Experts: No link between Asperger's, violence

NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger's syndrome, experts say there is no connection between the disorder and violence.

Asperger's is a mild form of autism often characterized by social awkwardness.

"There really is no clear association between Asperger's and violent behavior," said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger's.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger's, said psychologist Eric Butter of Nationwide Children's Hospital in Columbus, Ohio, who treats autism, including Asperger's, but has no knowledge of Lanza's case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

"But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown," he said in an email.

"These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles," he added.

Autism is a developmental disorder that can range from mild to severe. Asperger's generally is thought of as a mild form. Both autism and Asperger's can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger's does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

"I think it's far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger's," Laugeson said.

She said those with Asperger's tend to focus on rules and be very law-abiding.

"There's something more to this," she said. "We just don't know what that is yet."

After much debate, the term Asperger's is being dropped from the diagnostic manual used by the nation's psychiatrists. In changes approved earlier this month, Asperger's will be incorporated under the umbrella term "autism spectrum disorder" for all the ranges of autism.

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AP Writer Matt Apuzzo contributed to this report.

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Online:

Asperger's information: http://1.usa.gov/3tGSp5

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'Iron Chef' fundraiser in L.A. tries to cook up interest in Japan

It's tough to be Japan these days. China is bigger, with an economy that surpassed Japan's two years ago. South Korea is more hip, with addicting soap operas and "Gangnam Style" cool.

But Japan has what neither East Asian country does: the "Iron Chef" cooking show, a campy cult sensation that has spawned knockoffs in America, Israel, Australia, Britain, Thailand and elsewhere.

The show's most celebrated chef, Hiroyuki Sakai, made his first appearance in Los Angeles this month to raise money for educational programs that backers hope will boost Japan's public profile among youth. Drawing 225 fans to the $450-a-plate event, Sakai and two Los Angeles chefs whipped out a six-course dinner featuring such creations as Wagyu beef, Tasmanian salmon, octopus carpaccio and sweetbreads and abalone croquette.

Unlike the show, the Los Angeles event at the InterContinental Los Angeles Century City did not feature a cooking competition with a mystery ingredient, celebrity judges or an outlandishly costumed host. But there was plenty of kinetic energy as Sakai and InterContinental executive chef Jonathan Wood bopped from the kitchen to the stage to answer audience questions. Kitchen preparations were beamed to huge video screens in the dining hall, and soaring music heralded the serving of each course.

By the end of the night, the Iron Chef had helped raise $100,000 for youth programs offered by the Japan America Society of Southern California. Later, Sakai said he was particularly gratified by the Los Angeles audience's standing ovation and urged his fellow Japanese to continue competing globally by having pride and confidence in their talents.

Douglas Erber, the society's president, said he hoped the proceeds would help new generations of Americans learn and care about Japan.

"If we're going to foster the future of U.S.-Japan relations, we need to engage youth," he said.

Erber said American interest in Japan has waned since that nation's once-booming economy dropped into a long and deep recession beginning in the 1990s.

Reflecting those trends, the century-old society's membership declined by half from the 1980s to the late 1990s but has begun to recover and now totals about 2,000 individuals and 125 corporations, Erber said.

But on high school campuses, more students are shifting to study Mandarin amid China's economic rise. Enrollment in Chinese language classes at public high schools tripled from 2004 to 2008, compared with a 17% rise in Japanese studies during that same period, according to a survey released last year by the American Council on the Teaching of Foreign Languages.

To help promote interest in Japan, Erber said the society planned to offer its first-ever Japan Bowl for Southern California high school Japanese language students next spring. The academic competition, modeled on popular quiz shows, will test knowledge of the Japanese language, culture and Japanese American experience; local winners will advance to a national competition in Washington, D.C., and a chance to win a trip to Japan.

"We want to thank students for choosing Japanese as their language of choice when they could have chosen Spanish or another language," Erber said.

The society also hopes to expand its Japan in a Suitcase program, which brings Japanese school uniforms, lunch kits, textbooks and other items to Southern California classrooms.

The organization's other educational events include an annual Japanese kite workshop, in which a Japanese kite master teaches more than 1,000 underserved Los Angeles students in a dozen schools the art of traditional kite-making from bamboo and Japanese washi paper. The Japan America Kite Festival at Seal Beach attracts more than 12,000 people.

Erber said the society hoped eventually to bring on a full-time educational director to expand such learning opportunities for students about Japan and the U.S.-Japan relationship.

"We're hoping that, by opening their eyes to another culture, we'll help stimulate them to continue to explore the world around them," Erber said.

Fans who flocked to the recent Iron Chef dinner, which was supported by the InterContinental and Nitto Tire U.S.A. Inc., said Japan will always be a cultural and economic pacesetter despite its dip in U.S. public awareness.

Jon Kroll, a Los Angeles TV producer, said cultural trends may come and go in America — the film "Slumdog Millionaire" helped fuel interest in India for a time, and South Korea seems hot today, he said. But the inventive genius that produced such global hits as sushi, Hello Kitty and "Iron Chef" will keep Japan in the forefront, he said.

"Japan will rise again," Kroll said.

teresa.watanabe@latimes.com

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The Hard Road Back: Chaplain with Traumatic Brain Injuries, Finds Tables Turned

A Counselor in Need:
Sent home from Iraq, Lt. Col. Richard Brunk, an Army chaplain, returned to Houston, where he is learning to cope with a serious brain injury.

It was Lt. Col. Richard Brunk’s second Sunday in Baghdad, and so, of course, there was church. Only 16 soldiers showed up, but that was good for that busy day, election day across Iraq. The presiding chaplain asked everyone to take seats up front. It was a providential move.

A 122-millimeter rocket exploded outside, virtually collapsing the rear of the chapel. Colonel Brunk was pitched forward, an outstretched arm failing to stop his head from hitting the marble floor. Gathering himself amid the chaos, he noticed some foil-wrapped chocolates scattered like pebbles before him and offered one to the chaplain, sprawled on the ground nearby.

“If I’m going to die, it’s going to be with chocolate on my breath,” the colonel said jokingly. The chaplain moved his lips in reply. “And I realized: ‘Uh oh, I’ve got a problem,’ ” Colonel Brunk recalled. “Because I couldn’t hear him.”

The explosion broke Colonel Brunk’s wrist, shattered both his eardrums and rattled his skull, medical records show. It would be the first of two major blasts in 2005 that traumatically injured his brain.

Seven years later, the symptoms have not gone away. Colonel Brunk, who retired from the Army this summer, regained his hearing, but he still has daily headaches, ringing in his ears, double vision and dizziness, all typical of traumatic brain injury, or T.B.I. Occasionally he struggles to remember once-familiar words, faces and names.

The military says it has diagnosed more than 260,000 cases of T.B.I. since 2000, about 42,000 of them involving deployed troops. That is less than 2 percent of the service members sent to Iraq and Afghanistan, and many experts believe that the actual number is higher. Though three in four of those cases were labeled “mild,” many veterans like Colonel Brunk have struggled with powerful aftereffects for years.

In his case, age has been a factor. A chaplain himself, Colonel Brunk was 54 when he was injured, a rarity in these wars, where 99 percent of the 2.3 million troops who deployed to Iraq or Afghanistan were under 50. Now 62, he faces a much steeper path to recovery than a younger person, doctors say.

But emerging research shows that traumatic brain injuries may have long-term effects on troops of all ages. A study by the University of Oklahoma this year, for instance, found that a majority of veterans treated at a traumatic brain injury clinic continued having headaches, dizziness and poor coordination eight years after their injuries.

Data from the Center for the Study of Traumatic Encephalopathy at Boston University suggests that multiple traumatic brain injuries during one’s youth may be linked to degenerative brain disease later in life.

Colonel Brunk’s story underscores another important issue: how poorly the military understood brain injuries early in the wars.

Since 2009, the Pentagon has required troops suspected of having head injuries to rest immediately after blast exposure, a crucial period when brains can often heal themselves, doctors say.

But in 2005, Colonel Brunk was allowed to return to work within hours of his first exposure. When doctors eventually recognized that he had neurological damage, he was sent home for about three months but was treated mainly for hearing problems. He was then permitted to return to Iraq, at his own request, where he had a second, potentially devastating head injury.

He had gone to war not expecting to experience warfare quite so intimately. But once he was hurt, he was determined to rejoin his battalion and finish the tour with his flock. And like many of those soldiers, he did his level best to ignore injury, pain and, eventually, a collapsing marriage.

“I went to Iraq a chaplain,” Colonel Brunk says. “But I came home a soldier.”

But to those close to him, his dogged good cheer was a mask that did not always serve him well. “People look at him and say, ‘That’s Chaplain Brunk, he can’t be having problems,’ ” said Kathy Curry, a close friend. “But he’s got problems at home. He’s got T.B.I. He’s got pain.”

And so, not long after meeting him, Ms. Curry felt compelled to ask: Who counsels you? Who counsels the counselor?

The answer, for a time at least, was nobody.

He had wanted to be a doctor, but college microbiology killed that notion. So he followed his father, an Army chaplain, into the ministry, leading Texas parishes of the Evangelical Lutheran Church while volunteering as chaplain for fire departments and hospitals. But the military, a family tradition, called.

In the fall of 1989, Colonel Brunk found himself chatting with an Army chaplain recruiter at a church convention in New Orleans. By the end of their stroll down Bourbon Street, the minister had signed on for the Texas National Guard. He was 39.

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Donald Faison Marries Cacee Cobb

By Lesley Messer

12/15/2012 at 08:25 PM EST

Cacee Cobb and Donald Faison

Dr. Billy Ingram/WireImage

It's official!

After six years together, Donald Faison and Cacee Cobb were married Saturday night at the Los Angeles home of his Scrubs costar Zach Braff.

Cobb's friend Jessica Simpson was a bridesmaid. Sister Ashlee Simpson also attended.

"What a happy day," Tweeted groomsman Joshua Radin, a singer, who posted a photo of himself with Faison and Braff in their tuxedos.

The couple got engaged in August 2011. At the time, Faison Tweeted, "If you like it then you better put a Ring on it," and Cobb replied, "If she likes it then she better say YES!!"

Since then, the couple had been hard at work planning their wedding. On Nov. 12, Faison, who currently stars on The Exes, Tweeted that they were tasting cocktails to be served on the big day.

"Alcohol tasting for the wedding!" he wrote, adding a photo of the drinks. "The [sic] Ain't Say It Was Going To Be Like This!!!"

This is the first marriage for Cobb. Faison was previously married to Lisa Askey, with whom he has three children. (He also has a son from a previous relationship.)

Read More..

Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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Vandalism of memorials to CHP officer baffles widow

The first posthumous attack on John Pedro was a simple, senseless theft.

At the roadside shrine that popped up where the California Highway Patrol officer was killed near Watsonville in 2002, someone stole a flag.

"Some people hate the police," said Colleen Gilmartin, Pedro's widow and a former CHP officer herself. "I thought it was some kind of statement."

But the statements have grown more assertive and more bizarre in the 10 years since Pedro's cruiser slammed into a tree as he was pursuing a speeder. A highway sign erected to honor the soft-spoken, 36-year-old officer was chopped down and had the name "Pedro" hacked out. A 6-foot redwood cross was cut off at the base and stolen. Two months ago, the 200-pound granite slab marking Pedro's grave vanished.

Investigators at the Santa Cruz County Sheriff's Office say they have pored over his old case files but made no arrests. Meanwhile his colleagues at the CHP office in Aptos wonder why someone from Pedro's past might be trying so dramatically to seek revenge.

"It seems very personal," said Sarah Jackson, an agency spokeswoman, "and it needs to stop. We're trying not only to solve a crime but to give Colleen some peace."

Last month, Gilmartin had a new grave marker installed at the site where she and her daughter Sara, now 12, would so often talk and sing and just sit. There was no unveiling.

"Part of me is scared to death that something will happen to this one too," she said.

Pedro was the 193rd CHP officer to die in the line of duty. Two years earlier, his friend Sean Nava was the 190th. Nava was struck by a 20-year-old drunk driver near Carlsbad on Oct. 28, 2000.

The two were classmates at the California Highway Patrol Academy. Starting their CHP careers in San Jose, they shared an apartment for a year. They both married women who also became CHP officers and the couples frequently socialized.

"Sean's death was really hard on John," Gilmartin said. "That really drove it home: 'Oh my God, this is a dangerous job.' "

A graduate of Watsonville High School, Pedro had his heart set on police work. He was an excellent musician — he and his wife met as trombonists in a military band — but he had always been fascinated by a neighbor's stories about working for the state patrol. Also intrigued by the big rigs that his father, an immigrant from the Azores, used to drive, he wound up with his dream job: enforcing truck laws on the highways around his hometown.

Pedro would set up inspection stations and check drivers' logbooks. "Some companies didn't like him," Gilmartin said, but he wasn't the subject of threats or complaints.

Freddie Chavez, co-owner of Truck Drivers Institute, a school in Watsonville, said Pedro once pulled over one of his instructors and said the school's truck was hauling a trailer that was too big. But after agreeing to check paperwork back in the school's office, he admitted to Chavez that he'd made a mistake.

"He was a good guy," Chavez said. "He said he wouldn't pull my trucks over again."

Two days later, Pedro started his day parked at a favorite spot along California Highway 1. Evidently spotting a speeder, he accelerated to about 75 mph and, veering onto a curving offramp a mile south, lost control of his car. The speeder was never found.

Pedro's death reverberated throughout Watsonville.

Woodworker Lee Fellows was coming back from Santa Cruz when he saw Pedro's mangled cruiser being hoisted onto a flatbed truck. He'd never met Pedro but dreamed for the next two nights about making him a cross.

With materials donated from a local lumberyard, he planted one in concrete at the spot where Pedro crashed. It was gone within a few months, chopped off at the base.

"I've talked with numerous officers," said Fellows, who works in parking enforcement at the Santa Cruz courthouse, "and we've all come up with the same conclusion: It has to be someone who John put away."

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Changing of the Guard: Chinese Opposition to Labor Camps Widens

BEIJING — It is hard to say exactly which “subversive” sentiments drew the police to Ren Jianyu, who posted them on his microblog last year, although “down with dictatorship” and “long live democracy” stand out.

In the end, Mr. Ren, 25, a college graduate from Chongqing, the southwestern metropolis, was sent without trial to a work camp based on the T-shirt that investigators found in his closet: “Freedom or death,” it said.

Last year Mr. Ren was among tens of thousands of Chinese who were dumped into the nation’s vast “re-education through labor” system, a Stalinist-inspired constellation of penal colonies where pickpockets, petitioners, underground Christian church members and other perceived social irritants toil in dismal conditions for up to four years, all without trial. With as many as 190,000 inmates at any one time, it is one of the world’s largest systems of forced labor.

But now the labor system, known by its shorthand, “laojiao,” is facing a groundswell of opposition from both inside and outside the Communist Party. Critics say the once-in-a-decade leadership transition last month, which included the demotion of the chief of the nation’s vast internal security apparatus, has created a potential opening for judicial and legal reform.

“It’s high time we demolish this unconstitutional and abusive system that violates basic human rights, fuels instability and smears the government’s image,” said Hu Xingdou, a professor at the Beijing Institute of Technology who frequently rails against the system that Mao Zedong created in the 1950s to take down suspected class enemies and counterrevolutionaries.

The calls for change go beyond longstanding advocates of political reform like Professor Hu. China’s national bar association is circulating an online petition that has been signed by thousands. Legal experts have convened seminars to denounce the system. And almost every day, it seems, the state-run news media, with the top leadership’s tacit support, report on hapless citizens ensnared by the arbitrary justice that the local police impose with the wave of a hand.

Mr. Ren’s case would probably have gone unnoticed if not for China’s increasingly emboldened human-rights defenders, who showcased his plight on the Internet. Evidently prodded by the torrent of media coverage, Chongqing officials cut short his two-year sentence and freed him.

“It was a depressing, dreadful experience,” Mr. Ren said in a telephone interview this month, describing long days spent in the camp’s wire-coiling workshop.

Other examples abound. A migrant worker from Inner Mongolia was sent away for quarreling with an official at a restaurant. A mother from Hunan Province was given an 18-month sentence after she publicly protested that the men who had raped and forced her 11-year-old daughter into prostitution had been treated too leniently.

This month an 80-year-old Korean War veteran with Parkinson’s disease sobbed on national television as he described spending 18 months in a labor camp as punishment for filing local corruption complaints.

People’s Daily, the Communist Party’s mouthpiece, took aim at the system last month, saying it had become “a tool of retaliation” for local officials. In October the head of a government judicial reform committee noted a broad consensus in favor of addressing the system’s worst abuses.

And in a widely circulated recent essay, the vice president of the Supreme People’s Court, Jiang Bixin, argued that the government must act within the law if it is to survive. “Only with constraints on public power can the rights and freedoms of citizens be securely realized,” he wrote.

China’s incoming president, Xi Jinping, has not yet weighed in on the issue, but reform advocates are encouraged by a speech he gave this month talking up the widely ignored protections afforded by China’s Constitution, which include freedom from unlawful detention and the right to an open trial. “We must establish mechanisms to restrain and supervise power,” Mr. Xi said.

Until now, China’s powerful security establishment has staved off any erosion of its authority, warning of calamity if the police lose their ability to detain perceived troublemakers without the interference of judges or defense lawyers.

The Ministry of Public Security has other reasons to preserve the status quo. The system, which employs tens of thousands of people, is a gold mine for local authorities, who earn money from the goods produced by detainees. Officials also covet bribes offered to reduce sentences, critics say, and the payments families make to ensure a loved one is properly fed while in custody.

Patrick Zuo contributed research.

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Gunman's Father and Brother Are 'in Shock,' Says a Source

By Diane Herbst

12/14/2012 at 08:50 PM EST

State police personnel lead children to safety away from the Sandy Hook Elementary School

Shannon Hicks/Newtown Bee/Reuters/Landov

The father and older brother of the gunman who was blamed for the Connecticut school shooting are being questioned by authorities but are not suspects, a law enforcement source tells PEOPLE.

The Associated Press reports that the gunman has been identified as 20-year-old Adam Lanza.

His unidentified father, who lives in New York City, and his older brother, Ryan, 24, of Hoboken, N.J., are "in shock," the law enforcement source tells PEOPLE.

They were being questioned by the FBI in the Hoboken police station but "are not suspects, they have no involvement," the source says.

"Imagine the 24 year old – he's lost his mother. Imagine the father, his son killed 20 kids," the source says."   

As for Adam, "It looks like there's mental history there," the law enforcement source says.

Adam Lanza died at the scene of the shooting that killed 20 children and six adults at the Sandy Hook Elementary School in Newtown, Conn.

His mother, Nancy Lanza, was found dead at her home, according to CNN.

The source describes the weapons used by Lanza as "legitimate." According to CNN, Lanza used two hand guns that were registered to his mother and a rifle.

Adam's parents were no longer together, the source says.   

Read More..

Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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Glimpsing the hereafter, or just missing loved ones?

What do you wear to visit a psychic?

I pondered the question as I stood in the mirror, practicing my poker face.

Would she see through my Uggs to my mismatched socks? Will she know that I dug these jeans from the bottom of my hamper?

I'd made an appointment to meet with the psychic because I'd been worrying over a dream. It featured my late husband and my dead mother, who both passed many years ago and barely knew each other.

In the dream, they looked serene. Neither of them spoke. She was standing at the bottom of my stairs, he was outside on the porch.

I was overjoyed to see them together. Then I woke up and had to accept they are still dead. I pulled the covers over my head and stayed in bed.

I couldn't shake the memory of how happy I'd been, and wound up ruminating for months over what the dream might mean.

Was the visit just a friendly 'hello' from the people I missed most? Or was it some sort of omen that I'd be joining them soon?

I was surprised to discover I felt oddly OK with the thought of dying — but bothered by all that I'd leave undone.

I grappled with the practical issues the prospect presented: Should I increase my life insurance, use up my vacation days, teach my daughters to cook? I embarked on a flurry of medical visits.

The dream had stoked a longing I could not seem to quiet.

I wanted to know the unknowable. More than that, I wanted to summon my loved ones back.

::

I started my search for clarity the way searches always begin: I Googled "dream of dead mother and husband," and wound up looking for insight on "Your Online Spirituality Destination."

The website said my dream might simply have been "a way of resolving your sorrow psychologically while you slept." Then it confirmed my fears with this: "Some psychics who interpret dreams would say that such a dream could bode that you may die soon."

I can buy into the concept of psychics, but I have trouble with the specifics. I think some people may be blessed with celestial gifts. But I doubt they're the ones charging for mind-reading on websites like this.

I needed a psychic with references. A friend suggested Sabrina.

The blurb on her website sounded good, vaguely scientific: "Sabrina offers psychic readings through use of the tarot deck, clairvoyance and clairsentience."

The market for psychic readings is bigger than skeptics might think. Three-quarters of Americans believe in life after death, and almost half of those surveyed think it's possible to communicate with spirits or be visited by ghosts.

That's what draws us to reality shows like "Long Island Medium," where wisecracking star Theresa Caputo can't even get her teeth cleaned without picking up a message from a dead relative of some stranger in the waiting room.

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