Sen. Chuck Grassley of Iowa has worked to increase the federal government's actions to protect nursing home residents from unnecessary antipsychotic prescriptions and to protect the taxpayers from improper payments for these drugs.   In light of serious warnings about using these medications in dementia patients, and significant uses of the drugs in dementia patients in nursing homes, Grassley asked for a government inspector general audit of the practice.  The audit in 2011 found that 88 percent of the powerful antipsychotic drugs being prescribed to nursing home residents with dementia carry what are called black box warnings from the Food and Drug Administration.  The warnings cite an increased risk of death in elderly patients with dementia.   With a fellow senator, Grassley wrote to the administrator of the Centers for Medicare and Medicaid Services, seeking a description of the agency's actions to protect nursing home residents from unnecessary antipsychotic prescriptions.  Today, the Centers for Medicare and Medicaid Services (CMS) announced that "the national prevalence of antipsychotic use in long stay nursing home residents has been reduced by 9.1 percent since the last quarter of 2011."  Grassley made the following comment on this development.

"The 2011 inspector general audit documented serious challenges for the federal agency that oversees nursing home safety.  The federal government was right to respond.  Seeing a reduction in the use of antipsychotic drugs in nursing homes is a step in the right direction.  However, CMS needs to continue making progress toward protecting nursing home residents from unnecessary antipsychotic prescriptions.  The right kind and right level of medication are critical to nursing home residents' quality of care.   The government needs to be sure nursing home residents are getting good care in keeping with federal standards and good stewardship of tax dollars."

More Than 100 State Cooling Centers Open Across Illinois

CHICAGO - With hot weather expected this week, Governor Pat Quinn today is urging residents to take advantage of the state's cooling centers. This summer, Governor Quinn opened more than 100 cooling centers around Illinois in order to help those without air conditioning beat the heat.

"The combination of high heat and humidity is dangerous for people and pets alike," Governor Quinn said. "I urge residents to take the proper precautions to stay safe as another hot summer comes to an end."

The cooling centers are located at Illinois Department of Human Services (IDHS) offices throughout the state. IDHS cooling centers are open to the public during regular business hours from 8:30 a.m. to 5 p.m. In addition to the IDHS cooling centers, the Illinois Tollway Oases in the Chicago area are available 24 hours a day, seven days a week.

Governor Quinn and the Illinois Department of Public Health are also encouraging Illinois residents to watch for signs of heat-related illnesses. Symptoms of heat-related illness include headaches, skin that is hot to the touch, increased body temperature, loss of consciousness, seizures and irregular heartbeats.

To stay cool and avoid illness, people should increase their fluid intake but avoid drinks with caffeine, alcohol and sugar; decrease strenuous, outdoor physical activity and remain in air-conditioning when possible.

The Illinois Department on Aging also encourages relatives and friends to make daily visits or calls to senior citizens living alone. When temperatures and humidity are extremely high, seniors and people with chronic health conditions should be monitored for dehydration and other effects of extreme heat. Additionally, seniors should eat lighter meals, take longer and more frequent rests, and drink plenty of fluids.

To find a cooling center near you, call the IDHS hotline at (800) 843-6154 or visit www.keepcool.illinois.gov.

by U.S. Senator Chuck Grassley

At the end of this year, the coverage provisions of the Affordable Care Act will take effect.  Regardless of what a person thinks about the massive changes the law will make to America's health care system, it's important to understand the economic impact of the health care law's regulatory burden and 23 tax increases.

The reality is that the Affordable Care Act creates multiple levels of new government regulation and the cost of the law is covered with taxes and penalties on businesses and consumers who already pay for their insurance.  Health insurance premiums are expected to jump significantly as insurers shift costs to comply with mandated health care benefits.

The law also continues to cause great uncertainty among employers.  The employer mandate requires companies with at least 50 workers to provide health insurance to those who work at least 30 hours.  In anticipation, some employers have cut back hours or added part-time staff instead of full-time positions.  The Bureau of Labor Statistics' recent employment report shows that of the 162,000 jobs added in July, a disproportionate share is skewed towards lower-wage, part-time work.  The ranks of part-timers being hired are swelling due to the uncertainty created by the employer insurance mandate.  The White House in July unilaterally decided to postpone the employer mandate, but the one-year delay does not remove the future burden on employers.  The delay also opens up insurance subsidies to fraud, as the IRS likely will not be able to certify if those who apply legally qualify.

The tax increases prescribed in the Affordable Care Act to raise $1 trillion over a decade include :

• a 2.3 percent excise tax on the sale of medical devices effective January 1, 2013, increasing the cost of hip and knee replacements and other medical innovations that our aging society has come to depend on to extend quality of life;

• a tax penalty on individuals for not buying qualifying coverage effective January 1, 2014, that gradually increases over the next three years.  In 2014 the penalty tax is limited to $95 or 1 percent of taxable income, whichever is greater, but by 2016 the tax grows to $695, or 2.5 percent of taxable income.  In the years following, the penalty will increase by a cost-of-living adjustment;

• a payroll tax hike on higher-income taxpayers, lifting Medicare Part A's tax bite to 2.35 percent from those workers' paychecks;

• a 3.8 percent surtax on investment income for higher-income taxpayers;

·         a tax increase that limits contributions to Flexible Savings Accounts (FSAs) to $2,500 and eliminates tax-free reimbursements for over-the-counter medicine for both FSAs and Health Savings Accounts;

• limits on medical itemized deductions;

• an excise tax on insurers of employer-sponsored, high-end health plans, effective in 2018;  this change places a punitive tax on those who have health coverage to help pay for those who do not;

• annual fees on prescription drug manufacturing and health insurers; and,

• a 10 percent tax on indoor tanning services.

Expanding access to health care coverage for the uninsured has broad support and steps need to be taken to increase access to coverage, especially for individuals, and to increase transparency and competitiveness in the cost of health care services.  But the new federal taxes, excises, penalties, mandates and fees in the Affordable Care Act come with tremendous economic costs.  What's more, the health care law won't bend the spending curve on exploding health care costs or encourage medical innovation.

All things considered, just as Washington can't tax our way to prosperity, the federal government can't tax its way to universal health care coverage without inflicting more harm than good.

What's it like to be an English bulldog? More people are finding out, say integrated health specialists Dr. Michael Gelb and Dr. Howard Hindin.

"A bulldog's airway passages are quite restricted because of the shape of its face, and they are often especially vulnerable to illnesses such as cardiac disease and cancer," says Dr. Michael Gelb of The Gelb Center in New York (www.gelbcenter.com), a holistic dentist known worldwide for pioneering integrative treatments.

Dr. Hindin of the Hindin Center for Whole Health Dentistry (www.hindincenter.com) partners with Dr. Gelb in a multidisciplinary approach to treating chronic disease affecting millions of Americans.

"Our faces are becoming more like a bulldog, with smaller mouths, bigger tongues, misaligned teeth and bigger necks - all of which changes the structures of our mouths and makes breathing significantly more difficult," Dr. Hindin says.

The doctors say that's creating a health crisis.

They say these issues are often associated with Airway, Breathing and Sleep (ABSleep):

• ADHD and other children's issues: Ninety percent of our brains are developed by age 12. Obstructions and even increased effort in breathing cause children to have sleep disorders, and the effect is a range of related problems, from attention deficit hyperactivity disorder, to obesity and diabetes. The good news is that much of this is preventable - at 6, 18 and 30 months of age, doctors can predict children who are likely to develop behavioral and cognitive disorders due to poor breathing. Treatment is often complex and requires a team approach. Removal of tonsils and adenoids are among preventative measures, along with palatal expansion and myofunctional therapy. Additionally, early intervention can improve the shape of a child's face, lips and smile.

• TMJ: As our faces are becoming pushed in and our mouths are getting smaller there is increased pressure on the TMJ as well as increased muscle tension and clenching.

• Sleep apnea: People with sleep apnea can stop breathing hundreds of times each night. Each time this happens, the brain triggers the person to awaken, ever so slightly, in order to resume breathing. Up to 90 percent of people with obstructive sleep apnea have not been diagnosed, according to the American College of Physicians. Sleep apnea is just one of the disorders that can have serious lifelong consequences. But the causes are easily corrected. Children who snore loudly are twice as likely to have learning problems and are more likely to develop behavior problems and ADHD.

• Chronic headaches: Morning headache is one sign of obstructive sleep apnea. As the face is pushed in, nasal breathing is obstructed and mouth breathing results in a forward head posture. This puts a strain on the muscles and nerves at the base of the neck which increases headache.

• Other sleep disorders: You do not need to have apnea to have a sleep disorder that will interfere with performance and health. Snoring, restless leg syndrome and simple daytime drowsiness can be a signal that you are not getting the proper quantity and quality of restorative sleep. If you are suffering from chronic pain, inflammation, poor performance or behavior problems, consider looking into airway-breathing treatment.

About Michael Gelb, D.D.S., M.S.

Dr. Michael Gelb is an innovator in airway, breathing, sleep, and painful TMJ disorders pioneering Airway Centric. He has studied early intervention for sleep disordered breathing (SDB) specializing in how it relates to fatigue, focus, pain and the effects all of these can have on family health. Dr. Gelb received his D.D.S. degree from Columbia University School of Dental and Oral Surgery and his M.S. degree from SUNY at Buffalo School of Dental Medicine. He is the former Director of the TMJ and Orofacial Pain Program at the NYU College of Dentistry and is currently Clinical Professor in the Department of Oral Medicine and Pathology at the NYU College of Dentistry. He is a co-inventor of the NORAD, or Nocturnal Oral Airway Dilator appliance that reduces snoring by positioning the patient's tongue and jaw so that airways stay open. He co-founded the Academy of Physiologic Medicine and Dentistry (APMD) and a non-profit to prevent the proliferation of chronic disease in the U.S. based on airway, sleep and breathing awareness, research and education.

About Howard Hindin, D.D.S.

Dr. Howard Hindin is trained in all aspects of general dentistry. Since the 1990s, his practice has also focused on cosmetic dentistry, temporomandibular joint disorders and craniofacial pain. He is a graduate of New York University College of Dentistry. An acknowledged pioneer in the relationship between dental issues and whole body health, Dr. Hindin is President (2000-present) of the Foundation for the Advancement of Innovative Medicine (FAIM). He is also an active member of the American Academy of Pain Management, American Academy of Cranio Facial Pain, American Academy of Dental Sleep Medicine, Academy of General Dentistry, American Dental Association, International Academy of Oral Medicine and Toxicology, and the New York State Society of Acupuncture for Physicians and Dentists and is the co-founder of the American Association of Physiological Medicine and Dentistry (AAPMD).