From EB: Tramadol is widely used in nursing homes, but is it the most dangerous drug in the world?

This article says yes.

https://blog.iodine.com/tramadol-the-most-dangerous-drug-in-the-world-5500450d6cc6

Tramadol: The most dangerous drug in the world

image (cropped) courtesy of Frankie Leon (Flickr)

Imagine a prescription medication that relieves pain just as well as narcotics like Oxycontin, but isn’t addictive. Too good to be true?

Turns out, yes.

For years, that was the case with Tramadol, a synthetic opioid drug that was released in 1995 under the brand name Ultram to great expectations. This new drug seemed to offer all the benefits of more powerful, more addictive drugs, but with fewer of the downsides of dependency — at least in clinical trials. This was apparently in part because trials examined tramadol use by injection, but it is manufactured — and far more potent — in pill form.

And if the drug was unlikely to make people dependent, it was not likely to be abused, unlike other opioid alternatives like Vicodin (also known as Norco), Percocet — let alone be as dangerous as high potency opioid medications like morphineDilaudid, or Fentanyl.

So for many years, Tramadol was widely prescribed by doctors as a “safer” alternative to narcotics for pain. The difference between narcotics and opioids is subtle, but opioids are natural or synthetically made drugs that function metabolically in the body like opium derivatives derived from poppy plant, while narcotics is more often used as a legal term, classifying drugs that blur the senses and produce euphoria, including cocaine and other non-opiates.

Indeed, unlike other opioid drugs, the Drug Enforcement Agency didn’t classify Tramadol as a controlled substance, because the FDA believed it had a low potential for abuse.

Though there were concerns about tramadol abuse in the years after release, the FDA repeatedly determined that the drug was not being widely abused, and so left it as an unscheduled drug.

This made Tramadol a particularly dangerous drug — because it was, in fact, highly addictive and prone to abuse. But because it was easier to obtain and had less concerns from physicians, it was more widely prescribed. Over the years, as often happens, a difference between clinical trials and the real world started to emerge. Emergency rooms began to report a growing number of overdoses related to Tramadol, even as the number of prescriptions soared, especially after the drug went off patent and cheaper generic versions became available in 2009. In 2013, nearly 45 million prescriptions for tramadol were written for patients in the U.S., nearly doubling in just five years.

In fact, one of the reason people like taking Tramadol is because for some people it works as an antidepressant, producing euphoria or energy, unlike other opioids which tend to make people drowsy. This has led it being used recreationally, while people still go to work or live their daily lives.

The problem didn’t just emerge in the U.S. Tramadol has become a widely available and widely abused drug across the world, as a recent report in the Wall Street Journal spelled out, pointing out horrible abuse in African nations of Cameroon and Nigeria. Ireland has seen overdoses from Tramadol soar. Egypt has been another victim of the misleading perceptions of the drug, as cheap pills have spread as daily-helpers among the poor and working class.

Finally, in 2014, the DEA finally changed Tramadol to a Schedule IV designation as a controlled substance. But the World Health Organization continues to classify the drug without restriction, under the belief that it would become much more difficult to obtain by people who need legitimate pain relief, according to the Wall Street Journal report.

When you actually consider the real world experience of people taking the drug, however, it quickly becomes evident that Tramadol, like other opioids prescribed for pain relief, also carries the trade off of dependency and withdrawal. Among the 50 or so first-person reports on Iodine.com, many Tramadol users cite these effects.

“I wish I knew this was an addictive narcotic. My doc told me it was non narcotic,” offered one user, who identified herself as a 36 year old woman.

This is exactly what makes Tramadol so dangerous. Despite it’s reputation as being a “safe” opioid, it is still an opioid. These drugs have been massively over-prescribed over the past 20 years, causing an opioid crisis in the U.S. with thousands of people suffering the consequences of addiction, ruined lives, and death. In 2014 alone, more than 28,000 people died from opioid overdose — at least half of them prescription drugs, compared to street drugs like heroin (which are often the cheaper drug of choice among people who started with a prescription opioid).

On every page for an opioid drug at Iodine.com, we have placed a clear and emphatic warning about the risks of these drugs in a big orange box. For many people, these drugs serve a purpose, and are a necessary part of coping with pain. But people need to be careful before they begin using them, and they need to be aware that the drugs carry a significant risk of dependency that can squander lives. These are dangerous drugs that must be taken seriously.

From Joanne:

If your loved one needs pain relief, stop turning to aspirin, acetaminophen (Tylenol)  and Ibuprofen. Those are also very dangerous drugs and hard on your liver which has to process that poison.

Safe, highly effective all natural pain relief is as follows:

  1. tumeric and cayenne.  eat a lot of curries.  make a lot of curry. no more pain and both of these foods are highly nutritive and build up body tissues.  Most effective when heated and cooked. Don’t like hot stuff?  You can get both tumeric and cayenne tabs, but these are much more expensive, but no where near as expensive as the prescription meds a traditional MD is falsely taught to promote. Tumeric and cayenne is totally safe, effective, known to cause zero deaths and promote health and longevity. Google it. Check it our yourself.
  2. Many oils such as rosemary, clove and oregano. Zero side effects and they contain tons of phytonutrients.
  3. Lyposomal or lypospheric Vit C and D3 (get tested) and sulfur (about 2 gr per day). These build muscle tissue.
  4.  A low carb/low sugar diet.  Much pain is caused by inflammation. Inflammation is caused by the over growth of bad bacteria. Take probiotics and stop eating carbs and sugars. This includes:  oatmeal, beans, pastas, rice, — anything over 15 gr of carbs per meal. Start reading those food labels.

good luck and namaste.  You know the ALs and nursing homes feed a crap diet.  Ever see one advertise yoga, meditation, all organic diets, all vegetarian diets?  Ever see one advertise no psych drugs, all natural healing?  Sprituality, yoga and meditation? Heck no.  If they did that all their residents would be gone in 2 to 6 months. And, more important, nearly zero people in guardianship.  You want to stop guardianship, get educated on living to 100 to 120 and walking out of your body.  Get a clue. We need to make these opiate drugs illegal, take down the false and fraudulent drug companies that prescribe poison and their minion MD’s that get massive bennies from being their patrons and stop all this nonsense.

There is a new energy. And it is unstoppable.  The shutters have been taken down. We have peace and light and love.

joanne

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From AG: It’s women’s herstory month. How much do you really know about women’s legal herstory. How much do your kids know?

From Alan Greyson, Congressional Rep:

When do women face attacks on equal access to health care? Now.

When have women been denied equal pay? Now.

When have conservatives organized nationally to block the Equal Rights Amendment? Now. Here and now.

And if you’re looking for history (or herstory), look how slowly change has come: The 19th Amendment, giving women the vote, was ratified “only” 129 years after the Bill of Rights, and “only” 50 years after the 15th Amendment gave male ex-slaves the vote. Contraceptives weren’t covered under the Public Health Service Act until 1970, 26 years after the PHSA itself became law. “Female hysteria” was a recognized (albeit fictive) mental illness until 1952. (One of the baneful symptoms of female hysteria was “sexual desire.”) The states have passed more than a thousand anti-abortion laws to try to counter Roe v. Wade since 1973. And, of course, women are paid only 80 cents for every dollar paid to men.

Last question in today’s quiz. Who said this:

“I’m willing to fight for Social Security, Medicare, student loans, U.S. jobs, equal pay, progressive taxation and full employment.”

 
 
 From Joanne;
And don’t forget the EEOC was passed in 1964 with the Civil Rights Act, but had absolutely no teeth until much later in 1982.  Until then, women were not allowed to be lawyers, judges, doctors, engineers, architects etc. They were supposed to only be teachers and nurses.   If a woman graduated college in one of these fields (assuming she could get in), she was told she could only be a secretary or assistant to a man in those fields.
It is well known in patent history, women were told not to file patents or to file them in the name of a male relative.  I actually met patent attorneys who told women this years ago because they felt the examiners would not grant patents to a female name unless was for female clothing or personal products.
I actually sweated out getting my first job with General Motors Corp. because no car division was hiring female mechanical engineers, until the EEOC in 1982 finally told the Fortune 500 they had to start hiring women professionals and had to set quotas.  So I got a job.  I had great grades and references, etc. but otherwise I, like the other bright female engineers who loved math and science would have had to go back to get a masters degree and wait for jobs to appear.  Many of my friends in the Masters and PhD programs were just women waiting patiently for the EEOC.  Now a former judge from the EEOC, Mary Elizabeth Bullock has stories of how major corporations have corrupted even out own beloved EEOC.  You can friend this famous honest woman lawyer on Facebook.  She is still fighting for women and minorities to take back the EEOC to Truth and Justice.
Women fought long and hard for equal rights.  I remember being as young as 10, paying a quarter and going down to the Daley center by myself to attend the numerous women’s marches and ralleys for equal rights and it was mostly the hippies that pushed for this and pushed for peace during the war era years.  I believe they were the first wave of special entities sent for peace and love and truth and justice and they made a big splash.
Now we have the crystals, indigoes and rainbow kids and they are making their own wave with even more energy of the light; and no, they’re not going away, and there is no going back.
One of the signs I am told of ascension for the plant is equal rights between men and women and no gender wars and we just appreciate one another.  When we get the ERA, it will be another sign. Remember communism fell in a day and not due to any forces on earth. Same for the Berlin wall.  It is through prayer we make those changes here on earth.
It’s coming.   I’m praying for it.
JoAnne

From EB/NW: Sealed Guardinship cases? How are those even Constitutional?

https://projects.newsday.com/long-island/sealed-guardianships-cases/

SPECIAL INVESTIGATION

Sealed guardianship cases

An ailing mom, a family feud and a hidden court file

In June 2013, Nassau County Judge Angela Iannacci sealed a legal action brought by Dean Hart, now a candidate for State Assembly, to have a guardian appointed for his 79-year-old mother, whose mental faculties were in decline.

Iannacci’s order failed to provide any substantive justification for sealing the records, as required by the state mental health law. In such cases, concern for the privacy of the vulnerable party typically serves as the basis for sealing.

An examination of partial case records obtained by Newsday, however, raises the question of who actually benefited from the sealing order. It appears to have done little for the welfare of Beatrice Hart, who suffers from dementia, while shielding attorneys, the courts and a current candidate for public office from outside scrutiny.

The disturbing accusations leveled in the case include elder abuse, cronyism in the court system, and Dean Hart fleecing his mother of $4.5 million with help from the firm of attorney Steven Schlesinger, a powerful Democrat whose court-appointed stewardship of a wealthy charity is now under state and federal investigation.

The Hart case is one of 207 guardianship proceedings identified by Newsday that Long Island judges hid from the public during a roughly 10-year period.

These cases involve the appointment of legal caretakers for people who require help managing their personal affairs. They comprise two-thirds of the court actions Newsday found in its investigation of case sealing by Long Island judges.

After obtaining confidential records, Newsday two weeks ago reported state Sen. Tom Croci’s involvement in one of those cases. In 2013, Newsday reported, a court-appointed evaluator found that Croci had “taken advantage” of his elderly aunt, philanthropist Adele Smithers, for his own financial benefit and recommended that a judge reject his request to control her assets as guardian. Croci told Newsday that he always acted in his aunt’s interest and that he could not answer questions about the case because of the sealing order.

Read Part 1The order in the Smithers case, as in the Hart proceeding, fell short of the state mental health law’s requirements for sealing guardianships.

Documents in the Hart case, which is marked by an intense family schism, reveal the severity of the alleged misconduct that can be hidden when judges seal guardianship files. The records show that in 2012, Dean Hart’s wife pleaded guilty to disorderly conduct after a violent physical altercation with her mother-in-law.

And early in the case, Beatrice Hart’s lawyer, David A. Smith, wrote an impassioned letter to Iannacci, saying that he had witnessed Dean Hart confront his mother days earlier in a manner so disturbing that he’d summoned the police.

“In Beatrice Hart’s home,” Smith wrote, “Dean Hart repeatedly screamed at his mother, while positioning himself within inches of her face, that ‘I will get even with you for turning on me’; repeatedly cursed at her; told her that he did not consider her to be his mother anymore; and got so close to her while screaming at her that the independent agency nurse had to keep moving Beatrice from room to room of her home in order to seek, unsuccessfully, to get Dean to stop.”

In a recent interview, Hart — a Democrat vying to represent parts of Hempstead, North Hempstead and Oyster Bay through a self-financed campaign — said Smith’s letter is rife with “false accusations” and that the attorney had worked in concert with his estranged sister, Penny Hart, to smear him. Hart and his sister have disagreed vehemently over Beatrice Hart’s care, and while defending their own actions have accused each other of impairing their mother’s health and attempting to control her $5 million estate.

Schlesinger declined to be interviewed. In email responses, he disputed any suggestion of impropriety in his representation of Dean Hart or the $4.5 million trust transaction.

Privacy vs. transparency

Privacy concerns serve as the ostensible basis for sealing guardianship cases, which can be lurid and messy. Clashes over what’s in the best interest of an enfeebled relative are often what leads a judge to appoint a family member or outside attorney guardian. When money is at stake and there is entrenched family conflict, proceedings can turn especially vitriolic.

All this may seem to argue for confidentiality. However, elder advocate Jack Halpern, an observer of the state guardianship system for over 40 years, said the privacy concerns that judges and family members cite as justification to seal cases are often overblown and even disingenuous.

“In too many instances,” said Halpern, who is CEO of My Elder Advocate, a private senior advisory firm, “the sealing is not serving the interests of the elderly person, but those individuals or entities that are supposed to be caring for them.”

Dean Hart, who has gained notice with political stunts such as giving out plastic handcuffs while on the campaign trail to highlight public corruption, supported Iannacci’s sealing order in 2013. He said he did so, in part, out of a desire to protect his mother’s privacy.

Contacted for this story in August, however, Hart said that he’d like the case files made public, even if some voters took their contents “out of context” and turned against him. He said the sealing had allowed the court system to get “away with murder” in its treatment of his mother.

In one of the few areas of agreement between Hart and his sister, Penny Hart said she too would like to see the guardianship case involving her mother unsealed, saying the secrecy had masked her brother’s outrageous conduct.

“I have nothing that I need to hide in this,” said Penny Hart. “The only person who has something to hide is Dean. Let the world see.”

A month ago, Newsday asked state court leaders to vacate the sealing order in the Hart case and scores of others that were improperly concealed from the public. They have not responded to the request.

Balancing act required

The guardianship law is sensitive to privacy concerns. Judges must inform those who may be assigned a guardian of their right to request a sealing order. Issuing a sealing order simply when asked, however, is forbidden. Judges are supposed to balance any claim of the need for confidentiality against other factors, including the benefit of open court proceedings to the health of the justice system.

That balancing is required for good reason.

When outsiders have gotten a look inside this area of the courts, appalling conduct has sometimes been revealed. Government agencies and media reports have repeatedly identified abuses such as court-appointed lawyers or family members draining the estates of their vulnerable wards. In part, the sealing law is meant to encourage a degree of transparency and act as a check on abuses.

Newsday found that when applying the law, Long Island judges repeatedly relied on generic, stock phrases to overcome the presumptively public nature of the proceedings. This was most often true in Suffolk County, where 174 sealed guardianship cases were identified compared with 33 in Nassau.

In nearly all the Suffolk sealing orders, judges simply quoted verbatim a passage from the state mental health law that lists elements that must be weighed when deciding whether “good cause” exists to conceal a case. Suffolk Judge Sandra Sgroi, who now sits on a state appellate court, signed 108 orders of this kind in a five-year period. Sgroi declined to be interviewed for this story.

In Nassau, judges employed a blanket statement about case files containing privileged and confidential information to achieve the same end.

In the Hart case and four others, the orders lacked even this boilerplate language.

Dozens of sealed guardianship files Newsday identified involved efforts by hospitals and nursing homes to have residents declared incapacitated and in need of a guardian. That can happen when a hospital wants to discharge a patient who’s unwilling to leave or when a resident can’t pay nursing home bills.

One sealed guardianship proceeding was brought by the controversial Judge Rotenberg Center. The Canton, Massachusetts-based home for disabled youth has drawn criticism for its use of restraints and electroshocks to control residents.

The case appears to have stemmed from a dispute between the center and public agencies in New York State over the care of a resident from Long Island who’d been born addicted to cocaine and whose mother had killed another of her children. In one available record, the center alleged that the state had failed in its obligation to find a placement for the resident when she turned 21 and that it was owed nearly $180,000 in taxpayer dollars for providing the woman nine months of care.

Judge H. Patrick Leis, who sealed the case in 2009, declined to be interviewed.

Rotenberg attorney Jocelyne Kristal said the center brought the case in the hope that a guardian could provide the young woman appropriate care, which she contended public agencies had failed to arrange. She said the guardianship matter was secondary to related federal litigation that was of legitimate public interest, but that sealing the guardianship was appropriate to protect the woman’s privacy.

Inside the case

Significant documents in the Hart case obtained by Newsday provide an unusual look at one guardianship battle that was placed behind a wall of official secrecy.

In November 2012, as Beatrice Hart’s faculties began to diminish, she signed over $4.5 million from her personal trust to her son, Dean. The stated reason for the move was to minimize the tax obligation of Beatrice Hart’s estate. Penny Hart said her mother was gravely ill and being spoon-fed by a caretaker when she signed over the money. Lawyers in the firm led by Schlesinger, Dean Hart’s attorney, served as witnesses and prepared the paperwork.

Records show that during this time, Beatrice Hart expressed fear of Dean Hart and his wife, going so far as to obtain orders of protection against them based on allegations of physical abuse. Dean Hart was never criminally charged with being violent toward his mother, but in December 2012, Hart’s wife pleaded guilty to disorderly conduct following a violent episode with Beatrice Hart.

In an email to a reporter, Dean Hart wrote, “Every family has squabbles and in this case an isolated incident took place that my wife still deeply regrets. My wife still respects and cares deeply for my mother, as do I.”

In early 2013, Beatrice telephoned her daughter Penny Hart, who had long been estranged from the family. The women started to re-establish a relationship, something Penny Hart had been reluctant to do. Around this period, Beatrice began to voice suspicions about the trust transaction. Ultimately, her lawyer asserted, she came to believe that her son had “stolen” the money from her.

Dean Hart denies ever having swindled or abused his mother, saying his sister manipulated a senile Beatrice Hart into making the ugly charges.

“I’ve never done a thing that I am embarrassed about,” Dean Hart said.

It was during this period of high tension, in May 2013, that Hart petitioned the court to have his mother declared in need of a guardian. Schlesinger and multiple attorneys from his firm handled the legal action.

The case landed in Judge Iannacci’s court. Both sides would ultimately question the propriety of her having presided.

Eight years before, when Iannacci sought the Nassau Democratic Party’s support for what would become a successful Supreme Court bid, Schlesinger was the party’s law chairman, giving him a prominent role in deciding who would get on the ballot in judicial races.

A then-party official who wished to remain anonymous so as not to offend a sitting judge said that Schlesinger had been critical to securing party support for Iannacci.

In a recent interview, Dean Hart said that Schlesinger had “made Iannacci,” but that far from granting him any advantage in the guardianship case, the judge repeatedly sided against him to demonstrate that she owed Schlesinger nothing.

Schlesinger wrote in an email to a reporter that he was a member of a committee that chose Iannacci, but he had “never asked or sought any consideration on account of my participation on that committee.”

Though Penny Hart believes that the judge acted independently and protected Beatrice Hart from her brother, she said Iannacci should have recused herself due to her history with Schlesinger.

On June 13, 2013, Iannacci sealed the Hart case.

A hearing transcript shows that Schlesinger was present in the courtroom that day but left early for a dinner engagement. An attorney in Schlesinger’s firm requested the sealing, and Iannacci asked Beatrice Hart’s attorney, Smith, whether he would join the application. Smith said yes, and an attorney for Penny Hart, who was present as an interested party, consented to the sealing.

In her order, Iannacci noted that she was acting on the “request of all parties.” That’s an improper basis for sealing because the law is meant to prohibit judges from hiding guardianship cases merely because parties seek confidentiality.

Ten days later, Smith wrote the letter to Iannacci that included his account of the confrontation between Dean Hart and his mother. He also told the judge that the day before, Beatrice Hart had stripped Dean and his wife of any authority to make health care decisions on her behalf and visited the Nassau district attorney’s office to allege that her son had conned her out of the $4.5 million from her trust.

In September 2013, Iannacci appointed Nassau attorney Emily Franchina temporary guardian of Beatrice Hart’s property. The following month, Franchina was named Hart’s temporary personal-needs guardian, giving her the power to make decisions about Beatrice Hart’s health care and day-to-day affairs.

Franchina was given specific authority to investigate the $4.5 million transaction, which had become a flashpoint. Billing records indicate that Schlesinger’s firm, Jaspan Schlesinger, represented Beatrice Hart in the trust transaction, but Penny Hart said her mother never hired firm attorneys to handle her estate matters.

“How does he represent my mother and Dean at the same time?” Penny Hart asked, referring to Schlesinger. “It just drives me nuts. It’s just wrong.”

Smith, Beatrice Hart’s attorney, said he was unable to discuss a sealed case, but that when it comes to such sizable trust transactions generally, “it is to my mind critically important that the person making the transfer have their own counsel.”

In a ruling included in the partial case file Newsday obtained, Iannacci stated that Dean Hart had tried to establish that a Florida attorney, Diane Bell, had represented his mother in the trust transaction. However, Bell testified via Skype to the contrary, saying she believed that attorneys in Schlesinger’s firm had represented Beatrice Hart, Iannacci wrote.

Contrary to what Iannacci wrote and Bell testified, Schlesinger said in an email that the Florida attorney had in fact represented Beatrice Hart. Schlesinger also said the transaction was a minor matter. Beatrice Hart always planned to bequeath Dean Hart the money, he said, so the transaction was not a “substantive” change to the disposition of the funds. Bell did not respond to telephone calls.

Nassau district attorney’s office spokesman Brendan Brosh said that his agency ended its investigation of Beatrice Hart’s complaint after Iannacci appointed Franchina guardian and the office was assured “that any suspected criminal conduct would be reported for investigation.”

In May 2014, Iannacci made Franchina’s guardianship appointment permanent in a ruling that was blisteringly critical of Dean Hart, who’d wanted to be named his mother’s personal-needs guardian. Hart had not cooperated with Franchina, Iannacci wrote, and was ill-suited to serve as a court-approved caretaker.

“Petitioner has demonstrated through his actions and by his testimony that he is unable to comply with the orders of this court,” Iannacci wrote. “Petitioner is not the appropriate person to serve as personal needs guardian.”

Hart continued to use his mother’s checking account after Franchina’s appointment, testifying, according to Iannacci’s ruling, that he’d used the money to pay for “lunch with his attorney, taxis, children’s clothing and parking in New York City.” Iannacci said Hart had testified that “God had given [him] the right” to use his mother’s assets as he pleased in Beatrice Hart’s best interests, despite Franchina having been made guardian of her money.

Hart said Iannacci’s ruling was selective and distorts events. There was a gap between Franchina’s appointment and when the attorney took control of Beatrice Hart’s account, Dean Hart said, and during this period he continued to access his mother’s money, often to buy her necessities such as meals.

He contends that it has been the conduct of Iannacci, Franchina and the court system, not his own, that has been nefarious. The court, he said, has limited his involvement in his mother’s affairs to facilitate the exploitation of her assets.

Penny Hart said Franchina — who has collected $166,000 in fees from the case, according to state records — has done “a wonderful job of managing my mother’s personal needs, especially in light of the conflicting interests involved.”

Dean Hart has asked an appeals court to undo Iannacci’s appointments and decisions, but so far has lost at least twice. He said he is determined to fight on.

“The fact is I did nothing wrong,” Hart said. “I was a loving son. I am a caring person, I am a sensitive person. And I am pissed.”

In November 2015, as the case played out in secret, Hart narrowly lost a Nassau legislative race, taking 48 percent of the vote.

Iannacci did finally step aside in December 2015, after having presided over the case for more than 2 1⁄2 years. With the case sealed, it’s unknown whether she gave a reason for her recusal. Iannacci declined to be interviewed.

A court evaluator, Frank Perrone, was assigned to investigate claims in the case and protect Beatrice Hart’s interests. The findings of his written report are unknown due to the sealing order, and he declined to be interviewed.

As for Beatrice Hart, who lives in a Manhattan nursing home, both her children agreed that she is too diminished to be interviewed.


Review of guardians finds financial reports lag


Tracking 207 cases

For this story, Newsday identified 207 sealed guardianship cases that originated in Nassau state Supreme Court from 2003 to 2014 and Suffolk state Supreme Court from 2005 through early 2015. The 207 cases were identified using a code for sealing orders in Nassau’s electronic case management system and notes that clerks made to case minutes in Suffolk’s system. Neither Nassau nor Suffolk formally track sealed guardianship cases and there’s no way to be sure all were found.

Newsday found portions of some sealed guardianships attached as exhibits in other lawsuits. In some instances, partial case files were shared with a reporter.

The state mental health law bars judges from sealing a guardianship case “except upon a written finding of good cause, which shall specify the grounds thereof.”

In determining whether “good cause” exists, judges must “consider the interest of the public, the orderly and sound administration of justice, the nature of the proceedings, and the privacy of the person alleged to be incapacitated.”

Most of the sealed guardianships Newsday found were in Suffolk County. In nearly all instances, Suffolk judges copied the language above verbatim in their sealing orders, which made no reference to the specifics of the cases at hand.

From NYP/EB: Why NY pols never end up in prison for bribery

YOu can see the same twisted psychopathic logic flowing through the minds of dozens of pols in chicago and their cronies on the bench, at the FBI and states attorneys offices:

Why New York pols get away with corruption

Restauranteur and preferred de Blasio fund-raiser Harendra Singh continues his remarkable testimony in the federal corruption trial of Nassau County Executive Ed Mangano, giving us a unique window on the operations of the mayor’s money and influence machine.

Singh — who has already pleaded guilty to bribing the mayor in exchange for favorable conditions in his negotiations over the renewal of a lease for his restaurant — explained that de Blasio asked him to arrange donations for a number of sitting politicians and candidates for office.

Told that Singh would have to solicit money from other people — what are known as “straw donors” — and then illegally pay them back under the table, de Blasio reportedly responded, “Do whatever you gotta do, but I don’t want to know.”

The mayor denies all of this, and claims that “nothing that he describes as having happened, happened — period.”

Of course, that’s not really true — it is stipulated and accepted that de Blasio and Singh met several times, that Singh gave ample money to de Blasio and his assorted campaigns and that Singh received special treatment from City Hall.

The mayor is able to perpetuate his see-no-evil narrative of innocence because prosecutors decided not to indict him, based largely on the high standards of evidence for public corruption cases set by the Supreme Court in the McDonnell case.

It remains deeply curious that one man can be facing prison time for admitting to bribing an official, while the official in question can be re-elected to office and take trips to Florida to watch the Red Sox prepare for Opening Day — almost like there were different sets of laws that apply to politicians versus the rest of us. The one-sided tango is reminiscent of an old saying about a plate of ham and eggs: the chicken is involved, but the pig is committed.

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Meanwhile, for all the sniping between City Hall and Albany, Gov. Cuomo has his own issues, too. His close aide, friend and “brother” Joseph Percoco was found guilty of federal charges of bribery and fraud for steering state business to companies that gave him $300,000 in the form of cash and a sinecure for his wife.

The Percoco conviction is just an amuse-bouche, though, for the main course that is coming up in June — the trial of Alain Kaloyeros for allegedly “fixing” major state building contracts associated with SUNY Polytechnic and the “Buffalo Billion” economic development project. Hundreds of millions of public dollars, central to Cuomo’s master plan to revive upstate, were funneled through Kaloyeros’ offices.

New Yorkers have relied so far on the Department of Justice to take on these high-profile corruption cases.

But why should we have to count on the federal government to swoop in and clean up our soiled nest? New York has strict laws covering public corruption and campaign finance, and we have plenty of prosecutorial agents who are more than amply equipped to investigate malfeasance.

What we lack is the will to enforce the law. County district attorneys like Manhattan’s Cy Vance are uniquely empowered to prosecute violations of election law. But when Vance had de Blasio in his sights over the mayor’s seemingly blatantly illegal 2014 efforts to circumvent campaign-finance restrictions in state senate races, the DA dropped the charges as soon as he was able to hide in acting US Attorney Joon Kim’s shadow.

Attorney General Eric Schneiderman could act, too. Though state law supposedly limits his ambit regarding political crimes, he’s the one who set up a “Public Integrity Bureau” to “restore public trust in government.” So why doesn’t he use it?

Schneiderman would rather make headlines by suing Big Oil over climate change, while Vance receives kudos from the turn-’em-loose crowd for refusing to prosecute farebeaters.

The problem with New York is that the mayor, the governor, the AG, the DA — and almost everyone else who holds elective office — rely on the same voters, donors, consultants and party insiders. They’re all pals and allies.

There can’t be a game of musical chairs if the music never stops.

Seth Barron is assistant editor o

From EF: Pay to play well alive in Cook County Court System but this is not disclosed to voters or litigants

chicago summer

4:10 AM (1 hour ago)

to reportcorrupti.Elizabeth_Warr.correspondenceChicago.a
*can be published on all anti-corruption blogs and websites.
 
Dear All,
 
I continue to report rampant corruption and violations of ethics in Illinois Court system, where majority of judges obtained their judicial seats through connections with certain politicians and powerful judges.
 
Alison Conlon, a  relative to a well-connected lawyer William F. Conlon,  (daughter?), was  appointed on  February 2, 2015, as a Circuit Court Judge by the Illinois Supreme Court, at the recommendation of Justice Mary Jane Theis.
 
Alison Conlon has all mandatory merits to be a judge in Cook County Court. Surprisingly, she just got a Municipal Division seat, but I am confident that with her credentials she will be moved to the higher Division promptly.
 
Alison is an insider who knows many secrets in our Court system but will never disclose them  because  her family is a part of the business. 
 
Alison Conlon paid very substantial amounts of money to Cook County Democrats (aka Madigan and Berrios $40,200).  Her relative (my guess- father)  William F. Conlon  gave $3,500 to Justice Theis; and $1,500 to Ed Burke. His Firm, Sidley Austin gave Justice Theis $9,500.00; Ed  Burke $27,000 and Justice Anne Burke over $14,000, which is  also a substantial merit for selection of judges by Justices Theis and Burke.   
 
Alison Conlon’s connections with Senior Federal Judge Suzanne Conlon (my guess- either mother or aunt) is a huge merit.  Sidley Austin (where Obamas worked) represent many shady corporations, like Johnson & Johnson (and I actually didn’t know about these cases) and usually very successful.
 
Alison Conlon’s relationship with Julia Bauer, niece to  Judge William J. Bauer, Senior Judge in Federal Court of Appeals, is a  merit, too. 
 
Another huge merit is a relative (my guess-uncle) James J. Conlon who works for Chief Timothy Evans. This connection cannot be underestimated by any lawyer who needs a particular judge to be assigned on their cases. In 2014 Hinshaw & Culbertson’s lawyers (VIP insiders, with at least 5 personal judges in our Court) somehow replaced judge Flannery, whom I submitted my Motion,  with judge Hogan who denied it in the eye blink;  and ruled for H&C from whom he received  $4,550 (without disclosures to me, of course).  Now I know exactly how it happened. 
 
William Conlon is a Chair in Chicago Board of Ethics, which is another merit. Most recently he was presiding over  an “illegal lobbying” scandal with  Emmanuel which involved ..,  well, lets call by its real name – bribes to the mayor, where Conlon was criticized for covering violations.  Of course William F. Conlon  will never find any violations of ethics among those  who helps his family to rack $$$ legal fees and get taxpayers-funded paychecks. 
 
Attorney Kevin Fee – Sidley Austin LLP – is a trial lawyer for IL Judicial Inquiry Board. So, if a judge is caught for drunk driving – he/she could be suspended (if its not a clout-heavy  judge). If a judge obstructs justice, criminally conceals material  evidence and commits fraud upon the Court, like Senechalle; or pay $25,100 for her judicial seat to convicted in bribes Isaak Carothers for his aunt’s judicial seat, like Patricia Spratt  – it all  will be  covered. JIB never even bothered to respond my complaint against Spratt – even with a runaround. Its normal to detain people in her Courtroom without any cause; and any explanations – because her family connections with Judge Bauer and his cronies will prevail. 
 
Basically this is the main reason why non-clout lawyers and ProSe litigants will never find neither fair election or fair hearings – this Court is built by insiders to serve insiders. Insiders cover for insiders, and so on. 
 
Worth to mention, neither Alison Conlon, Clare Quish, Patricia Spratt, John C. Griffin, Daniel J. Pierce, Thomas Hoffman, and other insiders, never disclosed how well connected are their families and friends in our legal system.
 
Conlon only said that her parents raised her in Glencoe…without mentioning any  connections in the Court.
 
Quish was presented to voters as a “former clerk for an Appeal Court Justice (without justice’s name (Theis, of course)) and a girl who was raised mostly by IRISH mother (never mentioned her well-connected uncle-judge in Law Division, and her father); 
 
Spratt said that she worked many years  for an Attorney General; a Federal Judge and an Appeal Court Judge – collectively William J. Bauer, which was not mentioned; cited a quote from a “dear friend” aka William Bauer, and so on. 
 
So, they know that their raise to power was corrupt – and tried  to deceive  IL voters.
 
 And for those of you that don’t know this, Illinois Supreme Court Judge Anne Burke is married to Ed (Fast Eddie) Burke, who often receives substantial donations to the DNC in cash, it is said.  He has admitted publicly that he has “the list” of lawyers who will get judgeships–for the right price, of course, paid in cash.
 

From Newsweek: The Foster Care System Tied into Child Sex rings

http://www.newsweek.com/we-have-set-system-sex-traffic-american-children-779541

From Joanne;

The below article is exactly correct.   I have heard of scores of cases where a trumped up case was filed against parents, social workers lied, police lied, the kids were placed in Foster Care only to be sold to pimps and into the Sex Trade.  Illinois typically has thousands of kids missing from Foster Care.  This article explains the real problem right now with Foster Care and how it is a dirty big secret of the system.

From Newsweek

Senator Rob Portman (R-Ohio) introduced legislation in 2017 to amend an antiquated 1996 law that was ostensibly enacted to protect freedom of expression on the Internet, but, as Sen. Portman’s bill describes, allowed website operators (most prominently, Backpage ) to facilitate the sale of sex with victims of sex trafficking. In many of these cases, the victims are children.

The frequency of child sex abuse is a true epidemic. Since at least 2000, the U.S. Department of Justice has reported that some 67 percent of all sexual assaults are committed against victims under 18 years old.

The U.S. Department of Health and Human Services reports confirmed child sexual abuse cases number approximately 58,000 per year in recent years.

Unreported child sexual assaults are estimated at 80 percent and supported by multiple studies and experts.

Sex predators are misusing the Internet daily to access their prey, and by taking their shield away website operators who ignore such misuse—or profit from it—will have to monitor and prevent illegal user content.

Sen. Portman’s legislation is landmark and a key step in helping sex trade victims, but the reality is that predators will find other venues. We must ask the question that gets to the root of the problem: where are these victims coming from?

Here’s the ugly truth: most Americans who are victims of sex trafficking come from our nation’s own foster care system. It’s a deeply broken system that leaves thousands vulnerable to pimps as children and grooms them for the illegal sex trade as young adults.

We have failed our children by not fixing the systemic failures that have allowed this to happen for decades.

Most people don’t know about our nation’s foster care to sex trafficking pipeline, but the facts are sobering. The National Center for Missing and Exploited Children (NCMEC) found that “of the more than 18,500 endangered runaways reported to NCMEC in 2016, one in six were likely victims of child sex trafficking. Of those, 86 percent were in the care of social services when they went missing.”

Lolita_Trailer_(Sceenshot)Sue Lyon in a screenshot from the trailer of Stanley Kubrick’s film “Lolita” (1962). PUBLIC DOMAIN

The outcomes of law enforcement efforts against sex traffickers repeatedly support the NCMEC estimate. In a 2013 FBI 70-city nationwide raid, 60 percent of the victims came from foster care or group homes. In 2014, New York authorities estimated that 85 percent of sex trafficking victims were previously in the child welfare system.

In 2012, Connecticut police rescued 88 children from sex trafficking; 86 were from the child welfare system. And even more alarming: the FBI discovered in a 2014 nationwide raid that many foster children rescued from sex traffickers, including children as young as 11, were never reported missing by child welfare authorities.

The essential failure is how we care for these children. As NCMEC’s CEO told Congress in 2013, “Children in foster care are easy targets for pimps … [they] are the most susceptible to the manipulation and false promises that traffickers use to secure their trust and dependency. These children have fractured safety nets and few alternatives.”

Child welfare systems can, but often do not, prevent that reality for children. Pimps rely on that.

I have seen all of this up close as an attorney who represents children abused in foster and group home care—including those who ended up in the clutches of pimps. Much more needs to be done to stop abuse in care, and those who allow it to happen must be held accountable.

Children are learning all the time, and in abusive foster or group homes they learn that their worth as humans is not intrinsic. Their worth is what the abusive caregiver gets from them, whether simply a paycheck from the state or their bodies for sex, as happened to some of my clients.

This conditions them to be subservient to pimps—giving all they have in exchange for essential needs, like food and shelter. As one of my clients put it, after extensive physical and sexual abuse in state care, the day she turned 18 and left the system with no community support, job or money, she saw herself in one way: “There was a gold mine between my legs.”

The rates of runaways from state care remains essentially unchanged since 2003, so the volume of potential trafficking victims has not changed.

To protect our nation’s most vulnerable children, we need the federal government to compel states that accept hundreds of millions of dollars for child welfare systems to answer, in every case that a child goes missing, why it happened and why it continues to happen.

We need law enforcement consistently prosecuting those who fail to report child abuse and runaways in a timely manner so we can find them before the pimps do. From cases of child abuse victims I have represented, I can name dozens of adults who knew of abuse in institutional care, but failed to report it.

Not one of them was arrested, even when I asked law enforcement to do it. And we must fire child welfare officials accountable for their role. I have never seen an official be fired in any case; in fact, I’ve seen one responsible official get a job promotion.

With or without the Internet, predators will continue to find vulnerable children to build the sex trade. Until we address the source of the victims, this will continue to be the truth we create for our nation’s youth.

Michael Dolce is Of Counsel at Cohen Milstein, and a member of the firm’s Catastrophic Injury practice group.

From KD: who is managing health care payments in Illinois? Apparently no one and thievery is rampant.

Subject: Re: The elder cleansing HUMAN TRAFFICKING cover up is not over —
Date: Mar 25, 2018 5:27 PM
 
It is not a coincidence that the call for an Honest investigation creates such a violent reaction .    Indeed, it is also not a slip of the tongue for Jerome Larkin to equate the exposure of corruptness with “yelling fire in a crowded theater.”      The exposure of corruption could mean an end to the criminal enterprise that has long ruled Illinois. 
 
If the great unwashed does not wake up, we will have  no more America!    As it is, it is no longer safe to grow old in Illinois, Florida *****.  take a gander at the Philip Esformes indictment.    He was able to bribe State officials at will.    His March 2018 trial date seems to have disappeared.  Do you for a minute believe that such is not occuring in Illinois!           

Ken Ditkowsky

www.ditkowskylawoffice.com

From Joanne:

And I have repeatedly asked, when is Phillip Esformes going to be tried?  It was supposed to happen in March. March is almost gone. And why wasn’t his father Morris Esformes indicted?  He was part of it all and likely taught his son how to steal medicare/medicaid funds.

Well, I looked it up and in Jan. 2018, Defts apparently asked for and obtained a new trial date of 10.1.18. Bummer.

Here is order #707 in the 16 20549 indictment of Phillip Esformes.  Apparently a lot of nursing homes have filed intervenor motions.  Not sure what that is all about,.

https://drive.google.com/open?id=16NBO6XZ6QkLkn5-oUpF981s1ZI4HS0qc

On Sunday, March 25, 2018, 4:40:08 PM CDT, jdit@aol.com <jdit@aol.com> wrote:

Audit stings Illinois Gov. Rauner’s Medicaid program

new state audit raises questions about the Rauner administration’s ability to keep tabs on private insurers in a Medicaid program that is estimated to cost Illinois $60 billion over the next four years.

The Illinois Department of Healthcare and Family Services failed to adequately monitor $7.11 billion that flowed to and from private insurers in Medicaid managed care, a state program that aims to save the government money, according to a report released today by the Illinois auditor general.

HFS, which runs Medicaid, could not account for all claims that private insurers paid to medical providers in the 2016 fiscal year. Nor could the department account for claims that insurers denied or how much they spent on administration and coordinating patients’ care, the audit found.

Because the state hasn’t been keeping tabs on administrative costs, the department hasn’t reconciled $14.2 billion in payments to the insurers, also known as managed care organizations, since 2012. “Thus, HFS has not determined whether the MCOs were overpaid by the state,” the audit said.

The last time Illinois did square payments with insurers was six years ago, and Illinois recovered nearly $22 million.

The stinging report outlines the pitfalls of Gov. Bruce Rauner’s Medicaid managed care program before his new version began on Jan. 1. State lawmakers had called for an audit of managed care last year as Rauner pushed to further privatize the program—largely by steering a bulk of the state’s 3.1 million Medicaid recipients to insurers.

The new contracts Rauner forged a few months ago with six insurers are worth an estimated $60 billion over four years in what’s believed to be the state’s largest procurement ever. The bid process attracted a slew of criticism from lawmakers and other public officials who wanted more transparency, especially around how insurers spend the state’s money.

The auditor general analyzed the Medicaid managed care program in fiscal year 2016, when 12 insurers participated. They were largely for-profit carriers. The state spent $7.11 billion on managed care that year, about half of all Medicaid spending.

If Rauner’s goal is to lower costs by outsourcing Medicaid to insurers, understanding how they spend money is key. The goal is to spend less than the state’s traditional fee-for-service Medicaid program, in which Illinois pays doctors for each service they provide. That can easily rack up unnecessary bills.

In managed care, insurers not only administer medical benefits to Medicaid recipients on behalf of the state, but also focus on prevention. The idea is that if they improve people’s health, that will lower medical costs and ultimately save the state money. This hope has spurred the growth of managed care nationwide, even though research is mixed about whether the effort actually saves states money.

Among the audit’s other findings:

• HFS paid twice for 302 people, resulting in $590,237 in duplicate payments to private insurers.

• The state did not use data that captured how often Medicaid recipients received medical care. When setting rates for how much the department pays insurers, that’s a preferred, though not required, method.

• The state doesn’t know how often Medicaid recipients received medical care because HFS didn’t have complete data from insurers.

• The state did not track medical services that insurers paid doctors, hospitals and other providers for, so there was no way to calculate their average payout ratio. That’s key to understanding their costs.

• Insurers are required to provide the state data on claims submitted by medical providers that they deny, to ensure they’re appropriate denials. But HFS couldn’t provide auditors with any data. “Currently, the denial data is simply not valid nor reliable,” HFS told auditors.

• The state paid insurers nearly $138 million that the carriers, in turn, used to cover federal taxes and fees.

A spokesman for the department said HFS is “monitoring actual administrative costs, have put processes in place to remove duplicate clients and recoup overpayments from previous years, will provide clear instructions to managed care plans regarding reporting of denied claims and will monitor contracts to ensure compliance.”

Among the report’s recommendations:

• Determine if HFS overpaid private insurers dating back to 2013 so the department may recoup those costs if necessary.

• Require insurers to submit all data related to Medicaid payments they make to providers.

• Perform on-site reviews of the insurers’ financial data systems, and test the accuracy and completeness of their data.

In the audit, HFS agreed with most of the recommendations. But the department had this exception: It doesn’t need to conduct onsite reviews.

“Audit stings Rauners Medicaid program” originally appeared in Crain’sChicago Business.