By Liv Osby

Stimulus money to the tune of $5.6 million was awarded to Health Sciences South Carolina with a goal of getting 1,000 primary care doctors in the state to adopt the new electronic medical records system.

The funds will be used to set up a regional program called the Center for Information Technology Implementation Assistance. HSSC worked with the state Department of Health and Human Services to develop a statewide strategy for forging ahead with EMR.

“CITIA-SC will play a key role in supporting medical professionals throughout the state as they adopt and expand health information technologies in their practices,” said DHHS Director Emma Forkner.

DHHS spokesman Jeff Stensland said the University of South Carolina estimates about 60 percent of physician practices and 42 percent of hospitals have fully-integrated EMRs.

DHHS recently got a $9 million grant for its statewide health information exchange, which gives hospitals, doctors, clinics and other health care providers access to medical records.

HSSC is a partnership between universities and hospitals in the state to foster economic growth and improve health.

Above article publish on http://www.greenvilleonline.com/article/20100426/NEWS/304260003/1004/NEWS01/Medical-records-system-benefits–from-stimulus-funds-

By, Bernie Monegain

BETHESDA, MD – Investments in community health centers that provide care for about 15 million people who are poor, underserved and uninsured have helped expand the services, according to new research. The funds sometimes also give technology a boost.

The authors of the new study, published in the February 2010 edition of the journal Health Affairs estimate that a $500,000 increase in grant support for all centers would provide treatment for an additional 500,000 uninsured patients. The study does not mention the use of healthcare information technology in expanding services. But several community centers have either built their own in-house electronic health record or installed one that is commercially available.

Two of the 2009 Davies Award winners given by the Healthcare Information and Management Systems Society - Urban Health Plan and Heart of Texas - are community health centers that have employed EHRs to improve care delivery.

Urban Health Plan operates 13 sites in the South Bronx and Queens boroughs in New York. It rolled out its health record in 2006, and CEO Paloma Hernandez says the EHR has helped transform healthcare delivery and helped eliminate healthcare disparities in the communities the centers serve.

The authors of the new study say that their findings bode well for effective use of the more than $2 billion in funds provided to community health centers under the American Recovery and Reinvestment Act (ARRA).

The stimulus funding was the largest one-time investment in the centers in their history - and this study shows that in previous years, the centers used such investments to increase the care provided to low-income or underserved patients.

“Community health centers play a vital role in providing primary care and other services to those who cannot afford it or cannot access care,” says lead author Anthony Lo Sasso, a researcher at the University of Illinois at Chicago School of Public Health. “They are an investment that pays off for patients and the nation as a whole.”

Researchers examined investments and their effects on care in 1996-2006 from federal, state and local or private sources in so-called federally qualified community health centers. These are “safety net” providers such as community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless that meet federal criteria for receiving funding. Federal grants to federally qualified community health centers, for example, have grown from roughly $550 million in 1990 to nearly $2 billion in 2007.

The study authors found that these and other public dollars helped increase all services, especially mental health and substance abuse treatment and counseling.

The authors predict that an additional $500,000 in federal grants to federally qualified health clinics would help provide $135,000 worth of free or discounted care and could translate into 540 more uninsured patients who receive treatment. If federally qualified health centers leveraged their federal grant support to gain additional state, local, and private grant dollars, this could lead to higher levels of service and more care for the uninsured, the researchers conclude.

The health policy journal Health Affairs is published by Project HOPE.

Above article publish on http://www.healthcareitnews.com/news/stimulus-could-boost-technology-care-safety-net-centers

By Neil Versel,

Until HHS officially publishes proposed regulations near the end of this year, Dr. David Blumenthal can’t talk publicly yet about what “meaningful use” EMRs will look like, but the national coordinator for health information technology continues to discuss his vision for various components of federal health IT policy. His latest, communicated in an open letter released Thursday, is about health information exchange and what the Health Information Technology for Economic and Clinical Health (HITECH) Act–the health IT portion of the American Recovery and Reinvestment Act–says about the subject.

“A key premise: information should follow the patient, and artificial obstacles–technical, business related, bureaucratic–should not get in the way,” Blumenthal writes. “Exchange within business groups will not be sufficient–the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies’ vital needs.”

Blumenthal noted that the HITECH Act is specific about eliminating commercial, economic and technical barriers to health information exchange and that it provides “building blocks” for HIE across state lines, partly in the form of $564 million in grant money. He said that HHS will begin awarding grants this winter.

Blumenthal also promised another letter about strengthening privacy and security safeguards for personal health information. He is due to address the American Medical Informatics Association’s annual symposium in San Francisco Monday afternoon. FierceHealthIT will be there to cover the speech.

Above article published on http://www.fiercehealthit.com/story/blumenthal-stimulus-provides-strong-foundation-hie/2009-11-16

By John Moore

New York State has awarded about $60 million in grants for localized health information technology projects, one of three rounds of grants recently issued under the state’s Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) initiative.

Gov. David Paterson announced grants totaling $436 million on Sept. 25. In addition to health IT, the grants will fund collaborative projects among hospitals and improvements to long-term care.

The state will allocate the funds through its Department of Health and the Dormitory Authority of the State of New York.

The health IT portion of the grants, HEAL NY Phase 10, targets community-based projects focused on information sharing. Examples include a $6.7 million grant to the Fort Drum Regional Health Planning Organization to help launch electronic health records and health information exchange to “improve coordination of care for adult patients with chronic pulmonary disease,” according to the health department.

HEAL NY Phase 11, meanwhile, provides more than $174 million in grants that aim to promote collaborative arrangements among hospitals in an effort to boost the quality and efficiency of care delivery. In HEAL NY Phase 12, more than $172 million in grants will be issued to 19 applicants for long-term care related projects.

Above article published on

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$1.2 Billion Slated for HITECH Priority Grant Programs

By News Staff

Nearly $1.2 billion soon will be available to help the nation’s hospitals, physicians and other health care professionals purchase and use electronic health records, or EHRs, according to an Aug. 20 announcement from Vice President Joe Biden. Money from the Health Information Technology for Economic and Clinical Health, or HITECH, Act priority grant programs, which are funded by the American Recovery and Reinvestment Act of 2009, will start flowing in 2010.

“With electronic health records, we are making health care safer, we’re making it more efficient, we’re making you healthier, and we’re saving money along the way,” said Biden in the announcement. “These are four necessities we need for health care in the 21st century.”

The money will be divided between two programs.

• $598 million has been set aside to establish the Health Information Technology Extension Program, which will allow about 70 health IT regional extension centers to offer technical assistance and guidance to support health care professionals using EHRs.
• $564 million will fund the State Health Information Exchange Cooperative Agreement Program, an initiative designed to help states and other entities establish health information exchange capacity among hospitals and health care professionals.

According to David Blumenthal, M.D., M.P.P., the national coordinator for health IT, the rollout of the programs “represents a critical step forward in laying the groundwork for meaningful use of EHRs.”

“Together, the grants will offer much-needed local and regional assistance and technical support to providers while enabling coordination and alignment within and among states, ultimately allowing information to follow patients anywhere within the health care system,” Blumenthal said in an Aug. 20 update e-mailed to health IT stakeholders and posted on the HHS Web site.

Information about the HITECH priority grants program and application requirements is available online from HHS

Above article published on

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By Adriel Bettelheim

President Obama plans to huddle with his Cabinet and top advisers on Friday and Saturday to review lessons learned from his first six months in office. There’s bound to be some gnashing of teeth over the pace of the health care overhaul, and also some satisfaction over signs the economy is staggering back.

But based on his remarks at Wednesday’s town halls in Raleigh, N.C. and Bristol, Va., don’t expect a major recalibration of the administration’s message.

Obama continued to strenuously defend economic relief efforts launched in the aftermath of last fall’s financial crisis and lay some blame at the feet of former President George W. Bush. And he eagerly portrayed himself as a responsible steward of taxpayers’ money, to deflect persistent Republican charges that he’s incapable of controlling federal spending.

“I know that some critics in Washington think we’ve been slow to get these projects started,” Obama said in Raleigh, referring to work funded by the $787 billion economic stimulus package (PL 111-5). “They are saying we should have broken ground on all our highway projects on the first day. But everyone knows that’s impossible, especially because I wanted to be sure we did our homework and invested tax dollars only in those projects that actually created new jobs and jumpstarted our economy.”

Speaking in a state where the jobless rate is 11 percent, Obama said while there’s still much work left to be done to assure a complete recovery, “there is little debate that these steps, taken together, have helped stop our economic freefall.”

Obama also fired back at critics who blame him for running up the federal deficit, saying he inherited a $1.3 trillion shortfall. Without mentioning Bush by name, Obama said the staggering deficit was “a debt that is partially a result of two tax cuts that went primarily to the wealthiest few and a Medicare drug program, none of which was paid for.”

Finally, Obama continued to subtly recalibrate his health care message, casting the debate as one that revolves around curbing insurance companies’ less-savory business practices.

He outlined a series of consumer-protection measures aimed at preventing health plans from denying coverage to individuals who have preexisting medical conditions, dropping coverage for individuals who become seriously ill or charging unlimited out-of-pocket expenses. He also said the health overhaul would force the plans to pay for preventive care and routine checkups and remove arbitrary caps on the amount of coverage individuals can receive in a given year or in a lifetime.

Of course, many of these proposals aren’t major sticking points in the current debate. But talk about contentious stuff like public insurance options and how to pay for the overhaul should probably best be left to staff retreats and closed-door negotiating sessions on Capitol Hill.

Above article published on

http://blogs.cqpolitics.com/balance_of_power/2009/07/
obama-defends-stimulus-health.html

By JOHN MILBURN The Associated Press

TOPEKA | U.S. Labor Secretary Hilda Solis said Tuesday that $220 million in federal stimulus funds will be disbursed to programs across the country to train workers in health care and other high-growth industries.

Tuesday was the first day that training programs could begin applying for the money through the Labor Department. Solis unveiled the plan during a tour of the Shawnee County Community Health Care Clinic in Topeka and the University of Kansas Medical Center in Kansas City, Kan., saying health care services would be one of the fastest-growing career fields over the next decade as the population ages.

“We know there’s a shortage,” Solis said after touring the clinic.

She devoted much of her remarks to health care and President Barack Obama’s desire to push a health care reform bill through Congress this summer. She said such training grants were part of the equation, helping to provide an adequate work force to meet demands in rural states and areas seeing high unemployment.

Solis said $25 million of the funds would be reserved for training in communities hurt by the recent restructuring of the auto industry.

The stimulus money will go to public entities and private nonprofit groups that train workers in health information technology, nursing, long-term care and allied health careers.

Solis said she didn’t know how many potential jobs could be created from the grants. But she said she hoped they would encourage private donors and foundations to match the dollars.

“This is a first down payment,” she said.

The Shawnee County health center in Topeka, which would be eligible for the aid, is home to the public clinic and county health department. It has a staff of 179 and treated nearly 7,000 clients in 2008, including many without health insurance.

The Labor Department will begin taking applications for the stimulus funds Tuesday.

Solis said reviews of applications would begin within two months and grants would be awarded by year’s end. She said applications that build on existing collaborations, such as programs through community colleges or technical schools, would be looked upon favorably.

The program targets people like Clayton Bledsoe, 40, a former quarry worker who began nursing training in 2006 when the economy began to sour. Solis pointed to Bledsoe, who took courses through Neosho County Community College in eastern Kansas and eventually earned his registered nursing degree, as an example of the type of retrained workers the program hopes to create.

Bledsoe works with geriatric patients at Anderson County Hospital in Garnett, about 50 miles south of Topeka.

He wanted to enter a field where “I wouldn’t have to worry about looking to find a job again,” Bledsoe said.

During her visit to the Kansas City medical center, Solis met with medical students who said they intended to return to their rural hometowns to practice after graduation. She also viewed a telemedicine demonstration, in which doctors in Kansas City used Web cameras to interact with and diagnose patients in remote areas of the state.

Solis said she hopes the grants boost such programs, as rural areas are especially hard-hit by a shortage of health care workers.

Above article published on

http://www.kansascity.com/news/breaking_news/story/1338645.html

As President Refocuses on Domestic Agenda, Criticism of His Plans Grows Louder

By JAKE TAPPER and HUMA KHAN

Back from his overseas trip, President Barack Obama returns his focus to health care and the stimulus package, as the two issues face mounting criticism.

The president faces a number of hurdles in his push for health care changes, as the effort has gone from platitudes and rhetoric to cold, hard legislation, with tough choices on how the program will be paid for, or whether it will include a public, government-run health insurance plan. Obama wants to see health care legislation pass through both the House and Senate before the August recess, but Republicans, and even some Democrats, say that is unlikely.

The president today had stern words for those critics.

“It’s the same Washington thinking that has ignored big challenges and put off tough decisions for decades. And it is precisely that kind of small thinking that has led us into the current predicament,” Obama said while announcing Dr. Regina Benjamin as his pick for U.S. Surgeon General. “So make no mistake. The status quo on health care is no longer an option for the United States of America.”

“We are going to get this done. Inaction is not an option. And for those naysayers and cynics who think that this is not going to happen, don’t bet against us,” he said. “I understand people are a little nervous and a little scared about making change. … The muscles in this town to bring about big changes are a little atrophied, but we’re whipping folks back into shape.”

Critics of the president’s plan take issue with costs and the idea of a government-run health insurance plan.

“Republicans very much want reform but not on the backs of the American people with the kind of taxes and potential rationing of care that would result,” said Sen. Jon Kyl, R-Ariz, on “This Week With George Stephanopoulos.” “There is no chance that it’s going to be done by August. President Obama was right about one thing. He said if it’s not done quickly, it won’t be done at all. Why did he say that? Because the longer it hangs out there, the more the American people are skeptical, anxious, and even in opposition to it.”

But administration officials say the president is hopeful and sees the finish line in a chance to revamp health care for the first time in modern history. At a news conference marking the end of the G-8 Summit in Italy, the president resonated that optimism.

“We’re closer to that significant reform than at any time in recent history,” he said when asked to refocus on his domestic agenda at the speech in L’Aquila, Italy. “That doesn’t make it easy. It’s hard. But I’m confident that we’re going to get it done.”

When questioned whether it is a do-or-die before Congress breaks in August, Obama said, “I never believe anything is do-or-die. But I really want to get it done by the August recess.”

The bill faces resistance even from some conservative Democrats in Congress on who would pay for it.

Today, the president argued that his plan would not add to the deficit over the next decade, though Congressional Budget Office estimates of different congressional proposals have put the various price tags at close to a trillion dollars or more. Obama also repeated the promise that those making $250,000 a year or less would not pay more in taxes.

There is also heated debate about whether there should be a public-option plan, which would entail a government-run insurance program to compete with the private industry. Democrats like House Speaker Nancy Pelosi, D-Calif., have said that any plan going through Congress will have some form of public option, but Republicans argue that it will stifle the private market and dent competition.

As he takes his stimulus and health care push to Warren, Mich., Tuesday, the president is likely to push lawmakers to come together around a set of common principles and press them to find ways to compromise on key issues and put a system in place that would strip inefficiencies and help small businesses and families.

Heated Battle on the Stimulus

The president’s stimulus plan is also drawing the ire of some Republicans.

In an op-ed in the Washington Post Sunday, the president defended his $787 billion stimulus plan from concerns and criticism that it has been ineffective, asking Americans to be patient.

“The American Recovery and Reinvestment Act was not expected to restore the economy to full health on its own but to provide the boost necessary to stop the free fall,” Obama wrote. “So far, it has done that. It was, from the start, a two-year program, and it will steadily save and create jobs as it ramps up over this summer and fall.”

Administration officials point to the roughly $100 billion that has been invested in infrastructure projects and tax cuts, and say that the bulk of the stimulus spending will occur in the next 12 months.

But some Republicans say the stimulus plan has failed to work the way it was intended.

There is also the issue of expectations. Asked by ABC News how Americans should measure whether his economic plans are correct, the president said, “My initial measure of success is creating or saving 4 million jobs.”

But unemployment is a lagging economic indicator, meaning job growth will likely be one of the last parts of the recovery to start working. With unemployment rising to nearly 10 percent, critics say the stimulus hasn’t begun to save or create 4 million jobs.

“I think it’s now acknowledged, it hasn’t done what it set out to do,” Kyl said.

“All governors like ‘free money’ coming to the state. My governor is no different. But the reality is that it has added to our deficit. … It promised to … save 4 million jobs. We’ve now lost another 2 million jobs. The reality is it hasn’t helped yet.”

Critics are not buying the president’s argument that the economic situation could be worse without the recovery package.

“We’re finding out only 10 percent of the money has been spent, a lot of it has been on ridiculous projects,” Sen. John McCain, R-Ariz., said on NBC’s “Meet The Press” Sunday. “It included tax cuts, but a lot of them were in the wrong direction. … So what they promised us would be the result of this stimulus in a short-term has turned out not to be true.”

Talk of a second stimulus — which some Democratic lawmakers support — has elicited an even harsher response from the GOP.

“I think it’s a dumb idea, I think it will not work,” the ranking Republican on the Senate Banking Committee, Sen. Richard Shelby, R-Ala, told Fox News. “I know a second stimulus would be a mistake because we’re going to borrow that money. And it won’t turn the economy around. A lot of things will turn the economy around, but I don’t believe the stimulus will.”

But, despite the criticism, the president and his team argue that jobs are the last thing that will improve in this economy and cite improvements in the housing and credit markets as signs of progress.

“We must let it work the way it’s supposed to, with the understanding that, in any recession, unemployment tends to recover more slowly than other measures of economic activity,” Obama wrote in the Washington Post op-ed.

His supporters echo that optimism, saying that job creation is likely to accelerate as more stimulus money is spent.

“This is not a four-month plan, this is a two-year plan,” Sen. Charles Schumer, D-N.Y, said on “Meet The Press” Sunday. When you have such an awful situation, the worst economy that we’ve had in December, the president hamstrung because the usual tools of getting us out of a recession were lowering interest rates but interest rates were already at 1 percent, you need a strong, long-term plan that has a number of phases.

“Now you’re going to see the second part of the stimulus, which is the job creation part, really kick in.”

The president’s Council of Economic Advisers released a report today detailing how the U.S. labor market is expected to grow and develop in the next few years. Per the report, the expansion in the health care and environment-related sectors will likely create more employment opportunities. It also notes the impact the stimulus has had on construction and manufacturing markets, with a rebound expected as money from the stimulus is distributed.

Above article published on

http://abcnews.go.com/Politics/Story?id=8068326&page=2

More than 50% of healthcare providers surveyed by IVANS do not believe the federal stimulus package will successfully encourage health IT adoption.

By Marianne Kolbasuk McGee InformationWeek

Although a majority of healthcare providers remain skeptical about how they’ll benefit by the federal government’s $20 billion stimulus program, many plan to forge ahead anyway, according to a report released this week.

About seven in 10 healthcare providers believe electronic medical records will have a positive impact on their businesses and patient care, but 80% say the lack of money is their biggest obstacle to deploying health IT systems, said the new report by IVANS, a supplier of EDI and network services to the insurance industry.

The nationwide, e-mailed survey of 508 healthcare providers — including hospitals, clinics, private medical practices, nursing homes, home healthcare organizations and medical billing companies — found that while nearly 40% plan to forge ahead with e-medical record deployments within the next 12 months, more than 50% of healthcare providers do not believe the federal stimulus package will successfully encourage health IT adoption.

Healthcare providers’ doubt appears to be rooted to several factor, most notably uncertainty about the specifics of the government’s eligibility requirements for receiving HIT-related rewards. Starting in 2011, the federal government is expected to begin awarding approximately $20 billion over the next five years, rewarding higher Medicare and Medicaid reimbursements to doctors and hospitals that demonstrate “meaningful use” of health IT.

However, the details of what will constitute “meaningful use” haven’t been worked out yet. The federal government is in the process of investigating and defining the scope of what “meaningful use” of health IT will qualify for the American Recovery and Reinvestment Act of 2009’s HITECH (Health Information Technology for Economic and Clinical Health) stimulus funding incentives. Just this week, a federal advisory panel — the HIT Policy Committee — unveiled some of its recommendations for the “meaningful use” definition.

“They’re on the right track,” said Clare DeNicola, IVANS CEO, of the HIT Policy Committee’s recommendation so far to the U.S. Dept. of Health and Human Services about the “meaningful use” definition. “It’s not about technology, it’s about the care — we can’t lose sight of that,” she said about the committee’s suggestions for how IT can be used for improving quality of patient care and public health.

Also fueling uncertainty among healthcare providers participating in the survey was this: Home healthcare providers and nursing homes were among the 508, healthcare providers polled. However, so far the HITECH federal stimulus legislations is vague on how those healthcare providers will participate in the new programs, despite the growing population of aging baby boomers who’ll likely increasingly require their services in coming years.

In fact, despite their skepticism and uncertainly about the government incentive programs, about four in 10 healthcare providers are planning to implement e-medical record systems over the next 12 months.

Many are already making investments in IT, including those that can help support e-medical record deployments, including wireless networks, business continuity technologies and connectivity to remote locations.

“Healthcare providers are wary but they are moving forward with technology innovations,” said DeNicola. “They’re not driven so much by the stimulus funds as they are in their belief that these technologies can help improve their businesses and patient care,” she said.

Finally, when survey participants were asked who should take the lead on driving adoption of healthcare IT to ensure its success, 47% of healthcare providers named themselves; 21% suggested the government should lead; 14% said healthcare insurers/payers should have that responsibility; and 18% were divided between industry associations and consumers leading the charge, according to the report.

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By KRISTEN WYATT
ASSOCIATED PRESS WRITER

COLORADO SPRINGS, Colo. — Homeless teenagers at a central Colorado shelter are feeling the effect of the government’s economic stimulus package. It’s the feeling of a dentist’s drill.

The 20 runaway youths living at the Urban Peak shelter had no regular dental care until this spring, when a $1.3 million stimulus grant to a community health center paid for a mobile dental and medical clinic to visit once a month. The residents now get medical and dental screenings, and cavities filled, right from their shelter’s parking lot.

“I knew my teeth needed to be fixed but I had no money,” says Michelle Daulton, 18, who has been living at the shelter for about four months and hadn’t seen a dentist since she was 13.

Now she’s had three chipped teeth repaired. “It was absolute and pure relief, I mean that,” she said.

From the Colorado homeless shelter to rural Pennsylvania clinics that can accept new patients, health centers that serve the poor are among the first places the federal stimulus package is being spent.

The stimulus law sets aside $2.5 billion for free and low-cost health clinics, and a big chunk of it - about $500 million - is already being spent. The White House has promised another burst of money this summer.

“This has really been a boost for us,” said Bob DeFelice, CEO of First Choice Community Health Care. “It’s allowed a level of stability in some very difficult times.” DeFelice’s group runs nine community health clinics around Albuquerque, N.M., and used a $703,000 grant to hire two physicians and four support staffers.

Health clinic executives say the money will allow them to keep their doors open as the rolls of uninsured patients grow. An estimated 64 million people use rural health clinics, a number that is expected to rise as people lose their jobs and health insurance.

“We’re seeing more and more people,” said Edward Michael, president of the Rural Health Corp. in Wilkes-Barre, Pa. The six-clinic group in northeastern Pennsylvania had no room for new patients until it received a $311,000 grant in April. Now, Michael says, his clinics can expand from seeing 18,000 patients last year to 19,000 this year.

“You know, we weren’t there back in the Depression, so we never experienced being back in the ’30s standing in line for food, standing in line for a doctor,” Michael said. “This money is really going to prevent a lot of long-term hardship.”

The health clinic grants are one-time boosts, not long term health care fixes. The stimulus won’t make up for a lack of doctors in poor and rural areas, a shortage the Association of American Medical Colleges says is growing and could reach 159,000 doctors by 2025.

“I look at the stimulus bill as one step to health care reform,” said Maggie Elehwany, vice president for government affairs and policy at the Washington-based National Rural Health Association. “It isn’t everything.”

While Congress considers a health care overhaul, clinic workers hope just to keep up with basic needs such as vaccinations and exams.

“I can’t imagine not having the stimulus money right now because we wouldn’t be able to do any of this,” said Nicole Noll, who drives the mobile health clinic to the teen homeless shelter and rural elementary schools.

The van was provided by Ronald McDonald House Charities. But stimulus money pays for Noll, the doctors and the dentists.

Far more than a brighter smile can be at stake in dentistry. In Maryland, a 12-year-old boy whose Medicaid coverage had lapsed, Deamonte Driver, died in 2007 after bacteria from the abscess of an aching tooth spread to his brain. An $80 tooth extraction might have saved his life.

“I’m so glad they did this,” Michelle Daulton said. “My parents were cheap. They never took me to the dentist. And when you don’t have any money, your teeth, you just leave ‘em alone. Not anymore.”

Above article published on

http://www.seattlepi.com/national/1110ap_stimulus_health_clinics.html