- Associated Press - Monday, October 27, 2014

The Des Moines Register. Oct. 27, 2014.

Telemedicine rules create a double standard

Every day in Iowa, health care providers use technology at one location to connect with patients at another location. A doctor can oversee a procedure elsewhere using real-time videoconferencing. Psychiatrists can evaluate, diagnose and decide what drugs to prescribe for a patient they’ve never met in person. Specialists at the University of Iowa can treat burn and stroke victims remotely.

So-called telemedicine provides Iowans access to health services they may not otherwise have. Veterans, prison inmates and elderly residents do not need to travel long distances. This method of delivering care is especially important in a rural state, providing access to experts across the state and has been used in Iowa for many years.

Now the Iowa Board of Medicine is trying to catch up. For the first time, it has crafted administrative rules providing telemedicine standards for all physicians it oversees.

Unfortunately, board members are unable to reconcile the need to create basic guidelines with their fixation on driving abortion providers out of business by state rules.

The proposed rule rightly gives discretion about patient exams to doctors. The doctors must “ensure” patients undergo an exam “when medically necessary,” but the board acknowledges that “may not be in person.” Patients must also have “access” to follow-up care, but it does not need to be provided by the same doctor.

This guidance is at odds with another rule passed by the same board last year that imposes onerous requirements on Iowa doctors using videoconferencing to dispense abortion- inducing drugs. That rule, which is being challenged in court, requires the same physician who dispenses a drug to perform an in-person exam. Not a nurse. Not a physician’s assistant. Not even another doctor. The doctor also must be in the same room with a woman when she swallows the pill and schedule a follow-up exam at the same location.

Such requirements not only defy the very idea of telemedicine, but when combined with the newly proposed rule, create two sets of guidelines for Iowa doctors: one that applies to all physicians using technology to connect with patients and another for the three physicians now providing remote abortion services for Planned Parenthood of the Heartland.

Board members cannot have it both ways on telemedicine. They cannot recognize technology as a “useful tool” that can “provide important benefits to patients” and then refuse to extend those benefits to women seeking a medical service board members don’t like. The rules acknowledge a doctor does not need to be in the same room with a patient to provide quality care - unless that doctor is dispensing a specific drug that poses little risk to a woman. While the board recognizes telemedicine can provide Iowans “increased access to health care,” they don’t want that care to involve terminating a pregnancy.

The proposed telemedicine rules are a reminder of the hypocrisy of the current medical board. Members have made a mockery of a state entity that was previously a respected voice in medicine. They have used their positions to further a political agenda instead of remaining focused on patient care and safety.


Waterloo-Cedar Falls Courier. Oct. 24, 2014.

Being prepared is the best safety strategy

Waterloo is joining other school districts in a modified training program addressing armed intruder threats.

In doing so, the district is simply addressing a modern reality.

Willie Barney, the district’s executive director of supplemental services, explained the new plans to a group of parents last week during an informational meeting at Central Middle School.

The training adds the options of evacuating and countering an attack when appropriate - modifying the traditional lockdown strategy.

“We’ve now modified that to what we call an enhanced lockdown,” said Barney. The idea is to “increase survivability” when an intruder enters a school with a gun or other weapon.

The modifications are based on the U.S Department of Homeland Security recommendations and follow the “run, hide, fight” framework developed several years ago.

It’s the same program employed by the Cedar Falls School District, which implemented the training last spring.

Perpetrators shot students and teachers who were hiding in rooms during tragedies at Columbine, Colo., Virginia Tech University and Sandy Hook Elementary School in Newtown, Conn.

Anne Lane, of Waterloo was one of those who attended last week’s meeting.

“I’ve got a young elementary student and Sandy Hook really affected me, so it’s been on my radar,” she said. “I’m glad that the district decided to share it with the community and parents. I think it will help me talk with my student, and it gives me a little peace of mind that it’s being worked on.”

While we realize the chances of such an incident affecting any particular school in the local area are slim, we’ve also seen that such a situation can materialize pretty much anywhere.

As we’ve stated before, it’s truly a sad commentary our nation’s school districts need to have some type of school intruder or school shooter training. It’s also a reality such tragedies occur often enough it warrants such training.

Schools are a natural place to employ such strategies - for obvious reasons. Hundreds of children are apt to be inside a single building at one time.

It’s the same reason schools hold fire and tornado drills. They need to be ready to react quickly in an emergency. It doesn’t matter if potentially tragic events originate from human violence or natural disasters.

All of which legitimizes the implementation of up-to-date armed intruder training in our schools as part of their overall safety strategies.

The prior shootings across the nation were horrible tragedies. It would be shame if we didn’t learn from them.


Quad-City Times. Oct. 22, 2014.

Take control of forfeiture laws

America’s out-of-control civil forfeiture laws are an abomination of their original intent, turning some local, state and federal police into cash-seizing thieves little different from the crime bosses these laws were intended to stop.

That’s the summary of two Americans instrumental in starting the federal forfeiture initiative in the 1980s. John Yoder and Brad Cates were the first and second directors of the Justice Department’s Asset Forfeiture Office in its formative years, from 1983 to 1989. In a Washington Post column, the pair condemned the current civil forfeiture practices as, “a complete corruption of the process,” with “widespread abuses.”

They wrote after the Washington Post published an expose of federal seizures. That report followed a Des Moines Register investigation into Iowa seizures,, which followed a Daily Dispatch/Rock Island Argus investigation into Illinois seizures, which came after a Frontline report on the same thing.

Each of these investigations reveals police grabbing cash and property from Americans, often without felony prosecution.

The Register disclosed how Iowa State Patrol seized $100,000 in cash from two California poker players driving through the state from an Illinois tournament. Their offense? Failure to signal a lane change.

The Dispatch/Argus tallied seizures in Henry County, where former county prosecutor and judge Larry Vandersnick now works against the government. He advertises his, “track record of success in defending clients against government or police property forfeitures.”

The Washington Post last month linked the explosion of cash seizures on a, “thriving subculture of road officers on the network now competes to see who can seize the most cash and contraband, describing their exploits in the network’s chat rooms and sharing ‘trophy shots’ of money and drugs.”

A Frontline report said, “over 80 percent of the people whose property is seized under civil law are never even charged with a crime.”

Now the originators of this practice admit the best intentions of the 1980s have spun out of control. “This all may have been fine in theory, but in the real world it went badly astray,” the pair wrote for the Washington Post. “First, many states adopted their own forfeiture laws, creating programs with less monitoring than those at the federal level. Second, state law enforcement agencies and prosecutors started using the property - and finally even to provide basic funding for their departments.”

The Post investigation disclosed $2.5 billion in seizures since 2001, with about half of the seizures lower than $8,800. Because of the legal costs, fewer than 20 percent of the seizures were challenged in court. In those few challenges, better than 40 percent prevailed over the government.

These tactics used most frequently in drug enforcement have done nothing to reduce drug trafficking, cost or availability. They simply continue to take money from Americans, many of whom are never convicted - and some never charged - with any crime.

The money appears to be too tempting for police to curb these immoral seizures. So legislators must, with transparency laws that require full disclosure of seizures so that taxpayers, not just investigative journalists, can determine how often cash, cars and other goods are being taken from Americans never convicted. Then lawmakers at the state and federal levels must evaluate civil forfeitures effect on reducing crime, not just funding more seizures.


Iowa City Press-Citizen. Oct. 22, 2014.

Animal cruelty laws need to be strengthened

As of 5 p.m. Tuesday, an online petition calling for the maximum penalty possible to be brought against Leo A. Nopoulos had obtained 18,868 of the organizers’ 20,000 signature goal.

The problem is that, even though the organizers may have obtained those additional 1,132 signatures by now, there is no guarantee that such a petition would influence prosecutors, jurors or judges that Nopoulos is guilty of (and should be imprisoned for) allegedly torturing a young kitten for three hours straight and leaving the poor creature blind and maimed.

Nor should justice be doled out by petition - as if we were living in some fictional dystopian society in which everyone, not just jurors and judges, gets to participate online in determining the guilt of and appropriate sentences for the accused.

What should matter, as Johnson County Attorney Janet Lyness told the Press-Citizen, are:

- The facts of the case, including background information on the defendant.

- The details of the allegations.

- And the indicators about whether the defendant is a threat to his or her community.

“I’d say a petition is not going to influence the judge in terms of what sentence is given, but the judge would certainly take into account considerations of the facts of an individual case,” Lyness said. “. And certainly in this case, the facts that have been alleged so far probably would have an influence.”

That said, the accusations against Nopoulos are particularly grisly and definitely would seem to warrant a charge of “animal torture.” If convicted of that charge, Nopoulos would face a minimum fine of $625 and a maximum sentence that includes up to two years in prison. (Nopoulos was released Oct. 15 from the Johnson County Jail on $5,000 bond.)

Yet first-offense “animal torture” - even for something as heinous as what occurs in the video of this incident - is an aggravated misdemeanor, not a felony. That means, Nopolous could receive a deferred judgment, which would include up to two years of probation. And if he met the requirements of probation, the case could be expunged from his record with no fines or jail time served.

And even then, the bar for conviction is quite high.

Last year, an Iowa Appeals Court overturned the conviction and sentence against Zachary Meerdink, a Davenport man who had been found guilty in 2012 of beating a 7-month-old puppy to death with a baseball bat. In a 2-1 ruling, the court determined that Meerdink hadn’t committed “animal torture” because prosecutors failed to demonstrate he acted with “depraved intent” when he killed the animal. Iowa Attorney General Tom Miller asked the Iowa Supreme Court to reinstate the conviction and clarify Iowa’s animal torture law.

In response to situations like the Meerdink ruling, the Animal Rescue League of Iowa and other groups unsuccessfully lobbied the Legislature this year for a bill that would increase penalties for those convicted of animal neglect, abuse or torture. One bill, for example, introduced in January by Iowa Sen. Matt McCoy of Des Moines, would have made first first-offense animal torture a felony. (According to Iowa Code 717B.3A, animal torture is a Class D felony only for a second offense.)

Although online petitions should have little-to-no effect on judges, they have been known to have a more profound effect on state lawmakers. And we hope the publicity of this case and others will help spark a broader discussion of strengthening the state’s laws against animal cruelty.

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