Star Tribune, Aug. 27
Protect the public from deadly threat of flu
With the elderly comprising an estimated 90 percent of seasonal influenza's death toll, the flu vaccination rate among a group of professionals working closely with this age group — staff at hospitals, clinics and nursing homes — should be 100 percent or very close.
The public has every right to expect that doctors, nurses and other health care professionals have done everything possible to protect all patients — but especially those whose immune systems have weakened with age — from one of the nation's leading causes of death. Influenza, along with pneumonia, a common complication of the seasonal virus, makes a perennial appearance on the annual top 10 list of killers and currently ranks eighth.
Unfortunately, Minnesota hospitals and nursing homes fall alarmingly short when it comes to the annual shot, according to new data from the Minnesota Department of Health's FluSafe program. Just 34 state hospitals participating in the program had at least 90 percent of their staff vaccinated against this highly contagious virus.
Only 26 participating nursing homes crossed the 90 percent threshold, a level that has been deemed by public health officials as being critical for flu protection.
A total of 213 facilities participated in FluSafe for the 2013-14 flu season. For perspective, there are about 145 hospitals in Minnesota and around 375 nursing homes, suggesting that the slender slice of state facilities achieving the 90 percent rate is likely even slimmer than it first appears.
The FluSafe program is in its fourth year, and its goal is admirable: to encourage the state's hospitals and nursing homes to boost flu vaccination rates through friendly competition. Participation in the program, which also provides tools and promotional materials for providers, is voluntary.
Slow progress in improving health care workers' vaccination rates has long been lamented by infectious-disease experts. Nationally, about 72 percent of health care workers get the annual shot, a figure well below the 90 percent threshold officials are aiming for by 2020. While the flu shot isn't as effective as previously thought, it remains a vital tool to prevent influenza spread.
In the spirit of the ongoing State Fair, FluSafe awarded blue, red and white "ribbons" to Minnesota facilities with laudable vaccination rates. Those given blue-ribbon status hit the 90 percent mark or above. Red was awarded for 80 percent to 89 percent, with white ribbon recognition for rates between 70 percent to 79 percent.
While health officials said in a news release that they are pleased that the program had awarded "more ribbons than ever before," a closer look at the results undercuts the positive spin.
Just 28 percent of the Minnesota facilities participating during the 2013-14 flu season received a blue ribbon. Big metro hospitals were also disappointingly underrepresented in the blue-ribbon category. Only two had vaccination rates of 90 percent of higher: Children's Hospitals and Clinics' Minneapolis and St. Paul locations.
The metro's other big hospitals were awarded red or white ribbons. (The Fairview system, which doesn't participate in FluSafe, said its flu vaccination rate was 83 percent during the last flu season.)
Metro nursing homes were somewhat better represented in the blue-ribbon category. Still, only five achieved this recognition.
Vaccination rates at red- and white-ribbon facilities are at or above the national average but far short of where they should be for maximum protection. Leadership at these facilities, as well as those that didn't achieve ribbon status or participate in FluSafe, must toughen policies and find ways to boost participation rates as the annual flu season looms just a few months ahead. Clearly, traditional approaches such as pizza parties or other lighthearted incentives aren't good enough.
It's worth noting the hard-nosed approach that blue-ribbon winner Children's Hospitals and Clinics has taken. According to a spokeswoman, the health care system "strongly recommends" the shot and requires "all staff to document their vaccination status on their employee badge. If staff decline a vaccination, they must wear a mask in patient care areas."
State lawmakers also need to scrutinize the latest FluSafe results. During the last session, a bill championed by the Minnesota Hospital Association would have mandated "annual flu vaccinations for hospital and clinic employees with certain exceptions based on allergies or religious concerns." Health care employers would have been required to pay for the shot.
The bill didn't get a hearing in either the state House or Senate. The website for the Minnesota Nurses Association union still boasts of the organization's pressure on legislators to drop the issue. Next year, lawmakers' priority must be on public health and protecting patients. The legislation should at least get a hearing, and medical experts should be brought in to weigh its merits.
The Journal of New Ulm, Aug. 28
Right to bear arms should be subject to common sense
A news item out of Arizona is an example that even a constitutional right carries a lot of responsibility.
What was supposed to be a fun family day at the shooting range on Monday turned to tragedy when a nine-year-old girl, with her parents standing by videotaping her, accidentally shot and killed a shooting range instructor as he was teaching her how to shoot an Uzi automatic weapon. The recoil from the weapon caused the gun to rise over her head as she held down the trigger, and the bullets hit the instructor, Charles Vacca, 39, in the head.
We have no problem with parents wanting their children to learn how to safely handle firearms. Locally, the Izaak Walton League holds regular training sessions for young people, and it helps introduce them to the world of recreational hunting and target shooting.
But to give an automatic weapon like an Uzi, which has a reputation for a rapidly climbing recoil even in experienced hands, to a child is inexcusable folly. The instructor paid with his life, and the child — an innocent victim of this tragedy — will now have to live with this traumatic experience for the rest of her life.
But the parents and the gun range that allowed this to happen should be held accountable.
The right to bear arms should be accompanied by the responsibility to see that those arms are used safely and responsibly, especially if children are going to be using them.
St. Paul Pioneer Press, Aug. 26
Beware of veiled spending increases, MnSCU
New labor agreements are among milestones for MnSCU, the state's largest education system, as it prepares for a new school year.
The tentative agreement announced in July with one faculty union was reached after long, contentious negotiations. Two others were approved last week by a legislative subcommittee and are now in effect.
We approach the agreements from the standpoint of restraint, with concern about making promises that others — namely taxpayers— will have to keep:
— Members of the Inter Faculty Organization, representing educators at the system's seven state universities, would receive an overall salary increase of 7 percent over two years, the Pioneer Press has reported. A new provision -- an objective of the union's for about 20 years, and the first in a state-worker union contract, its president Jim Grabowska told us — would allow six weeks of paid parental leave on the birth or adoption of a child. The agreement is subject to approval by union members, MnSCU trustees and the Legislature.
— The contracts now in effect are with the Minnesota State College Faculty, representing members at two-year institutions, and the Minnesota State University Association of Administrative and Service Faculty, representing non-teaching faculty serving in academic and student-services departments. Both secured 6 percent increases over two years.
"We're absolutely delighted to have reached agreements with all three of our faculty unions," Chancellor Steven Rosenstone told us. "The real hurdle all along was having the base dollars we needed to bring to the bargaining table to reach agreements that were comparable" to those with other public-employee unions.
He credits help from the House, Senate and governor's office in securing supplemental funding that enabled MnSCU to close the contract discussion soon after the session ended.
A legislative leader, however, raises some thoughtful questions.
From her experience in the K-12 arena, "and really as someone who has had concerns around all of our labor contract negotiations, I think that whole process should be revisited," said Sen. Terri Bonoff, a Minnetonka Democrat and chair of the Senate Higher Education Committee.
Her point: Transparency. There isn't much when it comes to "the way these contracts are negotiated."
We may hear that a K-12 contract, she said, was settled for a 2 percent increase, for example.
"But that 2 percent is on top of what's already built into negotiations around what we call steps and lanes" — provisions for salary increases for experience and continuing education.
"Maybe, once you add those, that 2 percent isn't 2 percent — it's really 5 percent."
Performance, she believes, "ought to be part of any negotiation." Labor contracts should reflect current trends in employment, including those that emphasize that "nobody's raise should be independent of their performance review."
It's not just about seniority, she said, but rather about asking what outcomes "our teachers or professors are providing."
Grabowska explained that the tenure process for state university faculty is unlike others. They are, in effect, at-will employees for the first five years, he said. Each year, such faculty members provide and are evaluated on a plan in five areas, including teaching, research and professional growth. The new contract would grant time to first-year faculty members to work on such tenure objectives.
When it comes to transparency, the union — which has raised questions this year about board-of-trustees' operations — welcomes new trustees to the MnSCU board, Grabowska said. "We encourage them to take heed" of an admonition from the governor.
In announcing last week the six Minnesotans to fill vacancies, Gov. Mark Dayton said he expects "new members, and the entire board, to enhance transparency and accountability in the governance and operations of the MnSCU system."
He named Jay Cowles of St. Paul, as well as Kelly Carpentier-Berg, Coon Rapids; Robert Hoffman, Waseca; Maleah Otterson, Chanhassen; Louise Sundin, Minneapolis; and Erma Vizenor of the White Earth Nation.
We, too, expect a lot of them. Transparency is an important start. But spending restraint should be a constant.