Episodes
Newest firstAll episodes
Upcoming: Second DeJear chat
Aug 29, 202200:00:54Tap to summarizeIn the second conversation with Deidre DeJear, I caught up with her in March. She was at Drake - her alma mater - speaking to a group of Iowa girls from around the state. They ranged in age from middle to high school she told me. She took time out of her schedule that day to chat with me about:* the power of girls sports (and how anti-trans bill hurts all girls) * the possiblity of having to govern by veto (with a house and senate remaining under GOP control),* we've had governors in our path both Republicans and Democrats who've been able to carry on this torch, unfortunately, under Kim's leadership, that torch them.” * fundraising (and a couple of anonomously sourced DSM Register articles about her fundraising that raised issues of ethics in journalism) and pulling Iow— democrats together* And why she felt she had to call out Governor Reynolds on Twitter for lying to Iowans about the pandemic and federal resources.But - that will all be later this week as I am traveling and have to put the finishing touches on the audio! Transcript of clip:“Iowa, I firmly believe has been a Petri dish for political progress nearly 100 years before—the rest of the country to say that every student, regardless of their race, or gender should have access to quality public education. We continued along that path and rose to the occasion and became number one in this nation. And while we lead in education, we see the world and we feel this country as well. And so this is a battleground of how we fight for the best of who we are, and it can happen in the state because it's happened before.“I'm okay with us [Iowa] leading But needless to say, we've got to get back to leading and we need a governor that's going to take us in that direction because we've had governors in our path both Republicans and Democrats who've been able to carry on this torch, unfortunately, under Kim's leadership, that torch is dimming.” This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit andykopsa.substack.com/subscribe
Transcribe →
Accountability: Iowa Veterans Home
Jul 28, 202100:01:32Tap to summarizeIn what appears to be the first civil COVID-19 related resolution of its kind - the US Attorney’s Office of Northern Iowa (DOJ) entered into a settlement with the Care Initiatives in Dubuque for $214,200 for alleged deficiencies in COVID-19 safety protocols. A legal analysis found:While the settlement amount is small, the Care Initiatives matter serves as a concrete reminder that the government is scrutinizing the adequacy of COVID-19 safety protocols in the context of federal reimbursement—even with respect to the early days of the pandemic. Keep that bit in mind. I want to make clear Pedati isn’t the problem. She absolutely was in the early stages of the pandemic. But what she didn’t say matters tremendously. no one knew there was an outbreak - at the Iowa Veterans Home - a breakthrough infection to boot - at the State Veterans Hospital in Des Moines. This is a 1:30 minute audio clip. Key takeaway: IVH had a breakthrough COVID19 outbreak and the federal Vets Administration in Des Moines wasn’t told. ME: I called the state Veterans Hospital [in Des Moines] to ask them about crossover and what kind of oversight they had and about regulatory crossover [between a state facility IVH and the federal VHA] And I said I was just calling because of the outbreak. And this again was last month [JUNE 2021] at Iowa Veterans Home. And he - the Des Moines VA spokesman - just stopped. And it was silent for a minute. And he said, “I had no idea there was an outbreak at the Veterans Home.” ** pause ** “[VA Spox] because we see patients from the Veterans Home.” PEDATI: No, that's, you know that that's helpful. ME: Well, but the thing is it's a state run home is what I'm saying. And again, those were breakthrough infections. You see where where this is problematic is that there's a public facing issue. And then there's the behind the scenes issue of what's really going on with a pandemic in Iowa.This is where my conversation with a CMS - Centers for Medicare and Medicaid - came in. I asked a specific question about reporting requirements and federal oversight at state veterans homes. AK:I understand there is new HHS guidance in a recent rule for state-owned veterans homes bound by states that require them to report COVID cases directly to the CDC. Who has the ultimate authority over civilian and veteran nursing homes when it comes to legal actions if they don’t comply about reporting COVID data?CMS: CMS only has authority on facilities that are certified as meeting CMS’ federal requirements for long-term care facilities. Some veterans homes meet these requirements…..[IVH IS A CMS CERTIFIED FACILITY] Facilities that are certified by CMS are required to report resident and staff COVID-19 vaccination information weekly. Facilities that do not comply with the COVID-19 vaccination reporting requirement are fined for each week they fail to report. Anyone can call CMS, HHS, etc. with concerns. I suggest literally everyone does. Here’s the regional contact information from the national CMS website. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit andykopsa.substack.com/subscribe
Transcribe →
Conversation with Dr. Pedati
Jul 22, 202100:43:06Tap to summarizeBackground on this storyThis story started after residents and staff at The Iowa Veterans Home (IVH) in Marshalltown experienced the fifth outbreak of COVID-19 in June. Laura Belin of Bleeding Heartland and the Marshalltown Times-Republican posted stories, followed by other news media. Belin used letters received from concerned family members issued by the facility indicating the outbreak wasn’t due to the delta variant but instead due to a “new” variant. Iowa Department of Public Health (IDPH) spokesperson Sarah Ekstrand responded to Belin stating “an already-existing variant of the virus identified at the Iowa Veteran’s Home is not a variant of interest or variant of concern.” But questions remained. This led to IowaWatch reporting across state and federal agencies including the U.S. Centers for Disease Control and Prevention( CDC), the Centers for Medicare and Medicaid (CMS), Iowa State Hygienic Lab (SHL), the Iowa Department of Public Health (IDPH), numerous conversations with healthcare providers in Iowa, analyzing hours of county boards of supervisors’ meetings, accessing the U.S. Department of Health and Human Services grants website – Tracking Accountability in Government Grants System (TAGGS), the CDC Variant Classification and Tracking System and numerous other resources. For daily information on active cases, trends and long-term care facility outbreaks Iowan Sara Anne Willette aggregates data from CDC and CMS databases and provides analysis and county level data on her website Iowa Covid19 Tracker. And; Some background information, where to get a Test Iowa home test, guidelines for longterm care facilities (from US Department of Health and Human Services) and the first Iowa LTCF investigation by the US DOJ/CMS:Variant classifications (from the CDC): The U.S. government SARS-CoV-2 Interagency Group (SIG) developed a Variant Classification scheme that defines three classes of SARS-CoV-2 variants:Variant of interest: A variant with specific genetic markers that have been associated with changes to receptor binding, reduced neutralization by antibodies generated against previous infection or vaccination, reduced efficacy of treatments, potential diagnostic impact, or predicted increase in transmissibility or disease severity.Variant of concern: A variant for which there is evidence of an increase in transmissibility, more severe disease (e.g., increased hospitalizations or deaths), significant reduction in neutralization by antibodies generated during previous infection or vaccination, reduced effectiveness of treatments or vaccines, or diagnostic detection failures.Variant of high consequence: A variant of high consequence has clear evidence that prevention measures or medical countermeasures (MCMs) have significantly reduced effectiveness relative to previously circulating variants.Long-term care facilities backgroundA CMS spokesperson issued the following answers to questions from writer Andy Kopsa reiterating authority of CMS reporting outbreaks, cases and vaccination statistics at long term care facilities and the Iowa Veterans Home. There are 440 CMS certified long-term care facilities in Iowa. The Iowa Veterans Home is also CMS certified. All rules apply. AK:I understand there is new HHS guidance in a recent rule for state-owned veterans homes bound by states that require them to report COVID cases directly to the CDC. Who has the ultimate authority over civilian and veteran nursing homes when it comes to legal actions if they don’t comply about reporting COVID data?CMS: CMS only has authority on facilities that are certified as meeting CMS’ federal requirements for long-term care facilities. Some veterans homes meet these requirements, and are therefore subject to CMS’ requirements. However, if a state-owned veterans home has opted to not apply for, and be certified by CMS, then they would not be subject to CMS’ requirements, including the COVID-19 vaccination reporting requirement. Facilities that are certified by CMS are required to report resident and staff COVID-19 vaccination information weekly. Facilities that do not comply with the COVID-19 vaccination reporting requirement are fined for each week they fail to report. AK: What responsibility does a CMS-certified nursing home have to inform the public regarding COVID, and are there any mandates to do so?CMS: On May 11, 2021, CMS announced new requirements for long term care (LTC) facilities to submit COVID-19 vaccination information for nursing home residents and staff. On June 10, CMS posted the first set of weekly nursing home COVID-19 vaccination data, which includes vaccination status of both residents and staff, as reported by facilities. The data for the week ending May 30 can be viewed here: Nursing Home Data website. The current data show that approximately 75% of residents and 55% of staff in nursing homes have received a COVID-19 vaccine, which indicates a high level of protection from COVID-19.The weekly reporting of vaccination data for residents and staff will help ensure that facilities receive support for their COVID-19 vaccination efforts. The data are reported to the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN), the nation’s most widely used healthcare-associated infection tracking system. LTC facilities are already required to report COVID-19 testing, case, and mortality data for residents and staff to the NHSN. The Nursing Home Data website is updated every Thursday with data submitted by the previous Monday. AK:Are CLIA-certified labs bound by federal mandate reporting laws via CMS as well?CMS: CMS is committed to taking critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) public health emergency. Under the Clinical Laboratory Improvement Amendments (CLIA) law, labs testing for COVID-19 must have a CLIA certificate to ensure patient health and safety.In addition, per the Secretary’s guidance, laboratories will need to follow the June 4th Guidance for reporting SARS-CoV-2 test results. However, CLIA will only be assessing whether laboratories have, or have not, reported, or attempted to report, SARS-CoV-2 test results. In order to be in compliance with the CLIA reporting requirements, a laboratory will need to have documentation that it reported SARS-CoV-2 results or at least attempted to report the results. CMS will continue to work closely with laboratories across the country and other stakeholders to protect patient health and safety during the COVID-19 pandemic.A CDC spokesperson pointed out the healthcare value of the NHSN network but also the regulatory purpose it serves if a LTC doesn’t comply with federally mandated standards of care including reporting, testing and vaccination requirements for COVID19“NHSN is a national surveillance system, accessible to registered users through an online, web-based application. Healthcare facility users, including those from LTCFs, report data directly to NHSN”This allows them to: identify infection prevention problems by facility, state, or specific quality improvement project; benchmark progress of infection prevention efforts; comply with state and federal public reporting mandates, and ultimately; drive national progress toward elimination of healthcare-associated infections.CMS is serious about compliance for the health and wellbeing of Americans living in long term care facilities:“CDC has received reports from NHSN users indicating that in some healthcare facilities, some of the decisions about what infections should be reported to NHSN are made by individuals who may choose to disregard CDC’s protocol, definitions, and criteria or who are not thoroughly familiar with the NHSN specifications. While the...
Transcribe →
Why am I doing this?
Jul 13, 202100:11:03Tap to summarizeThis is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit andykopsa.substack.com/subscribe
Transcribe →
January 11 Articles of Impeachment
Jan 11, 202100:05:54Tap to summarizeReading aloud for my visually impaired friends. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit andykopsa.substack.com/subscribe
Transcribe →
Page 1 of 1