Cooking gas outages are frustrating many New Yorkers (Credit: iStock)Graham Ciraulo was living in Inwood in 2016 when he received a notice from his landlord: the building’s cooking gas had to be shut off.It didn’t say for how long. But weeks passed, then months, before tenants could use their stoves again.“It was a seven-month outage in total,” said Ciraulo, who works as a tenant activist. “We were given hot plates, which, ridiculously, we were eventually charged for.”By one measure, Ciraulo and others at 11 Seaman Avenue were lucky: At some buildings, tenants have gone without cooking gas for even longer. Property owners are required by law to keep apartments heated in winter, but no such guarantee exists for cooking gas.Restoring gas service can get bogged down by communication issues and unclear standards between several agencies, according to interviews with more than a dozen people familiar with the process.ADVERTISEMENTRead moreSite of East Village explosion sells for $6MTownhouse at explosion site listed for $33 millionCondo project slated for site of gas explosion Virtually everyone involved in shutting and restoring service agreed that the responsibility ultimately falls to the landlord — in Ciraulo’s case, the Parkoff Organization, which did not respond to requests for comment. However, several also said the service provider — Con Edison or National Grid, depending on which part of the city it is — and agencies such as the Department of Buildings are disingenuous when they deny a role in prolonging outages.Frank Ricci, director of government affairs for the Rent Stabilization Association, a landlord group, said the problem is substantial.“This is driving people across the city crazy,” he said, “because it’s a major inconvenience for tenants, and tenants are getting mad at the owners about this — legitimately — because they want their gas back on.”An explosive issueMany observers believe delays in restoring service got worse after New York was rocked by a pair of fatal explosions. The first, in Harlem in 2014, killed eight people, injured more than 50 and leveled the buildings at 1644-1646 Park Avenue. Con Ed in 2017 agreed to a $153 million settlement with the state in that incident.The second blast, in the East Village in 2015, killed two, injured 25 and destroyed buildings at 119, 121 and 123 Second Avenue.Con Ed spokesman Allan Drury said the company increased its efforts to get people to report gas leaks after the Harlem explosion and that the city cracked down on illegal “Mickey Mouse jobs” on gas lines after the East Village tragedy.In 2016 the city passed Local Law 152, which requires gas piping to be periodically inspected at least every five years. If a leak, illegal connection or other dangerous condition is found, the building owner must immediately correct it.Council member Rafael Espinal, who represents Bushwick and East New York, spearheaded the bill, which he said was a response to the Harlem and East Village explosions.“I found it to be surprising that buildings go through many inspections, and gas lines weren’t one of them,” he said.Despite the suspicions, a lack of data makes it difficult to prove that the length or frequency of gas outages has increased since the fatal blasts.Con Ed, which provides gas service in all of the Bronx and Manhattan and part of Queens, does not track the length of outages but has seen their number decline in recent years. In 2016 it dealt with outages in 3,531 buildings, then 3,005 the next year and 2,614 the following year. That number was on pace to decline further, to about 1,500, in 2019 as of late May.National Grid, which serves Brooklyn, Staten Island and part of Queens, does not keep statistics on gas outages at buildings, according to Karen Young, a spokesperson for the utility. Neither does the city’s Department of Housing Preservation and Development. Fixing gas leaks or moving pipes requires an alteration permit from the Department of Buildings, but the agency cannot break out data from permits to show which ones involved gas.Chany Rosen, an expediter who recently started her own company, Cavalry Associates, said the lack of statistics is one reason gas outages do not get enough attention.“There is no way to see the data on that information on one site: not the Department of Buildings, not National Grid,” she said. “That’s bothersome. If somebody would be able to gather that information and be able to actually see all the numbers, that wouldn’t be acceptable to anybody.”Referring to tenants dealing with gas outages, she added, “There’s no way for them all to come together and raise the point that something has to be done.”Ricci echoed that, noting that all of the information his group gets is anecdotal. Outages appear to be increasing based on the number of phone calls the RSA gets, but data is still almost impossible to come by.“That would be helpful to know. That does make sense to me,” he said. “I mean, you can’t solve a problem until you define the problem.”The blame gameWhen gas went out around October 2016 at a Parkoff Organization building at 500 West 235th Street, the landlord made sure to blame the utility company.Parkoff sent a notice to tenants saying they would receive hot plates while the gas was out and apologized “for any inconvenience that you may be experiencing during this period due to the disruption of gas services caused by Con Edison.”“This form is to acknowledge your receipt for temporary use of the hot plate and that you will return it once gas is restored to your apartment,” the notice said. “You acknowledge that the disruption of gas service is not the fault of the landlord.”Most parties involved with gas outages agree that responsibility for ending them is ultimately the landlord’s. But they differed on how big of a role others play.Con Edison and the Department of Buildings fervently denied having any control over the length of outages, pinning the wait almost entirely on landlords.From Con Edison’s perspective, dealing with outages is straightforward. Gas is turned off when someone detects a leak in house piping, at which point the owner needs to hire a plumber to make repairs, Drury said. The plumber then gets a certification of completion from the buildings department and shows it to Con Ed. The utility then sends gas through the building to see if the piping holds. If it does, the company resumes service.“The question of how long the process takes is nearly entirely dependent on the building owner or landlord and the plumber/contractor,” Drury said. “They control the repair process, not us.”The Department of Buildings struck a similar note. Gathfeny Sanders, director of Its LAA unit, which handles the permitting required to restore gas service, said the length of shutdowns has “nothing to do” with his agency. Assistant commissioner Lisa Amoia said the department’s role begins and ends with handling permit requests.“Once the ball is in our court, we follow through with these issues expeditiously, all the way to inspection and authorization,” she said.A decade ago, however, the president of the Masters Plumbers Council wrote that it could take up to five months to get a permit, making plumbers look bad and causing building owners to use unlicensed people to get the work done in a timely manner.But Sanders said the city now issues emergency notifications much faster, making it easier for the agency to hand out same-day permits.Plumbers often play a role in extending gas shutdowns, according to Amoia. She said they sometimes realize the job is more complicated than they thought, and building owners sometimes must hire a new plumber if the first one’s license or insurance expires.“Sometimes work begins, and it’s halfway through, and the licensee sometimes leaves the job for many different reasons,” such as “a dispute between the licensee and the owner,” she said. The size of the building also has a lot to do with how long the work takes.But the role of the Department of Buildings and utility companies in prolonged outages is not as limited as they claim, others said.Ricci cited two utility company practices that can protract gas outages. Sometimes, to save effort, utilities shut off gas for an entire building even if only one line needs closing. That can result in the whole building needing to be reinspected. Second, utilities test pipes at pressures of 75 to 100 pounds per square inch when the normal pressure is three to five PSI, he said.“If they can isolate a leak to a specific apartment or a specific part of the building, they should shut that down. They shouldn’t shut down the whole building,” Ricci said. “And if the pressure that normally goes through is under five pounds per square inch but they’re testing it close to 100, I don’t think that’s fair, either.”Drury denied that Con Ed inspectors shut an entire building’s gas for simplicity’s sake, saying it is “not at all unusual” for them to turn service off to just part of a building. He said the pressure for integrity tests “is at levels that provide assurance the piping is in fact safe for gas to be turned back on.”April McIver, executive director at the Plumbing Foundation, a nonprofit founded to help enact and enforce safe plumbing codes, said building owners are not in an enviable position.“It’s not always that easy to get the gas turned back on,” she said, “because when you’re dealing with certain gas piping that involves both the utilities and the Department of Buildings, some things overlap, and they keep changing their policies on how they want the process to go.”Terence O’Brien, senior director at the foundation, said part of the problem is stingy owners.“They don’t want to pay the money to get [a licensed] plumber to come do the work and get things done quickly, properly and meticulously,” he said.Landlord Lenny Katz said he has dealt with gas issues multiple times, including once at a building of his on East 22nd Street in Flatbush. He said the process is supposed to be simple, but coordination between the buildings department, the plumber and the utility company can make it difficult.The subjectivity of inspectors can make things tough as well, he said.“Very often, buildings inspectors have to come back multiple times,” he said. “You don’t always get the same inspector, so one inspector tells the plumber everything is fine except for A, B and C, and then when the next call for an inspector comes, it’s a different person, and they come down and say everything is fine except for C, D and E.”Owners can also be required to fix violations that are found even if they are unrelated to the gas leak.“DOB may require you to do a lot of work, and a lot of it has nothing to do with what was leaking,” Katz said. “But they want things brought up to the current code.”The fact that a building owner cannot turn to another agency or utility can hinder progress as well, Katz said.“You can’t call another gas company,” he said. “They work on their [own] schedule, so waiting for them to come, waiting for them to unlock the meter, to put in a new meter if you need it, can sometimes take a while.”The Department of Buildings said in a statement that long gas outages are usually because the building owner or plumber does not act quickly. It disputed that varying standards from different city inspectors can play a role.“An experienced licensed master plumber will know dangerous or illegal conditions when they see them and does not require DOB inspectors to point out these hazards,” the statement said. “If a plumber continues to make excuses about unforeseen issues and delays, we suggest hiring a new professional who has the time and experience to solve gas outages in a reasonable period of time.”What’s a tenant to do?With gas outages, the people who suffer the most have the least control over the situation: tenants. They have few options for recourse, according to real estate attorney Sam Himmelstein. Tenants can be entitled to rent abatements if their gas goes out, but generally not to escape their lease, he said.“To break the lease, you’ve got to have something that almost results in what we call a constructive eviction,” he said, “like no heat in the winter or no hot water or really bad leaks or mold — things that are really making the apartment uninhabitable.”Katz said that his company evaluates requests for rent relief during gas outages on a case-by-case basis. He maintained that there is not much landlords can do for tenants during these situations besides providing them with information and the customary hot plates.“It’s tough to give an anticipated completion date because sometimes you really have no idea. You think it’s going to be a week, and it turns out to be another month,” he said. “You just try to keep them informed.”Tenants with gas outages in rent-regulated apartments can file complaints with the state’s Division of Homes and Community Renewal. If the agency finds that the building owner has failed to maintain essential services, it can order a rent reduction.Landlords occasionally use gas outages as a way to drive tenants out of rent-stabilized apartments, according to Aaron Carr of the Housing Rights Initiative. If the outage is the only issue at a building, it is probably not a case of harassment, but if it occurs in conjunction with other maintenance issues, a landlord may be using it as a pretext to persuade tenants to leave, Carr said.“If you don’t have heat, and you don’t have gas, and you don’t have maintenance, that is an intolerable situation,” he said.These are typical of the complaints that Espinal said his office receives about gas outages.“In my district, it does take a long time for certain building owners to restore gas,” the council member said, “and the impression we get is that they are doing it with the hopes that it would push their tenants out.”Ciraulo believed that was the case at his Inwood building, given how long it took Parkoff to get service restored.“There was just a real dragging out with the gas,” he said. “They were just not interested in making it easier for us.”Ciraulo said some tenants moved out during the outage and that Parkoff only fixed it when tenants moved to take legal action. The rent law has since been changed to remove landlords’ financial incentives to push tenants out.O’Brien, of the Plumbing Foundation, maintained that the perception of lengthening service interruptions is inaccurate. Rather, they are being fixed more thoroughly, he said.“People are thinking gas outages are lasting longer. They aren’t lasting longer,” he said. “It’s just things weren’t done properly, and now they’re being a little bit more scrutinized, so it’s being done now more correctly than in years past.”Himmelstein disagreed, maintaining that lengthy outages have become much more common in the wake of the fatal Harlem and East Village explosions.“A few years ago, they might have just said, ‘Patch up that hole,’” he said. “Now, they make them do much more extensive work, and it takes months. I’ve seen it take a year or two.” This content is for subscribers only.Subscribe Now
Total Voters: 1,464WORLD HANDBALL REFEREE 2016 – Nacevski / Nikolov (Macedonia)JURY MEMBERS:Bjorn Pazen (Handball Woche, Germany)Rici Gjamovski (g-sport.mk, Macedonia)Lojze Grčman (SIOL, Slovenia)Stig Nygard (TV 2, Norway)Jozsef Simon (Nemzeti Sport, Hungary)Piotr Karpinski (NC TV, Poland)Johan Flinck (Aftonbladet, Sweden)Dražen Pinević (Sportske Novosti, Croatia)Jasmin Tajić (Oslobodjenje, Bosnia and Herzegovina)Jorge Dargel (MARCA, Spain)HANDNEWS TEAM (Handnews.fr, France)Yuki Hattori (Japanese Handball Magazine, Japan)Sergey Novikov (PRESSBALL, Belarus)Rui Guimaraes (O Jogo, Portugal)Konstantinos Chatzidimitriou (e-HANDBALL.gr, Greece)Igor Grachov (Komanda newspaper, Ukraine)Tarif Girgin (Hentbolgazete.com, Turkey)Luca Zadra (Pallamanoitalia.it, Italy)Sascha Staat (Kreis Ab, Germany)Sergey Prigolovkin (Rushandball.ru, Russia)Sreten Raskovic (Arena Sport TV, Balkan)Hernan De Lorenzi (Handball De Primera Radio, Argentina)Rasmus Boysen (Hballtransfers, Denmark)Peter Bruun (EHF, Denmark)Handbollskanalen TEAM (Sweden)Johannes Hahn (ORF, Austria)Nikola Nikolić (VIJESTI, Montenegro)Dean Shmuel Elmas (Sport 1, Israel)Života Bogdanović (Balkan-handball.com, Serbia)Walid Belaid Oui (Tunisia)JURY MEMBERS FROM EUROPE, ASIA, AFRICA AND SOUTH AMERICAOur goal that handball world gets a public and fair contest for the World best players of the year, since 2010 received a big support from the parts of handball globe. WORLD HANDBALL PLAYER 2017 Jury is consisted of the people with their names and CV’s with the clear aim to get opinion from different countries, continents, handball schools and traditions. Our Jury members are famous handball specialists in their countries, which coming from the biggest media (Marca, TV 2 NO, Globoesporte, Aftonbladet), but also from specialized websites and newspapers as Handball Woche, Handnews.fr, Balkan-Handball.com, rushandball.ru, Handbollskanalen, Stregspiller…WORLD HANDBALL COACH 2017 – PARTNERSCREATIC – https://creatic.hu/MASTERS HANDBALL WORLD CUP 2018 – mhworldcup.com 1 Comment Pingback: Danci Gjeding-Hansen najbolji sudijski par u 2017. godini! | Balkan Handball Cervar about Gjeding-Hansen: This was robbery! IHF must to expel them from their list! Recommended for you Lars Geipel and Marcus Helbig (Germany) (30%, 440 Votes) 5 ShareTweetShareShareEmail Gjeding about Karacic’s foul: It was my mistake! Martin Gjeding and Mads Hansen (Denmark) (67%, 985 Votes) 10 points BALLET OR HANDBALL: Momir Ilic sent-off in Zagreb… Related Items:Martin Gjeding and Mads Hansen, World Handball Referee 2017 – Martin Gjeding and Mads Hansen ShareTweetShareShareEmailCommentsDanish referee’s pair, Martin Gjeding and Mads Hansen, is the best in the world of handball in 2017! For the second year in a row Handball-Planet.com organized the Contest for the WORLD HANDBALL REFEREE 2017, based on opinion of handball journalists from all over the world and handball fans, who voted in the last two weeks and added their votes to existing number of points given by the expert’s jury.VOTES (cumulative number given by journalists / fans):Gjeding – Hansen 41+10 = 51Geipel – Helbig 42 + 5 = 47Sabroso – Raluy 41 + 1 = 42FANS’ SUPPORT:World Handball Referee 2017? Oscar Raluy and Angel Sabroso (Spain) (3%, 39 Votes) 1 1 Comment Leave a Reply Cancel replyYour email address will not be published.Comment Name Email Website Save my name, email, and website in this browser for the next time I comment.
“Greek experts estimate the impact of tourism in spreading the virus at 3 percent and figures show that we didn’t have the second wave in the middle of the summer, but a week later than the Northern European countries,” he said. “After all, even countries like Israel that haven’t opened for tourism had the second wave in the middle of the summer.” Greek Prime Minister Kyriakos Mitsotakis put the idea for a vaccination certificate to the Commission in January, for “facilitating the freedom of movement of persons who have been vaccinated against COVID-19.” But Theocharis said the process is moving too slowly. There are also practical reasons for giving small islands priority when it comes to vaccination, as officials say it would make little sense to send medical teams back and forth to administer doses to different population groups over time. Theocharis also dismissed criticism that tourism was to blame for the country’s second wave last autumn. With the country desperate to let holidaymakers back in, it’s making sure residents of small islands and islets are given their coronavirus vaccinations so those locations can be marketed as COVID-free. “The only thing one can say with certainty is that this year will be better than 2020,” Tourism Minister Harry Theocharis told POLITICO in an interview. “We managed last year, under much more difficult circumstances, to open and keep the necessary balance. This summer, with more tools and data at our disposal and with the confidence of the vaccination program, we will be able to achieve something much better.” “Tourists know how to protect themselves by now,” Tasios said. “They have had enough lockdowns in their countries and they will start assessing whether to book when we turn to the ‘green’ category.” “We can see the reverse trend from the same period last year,” he said. “Last March we were starting to give back some advance payments [to people who had booked to stay on the island], now we have some calls for potential reservations.” However, Theocharis said the European proposal is compatible with the Greek plan. The Greek government wants a deal to be struck at EU level on a vaccination certificate that people can use to show they’ve had the jab. European Commission President Ursula von der Leyen said earlier this month that the Commission wants to restart travel within the EU and beyond with what it calls a “Digital Green Certificate.” Greece was battered economically by the coronavirus, as tourism accounts for more than a fifth of its economic output and provides employment for about a quarter of the workforce, according to the World Travel and Tourism Council. “If Europe continues to move slowly, it risks losing a great opportunity to show its global leadership,” he said. “We have to move as fast as possible. I don’t think it’s a technical issue, there should be political will from all the countries for this to happen as soon as possible.” Fournoi, Chalki, Symi, Ereikousa and dozens of other tiny islets with fewer than 1,000 residents in the Aegean and Ionian seas have been targeted by the authorities. Kastellorizo, the country’s most remote island, located on the easternmost edge of the Dodecanese, was the first place in Greece to have its entire adult population vaccinated — all 500 of them. “Figures do not add up for our survival, even under the best scenario,” said Grigoris Tasios, president of the Greek Federation of Hoteliers and owner of a hotel in Halkidiki. “It would still be a 50 percent drop, after an 80 percent drop in 2020. I’m afraid that we will need to have an internal bailout in the tourism sector from 2022 to 2025.” ATHENS — Greece is thinking small — literally — when it comes to reopening to tourists this summer. Even if the minister’s timing is right, businesses groups estimate that tourism revenues would still only reach around 40 to 50 percent of 2019 levels. “It answers all queries one can have, it doesn’t exclude anyone: PCR tests, vaccines or antibodies are included. It is done carefully so that it doesn’t raise any privacy concerns. Its multiple options allow someone who doesn’t want to say he has been vaccinated to get a PCR test. It secures one of the main freedoms of the European Union, free movement,” the minister said. Hotels and tourism businesses will have to follow strict hygiene rules and maintain social distancing, and staff will have to be tested twice a month. It is not clear when and under which conditions nightclubs and bars will reopen, but Theocharis said that last year “the areas where parties were taking place were those that created all the trouble.” He says that as long as the country remains in the “dark red” category in terms of infections, there won’t be any tourists in Greece before June. But he expects tourist flows could start after that. “Pretty much everyone from 20 to 94 years old has been vaccinated. It makes us feel free and more optimistic about ourselves, about our lives, about the people around us,” said the island’s deputy mayor Stratis Amygdalos. Want more analysis from POLITICO? POLITICO Pro is our premium intelligence service for professionals. From financial services to trade, technology, cybersecurity and more, Pro delivers real time intelligence, deep insight and breaking scoops you need to keep one step ahead. Email [email protected] to request a complimentary trial. But once travel can restart, which Greece hopes will be as soon as May 14 — “we are relatively certain … that this date is safe, having the good weather and the vaccination progress as allies,” Theocharis said — it won’t be business as usual. The government says that those working in the tourism sector will be given priority when it comes to vaccination, after the inoculation of vulnerable groups is completed. However, there is no date set for that to begin. Even though Greece remains in lockdown, it signed a deal last month with Israel that will allow people vaccinated against the coronavirus to move freely between the two countries once travel restarts. Athens is working on more bilateral agreements, including with the United Kingdom and Serbia. Tourism revenue plunged to €4.28 billion in 2020 from €18 billion in 2019 and the economy as a whole shrank by 8.2 percent, putting pressure on a country coming out of a decade-long recession and that has one of the world’s heaviest debt burdens. The number of tourists was down by 76.5 percent to just 7.4 million in 2020, according to the Greek Tourism Confederation Institute (INSETE). Have certificate, will travel
With qualifying being rained out and set by owner’s points, Martin Truex Jr. will start from the top spot for the third straight week for Monday’s STP 500 (2 p.m. ET on FS1, MRN, SiriusXM NASCAR Radio). After two practice sessions for this race in the books, we’ve dissected the numbers and 10-lap averages to offer a suggested lineup worthy of your Fantasy Live consideration as you go to make roster decisions for the sixth Monster Energy NASCAR Cup Series race of 2018.PLAY NOW: Set your Fantasy Live lineup | How the new Fantasy Live worksMORE: Fantasy analysis for Martinsville | Driver stats | Full lineup | 10-lap averagesRJ Kraft’s revised Fantasy Live lineup following practices and the lineup being set:1: Kyle Busch2: Denny Hamlin3: Brad Keselowski4: Clint Bowyer5: Joey LoganoGarage: Jimmie JohnsonAnalysis: With the field set by owner points after rain washed out qualifying, I am going hard after stage points. That means minimum changes for me in my original lineup and it’s in the name of track position. I am swapping out AJ Allmendinger for Joey Logano. Allmendinger will start 25th, while Logano will line up third and has a solid Martinsville history. I feel pretty confident in the Team Penske driver’s ability to bag some stage points — he has the sixth-most in the series through five races.I am setting my lineup by starting position, which means Johnson to the garage. However, having a nine-time winner at “The Paperclip” is a really nice insurance policy to have tucked away to swap in. Busch, Hamlin and Keselowski were picks I was not moving away from this weekend, and Bowyer was in the top six 10-lap averages in both practice sessions to firm up my belief that he will be in the mix here.My bonus picks will include a stage win for Martin Truex Jr. and one for Kyle Busch. I am leaning toward Ford for the manufacturer winner, but still very much debating the race-winner pick.
LAS VEGAS — For the first time in 16 years Hendrick Motorsports driver Jimmie Johnson won’t be a part of NASCAR’s championship Playoff run. However, his three young teammates will. Chase Elliott, 23, paced the championship organization with two wins – at Talladega and Watkins Glen – this season and heads into Sunday’s playoff opener ranked seventh. The driver of the No. 9 Hendrick Motorsports Chevrolet is a perfect 4-for-4 in qualifying for the Cup playoffs. His best championship finish was fifth in 2017 – his second year at the Cup level.RELATED: Meet the full playoff field | What the 16 drivers are saying Alex Bowman, 26, driver of the No. 88 Hendrick Motorsports Chevrolet, earned his career first Cup victory at Chicago this summer to secure his second consecutive playoff run. He’s ranked ninth heading into the Vegas opener.And the series’ youngest Cup driver, 21-year-old William Byron, brings the famed No. 24 Hendrick Motorsports Chevrolet back to the Playoffs. He’s ranked 13th in the playoffs’ points re-set and is already turning in a career year in top-fives (three) and top-10s (nine). He has won a team-best four pole positions too. And while it may seem like a stretch for the driver to have earned a playoff bid in only his second Cup season, Byron said that was actually the expectation.“I think for our team we at least expected to make it for a while now,’’ Byron said. “We don’t feel like we’re just sneaking into the Playoffs or anything. We locked it in a couple races ago. So I feel good about that. I think the next step is just how do we perform in the Playoffs and how do we get to the next level of our progression as a program.’’And with so much buzz surrounding the three Joe Gibbs Racing teammates – Kyle Busch, Denny Hamlin and Martin Truex Jr. – or the title talk about Team Penske’s high expectations to earn a second consecutive Cup title, Byron said he doesn’t mind making his first playoff run perhaps a little more under the radar.“It’s a little bit of an advantage to have that lack of pressure on our team,’’ Byron said. “Our goal was obviously to make the Playoffs and to accomplish that has been really good. I feel like now we can focus more on executing the first three races and try to get through that round. So yeah, I don’t think it really matters either way, but it does help that we don’t really have that pressure on us.’’
In the closing address, Arthur Cooper, MD, director of pediatric surgical services and the regional trauma center at Columbia University in New York City, said there_s little data readily available on ambulance crashes, no epidemiology to determine what elements negatively affect ambulance transport safety and no idea of the true costs of ambulance-safety issues to EMS personnel and patients.”ž If you prefer to write a letter, AEMS makes it easy: Visitwww.advocatesforems.organd click on “Take Action” for all the tools you need. One theme that arose throughout the meeting was the lack of ambulance-safety research and data. Researchers identified only 40 papers published over the past 30 years that deal specifically with ambulance safety, although highway incidents killed 39% of the U.S. EMS personnel who_ve died in the line of duty. Levick noted that the National Transportation Safety Board initially declined to gather data specific to ground ambulance crashes but reversed that stance in October. PRO BONOSignature Rules ChangeÆ’Again!In Jan. 1, 2009Æ’exactly one year to the day after Medicare implemented new regulations for beneficiary signatures necessary to submit a claim for ambulance servicesÆ’the regulations have changed again. Although the 2008 changes were significant, the 2009 regulations don_t represent a major modification to the previous rules. What do you think? Visit”žjems.com/jems“žto let us know. William Maisel, MD, a cardiologist at Beth Israel Deaconess Medical Center in Boston, tested eight headphone models on 60 patients and found they interfered with four of 27 pacemakers and 10 of 33 ICDs if they were placed within an inch of the device. Neodymium, a powerful magnetic substance used in some models, could cause heart palpitations or prevent an ICD from firing.”ž Pro Bono is written by attorneysDoug WolfbergandSteve WirthPage,Wolfberg & Wirth LLC, a national EMS-industry law firm. Visit the firm_s Web site atwww.pwwemslaw.comfor more EMS law information. Eileen Frazer, executive director of the Commission on Accreditation of Medical Transport Systems (CAMTS), said that both CAMTS and the Commission on Accreditation of Ambulance Services would release new standards in 2009 that include safety issues for the first time.”ž But AEMS needs your help to recruit your members of Congress into the EMS Caucus. Congress is in recess until after the Jan. 20 presidential inauguration, making this the ideal time to visit your representative_s local office to introduce yourself and your issuesÆ’especially to newly elected members of CongressÆ’and ask them to join the caucus. Lawmakers welcome constituent visitsÆ’especially by uniformed public safety officers. Should Medics Get Bonuses for Improving Performance?“žEMTs and paramedics employed by Winona Area Ambulance Service (WAAS), a small hospital-based agency in Minnesota, can earn up to $1,000 extra each year if they collectively meet six performance measures. In 2007, for example, full-time medics took home an extra $900 each for completing patient care reports within three hours; meeting out-of-chute time goals; performing an ECG on every patient with non-traumatic chest pain; assessing and providing appropriate relief for traumatic hip pain; and documenting the time of stroke symptom onset. (Part-timers were paid prorated amounts.) WAAS medics could have earned another $100, but they narrowly missed the target of giving aspirin to at least 98% of the patients with non-traumatic chest pain. Quick TakesNew Jersey Proposes EMS StandardsThe New Jersey EMS Council has drafted legislation that would put all EMS under state health department control, require communities to make provisions for EMS (as they must for fire and police services), establish response times and mandate at least two EMTs on every emergency ambulance. Currently, only hospital-based services may provide ALS in the state, with most BLS provided by volunteer services that have fought state control. A 2007 study mandated by the legislature recommended 55 changes. “The failure of New Jersey_s EMS system is not about to happen, it has already begun, quietly worsening each year,” said the report on the study_s findings. According to the Newark Star-Ledger, legislators promise public hearings in early 2009 before they introduce and vote on a formal bill.“ž Safety First”ž First Federal Summit addresses the need for ambulance research & data”ž More than 150 individuals and organizations participated Nov. 7 (in person or via Webinar) in the first Ambulance Transport Safety Summit sponsored by the EMS Transport Safety Subcommittee of the Transportation Research Board, one of six major divisions of the National Academy of Sciences/National Research Council. The meeting focused on the availability of ambulance-crash data (or lack of such data) and on vehicle design and operations, human factors, ergonomics and safety standards for ambulance services. WAAS Medical Director Brett S. Whyte, MD, says WAAS began the incentive program in 2005 after other attempts to improve compliance met with little success. Now, he says that although the EMTs and paramedics no longer”žreceive a bonus for meeting a specific objective, they usually maintain the improvement because it_s become part of their regular practice. Coming Soon:Guidelines for Safely Transporting Kids“žThe National Highway Traffic Safety Administration launched a two-year project in November to develop recommendations for safely transporting children in ground ambulances. The NHTSA EMS Office and NHTSA Occupant Protection Division are jointly sponsoring the project. Maryn Consulting, an IT/human resources consulting firm, will work with national experts to create the guidelines. For more information, contact NHTSA EMS Specialist Dave Bryson at”ž[email protected] Action AlertHelp Build an EMS Caucus in CongressAmbulance services nationwide are struggling with a broad array of reimbursement and regulatory issues, and federal lawmakers can help. But members of Congress need education on EMS issues and a focused push to address EMS concerns and get more federal funding and other resources for ambulance services and EMS personnel. To gain more Congressional clout, Advocates for EMS (AEMS), an entity created in 2003 by a coalition of national organizations to educate Congress on EMS issues, has recruited several members of the U.S. House of Representatives to start a Congressional EMS Caucus. Reps. Dutch Ruppersberger, D-Maryland, Charles Boustany, R-Louisiana, and Tim Walz, D-Minnesota, have agreed to lead the new caucus. It will focus on issues that affect the day-to-day operations of EMS providers throughout the country, including improving Medicare and Medicaid reimbursement, getting more federal resources for EMS disaster preparedness, research, the National Emergency Medical Services Information System and addressing EMS workforce issues. Dangerous“žHeadphonesIn 2007, concerns arose about the potential for iPods to interfere with pacemakers or implantable defibrillators (ICDs). The U.S. Food and Drug Administration checked that out and recently said iPods posed no problems. ButÆ’surpriseÆ’there_s a problem with some MP3 player headphones! Turns out some headphones can create chaos with a pacemaker or an ICDÆ’even if they_re unplugged and in a shirt pocket or hanging around someone_s neck.”ž The 2008 regulations also allowed ambulance services to submit claims for emergency ambulance transport services even when they can_t obtain the signature of the patient or authorized signer. To use this “emergency exception,” the ambulance service must obtain three forms of documentation before the claim can be submitted to Medicare: a signed statement by an EMS crew member that the patient was unable to sign and no authorized signer was available or willing to sign; documentation with the date and time the patient was transported, along with the name and location of the receiving facility; and a signed statement from a representative of the receiving facility documenting receipt of the patient, or some other secondary form of verification on a facility record showing receipt of the patient from the ambulance service. Under the 2008 regulations, all claims submitted to Medicare must have the patient_s signature, but if the patient is physically or mentally incapable of signing, an authorized signer can sign on their behalf. Authorized signers include the patient_s legal guardian, a relative or other person who receives Social Security benefits on the patient_s behalf or arranges for the patient_s treatment or exercises responsibility for their affairs or a representative of an agency or institution that has furnished care, services or assistance to the patient (other than a representative of the ambulance service submitting the claim). But Whyte admits not everyone approves of the program. “Some”žmedics say we should be doing these things anyway,” he says.”ž Although the signature rules haven_t changed significantly, the important message remains the same: It_s vital that EMS personnel do everything possible to obtain a signature from the patient or other authorized signer at the time of service. Otherwise, the burdens of obtaining a qualifying signature after the fact can significantly delay an ambulance service_s cash flow. A panel on human factors and ergonomics included an ergonomist, a paramedic expert on emergency-vehicle visibility and an ambulance service director who discussed the value of driver-monitoring equipment for identifying and correcting poor driving. The panel stressed that designers of ergonomically safe ambulances must consider specific requirements for patient-compartment access and egress from rear and side doors, the loading and unloading of stretchers and how personnel access equipment during transport. For PowerPoint presentations and an audio recording of Summit proceedings, visit”žwww.objectivesafety.net.“ž Æ’Glenn Luedtke”ž CONTROVERSYShould Medics Get Bonuses for Improving Performance?“žEMTs and paramedics employed by Winona Area Ambulance Service (WAAS), a small hospital-based agency in Minnesota, can earn up to $1,000 extra each year if they collectively meet six performance measures. In 2007, for example, full-time medics took home an extra $900 each for completing patient care reports within three hours; meeting out-of-chute time goals; performing an ECG on every patient with non-traumatic chest pain; assessing and providing appropriate relief for traumatic hip pain; and documenting the time of stroke symptom onset. (Part-timers were paid prorated amounts.) WAAS medics could have earned another $100, but they narrowly missed the target of giving aspirin to at least 98% of the patients with non-traumatic chest pain. What do you think? Visit”žjems.com/jems to let us know. receive a bonus for meeting a specific objective, they usually maintain the improvement because it_s become part of their regular practice. But Whyte admits not everyone approves of the program. “Some”žmedics say we should be doing these things anyway,” he says.”ž WAAS Medical Director Brett S. Whyte, MD, says WAAS began the incentive program in 2005 after other attempts to improve compliance met with little success. Now, he says that although the EMTs and paramedics no longer”ž Defibrillators”žAdd FeaturesZOLL and Masimo issued a joint announcement Nov. 13 that Masimo Rainbow SET pulse CO-oximetry would be integrated into all ZOLL E Series defibrillators, allowing the non-invasive and continuous measurement of carbon monoxide (SpCO) and methemoglobin (SpMet) in the blood. This will provide “the advanced clinical intelligence that today_s EMS and fire professionals need to accurately diagnose and treat victims of carbon monoxide poisoning,” says ZOLL CEO Richard A. Packer. Also, Physio-Control is awaiting U.S. Food and Drug Administration 510(k) clearance to release its new LifePak 15, which incorporates Masimo_s Rainbow technology for SpCO and SpMet monitoring. “We can_t project when that might happen,” says Physio-Control spokeswoman Ann Devine.”ž Ralph Grzebieta, PhD, an Australian road-safety research leader, advocated a “safe systems approach,” including safe vehicle design, road design and driving habits. He stressed that the side-facing seats and protruding cabinets in today_s ambulances are inherently dangerous. An ambulance manufacturer_s representative noted that the latest federal KKK standard for ambulances”ždoes”ž allow for front- or rear-facing seating instead of a squad bench.”ž Summit panelists agreed on the need to develop consensus definitions to help compile ambulance crash data and create a database as the foundation for a National Clearing House for EMS Transport Safety Resources and Research. They also agreed federal agencies should work together to provide comprehensive information and design solutions for safer ambulances, and the EMS community should develop an EMS Transport Safety Agenda for the Future. EMS Transport Safety Subcommittee ChairNadine Levick, MD, MPH, an emergency physician, academic and interdisciplinary researcher, chaired the four-hour meeting. Nineteen leaders from EMS, public-health research, government, fire service and private provider agencies participated in panel discussions.”ž Levick noted that federal KKK standards don_t require dynamic ambulance testing and federal motor vehicle standards specifically exempt ambulances. In fact, the U.S. currently has more safety standards for moving cattle than for moving patients.”ž The most significant change in the 2009 regulation is that Medicare has expanded the emergency exception to include non-emergencies as well. Again, three alternate forms of documentation are required when the patient is physically or mentally incapable of signing. “It_s smart to keep small electronics at least a few inches from implanted medical devices and not let someone wearing headphones lean against your chest if you have [an implanted device],” Maisel told the Associated Press after he presented his findings at the American Heart Association conference in November.”žJEMS
AddThis Sharing ButtonsShare to FacebookFacebookFacebookShare to TwitterTwitterTwitterShare to EmailEmailEmailShare to RedditRedditRedditShare to MoreAddThisMoreWith higher gas prices becoming a recurring reality, you should follow these tips to help reduce the amount of gas you use. Including advice about cruise control and what kind of gas and oil you should buy, these tips can save you money1) Don’t Drive Like You Have a Dying Man in the Car Unless you DoAggressive driving (speeding, rapid acceleration and braking) wastes gas. It can lower your gas mileage by 33 percent at highway speeds and by 5 percent around town. Sensible driving is also safer for you and others, so you may save more than gas money.2) Remove Excess WeightAvoid keeping unnecessary items in your vehicle, especially heavy ones. An extra 100 pounds in your vehicle could reduce your MPG by up to 2 percent. Your equivalent gasoline savings would be between $0.04–$0.07 per gallon. The reduction is based on the percentage of extra weight relative to the vehicle’s weight and affects smaller vehicles more than larger ones.3) Observe the Speed LimitThis graph shows MPG vs Speed. While each vehicle reaches its optimal fuel economy at a different speed (or range of speeds), gas mileage usually decreases rapidly at speeds above 60 mph. Every 5 mph you drive over 60 mph is like paying an additional $0.24 per gallon for gas.4) Avoid Idling Your Motor While ParkedIdling gets 0 miles per gallon. Cars with larger engines typically waste more gas at idle than do cars with smaller engines.5) Use Cruise ControlUsing cruise control on the highway helps you maintain a constant speed and, in most cases, will save gas.6) Use Overdrive GearsWhen you use overdrive gearing, your car’s engine speed goes down. This saves gas and reduces engine wear.7) Keep Your Engine Properly TunedGet a tune-up! Fixing a car that is noticeably out of tune or has failed an emissions test can improve its gas mileage by an average of 4 percent, though results vary based on the kind and quality of repair. Fixing a serious maintenance problem, such as a faulty oxygen sensor, can improve your mileage by as much as 40 percent.8) Keep Tires Properly InflatedYou can improve your gas mileage by up to 3.3 percent by keeping your tires inflated to the proper pressure. Under-inflated tires can lower gas mileage by 0.3 percent for every 1 pound (per square inch) drop in pressure of all four tires. Properly inflated tires are also safer and prolong the life of the tires. The proper tire pressure for your vehicle is usually found on a sticker in the driver’s side door jamb or the glove box and in your owner’s manual. NOTE: Do not use the maximum pressure printed on the tire’s sidewall. 9) Change Your Oil and Use Recommended Grade of Motor OilYou can improve your gas mileage by 1–2 percent by using the manufacturer’s recommended grade of motor oil. For example, using 10W-30 motor oil in an engine designed to use 5W-30 can lower your gas mileage by 1–2 percent. Using 5W-30 in an engine designed for 5W-20 can lower your gas mileage by 1–1.5 percent. Also, look for motor oil that says “Energy Conserving” on the API performance symbol to be sure it contains friction-reducing additives.10) Plan Ahead and Combine Your ErrandsCombining errands into one trip saves you time and money. Several short trips taken from a cold start can use twice as much fuel as a longer multipurpose trip covering the same distance when the engine is warm. Trip planning ensures that traveling is done when the engine is warmed-up and efficient, and it can reduce the distance you travel.11) Commute to Work at Off-Peak Rush HoursDrive your most fuel-efficient vehicle and consider telecommuting (working from home) if your employer permits it. Take advantage of carpools and ride-share programs. You can cut your weekly fuel costs in half and save wear on your car if you take turns driving with other commuters. Many urban areas allow vehicles with multiple passengers to use High Occupancy Vehicle (HOV) lanes which are typically less congested, further improving your fuel economy.12) Avoid Driving With Items on Your Roof RackAvoid packing items on top of your car. A loaded roof rack or carrier creates wind resistance and can decrease fuel economy by five percent. Place items inside the trunk whenever possible.13) Use the Octane Level You Need Your owner’s manual recommends the most effective octane level for your car. For most cars, the recommended gasoline is regular octane. In most cases, unless your engine is knocking, using a higher octane gas than the manufacturer recommends offers no benefit and is a waste of money.14) Buy a Fuel-Efficient CarSelecting which vehicle to purchase is the most important fuel economy decision you’ll make. The difference between a car that gets 20 MPG and one that gets 30 MPG amounts to $880 per year (assuming 15,000 miles of driving annually and a fuel cost of $3.52). That’s $4,400 extra in fuel costs over five years.For Data Sources, visit FuelEconomy.govTire photo by alvimann via MorguefileAddThis Sharing ButtonsShare to FacebookFacebookFacebookShare to TwitterTwitterTwitterShare to EmailEmailEmailShare to RedditRedditRedditShare to MoreAddThisMore
We know what we’re gettin’ and when! The brand-new musical Gettin’ the Band Back Together has announced the release of its original cast album on CD and in digital formats on September 28. Gettin’ the Band Back Together concluded its Broadway run on September 16.Gettin’ the Band Back Together follows Mitch Papadopolous, who always dreamed of being the next Bon Jovi, but chose security over stardom and left those daydreams behind for a day job. He dusts off his guitar, gathers his old gang—the math teacher who isn’t good at math, the Irish cop who dreams about being on Broadway, the dermatologist who can’t get a date and a 16-year-old Jewish rapper who makes Vanilla Ice look cool—and sets out to win The Battle of the Bands…and maybe even win back the high school sweetheart he left behind.The Broadway cast was led by Mitchell Jarvis as Mitch Papadopolous, Marilu Henner as Sharon Papadopolous, Jay Klaitz as Bart Vickers, Paul Whitty as Michael “Sully” Sullivan, Sawyer Nunes as Ricky “Bling” Goldstein, Brandon Williams as Tygen Billows, Tamika Lawrence as Roxanne Velasco, Kelli Barrett as Dani, Garth Kravits as Ritchie, Manu Narayan as Dr. Rummesh “Robbie” Patel, Becca Kötte as Tawney and Noa Solorio as Billie. The ensemble includes Ryan Duncan, J. Elaine Marcos, Rob Marnell, Jasmin Richardson and Tad Wilson.Gettin’ the Band Back Together features a book by Ken Davenport and The Grundleshotz with additional material by Sarah Saltzberg, with an original score by Mark Allen. The show was directed by John Rando, with choreography by Chris Bailey, musical direction by Sonny Paladino and orchestrations by Doug Katsaros and Sonny Paladino. The musical began previews on July 19 and officially opened at the Belasco Theatre on August 13. View Comments
The Federal Emergency Management Agency has so far obligated more than $133 million to repair eligible storm-impacted roads, bridges, culverts and other elements of Vermont’s infrastructure; the Public Assistance process continues. In their ongoing partnership, FEMA and the State of Vermont announce a series of meetings to update individual applicants from local governments and some private non-profit organizations. The meetings, the first of which is scheduled to be held on Monday, August 6, are intended to update Public Assistance applicants in Addison, Bennington, Chittenden, Essex, Franklin, Lemoille, Orange, Rutland, Washington, Windham and Windsor counties. “These meetings will serve to underscore FEMA’s commitment to working with the State of Vermont to ensure that all applicants for Public Assistance receive the maximum amount of funding for which they are eligible,” said FEMA Federal Coordinating Officer Nick Russo. The meetings are intended to provide a common understanding as to the way ahead, including changes of scope, time extensions and appeals. Applicants will be briefed on the close out process, relevant terminology and other topics related to exit interviews. “It is the intent of the state to support FEMA’s effort to ensure Public Assistance applicants are aware of the status of project worksheets and have a common understanding as to the road ahead,” said State Coordinating Officer Ross Nagy. FEMA’s mission is to support our citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.Follow FEMA online at twitter.com/fema, www.facebook.com/fema(link is external), and www.youtube.com/fema(link is external).
The World Health Organization (WHO) has started posting weekly situation updates on outbreaks of Zika virus and possible complications from the disease, and it also has issued an interim case definition for the illness.Both reports were posted Feb 12, capping a busy week of new developments with the virus, including studies that strengthened the association between maternal Zika virus infection and microcephaly in babies. In other developments, Brazil updated its microcephaly investigation totals and refuted an environmental group’s claim that a larvicide used in drinking water may be causing the birth defect.WHO sets 6-month tasks, prioritiesThe WHO said in its situation update that it and partners have established a strategic response framework that sets tasks and priorities for the next 6 months, covering surveillance, community development, vector control, child and maternal health, and research and development. It added that it is finalizing an overview of urgent needs for the Zika virus response.At WHO headquarters and at its Pan American Health Organization (PAHO), incident management systems have been activated, with the two groups coordinating responses with national governments, United Nations agencies, and nongovernmental organizations.The report provides a big-picture view Zika virus activity, which according to estimates has sickened 1.5 million so far in Brazil, followed by 25,000 suspected cases in Colombia, the next worst hit country. Columbia has confirmed 1,331 cases since October. The WHO added that Cape Verde has reported more than 7,000 suspected Zika virus cases.So far, Brazil and French Polynesia are the only affected countries reporting congenital abnormality levels that are well above average, though isolated microcephaly cases—one in Hawaii and one in Slovenia—have been reported in women who visited or recently lived in Zika-hit countries. Colombia hasn’t reported any microcephaly cases, but health officials there are closely watching for any unusual increases.Five countries have reported rises in Guillain-Barre syndrome (GBS): Brazil, Colombia, El Salvador, Suriname, and Venezuela. However, the possible association with Zika seems less clear cut. The WHO said none of the GBS cases in Colombia or El Salvador involved lab-confirmed Zika infection, and it added that the cause is unknown, especially since dengue, chikungunya, and Zika virus have all been circulating at the same time in the Americas. “Investigations to determine the cause of infection are ongoing in countries with increased incidence of GBS,” the agency said.In Brazil, the outbreak’s epicenter, public health officials have visited 20 million households to look for mosquito breeding grounds, and 500,000 people are working on vector control and public health messaging activities, according to the WHO report. Brazil has no plans to cancel its hosting of the 2016 Olympic Games in Rio. The August timing of the event comes during winter, when mosquitoes are least active.Interim case definition to help with surveillanceThe WHO also on Feb 12 issued an interim case definition of Zika virus infection to help standardize classification and reporting.A suspected case is defined as person with a rash and/or fever with at least one of the following: arthralgia, arthritis, or conjunctivitis. The WHO defines a probable case as a suspected case with IgM antibody against Zika virus and an epidemiologic link, such as contact with a confirmed case or residence in or travel to an area with local Zika transmission.A confirmed case is defined as a person with a recent Zika infection as confirmed by detection of viral RNA or antigen in serum or other samples or detection of IgM antibody against Zika and a 90% plaque-reduction neutralization test at certain cutoffs compared with other flaviviruses, with exclusion of such viruses.Brazil updates microcephaly count, rejects larvicide suspicionMeanwhile, Brazil’s health ministry said Feb 12 that it had received reports of 296 more suspected cases of microcephaly. However, it ruled out 765 earlier suspected ones, according to an official statement translated and posted by Avian Flu Diary, an infectious disease news blog.Brazilian authorities are still investigating 3,862 suspected microcephaly cases, with 462 of them now confirmed and 765 ruled out as of Feb 2. The cumulative number of suspected cases is now at 5,079.Brazil’s 462 confirmed microcephaly cases span 175 cities in 13 states, an increase from 156 cities in 9 states reported in the ministry’s report the week before.The health ministry said that despite the possible relationship with Zika virus, microcephaly can be caused by other conditions such as syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes virus.In other developments, the health ministry on Feb 13 issued a statement countering an Argentine environmental group’s charge that the larvicide pyriproxifen, used in some drinking water supplies, is a more likely microcephaly culprit than Zika virus, according to statements translated and posted by Avian Flu Diary.The charges led one of Brazil’s southern states, Rio Grande Do Sul, to temporarily suspend use of the larvicide in drinking water. However, Brazil’s health ministry quickly posted a clarification on the use of pyriproxifen, noting that the product had been cleared by the WHO’s pesticide evaluation process and had also been certified by Brazilian safety officials.It added that there is no scientific basis for a link between the use of pyriproxifen and microcephaly and that some cities that haven’t used it have also reported microcephaly cases.NAS workshop to air Zika priorities tomorrowThe National Academies of Sciences, Engineering, and Medicine are hosting a public workshop tomorrow to discuss research priorities, given the emergence of Zika virus in the United States. The meeting was requested by the US Department of Health and Human Services’ Assistant Secretary of Preparedness and Response (ASPR).According to the meeting announcement, stakeholders will discuss steps to reduce the likelihood of local Zika virus transmission in the United States, identify knowledge gaps, pin down the most important research questions, such as the link between Zika virus and microcephaly, and assess communication needs regarding the risks and mitigation strategies.The meeting will take place at the National Academy of Sciences building in Washington, DC, starting at 8:30 am Eastern time, but it will also be Web-streamed live.A document summing up the presentations will be prepared at the end of the session, but no consensus findings or recommendations.See also:Feb 12 WHO Zika virus situation reportFeb 12 WHO Zika infection interim case definitionsFeb 12 Avian Flu Diary postFeb 13 Avian Flu Diary post on larvicide controversyNAS Zika workshop meeting background