MILLSBORO -- Marya Grier moved to Millsboro from New Jersey in November, and one of her top priorities was to find a primary care physician.
Although Grier, 70 and on Medicare, is on medication and needs to be monitored by a doctor regularly, she's been struggling to find care. One doctor cut back on his practice and another said it would be a six-month wait for an appointment.
For now, she's continuing to make the three-hour trek to see her doctor in New Jersey.
"It's kind of upsetting in a way," she said. "I'm certainly not in any dire straits, but if I had any issues with the medication, who would I go to? My only option is to go to Jersey, but that's a day trip and that's expensive."
Sussex County is considered a medically underserved area by the U.S. Department of Health and Human Services.
According to the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation's County Health Rankings, Sussex County has 157 primary care physicians and a population to primary care physician ratio of 1,208-to-1. The same figure in New Castle County is 806-to-1, while the national benchmark that has been set is at 631-to-1.
"In a perfect world, we would have at least one doctor to every 630 patients," said Megan Williams, director of Population Health at Beebe Medical Center. "The idea there is that if we had a provider for every 630 patients, (the provider) would have ample time, knowledge and resources to provide robust primary care for their patients."
Williams said one reason the county has "a pretty dramatic shortage of primary care providers in the area" is its rural setting.
"We don't necessarily have medical education or a medical school here in Delaware, or certainly close to Sussex County," she said. "By virtue of that, we don't have folks who are doing a lot of their training and education here. Right out of the gate, that puts us at a disadvantage."
Kelly Griffin, director of marketing and communications at Beebe, said the wait for a someone who uses the center's physician referral line to seek primary care is usually two to three months. More than 200 local physicians who are affiliated with Beebe and deal with family practice and internal medicine are on the list.
"Often we can help, but it depends on whether they want to travel a little bit further," she said.
Beebe actively recruits for additional primary care physicians. Marilyn Hill, director of physician services, said there are fewer people who aspire for physician positions, for a number of reasons, including the high costs to get to that point.
"It's difficult to entice people to go into it," she said. "It's very expensive to go through medical school, residency and fellowship training. You have to have a passion for it and want to do it for the right reasons."
Hill said when she recruits, she tries to promote the workplace community and the local community and focuses on the positives.
Grier said she believes the wait is so long because many local doctors are retiring and no one is taking their place.
Sussex County Administrator Todd Lawson said while there are no marketing plans at this time to bring more physicians into Sussex County, discussions with Beebe and Nanticoke Health Services have taken place with that in mind.
"We all recognize the fact that health care and our health care industry locally is being stretched right now with our population shifts, so we need to plan for that," he said.
Lawson said despite having the beach and the infrastructure, as well as being two hours away from three metropolitan areas, the county is having issues attracting the talent.
"Getting those young professionals in here is a challenge," he said. "We've had many discussions on how to combat that. I don't have an answer that we have a plan in place, but we recognize the issue."
As for Grier, she is still undecided about what she will do.
"I'm sort of hanging on the edge as to what I'm going to do next," she said.
On Twitter @JonBleiweis
Source: www.delmarvanow.com
Efficiency law could 'triple' energy services market - EurActiv.com
The draft bill contains the strongest incentives to date for triggering a boom in the market for energy efficiency services, according to a number of experts working in the field.
In its current form, the draft directive requires central governments to achieve a 3% renovation rate for the buildings they occupy, on a yearly basis. It also imposes an obligation on power utilities to achieve 1.5% annual energy savings among their final customers - including large commercial and public building owners.
As a result, power companies are expected to change their business model by seeking profitability in selling energy services rather than supplying energy only.
"If the final text is somewhere between what the Parliament is proposing and what the [member states] are recommending, then I think we're going to have something fairly solid," Brook Riley of green group Friends of the Earth Europe said after the latest round of 'trialogue' talks which took place between the EU's three institutions on 29 May.
This would be enough jump-start the energy efficiency services market, he added.
Market set to 'triple'
Adrian Joyce, senior policy expert at EuroAce, a trade group representing companies involved in the energy savings goods and services industry, was equally optimistic. With the right incentives in place, "the demand for and supply of energy-efficiency services is set to double or even triple in five years' time," he told EurActiv.
For Brook Riley of Friends of the Earth, only legally-binding measures will create room for the market to find the appropriate investors. "If we make it obligatory, we will have a market for energy savings," Riley said. "State guarantees is what investors need," he added, giving as an example the growing appetite for energy efficiency investments in the Unites States, where there are state-level laws to foster them.
In Europe, on example is Denmark, where the public sector played a role in guaranteeing a return on investment. As the price for fossil fuels went up, Danish company Dong Energy found that they were actually making more money from selling energy efficiency services than from selling energy itself.
This resulted in a boom for the energy efficiency services market in Denmark. Coupled with national awareness-raising campaigns and change in consumers' behaviour, this all reflected in better insulation and automation of buildings and in the end, lower energy bills.
Not everyone is applauding, however. The Danish Energy Association told EurActiv they understand why EU governments are sceptical when it comes to funding energy-efficiency schemes, which come at a high costs for national public finances at a time when all governments are trying to cut spending.
“With energy savings, you will always experience initial costs, plus with the austerity measures taken all over the EU, it all translated into an eternal discussion of whether this investment pays off,” a spokesperson of the Danish Energy Association said.
These measures were taken in Denmark some time ago, far from an economic crisis like the one Europe is experiencing today, but during the 1970s oil crisis which pushed for urgent action. Whilst hard to introduce at first, evaluations of the Danish system have so far been positive.
Private sector already taking steps
If government incentives do help, some companies have not waited for binding laws to offer services for large commercial or public buildings owners.
“It's important for governments to offer incentives”, Maureen Lally of energy service provider Trane told EurActiv. However, she added, many building owners are moving on their own by asking for the services of specialised companies.
An initial energy-audit shows tenants where they are wasting the most energy, and how they can save money from electricity or gas bills. “After the audit, we identify areas of improvement,” said Michel Rozendaal, energy expert for Trane. “This could mean putting controls in or more equipment or taking energy conservation measures, for example. Then we do a cost-benefit analysis and determine whether it is or not economically feasible and then we model to predict how their building will operate over time,” Rozendaal explained.
Companies like Trane have developed their analytical models over time, based on their existing projects and taking into account factors such as weather, geographical conditions, humidity, the duration of daylight and nighttime.
From the customer end, the biggest obstacle is scepticism over the period of time needed to recoup the investment. But reluctance to invest in projects with long investment-return can sometimes be addressed by experts equipped with the right tools. “There are many customers who realise they need to save energy and are looking for solutions, but also many who have no idea about the potential,” Rozendaal said.
Most investments Trane makes in fact have a two to five year payback, he added. Then, buildings start saving money from their reduced energy bills, making up entirely for the initial financial effort.
Social benefits are also considerable, experts argue. The productivity of workers increases in a better insulated, more comfortable and healthier commercial or public building, according to Adrian Joyce, energy expert for industry group EuroAce.
Source: www.euractiv.com
Law requires Ga. cities to submit tax records - Tifton Gazette
Law requires Ga. cities to submit tax records
TIFTON — A state law aimed at making the budget process more transparent has so far met with mixed success, according to a report by Morris News Service.
Morris News Service reported Sunday that, under the law, any local government with a budget totaling more than $1 million must submit copies of their taxes and expenses to the University of Georgia's Carl Vinson Institute of Government. Most governments have until the end of June to comply with the law.
So far 117 of 535 cities have submitted the records, while 76 of 159 counties and 169 of 180 school districts are in compliance, according to Morris News Service. Some of those not complying could be exempt because their budgets are too small.
Smaller cities have expressed frustration over the law. They say reports can be difficult for small governments with few staff members.
"We don't mind providing the information, but we think it's come to the point where the state government doesn't have anything better to do other than asking local governments to submit information," said Carter Crawford, city manager in Sylvania. "It's just aggravating. It takes time away from duties that we can do elsewhere."
And the documents aren't easy to find. The website doesn't come up in a simple Google search, so the public has to go to the UGA website and search there to view anything that's been submitted.
The Vinson Institute doesn't track how many people actually visit the site or view the budget documents.
Angela Palm with the Georgia School Boards Association said many local education officials see the law as unnecessary because the same information goes to the state departments of revenue, education and audits.
"We keep making more information available or available at other places, but I don't that the general public knows or uses it," she said.
___
To view local government documents online, visit https://ted.cviog.uga.edu/financial-documents/
Source: tiftongazette.com
Indian law on teen sex ‘regressive’ - Independent Online
.
New Delhi - India is raising the age of consent for sex to 18 under a new law seen by some children's rights activists as being out of step with social changes and open to abuse.
Under a provision in the Protection of Children from Sexual Offences Act approved by parliament last month, sex with a person under the age of 18 will be deemed as statutory rape and subject to prosecution.
Once formally signed into law by the president, the new legislation will supersede a clause in India's Penal Code that previously set the age of consent at 16 and will carry sentences ranging from three years to life imprisonment.
Critics say the change is open to misuse by police and overprotective parents, puts India at odds with other countries and is further proof of a government run by elderly politicians out of touch with most of the country.
“We can't pretend children are not sexually active when they are adolescents,” says one senior child welfare official working for a government body who did not want to be named. “This law is plain regressive.”
The third National Family Health Survey, the most recent comprehensive government study from 2005-2006, states that 43 percent of women aged 20-24 had had sex before they were 18.
In rural areas, the high proportion is because of the prevalence of child marriage - more than 47 percent of women aged 20-24 were married by 18 - while in urban areas attitudes on everything from religion to sex are changing.
Surveys from news magazines such as India Today and Outlook find young urban Indians are increasingly open to pre-marital intercourse and more exposed to sex through pornography or steamy films and television shows than ever before.
For Shantha Sinha, the chief of the National Commission for Protection of Child Rights, a state-funded body, the law was open to abuse.
“It can be used to the disadvantage of children if one has to settle scores,” she says, raising the scenario of under-age girls using the law against former partners even if the sex was consensual.
The police may be able to use it to “harass young couples in parks”, Sinha says, while partners who elope - a common occurrence in India where arranged marriages are the norm - could also be targeted.
“You have cases where young people in love elope to escape parental objections and censure. The parents can use this law and make it legally tough for them,” she said.
A trial court judge in New Delhi made the same observation during a hearing in the case of a man accused of kidnapping and raping a girl of 15. The judge acquitted the defendant and ruled the girl had eloped voluntarily.
The change in the law “will open the floodgates for prosecution of boys for offences of rape on the basis of complaints by girls' parents irrespective of whether the girl was a consenting party”, noted the judge.
But experts in favour of the change say it will help protect the most vulnerable sections of society, including the millions of girls and young women who work as servants in Indian homes.
Amod Kanth, a former police officer who was part of the drafting process, argues that this consideration must override any other concerns in a country where child abuse is rife.
“We carried out a study in 2007 and found that nearly 53 percent of children had suffered some kind of sexual abuse,” Kanth said.
“We felt such children needed to be protected and that there should be a specific law for this.
“Tomorrow the same people who are asking for 16 as the legal age of consent will ask for 13,” he added.
The age of consent across the world ranges from 13 to 18, with many countries, including Britain, Norway and Canada setting it at 16, according to Avert, a British charity that works in sexual health.
A few states of the United States, including California, fix the age of consent at 18, but they include a “close-in-age” reprieve for teenagers who have consensual sex.
For Zafar and his friends, who study in a private school in New Delhi, the new law is a fresh example of restrictions imposed on youngsters by “insensitive” adults.
“Most of my friends have already made their sex debut,” said Zafar, 17, who asked to be identified by his first name only.
“Some are in serious relationships, some are doing it for fun, others because they are simply curious.”
The Childline Foundation, a non-profit agency that runs an emergency phone service for children in need of care, says the most important thing is making sex education compulsory in all schools across the country.
“This will help children make informed choices and avoid the pitfalls,” Komal Ganotra, advocacy and training specialist at the Foundation, said. - Sapa-AFP
Source: www.iol.co.za
No comments:
Post a Comment