Monday, June 30, 2008
This is a Galapagos Tortoise not the Plainfield Council
While I contemplate what I have to say for Tuesday's blog about the Council meeting and my latest intake on the Muhlenberg fiasco, I can give a little data about this tortoise. Darwin discovered that the birds and animals on each of the islands appeared to be distinct from those on other islands. He surmised that each group had evolved separately and were influenced by local conditions. If he had the ability to test for DNA he could have proven his theory and also trace the animals back to common ancestors.
Horizon plans for Blue Shield to become "for profit". The history of changing non- profit health plans to for profit is continuing. The "Blues Plans" known as Blue Cross many years ago not only changed purpose and tried to become money makers . Many became involved in ,mergers to be bigger entities.
The fallacious arguments were cost effectiveness and ability to compete with the commercial carriers such as Aetna and Cigna. The real objective was the awarding of large stock blocks to the favorite insiders who orchestrated the conversions and the IPOs.
The Blue Shield Plans were originally independent not for profit companies initiated by coopering physician members. The goal was to provide low cost affordable physician services. I can not recall how they became bound to the for profit "Blues".
That must have occurred with the advent of the HMO concept. The Horizons of the world could now sell a complete package including Health Care facilities and the "providers" ( IE: physicians , therapists etc) to staff them. Cost effectiveness and profits were achieved by market forces such reimbursement restrictions and downgrading utilization in addition to blackballing "uncooperative hospitals and physicians.
Today, the greater part of the Blue Shield component of Horizon comes from the for profit HMOs and not the now prohibitively expensive non profit individual subscriber patient.
The argument that the for profit model has reduced costs reverts to publishing numbers not facts producing them. Certainly as with Anthem the California equivalent of Horizon there has been between a 3 to 7% drop in its health care costs. Unfortunately that has not been accomplished through reduced organizational expenses but due to restricting services.
The carrot being dangled before the public is the 1 to 3 billion dollars that will supposed enrich the states (and politicians) coffers as a result off the loss of non-profit tax exempt status. But no one questions where that money will come from. Not from operating efficiencies. Executive reimbursements will increase. The only source will be the insuree's pocket book.
So much for the State's government and the Star Ledger's concern for the public's health.
Years ago.on a bus trip from Playa del Carmen to visit Chicken-Itza we stopped for a short stretch in a town that I think was Valladolid. Just down the street was a school with an open doorway from the classroom to the street. Sitting near the open door sharing a desk were these two students. This delightful little girl intrigued by the strangers walking past made a perfect subject for a candid picture.
I thought of this girl while reading one of Donna Quixote-Maria's blogs about the BOE. I am sure Maria feels that she is flailing at windmills. She is probably hurt by the unwarranted attacks upon her by those who feel threaten by the truth.
Plainfield needs people like Maria , whose desire is to insure quality education for her children as well as every one that attends public schools.
Her articles expose the lack of organizational skills and direction that is evident by the Board's decisions. There frequently seems to be an abnormal impact of personal agendas on the school administration. The disregard for mandated procedures such as solicitation of bids for construction, services, or supplies. Frequent software and curriculum changes denote lack of direction or authority.
This continued exposure of the lack of understanding of its role by the members of the BOE should be an eyeopener for all the city's voters, especially the 10% who elect the individuals who determine the biggest single budget in the city.
I have always felt that the change from an appointed Board of Education to an elected one was a move in the wrong direction.
The argument that the appointed board could be controlled by an administration that would use it for patronage purposes is a valid one. Never the less, responsibility and accountability would fall upon one person and one political entity. If too much hanky-panky occurs the head of the serpent can be cut off.
On paper the concept that a board chosen in a nonpartisan election would best reflect the public's interests appears to be ideal. However in reality, without admitting to the facts, local political parties and fractions as well as special interests groups have run slates to fill the open slots. With the general apathy of the public when less than 15% vote it becomes easy to influence the election results. Too often there is a board that is beholden to a local political boss. Compliant members become selected candidates for acknowledge political office.The BOE should not be a training ground for would be politicians.
I would be remiss not to mention Maria's other civic campaign against ethnic bigotry. Although her specific focus falls on the growing Latino presence in the community her message relates to all minority groups. The term "Minority" used here is statistical not the unfortunate political one.It is amazing how the previous "bigotees" have become the "bigoters".
I would suggest that the new school hierarchy obtain the free material from "The Southern Poverty Law Center" and require its use in the curriculum.
Maria, don't stop being a crusader. You are heard, and gradually the needed reforms will occur.
Sunday, June 29, 2008
These two photos are pictures of the north shore of the Gaspe along the St. Lawrence River
The next two (right) are views of the "Rock at Perce" which is off shore in the Atlantic Ocean. It is a bird sanctuary and is the home of thousands of Great Cormorants. The final two shots (below) show the birds on ledges of the Rock with the reflection in the water and on a small outlying rock.
Shame for the Star Ledger for its single editorial praising the inevitable action of the Commissioner of DHSS. Aside from that one "opinion" the Ledger seemed oblivious to the Plainfield area's problem. I can not recall a letter published on the "editorial page" relating to Solaris's actions and the impact upon the community.
Does the Newhauser family of Syracuse still own the newspaper chain that published the Star Ledger? Years ago a member of that family , Mrs James Miron, was an active civic resident of Plainfield.
Saturday, June 28, 2008
Since neither calender or business days are specified in the charter I would presume that the writers of the charter intended calender days.
I had missed the June 20th notice of a special meeting on June 3o which would include not only the tabled liquor licenses, but also discussion on a contract agreement between the Kings Temple Community Development Corp., the New Jersey Redevelopment Authority and the city. On the 24th I had suggested to several council members that discussion on the pending action of the SHPB should be included in the special meeting agenda. There would be ample time to post notification. I can find no information about the meeting on the city official web site. Time is awasting.
Friday, June 27, 2008
Among ignored warning signs were the subtle changes in OR scheduling procedures that made it more desirable for surgical specialist such as orthopedics and vascular to use JFK rather than MRMC. These created the significant drop in overall admissions.
The sale of the SurgiCare center 6 years ago to the doctors who would admit to the same day surgery unit not only shifted patient admissions away from the hospital but gave statistical data to support the claim that the bad doctors were contributing to the hospital losses by using free standing facilities.
The State Health Planning Board's consists of 11 members, 4 are so called Providers, 3 more "Consumers" , 2 Ex-Officio with vote, representing the the Health Care Administration Board ,and the Public Health Council, and 2 Ex-Officio without vote ,one from the Commissioner of Health and Senior Services office, the other representing the Commissioner of Human Services.
Only 5 members, a quorum,were present for the final hearing, Until I see the list of those present the mix is unknown, but I would imagine that all were voting members. At least one voter was an Ex-Officio member,Michael Baker representing the Health Care Administration Board also a department of the Department of Health and Senior Services (DHSS).
The fact that they voted shortly after the end of the hearing suggests that the outcome was predetermined. Unless I have missed it, the minutes of the previous meetings do not included receipt of written comments on the CN.
What waits to be seen is how quick the Commissioner signs off on the CN. How rapidly Solaris closes the doors. And how soon a buyer for the various 'lots" appears on the scene.
What is critical is whether the civil authorities are ready to take action within hours after the CN becomes effective. If there will be an injunction filed? Will Plainfield start "eminent domain" proceedings? Will JFK be presented with a tax bill the day they stop operating as a non-profit?
Granting the fact that Solaris has proceeded so completely into the operational destruction of MRMC , there is no possibility to return the hospital to the high quality medical facility that we knew. Therefore ,new entity will have to be created, hopefully without loss of continuity. It is imperative that we get the time. Solaris will of course do every thing in its power to deny any stay.
We are aware that there is at least one viable option in the wings to replace the present hospital with a smaller functional hospital that will meet the area's needs. Obviously the unused structures may be converted into profitable facilities.
What we need is total civic and communities support. Without delay the affected municipal governments must take assertive action. It is almost to late to "talk the talk", we must without delay be prepared to "walk the walk". For some time, Plainfield's Council has been request by concerned citizens to initiate the frame work for a proactive response. Will continued inaction kill all hope?
I hope to have an opportunity to view the SHPB's report to Commissioner Howard. Will there be any credence given to the Public Advocates remarks? Was there any efforts given to verify Solaris's statistics, and what impact has the delayed filing of the 2007 financial reports had on the veracity of claimed losses.
I will continue this analysis within the next few days.
Until I have a chance to read the papers and comments from those who attended yesterday's hearing this will have to do for today's posting. I do understand that a 5 panel group which is a quorum (!) for the commission voted to recommend approval of the Solaris CN. Lower Manhattan 1984 represents that which was the best.
Thursday, June 26, 2008
Can we blame New Democrats, Green Democrats, or just plain stupidity for this farce?
This is an appropriate photo today. It has been treated in a monochromatic technique since the original has deteriorated. This is the infamous 'Bridge of Sighs" in Venice. It went from the upper floor of the Doge's Palace to the prison (on the right). It received its name because once a prisoner crossed it he was very rarely heard from again. Today the prisoner is Muhlenberg.
Wednesday, June 25, 2008
Perhaps my opinion was the result of being a frustrated writer, On May 14th I had submitted a rather long essay requesting it to be considered for the op/ed page. I was not surprised when it never appeared inasmuch as I have no status as an agency executive or professor to merit inclusion among the papers stable of paid columnists.
for those who have the time, I am reproducing the letter here.
IMPACT OF HOSPITAL CLOSINGS
Affordable accessible health care is a paramount political issue today. New Jersey’s present policy in reducing hospital beds in medically under-funded population locations is not an appropriate answer to this problem.
Closing Muhlenberg Hospital in Plainfield is the wrong answer for New Jersey’s Health Care System. The fact that the excessive hospital beds are in the north and central portions of the state does not justify indiscriminate closing hospitals that operate at a loss. No attention has been directed at the economic demographics of the affected areas.
Among the recent 22 Hospitals closed since 1992are; Columbus and St James in Newark, Alexian Brothers and Elizabeth General (merged into St Elizabeth Hospital) in Elizabeth, Barnert in Patterson, and Union Memorial in Union. All had a commonality, an urban hospital serving a population with a high percentage of uninsured or Medicaid dependent individuals.
Nonprofit hospitals in NJ are mandated to care for all regardless of ability to pay. The State has repeatedly reduced funds allocated for reimbursement of such hospitals care. Medicaid reimbursement is probably well below true operating costs.
Prior to issuing a closure CN in depth auditing of the books determined the actual loss necessitating closure must be performed. The book losses must be due to actual operation costs, not number manipulations or coast/income shifting in a multiple unit hospital system.
How much of Solaris’s increasing operating loss can be attributed to Muhlenberg Regional Medical Center patient mix or due to a JFK reported 116 unoccupied beds in an affluent community and a desire to eliminate competitive beds from another portion of its system. Or was it due to the sale or transfer of profitable services away from MRC? These too are questions that deserve clarification.
However one fact remains, Accepting society’s and government’s responsibility to provide care to the less fortunate, why is the State permitting the loss of the only beds that service that population? Logically, the bed reduction should come from the overabundance of affluent area hospitals. Hospitals providing care to a poor urban population must receive in-creased economic support.
The humanitarian and prognostics outcome of the changes in care patterns have not been addressed. Minutes can be the difference between life and death. Yet, no concern has been directed to the increase time re-quired to reach treatment as a result of these closures.
Perhaps that is due to the proximity of the remaining hospitals. The road network could also be a mitigating factor.
The Pascack Valley demise demonstrates the opposite. A recent newspaper article stated “While the average ambulance run to Pascack Valley and back was an hour, according to EMTs, “it now takes at least 90 minutes for round trips to the next closest hospitals - The Valley Hospital in Ridgewood or Englewood Hospital and Medical Center” said a veteran Park Ridge EMT”.
The time for rescue squads to transport Plainfield’s residents to JFK’s ER will increase from 10 minutes to 25 or more depending on traffic conditions. Since according to local EMTs JFK’s ER has been on "divert" for two hours almost daily, without an increased load from the MRC area. How long will it take to reach a more distant functioning receptive ER over the poor existing road networks?
I have deliberately used the term functioning since an ER as proposed for MRC without the readily availability of acute in-hospital facilities is nothing more than a walk-in –clinic. No EMT would consider transporting a critical patient to such a facility. For patient inadvertently initially treated in such an ER there would be further time delay for an ambulance to arrive load and transport to the acute care hospital where triage would occur before treatment.
Finally there is the issue of the ability for car less members of a family to visit patients in the surviving hospitals.
There is no problem relating to good public transportation and road net-work access for the Elizabeth, Newark, Patterson, and even Union hospitals are in areas where there is public access.
However, consider what will happen in the Muhlenberg core area. From Plainfield to JFK by public transport would involve a train or bus to Penn Station Newark, a train to Menlo Park, and then a bus to the hospital. The bus from Plainfield could also be used to take the Menlo Park train from Elizabeth NJ Transit RR Station. Please figure out the time and cost for such an adventure. On the other hand a taxi from Plainfield to JFK costs $30.00 one way.
The State cannot permit or condone the fait accompli closure of Muhlenberg Hospital? For the community welfare of the core Muhlenberg population, Commissioner Howard must take positive corrective action to restore, not close, Muhlenberg to full service capabilities.
However all is not lost even if Commissioner Howard issues the CN requested. It will take a bonding of purpose from all municipalities affected plus a financial commitment. It will also take the whole hearted support of the citizens themselves.
Both the Plainfield government and its tax payers must take the initiative before the opportunity pass. The alternative for lack of action is a health disaster, and the blame will be upon ourselves not Solaris.
I would surmise that legal action will be necessary, and unless some attorneys with give their services "pro bono" we know that lawyers do not come cheaply. However we have only a limited time to bite the bullet.
To those who can not see beyond their nose, do some soul searching. No one should be above the good of the community. No one should be so self centered that they can not understand that every one living in the 13 communities will be affected.
Tuesday, June 24, 2008
Anyone who post a opinionated blog should expect that sooner or later someone will disagree in a vicious manner. With snail mail those go directly onto the circular file.
On the other hand I know of no one who does not appreciate a positive note. All I ask is that some who read it find my blog to be thought provoking or more often, entertaining. I also hope that if you have an opinion pro or con about anything I throw out, please feel free to express it.
For goodness sakes if you have something to say b e person enough to say it openly, not as a coward. If you are ashamed of your words don't write them. If there is to be a rebuttal it would be nice to know to whom it would be directed. The First Amendment can not be ignored, but don't use it as a weapon.
I know I use a pen name. However, I do not believe that my identity is a secret, nor have I made any attempt to make it one. When I was President of the MRMC medical staff I thought as a gag to get a special license plate "TOPDOC" but felt that too many could not appreciate a joke and believe that I was being a pompous ass. There is a story about "olddoc" but it is not relevant although in Denver it too started as a gag .
With that off my chest, enjoy this picture of western Scotland.It was taken from "The Train".
Monday, June 23, 2008
About the camel; Helen is the ??driver?? and I am giving advice- "get me off".
A long long time ago my wife and I took a fall foliage cruse on the Delta Queen from Cincinatti Ohio to St. Louis. One of the most amazing sights along the Ohio and the Mississippi were the "flood walls" surrounding many of the cities. Cape Gieardeau, MO. is an excellent example.
The first two pictures were taken from the Delta Queen when it docked there. In October the river was at a low but navigable level to St Paul and beyond. But here despite the shallow draft of the sternwheeler, the long gangplank was need to reach shore.
We could never imagine the height of the wall and the gate which resembled a canal lock. One can see the high water mark from previous floods. A few years ago the river did a flank maneuver and broke through levees on the sides of the town.
Doesn't it look like we are back in the Middle Ages with fortified cities similar to this one (Oschenfurt ?) on the Main River?
Sunday, June 22, 2008
I also forgot to mention that the model is a convertible and accommodates a backseat driver, (see Picture)
Unless there is something in the papers that will provoke comments, this will be it for Sunday .
Saturday, June 21, 2008
There are some other minor disadvantages; a driver (walker leader) is required. The ride is unusual since in motion the "seat" is going in several different directions at the same time. The vehicle is balky and will bite if given the opportunity. Moreover it seems to suffer from a severe case of halitosis.
Probably the only place one could be kept would be at the Peterson's farm on Cushing Rd.
Friday, June 20, 2008
Dottie Gutenkauf yesterday posted the up to date state of affairs pertaining to MRMC.
Her report should have been no surprise. The one group, our local and state political leaders, that may have had some effect in slowing the process excelled in minimal action. At no time did any municipal government use proactive action to achieve time to preserve the hospital. An injunction might have worked.Who knows? It was never considered.
I knew a month ago that the Colon/Rectal groups were folding their tent and terminating a 50+ year affiliation with Muhlenberg. The promise of a dedicated floor which they can fill at JFK and reserved OR slots would be too much to resist. Solaris had previously stopped providing specific Muhlenberg OR times to the orthopedists and the vascular surgeons who subsequently transferred their affiliation to the more cooperative JFK.
Residency terms begin July 1 for the year. Since there were none offered for 2008-09 no service could be given to the CCUs effectively shutting them down. Without house officers no acute care hospital can safely function. The only alternative would be the employment of coverage physicians.
No nursing staff would stay under such condition.
We must accept the fact that Muhlenberg no longer exists. Solaris has made it almost impossible for another operator to run the hospital even in a cut down mode. We can also be assured that conditions would not have reached this point without the active collaboration of Commissioner Howard, and the tacit approval of the Governor.Howard's earlier public remarks about the need to close Muhlenberg were callous but revealed a complete disregard of constitutional rights and procedures.
It is unfortunate that now no legal action can be timely enough or effective. We have a fait accompli before the final hearing and DHSS action.
Perhaps there may be grounds for action against Solaris executives and Board as well as the Commissioner for collusion and malfeasance. There may even be evidenced of criminal altering the books, Who knows and who has the funds to pursue such a course?
Interesting items from the"State Staff report"·
71% of Muhlenberg admissions were dependent on “government payment (Medicare, Medicaid, and charity care). Of these cases in 2006 18.2 %( page 13) were charity or Medicaid. That would mean that 52% admissions were Medicare which the Federal Government claims is appropriately funded plus 29% reimbursed through insurance carriers or the patient’s own funds.
· The increase in Medicaid and charity care from 2003 to 2006 was only 2%
· There was a decrease of approximately 500 Medical/Surgical Admissions or 7% from 2005 through 2007, whereas there was an increase of 23% in ICU/CCU during the same period. There has been a small increase in OB/GYN admissions during the same period. Inpatient Psychiatric care has remained stable, and is not offered by JFK.
The first two can't justify the Solaris claim of a 200% increase in loss from 2006 to 2007, the third one can be explained by Solaris's policy to destroy Muhlenberg including offering special perks at JFK and denied at MRMC to high admitting surgeons and medical specialists. The increase in ICU/CCU reflects the true need of an acute care hospital in Plainfield.
The travel times listed were from MRMC to other hospitals when you add on time to MRMC or equivalent travel only to JFK would be marginally acceptable according to standards. Will the State consider that?
Thursday, June 19, 2008
While stewing about the almost inevitable loss of critical health care in Plainfield, I came across this uncropped slide which represents one, albeit not applicable here, solution to the difficulties in transporting patients to hospitals.
As usual there is a tale to tell. In the early 60s, my wife, oldest daughter, and I were on a cruise aboard the Stella Oceanis. The ship had been built during WW II, as a freighter, and after the war an enterprising Greek shipping entrepreneur had converted into a popular cruise ship.
One port was Corinth, where we had a choice of tours. History buff me decided to visit Mycenae and the ruins of Agamemnon's palace with its famous Lions Gate. My daughter and wife went to Athens.
When I returned to the ship I found her sitting in a WW 1 wheelchair that had no brakes. While she was in Athens a man running full blast had bowled her over and she could not get up. They carried her to the bus and back to the ship.
I might note that this was a medical sponsored cruise for orthopedists. Those docs decided (wrongly)after learned consultations among themselves, that she must have had some type of a fractured hip. An x-ray was needed. Since the next two ports were in Yugoslavia the Greek ship doctor "could not make arrangements" for the x-rays in that country. However when we reached Venice, the end of the cruise, arrangements were made for her to go by "water ambulance" to the Reunited Hospital in Venice.
How many people on their first visit to Venice have the opportunity not only to sight see on the Grand Canal but also some of the side canals. The top of the motor launch just cleared some of the bridges over the secondary canals.
This shows her on the chair stretcher leaving the ambulance to be placed on a hospital stretcher for the x-rays. That is another narrative worth telling. Fortunately she did not have a fractured hip, however her pubic rami of the pelvic bone was broken.
Pelvic fractures are not treated with a cast, just bed rest for 4 to 6 weeks plus pain medication.The treatment is still rest and pain pills. There is no immobilization so we packed her on the plane and flew home.
An after thought;do you think that Solaris might consider recommending a canal to the state as one of its responses to condition #11 in the state staff report??
Since most of us have not had the opportunity to read even an summary much less than the complete 19 pages of the report an intelligent analysis is impossible.There is no mention that the staff did an in depth analysis of Solaris's financial documentations.
We can only hope that although this justifying internal report will have great impact on the State Health Planning Board's recommendation, that the Board's deviation from its standard procedures by holding extensive and prolong hearings including the planned June 26th one suggests that there will be an honest attempt to arrive at a proper recommendation .
The down side is that the State Health Planning Board only makes a non binding recommendation to the Commissioner of the state Department and Senior Services. The final decision will be political not based on human relations and health needs.
The Courier's article gives the impression that this report is the standard "grunt" justifying analysis which could be expected from a routine planned hospital closing. The article quotes Solaris's spokesman as saying "doesn't seem to be much of a concern with the recommendations". Although this was taken out of context, I would interpret it to mean that this report supports the Solaris request, which is a valid analysis.
It is true that the so called conditions recommendations are meaningless. A non operating shell has no value. The only positive action by the department would be denial of the CON, and the requirement that Solaris restore the conditions under which Muhlenberg operated in 2006.
Finally, if Kennedy itself is in financial trouble due to its over expansion, why not downsize that hospital or even close it except for the rehab unit. The population served by JFK has easier access to Rahway, Perth Amboy,New Brunswick and Muhlenberg, than does Muhlenberg's service area to any still functioning facility.
Wednesday, June 18, 2008
This is one of my all time favorite photos. Believe it or not this is a scene from the Netherlands's Keukenhof flower gardens. Not a tulip in sight. Obviously, there must be a story about this picture.
My wife and I were strolling through the gardens overwhelmed by the tremendous plantings of tulips. We had just crossed over a little brook when she said "You must take a picture of this".I turned back to see what she saw. A little brook with sunlight filtering through the heavy foliage and some leaves and petals floating on the water? Waste film on that? But being a surviving husband I felt that I had to humor her. Thus a serendipitous picture which I like so much that when I was President of the Medical Staff I had a print made for the office .
"On the re-naming of Emerson School, Yvonne Taylor *************** said the school was named for Ralph Waldo Emerson, but added, “Our children cannot relate to this person in the current date.”
She said surveys of parents yielded a wish to re-name the school the Rosa Parks Academy of Excellence (Italics mine). The name, she said, would set a higher expectation of achievement for the school’s mostly African-American and Hispanic children."
I have no problem with accepting the comment that the present name has no meaning to today's parents or their children. Nor can I object to naming the school to honor Rosa Parks who represents an icon in the fight against bigotry and discrimination.
I do however believe that a school is as a "school" a place dedicated to excellency in education, not a glorified baby sitter. Thus " Excellency" has no place in the name. Likewise, "Academy" has a meaning according to the dictionary as "a secondary school, esp a private one" (italics mine). Unless the BOE suffers from either jealousy or has developed a misguided sense
of snobbery that word does not belong in the schools name.
By all means name the replacement school the Rosa Parks School. Emerson School has been torn down, it no longer exists and the name need not be retained. But with the new school and what the name stands for, please do not forget that bigotry is equally unconscionable if the former victims exercise it against any other ethnic group.
It connects the Mediterranean Sea at Sette with the navigable to the Atlantic Ocean. Garrone River at Toulouse. The canal was built to avoid the long dangerous pirate infested passage past Gibraltar and up the coast of Portugal.
The canal system in western Europe developed into extensive networks, and before the railroads a relative inexpensive way to move bulk cargoes. Even today it is possible by medium size yachts to go from the Mediterranean to the Seine River or the Rhine or the Netherlands by sailing up the Rhone and Saon Rivers and using various canal routes and other navigable rivers..
Today, "Hotel Barges" carry anywheres from 6 to 14 passengers in rather cramped "staterooms" complete with toilet and shower facilities. Some rooms are so small that one has to duck the partner's arms when dressing. All meals featuring fresh local produce.
During a week trip probably no more than 40 miles are travelled but one can relax, sit on the open deck and watch the world go by. The tow paths make walking between locks any easy venture, on some canals the locks are less than a mile apart. Most barges carry bikes, and off the canal wanderings are enjoyable. My bicycle riding days are long past so I would no longer enjoy that pastime. The "hotel barges" have buses following them to take the passengers on daily trips to nearby sites of interest.
Tuesday, June 17, 2008
Additionally the Council approved the temporary appropriations for the months of July, August and September which will be covered by the 2009 budget. Although the fiscal year starts July 1 2008,it seems that the city's budget is not approved until the following February. It is unacceptable that only 1/4 of the fiscal year remains before an operating budget is approved. No business can operate continually spending money before it has it. There exists lack of controls and accountability. Is the lack of a full time CFO, and changes in city administrators the problem? If so how soon will our administration rectify this defect.
As usual very few citizens attended the business portion of the meeting. At the Public Comment portion at the end of the meeting, Bernice Paglia commented on the fact that errors in resolutions that were annually renewed were never corrected. Also there were discrepancies in the terms of appointments to commissions from those stated in the ordinances creating the commissions. Gayle Jones asked if there were any provisional changes in the community's disaster plan if Muhlenberg was closed. I am not sure by the tenor of the responses if any proactive planning had even been contemplated.
I would be remiss not to mention that the meeting was preceded by well deserved awards for valor to members of the Fire Department. I hope the media will have covered this portion of the meeting. The local TV channel was taping it.
Monday, June 16, 2008
This is a correction somehow part of the post went galley west.
From the official City website the following is a statement about the Council'cs agendas:
"Agendas for both The Agenda Fixing Session & The Regular Meeting of the Plainfield Municipal Council are made available for public distribution in the office of the City Clerk at least 24 hours prior to each meeting."
If the Council's Agenda were to be available 24 hours before the meeting, that would mean that (a) The City Clerk's office should be open from 8 pm Sunday and accessible after that, (b) In this day and age of computer capabilities with on line communication it would be posted no later than the clerk's office closing the day prior to the 7:30/8 pm meeting. Logically it should be posted on line by the close of business on Friday. No one would expect "(a)" to be practical, but can't option (b) be met?
"Chicken Street" Kabul. That is the local name for the street because of the live birds for the meat markets.
On May 27th I wrote about "Toasters and Roads" deploring the atrocious state of Plainfield's streets. I did not expect any noticeable response , and continue to run the obstacle course when I drive downtown on Watchung Ave.
For the past few years the potholes have been a prominent year round feature of Plainfield's streets. All area communities seem to be afflicted with this problem. None, however, have approached the level of Plainfield's.
Heavily traveled Leland and Watchung Avenues are not only a civic disgrace but a danger to property and life. There is probably not one street in Plainfield without unrepaired damage. How many times has the city been responsible for damaged tires, wheels or axles?
Much of the problem has resulted from the substandard street closure repairs performed by contractors and utilities after "opening the street". Is there any regulation specifying the standard for these road closures? If so is there ever any inspection to make sure those patches meet required standards? Are records kept, and violators fined? Are contractors and utilities required to post a performance bond before jackhammering the street?
It is a fact that although we are now in the 4th year of a 6 year plan adopted by the Plainfield Council there has been no visible improvement. Many of the roads that were to be repaired are still an adventure to drive on.
According to the Plan the estimate costs for some of the streets such as Kensington in 2006 was $$672,039.50. for Evergreen in 2006 was $413,236.89 and for Thornton in 2007 was $199,853.89. Why have they not been touched? Bad planning or diversion of funds could be an answer.
Were funds budget for and appropriated for these and the other streets in the plan? How much of the recent bond issues were designated for street resurfacing? What funds were supposed to come from grants ? Were they ever applied for? If received what happened to the money? How much of the estimated cost have been allocated and paid for preliminarily design and engineering costs? Will this be like the Woodland Ave fiasco which took years to complete and within a decade is deteriorating?
And what is happening to pothole repairs. That appears to be a haphazard, willy-nilly project. When and where it occurs one or two may be filled , but others adjacent are left untouched. Is the problem lack of personnel or lack of supervision or poor budgeting?Why have not early potholes around manhole covers filled before the pavement was completely compromised?
Over a month ago I called the Council's attention to Leland Ave south of 7th Street. I assume since there is a $1,061,869.43 estimate for total resurfacing that street from city line to city line on the plan for 2008, that the street will be allowed to deteriorate so that by the time this street is acted upon probably 2012, it will merit complete reconstruction. If proper maintenance were to be done, perhaps there would be no need for such an expensive outlay.
Some time ago ,if my memory is still intact, cracks in the asphalt pavement were routinely filled with hot tar. Every street has long lengthwise cracks in the surface that are the site of early disintegration of the pavement. These cracks occur where adjacent strips of new pavement are laid down and probably result from incomplete bonding of the two segments. It has been decades since this has been done here in Plainfield and the surrounding communities. Was the practice discontinued because it failed to save the pavements, or because of municipal budget cutbacks? Or was it stopped since there seems to be state grants for re pavement and thus no incentive for protective maintenance? I am sure that this was a combination of both.
The people deserve answers.
Don't overlook the individual blogs that Councilmen Burney and Storch occasionally post and keep us informed about local governmental actions. How else would we learn that Kensington Ave. was scheduled according to the "6 YEAR CAPITAL IMPROVEMENT PLAN" to be reconstructed in 2006. What happened to the $440,000.00 budgeted for that job?
Sunday, June 15, 2008
For the first six years of the 80s, I spent every Father's Day in Chicago at the American Medical Association's annual meeting. I suppose those six days were selected because adequate hotel space was available.
For those who are curious, "King of the Hill" resided in Scotland.
To all you dads, count your riches.
Friday, June 13, 2008
Enjoy . There are more for a future date.
"A vet wanted to ask if a 2x4 and a bail of cotton mean anything to you?"
I should have known the answer but it took this comment to jar my memory;
Anonymous said.. "I believe it is a reference to a q-tip and treatment of venereal disease."
How could I have forgotten? 55 years ago is not that remote. Venereal disease was a problem that the armed services and the public had to face. The antibiotic era was just dawning and the treatments for gonorrhea for example would probably be considered unacceptable torture today.
Anyhow, boys will be boys and girls will be girls. In an attempt to prevent infections from sexually transmitted diseases the services supplied to medical detachments prophylactic kits for post intercourse use, that were to be distributed on request.
"Argyrol" a silver protein compound that had anti bacterial properties was supplied in a small toothpaste like tube that had a small nipple. The solution was to be injected by the individual into the urethra orifice. The swab was to paint the tip of the penis in the hope that to prevent a syphilis infection.
I have no clue as to the effectiveness of the kits. Argyrol solution had a wide spread use, including as a gargle for strep. throat. Silver protein compounds have demonstrated a true bactericidal property and were one of the most effective treatments in their day.
One afternoon in the Bulge while the battalion was in active combat I was blown away by a trooper appearing at the aid station and requesting a "pro kit"
June 26 the day of destiny for Muhlenberg is rapidly approaching.
We can only hope that the Department of Health and Senior Services will implement the guide lines from the New Jersey Commission on Rationalizing Health Care Resources final report in reaching its decision on Solaris's application.
There is no question in our opinion that Muhlenberg meets all the requirements for a Medical Essential Hospital and should not be closed. No one can predict how a State bureaucracy will act.
I have reproduced the pertinent criteria and my responses as follows:
• Whether the services provided by a hospital are available and accessible elsewhere in the hospital market area; No hospital in area has available beds or acceptable accessibility to provide safe obstetrical care. No adequate psychiatric facility in nearby hospitals. Muhlenberg is the only local area hospital certified for elective angioplasty as well as life saving emergency cardiac angioplasty.
• What the impact on residents would be in terms of travel time/distance to access hospital care in the event of a hospital’s closure: The time for rescue squads to transport Plainfield’s residents to a functioning ER will increase from 10 minutes to 35 or more depending on traffic conditions. I have deliberately used the term functioning since an ER as proposed for MRC without the readily availability of acute in-hospital facilities is nothing more than a walk-in –clinic.
• Whether a hospital is part of a hospital system and the extent of the resources available to the system to support a financially distressed facility; The problem facing Muhlenberg is part of Solaris’s deficits in their not for profit components. The questions proposed above need to be answered.
• What public transportation alterations or other transportation solutions are available or would be necessary to maintain access to care in the event of a hospital’s closure::There exists no direct route to any of the nearby hospitals. From Plainfield to JFK by public transportation would involve a train or bus to Penn Station Newark, a train to Menlo Park, and then a bus to the hospital. The bus from Plainfield could also be used to take the Menlo Park train from Elizabeth NJ Transit RR Station. Please figure out the time and cost for such an adventure. On the other hand a taxi from Plainfield to JFK costs $30.00 one way. To Overlook in Summit would require train or bus to Newark and a second train or bus to Summit. If by train there would also be a transfer in Newark by light rail from Penn Station to the Broad Street Station of the Morris Essex line.
• What quality of care and efficiency improvements are possible and necessary in financially distressed, essential hospitals; Muhlenberg has one of the best performance statistics among New Jersey Hospitals. The need is not to let that capability to be destroyed.
• What potential access to care implications would be for particular medically underserved populations if a hospital were to close; Catastrophic! The population affected has a demonstrated above average risk for diabetes, cardiac disease, obstetrical and child care exposure.
• What the potential impact on access to key ambulatory services would be if a hospital ceased operating as an inpatient facility; if complete diagnostic facilities are not maintained including as a minimum CT scan only first aid type care could be provided.• What the impact on employment in the hospital market area would be should a hospital close. The loss of 1100 jobs plus those in outside service industries would be disastrous for a community with an already large population dependent on “day jobs”.
Thursday, June 12, 2008
I was asked if the photo I posted was taken in the Keukenhof. Yes it was and for those who would like to know more the following is from Wikipedia.
Keukenhof (pronounced [ˈkøːkənˌhɔf], in Dutch: Kitchen garden), also known as the Garden of Europe is situated near Lisse, Netherlands, and is the world's largest flower garden. According to the official website for the Keukenhof Park, there are approximately 7,000,000 (seven million) flower bulbs planted annually at the park. 
Keukenhof is located in South Holland between the towns of Hillegom and Lisse, south of Haarlem and southwest of Amsterdam. It is accessible by bus from the stations of Haarlem or Leiden. It is located in an area called the "Dune and Bulb Region" (Duin- en Bollenstreek).
The flower garden was the idea in 1949 of the then-mayor of Lisse, a small town south of Amsterdam. The idea was to have a flower exhibit where growers from all over the Netherlands and Europe could show off their hybrids which will help the Netherlands as it is the world's largest exporter of flowers. Keukenhof has been the world's largest flower garden for over fifty years.
Keukenhof is open annually from the last week of March to mid-May. The best time to view the tulips is around mid-April, depending on the weather. In 2008 the Keukenhof will be open from March 20 to May 18.Check the linksor google, there are many pictures.If you are ever in Holland during the garden's exhibit period, it is a must not miss visit.
I had intended to post my venting on Plainfield's streets. However I did not like the composition so it will wait. After all the potholes will still be there.
I intend to fax an addition of my remarks on Muhlenberg to the state on the 12th. I had submitted a paper at the first hearing which differed from my spoken comments which were extemporaneous.They would have taken more than the allotted 3 minutes. I expect to amplify on that submission.I hope my fax works.
Years ago we were lucky to be in Amsterdam at the height of the Tulip season. Little did I know that the bulbs we purchased after one year would be deer fodder.
This pictures was taken in the National Gardens outside Amsterdam.
Wednesday, June 11, 2008
"A vet wanted to ask if a 2x4 and a bail of cotton mean anything to you?"
I must confess that I never heard the phrase. The "troopers" may have used it, but not in earshot of their officers. If someone knows,please send a comment. If you wish to keep it private, say so. Thank you.
As expected publishing deadlines prevented any articles in either paper from appearing today. It will be of interest to know if the BOE meeting was covered. We need more info on the software and the costs. Who and why was the present system picked? Was due diligence done? What is the vendors record on support? Are the merits of the new system sufficient to warrant the expense of change/
We taxpayers need reassurance e that our monies are being properly utilized and not wasted on personal whims. With the continued turmoil in Plainfield education the BOE must be above board.
Tuesday, June 10, 2008
In the fall of 1945 while in Berlin, I had the good fortune of being sent for 6 weeks temporary duty in Paris. I was assigned to the only US Army Hospital, a University of Buffalo unit, that was based inside the city. It was locate in a famous French Hospital on the Blvd St. Michele. Just outside the hospital main gate was a "subway" station.
I inherited a great job for those weeks.The chief of the venereal disease service had just been returned to the States, so I was select ed to fill his shoes! My patients all had third stage syphilis. Five mornings a week I performed lumbar punctures to obtain spinal fluid. The medics and nurses administered their intravenous doses of penicillin. We were still treating with intragluteal injections of Bismuth. This medication was never completely absorbed and throughout the rest of the patient's life ,on pelvic area xrays, was a diagnostic marker for the disease.
By noon I was free to leave the hospital and tour Paris. The photo taken along the Seine River, I not sure which bank, shows that the artists were back at work.
I had never been to an opera so one day two of us decided to take advantage of one of Paris's cultural highlights. Unfortunately the Paris Opera was in hiatus, but the less famous, but not second rate, Opera Comique was in season. Today, in New York City the Metropolitan Opera and The New York State Opera have similar seasons at Lincoln Center in different buildings.Tickets for Lakme were easily obtained and we went.
The tenor was more than slightly overweight and Lakme was equal in size. During the entire performance, a Frenchman behind me kept tapping me on the shoulder, and saying " You should see Lilly Pons in that role". Even I knew that Lakme was the sylph like Pon's signature role.
Another resolution to be enacted next Monday was to terminate the developer for the controversial Richmond Street and East Third Street redevelopment area amd to authorize the negotiation of a redeveloper's agreement. Simple me, I would think that would be two seperate resolutions. However we who are not goverment people know little about how laws and resolutions are written. If there would be a problem I guess the lawyers will figure it out.
Olive Lynch addressed the Council during the public hearing portion and gave an overview of the present status of the MRMC situation. She asked for a more formal indication of the Council's support of the civic efforts to arrive at a solution that will meet Plainfield's needs.
Councilor Storch suggested that the Council pass a resolution requesting the Legislature to immediately pass legislation enabling the recommendations of the New Jersey Commission on Rationalizing Health Care Resources. It was noted that the State Legislature's session is scheduled to end this June, and that the next Council meetings will be in July-monthly summer schedule.
Precedent exist for a resolution that had not been presented at the agenda setting session to be introduced and acted upon at the business meeting. I would have thought that this suggestion would meet that criteria.
For all's benefit I have copied the conclusions of that report:
This chapter provides an overview of the analytic
approach to identifying which financially distressed
hospitals in New Jersey are potential candidates for
financial assistance from the State. It should be noted
that the analytic framework represented by Figure 12.2
is based only on strictly quantifiable metrics. As such, it
cannot possibly address all of the social, economic and
geographic issues that must be examined by government
in determining which financially distressed hospitals the
State should support to maintain access to care. The
quantitative analytic framework, therefore, must be
supplemented by an assessment of non-quantifiable
factors and input from policy analysts and policymakers
regarding their knowledge of local conditions. In the
end, mere numbers cannot take the place of sound
judgment; they can only guide that judgment.
Among the non-quantitative issues that the Commission
and State need to consider in determining which
financially distressed hospitals are essential to
maintaining access to hospital care, include but certainly
are not limited to:
• Whether the services provided by a hospital are
available and accessible elsewhere in the hospital
• What the impact on residents would be in terms of
travel time/distance to access hospital care in the
event of a hospital’s closure;
• Whether a hospital is part of a hospital system and
the extent of the resources available to the system to
support a financially distressed facility;
• What public transportation alterations or other
transportation solutions are available or would be
necessary to maintain access to care in the event of
a hospital’s closure;
• What quality of care and efficiency improvements
are possible and necessary in financially distressed,
• What potential access to care implications would be
for particular medically underserved populations if a
hospital were to close;
• What the potential impact on access to key
ambulatory services would be if a hospital ceased
operating as an inpatient facility;
• What the impact on employment in the hospital
market area would be should a hospital close.
An unfortunate part of that report is that Plainfield is placed in the Morristown service area. Public transportation is good from Plainfield.:Train from Plainfield to Newark Penn Station, Light Rail car to Newark Broad Street Station, then train to Morristown.
Monday, June 9, 2008
Instead lets dream of pleasent waters. Look at these photos and then close your eyes and dream
Wouldn't it be great to join the bathers on this quiet Algarve (Portugal) beach near Albuferia. Obviously there are steps down the cliffs to reach the beach. The cliffs that mark this coast are the results of eons of action by the ocean waves.
To the east at Albuferia there is direct entry to the beach. This resort town caters to tourist as an high grade alternative to the French Riviera. It was and probably still is a favorite of the British.
The Algarve shore is golden sand. unlike the Mediteranean Riviera beaches which are pebble and stone
The beach at Nice. Look carefully at the lage stones which are typical of these beaches, don't look too hard at what else is typical of the Riviera beaches. You have to rent the pltforms to sunbath.
Not far to the west of Albferia lies Portimeao, the largest city of the Algarve. It is the Sardine Capital of southern Portugal. When the sardine boats come in and unload their catch, street vendors set up and grill sardines over charcoal/wood fires. These small fish cooked coated in oil and garlic are a gourmet's delight.
Further west is Lagos, the port from which Henry the Navigator and other Portuguese set sail. And only a short distance westward is Cape St. Vincent, the westernmost portion of Continental Europe.
It is hard to imagine that this is the Atlantic Ocean and yet so calm.
The Crescent Times has again called our attention to the fact that in Plainfield so called political affiliation has no meaning. In this overwhelming Democratic community there are appointed commission members who in the past have been active Republicans. We have had elected officials who have switched from party to party as needs indicated.
No one has ever said that politics is "black and white". That is not meant to be racial statement, just a common expression. However, it will take very astute and resourceful individuals to be able to peel away all the layers to find out who really calls the shots in Plainfield. If this could be done , would we be in for surprises.
Plainfield Plaintalker is as usual what an investigative news media should be. At present the agenda setting session of the Council is where all action takes place. The so called business meeting just reaffirms what has been decided at the agenda session. I can't remember when was the last time public comments at the "open meeting" caused the Council to reconsider action which had been predetermined.
Plainfield Today raised questions about the intent of a Courier News letter. Supposedly the Courier checks on the identity of letter writers prior to publishing. I am sure that occasionally established procedures can be overlooked. Although the writer is not registered as a Democrat is she a registered voter? That can be checked . She could be a so called independent who is not desirous of exercising her citizen's rights on primary day.
Not mentioned, but worth thinking about; Is there not a central clearing house so that potentially important meetings of public interest are not scheduled for the same time? Some meetings are required to have their times publicized. Those that do the city's business must not conflict. The Council's schedule must take precedence over all.
With that, I shall take the day off and think about potholes and meetings.
Sunday, June 8, 2008
Cool off--Wish we were there
From the late 50s to the mid 90s my wife and I would spend what vacation time I took traveling.
We often took cruises, rarely on the bigger ships in favor of those that carried 120 to 250 passengers. The trade off from not having nightly "professional entertainment", was the friendly congenial fellow passengers who enjoyed visiting the smaller out of the way ports. . More about cruises some other time.
I was also an avid photographer and probably have well over 1000 slides from our trips. Unfortunately the earlier ones were taken using Agfachrome, Anascochrome, Ecktachrome, and slow Kodachrome films. By the time it became feasible to transfer these images to CD discs, with the except of some of the Kodachromes the dyes on almost all the earlier shots had disintegrated or change colors.
I would hope to share some slides that I like with you. Please excuse the spots and occasional smudges that mar some views. There are little stories about all of them. The group that I found today are from a cruise that called at the small Greek Island of Kythira off the southern most tip of Peloponnese. We were fortunate to arrive on the Orthodox Greek Easter Sunday. There were no organized tours but we were able to hire a car and driver to travel the one road around the island
This island is mountainous as the views from the road illustrate. Along the way we stopped to explore a wooded area where there was the waterfall. This is the broad view of the waterfall in the woods
As it was Easter Sunday the people were preparing their family feasts. Every where in the villages and houses along the road, lambs and/or pigs were being roasted on spits over fires.
A family enterprise
The meal cooking
These friendly folks insisted on inviting us to share their meal. Along with the local wine and song and human warmness, this was the best meal we had on that trip. Our fellow travellers had similar experiences.
Saturday, June 7, 2008
Likewise, the 1st and 4th Wards were the dwelling place for Plainfield’s large Irish, Italian and Polish “blue collar” working class. There was also a significant Afro-American population that lived mostly between Plainfield Ave and Grant Ave on West 2nd and 3rd Streets, among the other working population.
The Queen City area was the location of the country’s three major printing press manufacturers. Plainfield boasted Wood’s along the railroad tracks from Grant Ave east. Next to the tracks on South Ave. was the Scott’s plant which is still standing but used by other industries.
In Middlesex, bordering Dunellen was the Hoe’s printing press works. All had a foundry as part of the assembly plant. After World War II, these plants became outdated due to changes in the technology of printing the factories that produce the printing presses closed down.
In the West End law between Grant Ave., and Clinton, The Mack truck factory occupied both sides of the railroad. During WWI this plant was the leading supplier for heavy duty trucks. Interestingly the rear wheels were chain driven and of course the trucks were not speedy. By the end of WWII this plant which had grown like topsy became inefficient to operate. Mack trucks in a move to escape a strong union in an outdated plant transferred some of its operations to Allentown Pennsylvania. Truck production was relocated to a new modern facility in Hagerstown, Maryland. Since this was rural farm country, labor costs were much lower than here.
Thereafter, Plainfield had no heavy industry to produce a major source of personal and taxable income.
Between Roosevelt and Berkman north of the tracks was a railroad engine house with a turntable and storage tracks plus a still standing warehouse. Further east of Berkman on the north side of the tracks, was the large electrical motor manufacturing factory, Howell. There was also the large Samoset Laundry building which was destroyed by fire long after it had been abandoned.
Because of the availability of excellent road networks, the railroads no longer were an absolute necessity for the manufacturing and transportation of goods.
The Pennsylvania coal mines lost importance for several reasons. Anthracite (hard) coal was more difficult to use than the soft bituminous coals from West Virginia and the western states. Pipelines made oil and natural gas cheaper and cleaner sources of energy.
In the east all the railroads were no longer financial viable industries.
Other industries that closed within a little over a decade after World War II included the Bronston’s Hats\. This manufacture of men’s hats was a victim of the change in fashion.
Another casualty, although not manufacturing, was the large manufactured gas storage tank by the railroad tracks off Watching Ave. A parking lot now occupies that spot.
In South Plainfield the buildings of the sprawling Spicer plant along the Lehigh tracks at Hamilton Ave became an Industrial Park. Today its revitalization is complicated by the grossly contaminated soil.
Harris Steel was once one of the major structural steel plants in the East. There are other smaller companies occupying the plant space.
Dunellen’s Art Color plant, once one of the largest producers of magazines and catalogs in the country, became a victim of the n ewer technologies and closed.
Plainfield was no longer a major manufacturing town. The loss of revenue from those factories would never be recovered. Unlike the other towns which had available land for commercial development Plainfield and Dunellen suffered from the shifts in economic enterprises.
What has this 1980s train in the Pyrenees Mountains of France along Spain's border have to do with factories? Nothing what so ever! Perhaps it is symbolic of the aimless course Plainfield has been on for the last three decades. You can not tell whether it is coming or going, since there is no engine, each car is self powered through a third rail. The cars are wooden. Accept it as just a picture I liked.