SIOUX FALLS, S.D. (AP) - A troubled government-run hospital on the Pine Ridge Indian Reservation has been given a one-month extension to reach a significant improvement agreement with federal officials to avoid losing its Medicare and Medicaid funds.

The Centers for Medicare and Medicaid Services on Friday notified the hospital's administration of the funding cutoff extension.

The hospital administered by the Indian Health Service must reach the agreement by April 29 to enter a last-chance remediation program. If the agencies fail to reach an agreement, the hospital won't be allowed to bill the government for services provided to Medicare- and Medicaid-eligible patients after May 16.

The Centers for Medicare and Medicaid Services notified the administration of the hospital on the Pine Ridge Indian Reservation about the extension a little more than a month after the hospital on the Rosebud Indian Reservation received the same extension. The latest notification comes days after the top officials at the Indian Health Service, which administers the hospitals, met with tribal leaders and pledged to improve the services provided at the facilities.

Both hospitals have an April 29 deadline to reach an agreement to enter what constitutes a last-chance remediation program. If not, the facilities won't be allowed to bill the government for services provided to Medicare- and Medicaid-eligible patients after May 16.

The purpose of the agreement for the Pine Ridge hospital would be "to effectively safeguard patient health and safety ... and effectively address underlying systemic problems" that have kept the hospital from achieving or sustaining compliance with regulations, according to the letter from CMS addressed to IHS's top leader, Mary Smith, and Sophia Conroy, the hospital's acting administrator.

The funding cutoff warning for the 45-bed Pine Ridge hospital comes after federal inspectors found serious deficiencies during an unannounced visit in October, including records from three of six sampled medical staffers who lacked appropriate permission to practice at that hospital; unlocked cupboards with syringes, needles and other equipment; and unsecured drugs and medical records.

Optimists and skeptics sat down Tuesday with the new head of the Indian Health Service to hash out plans for improving care for Native Americans in Iowa, Nebraska, North Dakota and South Dakota.

At a tense two-and-a-half-hour meeting, IHS Principal Deputy Director Mary Smith outlined plans for short and long-term changes at IHS hospitals and clinics in the Great Plains region.

The visit follows a federal investigation into IHS hospitals in South Dakota that found poor sanitation and improper record-keeping and lead to the closure of the emergency room in Rosebud.

"Here we are in April and we're still on diversion," Evelyn Espinoza, Rosebud Sioux tribal health administrator, said of the Rosebud emergency room that has been closed for four months. "We have these people losing their lives. We have these children losing their parents."

It was wonderful to see Hillary in Wisconsin last night. I remember in 2008 when we started realizing how close my election was going to be. Hillary called and said she'd do anything to help. She ripped up her schedule and came to Minnesota in the last few months of the campaign. Twice. She never wavered in her support, and I know as President she won't waver in furthering our progressive values. She stood by me when I ran for the U.S. Senate, and I'm proud to be standing with her today. We need someone who can get the job done, and Hillary Clinton is the woman for the job.

For those fast food employees striking for $15 an hour, let's do some math.

At $15 an hour Johnny Fry-Boy working 40 hours per week would make $30,000
annually.

An E1 (Private) in the military makes $18,378 annually.

An E5 (Sergeant) with 8 years of service only makes $35,067 annually.

So you're telling me, Sally McBurgerflipper, that you deserve as much as
those kids getting shot at, deploying for months in hostile environments,
and putting themselves on the line every day protecting your unskilled
butt!?

Here's the deal Sweetheart Baconator, you are working in a job designed for
a kid in high school who is actually supposed to be learning how to work and
earning enough for gas, movies , and hanging out with their equally goofy
high school pals. If you have chosen this as your life long profession, you
have failed.

If you don't want minimum wage, don't have minimum skills!

If you can read this, thank a teacher.

If it's in English, thank a Veteran.

Low military pay was not mentioned in the State Of The Union speech. However, increasing the minimum wage was for those fast food employees striking for $15 an hour. Let's do some math: At $15 an hour Johnny Fry-Boy would make $31,200 annually.

An E1 (Private) in the military makes $18,378. An E5 (Sergeant) with 8 years of service only makes $35,067 annually.

So you're telling me, LaTisha McBurger flipper, that you deserve as much as those kids getting shot at, deploying for months in hostile environments, and putting their collective asses on the line every day protecting your unskilled butt!?

Here's the deal, Baconator, you are working in a job designed for a kid in high school who is learning how to work and earning enough for gas, and hanging out with their equally goofy high school pals. If you have chosen this as your life long profession, you have failed. If you don't want minimum wage, don't have minimum skills.

My Two Cents worth, just saying......

This is highly misleading.

It is true that an E-1 base pay is relatively low. However they also receive housing and food, either directly or through a tax free allowance called BAH and BAS. BAH varies by region with the cost of housing. In San Diego, an expensive market that has a high military presence, an unmarried E-1 Marine fresh out of boot camp will receive at BAH of $1713 per month, tax free, plus about $350 a month for food, tax free. That's an additional $25000 a year, tax free, and it goes up every year and every promotion. So the real "pay" for our hypothetical E-1 is closer to $43000 a year, with more than half of that exempt from taxation.

There are other benefits too: full medical and dental, tax free shopping, GI bill for college, etc.

Maybe this is not enough to pay our men and women in uniform. If you think so, ask yourself why it's so low? Answer: because their compensation package must compete with other opportunities, including minimum wage jobs. A low minimum wage means you can pay recruits less (not to mention other private sector workers). Raise the former and the latter will have to rise to be competitive.

There's also a sad (and cliche) helping of class on class warfare in this post, the same attitude that allows things like slavery and Jim Crow to exist. Too many people are happy to get shafted so long as they have someone else they can look down on.

(The leaflet in question is usually claimed to be a 1942 publication by the Committee for Constitutional Government entitled "Lincoln on Limitation[s]," with the confusion in attribution coming about either because one version of the leaflet omitted Boetcker's name, because the printed credits mistakenly switched Boetcker's name with Lincoln's, or because readers glossed over Boetcker's unfamiliar name and mistakenly assumed all the material in the leaflet originated with the much more familiar figure of Abraham Lincoln.)

Once the runaway train of misattribution got rolling, there was no stopping it. As William Boetcker faded from public memory and Abraham Lincoln grew ever larger in American historical legend, few people had an interest or desire in setting the matter right — in accordance with another principle set forth by Keyes: "If words we like can't be credited to someone we've heard of, they might as well not have been said at all."

An outspoken political conservative, Rev. Boetcker is perhaps best remembered for his authorship of a pamphlet entitled The Ten Cannots that emphasizes freedom and responsibility of the individual on himself. Originally published in 1916, it is often misattributed to Abraham Lincoln. The error apparently stems from a leaflet printed in 1942 by a conservative political organization called the Committee for Constitutional Government. The leaflet bore the title "Lincoln on Limitations" and contained some genuine Lincoln quotations on one side and the "Ten Cannots" on the other, with the attributions switched. The genuine Lincoln quotations may have been from an address on March 21, 1864 in which Lincoln said "Let not him who is houseless pull down the house of another; but let him labor diligently and build one for himself, thus by example assuring that his own shall be safe from violence when built." [1] The mistake of crediting Lincoln for "The Ten Cannots" has been repeated many times since, notably by Ronald Reagan in his address to the 1992 Republican National Convention in Houston.[2][3]

There are several minor variants of the pamphlet in circulation, but the most commonly accepted version appears below:
You cannot bring about prosperity by discouraging thrift.
You cannot strengthen the weak by weakening the strong.
You cannot help little men by tearing down big men.
You cannot lift the wage earner by pulling down the wage payer.
You cannot help the poor by destroying the rich.
You cannot establish sound security on borrowed money.
You cannot further the brotherhood of man by inciting class hatred.
You cannot keep out of trouble by spending more than you earn.
You cannot build character and courage by destroying men's initiative and independence.
And you cannot help men permanently by doing for them what they can and should do for themselves.

Boetcker also spoke of the "Seven National Crimes":[4]
I don’t think.
I don’t know.
I don’t care.
I am too busy.
I leave well enough alone.
I have no time to read and find out.
I am not interested.

Editor,

Has America become the land of special interest and home of the double standard?

Lets see: if we lie to the Congress, it's a felony and if the Congress lies to us its just politics; if we dislike a black person, we're racist and if a black person dislikes whites, its their 1st Amendment right; the government spends millions to rehabilitate criminals and they do almost nothing for the victims; in public schools you can teach that homosexuality is OK, but you better not use the word God in the process; you can kill an unborn child, but it is wrong to execute a mass murderer; we don't burn books in America, we now rewrite them; we got rid of communist and socialist threats by renaming them progressive; we are unable to close our border with Mexico, but have no problem protecting the 38th parallel in Korea; if you protest against President Obama's policies you're a terrorist, but if you burned an American
flag or George Bush in effigy it was your 1st Amendment right.

You can have pornography on TV or the internet, but you better not put a nativity scene in a public park during Christmas; we have eliminated all criminals in America, they are now called sick people; we can use a human fetus for medical research, but it is wrong to use an animal.

We take money from those who work hard for it and give it to those who don't want to work; we all support the Constitution, but only when it supports our political ideology; we still have freedom of speech, but only if we are being politically correct; parenting has been replaced with Ritalin and video games; the land of opportunity is now the land of hand outs; the similarity between Hurricane Katrina and the gulf oil spill is that neither president did anything to help.

Response to an Editorial by Ken Huber

I got another right-wing e-mail the other day. At least, I assume it's right wing, since most of the arguments in it tend to lean that way, and it specifically criticizes "progressive" stances as wrong. However, it's a bit hard to tell. Maybe it's better just to chalk this up as one of those rants where everything was so much better in the good ol' days, but now the world's going to Hell in a hand basket.

This one was supposedly a reprint from an editorial, but I've been unable to find it online to determine what paper it was originally printed in. I was able to find it in examiner.com, but only as basically a reprint. The only clue is that the man who supposedly wrote it, Ken Huber, signed his name from Tawas City, which Google tells me is in Michigan. For the sake of argument, I'll just assume that someone named Ken Huber did actually write this editorial, and that it did actually appear in print. It doesn't really matter much, since this article has taken on a life of its own in e-mail forwards.

Before getting into my response, I'll note that after I wrote all this, I came across three other very good responses, which I'm linking to below. The first is the shortest and pithiest. The other two are a bit more thoughtful.
•http://www.realkato.com/blog.php?pid=1829
•http://michaelliddy.wordpress.com/2011/07/01/response-to-ken-huber/
•http://dolphindentist.blogspot.com/2010/10/response-to-ken-huber-and-what-has.html

First off, the waiting list for Section 8 housing, even to get a voucher to play the system like points 1-5 is suggesting, is incredibly long. You'd have to wait years for that to kick in.

6: The Affordable Care Act does provide subsidies for lower income families, but only provides "Free" healthcare to incredibly low incomes. Even then, those on the plan still have to pay out for co-pays, hospital visits, etc etc. The girlfriend in question could possibly get the kids on a state Medicaid program, but, once that's done, the state will look to the father to see if he is getting insurance through his employer and would then force him to cover the kids through his plan, thus screwing up the plan for the father is this hypothetical scenario.

7. If there were a way for a single parent to go to college for free, I'd have had my PhD by now. There simply aren't any state or federal programs that do that. The best one could do is qualify for a Pell Grant, but such grants are not dependent on one's parental status. And, if we're to assume that the girlfriend in question is a stay-at-home mom, then how is she going to have the time to go to class?

8. A family of three (girlfriend + 2 kids) would qualify for a MAXIMUM of $486 in SNAP benefits. This assumes zero income, as Mr Tabb states that the girlfriend in this hypothetical scenario is a stay at home mom. In most cases, if a single mother applies for SNAP benefits, the state will go after the father for child support payments to the mother in order to reduce/eliminate her monthly benefit. So, the father in this hypothetical piece would be screwed.

First off, the waiting list for Section 8 housing, even to get a voucher to play the system like points 1-5 is suggesting, is incredibly long. You'd have to wait years for that to kick in.

6: The Affordable Care Act does provide subsidies for lower income families, but only provides "Free" healthcare to incredibly low incomes. Even then, those on the plan still have to pay out for co-pays, hospital visits, etc etc. The girlfriend in question could possibly get the kids on a state Medicaid program, but, once that's done, the state will look to the father to see if he is getting insurance through his employer and would then force him to cover the kids through his plan, thus screwing up the plan for the father is this hypothetical scenario.

7. If there were a way for a single parent to go to college for free, I'd have had my PhD by now. There simply aren't any state or federal programs that do that. The best one could do is qualify for a Pell Grant, but such grants are not dependent on one's parental status. And, if we're to assume that the girlfriend in question is a stay-at-home mom, then how is she going to have the time to go to class?

8. A family of three (girlfriend + 2 kids) would qualify for a MAXIMUM of $486 in SNAP benefits. This assumes zero income, as Mr Tabb states that the girlfriend in this hypothetical scenario is a stay at home mom. In most cases, if a single mother applies for SNAP benefits, the state will go after the father for child support payments to the mother in order to reduce/eliminate her monthly benefit. So, the father in this hypothetical piece would be screwed.