WSSNEWS Bloggers

Dallas McKinnon

By Dallas McKinnon, In conjunction with Lincoln Financial Advisors/Sagemark Consulting, a division of Lincoln Financial Advisors, a registered investment advisor.

You have an estate plan; you probably even remember creating it—making the decisions and pulling together the documents was probably a time-consuming and tedious effort. The initial process of creating an estate plan can be so painful and involved that people may avoid reviewing it again for years.

But your estate plan does not exist in a vacuum. Life events such as marriage, separation, divorce, births, deaths, relocations and tax law changes all impact your estate planning needs. By revisiting key elements of your estate plan annually, you can correct errors, make adjustments for life changes and guarantee that your current wishes are known. Here are some items to review:

Friends & Family

• Beneficiary designations. Be sure that life changes make your beneficiary designation selections relevant and that they still reflect your current desires.
• Legal roles. Are your powers of attorney and estate executor(s) still competent and can they represent you? Have either of you relocated, causing you to consider if someone living locally could carry out the responsibilities more efficiently? Some states have updated their forms and require a redrafting of your power of attorney; talk to your financial planner about your situation.
• Long-term care insurance. Every person moving toward retirement or working in their sunset years should consider long-term care insurance. All you have to do is the math on the economic impact to a family of a nursing home stay. Long term care insurance can be an inexpensive alternative if the right policy is purchased at the right time.

Review of Assets

• Property titles. Have you established ownership and survivorship in the way you intended? Is it supported by current state titling laws?
• Business succession plans. A significant number of buy-sell agreements call for annual revaluation of the business that most people forget about. Not having an updated appraisal presents two concerns: You don’t have a current figure for the value of your business for your own planning, and in the event an owner or partner dies, an arbitrator without a true sense of the business will negotiate the reappraisal.
• Life insurance. Do you still need your current policy; do you need a different policy? Is the policy performing as originally illustrated? Policies are affected by interest rates and the investment options. If you expect the policy to provide for a particular need, it is important to review its performance annually.

Legacy Instructions

• Will. Your will is less likely to be contested as outdated if you have updated it every few years with your attorney.
• Ethical will/letter of instruction. Does the letter you have drafted still reflect the message that you want to leave your heirs? Have there been changes to your will or estate planning that you want to explain or emphasize.

Staying Current

• Tax law changes. Talk to your financial planner and accountant at least three months before the end of the year to see if tax law changes will negatively impact your current plan, you will have time to make any necessary adjustments.

Organization Eases the Task

Though it can be time consuming, it’s worth organizing your legal documents in a way that makes them easy to review and update. Be sure to keep these documents in a safe or fire-proof cabinet:

• Document finder. Lists your legal documents and where they are stored. If access requires a key or password, include instructions on how to find them.
• Estate planning summary. Includes a list of professional advisors and passwords for each account (including Web access). Adding the dates the documents were created can help prompt you to keep wills, powers of attorney and health care proxies up-to-date.
• Net worth statement. Describes every asset, including account numbers, titling, beneficiaries and current value. This statement identifies areas for in-depth review and serves as an overview for your estate executor.

These documents ease the access of information for those who—in the event of an emergency, or if you become incapacitated—will need to know where to find your estate plan and the legal documents that will guide them in support of your wishes. Creating an estate plan is just the first part of managing your future; keeping it up to date is essential for the long-run.

Do It Right, Do It Now

Dallas McKinnon is a CERTIFIED FINANCIAL PLANNER™ and President of McKinnon & Associates Private Wealth Services in Redlands.  He has lived in Redlands and helped his clients in the Inland Empire for over 20 years.  You can reach him at 909 363-4026 or at www.McKinnonandAssociates.com

Akilah C. Thompson

By Akilah C. Thompson

Social media is one of the most powerful forms of communication teens and adults use today.  Here are some tips to help you use social media safely and effectively.

1.     Respect yourself.  ­  Show off how great you are with class. You are a brand and should represent yourself accordingly on social media.  Make sure your photos are appropriate.  Do not post or text photos of yourself naked, dressed provocatively, or making obscene gestures. Avoid uploading anything you would not want your grandmother to see on the front cover of the New York Times! Social media plays a major role in building and ruining personal images. Be wise! 

2.     Post with positivity – Keep it cool! If you don¹t have anything good to say, don¹t post. Avoid ranting or arguing with people on social media and posting when you¹re upset. You may be upset with your mom but it would be very disrespectful to share your anger with the world. What do you think college recruiters or future employers might think about you disrespecting your mother on social media?  No Bueno!  Share positivity and good vibes on the web.

3.     No ³twerking² videos please! ­ Just because you see a trend starting on social media, doesn¹t mean it is something you should do. Do not post videos that portray negative images of you, your friends or family involving profanity, sex, nudity, crime, drugs, discrimination, violence, lewd gestures, or anything that could be offensive to the public. Keep your video posts kid friendly. You don¹t want a video of you intoxicated and ³twerking² inappropriately with friends to surface while you are campaigning for President in 20 years.  Definitely not a good idea!

4.     Know your followers ­ Allowing strangers to follow you can be very dangerous. Even if their account looks harmless, be aware that there are many fake accounts where creeps follow their prey. If you don¹t know them, ignore them and don¹t let them follow you. Also, use privacy settings to protect your accounts from being viewed by strangers. Proceed with caution!

5.     Be careful what you post for likes ­ You don¹t want to end up ³instafamous² for something that could destroy your future.  Keep your posts positive, dignified and smart. Social media is a great way to build a web presence for future endeavors.  Don¹t compromise your future for ³likes² or ³followers.²  Make your mark on the web, the right way!

6.    Play nice ŠDon¹t cyber bully! – No one has the right to harass anyone based on their sex, race, age, orientation, personal beliefs, values, etc. The impact of harassment is heightened and can have deadly consequences when acted out over the Internet. Avoid engaging in cyber brawls on twitter and status face-offs on Facebook. If you have a personal issue with someone, keep it off the Internet. If anyone is saying things about you on social media, report their account and let a relative know.

7.     Think before you post.  – Nothing is ever truly deleted, so be very sure about what you post before you hit the ³post² or ³send² button.   Once you post a picture or a status it is stored on the site¹s server and can normally be retrieved even if you delete it from your profile. So, be smart and post with care for your future!

8.     If you see something, say something! – Report anything inappropriate. Block or un-follow people that post negative comments on your timeline, make you uncomfortable or harass you in any way.

9.     Manage your use wisely ­ Too much of anything can become a bad thing. Is social media keeping you from getting work done? Try putting time limits on your social media usage to make sure it is not impacting your productivity.

10. Don¹t post your every move  – Leave some information to share with your real friends and family over the phone. Your best friend would probably want to know you and your boyfriend broke up before the whole world knows via your relationship status change.  Also be careful sharing info when you are going out of town. You don¹t want to alert a potential burglar that you will be in the Bahamas for a week with your family.

As a teenager it is important that you are aware, informed, and understand the risks that come along with using social media.  Remember to protect yourself, censor what you post, and chose the crowd you associate with wisely.

About Akilah C. Thompson:

Akilah C. Thompson is a Summa Cum Laude graduate of North Carolina A & T State University where she earned Bachelor of Science degrees in Accounting and Business Economics. She is an IRS Enrolled Agent, Certified Life Coach, Licensed Zumba Instructor, and Inspirational Speaker. She is the Founder & CEO of her trademark company ACT Inspires Inc and nonprofit, Generations Inspired Inc. Akilah is also a model, actor, and author. Her life goal is to inspire and empower others to be Ambitious, Courageous & Talented.   For more information, please visit Act Inspires.

Hakim Hazim

“An institution is not a place; it’s a state of mind.”- Tom Pomeranz

It’s impossible to listen to commentary about the state of affairs concerning Black America and not form an opinion. This will not be your typical article on Black History. I’m going to take a different approach, one that attempts to point out an empirical thing that we can remedy as a people still striving to fulfill the promise of the God we serve in Christ and the dreams our ancestors had for us. By using Pomeranz’s definition above, I’ll attempt to provide some clarity by defining institution as a state of mind, and I’ll call for an exodus away from the mindset. In this day and age of increasing government deficits and ineptness we cannot continue to look to institutions, no matter how evolved, for answers.

The primary function of any type of institution is to govern in some form.  People conditioned by institutions of any type look to the authorities and seek guidance, counsel, permission and ultimately favor from the leaders. We were brought here as powerless people, and we were liberated by the bold actions of abolitionists, a president of conviction and the blood of countless soldiers. During the Civil Rights Movement, we compelled the government to give us equal treatment. In short we were reformers of the status quo, not dependent on it. In our battle to secure rights and privileges from the institution of government, we, especially as Christians, must ask ourselves if we have become dependent on it.  The institution has helped us, but it is not our liberator.

I was once privileged enough to sit in on a training by national disabilities clinician, Tom Pomeranz. He spoke of institutions in a profound way—as a way of thinking and acting by the people who depend on it and those who provide services and instruction to those they are entrusted with. These three characteristics were evident:

• Belief in segregation (Certain people should be kept away from others)
• Belief in limiting choice (Certain people can’t handle decision making)
• Belief in limiting privacy (A mindset that encourages and tolerates intrusion)

I cringed when I heard these words. I knew it to be true. In some ways we were all institutionalized in regards to our thinking regardless of race. But slavery had a profound impact on Blacks traumatizing generations to come. It scarred the soul of the oppressor and oppressed. Martin Luther King, Jr., attacked the institutions of the day that promoted the belief in segregation, limiting our choices and violating the most basic private rights of our people. Law enforcement routinely violated Black families, homes and even taped confidential conversations. The government upheld and codified these approaches into law and enforced them with vicious brutality.

I am thankful this is no longer the status quo approach of the government, but I lament the current state of affairs so many Black folks are disproportionately ensnared in poverty, fatherlessness, addiction and skyrocketing incarceration rates.

The pain caused by these things prompt us to look for a source of relief. In the past, government came to our aid; currently, many of our leaders teach us that it’s impossible for minorities to have success without its intervention. I beg to differ. I changed my mind a long time ago.  We need to raise a generation of ministers, entrepreneurs, educators, politicians, and people who excel in the natural social sciences. We have to raise expectations. If we expect the exceptional from the marginalized, they will give it to us.

ABOUT HAKIM HAZIM:

Hakim Hazim is the founder of Relevant Now and co-founder of Freedom Squared. He is a nationally recognized expert in decision analysis, criminality and security.

Diana Hex

LOS ANGELES, CA- As we close out Black History Month and jump into Woman’s History Month in March, we would love to introduce our readers to professional dancer and celebrity trainer, Diana Hex, who not only is breaking barriers in the aerobics arena but is also a full time mom who exemplifies why we celebrate “Women’s History Month”.

Hex is originally from Birmingham, Alabama, but grew up in Los Angeles. Dancing has always been embedded in her genes. Her mother was a professional dancer, so she has taken on the torch and followed in her footsteps. As she evolved into the world of dance, Diana started teaching Hip-Hop and Cardio Sculpt at the Madonna Grimes Dance/Fitness Theater in West Los Angeles when she was asked to join an aerobics class. At first it was tiring, but the more that she became involved in it, she started to fall in love with it; and her fitness journey in competitions began.

“I really just broadened my whole world,” she stated.

This year is off to a running start for the fitness coach. She recently participated in The Fit Expo, which was held in Los Angeles, where she participated as a model for Promera Sports. As one of the company’s newest ambassadors, she handed out products and motivated participation in contests and poster signings by IFBB bodybuilder Fred “Biggie” Smalls and IFBB bikini model Ana Delia De Iturrondo. The event set the bar for more opportunities resulting in an invitation to participate in The Arnold Sports Festival and Fitness Weekend, which kicks off on February 28 in Ohio.

In addition to the expo events, the former LA Clipper’s cheer leader’s primary goal for this year is to get back into competitions. She will be participating in “Ms Fitness Inland Empire” on April 5 in Corona, and “Miss Fitness Hollywood” on June 28. It has been over five years since she was involved in a competition. The last one was in 2009 where she won fourth place in the “Miss Fitness” competition.

“I want to get back into it. I’m very excited and confident. I feel that I am in the best shape of my life”, Ms. Hex said.

Other plans for the year include participation in the LA Marathon for the first time; choreographing and assisting as the associate producer of an exercise video that is designed to motivate others to have fun while getting in shape; she will also be finishing her book entitled, Diana Hex: 30 Day Success Journal, which will showcase her passion for dance and helping others reach their goals; and she will be continuing to teach her Zumba classes throughout the week.

Overall, Diana Hex wants to assist others in completing their journey to become better within themselves on a healthier scale. Many of us start an exercise regiment and stick to it for a few days, but then we fall off. For starters, the sought after coach has provided three easy steps to help in accomplishing your goals, which is to create a fitness collage of the things that inspire you that you can look back at and reflect on; next is to find a role model that can help get you on the right track; and lastly, create a 3-by-3 month plan of your goals, write them down and hang them up somewhere.

For more tips or to take a Zumba class, please visit www.dianahexfitness.com. She is accepting new choreography and training clients and would be glad to assist you in getting back on the right track.

In a critical period of Obamacare outreach, will more black consumers take advantage of benefits available through the California healthcare exchange?

 By McKenzie Jackson, California Black Media

When Andre Andrews signed on to the Covered California website on February 7, he was in the midst of coping with a medical emergency.

A week before, Andrews had been the victim of a hit-and-run. The Burbank resident was walking his bike up the side of a street late one night, when he was suddenly struck by a passing motorist who never bothered to stop. The impact left him with missing teeth, lacerations to his face and an ambulance bill alone of over $1,000.

Uninsured since leaving a job in early January, Andrews has already paid $500 of the bill, but he now feels more secure because of his coverage eligibility under the Affordable Care Act, also known as Obamacare, it is made available in this state through Covered California, which Andrews is confident will help him better manage medical expenses and aid with any future health problems he might experience.

“I never really go to the doctor, but I still need health insurance, especially since this happened,” said Andrews. “All these other healthcare insurance providers online are expensive.” For the 30-year-old, what he found through Covered California “is less expensive. I’m one of those guys that thought nothing would ever happen. But clearly it can. You don’t know what is going to happen.”

More than 11,000 black Californians, and potentially millions more across the United States, can identify with the peace of mind Andrews enjoys today as a result of Obamacare. Following a difficult rollout, there has been a surge of enrollments over the last two months; on January 25, the Obama administration announced that three million Americans had signed up for private health plans under the law, including 800,000 in the month of January alone.

California accounts for 625,000 of those enrollees, but thus far only 3.1 percent, or 11,153, are African-Americans, despite blacks being nearly seven percent of California’s population. That is compared with whites, who have accounted for 54.7 percent, or 199,186, of Obamacare enrollees, tops in the state.

Obamacare ensures that all Americans have access to affordable health insurance, by offering discounts or tax credits on health insurance plans and enlarging the Medicaid assistance program to include more individuals that can’t afford healthcare in their budgets.

A household with an income between one and four times the Federal Poverty Level is ideal for receiving the health insurance discounts. Despite common misperceptions, that only single mothers can qualify for healthcare assistance, for example, or that a family must be in a deep poverty to get help, even individuals who earn too much to qualify for discounts and tax credits are entitled to buy plans through Covered California.

In California and across the nation, individuals with Obamacare have benefits in 10 categories including ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment and prescription drugs. The health plan also helps cover rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services such as dental and vision care.

Among those who have yet to enroll in a healthcare plan, despite the fact that he would almost certainly be eligible for coverage and/or subsidies, is 30-year-old Clint Thompson of Santa Monica. Thompson, who recently returned to California from New York City, is debating whether to enroll in a plan through Covered California, or try the insurance offered through his employer, a clothing retailer.

“I’m weighing the options of each,” said Thompson, “but I really haven’t looked as in-depth as I should.”

Thompson and others like him, those who remain on the fence about obtaining healthcare coverage, have until the March 31 open enrollment deadline to either enroll in a plan of some kind or be subject to a penalty.

Covered California this month launched an outreach campaign covering 21 counties across the state, Kern, Orange, Riverside, Sacramento, San Diego, Santa Clara and Ventura among them,  that includes opportunities for free enrollment assistance at libraries, community centers and other locations. Opportunities to enroll and information about outreach locations can be found on the website at www.coveredca.com.

Although online enrollment remains a viable and popular option, Covered California Executive Director Peter V. Lee said many people are more comfortable with face-to-face discussion.

“Many people want to speak with an expert in person in their own language,” he said recently, “rather than over the phone or on the Internet when making such a personal decision about health insurance.”

Next week: As a Covered California deadline approaches, African-American consumers, healthcare experts and advocates assess the effectiveness of healthcare outreach to the black community.

Posted by Tahira Wright. She is a blogger and has her own website at www.happilydivorcedandafter.com where she discusses relationship issues, insights on trending news and celebrity insights and her journey in becoming a happily divorcee. Her style is reality-based with a quirky and comedic twist.

Many times when entering in a relationship or friendship there is initial acceptance of a certain level of trust. What increases your level of comfort with someone? Is it time that has elapsed since initially engaged with that person or the depth of your communication?

When reflecting over obstacles faced in my relationships, I cannot help but to say to myself, now had we communicated our thoughts better this issue would of been a moot topic. In my opinion, trust and communication are directly correlated. Between two people of the opposite sex, this becomes a challenge. When speaking to my girlfriends we have very descriptive conversations, share our emotions whether it is the way our feet felt in our brand new pumps when we hit the town last night or how we are excited in meeting a new guy. Men on the other hand tend to be more reserved, keep it simple share on a need to know basis. If you want to know how there day was, you have to pry it out by asking specific questions. “What type of feedback did you receive from your manager on the presentation you were up all night preparing for?” Not just how did it go. On the other hand, when a man asks a woman how her day went, we as women will start to tell a story. We discuss  how our boss looked at us, what they were wearing and want it to be interpreted by our mate.  But men don’t want to hear all that. They just want to know it went well and as a result there will be a peaceful evening.

The imbalance in my opinion can create trust issues if the man and woman aren’t understanding of the communication expectations from each other. What communication feedback do I as a woman want and need in a relationship? When initiating the possibility of a relationship: communicate expectations upfront. When you are dating: still communicate updated expectations. When exclusively dating or married: still communicate updated expectations. When I refer to expectations not I want to get married in so many months. Gees relax men! Some men hear expectations and think us women are trying to race them to the altar or give them a long list of rules. No not the case at all. In my opinion for most women, we want to hear what type of woman our potential mate likes and explain what keeps us attracted. What thrives you and goals do you have are the questions we want answered. Now these expectations change. So it is important for both mates to stay updated. Only difference is that maybe the communication will need to be more direct and less colorful when speaking to a man. For the man he will need to step up his convo and be a bit more descriptive.

When there are too many unknown variables….alternative conclusions and assumptions are made. Expectations are not met and trust begins to erode as opposed to increasing. Hence, in my opinion communication and trust are intertwined together.

What Are Your Thoughts? Do You Think Communication Fosters Trust?

SACRAMENTO – In response to forecasts for excessive heat through Monday throughout much of California, state emergency and public health officials are urging Californians to drink plenty of water, wear lightweight, loose-fitting clothing and take other actions that will reduce their risk of death or heat-related illness.

This warming trend has prompted the issue of Excessive Heat Warnings by the National Weather Service (NWS) through Monday for parts of Imperial, Kern, Los Angeles, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara and Ventura counties and Special Weather Statements for most of the Sacramento and San Joaquin Valley and foothills, as well as the east Bay Area.

“Prolonged exposure to excessive temperatures can be extremely dangerous, if not deadly, particularly for infants, small children seniors and those with health problems,” said Dr. Ron Chapman, director of the California Department of Public Health.  “Last year was the hottest year on record in the United States.  Heat waves in California are projected to occur earlier in the season, be more intense and last longer.”

He noted that at on average heat-related emergencies cause 56 deaths in Californians each year and prompt 3,800 people to seek treatment at hospital emergency rooms for heat-related symptoms, with approximately 500 cases per year requiring hospitalization.   At least 136 Californians died due to illnesses prompted by the 13-day heat wave that struck the state in July 2006.

“Cal EMA and its partner agencies have been preparing for excessive heat in many areas of the state this summer and fall by reviewing internal procedures, updating cooling center data bases, identifying state fairgrounds and facilities that serve as cooling centers and taking other actions to help cities and counties throughout the state ensure the safety of their residents, but it’s important that every Californian who is able do the simple, but important things that can make the difference between life and death,” said California Emergency Management Agency (Cal EMA Secretary Mark Ghilarducci.

Key actions residents and visitors of California can take to reduce their risk of heat-related death and injury include:

• Monitoring local media for the latest weather forecasts and information from local officials
• Learning the signs of heat-related illness
• Staying out of the sun
• Drink plenty of liquids and reducing physical activity
• Using air conditioning and fans or getting to a location that is air conditioned such as the mall, the theater or a designated cooling center
• Using cool compresses, misting and baths to lower body temperatures
• Wearing lightweight, loose fitting clothing.
• Taking shelter and breaks periodically, as well as staying hydrated, if you must work outside.

The recommendations from state emergency and health officials come as state agencies implement the “Heat Alert” phase of the state’s Contingency Plan for Excessive Heat Emergencies. 

Actions taken by Cal EMA and other state agencies as part of the implementation of “Heat Alert” phase activities include:

• Coordination calls among Cal EMA, key state agencies and the potentially affected operational areas and regions with weather and power updates.
• Coordination by Cal EMA with the California Independent System Operator and the California Utilities Emergency Association for power updates.
• Dissemination of information related to the warming trend to key partners
• Coordination by Cal EMA of information requirements and needs with the Access and Functional Needs Community, the Department of Developmental Services, the Department of Aging and Department of Rehabilitation
• Dissemination of safety tips and resource information to the public via the Heat Portal of the Cal EMA website
• Coordination with state and regional public information officers by Cal EMA and outreach by Cal EMA to media partners
• Coordination by CDPH regarding the excessive heat event with local public health and other officials.

Additional information on preparing for heat-related emergencies is available at:

• http://www.calema.ca.gov/PlanningandPreparedness/Pages/Heat.aspx

• http://www.bepreparedcalifornia.ca.gov/beinformed/naturaldisasters/extremeheat/Pages/ExtremeHeat.aspx,
• http://www.dir.ca.gov/dosh/HeatIllnessInfo.html

By Mickey MacIntyre and Sean Crowley

Imagine your 90-year-old mother has Alzheimer’s disease and is near death. But before she became mentally incompetent, she gave you power of attorney to sign a Do Not Resuscitate (DNR) order so medical personnel would honor her wishes to die peacefully, without aggressive medical interventions in her final days.

Then your worst nightmare unfolds: your mother goes into cardiac arrest, and is subjected to the very treatment she had been determined to avoid: aggressive, traumatic Cardio Pulmonary Resuscitation, and other extreme measures, including having a hole cut in her throat, being injected with paralyzing drugs, having tubes forced down her throat and into her stomach, and having air forced into her lungs.

Two days after this aggressive, traumatic resuscitation, you are in the indescribably horrifying situation of having to direct that your mother’s ventilator be removed so she can finally die and her suffering end. But she lingers on in a slow decline for another five days while you maintain a heartbreaking, bedside vigil each day and night until she finally passes away. Then to add insult to injury, the hospital hands you a bill for this unwanted medical treatment totaling thousands of dollars.

Sound preposterous? Unfortunately, it’s not. It is Sharon Hallada’s real life, front page news nightmare.  It prompted the leading national organization dedicated to ensuring that medical professionals honor patients’ end-of-life choices, Compassion & Choices, to help Sharon file a lawsuit against a hospital and a nursing home in Lakeland, Florida, for failing to honor her mother’s wishes, despite the fact that they had been clearly and legally specified in the DNR. Sharon sued on behalf of her deceased mother, Marjorie Mangiaruca, to ensure no else’s parent has to endure this kind of traumatic experience.

In fact, medical professionals override or ignore many patients’ decisions in the weeks and months before their deaths. It happens for a variety of reasons and can lead to invasive and fruitless testing, needless suffering, unrelenting pain and a prolonging of the period before death. Patients are tethered to monitors and machines despite their determination to reject treatment and desire to die at home in the embrace of loved ones.

A recent study published in Journal of the American Medical Association found that between 2000 and 2009 treatment in intensive care units in the last month of life increased from 24 percent to 29 percent. The accompanying editorial concluded, “The focus appears to be on providing curative care in the acute hospital regardless of likelihood of benefit or preferences of patients. If programs aimed at reducing unnecessary care are to be successful, patients’ goals of care must be elicited and treatment options such as palliative and hospice care offered earlier in the process than is the current norm.”

To stop this disturbing trend, policy makers can and should provide both the carrot and the stick to ensure that patients’ wishes are honored: financial incentives for honoring advance directives and financial disincentives for disregarding patients’ expressed wishes.

The Centers for Medicare and Medicaid Services (CMS) should deny payment to providers when there is clear evidence that patients were subjected to  treatments they didn’t want — just as current policies deny payment when patients receive unnecessary treatment.

The Justice Department is investigating hospitals and doctors’ groups for unnecessary treatment and taking legal action against the perpetrators when they find evidence of such treatment. The same diligence should be trained on unwanted medical treatment. It is always unnecessary and should never be considered acceptable.

Compassion & Choices recently recommended CMS initiate several steps to improve the quality of conversations among health care professionals, patients and families about end-of-life decisions, including:

1.      Reimbursing medical providers for participation in advanced care planning with patients and their families well in advance of illness or before facing end of life;

2.      Providing financial incentives and training to encourage medical providers to offer all the information and counseling necessary for a patient’s decision making when they secure informed consent;

3.      Ensuring that the full range of medical care and treatment decisions, including curative care, palliative care and medical assistance in dying, are freely available to patients without institutional or reimbursement barriers.

Mickey MacIntyre is the Chief Program Officer for the nation’s leading end-of-life choice advocacy group, Compassion & Choices. He recently testified before the Institute of Medicine’s Committee on Transforming End-of-Life Care.

Residents are advised to stay cool, stay hydrated, and stay informed

San Bernardino: County Health Officer, Maxwell Ohikhuare, M.D. has issued an extreme heat alert for San Bernardino County, due to high temperature forecasts for the inland and desert regions. Residents are urged to take precautions that will prevent heat-related illness.

Extremely high or unusually hot temperatures can affect your health. Most vulnerable are the elderly, those who work or exercise outdoors, infants and children, the homeless or poor, and people with a chronic medical condition.

Take the necessary precautions to prevent serious health effects such as heat exhaustion or heat stroke.

Stay cool

• Stay in air-conditioned buildings.
• Find an air-conditioned Cooling Center open to the public by dialing the United Way’s toll-free resource telephone line at 2-1-1, or online at www.coolingsb.org.
• Do not rely on a fan as your primary cooling device.
• Limit outdoor activity, especially midday when it is the hottest part of the day, and avoid direct sunlight.
• Wear loose, lightweight, light-colored clothing.
• Take cool showers or baths to lower your body temperature.
• Check on at-risk friends, family and neighbors at least twice a day.

Stay hydrated

• Drink more than usual and don’t wait until you’re thirsty to drink.
• Drink from two to four cups of water every hour while working or exercising outside
• Avoid alcohol or liquids containing high amounts of sugar.
• Make sure your family, friends and neighbors are drinking enough water.

Stay informed

• Check your local news for extreme heat warnings and safety tips.
• Visit http://emergency.cdc.gov/disasters/extremeheat to find information and tips for preventing heat sickness.
• Sign up for free weather alerts to your phone or e-mail from websites such as www.weather.com/mobile. .
• Keep your friends, family and neighbors aware of weather and heat safety information.

  Additionally, the San Bernardino County Department of Public Health encourages all residents to learn the signs and first aid response for heat-related illness. Warning signs and symptoms vary but may include:

   

  
  

  Heat Exhaustion

  Symptoms

  • Heavy sweating
  • Weakness
  • Skin cold, pale, and clammy
  • Weak pulse
  • Fainting and vomiting

   

   

   

• Heat Stroke

  Symptoms

  • High body temperature (above103°F)
  • Hot, red, dry or moist skin
  • Rapid and strong pulse
  • Possible unconsciousness

Today, the U.S. Department of Education updated its College Affordability and Transparency Lists as part of the Administration’s ongoing effort to increase transparency around the cost of college. The updated lists highlight institutions with the highest tuition prices, highest net prices, and institutions whose costs are rising at the fastest rates.

“With so much information out there, it’s important that students and their families are equipped with the tools they need to make informed decisions about where to go to college,” said U.S. Secretary of Education Arne Duncan. “Everyone has a role to play in keeping college affordable, and these lists help consumers compare the costs of higher education institutions.”

The lists, available at the College Affordability and Transparency Center, are required by the Higher Education Opportunity Act of 2008 and released by the Department to make the costs of college more transparent for students and their families.

In 2011, the Department published the first set of College Affordability and Transparency Lists. Last year, the Department updated the lists to include newer information. Similar to previous releases, three of this year’s lists focus on tuition and fees, and three others look at the institution’s average net price, which is the average price of attendance that is paid by full-time, first-time students after grants and scholarships are taken into account. Those colleges and universities where prices are rising the fastest will report why costs have gone up and how the institution will address rising prices, and the Department will summarize these reports into a document that it will post online.

Of the approximately 7,500 Title IV participating institutions of higher education, there are 1,498 institutions included on these lists, and schools are allowed to appear on more than one of the lists.

In addition to the College Affordability and Transparency Lists, the Administration has also released other tools to help families as they pursue higher education. The College Scorecard and Financial Aid Shopping Sheet are two of the Administration’s latest resources that provide consumers with easy-to-understand information about institutions and affordability. These tools are all part of the Administration’s continued efforts to hold colleges accountable for cost, value, and quality so that students choose a students choose a schools that is well-suited to meet their needs, priced affordable, and is consistent with their education and career goals.

In response to several requests from consumers last year for more comparison data, the Department provided tuition and net price information for all institutions, broken out by sector in order to allow students to compare costs at similar types of schools. The comprehensive lists are provided this year as well.

Lists
Highest tuition and fees (top 5 percent)
Highest average net price (top 5 percent)
Lowest tuition and fees (bottom 10 percent)
Lowest average net price (bottom 10 percent)
Highest percentage increases in tuition and fees (top 5 percent)
Highest percentage increases in average net price (top 5 percent)
 

Sectors
4-year public
4-year private nonprofit
4-year private for-profit
2-year public
2-year private nonprofit
2-year private for-profit
Less-than-2-year public
Less-than-2-year private nonprofit
Less than-2-year private for-profit

Institutions report data on their tuition and fees and net price annually through the Department’s Integrated Postsecondary Education Data System (IPEDS). Additional updated data on individual schools is available on the Department’s College Navigator site. To view the lists, visit: http://collegecost.ed.gov/catc/Default.aspx.