2008 World's Strongest Man Competition, Charleston, WV

The 2008 World's Strongest Man Competition will be coming to Charleston, West Virginia next week, September 6-14. Find the full schedule of events and locations here and a list of the international competitors who will be arriving in Charleston to compete.

Phil Pfister, Charleston native and 2006 winner of the competition, will be competing this year in his home town. Today's Charleston Gazette has a feature sports article on Phil who will likely be competing in his last strongman competition.

I know Phil and his family personally because our sons go to school together at Mountaineer Montessori. Phil is a great guy and ambassador for West Virginia.

The first time I met Phil was through my son back in 2006 when he came home from school one afternoon and said, "Guess what, Wyatt's dad can pull a fire truck." I said, "Sure he can . . ." Then a couple of days later he came home and said, "Wyatt's dad is the strongest man in the world." Again, "Yea, sure he is . . ." Then I met the 6' 6" 375 lb. Phil at a school event and realized my son's stories were not just playground talk.

I hope that everyone in Charleston and West Virginia will come out to support Phil and the event.

UPDATES (CHECK THE LATEST GOOGLE NEWS):

• Photos courtesy of the Charleston Gazette from the first day of the preliminary competition at Magic Island.

• Photo of Phil Pfister showing perfect form in the keg toss by Charleston based photographer and blogger, Rick Lee, who I suspect will get some great shots throughout the competition.

• Photos by Charleston photo blogger, Jason Means. Check out his Flickr stream for more photos.

• Charleston Gazette article on the first day of the event and how it went for hometown favorite, Phil Pfister.

• Strongmen have big hearts too - they made a visit to the East End Family Resource Center to spend time with kids in the after school program. Check out the details at Jim McKay's blog, Wabi-Sabi. Also, if you plan to go to the events stop by the Strong Families Festival. Check out the video highlights of their visit below.

UPDATE (9/12/08):

Today is the first day of the finals of the event. Today's Daily Mail gives a run down of the events scheduled for today and over the weekend. A second article also covers ESPNs film crew and their effort to capture the beauty of West Virginia for the cut away shots during the final produced show for ESPN. Great to see them adding this footage into the final production.

There is also a photo of the 10 finalists. The top finishers in the preliminaries who will be competing over the weekend, including Charleston's own Phil Pfister are:

Sebastian Wenta, Poland; Arild Haugen, Norway; Tarmo Mitt, Estonia; Dave Ostlund, Minnesota; Travis Ortmayer, Texas; Terry Hollands, England; Jason Bergmann, Wisconsin; Derek Poundstone, Connecticut; and reigning champion Mariusz Pudzianowki, Poland. The alternate is Jimmy Marku, England.

John Stossel's Perspective on WV Certificate of Need Law

Yesterday's Daily Mail article reports that John Stossel, co-anchor of ABC's 20/20 speaking at the West Virginia Chamber of Commerce's Business Summit spoke out against West Virginia's Certificate of Need laws. Stossel argues that free market is better than regulation of health care.

Regulation vs. free market makes for great conversation. The debate as it relates to health care is made more complex when we have a largely single payor (government funded) health care reimbursement system in West Virginia. I don't know the actual statistics but well over half and probably near 75% of health care costs are paid in West Virginia by Medicare, Medicaid, PEIA and other government payors. As for private payors we only have a few that have any influence in West Virgina. This makes West Virginia close to a microcosm for a wwhat a single payor government run health care system might look like. What impact does this stagnation of competition on charges/costs have on the regulation vs. free market question. Is a single payor system better for West Virginia and the U.S.? Interesting questions as we approach the election in November.

Also, in my inbox this morning was an email from friend and health colleague, Mike Ryan, letting me know about the HealthDecisions '08: Obama and McCain on Health Care. Although I haven't had a chance to explore the site in detail I like the side by side comparison on the main page.

The press release indicates:

HealthDecision '08 by HealthCare.com is an initiative to inform, educate and deploy the power of the web to gather public opinion on the health care proposals put forth by Senators Barack Obama and John McCain. HealthDecision '08 provides a side-by-side comparison of Obama's and McCain's healthcare positions and proposals, along with interactive voting tools that enable users to vote for their preferred health care plan and offer their own comments after weighing through the issues.

What do others think? Post your comments.

Lets Go Mountaineers . . .

Everyone in West Virginia is excited about the start of the WVU college football season. There is a a lot of buzz about the Mountaineers, its #3 AP ranking and Heisman hopefuls, Steve Slaton and Pat White (check out his Pitt growl). Good luck to the Mountaineers as they start there season this weekend. Go Mountaineers and their #1 rated fans!

This clip is a year old but I just saw it after my dad sent it to me. What a great commercial. For those of you who don't get the commercial check out this Google search.

Learning: Privacy and Security Monitoring, Audits and Investigations

On November 13, 2007, I will be speaking at a Lorman Eduational Services seminar to be held in Charleston, West Virginia. The seminar topic is "Health Care Information Privacy and Security Monitoring, Audits and Investigations: How to avoid an investigation and what you should expect if the state or federal officials call". You can register online here.

Also speaking at the seminar will be (read full bios):

• Terri Barrett, the assistant chief privacy officer at the West Virginia Health Care Authority in Charleston

• Mike Harmon, compliance officer for the West Virginia Public Employees Insurance Agency who oversees HIPAA compliance for PEIA and the Department of Administration

• Jack Shaffer, CIO for the Community Health Network of West Virginia who has experience in all aspects of technology, including systems development, enterprise application integration, networking, telecommunications, data center operations, database administration, disaster recovery, security and mobile computing.

Below is a copy of the seminar agenda:

9:00 am – 10:30 am	Legal Overview of HIPAA Privacy and Security Enforcement
	Robert L. Coffield, Esq.
	HIPAA Refresher on Enforcement Rules and Penalties OCR Privacy Investigation Statistics Best Practices on Conducting Internal Investigations Responding to OCR/CMS Investigation
10:30 am – 10:45 am	Break
10:45 am – 11:30 am	Preparing for an Audit
	Michael T. Harmon, CIPP/G
	Auditing vs. Monitoring Other Governmental Auditors – e.g., OIG, Legislature Elements of the OIG Audit of Piedmont Hospital in Atlanta New Kennedy/Leahy Legislation and Changes to Current Practice Privacy and Security Accreditation
11:30 am – 12:30 pm	Lunch (On Your Own)
12:30 pm – 2:30 pm	Technologies and Procedures for HIPAA Compliance
	Jack L. Shaffer Jr.
	Acceptable Use Policies and Enforcement Protecting PHI With Encryption Technologies Auditing and Monitoring Tools
2:30 pm – 2:45 pm	Break
2:45 pm – 3:45 pm	The Role of the Privacy Officer
	Terrisita Barrett, CIPP
	The Changing Privacy and Security Landscape Role and Responsibilities: Past, Present and Future Challenges Affecting the Privacy Officer Role
3:45 pm – 4:30 pm	Panel Discussion, and Questions and Answers
	Terrisita Barrett, CIPP, Robert L. Coffield, Esq.,
	Michael T. Harmon, CIPP/G, and Jack L. Shaffer Jr.

The Beauty of West Virginia

Our state receives a lot of negative national news - lately its been about the business climate and our weight problem. However, here is the reason I live in and love West Virginia. Another terrific shot (large image) from local photo blogger, Rick Lee.

eHealthWV: West Virginia EHR Public Service Announcement

As a part of West Virginia's participation in the Health Information Security and Privacy Collaborative (HISPC), West Virginia Medical Institute and its partners launch the eHealthWV website focused on educating consumers about electronic health records and health information exchange.

West Virginia was one of a number of states awarded a grant by RTI International to participate in the HISPC, a national collaborative effort to study health information security and privacy. To learn more about EHRs and HIEs check out the website. They also have a toolkit of brochures for physician practices to use.

Project Director, Patty Ruddick, notified me last week that they had filmed a new EHR/HIT public service announcement that will start airing across West Virginia over the next few months. I thought I would upload the PSA to YouTube and share a copy (click below to watch).

Latest on CMS's Challenge to WV Oxycontin Settlement

Larry Messina provides the latest on CMS's challenge to the $10M Oxycontin settlement by the West Virginia Attorney General's office against Purdue Pharma. Last month the West Virginia Bureau of Medical Services received from CMS a $4.1M notice of disallowance stating that the state failed to share a portion of the settlement with federal Medicare.

Larry Messina's article in today's Herald Dispatch, "Feds threaten $4.1M in Medicaid funds over Oxy Settlement".

Viral Health Effort Via Twitter: Fit West Virginia (#FitWV)

Dawn Miller of the Charleston Gazette highlights the ongoing Fit West Virginia (#FitWV) effort ongoing via Twitter in her op-ed piece, West Virginians try to tip scales on obesity.

The idea was born back on West Virginia Day as a result of Jason Keeling asking his blog readers to discuss solutions to West Virginia's problems in a post, West Virginia: Using Social Media for the Mountain State's Betterment. In response, Skip Lineberg of Maple Creative responded with his post, A Fitter West Virginia.

As a result of that "healthy idea seed" being planted a core group of West Virginia tweeters have been regularly posting on Twitter using the hashtag #FitWV. The effort has created a viral movement of West Virginians supporting other West Virginians in making health choices, exercising regularly, etc. Hopefully, this positive discussion is bringing about positive change and support to those participating.

As the country discussed health care reform efforts like #FitWV should be made a part of the equation. As Jordan Shlain, MD says in his recent op-ed over at The Health Care Blog:

. . . Nowhere in this debate is the patient, the consumer, and the citizen: the American! We lack accountability, responsibility and civic sensibility. It is Joe Diabetic that snacks on ice cream, misses appointments and doesn't take his insulin that increases the cost of health care. This diabetic will be admitted to your local ER with diabetic ketoacidosis and have many subsequent hospital admissions at our (read: your) expense, not his. This is a fundamental collective action problem.

Our town square is so big that we can get away with malfeasance to our village (and our country) with no shame. Yet, the forces of economics do not defy gravity and the cost of health care is now affecting all of us. Those of us that are untethered from the reality of cost are driving our health care 'car' into the ground. . .

If you use Twitter -- please join the effort.

Dawn Miller also provides a link to some great new information from the Centers for Disease Control. The CDC released last month "Recommended Community Strategies and Measurements to Prevent Obesity in the United States."

Ms. Miller writes:

The CDC did all the research and evaluation work, so individual communities don't have to. They assembled a group of people with experience in urban planning, nutrition, physical activity, obesity prevention and local government. The group reviewed a couple years' worth of research, evaluated various tactics and settled on 24 recommendations. For each one, the CDC summarizes the evidence behind it and suggests ways to measure progress. Communities should:

1. Make healthier food and drinks available in public places. Schools are key, but think also of after-school programs, child care centers, parks, playgrounds, swimming pools, city and county buildings, prisons and juvenile detention centers.

2. Make healthier food more affordable in those public venues. Lower prices, provide discount coupons or offer vouchers for healthy choices.

3. Improve the availability of full-service grocery stores in underserved areas. One study of 10,000 people showed that black residents in neighborhoods with at least one supermarket were more likely to consume the recommended amount of fruits and vegetables than those in neighborhoods without supermarkets. Residents consumed 32 percent more fruits and vegetables for each additional supermarket in their census tract.

More supermarkets also raised real estate values, economic activity and employment and lowered food prices.

4. Provide incentives to food retailers -- supermarkets, convenience stores, corner stores, street vendors -- to locate in underserved areas or to offer healthier food and drinks. Incentives can be tax benefits and discounts, loans, loan guarantees, start-up grants, investment grants for improved refrigeration, supportive zoning and technical assistance.

5. Make it easier to buy foods from farms.

6. Provide incentives for the production, distribution and procurement of foods from local farms.

Did you know that the United States does not produce enough fruits, vegetables and whole grains for every American to eat the recommended amount of these foods? Dispersing agricultural production throughout the country would increase the amount of available produce, improve economic development and contribute to environmental sustainability.

7. Restrict availability of less healthy foods and drinks in public places.

8. Offer smaller portion options in public places.

9. Limit advertisements of less healthy foods and drinks.

10. Discourage people from drinking sugar-sweetened beverages.

11. Support breastfeeding, which appears to provide some protection from obesity later in life.

12. Require physical education in schools.

13. Increase the amount of physical activity in school PE programs. Modify games so that more students are moving at all times, or switch to activities in which all students stay active. Improving phys ed improves aerobic fitness among students.

14. Increase opportunities for extracurricular physical activity.

15. Reduce screen time in public settings. TV and computer time displaces physical activity, lowers metabolism, increases snacking and exposes children to marketing of fattening foods.

16. Improve access to outdoor recreational facilities, such as parks, green spaces, outdoor sports fields, walking and biking trails, public pools and community playgrounds. Access also depends on how close such places are to homes and schools, cost and hours of operation.

17. Support bicycling. Create bike lanes, shared-use paths and routes on existing and new roads. Provide bike racks near commercial areas. Improving bicycling infrastructure can increase how often people bike for utilitarian purposes, such as going to work and school or running errands.

18. Support walking. Build sidewalks, footpaths, walking trails and pedestrian crossings. Improve street lighting, make crossings safer, use traffic calming approaches. Walking is a regular activity of moderate intensity that a large number of people can do.

19. Locate schools within easy walking distance of residential areas.

20. Improve access to public transportation to increase biking and walking to and from transit points.

21. Zone for mixed-use development, including residential, commercial, institutional and other uses. This cuts the distance between home and shopping, for example, and encourages people to make more trips by foot or bike.

22. Enhance personal safety in areas where people are or could be physically active.

23. Enhance traffic safety in areas where people are or could be physically active.

24. Participate in community coalitions or partnerships.

CMS Awards WV Medicaid $945K Federal Matching Funds for EHR Incentive Programs

iHealthBeat reports that West Virginia Medicaid along with five other states will receive federal matching funds from the Centers for Medicare and Medicaid (CMS)to help implement electronic health record (EHR) incentive programs.

West Virginia Medicaid will receive $945,000 in federal matching funds. The CMS press release indicates that West Virginia will use the funds for planning activities that include conducting a comprehensive analysis to determine the current status of HIT activities in the state. The funds will be used to gather information on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan.

The CMS press release states:

WEST VIRGINIA TO RECEIVE FEDERAL MATCHING FUNDS FOR ELECTRONIC HEALTH RECORD INCENTIVES PROGRAM

In another key step to further states’ role in developing a robust U.S. health information technology (HIT) infrastructure, the Centers for Medicare & Medicaid Services (CMS) announced today that West Virginia’s Medicaid program will receive federal matching funds for state planning activities necessary to implement the electronic health record (EHR) incentive program established by the American Recovery and Reinvestment Act of 2009 (Recovery Act). West Virginia will receive approximately $945,000 in federal matching funds.

EHRs will improve the quality of health care for the citizens of West Virginia and make their care more efficient. The records make it easier for the many providers who may be treating a Medicaid patient to coordinate care. Additionally, EHRs make it easier for patients to access the information they need to make decisions about their health care.

The Recovery Act provides a 90 percent federal match for state planning activities to administer the incentive payments to Medicaid providers, to ensure their proper payments through audits and to participate in statewide efforts to promote interoperability and meaningful use of EHR technology statewide and, eventually, across the nation.

“We congratulate West Virginia for qualifying for these federal matching funds to assist its plan for implementing the Recovery Act’s EHR incentive program,” said Cindy Mann, director of the Center for Medicaid and State Operations at CMS. “Meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.”

West Virginia will use its federal matching funds for planning activities that include conducting a comprehensive analysis to determine the current status of HIT activities in the state. As part of that process, West Virginia will gather information on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan, which will define the state’s vision for its long-term HIT use.

Almost Heaven . . . eBay

Almost Heaven West Virginia eBay.

Interesting survey results from Scarborough Research showing that Charleston, West Virginia is the #1 U.S. market for eBay visitors. 41% of adults in Charleston who accessed the internet in the last month are eBay visitors.

Skip Lineberg at Maple Creative has some additional thought on what this means for Charleston business? Jeff James at CreateWV provide more commentary in the post, "Is eBay the Killer App to Drive WV Broadband Adoption?"

WV Medicaid Redesign Program: New Report Examines The Mountain Health Choices Program

A new report prepared by West Virginia University researchers examines the the Mountain Health Choices Program, one of the two redesigned West Virginia Medicaid plans to target improving the long-term health of West Virginia Medicaid beneficiaries through engaging beneficiaries to become more involved in their health care.

Today's Charleston Gazette reports on the release and outcome of the report. The Gazette describes the program as follows:

"The program created a two-tier system in which people who agreed to sign pledges committing them to certain behaviors like visiting the doctor more frequently were enrolled in an enhanced plan with more perks than traditional Medicaid offered. Those who didn't sign the agreements are enrolled in a basic plan, with fewer benefits than traditional Medicaid."

The report, Mountain Health Choices Beneficiary Report - A Report to the West Virginia Burea for Medical Services was released this week at the West Virginia Health Improvement Institute meeting. The report was prepared by the Bureau of Business and Economic Research.

West Virginia Health Improvement Institute

The West Virginia Health Improvement Institute has launched its website that provides an overview of the efforts to improve the health care system in West Virginia.

The mission of the Institute is to assist with the execution of the strategies outlined in the Transformation Grants awarded by the Centers for Medicare and Medicaid. One main focus is on migrating primary care in West Virginia to the medical home model. The "About WVHII" has more about the Institute - what it is? why it's needed? its structure? etc.

As a part of the project I am chairing one of the four workgroups, the work group on the Adoption of Health Information Technology. The other work groups are:

• Measurement/Reporting/Reimbursement
• Provider Outreach and Education
• Self Management

The Adoption of Health Information Technology work group's efforts will be focused on understanding what health information technology is currently being used successfully by providers in West Virginia. We will be looking at opportunities to innovate and participate in projects that help to accelerate the adoption of technology, including that which supports the medical home model.

For more information on our work group and the other three work groups - check out the Workgroups section.

Creatively Living In West Virginia

Are you creative, looking for a place to be creative or have a need to find others who create?

Come experience all that West Virginia has to offer. For a taste of the creative community plan to attend the Create West Virginia Conference 2008. More on Create WV.

Watch the instructional/art video of creating Create WV Conference by KD Lett.

Create West Virginia Conference 2008
October 20-22, 2008
Snowshoe Mountain Resort
Snowshoe, WV
Register Here

What is the focus of the conference?

West Virginia is in a state of creation! Communities in every pocket of West Virginia are embracing new opportunities brought about by the New Economy.

Hear how communities just like yours are attracting young entrepreneurs, artists, scientists, technologists and others who are adding quality and growth to our state. Learn how improving your community’s quality of place, access to and adoption of technology, embracing tolerance and diversity for new people and ideas, and innovative education and talent development are opening new opportunities for everyone in West Virginia!

Check out the full agenda, speakers, etc. here. More on Create WV via Create WV Facebook Group.

The Use of Arbitration Agreements in Health Care

Ryan Brown, a health care attorney at Flaherty, Sensabaugh & Bonasso, PLLC who I regularly work with recently put together information on the use of arbitration agreements in the health care setting. More and more these types of agreements are being used as a way to avoid unnecessary litigation and provide an alternative venue to resolve health care conflicts between provider and patient.

Following are some excerpts about the topic from Ryan:

As many health care providers know all too well, disputes can often arise between a patient and a health care provider. Many times, the dispute can result in litigation in which a jury will be given the ultimate responsibility of resolving the conflict. However, courts are not the only venue for resolving these conflicts. An ever increasing number of health care providers, especially long-term care facilities, are looking at arbitration as an alternative to the traditional litigation system.

Health care providers in favor of arbitrating disputes point to benefits such as the ability to select an arbitrator who is an expert in the appropriate field, the ability to keep the dispute private, reduced time frame for resolving disputes, and the finality of the decision. Arbitration advocates also point out that arbitration is less expensive than the traditional litigation system.

Over the last decade, many state courts have upheld arbitration agreements that were signed prior to the patient receiving treatment by a physician, hospital, or nursing home. Additionally, courts have held that these arbitration agreements are enforceable not only to the patient, but also any potential beneficiaries of the patient’s estate.

In order to maintain the enforceability of arbitration agreements, a health care provider should strictly comply with the Federal Arbitration Act, state arbitration statutes, and state contract law. Additionally, health care providers should be mindful to carefully draft arbitration agreements and establish proper procedures for presenting arbitration agreements to patients so that courts do not determine the arbitration agreements to be unenforceable.

Ryan A. Brown concentrates his practice on providing legal counsel to a variety of health care providers in medical professional liability actions. Mr. Brown’s experience in medical malpractice cases includes defending nursing homes, hospitals, physicians, and nurses in all phases of litigation. Apart from his health care litigation practice, Mr. Brown provides legal counsel to health care providers and corporations involved in acquisitions and joint ventures.

Contact Ryan if you are interesting in learning more about the use of arbitration in the health care setting and how to include arbitration provisions and protections in your health care agreements.

YouTube Debate: WV's Mike Sharley's YouTube Video on Health Care

Great to see my law school classmate, Mike Sharley, asking the Democratic candidates at the YouTube debate about health care. Thanks to Larry Messina at Lincoln Walks At Midnight for the tip on the video. You can also get Hoppy's take.

Mike is an amazing individual with great creativity.

West Virginia Health Care Authority Revises Fee Schedule for Certificate of Need Program

On July 15, 2009, the West Virginia Health Care Authority filed with the West Virginia Secretary of State proposed amendments to the its procedural rule regarding the schedule of fees for the filing of certificate of need applications and exemption requests under the West Virginia Certificate of Need Program.

The amendment revises the fee schedule pursuant to Senate Bill 321 passed during the 2009 Legislative Session. The amendment required the fee schedule contain a maximum amount or cap for certificate of need application fees.

The proposed rule, Fee Schedule for Certificate of Need Matters, CSR 65-10 (redline version showing amendments) has been filed with the West Virginia Secretary of State. Written comments to the proposed rule may be submitted to the Authority before August 14, 2009 at 5:00 p.m.

Injunction Halts WVHCA Cardiac Demonstration Project

Today's State Journal reports on Kanawha County Circuit Judge Stucky's granting of a preliminary injunction halting the West Virginia Health Care Authority from moving forward with a demonstration program that would enable three West Virginia hospitals to perform therapeutic angioplasties without having open heart backup services. The injunction was filed in seperate actions by St. Mary's Medical Center and St. Joseph's Hospital.

Details on the demonstration pilot project can be found under Section VII of the State Health Plan Cardiac Catheterization Standards.

Ongoing Debate Over Revised Cardiac Catheterization Standards

Larry Messina at Lincoln Walks at Midnight round up of latest links/articles discussing the ongoing debate over the revised certificate of need Cardiac Catheterization standards. The debate has pitted hospital against hospital and resulted in full page ads and a media blitz by both sides in the debate.

Governor Manchin has until Friday (tomorrow) to decide whether he will approve the revised standards developed by the West Virginia Health Care Authority or send them back with recommended modifications.

For more history on the standards with links to the revised standards see my previous post.

UPDATE (7/18/08): This morning Governor Manchin issued the following statement indicating that he is sending the proposed Cardiac Catheterization standards back to the West Virginia Health Care Authority to revise and clarify the "medical transport drive time" language.

The Daily Mail reports on the decision.

STATEMENT FROM THE GOVERNOR ABOUT HEALTH CARE AUTHORITY’S PROPOSED ANGIOPLASTY STANDARDS

Contact: Lara Ramsburg, 304-558-2000

Gov. Joe Manchin today released the following statement about his approval, WITH EXCEPTION, of new West Virginia Health Care Authority rules that would allow some smaller hospitals in the state to perform angioplasty and other cardiac catheterization procedures:

“Any time we’re charged with making a decision that affects the quality of health care for our citizens, it’s a decision that must be carefully considered. In this case, we’ve taken a very close look at data gathered over several years, and a number of other facts about the ability of our hospitals to perform heart angioplasty procedures that have the potential to save hundreds of lives, especially given our state’s high heart disease rates and rural nature.

“Based upon this research, and the recommendation of the Health Care Authority, I am approving the majority of the standards that will give our citizens easier access to important emergency heart procedures; however, I have directed the Health Care Authority to revise the rules as they pertain to elective cardiac catheterization service and return them to me for reconsideration as soon as possible.

“Due to the ambiguity in the term ‘medical transport drive time,’ the current language in the proposed standards does not make it clear as to which hospitals could provide the elective procedure to their patients, so I believe the standards should be written to make sure that the appropriate hospitals are allowed to provide this service, under the strict guidelines and monitoring of the Health Care Authority.

“This decision, in its entirety, is solely based upon one objective – to provide all of our citizens, regardless of their location, access to the best possible medical care in their time of need.”

– Gov. Joe Manchin

Inspired by Rick Lee . . . Bugs!

I haven't been posting a lot because I've been very busy at work. However, I was inspired by Rick Lee tonight. In tribute to Rick's "Friday the 13th bug post" I thought I better post what's been bugging me. After returning from the grocery store (Monday night is grocery night at the Coffield House) I found this guy hanging out in our kitchen.

Not sure what he is (maybe someone out there can offer assistance). I have saved him for the night in the kids bug catcher so they can check him out in the morning.

WV Business Litigation Blog Hosts Blawg Review #168

This week's edition of Blawg Review is hosted by another West Virginia law blogger, Jeff Mehalic, over at the West Virginia Business Litigation Blog. Check out Blawg Review #168 for the latest in what is happening this week around the legal blogosphere.

Congrats to Jeff on a great job hosting. I appreciate his mentioning a couple of post at the Health Care Law Blog even though I didn't formally submit a post for this edition of Blawg Review.

Happy Bastille Day!