Category: Jennifer Schultz
Connecticut to Revamp Pandemic Flu Strategy
WASHINGTON, Dec. 16– Scientists everywhere are breathing a sigh of relief: Pandemic flu is finally on the global agenda. But the task ahead is just as daunting, as health professionals and government officials prepare for an eventual outbreak. The states carry a particular burden, faced with a logistical nightmare and limited resources.
In the United States, state and local health departments are considered the nucleus for protecting and responding to a health crisis like a flu pandemic== an outbreak of the disease that affects large numbers of people simultaneously and is geographically widespread.
Their responsibilities range from monitoring for unusual sickness to creating emergency response plans to help treat sick residents and stop the spread of a disease outbreak. Leaders and health workers are expected to coordinate an efficient and effective plan to protect their community.
Connecticut health officials agree the main challenges they face are logistical – things like personnel shortages and being able to mass-distribute whatever treatments are available at the onset of a major health crisis.
The federal government, in the November release of its National Pandemic Influenza Preparedness Plan, acknowledged this weighty but essential state role.
Earlier this month, U.S. Health and Human Resources Secretary Mike Leavitt convened a meeting of senior state and homeland security officials to address pandemic planning. Leavitt chose strong language to underline the seriousness of the threat and noted that no one can predict when the next massive outbreak will strike.
The immediate fear concerns a deadly avian – or bird – virus, called H5N1, that continues to affect mostly birds but has also shown a rare capacity to kill people and other animals. Experts worry that the virus may acquire the ability, through genetic mutation, to pass easily from person to person.
“The reality is–and you know it – pandemics happen,” said Leavitt, who began a 50-state tour to meet with health and government officials after the meeting in Washington. “When it comes to a pandemic, we are overdue and we are under-prepared.”
While the federal move to action on planning for a health crisis of this magnitude is generally commended, some advocacy groups, including Trust for America’s Health, a nonprofit group that advocates for disease prevention, expressed concern about some aspects of the national plan that relate to state responsibilities.
“The Bush plan calls for states to spend $510 million for anti-flu drugs, which can reduce the severity of the flu,” read a statement released by the group. “However, earlier this year, the administration proposed a cut of $130 million in state and local public health preparedness.” While the national plan calls for $100 million to states to ramp up pandemic planning, the group said that “this sum does not even offset the previous proposed cut in funding.”
A recent report by the trust gave the federal government a grade of D+ on public health emergency preparedness. Many states did not fare much better in their evaluations. The study looked at such things as “capabilities to test for chemical and biological threats and hospital surge capacity to care for patients in a mass emergency.” Connecticut earned a score of 5 out of 10.
Connecticut has a pandemic action plan to guide emergency responders and other relevant groups, but it was created before Washington announced its national strategy. Most states, including Connecticut, are working to update their plans. Gov. M. Jodi Rell established a joint committee, drawing upon the efforts of four state agencies, to address this need. She asked the four agency heads to complete the State Plan for Influenza Preparedness and Response by next month.
The Connecticut plan is more strategic than operational, said Dr. James Hadler, the state epidemiologist and director of the infectious disease section of the Department of Public Health. “It outlines issues, responsibilities and methods we’d consider,” he wrote in an e-mail message. “We will be developing operational plans in the future – for example, how we’ll actually distribute vaccine and antivirals to healthcare providers who aren’t part of a larger healthcare system such as a hospital or community health center.”
One important update to the state plan, Hadler said, will identify priority groups that comply with federal recommendations to receive antiviral medications and vaccines. The national plan calls on states to first vaccinate health care workers who are directly exposed to patients.
Because of the uncertainties inherent in a flu pandemic, he emphasized that any emergency response plan must be flexible.
“For example, we don’t know if a pandemic strain will spread as quickly as regular influenza,” he said. “We don’t know how virulent it will be; we don’t know if it will preferentially affect one age group or another; and we don’t know how fast it will get to the U.S.”
He added: “All of these are relevant factors in determining an appropriate response at the time.”
One of the most outspoken congressional advocates for pandemic planning, Sen. Tom Harkin, D-Iowa, said that while the administration’s plan embraces the major components of a national strategy, its “greatest weakness is helping improve state and local health infrastructure.” He said states need to hire more epidemiologists, lab workers and emergency responders.
Harkin added that states could look into mobilizing nurses and other health care workers who are not currently active in the workforce.
He also reiterated a common theme among experts: It’s likely the public health system in its current state will be overwhelmed during a pandemic.
“This is not Chicken Little alarmism,” he said.
The flu presents a unique set of challenges. Each year around 36,000 Americans die from seasonal human flu, with children and elderly populations disproportionately affected. A pandemic flu is different from the seasonal flu in one critical way: it is a brand new virus to which humans have no prior immunity. This would probably enable the pandemic virus to affect a cross-section of the population, regardless of age or health.
Because a pandemic virus would spread quickly and incapacitate scores of people, emergency responders woulod be first in line to receive vaccinations and other treatments, according to the national plan.
That plan lays out a worst-case scenario, in which by week six of a pandemic, 722,000 Americans could be infected. The hypothetical outbreak would begin in a small Thai village, and by the 16 th week, 92 million Americans would be infected with the H5N1 bird flu.
According to health officials, vaccination is the bedrock for averting or at least minimizing the impact of a pandemic. President Bush in the national plan calls for $7.1 billion, in part to improve vaccine production. The current systems in place are riddled with obstacles that make development and production a slower process than necessary.
Doctors have advice for the general public too. They say to practice good hygiene – like washing hands and covering mouths when sneezing or coughing – and avoid putting others at risk if flu symptoms are present.
The states monitor flu activity, observing trends in patient reports and looking for atypical health threats. One primary way states conducts what is broadly called biosurveillance is by collecting regular reports from labs, hospitals and physicians on incidents of flu. The states, in turn, contribute to a national tracking system.
The federal Centers for Disease Control and Prevention calls on states in the event of a pandemic to establish a network of clinics to each treat several thousand patients for a limited number of days. According to Connecticut’s pandemic plan, 70 clinics are necessary to serve the entire population.
State health officials are also concerned about the process proposed in the national plan for states to obtain antiviral drugs, which help lessen symptoms after infection.
” I think most people in [the] states believe we shouldn’t be competing with each other to buy antivirals and have some states that are ‘haves’ and others that are ‘have nots,’ ” Hadler said. A fairer and more effective route, he said, would rely on a central federal purchaser. But he added, “It would make sense to have much of the stockpile pre-positioned in states.”
“Requiring each state to purchase antivirals separately does not make sense from a health perspective,” Trust for America’s Health said. “Germs don’t respect jurisdictional boundaries, and we must have the flexibility to provide the medication where outbreaks are most severe.”
Flu pandemics are recurring events. Past outbreaks have led to soaring levels of illness and death, and great social and economic disarray. The pandemic flu virus of 1918 killed 20 million to 50 million – possibly more – people worldwide. Two other pandemics struck later in the 20 th century. Furthermore, a second, though usually less severe, wave of infection usually follows after a lull in the first outbreak. Pandemic readiness plans typically take this into account.
There are three conditions a flu virus must meet to be defined as a pandemic. The H5N1 strain has met two: it is a novel virus and it causes severe illness. The third condition – ease of transmission between people – has not been achieved, and there is no way to know if it will. However, as long as it continues to infect people and birds it threatens to initiate a pandemic.
Experts expect H5N1 to spread to all corners of the world via migratory flocks and interstate trade. The United States, they say, is no exception.
Human cases are still rare, and attributed in almost all cases to direct contact with sick birds. The World Health Organization maintains an official Web site that tracks the number of human infections and deaths. As of Dec. 9, 137 cases of human infection were reported since the onset, with 70 cases ending fatally. Health officials are particularly worried about the high death rate and the types of people – a number of them young and healthy – attacked by the virus.
In more-acute cases, bird flu in people has caused symptoms like “acute respiratory distress, viral pneumonia and other severe and life-threatening complications,” according to the Centers for Disease Control and Prevention.
Scientists in Hong Kong said that H5N1 bird flu can cause “a ‘storm’ of immune system chemicals that overwhelms the patient,” Reuters reported. The chemicals can suddenly engulf infected lung tissue to the point where it can prove fatal for the patient.
It is this potential menace that prompted Secretary Leavitt to warn the 50 governors that “we are facing one of our most serious public health challenges. The threat of an outbreak of pandemic influenza is real.”
Childhood Obesity Trends in Connecticut Alarming
WASHINGTON, Nov. 16- A fourth of Connecticut's 6- to 17-year olds are considered overweight, while a conservative estimate puts the number of obese children at 12 percent of this age group, according to a new study released Wednesday.
The research project, from the University of Connecticut's Public Health Program, assembled data from more than 130 communities around the state.
Obesity, now considered an epidemic by the Centers for Disease Control and Prevention, is blamed for a host of physical, social and economic problems. In Connecticut, as with the nation, children in certain groups face a greater risk of becoming obese. Childhood obesity rates, for example, are higher in lower socioeconomic communities. Race and ethnicity are also factors, with African-American and Latino children more likely to be obese than white children.
At Diloreto Elementary School, school nurse Patty King can see the growing problem firsthand.
"Childhood obesity is getting more prevalent," she said. "Children are not exercising as much, they're not getting outside and playing as much."
In lower socioeconomic communities, she said, parents are more likely to opt for quick and less expensive meal options-which generally spell poor nutrition.
She worries that childhood obesity may follow the same trend as asthma, another chronic health condition afflicting children and adults at alarming rates. Instanes of asthma in the United States have doubled over the past decade, according to the Centers for Disease Control.
In the past three decades, data from the Centers show, the rate of childhood obesity nationwide has more than tripled for children 6 through 11; it has doubled for children 2 through 5 and 12 through 19.
Though Connecticut has cause for concern, the state has a lower childhood obesity rate than the national average.
With excess weight comes a greater risk of developing health problems. Obese children face an increased risk of developing Type 2 diabetes, hypertension and sleep disorders. They are more likely to be depressed and have low self-esteem. Among their peers and in society, they are faced with the stigma and negative stereotypes associated with being overweight. And obese children may be the targets of bullying and be marginalized in social settings.
"What we found the most startling is the severity of the problem, that is, the number of children suffering from adult diseases because they are obese or overweight," Luce Buhl, a graduate student who worked on the university study, said in a press release. For instance, obese children have an additional risk factor for heart disease, and they are more likely to experience bone and joint problems.
Children who are overweight are likely to carry the condition with them into adulthood. This creates a burden on the individual and the general public-which picks up a good chunk of the tab for obesity-related health care.
"In 2000, an estimated $117 billion was spent for health-related expenditures due to obesity, with direct costs accounting for an estimated $61 billion," according to a Government Accountability Office report requested by Sen. Christopher Dodd, D-Conn., and others. The report also says, "Nearly half of all medical spending related to adult obesity is financed by the public sector, through Medicaid and Medicare."
The obesity epidemic is a complex issue, and health officials differ over how exactly to combat the problem. Nutrition and physical activity are key determinants of weight and overall health. Genetics also play a role. But the university study confirmed what other national studies have found, that social and environmental circumstances may create obstacles for families in shopping for healthy food and providing a safe place outside for kids to play.
Twenty-five graduate students in the university's public health department were instructed a year ago to examine the issue of childhood obesity in Connecticut. Katie Zito, one of the student researchers, said the group was surprised to find out the state does not monitor obesity. After crunching numbers and partnering with 130 community organizations statewide for their research, they gathered what Zito called "a book's worth of information."
Zito said local and state officials will receive a copy of the report, along with the Public Health Department, which contributed to the study.
House Moderates Serve Blow to Arctic Oil Drilling
WASHINGTON, Nov. 10 - After last-minute maneuvering Wednesday night, House GOP leaders agreed to strike a clause from a sweeping multi-billion dollar budget-cutting bill that would allow for oil drilling offshore and in Alaska's Arctic National Wildlife Refuge.
The debate focuses on a 1.5 million acre section of the 19 million acre refuge. D rilling in the refuge is a key to President Bush's energy policy, and oil companies have been lobbying for years to secure the legislation, arguing that they can drill without spoiling the environment there. Opponents argue that the area should be left pristine.
Rep. Nancy Johnson, R-Conn., played an instrumental role in opposing Artic drilling. She was among the 26 House Republicans who warned GOP leaders they would vote against the budget bill if the oil drilling provision was not removed. Rep. Rob Simmons, R-Conn., and Rep. Christopher Shays, R-Conn., were also among the GOP rebels.
"We're very pleased with the Connecticut delegation on both sides," said John Calandrelli, Connecticut chapter coordinator for the Sierra Club, the nation's largest environmental group.
Calandrelli, who called Johnson's office Thursday morning to express gratitude for her leadership, said, "Everyone's wanting to pop champagne already." But, acknowledging what he calls "middle age skepticism," he said that Arctic drilling is an issue that's far from over.
Republican moderates were able to capitalize on all-out opposition by Democrats to the budget bill's proposed cuts in social programs, and the narrow margin of GOP control in the House. Even so, some analysts predict a backlash by the large majority of Republicans who back drilling.
After the House votes on the budget bill-which was expected as early as Thursday night-lawmakers from the Senate and House return to the negotiating table to hash out differences in their two versions of the bill. The Senate, for instance, narrowly passed the measure allowing for drilling in the refuge, also known by its acronym, ANWR, as a part of its budget package.
"The good news for us is the moderate position makes it unlikely that ANWR will sneak back in," Calandrelli said.
The Bush administration and backers of new oil drilling say it's necessary to lessen dependence on foreign oil. Other benefits, they argue, include job creation and big-time revenue.
Backers of drilling in the region say that between 6 and 16 billion barrels of usable oil exists in the area that would be used for drilling.
Calandrelli said Connecticut played a major role in the national boots-to-the-ground effort to halt the drilling measure. Environmentalists faced a big setback when it appeared in the budget-cutting bill. Connecticut residents, Calandrelli said, moved quickly to inundate lawmakers with letters of opposition.
" Democracy reared its ugly head again," he added with a laugh.
Rep. Johnson Donates Big to Pro-choice Republican Group
WASHINGTON, Nov. 2 -- On Capitol Hill, money is to politics what gasoline is to a car: You need one to fuel the other. That could explain why Fifth District Republican Rep. Nancy Johnson both rakes in the dough and generously doles it out through her two political action committees (commonly called PACs).
One of Johnson's PACs is Leadership Encouraging Excellence, or LEE, after her maiden name. Through LEE, Johnson garners funds for fellow Republicans and conservative interests. In the case of her longtime alliance with the group WISH List, she supports a network of Republicans whose mission is to fan out and shore up support for moderate female GOP challengers and endangered incumbents.
Well into the 2005-2006 fundraising cycle, Johnson is a leading donor to the Women in the Senate and House List, or WISH List, which helps finance Republican women who support abortion rights. Johnson's LEE PAC has given $5,000 to the WISH List, according to Federal Election Commission records. Since the 1997-98 election cycle, she has given at least $11,000, according to PoliticalMoneyLine.org, an independent campaign finance watchdog.
"Nancy believes strongly in electing more women and moderate Republicans to Congress, that their voices and leadership are key to our shared agenda for job creation, affordable health care, environmental protection and national security," said Johnson spokesman Brian Schubert.
Dubbing itself a "forward-thinking group of Republicans," the WISH List identifies female potential leaders in the party and then aids their runs for office with money and training resources. But it is also the largest fundraising alliance for Republican women candidates who support women's right to abortions.
"Our mission is to elect more pro-choice women at all levels," said WISH President Pat Carpenter. "Nancy [Johnson] is certainly supportive of that."
Carpenter called Johnson a "tremendous leader" for the organization's cause and, more broadly, a supporter of moderate Republicans.
Since the group was founded in 1992, there has been a four-fold increase in the number of abortion-rights Republican women in the Senate and a 50 percent increase in the House, according to its Web-site. The group argues it's no coincidence, but exactly how much influence the WISH List had in this development remains unclear.
One thing is clear: WISH has an impressive record of supporting candidates. During the 2003-04 election cycle, a majority of the 200 candidates WISH backed were elected.
In 1992, WISH helped elect a handful of prominent women, including Jennifer Dunn of Washington and Deborah Pryce of Ohio, past and current chairs of the House Republican Conference, the highest rank Republican women have reached in House GOP leadership. Another coup for the group occurred the following year when Christine Todd Whitman became New Jersey's first woman governor.
In 1994, WISH helped seat both of Maine's Republican Senators, Olympia Snowe and Susan Collins.
While the group spends considerable resources on recruiting and electing women, they also are active during tight election races to help incumbents, as was the case with Johnson in 1998.
Lawmakers who support WISH do so in a variety of ways, Carpenter said. Aside from monetary donations, they will, for example, appear at fundraising and awareness events.
Johnson serves on the WISH honorary advisory board, which is largely a symbolic honor for lawmakers who donate their time and money.
WISH has raised about $528,000 this year through Sept. 30, according to records filed with the Federal Election Commission. The bulk of donations came from individual donors, though PACs contribute a fair share. The group now routinely raises $1 million annually. For the current cycle, WISH is second only to the Democrat-leaning EMILY's List, upon which the WISH List was modeled, in raising the most funds for a political women's group, according to OpenSecrets.org, another independent group that tracks Washington transactions.
Flu Pandemic: “Risk for Near or Distant Future”
WASHINGTON, Oct. 13-The year was 1918. "A strange form of disease of epidemic character" had cropped up in Spain, according to press reports from Madrid. Within a year, between 20 and 50 million people worldwide had succumbed to what was later identified as flu. When the virus finally lost its strength the following year, half of the world's human population-around one billion people-had been affected.
Today experts generally agree another influenza pandemic is inevitable. It's more a question of when than if.
But, as Dr. Joseph Garner, who specializes in infectious disease at the New Britain General Hospital, points out, "This isn't 1918."
There have been significant medical and technological advances over the past century, Dr. Garner said, whereas the global community in 1918 had very limited means of preparing and treating a flu virus that came without warning.
The global healthcare community is closely monitoring a bird flu, called H5N1, that is circulating mostly within countries in Southeast Asia. Since 1997, the flu has been detected in at least 10 countries and led to the deaths of 60 people. Though transmission of the flu from birds to people remains extremely rare, the World Health Organization (WHO) has confirmed 117 human cases. It is believed that most if not all cases were the result of human contact with an infected bird.
"To assume it won't happen is dangerous," Dr. Garner said of a possible flu pandemic. But he emphasized that we are dealing with unknowns, and that a major outbreak could be an issue for "the near or distant future."
Officials are worried the virus will mutate in ways that make it highly contagious among humans. Since people have no previous immunity to this strain, a geographically widespread outbreak, or pandemic, could result, something both federal and state officials, including in Connecticut, have taken measures to address.
"Three times in this century we have experienced pandemic [flus] and they will come again," Michael Leavitt, secretary of Health and Human Services, told health officials during a recent four-nation tour through Asia, according to the department's Web site.
"Our preparations are not yet complete nor are they adequate," he said.
The last flu pandemic was in 1968. It was first detected in Hong Kong, according to the Centers for Disease Control and Prevention, and spread to the United States later that year. It caused an estimated 34,000 deaths nationwide. Only 11 years had passed since the previous flu pandemic, in 1957-58, this one originating in China, and responsible for about 70,000 deaths in the United States. Both pandemics were the result of human flu mixing with bird flu to create a new lethal virus.
The 1918 flu, known as the Spanish flu and by far the most catastrophic, killed more people within the shortest span of time than any other known epidemic in history.
Until last week, the 1918 virus also remained the most elusive to researchers. A team of scientists in the United States under the direction of Dr. Jeffery Taubenberger, of the Armed Forces Institute in Washington, and the CDC's Terrence Tumpey, determined the exact genetic makeup of the 1918 virus. From this they were able to confirm that the pandemic was caused by bird flu-not an assortment of human and bird flu like those that caused the 1957 and 1968 pandemics, according to the CDC Web site.
A development like this, said Dr. John Shanley, of the Infectious Disease Unit at Connecticut University Health Center, is added reason to believe the current bird flu "is something of serious concern." He has studied the flu for the past 25 years, and said the patterns of this strain have the most significant implications he has seen thus far.
Another discomforting characteristic of this bird flu, he said, is that more than half of people infected have died-60 total. Furthermore, the virus has infected the old and young, weak and strong alike. Dr. Shanley said this is proof of the flu's aggressive nature.
So what precautionary steps are being taken?
Shanley and Garner agree that the conventional hospital system would be completely overwhelmed by a pandemic. They said that quarantines might be ineffective based on the speed and force at which the virus spreads. Increased development and production of flu vaccines and treatments, Shanley said, are the best bet for avoiding or containing a pandemic.
At present, there is no vaccine for the bird flu. The U.S. government is testing a vaccine that, based on trial experiments, looks promising, according to Dr. Garner. A challenge, as always with flu vaccines, will be mass production and distribution.
"In the event of a pandemic, Connecticut would receive anti-virals through the Strategic National Stockpile," said Matt Cartter, coordinator of the epidemiology program at the state's Department of Public Health.
Since 1997, the department has developed the Connecticut Influenza Pandemic Preparedness Plan. The working plan is a guide for how governmental agencies and private organizations can combine efforts to minimize the consequences of a flu pandemic. There are two national plans currently available and a new plan is expected this month, Cartter said. Connecticut's draft plan will require additional revision to stay consistent with federal plans, he said.
The statewide plan calls on active healthcare professionals and emergency responders, but also draws upon a large group of qualified persons who have pledged to help in the case of a widespread emergency, such as a bioterror attack or flu outbreak. Dr. Shanley loosely compared the volunteer group to the military reserves. The volunteer group has conducted mock drills of potential emergencies, with a recent drill last year called "Top Down."
"We need to have anti-virals, we need to have vaccines, we need to have the capacity to deal with the American people and to tell them what's happening," Secretary Leavitt said in another recent meeting with public health officials. "We need state and local preparedness. Those are vital components to a comprehensive plan."
Pentagon to Reimburse Troops for Safety Equipment, at Urging of Dodd and Senate
WASHINGTON, Oct. 6-Only hours before the Senate spoke out unanimously on the subject, the Department of Defense announced a program to reimburse troops for safety equipment they purchased for the wars in Iraq and Afghanistan.
The Pentagon was more than seven months late. Congress ordered the reimbursement program nearly a year ago and required the Pentagon to institute the program by Feb. 25 of this year.
Senator Chris Dodd (D-Conn.) led the renewed call for action, introducing an amendment to a defense spending bill Wednesday afternoon that would shift authority on this issue away from Defense Secretary Donald Rumsfeld and into the hands of military unit commanders.
"The United States government has few higher priorities than the safety and well-being of U.S. troops deployed in harm's way," Dodd told the Senate. "In my view, that starts with equipping them with the gear they need to operate safely and successfully." He added: "We shouldn't have to introduce legislation for this to happen."
The new Pentagon guidelines allow reimbursement for helmets, ballistic eye protection, hydration systems, tactical vests and a variety of body armor. The maximum reimbursement is $1,100 and in most cases items become government property. To qualify, the purchase had to have occurred between Sept. 10, 2001, and Aug. 1, 2004.
But Dodd said this list is not sufficient, leaving off such things as additional Humvee armor and radios. He accused the Department of Defense of "dragging their feet" and called the list of reimbursement items one more example of that.
Dodd told the Senate about "Gordon," a Connecticut father who purchased equipment for his son fighting in Iraq.
"Gordon is a good American," Dodd said. "He is a former mayor of a small town in Connecticut and a Vietnam veteran. . A loyal Republican, Gordon is not looking for government handouts or to be challenging the president of the United States. He just wants his son to be safe. That is why last month he contacted the online store Diamond Back Tactical and ordered combat gear for his son totaling $683.36."
Undersecretary of Defense David S.C. Chu announced the guidelines on the same day the Senate unanimously passed Dodd's proposal. Pentagon officials had previously opposed the program, calling it "unmanageable" and "an open-ended financial burden."
Conn. Delegation Reacts to Nomination of Harriet Miers to Supreme Court
WASHINGTON, Oct. 5 -- Reaction on Capitol Hill to President Bush's nomination of Harriett Miers to the Supreme Court has been unusually mild, as lawmakers in both parties try to make sense of a nominee with no prior judicial experience.
It could be the calm before the storm. Though her accomplishments are well known, little is known about her personal views on hot-button topics like abortion and affirmative action. This lack of paper trail coupled with the likelihood that the White House will withhold documents that could cast light on her legal views-as they did with John Roberts-could foreshadow a resistance from both conservatives and liberals-groups from whom she has already received some sniping.
Though the nomination hearings have yet to begin, some legislators have already expressed support for Miers. Senate Minority Leader Harry Reid, D-Nev., called her "a very fine lawyer," and said her lack of judicial experience was "a plus, not a minus." Reid expressed delight that, like him, she was a trial lawyer. In fact, Reid had suggested to President Bush that he consider Miers for the position.
The Connecticut delegation has been more reserved in their initial reactions.
"Before this morning I knew nothing about Harriet Miers except her name and title," Sen. Joe Lieberman, D-Conn., said in a press release. "So I have a lot to learn before deciding whether or not to 'advise and consent' to her nomination to replace Justice Sandra Day O'Connor on the Supreme Court."
Sen. Chris Dodd, D-Conn., echoed similar sentiments. "Justice O'Connor was an independent, intelligent and fair jurist and the person who replaces her will play an important role in shaping the direction of the Supreme Court for years to come," he said in a press release. "I view the vote on a Supreme Court nominee as one of the most important votes I cast as a senator and as always will carefully examine Harriet Miers' background and temperament to determine whether she's qualified to serve on the highest court in the land."
Everyone seems to agree on one point: Miers is a remarkably accomplished individual. Friends and colleagues say she is a hard-worker and dedicated advocate. Blazing a trail for women in law, she helped crack open the male-dominated legal system in Texas, becoming the first woman to preside over the Texas bar association.
Miers and President Bush go way back. The relationship began when she served on his staff during his bid for Texas governor. She was his appointee to the Texas State Lottery Commission, then joined him in Washington, first as White House staff secretary, then as a deputy White House chief of staff and most recently as White House counsel.
Before signing on to Bush's team, Miers worked for a large Texas law firm, and was a Dallas city councilwoman. She received both her undergraduate and law degrees from Southern Methodist University.
If Miers joins the court, she will be the only current justice who has not served on a federal appeals court. But some of the most influential Supreme Court justices had no prior judicial experience either: John Marshall, Earl Warren, Louis D. Brandeis, Robert H. Jackson, Felix Frankfurter and William H. Rehnquist.
Lawmakers Say Trim Pork for Katrina Relief
WASHINGTON, Sept. 29 - The question of how to pay for Hurricane Katrina looms large over Congress. With a record budget deficit-$427 billion-and pressure to cut spending, some lawmakers are doing the unheard of: offering up their own pet transportation projects.
Costs associated with Katrina could soar to $200 billion or more, according to Republican leaders. Congress has already approved $62 billion in hurricane relief and promises more to come.
House Minority Leader Nancy Pelosi (D-Calif.) and Rep. Mike Pence (R-Ind.) said they are willing to give up money earmarked for projects in their states in the highway bill, signed into law in August.
Sen. Christopher Dodd (D-Conn.) said he might consider doing the same, but added: "You're not going to find the billions you want there. That's going to come by the president saying we're not going to eliminate the estate tax; that we're not going to make permanent the tax cuts of 2001; and by also, of course, looking at some of these other areas like the Iraq war and so forth--we need to reduce those costs."
Critics have called the highway bill "pork-filled," referring to the 6,371 state projects tacked on by lawmakers. Some projects are not very controversial. Moving a bridge project and renaming it after yourself for a whopping $231.4 million, as Rep. Don Young (R-Alaska) did, is a different story.
"The most egregious ones are obviously the ones that have been widely reported," Dodd said.
Citizens Against Government Waste, a fiscal watchdog group, called foul on the highway bill. "The highway bill is a fiscal car wreck," President Tom Schatz said in a press release. "The sweet smell of pork has blinded members of Congress to the waste and inefficiency of federal transportation policy."
The highway bill will cost $286 billion, with $24 billion for member-designated projects. Connecticut will receive $2.5 billion-a 19 percent jump from the previous highway bill-over the next five years, for such projects as widening I-95 east of New Haven ($7.5 million) and replacing the Pearl Harbor Memorial Bridge ($10 million).
Changes Scheduled in Social Security Disability Benefits
WASHINGTON, Sept. 28- Sweeping changes could be in the pipeline for disabled persons seeking Social Security benefits under legislation aimed at improving the process for determining who qualifies for aid.
"I did not assume the position of commissioner of Social Security to manage the status quo," Jo Anne Barnhart, who brought the proposed changes to the Hill, told the House ways and means committee on Monday.
Developing the proposal has been a meticulous two-year process. Barnhart has attended more than 123 meetings, many with disability advocates and other interested groups. She also consulted legal and medical professionals and Social Security agency employees. A Web site, with a comment section available until Oct. 25, was set up to allow public participation in the process. So far, more than 800 individuals have chimed in with their two cents.
Representative Nancy Johnson (R-CT), who sits on the ways and means committee, believes "there should be fair, accurate and timely disability determinations," said Brian Schubert, her spokesman. "She is pleased the commissioner has made this issue a priority."
The most significant changes under consideration seek to streamline the determination process. Barnhart said the new process would be more transparent and holds officials to a higher standard of accountability. Gaps in the system that allow for overpayment and fraud should tighten, she said. Among the recommendations:
Establish a quick disability determination process for the obviously disabled, with claims going directly to special units at the state level.
Create federal expert units to provide specialized medical and vocational advice to improve determinations.
Establish federal reviewing officials to review State agency determinations at the request of claimants.
• Require administrative law judges to provide a written rationale for their decisions; Barnhart said claimants currently receive an up-or-down "boilerplate" determination.
• Move the Social Security Administration from paper to an electronic file system to improve accuracy and efficiency in the determination process as well as improve distribution of benefits-especially in widespread crisis situations, according to Barnhart.
But some critics worry that streamlining would remove important safeguards for claimants. "We strongly support changes to the process so long as they do not affect the fairness of the procedures used to determine a claimant's entitlement to benefits,"Thomas Sutton, president of the National Organization of Social Security Claimants' Representatives, told the committee.
Some changes are positive, Sutton said, but others may "elevate speed of adjudication above accuracy of decision-making."
Changes to time limits were another point of contention. For example, the new program would require a claimant to submit evidence at least 20 days before a hearing. Evidence submitted after this deadline would be included at the discretion of an administrative law judge.
"Closing the record before the hearing is inconsistent with the Social Security Act," Sutton argued. The law affords claimants the right to a decision based on evidence presented at the hearing, he said. Under current regulations, claimants may submit new evidence at the hearing.
If the proposed rules changes are adopted, one of the 10 Social Security Administration regions would be chosen as a pilot site. Reforms would then be phased in by region, Barnhart said. This would allow the administration to easily monitor progress and make changes, she said. But that means benefits would probably not reach all regions for several years. Barnhart said that next April would be a feasible starting date.
