Moran, Tester, Thune Introduce Bill to Preserve Rural Therapy Care

Moran, Tester, Thune Introduce Bill to Preserve Rural Therapy Care
-PARTS Act would protect rural Americans’ access to important health services-

John_Thune,_official_portrait,_111th_CongressWASHINGTON, D.C. – U.S. Sens. Jerry Moran (R-Kan.), Jon Tester (D-Mont.), and John Thune (R-S.D.) – members of the Senate Rural Health Caucus – today introduced S. 257, the Protecting Access to Rural Therapy Services (PARTS) Act. The legislation would ensure rural and other patients have access to a full range of outpatient therapeutic services in hospitals in their own communities. The senators introduced the PARTS Act last Congress (S. 1143).

“Requiring supervising physicians to be present for some outpatient therapy services places an unnecessary strain on the already overextended staff of rural health care facilities,” said Sen. Thune. “Further, this CMS requirement can place extraordinary demands on physicians, and it is these kinds of regulations that keep physician recruitment to rural areas challenging. I look forward to working with my colleagues in the Senate to move our common-sense legislation forward, ensuring we provide rural health care facilities in states like South Dakota with the flexibility needed to continue to deliver quality outpatient therapy services without being subjected to budget-busting workforce regulations.”

“Rural hospitals need reasonable flexibility to appropriately staff their facilities so they can provide a full range of services to their communities,” Sen. Moran said. “Many hospitals find the Centers for Medicare and Medicaid Services’ direct supervision requirements impossible to meet, which jeopardizes access to this important care. The PARTS Act would preserve patient safety and oversight while easing unreasonable supervision requirements for therapy care. This bill is crafted to make certain federal regulations reflect the realities of rural health care and address this issue on a permanent basis.”

“Rural families face unique health care hardships and they deserve access to quality care without being forced to travel long distances,” Sen. Tester said. “This bill removes burdens for rural patients, provides Critical Access Hospitals certainty, and upholds the standard of health care that rural Americans expect.”

“Outpatient therapeutic services” include services such as pulmonary rehabilitation, certain behavior health assessments and counseling, demonstration/evaluating the use of an inhaler or nebulizer, and certain casting/splinting procedures. Hospital outpatient therapeutic services have always been administered by licensed, skilled professionals under the overall direction of a physician. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) abruptly shifted policy to require that outpatient therapeutic services must be furnished under the “direct supervision” of a physician who is required to be physically present in the department at all times that Medicare beneficiaries receives these services. While CMS subsequently revised its standard to also permit direct supervision by certain qualified non-physician practitioners (NPPs), the agency still requires the physical presence of the supervising professional by mandating the supervisor be “immediately available” at all times these services are provided to beneficiaries.

While the need for this “direct supervision” is recognized for certain high risk, complex outpatient services, CMS’ policy often applies to even low risk services, such as some medication injections and minor wound debridement. For many years, these procedures have been safely administered in hospital outpatient departments under “general supervision,” a standard that permits services to be furnished under the general oversight and control of a supervising practitioner without requiring his or her physical presence. In fact, in December 2014 President Obama signed into law H.R. 4067 – legislation unanimously passed by Congress – that suspended enforcement of this CMS regulation on Critical Access Hospitals (CAHs) and other small rural hospitals in 2014.

The PARTS Act would:

  • Require CMS to allow a default setting of general supervision, rather than direct supervision, for outpatient therapeutic services;
  • Create an advisory panel to establish an exceptions process for risky and complex outpatient services;
  • Create a special rule for CAHs that recognizes their unique size and Medicare conditions of participation; and
  • Hold hospitals and CAHs harmless from civil or criminal action for failing to meet CMS’ current direct supervision policy for the period 2001 through 2016.

Click here to read the text of the bill.


Bosworth trial delayed. Time for more letters?

The Bosworth Trial will be delayed until May? NOOOOOOOO!

Good gosh, we’re going to be treated to another dozen letters, and three times as many missives from Gordon Howie how she should be let off.

From Tony Mangan at Today’s KCCR News:

Sioux Falls physician Annette Bosworth was scheduled to stand trial starting Monday in Hughes County Circuit Court. That trial has now been rescheduled for May 18-22.

Bosworth was a candidate in June Republican U.S. Senate primary. After the election, she was  indicted by a grand jury in June for six counts of offering false or forged instrument for filing and six counts of perjury.  The charges carry a maximum punishment of 24 years in prison and $48,000 in fines. 

Read it all here.

Where does common core fit into the puzzle brought by House Bill 1101? And could evolution be shown the door?

House Bill 1101 was introduced this week explicitly noting that the State Board of Education has no ability to require the use of a specifically designated curriculum.  And from a reading of the language, I have to wonder where people’s concerns over the common core curriculum fits into the puzzle, based on this legislation:


Introduced by: Representatives Sly and Partridge and Senators Rampelberg and Tieszen

FOR AN ACT ENTITLED, An Act to ensure local control over curriculum and methods of instruction.

Section 1. That § 13-1-12.1 be amended to read as follows:
13-1-12.1. The South Dakota Board of Education shall promulgate rules pursuant to chapter 1-26 to establish standards for the classification and accreditation of schools within this state, to establish standards for preparation of certified personnel, to set forth procedures for determining the eligibility of school districts to receive state foundation aid effective January 1, 1997, to adopt policies and rules necessary to establish standards and procedures for career and technical education and to establish curriculum requirements for a recommended high school program for all public and nonpublic schools within the state. The recommended high school program shall include a rigorous high school curriculum in both academic and career and technical courses. The requirements of the recommended program shall be aligned to the academic content standards developed pursuant to § 13-3-48 and shall, at a minimum, include the content standards tested pursuant to § 13-3-55.

    Nothing in this section authorizes the board to require the use of specifically designated curriculum or methods of instruction.

Follow the legislation here.

The addition to the law is the underlined section, noting “Nothing in this section authorizes the board to require the use of specifically designated curriculum or methods of instruction.”  But does it prevent it, if the school chooses to implement it?

And I have to speculate… if the State Board of Ed is unable to require the use of specifically designated curriculum, or methods of instruction, to what degree would school boards then have the ability to locally determine what is taught?

Could a local school board choose do adopt a science curriculum of creationism supplanting the teaching of evolution in the science classroom?

Congrats to Mrs. War College regarding Senate Commemoration 3

My long suffering wife, (greeted by some as Mrs War College) is the recipient of a nice honor from the South Dakota State Legislature for her work in Special Education as part of a group of State School Administrators recognized by their peer organization:

 A LEGISLATIVE COMMEMORATION, Commending and honoring the 2013-2014 Outstanding School Administrators of South Dakota, including Tim Mitchell, Rapid City, School Superintendent; Anita Stugelmeyer, Lemmon, School Business Official; John Decker, Watertown, Elementary School Principal; Brad Seamer, McCook Central, Secondary School Principal; Peggy Diekhoff, Todd County, Assistant Secondary School Principal; Kym Johnston, Lennox, Curriculum Director; Michelle Powers, Brookings, Director of Special Education; and Rhonda Gross, Arlington, Middle School Principal, for being named outstanding administrators by their respective administrator parent groups.

Read it all here.

Press Release: Gov. Daugaard Names Kim Malsam-Rysdon As Secretary Of Health

Gov. Daugaard Names Kim Malsam-Rysdon As Secretary Of Health

PIERRE, S.D. – Gov. Dennis Daugaard announced today that he will appoint Kim Malsam-Rysdon as Secretary of Health.

Malsam-Rysdon has held the position in an interim role since last month. She will replace Secretary Doneen Hollingsworth, who retired after nineteen years as secretary.

“Public health has never been more important as we see the need to respond to emerging issues such as Ebola and a recent outbreak of contagious diseases like measles”, said Gov. Daugaard. “Kim will not only be able to lead our state’s response to these issues but also ensure we are doing all we can to address chronic diseases and access to quality health care services across our state”.

Malsam-Rysdon will continue to serve as senior advisor to the Governor and as a member of the Governor’s Executive Committee. She previously served as Secretary of the Department of Social Services.

“I appreciate the ability to serve the state of South Dakota in this role and look forward to leading our state’s health department,” said Malsam-Rysdon. “Public health issues and access to health care are critical issues that impact individuals and families across South Dakota. I look forward to working with stakeholders throughout our state to address these needs.


Donald and Michael London Indicted by Brule County Grand Jury

Donald and Michael London Indicted by Brule County Grand Jury

PIERRE, S.D – Attorney General Marty Jackley and Brule County States Attorney David Natvig announced today that Donald G. London, 42, Kimball and Michael J. London, 66, Chamberlain, were indicted last week by a Brule County Grand Jury. Donald G. London was indicted on two counts of attempted first degree murder, class 2 felony, punishable by up to 25 years in the state penitentiary and/or

$50,000 fine and 3 counts of aggravated assault on law enforcement officer, class 2 felony, punishable by up to 25 years in the state penitentiary and/or $50,000 fine. With the Habitual Offender filing, Donald G. London faces up to faces up to fifty years imprisonment. Michael J. London was indicted on 2 counts of aiding and abetting aggravated assault on law enforcement officer, class 2 felony, punishable by up to 25 years in the state penitentiary and/or $50,000 fine and 1 count of accessory to crime, class 5 felony, punishable by up to 5 years in the state penitentiary and or $10,000 fine.

Charges stem from the armed standoff in Kimball, South Dakota on January 7, 2015. Arraignment is scheduled for January 27, 2015 at 1:30 p.m. at the Brule County Courthouse.

The case continues to be investigated by the Division of Criminal Investigation and is being prosecuted by the Brule County States Attorney’s Office and the Attorney General’s Office.



Dem’s minimum wage increase to benefit students causing service cuts for students.

Remember the minimum wage increase promoted by State Democrats and passed by voters? Democrats poo-poohed arguments that it mainly benefitted high school and college students who are working these low wage, part-time positions while they also go to school.

Well, here’s a real world example of exactly who the measure is hurting. In the January 14th edition of the SDSU Collegeian student newspaper, the top of the fold story is titled “New Minimum Wage Affects Union Hours”  and discusses how the SDSU Student Union has been forced to cut hours so as to remain on budget directly as a result of the minimum wage:

Students learned this week that the Union will close at 10 p.m. daily. This cuts two hours off of the former hours in order to adjust, for the minimum wage increase that went into effect Jan. 1 according to this week’s Monday morning message sent out by Students’ Association President, Caleb Finck.


In order to compensate for the minimum wage increase from $7.25 to $8.50 per hour, Novotny along with other administration, including the Student Union Advisory Committee, had to make changes in the facility, Novotny said The. changes need to compensate for a total of $30,000 in student labor.


If The Union goes back to closing at midnight next year, funding for the facility will have to increase. This money will most likely come from a General Activity Fee increase, meaning that students will have to pay more to keep the building open later.

Read it all here.

Cutting hours to remain on budget… and if they want those hours back, they’re going to face a general activity fee increase, pushing their tuition up higher.

Cuts in services and increased tuition fees. All I have to say is to remind them to remember who made this happen. The South Dakota Democrat Party.

It’s possible they wanted to elect Pressler to US Senate because the teacups haven’t been issued yet.

This is on eBay right now:


Here is a set of six footed water glasses made by Fostoria for US Senator Larry Pressler, Republican, who represented South Dakota from 1978 to 1996. He was defeated in ’96 by Democrat Tim Johnson who retired this year, and Pressler ran for Johnson’s seat as an independent. During his career he was regarded as an iconoclastic, somewhat quixotic, quirky Senator, certainly one of the more interesting members of Congress at the time.

The glassware was made by Fostoria, and is marked on the bottom of each glass, shown in a photo. They are heavy high quality glass engraved with the United States Senate seal and Larry Pressler’s signature on the side. They are 5 3/4″ tall and 3 1/4″ diameter across the top. They show no wear, and have no chips or hairlines. You are bidding on the entire set of six.

Included as a bonus is a 1993 booklet welcoming Senator Pressler’s visitors to Washington. It is 46 pages long, filled with general information to help visitors locate interesting things to do and see, and to find their way around DC and vicinity. The booklet is in near mint condition.

Read it here.

Remember the dishes issued by supermarkets, where they’d sell the plates one week, and a serving platter the next?

It’s entirely possible that someone wanted to elect Larry Pressler to the US Senate because the “Larry Pressler” teacups hadn’t been issued yet, and well, they needed that to complete their set.

At taxpayer expense.