Check Point Screening

GAO Report.

Pandemic

DEPARTMENT OF HEALTH & HUMAN SERVICES
Office of the Secretary
____________________________________________________________

WAIVER OR MODIFICATION OF REQUIREMENTS
UNDER SECTION 1135 OF THE SOCIAL SECURITY ACT

October 27, 2009

1. Pursuant to Section 1135(b) of the Social Security Act (the Act) (42 U.S.C. § 1320b-5), I hereby waive or modify the following requirements of titles XVIII, XIX, or XXI of the Act or regulations thereunder, and the following requirements of Title XI of the Act, and regulations thereunder, insofar as they relate to Titles XVIII, XIX, or XXI of the Act, but in each case, only to the extent necessary, as determined by the Centers for Medicare & Medicaid Services, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the 2009-H1N1 influenza pandemic, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse:


a. Certain conditions of participation, certification requirements, program participation or similar requirements for individual health care providers or types of health care providers, including as applicable, a hospital or other provider of services, a physician or other health care practitioner or professional, a health care facility, or a supplier of health care items or services, and pre-approval requirements.


b. Requirements that physicians or other health care professionals hold licenses in the State in which they provide services, if they have an equivalent license from another State (and are not affirmatively barred from practice in that State or any State a part of which is included in the emergency area).


c. Actions under section 1867 of the Act (the Emergency Medical Treatment and Labor Act, or EMTALA) for the direction or relocation of an individual to another location to receive medical screening pursuant to an appropriate state emergency preparedness plan or a state pandemic preparedness plan or for the transfer of an individual who has not been stabilized if the transfer is necessitated by the circumstances of the declared public health emergency for the 2009-H1N1 influenza pandemic.


d. Sanctions under section 1877(g) (relating to limitations on physician referral) under such conditions and in such circumstances as the Centers for Medicare & Medicaid Services determines appropriate.


e. Limitations on payments under section 1851(i) of the Act for health care items and services furnished to individuals enrolled in a Medicare Advantage plan by health care professionals or facilities not included in the plan’s network.


2. Pursuant to Section 1135(b)(7) of the Act, I hereby waive sanctions and penalties arising from noncompliance with the following provisions of the HIPAA privacy regulations: (a) the requirements to obtain a patient’s agreement to speak with family members or friends or to honor a patient’s request to opt out of the facility directory (as set forth in 45 C.F.R. § 164.510); (b) the requirement to distribute a notice of privacy practices (as set forth in 45 C.F.R. § 164.520); and

(c) the patient’s right to request privacy restrictions or confidential communications (as set forth in 45 C.F.R. § 164.522); but in each case, only with respect to hospitals in the designated geographic area that have hospital disaster protocols in operation during the time the waiver is in effect.


3. Pursuant to Section 1135(b)(5), I also hereby modify deadlines and timetables and for the performance of required activities, but only to the extent necessary, as determined by the Centers for Medicare & Medicaid Services, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the 2009-H1N1 influenza pandemic, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.
These waivers and modifications will become effective at 5:00 P.M. Eastern Standard Time on October 29, 2009, but will have retroactive effect to October 23, 2009, nationwide, and continue through the period described in Section 1135(e). Notwithstanding the foregoing, the waivers described in paragraph 2 above are in effect for a period of time not to exceed 72 hours from implementation of a hospital disaster protocol but not beyond the period described in Section 1135(e). The waivers described in paragraphs 1(c) and 2 above are not effective with respect to any action taken thereunder that discriminates among individuals on the basis of their source of payment or their ability to pay.


The waivers and modifications described herein apply in the geographic area covered by the President’s proclamation, pursuant to the National Emergencies Act, on October 23, 2009, that the 2009-H1N1 influenza pandemic constitutes a national emergency; and former Acting Secretary Charles E. Johnson’s April 26, 2009, determination, pursuant to section 319 of the Public Health Service Act, that a public health emergency exists nationwide involving Swine Influenza A (now called 2009 – H1N1 flu), renewed by me on July 24, 2009 and October 1, 2009.
Date:
___________________________
Kathleen Sebelius
Secretary
Department of Health and Human Services

Where to get the H1N1 Vaccine.

Pandemic to Choke Financial Markets

GAO Report.

7-5 Fuel Tank

Notice of Propeosed Rulemaking.

H1N1 from the CDC

Passenger Screening.

Where to get a vaccine shot.

Fly Bye

Delta/Northwest Crews Working Together.

Here's a plausible explanation: both were on demand masks, the O2 was contaminated with laughing gas like you'd get in a dentist's chair. They lost awareness b/c of the contaminated gas. Both cylinders should be empty.

Air Travel (other blogs)

Not Mine, but may interest you.

Bureau of Transportation Statistics

Employment.

This is your purser speaking. . .

Cockpit to Cabin (and visa versa) communication post 9/11.

Excerpt:

The events of September 11th, 2001, have magnified the importance of flight attendants protecting safety of passengers and crew, as well as, providing critical information to the pilots. The events of September 11 changed forever our concepts of aviation safety. The use of a hijacked aircraft as a weapon requires a new strategy to ensure that the crew always retains control of the aircraft. Flight Attendants have an immediate need for updated security training. This training should include basic defense maneuvers to allow them to defend themselves and slow down any terrorist attack. Crew communication and coordination should be integrated in this training. Currently, there is no comprehensive training that explains what the flight attendants, pilots and air marshals do in case of an attack. These groups should be trained to work together as a team, to be as effective as possible. This information was made evident in the testimony of Patricia Friend, International Presidents, Association of Flight Attendants, CWA, AFL-CIO, before the subcommittee on transportation security and infrastructure protection of the homeland security committee, U.S. House of representatives, November 1, 2007.

Aircraft Drinking Water Supplies

The EPA gets involved.

Lithium Batteries in Air Transport

Shipping Lithium Batteries, Courtesy of Cryptome(dot)org.

Since 1991, we have identified over 40 air transport-related
incidents involving lithium batteries and devices powered by lithium
batteries. A list of these incidents can be found on the FAA Web site
at:


Chart.



These incidents occurred aboard passenger aircraft and cargo
aircraft, prior to loading batteries aboard an aircraft, and after
batteries were transported by air. Many of the incidents were directly
related to a lack of awareness of the required safety measures
applicable to shipments of lithium batteries or because passengers
failed to follow preventative measures to protect batteries from short
circuit or damage.
On September 9, 2009 a passenger flight declared an
emergency after a passenger attempted to hand the flight attendant a
carrier-provided personal electronic device (PED). The PED was dropped
and upon impact with the cabin floor the battery pack sparked and began
smoking. Two flight attendants extinguished the fire with water.
On August 25, 2009 DOT received information related to a
smoking and burning package that was discovered at a Medford,
Massachusetts sorting facility. Upon inspection, the consignment was
discovered to contain 30 individual batteries grouped together in six
or seven battery packs. The package contained lithium batteries that
were shipped as general cargo. There were no markings or labels on the
outer package indicating the material was a hazardous material.
On August 15, 2009 a package containing lithium ion
batteries was found smoldering, and emitting smoke in a unit load
device (ULD) in an aircraft loading facility in Taipei, Taiwan. The ULD
had been carried from the Island of Macau. Personnel in the Taiwan
facility responded quickly to extinguish the

[[Page 51644]]

smoldering fire before any open flames were seen. The packages were
unmarked and the contents were noted on the invoice as ``electrical
adapters.''
On August 14, 2009 after landing the aircraft, the flight
crew received a warning indicating smoke in the forward cargo
compartment. Initial indications are that a fire originated with a
shipment of approximately 1,000 e-cigarettes, each containing a lithium
metal battery. There were no markings or labels indicating the
materials posed a specific hazard or contained lithium batteries.
On July 15, 2009 one of several related packages
transported from Romulus, Michigan was discovered emitting smoke and
smoldering upon arrival in Santo Domingo, Dominican Republic. Upon
inspection, the package was found to contain numerous loose lithium-ion
cell phone batteries haphazardly packed with no apparent measures to
protect against short-circuits or overheating. Package documentation
indicated, ``used batteries--non haz.''

FAQ Lithium Batteries.

Expect Delays

Brookings Institute Report.

TSA Workforce

Airport Security Workforce, from the GAO.

What Airport Security Knows About You

Via Bruce Schneier's Blog:


What Airport Security Actually Knows About You.