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911

The latest abortion hysterics

Good grief.

Sadly, this isn't a joke

Sadly, this isn’t a joke

Women who are feeling pressured by their parents or partner to have an abortion are being advised by the state to pick up the phone and dial 911, according to a new pamphlet the state released Monday.

The Combined Law Enforcement Associations of Texas is not pleased, saying such calls could impede the response to emergencies like shootings and home invasions.

“Texas police are short-staffed all over the state in big urban departments and in small rural places and everything in between, so unless someone’s holding you down trying to force you to have an abortion, then you’re going to be placed on a priority two or three,” said Charley Wilkison, executive director of the Combined Law Enforcement Associations of Texas, also known as CLEAT.

The state’s advice comes amid a host of changes in “A Woman’s Right to Know,” a brochure health clinics and abortion providers are required by state law to give women considering an abortion.

“No one can force you to have an abortion, not even your parents or the father of your baby,” reads the new introduction to the brochure. “If you are feeling pressure (also called coercion) from someone to have an abortion, you have options. Talk to your doctor, counselor or spiritual adviser about your feelings, and ask for a phone to call 9-1-1 for immediate help.”

“Technically, this is not what we consider an emergency call,” said Joe Laud, the administration manager of the Houston Emergency Center. Emergency calls are for life-threatening situations, he said, adding he was not aware of any directive or training to expect to handle 911 callers reporting they feel coerced into an abortion.

[…]

Critics have lambasted the brochure for using loaded language and reprinting factual errors, such as linking abortion to a higher risk of breast cancer and that a fetus can feel pain in the early stages of pregnancy. In both cases, scientific studies have debunked those suggestions, although the pamphlet reports them as fact.

Other revisions are linguistic, such as increasing use of the term “your baby” to describe the fetus from four references in the last version to 79 in the version released Monday.

“It’s misinformation intended to change, stigmatize abortion and to dissuade women from making a free choice about their health care by providing that kind of propaganda and misinformation,” said Blake Rocap, legislative counsel for NARAL Pro-Choice Texas.

The other day I listened to a podcast interview with Diane Horvath-Cosper, a doctor and reproductive specialist who provides abortions and who also lobbies on issues of women’s health and reproductive choice. According to her, the first line of defense against any woman being coerced into having an abortion are the doctors and staff at clinics that provide them, who will speak to the woman privately, discuss all her options, and put her in touch with social services if need be. You have to be a member of Slate Plus to hear the interview (if you are a Slate Plus member, I highly recommend it), so if that’s not an option for you, here’s an op-ed she wrote in the Washington Post last year about her experiences. If there’s any coercion going on, it’s aimed at people like Dr. Horvath-Cosper and her patients.

I think the reason why the people who pushed for this language to be added to this brochure, which as a purportedly educational offering is more harmful than helpful to its target audience, is because they really want it to be true that women are being pressured into terminating pregnancies, in the same way they really wanted the fraudulent videos about Planned Parenthood to be true. They want to see themselves as stalwart defenders protecting the helpless against unspeakable atrocities, but in order to do that they need for those atrocities to be happening, so they can defend against them. And if reality isn’t cooperating, they can always pretend that it is. In today’s world, that’s more than good enough. Juanita, the Statesman, the Austin Chronicle, and the Current have more.

Ambulances and ERs

Very interesting story about the overuse of ambulances in Houston and how the city is trying to deal with it.

But in truth little works in a system that has been broken for years. Over the past generation, patients began to see emergency rooms as doctor’s offices, taking ambulances to get there.

It’s the most expensive ride to the most expensive kind of medical care in the world.

An ambulance trip costs at least $1,000. Just walking through the ER doors adds another grand and a half.

More troubling is a recent study by the University of Texas’ School of Public Health that showed 40 percent of patients streaming into Harris County’s overburdened ERs don’t need to be there; either their condition is not urgent or they are using the ER for something that can be or should have already been handled by a primary-care doctor or clinic.

The reasons behind this shift are not fully understood, buried somewhere in a tangle of public misperceptions, lack of access to primary care and habit.

[…]

Last year in Houston, 318,630 calls to 911 got routed to the fire department, with medical calls outstripping fires by nearly seven times. About 80 percent resulted in trips to the hospital. It is not known how many were true emergencies, but one indicator is how often lights and sirens were used en route to the hospital. The best guess is more than half are not urgent, fire officials say.

The result has created a crisis, especially for public hospitals. At Harris Health System, there were 144,891 ER cases between March 2014 and February. Of those, 61.5 percent of patients were indigent or uninsured.

“It’s unsustainable,” says Dr. David Persse.

He has seen all sides. In the 1980s, he worked as an EMT and paramedic in Buffalo, N.Y. He then went to Georgetown University to study emergency medicine. He came to Houston in 1996 and is now physician director of Emergency Medical Services for the Houston Fire Department and head of Houston’s Public Health Authority.

Six months ago, he helped launch a first-of-its kind project that had been percolating for years. It is called ETHAN, for Emergency Tele-Health and Navigation, a common-sense concept that mashes EMT tradition with emergency-room triage and wraps it in modern technology.

When a fire truck or ambulance arrives on a 911 call, a quick assessment is done. If the patient appears critical, he or she is transported. But if the complaint does not seem to rise to an emergency, a doctor trained in emergency medicine is called to talk to the patient by video chat on a specialized tablet.

The doctor searches troubled voices, inconsistent stories and the grainy images for clues. If the condition could be handled by a primary care physician or at a clinic, the doctor makes the appointment on the spot and arranges city-paid transportation by cab – a sliver of the cost of an ambulance. If the patient still wants to go to the ER, the ETHAN doctor has the power to insist they go by cab or find another ride.

Not only does this cut costs, it gets ambulance crews back into service faster.

Since the December launch, there have been about 1,000 ETHAN calls. By some estimates, it has already saved the city $1 million.

Once patients are in the ETHAN system, they are contacted by a public health nurse or counselor for a follow-up home visit to make sure they have a doctor and keep their appointments. Living conditions are assessed to see if other types of assistance are needed. The goal is to keep people from returning to the ER.

There’s more, so read the whole thing. I suspect a big portion of this is lack of access to primary care, which is undoubtedly related to lack of insurance for many people. Cities and counties are left picking up the tab for that, which can be laid at the feet of our Governor and Legislature. Still, even in a context where we had Medicaid expansion and broader insurance coverage, there would be a need for this. It’s a smart idea, and I hope it continues to pay off.

911 to text is here

As expected.

Text-to-911 service is available now in Harris and Fort Bend counties for Verizon and T-Mobile wireless customers.

“This is not to be used just because people like to text, but when people cannot make a voice call,” said Sonya Clauson, spokeswoman for the Greater Harris County 911 Emergency Network.

The service for Verizon and T-Mobile subscribers went live on Tuesday, Clauson said. Sprint and AT&T cellphone customers in the two-county area are expected to be able to use messaging services to reach emergency help next month.

See here and here for the background. Remember, as the National Emergency Number Association says, call if you can, text if you can’t. Hair Balls has more.

Text to 911 option coming locally

Ever wonder why you can’t text 911? Well, in Harris and Fort Bend Counties, you will soon be able to.

By the end of the year, millions of Houston-area residents are expected to have a silent alternative: the Text-to-911 option for emergencies.

Despite the popularity of messaging, the service hasn’t been available in most of the nation and much of Texas for the most life-threatening situations: pleas for fire, police or medical assistance.

In May, the nation’s four major wireless carriers met a voluntary deadline to have their end of the Text-to-911 technology ready to deliver customers’ messages topublic safety agencies that request the service, the Federal Communications Commission reported.

As a result, dozens of call centers nationwide and several in Texas can now receive texts from cellphones on AT&T, Sprint, T-Mobile and Verizon networks.

The Greater Harris County 911 Emergency Network, which provides technical support for call centers in Harris and Fort Bend counties that serve more than 5 million residents, will be ready in the coming months to do the same with at least one carrier.

That’s important because most people in the Houston area call for emergency help by cellphone. In the first seven months of this year, 84 percent of emergency calls in Harris and Fort Bend counties originated from wireless lines, Greater Harris County 911 figures show.

[…]

FCC rules specify that by year’s end, all wireless carriers – not just the major companies – should be able to provide text messages to call centers that have requested the service.

Those centers, however, are not required to exercise that option, said Brian Fontes, CEO of the National Emergency Number Association – which is known as NENA.

Some states, such as Indiana and Vermont, are deploying the service statewide, he said. Others, such as California, leave the decision to individual public safety call centers or networks.

According to an FCC list dated Aug. 25, 18 states had at least one 911 center that could receive texts, though some were limited to one or two major carriers. The police departments in the Lone Star State which can receive texts are mostly in the Dallas Metroplex. There are none so far in the Houston area.

With the major carriers ready, the last hurdle is preparation at local 911 centers, said NENA government affairs director Trey Forgety.

As we know, text to 911 is currently available in some North Texas counties, which are so far the only places where it has been deployed. Nationally, however, only about two percent of emergency call centers around the country are prepared to handle text messages, and compliance is voluntary at this time. I’d guess that while cell calls are the bulk of 911 contacts, there’s still not much demand for texting emergency services.

All of Collin County supports the service. But it isn’t offered anywhere in Denton County. A handful of police departments in Dallas County can receive emergency texts: Balch Springs, Cockrell Hill, Sachse, Seagoville and Wilmer.

But texts still account for only a fraction of 911 requests in North Texas.

The North Central Texas Council of Governments oversees 44 call centers in a 16-county region that includes Dallas, Denton, Collin and Tarrant counties.

Of those centers, 25 have text-to-911 capability, and the rest will have it by the end of September, said Christy Williams, chief 911 program officer for the agency.

Since the service launched in January 2013, dispatchers at these centers have received only 12 text messages, compared with more than a million 911 calls, she said.

You can see why the rollout is proceeding slowly. To some extent, this is a chicken-and-egg question, and I’ve no doubt that over time usage will grow. There are also still some technical advantages to calling 911, though perhaps over time that will change as well. For now, the potential remains theoretical. For more on the text-to-911 program, see the FCC webpage.

Texting 911

This is clearly the way of the future, though I admit that I myself would be a bit leery of using it right now.

With eight of 10 Americans using their cellphones to send or receive text messages, some emergency response centers are updating their technology. Among them are centers in 12 Texas counties, hoping to accommodate situations in which calling 911 may be risky or impossible.

The text-to-911 service is an early step in a national initiative to modernize the emergency call system. The initial deployment in Texas, where the service is available at 27 call centers for Verizon or T-Mobile users, is one of the largest so far in the country.

Text-to-911 technology, which allows a user to send a text to 911, also makes emergency response more accessible to the deaf community. Phone calls remain the priority, officials said, because voice calls have better location-targeting capabilities.

[…]

North Texas counties were among the early adopters, partly because the call centers run by the North Central Texas Council of Governments already had an Internet-based calling system that enabled the cost-free installation of text-to-911. Call centers with older equipment would need to spend anywhere from $80,000 to $8 million to enable the service, depending on their size, said Christy Williams, the chief 911 program officer with the council.

LeAnna Russell, the system’s 911 database supervisor, said that while the several 911 texts sent in North Texas so far have not been the most dramatic of circumstances, they have been important. “We’re just glad they’re using the system,” she added.

Williams, who will become the president of the National Emergency Number Association next month, said the long-term goal was to make sure emergency response technology kept up with cellular technology used by consumers.

“We’re ripping out and replacing an infrastructure that’s over 45 years old,” she said. “Once that’s done, we can provide enhanced features for citizens and public safety responders.”

Potential future advances in 911 technology include incorporating video and photo messaging in emergency response systems and allowing different 911 call centers to share maps and databases, which could cut costs and improve efficiency, Fontes said.

“In a next-generation 911 environment,” he said, “when a car crash happens, people could move around, take pictures of the scene and the license plates, and all of this information will be pushed through the responders and hospitals before they even arrive.”

My initial reaction to this was one of skepticism – I thought, if I’m having an emergency, I’d rather have a live person I can talk to on the other end of the line – but the more I think about it, the more I can see the utility of this. For one thing, texting would be mighty handy in any situation where making noise could be dangerous. For another, in the context of an app you could attach a photo or other useful evidence, as you now can for non-emergency purposes as with Houston’s 311 app. Down the line I could imagine integrating Skype or Facetime or some other video chat function. Not many people use this now, but that will surely change. I figure by the time this is rolled out nationally, it will be an indispensable tool in the kit.