehr says. &ldquo;That&rsquo;s the ingredient in what used to be called a Mickey Finn in a bar.&rdquo;</p><p>According to <a href="http://books.google.com/books?id=pdcSAQAAMAAJ&amp;printsec=frontcover&amp;source=gbs_ge_summary_r&amp;cad=0#v=onepage&amp;q&amp;f=false">an 1886 state investigation</a>, one of the sedatives used at Dunning was a mixture containing chloral hydrate as well as cannabis, hops and potash. The investigation also found that Dunning was serving two kegs of beer a day; patients as well as employees were apparently drinking the beer.</p><p>The same state probe harshly criticized the food Dunning served to its inmates. A lack of fruit and fresh vegetables had caused an epidemic of scurvy, with about 200 patients suffering from the illness. &ldquo;The cooking, we are convinced, was bad,&rdquo; the investigators said.</p><p>In spite of all their appalling discoveries, the investigators quoted one doctor who said &ldquo;there were some attendants who were most excellent, who were conscientious, and endeavored to mitigate the sufferings of the insane in every way possible.&rdquo; But these employees were in the minority, and they felt intimidated by Dunning&rsquo;s irresponsible workers.</p><p>The situation inside the Dunning poorhouse seemed somewhat better by 1892. A journalist who visited that year didn&rsquo;t encounter the same horrors others had witnessed in earlier times. But she reported that many of the poorhouse residents were &ldquo;too old and infirm to do anything except sit about in joyless groups.&rdquo; The superintendent told her that many people ended up in the poorhouse as a result of alcoholism. &ldquo;Whisky brings the most of them,&rdquo; he said, adding, &ldquo;They&rsquo;re foreigners mostly.&rdquo;</p><p><strong><a name="deck1"></a>Insanity cases in the news</strong></p><p dir="ltr">In that era, Chicago newspapers often reported the stories of local people suffering from mental illness, openly describing their symptoms and sometimes publishing their names. In many of these stories, patients were taken first to the Cook County Detention Hospital (at the northwest corner of Polk and Wood streets), where judges ordered them committed at Dunning.</p><p>Here&rsquo;s a sample of several cases reported in 1897:</p><blockquote><ul dir="ltr"><li style=""><em><strong>Frank Johnson</strong> was committed to Dunning after he cut off his right hand in a fit of religious mania. &ldquo;I think he will grow again,&rdquo; he told a judge.</em></li><li style=""><em><strong>John E.N.</strong>, 28, believed he was Jesus Christ.</em></li><li style=""><em><strong>Timothy O&rsquo;B.</strong> became &ldquo;a raving maniac&rdquo; after a policeman struck him in the head.</em></li><li style=""><em><strong>William Mitchell</strong>, 43, an extremely emaciated African-American man, said he was hearing &ldquo;the voices of spirits&rdquo; and believed that people were &ldquo;after him for murderous purposes.&rdquo;</em></li><li><em><strong>Theresa K.</strong>, 35, was sent to Dunning after she refused to eat, declaring that her food was poisoned.</em></li><li style=""><em><strong>Catherine T.</strong>, 56, &ldquo;was something like a wild cat.&rdquo; Maggie Mc., who may have fractured her skull five years earlier, was described as &ldquo;silly, helpless, Irish, very poor, and 28 years of age.&rdquo;</em></li><li style=""><em><strong>Fredericka W.</strong>, 35, who was unkempt with a weather-beaten complexion, was sent to Dunning after a policeman found her sitting in a park. She said she &ldquo;was searching for a prince, who had promised her marriage.&rdquo;</em></li><li><em><strong>William L.</strong>, 45, was arrested when a policeman found him &ldquo;wandering about the boulevards ogling women and girls.&rdquo; After hearing the details of the case, a judge declared, &ldquo;Dunning.&rdquo; As the bailiff quickly hustled William L. toward the door, the patient turned around and shouted, &ldquo;It doesn&rsquo;t take long to do up a man here!&rdquo;</em></li></ul></blockquote><p>Patients like these were sent by train from the Cook County Detention Hospital to Dunning. &ldquo;It was a hospital car, and they had a doctor aboard and a couple of nurses,&rdquo; Opitz says. &ldquo;The train was called the &lsquo;crazy train.&rsquo; &hellip; There was a guard on both ends so people couldn&rsquo;t get out.&rdquo;</p><p>About half of Dunning&rsquo;s patients suffered from &ldquo;chronic mania,&rdquo; according to the asylum&rsquo;s annual report for 1890. Other patients had conditions described as melancholia, impulsive insanity, monomania and circular insanity. The doctors listed masturbation as one of the most common &ldquo;exciting causes&rdquo; of insanity among Dunning&rsquo;s male patients. According to the report, other patients had become insane as a result of religious excitement, domestic trouble, spiritualism, sunstrokes, disappointment in love, alcohol, abortion, narcotics, puberty and overwork.</p><p><strong>Dunning&rsquo;s unmarked graves</strong></p><p dir="ltr">Throughout its early history, Dunning also included cemeteries &mdash; not only for poorhouse residents and asylum inmates who died, but also for anyone who died in Cook County and whose family couldn&rsquo;t afford to pay for a burial. Some bodies were moved to Dunning from the Chicago City Cemetery, which was underneath what is now Lincoln Park. The people buried at Dunning include 117 victims of the Great Chicago Fire of 1871 and Civil War veterans &mdash; including Thomas Hamilton McCray, a Confederate brigadier general who moved to Chicago after the war and died in 1891.</p><p>One of the most notorious people buried at Dunning was Johann Hoch, a bigamist who was believed to have married 30 women and murdered at least 10 of them. After he was hanged at Cook County Jail in 1906, other cemeteries refused to accept his body. &ldquo;In that little box that they had made at the jail, the remains of Hoch were buried anonymously somewhere on the grounds at Irving and Naragansett,&rdquo; says Lindberg, who told the story in his 2011 book <a href="http://www.niupress.niu.edu/niupress/scripts/book/bookResults.asp?ID=594">&ldquo;Heartland Serial Killers.&rdquo;</a></p><p>The same fate befell George Gorciak, a Hungarian immigrant who died penniless in 1895, succumbing to typhoid. His family took his body to Graceland Cemetery, apparently unaware that they needed to pay for a plot there. By the end of the day, they&rsquo;d hauled his coffin out to Dunning, where burials were free in the potter&rsquo;s field.</p><p dir="ltr">The burials at Dunning included many orphans and infants &mdash; and adults whose identities were a mystery. In 1912, an &ldquo;Unknown Man&rdquo; who&rsquo;d apparently stabbed himself to death was placed in the ground at Dunning.</p><p>Scandals sometimes erupted over bodies being stolen from Dunning&rsquo;s cemetery by people who wanted them for anatomy demonstrations. In one <a href="http://www.alchemyofbones.com/stories/bodysnatchers.htm">1897 case</a>, four bodies were taken as they were being prepared for burial. Henry Ullrich, a watchman who worked at Dunning, was convicted of selling the corpses to Dr. William Smith, a medical professor in Missouri.</p><p>The professor claimed that the watchman had offered to kill a &ldquo;freak&rdquo; and sell him the body. Smith recalled telling Ullrich, &ldquo;I only want the dead ones.&rdquo; Ullrich supposedly replied, &ldquo;That&rsquo;s all right, Doc &hellip; he&rsquo;s in the &lsquo;killer ward&rsquo; and they&rsquo;d just think he&rsquo;d wandered off. They&rsquo;re always doing that, you know.&rdquo;</p><p>County officials denied the existence of a &ldquo;killer ward.&rdquo;</p><p dir="ltr"><strong>State takes control</strong></p><p dir="ltr">In 1910, Dunning&rsquo;s poorhouse residents were moved to a new infirmary in Oak Forest. And in 1912, the state took over the Dunning asylum from Cook County, changing the official name to Chicago State Hospital.</p><p>Conditions had already been improving at Dunning over the previous decade, Mehr says. One reason was the construction of smaller buildings to house patients. And a civil service law passed in 1895 had decreased the problems with patronage. After the state took control, Mehr says, &ldquo;It ended the scandals around the issue of graft and corruption.&rdquo; But incidents of patients being abused still made news from time to time, he says.</p><p>Ross Goodrich says his great-grandmother, an immigrant from Prague named Fannie Hrdlicka (pronounced Herliska), was placed in Dunning when she became depressed after one her children died.</p><p><a href="http://www.encyclopedia.chicagohistory.org/pages/11195.html"><img alt="" class="image-original_image" src="http://llnw.wbez.org/styles/original_image/llo/insert-images/1947chicagodailynews.jpg" style="margin: 5px; float: left; height: 225px; width: 275px;" title="This February 1947 photo, taken inside the Chicago State Hospital, shows the poorly ventilated, narrow and congested hallways where some patients slept. (Chicago Daily News
photo, Chicago History Museum, ICHi-16073)" /></a>According to the family story, he says, &ldquo;When the baby died, my great-grandmother rocked the baby for a couple of days, and wouldn&rsquo;t let it out of her arms. And then she was placed in Dunning because they thought she was a little crazy. But we suspect it could have been a case of postpartum depression. &hellip; If she was having mental difficulties of any kind, I&rsquo;m not sure that there were any other places available in those days for her to go.&rdquo;</p><p>Hrdlicka was released from Dunning and then readmitted. She died there in 1918.</p><p>Steven Hill says he doesn&rsquo;t know why his great-grandfather, John Ohlenbusch, was living at Dunning when he died in 1910. But the death certificate says he had dementia, so Hill suspects Ohlenbusch&nbsp;may have had what later became known as Alzheimer&rsquo;s disease. Hill says his grandmother never discussed her father&rsquo;s death at Dunning.</p><p>&ldquo;People did not talk about the rough lifestyles they had and how poor they were,&rdquo; Hill says. &ldquo;But I do know they had a very, very tough life.&rdquo;</p><p>Goodrich and Hill would like to find out more about what happened to their ancestors at Dunning, but documents are not easy to find. The <a href="http://www.cyberdriveillinois.com/departments/archives/">Illinois State Archives</a> in Springfield has Chicago State Hospital&rsquo;s admission and discharge records from 1920 to 1951, but you need a court order to see them. Some early Cook County records, showing patients who were sent to Dunning between 1877 and 1887, are available for anyone to see in the state archives branch at Northeastern Illinois University.</p><p dir="ltr"><strong>Changing mental health treatments</strong></p><p>In the first half of the 20th century, Chicago State Hospital used several different treatments for mental illness. Hydrotherapy used hot or cold water to soothe people who were depressed or agitated. Fever treatments induced high temperatures to kill off bacteria in the brains of patients with syphilis.</p><p dir="ltr">Lobotomies were not performed at Chicago State Hospital, but Mehr says the hospital did send some of its patients elsewhere for the treatment, which cuts the brain&rsquo;s frontal lobe. &ldquo;That&rsquo;s like shooting someone in the head with a shotgun,&rdquo; he says.</p><p dir="ltr">For a time, some patients at Dunning and other Illinois hospitals were given electroshock therapy &ldquo;once a day, every day for years, which is just an absolute abomination,&rdquo; Mehr says. &ldquo;That was a terrible thing to do.&rdquo;</p><p>A new era of psychiatric treatment began in 1954, with the discovery Thorazine, the first in a new wave of drugs that directly affected the symptoms of mental illness.</p><p>Mehr, 71, worked for a year at Chicago State Hospital, during an internship from 1964 to 1965. He says the conditions he witnessed were vastly superior to the travesties of Dunning&rsquo;s early history. &ldquo;My impressions weren&rsquo;t all that bad,&rdquo; he says. And yet, he adds, &ldquo;The problem &hellip; was that these state hospitals were overcrowded.&rdquo;</p><p>Chicago State Hospital&rsquo;s buildings closed after it merged in 1970 with the nearby Charles F. Read Zone Center, which had opened on the west side of Oak Park Avenue in 1965. Since 1970, it has been known as Chicago-Read Mental Health Center. Today, for better or worse, fewer people with mental illnesses stay for prolonged periods of time in hospitals.</p><p><strong><a name="deck2"></a>Bodies discovered in 1989</strong></p><p dir="ltr">In the years after Chicago State Hospital closed, the state sold much of the property. Today, the land includes the Dunning Square shopping center, which is anchored by a Jewel store; the campus of Wright College; the Maryville Center for Children; and houses and condominiums.</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/davidkeene.JPG" style="margin: 5px; float: right;" title="Archaeologist David Keene was hired to examine the Dunning site, after remains were discovered there in 1989. (WBEZ/Robert Loerzel)" />State officials apparently didn&rsquo;t realize that human bodies were buried underneath a section of the Dunning land when they sold it to Pontarelli Builders, which began work putting up houses. In 1989, a backhoe operator working on the project found a corpse. The state had recently passed a law requiring archaeological assessments before construction is allowed on any property where human remains have been found, so archaeologist David Keene was hired to examine the site. Keene was on the faculty at Loyola University at the time, and now he runs his own company, <a href="http://www.arch-res.com/">Archaeological Research</a>.</p><p>&ldquo;The area was just littered with human remains, with human bone all over the place, where they had disturbed things,&rdquo; he says.</p><p>Keene has a vivid recollection of that corpse found by the backhoe. It appeared to be a Civil War veteran. Much of the body was still intact, probably because it had been embalmed with arsenic, a common treatment at the time, which would kill any organisms that would try to consume the flesh.</p><p>&ldquo;He was cut in half at the waist by the backhoe,&rdquo; Keene says. &ldquo;His skin was in relatively good condition &hellip; I mean, you could see his face. But there was considerable deterioration on the face. You could see the mustache. You could see his hair. He had red hair, but it was patchy. The other distinguishing features of the face were no longer there. And he had a jacket on &hellip; it was obviously a military jacket. We only saw it briefly. We didn&rsquo;t spend a lot of time with it &mdash; mostly because the odor was unbelievable, to say the least.&rdquo;</p><p>Keene guided a careful excavation of the land around this gruesome discovery &mdash; stopping the digging whenever a coffin or human remains were revealed. He determined that a five-acre cemetery was hidden, just northwest of the current-day corner of Belle Plaine and Neenah avenues. As a result of Keene&rsquo;s findings, that property was set aside as the Read-Dunning Memorial Park, which was dedicated in 2002. Construction was allowed on the land south of it.</p><p>This was just the second-oldest of three cemeteries on the Dunning grounds. The earliest cemetery was near the original poorhouse, just west of Naragansett Avenue and north of Belle Plaine. County officials had supposedly moved the bodies out of that cemetery into the second graveyard, but Keene says bodies did turn up there during another construction project. &ldquo;We found a little over 30 individuals there, and we were able to remove them so (the developer) could build his building there,&rdquo; Keene says.</p><p>And when Wright College was under construction on the former asylum grounds in the early 1990s, scattered human remains surfaced there, too, Keene says.</p><p>&ldquo;A femur would pop up,&rdquo; he says. &ldquo;And it wasn&rsquo;t associated with a grave of any sort. It was just mixed in with the soil from previous construction and removal of buildings in the past. In this area, you can walk into any one of these yards and dig in the flowerbeds and come up with human remains. They&rsquo;re part of the scattered remains from construction activity that took place in the &rsquo;20s, &rsquo;30s, &rsquo;40s, &rsquo;50s and &rsquo;60s. Every time they built a building, human remains would go flying.&rdquo;</p><p>As Keene explains, state officials constructed hospital buildings between 1912 and the 1960s on this land without any regard to whether people had been buried there.</p><p>&ldquo;The state came in and &mdash; as far as we can tell, from the archaeological evidence &mdash; removed any surface evidence of burials in the entire area,&rdquo; Keene says. &ldquo;They actually built right on top of graves.&rdquo;</p><p>The third Dunning cemetery was located farther west &mdash; underneath what is now Oak Park Avenue near Chicago-Read Mental Health Center. While Keene was conducting his investigation in 1989, some workers walked over and told him they&rsquo;d found human remains while they were working on a broken water main at Chicago-Read&rsquo;s entrance.</p><p>&ldquo;So we just walked over there,&rdquo; Keene recalls. &ldquo;And sure enough, there were human remains everywhere. And so we began doing some research there to figure out what the boundaries were.&rdquo;</p><p>Keene says it&rsquo;s obvious that someone must have known about the existence of those graves when the road was put on top of them. &ldquo;It&rsquo;s pretty clear,&rdquo; he says. &ldquo;When we were there &mdash; and this is just the plumbers trying to get to the leak &mdash; they were cutting right through coffins. So somebody had to cut through some of those coffins in order to put the original lines in.&rdquo;</p><p>In 1989, genealogist Barry Fleig studied the available records about Dunning and documented that more than 15,000 people had been buried in the graveyards there. But the records are incomplete, and Fleig extrapolated that the total is closer to 38,000.</p><p>Opitz says the county&rsquo;s record keeping was slipshod. &ldquo;So consequently, the number of cadavers or people that were buried here is somewhat nebulous,&rdquo; he says.</p><p>The exact figure is unknown, but Keene says 38,000 is a reasonable estimate. For Keene, the lesson of the Dunning graveyards is that burial places are not as permanent as many people think they will be.</p><p>Neighborhood resident Silvija Klavins-Barshney, 50, says she was shocked when she found out about Dunning&rsquo;s graveyards a couple of years ago. She serves as the vice president of the church board of the Latvian Lutheran Zion Church, which is located inside a building that was part of Chicago State Hospital. After learning about the Dunning cemeteries, she created a Facebook page called &ldquo;<a href="https://www.facebook.com/pages/38000-souls-forgotten-The-Read-Dunning-Memorial-Project/208801952501257">38,000 Souls Forgotten: The Read-Dunning Memorial Project</a>.&rdquo; She hopes she can persuade city or state officials to improve the Read-Dunning Memorial Park, such as adding landscaping or a more substantial monument.</p><p dir="ltr">The Illinois Department of Central Management Services owns and maintains the park.</p><p>&ldquo;The more research I did, the more I felt that the story needs to get out,&rdquo; she says, &ldquo;because most of the people &hellip; who were buried here are people that were forgotten in life. They were just left. Or disposed of. Or hidden. And if that&rsquo;s how they lived their lives, how dare we allow them to live their afterlife like that? &hellip; How can 38,000 people be buried and then forgotten?&rdquo;</p><p dir="ltr">Michael Dotson &mdash; who posed the question about Dunning for Curious City &mdash; visited the Read-Dunning Memorial Park with WBEZ in April. &ldquo;When you look around the vicinity, you see apartments and condos and houses and a college and construction going on in the background,&rdquo; he said. &ldquo;It&rsquo;s really hard to &hellip; realize what was here. But if you can kind of separate yourself from all of that, there&rsquo;s just that slight feeling of fear and dread and a little bit of sadness and also fascination. &hellip; It&rsquo;s crazy to think what was here and what&rsquo;s here now and that we&rsquo;ve completely lost sight of that.&rdquo;</p><p><em>Robert Loerzel is a freelance journalist and the author of &ldquo;Alchemy of Bones: Chicago&rsquo;s Luetgert Murder Case of 1897.&rdquo; Follow him at <a href="http://twitter.com/robertloerzel">@robertloerzel</a>.</em></p></p> Tue, 30 Apr 2013 07:35:00 -0500 http://www.wbez.org/series/curious-city/story-dunning-tomb-living-106892 Fewer Illinoisans get health insurance at work http://www.wbez.org/news/fewer-illinoisans-get-health-insurance-work-106600 <p><p>A new report says the percentage of Illinoisans who get health insurance through work has declined.</p><p>The report, released Thursday, finds the portion of non-elderly Illinois residents with insurance through their jobs dropped from 74 percent in 2000 to 62 percent in 2011.</p><p>It&#39;s a national trend. Overall, the report finds that 11.5 million fewer Americans received health insurance through an employer or a family member&#39;s job in 2011 than in 2000.</p><p>Fewer employers are offering insurance and fewer workers are accepting it, possibly because of rising costs.</p><p>In contrast, more young adults are covered through employer-sponsored insurance. The researchers attribute that to a provision of the Affordable Care Act, passed in 2010.</p><p>The report is from the Robert Wood Johnson Foundation and the State Health Access Data Assistance Center.</p></p> Thu, 11 Apr 2013 09:40:00 -0500 http://www.wbez.org/news/fewer-illinoisans-get-health-insurance-work-106600 Prison doctor to inmate: ‘That’s bad. You should have someone look at that.’ http://www.wbez.org/news/prison-doctor-inmate-%E2%80%98that%E2%80%99s-bad-you-should-have-someone-look-that%E2%80%99-106298 <p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Vandalia%20Health%20Pic%203.JPG" style="float: right; height: 220px; width: 300px;" title="William Jessup looks through grievances he’s filed at Vandalia. He says the dentist told him he had cavities and offered to pull the teeth but wouldn’t give him fillings. He kept his teeth and the cavities. (WBEZ/Rob Wildeboer)" /></p><p>When William Jessup got to Vandalia prison he went to the dentist. Jessup says the dentist told him he had two cavities and offered to pull them.</p><p>Wait..huh?</p><p>&ldquo;No, you&rsquo;re gonna pull my teeth out. Any qualified dentist will tell you it&rsquo;s always best to keep your teeth,&rdquo; said Jessup in a recent interview at the Vandalia prison in southern Illinois. &ldquo;I&rsquo;m assuming it still applies here but obviously it don&rsquo;t, because I still have the two cavities.&rdquo;</p><div class="image-insert-image ">When Anthony Rivera first got to Vandalia prison he caught some sort of foot fungus. His feet started smelling bad and he started getting sores, so he went to the doctor there and the doctor gave him foot cream but it was expired. When he told the doctor it was expired, he says the doctor told him that those were just numbers on the container, not an expiration date. &ldquo;I&rsquo;m like, what are you talking about,&rdquo; said Rivera. &ldquo;It says 9/17/2010. How that&rsquo;s gonna be just regular numbers?&nbsp; He&rsquo;s like, well you don&rsquo;t want it then leave, so I took it just to take it.&nbsp; I put it on my feet but it got worse.&rdquo;</div><p>Rivera says the sores on his feet got so large and painful that eventually he couldn&rsquo;t walk. &ldquo;They gave me some kind of a shot and it relieved it a little bit but it took a nice three months,&rdquo; said Rivera.</p><p>Illinois taxpayers are paying Wexford Health Sources, a private health care company, moe than $1.3 billion over ten years to provide care for inmates in prisons. But most of the inmates WBEZ has talked to say, unless it&rsquo;s an emergency, they&rsquo;re not getting the care taxpayers have already paid for. And the Illinois Department of Corrections doesn&rsquo;t seem to have any mechanism to ensure that taxpayers aren&rsquo;t being fleeced in the health care deal.</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Vandalia%20Health%20Pic%202.JPG" style="float: left; height: 200px; width: 300px;" title="Anthony Rivera says the doctor at Vandalia prison treated his foot fungus with an expired cream. Rivera says the fungus got so bad that he couldn’t walk and then the prison doctor gave him a shot which eventually cleared it up. (WBEZ/Rob Wildeboer)" /></p><div class="image-insert-image ">One more case. Jeff Elders. (Elders and Jessup were both featured in <a href="http://www.wbez.org/news/illinois-taxpayers-spend-50000-punish-man-111-theft-106280">our story Tuesday</a> about Illinois spending big money on people convicted of relatively minor crimes. Jessup got a four-year sentence for having a stolen license plate sticker. Elders got a couple years for trying to steal $111 from J.C. Penney.)</div><p>Elders has a hard growth on the palm of his right hand.&nbsp; He holds it up for me to see and pokes at the hard part.</p><p>&ldquo;It&rsquo;s all along the tendon,&rdquo; said Elders. It&rsquo;s climbing probably three inches up my hand on my tendon. That&rsquo;s all hard, real hard and right here there&rsquo;s a big ol&rsquo; thing. It&rsquo;s pulling that finger in. They say it&rsquo;s a calcium build-up.&nbsp; They called it some kind of hemotobin globin, er...&rdquo;</p><p>It&rsquo;s like a hard stick under his skin that runs from his wrist towards the ring finger on his right hand. It breaks into two strands as it approaches the knuckle, making the growth under his skin look like the letter &lsquo;Y.&rsquo; It pulls his one finger back so it&rsquo;s constantly curled and he can&rsquo;t straighten it out, and it&rsquo;s getting worse. He went to see the prison doctor about the problem.</p><p>&ldquo;They tell you flat out, they can&rsquo;t do nothing for you,&rdquo; said Elders. &ldquo;Unless it&rsquo;s an immediate issue, they&rsquo;re not doing nothing for you. He said, well, I&rsquo;ll give you some aspirins and I suggest you take care of it as soon as you can when you get out or you&rsquo;re going to end up like this, all crippled up, but there&rsquo;s nothing we&rsquo;re going to do for you here.&rdquo;</p><p>Elders wasn&rsquo;t surprised by the &lsquo;treatment.&rsquo; &ldquo;That, to me, it&rsquo;s what I&rsquo;m used to. It&rsquo;s the system. Everything&rsquo;s blamed on not enough money. What can you do with that? I have no kind of say so. If you back-talk anybody you&rsquo;re in trouble,&rdquo; said Elders.</p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Vandalia%20Health%20Pic%204.JPG" style="float: right; height: 201px; width: 300px;" title="Victor Dozier is the warden at Vandalia prison. (WBEZ/Rob Wildeboer)" />I took some of these stories to the guy in charge of Vandalia prison, Warden Victor Dozier. I told Dozier about Jessup, the guy who was told by the dentist that he had cavities and was also told that all they would do for him was pull the teeth.</div><p>DOZIER: Really.</p><p>WILDEBOER: Yeah.</p><p>DOZIER: That&rsquo;s hard to believe but....</p><p>I also asked Dozier about Elders and the growth on his hand. Dozier said offenders can file grievances. That&rsquo;s the name for the formal complaint process in Illinois prisons. But in the next breath Dozier all but admitted that filing a grievance on a medical issue would be pointless.</p><p>&ldquo;If the doctor states, gives him a rational why he can&rsquo;t do it, I mean, he&rsquo;s our medical director. I can&rsquo;t question what he tells the offender,&rdquo; said Dozier.</p><p>Admittedly, a corrections professional shouldn&rsquo;t be overruling the health care decisions of a medical professional. But then who does vet the health care decisions being made?</p><p>In written statements given to WBEZ over the last several months, the Department of Corrections has said repeatedly that it oversees health care, holding, &ldquo;monthly continuous quality improvement meetings.&rdquo; But the department has yet to provide someone who can explain exactly what happens at these meetings, who&rsquo;s involved or what information they&rsquo;re looking at.</p><p>According to the prison watchdog group the John Howard Association no one seems to be providing meaningful oversight of prison health care. In fact, last year, the John Howard Association reported that the state entered into a more than $1.3 billion contract with a company called Wexford Health Sources without auditing the company&rsquo;s previous performance in the state.</p><p>I asked Warden Dozier how he, as the top official at the Vandalia prison, ensures that Wexford is delivering the care that Illinois taxpayers have been paying for.</p><p>&ldquo;Okay, I don&rsquo;t have an answer for that,&rdquo; said Dozier.</p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Vandalia%20Health%20Pic%205.JPG" style="float: left; height: 201px; width: 300px;" title="Outside the gate at Vandalia prison in southern Illinois. (WBEZ/Rob Wildeboer)" />The lack of oversight has caught the attention of state Rep. Greg Harris.</div><p>&ldquo;Well, I&rsquo;ve heard similar stories and actually worse, and I&rsquo;m very concerned that we&rsquo;re paying about $1.3 billion dollars to a private company to manage health care in our prisons, and I want to look into are we getting quality health care for the folks for the money that we&rsquo;re paying,&rdquo; said Harris.</p><p>Greg Harris has been looking into the health care contract. His interest was piqued by the John Howard Association report last year. Harris says his review of the contract shows that the deal is a good one as long as Wexford actually provides the care they&rsquo;re supposed to provide. &ldquo;I mean we can&rsquo;t take the Department of Corrections word for it and we can&rsquo;t take the private company&rsquo;s word for it,&rdquo; said Harris. &rdquo;I want somebody to go in and independently verify that people are being adequately treated.&rdquo;</p><p>Harris is planning to hold a hearing on April 4th in Chicago to take a closer look at the contract. He&rsquo;s pushing to bring the National Commission on Correctional Health Care into Illinois prisons to provide independent oversight.</p><p>Wexford declined to be interviewed for this story. In fact, the company with a billion-dollar public contract in Illinois has refused all of our requests for interviews. However, in a written statement, they said they provide medically necessary care as required by the constitution while at the same time acting as responsible stewards of taxpayer dollars. Wexford also says it welcomes Rep. Harris&rsquo; push to bring a third party into the Illinois prisons to audit Wexford&rsquo;s performance.</p></p> Tue, 26 Mar 2013 17:45:00 -0500 http://www.wbez.org/news/prison-doctor-inmate-%E2%80%98that%E2%80%99s-bad-you-should-have-someone-look-that%E2%80%99-106298 UIC hosts open forum on transgender health http://www.wbez.org/blogs/nico-lang/2013-03/uic-hosts-open-forum-transgender-health-106135 <p><div class="image-insert-image "><div class="image-insert-image " style="text-align: center;"><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/55445_jn_new_kling01_012213f%20%281%29_0.jpg" style="width: 512px; height: 280px;" title="(Julia Nagy/The State News) Rebecca Kling, from 2013 workshop at MSU" /></div></div><p>This month marked a historic first for the trans* community. March boasted the inaugural National Month of Action for Transgender Healthcare, a campaign co-sponsored by groups as diverse as Pride at Work, the Transgender Law Center, Basic Rights Oregon and the National Center for Transgender Equality. Our first &ldquo;Trans* Month of Action&rdquo; has seen events in San Francisco, Oregon and now Chicago, as trans* community organizer Rebecca Kling has worked with Erica Mott, Paul Escriva, Dion Walton and Hale Thompson to bring conversations on LGBT community health to the University of Illinois at Chicago.</p><p>Held at the UIC Division of Community Health Sciences, the Open Forum on &ldquo;<a href="http://www.facebook.com/events/262589797205013/">Health, Healthcare and the Trans* Community</a>&rdquo; focuses on two central questions: &ldquo;What issues do trans people face in navigating their health care? And how can the health of the trans community, as broadly defined, be improved?&rdquo;</p><p>A 2011 survey from the National Gay and Lesbian Task Force outlined the problems facing the trans* community in regards to obtaining health care services. Their statistics stated that 19 percent of gender non-conforming and trans* people are denied access to health care outright, whereas another 28 percent &ldquo;postpone medical care because of fear of discrimination.&rdquo; According to <a href="http://inourwordsblog.com/2013/03/14/historic-labor-led-campaign-for-transgender-health-launches-in-march/">In Our Words</a>,</p><blockquote><p>&ldquo;Key findings also reveal that respondents experienced double the rate of unemployment as the general population; near universal harassment on the job; significant losses of jobs and careers; and higher rates of poverty. Not surprisingly, the economic inequality experienced by so many transgender people often leads to a lack of quality health care options.&rdquo;</p></blockquote><p>I grabbed a cup of coffee over the weekend with trans* forum organizer Rebecca Kling. Kling, a writer and performer, says these health issues were a major concern during her recent gallbladder surgery. In 2010, Kling was rushed to the ER for emergency surgery, and she was worried that the doctor wouldn&rsquo;t handle her case because of her gender identity. Kling stated, &ldquo;Going to the ER at 2 in the morning is scary enough without having to worry that my identity won&rsquo;t be respected. It&rsquo;s tiring to live in a world where you think everyone is out to get you.&rdquo;</p><p>However, Kling was lucky. When she was in the hospital, Rebcca Kling&#39;s mother stayed with her &ldquo;all day and night&rdquo; out of fear for her safety. Her mother remembered Rebecca telling her a story about a woman on the East Coast that medics refused to treat when they saw that she was trans*. She died on the side of the road. Her mother couldn&#39;t to let the same thing happen to her.</p><p>&ldquo;These issues don&rsquo;t just affect trans* people,&quot; Kling said. &quot;They affect the people who care about us.&rdquo;</p><p>Kling said &ldquo;the distrust [toward the medical community] fosters a hesitancy toward these structures that are supposed to be there to help us. Even when doctors are caring for trans* people in a positive way, individual compassion only goes so far. We need the right systems in place.&rdquo;</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/58419_10100448741046165_139692507_n%20%281%29.jpg" style="float: right;" title="(In Our Words) Flier for forum" />Kling detailed her own struggles with her gender reassignment surgery (or &ldquo;Vagification,&rdquo; as she very cleverly puts it) and getting her medical insurance to cover the costs.</p><p>&ldquo;My insurance has a specific exclusion for gender reassignment surgery, and I&rsquo;m trying to fight that because it&rsquo;s discriminatory,&rdquo; Kling said.</p><p>Kling explained trasition doesn&rsquo;t come cheap. For trans* women, there are a litany of options, including hormones, hair removal, trach shaves and reassignment surgery, all of which cost money. Similarly for trans* men, there&rsquo;s breast removal, hysterectomy and hormones. According to Kling, &ldquo;even the most inclusive coverage often only covers hormones and assignment surgery. That leaves out a lot.&quot;</p><p>&ldquo;This creates an economic barrier to transition,&rdquo; Kling said. &ldquo;My ability to transition is a result of having awesome parents, jobs that didn&rsquo;t fire me and being able to scrape together the money to do these things. Access to medical care is an economic class issue. Being trans is no different.&rdquo;</p><p>A major focal point of the Open Forum&rsquo;s discussion will be the Affordable Care Act, which, in its essence, bans medical discrimination against LGBT people.</p><p>Commenting on an anecdote from Mara Kiesling of the National Center for Transgender Equality, whose friend was denied treatment for anemia because of her &ldquo;transsexual blood,&rdquo; The Nation writes,&ldquo;The Affordable Care Act will end many of these absurd exclusions. In 2014, the Patient&rsquo;s Bill of Rights will prevent insurance companies from denying coverage based on pre-existing conditions. What&rsquo;s more, the ACA will bring Title VII federal nondiscrimination protections to the health care field.&quot;</p><p>However, Kling said that the bill&rsquo;s implementation and purview is far from perfect. It doesn&rsquo;t include gender reassignment surgery.</p><p>&ldquo;The Affordable Care Act says that we shouldn&rsquo;t exclude LGBT people from insurance coverage, but the Department of Health and Human Services says that coverage doesn&rsquo;t include transitioning,&rdquo; Kling stated. &ldquo;That&rsquo;s a contradiction.&rdquo;</p><p>As part of the national conversation on health care, the queer community is too seldom included in the discourse, and Kling hopes that dialogues like the Trans* Month of Action and the Open Forum will help change that.</p><p>&ldquo;We need to open this conversation up further, because no one person has the same health care needs as any other,&rdquo; Kling said.</p><p>Monday&rsquo;s forum will include panelists such as Jen Richards of We Happy Trans, Alexis Martinez of the Trans Oral History Project, Channyn Park of the Chicago House and Trans Life Project and Dr. Margo Bell of Stroger Hospital.</p><p>As a forum, Kling said they are trying to be mindful of the inherent power dynamics in the discussion and to create a space for discourse, rather than &ldquo;imparting wisdom onto the audience.&rdquo; Kling assured me, &ldquo;We don&rsquo;t want to tell you what the community needs.&rdquo;</p><p>For Kling, the most exciting part is the variety of perspectives being offered. Although she feels one panel could never be reflective of the breadth of the community, the forum has solicited questions from attendees to further include a diversity of experiences. Many respondents have come up with topics she wouldn&rsquo;t have thought of.</p><p>&ldquo;Someone asked, &lsquo;How can health care be supportive of non-traditional paths?&rsquo; Kling said. &quot;That didn&rsquo;t even occur to me. It&rsquo;s not my experience, but it&rsquo;s valid and important.&rdquo;</p><p>Kling says she&rsquo;s most excited to see the energy behind the forum.</p><p>&ldquo;This is a conversation that it seems like people are eager for and that they needed to happen,&quot; Kling said. &quot;I hope we live up to their expectations.&rdquo;</p><p><em>The Open Forum on Transgender Health, Healthcare and the Trans* Community will take place at UIC&rsquo;s Division of Community Health Sciences at 1603 W. Taylor Street on March 18 from 6 to 8:30 p.m. The event will be held in the first floor auditorium and is free and open to the public. More information can be obtained on their Facebook <a href="https://www.facebook.com/events/262589797205013/">page</a> or by emailing Rebecca Kling at rebecca@rebeccakling.com.</em></p></p> Mon, 18 Mar 2013 05:00:00 -0500 http://www.wbez.org/blogs/nico-lang/2013-03/uic-hosts-open-forum-transgender-health-106135 Misery is ... Chicago (according to Forbes) http://www.wbez.org/blogs/charlie-meyerson/2013-02/misery-chicago-according-forbes-105675 <p><div class="image-insert-image "><a href="www.forbes.com/pictures/mli45lmhg/4-chicago-ill/" target="_blank"><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/unhappy%20flickr%20quinn%20anya.jpg" style="height: 171px; width: 256px; float: right;" title="(Flickr/Quinn Anya)" /></a></div><p><strong>&#39;CHICAGO: WE&#39;RE NOT AS MISERABLE AS _______&#39;&nbsp;</strong>The city&#39;s new travel slogan is ready. Based on&nbsp;<em>Forbes</em>&nbsp;magazine&#39;s 2013 rating of &quot;<a href="http://www.forbes.com/sites/kurtbadenhausen/2013/02/21/detroit-tops-2013-list-of-americas-most-miserable-cities/" target="_blank">America&#39;s Most Miserable Cities</a>,&quot; you could fill that blank with the names of three other cities &ndash; Detroit, Flint and Rockford &ndash; because <a href="http://www.forbes.com/pictures/mli45lmhg/4-chicago-ill/" target="_blank">Chicago shows up at No. 4</a>.</p><p>* Retired general who led military response to Hurricane Katrina:&nbsp;<a href="http://www.chicagotribune.com/news/local/ct-met-chicago-violence-honore-20130222,0,2012172.story" target="_blank">National Guard could help Chicago</a>.<br />* Search <a href="http://crime.chicagotribune.com/chicago/" target="_blank">crime data in your community</a> (<em>Tribune</em> interactive database).<br />*&nbsp;<a href="http://www.suntimes.com/18382697-418/new-attractions-could-be-in-place-in-months-tourism-chief-says.html" target="_blank">New tourist attractions for Chicago</a>&nbsp;could be up and running within months.<br />* <a href="http://www.chicagobusiness.com/article/20130221/BLOGS04/130229922/justin-timberlake-jay-z-summer-tour-coming-to-soldier-field-reports" target="_blank">Justin Timberlake, Jay-Z reportedly headed to Soldier Field</a> this summer.<br />* Chicago to be home of new&nbsp;<a href="http://www.huffingtonpost.com/2013/02/20/american-writers-museum-chicago_n_2728411.html" target="_blank">American Writers Museum</a>.<br />* Congress Theater owner plans&nbsp;<a href="http://www.dnainfo.com/chicago/20130221/logan-square/congress-theater-owner-wants-restore-it-its-1920s-glory" target="_blank">ambitious renovation</a>.</p><p><iframe align="right" frameborder="0" height="144" scrolling="no" src="http://media.mtvnservices.com/embed/mgid:cms:video:thedailyshow.com:424058" width="256"></iframe></p><p><strong>&#39;THE AMBULANCE INDUSTRY TAKES IN MORE MONEY EVERY YEAR THAN HOLLYWOOD.&#39;</strong> That&#39;s&nbsp;Steven Brill, author of&nbsp;<em>Time</em> magazine&#39;s &quot;<a href="http://www.mediabistro.com/fishbowlny/time-cover-story-longest-by-single-writer-in-magazines-history_b76963" target="_blank">longest single piece ever published by a single writer</a>&quot; &ndash; 36 pages on &quot;<a href="http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/" target="_blank">Why Medical Bills Are Killing Us</a>&quot; &ndash; in <a href="http://www.thedailyshow.com/watch/thu-february-21-2013/exclusive---steven-brill-extended-interview-pt--1" target="_blank">an extended, online-only <em>Daily Show</em> interview with Jon Stewart</a>.<br />* Brill&#39;s article&nbsp;<a href="http://mediadecoder.blogs.nytimes.com/2013/02/21/how-brills-health-care-opus-jumped-from-the-new-republic-to-time/" target="_blank">wasn&#39;t originally supposed to run in <em>Time</em></a>.<br />* FBI declares <a href="http://www.theatlanticwire.com/business/2013/02/fbi-declares-war-scooter-store/62383/" target="_blank">war on The Scooter Store</a>.</p><p><strong>... AND&nbsp;<a href="http://cpm.polldaddy.com/s/meyerson-wbez-news-quiz-no-6" target="_blank">THIS WEEK&#39;S NEWS QUIZ</a>:</strong></p><script type="text/javascript" src="http://i0.poll.fm/survey.js" charset="UTF-8"></script><noscript><a href="http://cpm.polldaddy.com/s/meyerson-wbez-news-quiz-no-6">Take Our Survey!</a></noscript><script type="text/javascript"> polldaddy.add( { type: 'iframe', auto: true, domain: 'cpm.polldaddy.com/s/', id: 'meyerson-wbez-news-quiz-no-6' } ); </script><p>&nbsp;</p><p>&nbsp;</p><hr /><p><em><strong>ANNOUNCEMENTS.</strong></em><br /><em>* Suggestions for this blog?&nbsp;<a href="mailto:cmeyerson@wbez.org?subject=Things%20and%20stuff">Email anytime</a>.<br />* Get this blog by email, free.&nbsp;<a href="http://feedburner.google.com/fb/a/mailverify?uri=feedburner/AELk&amp;amp;loc=en_US" target="_blank">Sign up here</a>.</em><br /><em>* Follow us on Twitter:&nbsp;<a href="https://twitter.com/wbez" target="_blank">@WBEZ</a>&nbsp;and&nbsp;<a href="https://twitter.com/meyerson" target="_blank">@Meyerson</a>.<br />* Thanks to WBEZ&#39;s <a href="http://www.wbez.org/users/akeefe-0" target="_blank">Alex Keefe</a> for inspiration.<br />* This blog is taking a day off Monday. See you early Tuesday.</em></p></p> Fri, 22 Feb 2013 05:00:00 -0600 http://www.wbez.org/blogs/charlie-meyerson/2013-02/misery-chicago-according-forbes-105675 Jury awards $12 million to family of man denied medicine in Illinois prison http://www.wbez.org/news/jury-awards-12-million-family-man-denied-medicine-illinois-prison-105032 <img typeof="foaf:Image" src="http://llnw.wbez.org/main-images/ray fox family.JPG" alt="" /><p><p>A Chicago jury awarded $12 million on Friday to the family of a man whose family said he did not get proper medical attention while in a state prison.</p><p>Ray Fox was in Stateville prison in 2007 when he had a brain aneurysm. His attorneys said that aneurysm happened because Fox wasn&rsquo;t provided his anti-seizure medicine for days, even though he&rsquo;d been calling out for it.</p><p>The 50-year-old Fox now needs constant, around-the-clock medical attention, which he gets from his mom, Rose Fox.</p><p>&ldquo;You trust the system to take care of your loved ones and then they abuse them,&rdquo; Rose said after the verdict. &ldquo;And that&rsquo;s terrible. &nbsp;What happened to Ray should never happen.&rdquo;</p><p>During the week-long trial, jurors heard testimony from Trisha Fox, Ray&rsquo;s daughter. She said since his aneurysm, her father sometimes pounds on his chest uncontrollably, has trouble walking and going to the bathroom and gets aggressive.</p><p>&ldquo;It&rsquo;s about the psychology of not seeing the human portion of the people that are incarcerated for any number of reasons,&rdquo; said Michael Kanovitz, Fox&rsquo;s attorney. &ldquo;Most people, if they break a law and they have to go to prison, they are there to pay their debt to society. It is not right to injure them in a way that will follow them for the rest of their life.&rdquo;</p><p>The Fox family sued several parties that provide health care services in Illinois&rsquo; prisons.&nbsp;Most settled out of court. &nbsp;Two who did not were David Barnes and Michael Borkowski,&nbsp;medical technicians who delivered medicine to inmates. They are represented by attorneys with the Illinois Attorney General&rsquo;s office.</p><p>Those attorneys argued it&rsquo;s not clear Fox had seizures that caused his debilitating aneurysm.</p></p> Fri, 18 Jan 2013 16:18:00 -0600 http://www.wbez.org/news/jury-awards-12-million-family-man-denied-medicine-illinois-prison-105032 Hospitals crack down on workers refusing flu shots http://www.wbez.org/news/hospitals-crack-down-workers-refusing-flu-shots-104884 <img typeof="foaf:Image" src="http://llnw.wbez.org/main-images/AP090901027160.jpg" alt="" /><p><p>Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won&#39;t get flu shots, with some workers losing their jobs over their refusal.</p><p>&quot;Where does it say that I am no longer a patient if I&#39;m a nurse,&quot; wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.</p><p>Hospitals&#39; get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.</p><p>Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.</p><p>In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.</p><p>Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.</p><p>Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.</p><p>&quot;We would all like to see stronger data,&quot; she said. But other evidence shows flu vaccination &quot;significantly decreases&quot; flu cases, she said. &quot;It should work the same in a health care worker versus somebody out in the community.&quot;</p><p>Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly &quot;a personal thing.&quot; She&#39;s among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes &quot;the injustice of being forced to put something in my body.&quot;</p><p>Medical ethicist Art Caplan says health care workers&#39; ethical obligation to protect patients trumps their individual rights.</p><p>&quot;If you don&#39;t want to do it, you shouldn&#39;t work in that environment,&quot; said Caplan, medical ethics chief at New York University&#39;s Langone Medical Center. &quot;Patients should demand that their health care provider gets flu shots &mdash; and they should ask them.&quot;</p><p>For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.</p><p>A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.</p><p>At Calhoun&#39;s hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, &quot;I&#39;m wearing the mask for your safety,&quot; Calhoun says. She says that&#39;s discriminatory and may make patients want to avoid &quot;the dirty nurse&quot; with the mask.</p><p>The hospital justified its vaccination policy in an email, citing the CDC&#39;s warning that this year&#39;s flu outbreak was &quot;expected to be among the worst in a decade&quot; and noted that Illinois has already been hit especially hard. The mandatory vaccine policy &quot;is consistent with our health system&#39;s mission to provide the safest environment possible.&quot;</p><p>The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.</p><p>According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That&#39;s up from previous years, but the government wants 90 percent coverage of health care workers by 2020.</p><p>The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.</p><p>Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.</p><p>Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.</p><p>Starting this year, the government&#39;s Centers for Medicare &amp; Medicaid Services is requiring hospitals to report employees&#39; flu vaccination rates as a means to boost the rates, the CDC&#39;s Bridges said. Eventually the data will be posted on the agency&#39;s &quot;Hospital Compare&quot; website.</p><p>Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they&#39;re adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.</p><p>Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work &mdash; partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.</p><p>While not 100 percent effective, this year&#39;s vaccine is a good match, the CDC&#39;s Bridges said.</p><p>Several states have laws or regulations requiring flu vaccination for health care workers but only three &mdash; Arkansas, Maine and Rhode Island &mdash; spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policikfriedenes and co-author of a study appearing this month in the journal Vaccine.</p><p>Rhode Island&#39;s regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.</p><p>Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.</p><p>&quot;We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole,&quot; but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.</p><p>Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.</p><p>Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.</p><p>Calhoun, the Illinois nurse, says she is unsure of her options.</p><p>&quot;Most of the hospitals in my area are all implementing these policies,&quot; she said. &quot;This conflict could end the career I have dedicated myself to.&quot;</p></p> Sat, 12 Jan 2013 14:32:00 -0600 http://www.wbez.org/news/hospitals-crack-down-workers-refusing-flu-shots-104884