Susan Jaffe: Feds rein in Medical Advantage predictive software
From Kaiser Family Foundation Health News
Judith Sullivan was recovering from major surgery at a Connecticut nursing home in March when she got surprising news from her Medicare Advantage plan: It would no longer pay for her care because she was well enough to go home.
At the time, she could not walk more than a few feet, even with assistance — let alone manage the stairs to her front door, she said. She still needed help using a colostomy bag following major surgery.
“How could they make a decision like that without ever coming and seeing me?” said Sullivan, 76. “I still couldn’t walk without one physical therapist behind me and another next to me. Were they all coming home with me?”
UnitedHealthcare — the nation’s largest health-insurance company, which provides Sullivan’s Medicare Advantage plan — doesn’t have a crystal ball. It does have naviHealth, a care-management company bought by UHC’s sister company, Optum, in 2020. Both are part of UnitedHealth Group. NaviHealth analyzes data to help UHC and other insurance companies make coverage decisions.
Its proprietary “nH Predict” tool sifts through millions of medical records to match patients with similar diagnoses and characteristics, including age, preexisting health conditions, and other factors. Based on these comparisons, an algorithm anticipates what kind of care a specific patient will need and for how long.
But patients, providers, and patient advocates in several states said they have noticed a suspicious coincidence: The tool often predicts a patient’s date of discharge, which coincides with the date their insurer cuts off coverage, even if the patient needs further treatment that government-run Medicare would provide.
“When an algorithm does not fully consider a patient’s needs, there’s a glaring mismatch,” said Rajeev Kumar, a physician and the president-elect of the Society for Post-Acute and Long-Term Care Medicine, which represents long-term care practitioners. “That’s where human intervention comes in.”
The federal government will try to even the playing field next year, when the Centers for Medicare & Medicaid Services begins restricting how Medicare Advantage plans use predictive technology tools to make some coverage decisions.
Medicare Advantage plans, an alternative to the government-run, original Medicare program, are operated by private insurance companies. About half the people eligible for full Medicare benefits are enrolled in the private plans, attracted by their lower costs and enhanced benefits like dental care, hearing aids, and a host of nonmedical extras like transportation and home-delivered meals.
Insurers receive a monthly payment from the federal government for each enrollee, regardless of how much care they need. According to the Department of Health and Human Services’ inspector general, this arrangement raises “the potential incentive for insurers to deny access to services and payment in an attempt to increase profits.” Nursing home care has been among the most frequently denied services by the private plans — something original Medicare likely would cover, investigators found.
After UHC cut off her nursing home coverage, Sullivan’s medical team agreed with her that she wasn’t ready to go home and provided an additional 18 days of treatment. Her bill came to $10,406.36.
Beyond her mobility problems, “she also had a surgical wound that needed daily dressing changes” when UHC stopped paying for her nursing home care, said Debra Samorajczyk, a registered nurse and the administrator at the Bishop Wicke Health and Rehabilitation Center, in Shelton, Conn., the facility that treated Sullivan.
Sullivan’s coverage denial notice and nH Predict report did not mention wound care or her inability to climb stairs. Original Medicare would have most likely covered her continued care, said Samorajczyk.
Sullivan appealed twice but lost. Her next appeal was heard by an administrative law judge, who holds a courtroom-style hearing usually by phone or video link, in which all sides can provide testimony. UHC declined to send a representative, but the judge nonetheless sided with the company. Sullivan is considering whether to appeal to the next level, the Medicare Appeals Council, and the last step before the case can be heard in federal court.
Sullivan’s experience is not unique. In February, Ken Drost’s Medicare Advantage plan, provided by Security Health Plan of Wisconsin, wanted to cut his coverage at a Wisconsin nursing home after 16 days, the same number of days naviHealth predicted was necessary. But Drost, 87, who was recovering from hip surgery, needed help getting out of bed and walking. He stayed at the nursing home for an additional week, at a cost of $2,624.
After he appealed twice and lost, his hearing on his third appeal was about to begin when his insurer agreed to pay his bill, said his lawyer, Christine Huberty, supervising attorney at the Greater Wisconsin Agency on Aging Resources Elder Law & Advocacy Center in Madison.
“Advantage plans routinely cut patients’ stays short in nursing homes,” she said, including Humana, Aetna, Security Health Plan, and UnitedHealthcare. “In all cases, we see their treating medical providers disagree with the denials.”
UnitedHealthcare and naviHealth declined requests for interviews and did not answer detailed questions about why Sullivan’s nursing home coverage was cut short over the objections of her medical team.
Aaron Albright, a naviHealth spokesperson, said in a statement that the nH Predict algorithm is not used to make coverage decisions and instead is intended “to help the member and facility develop personalized post-acute care discharge planning.” Length-of-stay predictions “are estimates only.”
However, naviHealth’s website boasts about saving plans money by restricting care. The company’s “predictive technology and decision support platform” ensures that “patients can enjoy more days at home, and healthcare providers and health plans can significantly reduce costs specific to unnecessary care and readmissions.”
New federal rules for Medicare Advantage plans beginning in January will rein in their use of algorithms in coverage decisions. Insurance companies using such tools will be expected to “ensure that they are making medical necessity determinations based on the circumstances of the specific individual,” the requirements say, “as opposed to using an algorithm or software that doesn’t account for an individual’s circumstances.”
The CMS-required notices nursing home residents receive now when a plan cuts short their coverage can be oddly similar while lacking details about a particular resident. Sullivan’s notice from UHC contains some identical text to the one Drost received from his Wisconsin plan. Both say, for example, that the plan’s medical director reviewed their cases, without providing the director’s name or medical specialty. Both omit any mention of their health conditions that make managing at home difficult, if not impossible.
The tools must still follow Medicare coverage criteria and cannot deny benefits that original Medicare covers. If insurers believe the criteria are too vague, plans can base algorithms on their own criteria, as long as they disclose the medical evidence supporting the algorithms.
And before denying coverage considered not medically necessary, another change requires that a coverage denial “must be reviewed by a physician or other appropriate health care professional with expertise in the field of medicine or health care that is appropriate for the service at issue.”
Jennifer Kochiss, a social worker at Bishop Wicke who helps residents file insurance appeals, said patients and providers have no say in whether the doctor reviewing a case has experience with the client’s diagnosis. The new requirement will close “a big hole,” she said.
The leading MA plans oppose the changes in comments submitted to CMS. Tim Noel, UHC’s CEO for Medicare and retirement, said MA plans’ ability to manage beneficiaries’ care is necessary “to ensure access to high-quality safe care and maintain high member satisfaction while appropriately managing costs.”
Restricting “utilization management tools would markedly deviate from Congress’ intent in creating Medicare managed care because they substantially limit MA plans’ ability to actually manage care,” he said.
In a statement, UHC spokesperson Heather Soule said the company’s current practices are “consistent” with the new rules. “Medical directors or other appropriate clinical personnel, not technology tools, make all final adverse medical necessity determinations” before coverage is denied or cut short. However, these medical professionals work for UHC and usually do not examine patients. Other insurance companies follow the same practice.
David Lipschutz, associate director of the Center for Medicare Advocacy, is concerned about how CMS will enforce the rules since it doesn’t mention specific penalties for violations.
CMS’ deputy administrator and director of the Medicare program, Meena Seshamani, said that the agency will conduct audits to verify compliance with the new requirements, and “will consider issuing an enforcement action, such as a civil money penalty or an enrollment suspension, for the non-compliance.”
Although Sullivan stayed at Bishop Wicke after UHC stopped paying, she said another resident went home when her MA plan wouldn’t pay anymore. After two days at home, the woman fell, and an ambulance took her to the hospital, Sullivan said. “She was back in the nursing home again because they put her out before she was ready.”
Susan Jaffe is Kaiser Family Foundation reporter.
Llewellyn King: Artificial intelligence and climate change are making 2023 a scary and seminal year
Global surface temperature reconstruction over the last 2000 years using proxy data from tree rings, corals and ice cores in blue. Directly observed data is in red.
The iCub robot at the Genoa science festival in 2009
— Photo by Lorenzo Natale
His job is probably secure.
WEST WARWICK, R.I.
This is a seminal year, meaning nothing will be the same again.
This is the year when two monumentally new forces began to shape the way we live, where we reside and the work we do. Think of the invention of the printing press around 1443 and the perfection of the steam engine in about 1776.
These forces have been coming for a while, they haven’t evolved in secret. But this was the year they burst into our consciousness and began affecting our lives.
The twin agents of transformation are climate change and artificial intelligence. They can’t be denied. They will be felt and they will bring about transformative change.
Climate change was felt this year. In Texas and across the Southwest, temperatures of well over 100 degrees persisted for more than three months. Phoenix had temperatures of 110 degrees or above for 31 days.
On a recent visit to Austin, an exhausted Uber driver told me that the heat had upended her life; it made entering her car and keeping it cool a challenge. Her car’s air conditioner was taxed with more heat than it could handle. Her family had to stay indoors, and their electric bill surged.
The electric utilities came through heroically without any major blackouts, but it was a close thing.
David Naylor, president of Rayburn Electric, a cooperative association providing power to four distribution companies bordering Dallas, told me, “Summer 2023 presented a few unique challenges with so many days about 105 degrees. While Texas is accustomed to hot summers, there is an impactful difference between 100 degrees and 105.”
Rayburn ran flat out, including its recently purchased natural gas-fired station. It issued a “hands-off” order which, Naylor said, meant that “facilities were left essentially alone unless absolutely necessary.”
It was the same for electric utilities across the country. Every plant that could be pressed into service was and was left to run without normal maintenance, which would involve taking it offline.
Water is a parallel problem to heat.
We have overused groundwater and depleted aquifers. In some regions, salt water is seeping into the soil, rendering agriculture impossible.
That is occurring in Florida and Louisiana. Some of the salt water intrusion is the result of higher sea levels and some of it is the voracious way aquifers have been pumped out during long periods of heat and low rainfall.
Most of the West and Florida face the aquifer problem, but in coastal communities it can be a crisis — irreversible damage to the land.
Heat and drought will cause many to leave their homes, especially in Africa, but also in South and Central America, adding to the millions of migrants on the move around the world.
AI is one of history’s two-edged swords. On the positive side, it is a gift to research and especially in life sciences, which could deliver life expectancy north of 120 years.
But AI will be a powerful disruptor elsewhere, from national defense to intellectual property and, of course, to employment. Large numbers of jobs, for example, in call centers, at fast-food restaurant counters, and check-in desks at hotels and airports will be taken over by AI.
Think about this: You go to the airport and talk to a receptor (likely to be a simple microphone-type of gadget on the already ubiquitous kiosks) while staring at a display screen, giving you details of your seat, your flight — and its expected delays.
Out of sight in the control tower, although it might not be a tower, AI moves airplanes along the ground, and clears them to take off and land — eventually it will fly the plane, if the public accepts that.
No check-in crew, no air-traffic controllers and, most likely, the baggage will be handled by AI-controlled robots.
Aviation is much closer to AI automation than people realize. But that isn’t all. You may get to the airport in a driverless Lyft or Uber car and the only human beings you will see are your fellow passengers.
All that adds up to the disappearance of a huge number of jobs, estimated by Goldman Sachs to be as many as 300 million full-time jobs worldwide. Eventually, in a re-ordered economy, new jobs will appear and the crisis will pass.
The most secure employment might be for those in skilled trades — people who fix things — such people as plumbers, mechanics and electricians. And, oh yes, those who fix and install computers. They might well emerge as a new aristocracy.
Llewellyn King is executive producer and host of White House Chronicle, on PBS. His email is llewellynking1@gmail.com and he’s based in Rhode Island and Washington, D.C.
‘Somatic responses’
Selections from Maggie Nowinski’s show “Cicatrix/In Bloom,’’ at Tremaine Art Gallery, at the Hotchkiss School, Lakeville, Conn., through Oct. 15
Maggie Nowinski is a Massachusetts-based multi-modal artist, teaching artist and curator Maggie Nowinski.
The gallery says: “Through her work, Nowinski ‘explores somatic responses to environment, internal and external passageways, and collected disturbances through imagined specimen drawings that depict abject human-botanical entities’ with line drawings, prints, found objects and sound.’’
The Litchfield Hills and Lake Wononscopomuc, as seen from the grounds of the Hotchkiss School, Lakeville, Conn.
Sam Pizzigati: Time for a general strike at hyper-rapacious Dollar General
— Photo by Mike Kalasnik
Dollar General headquarters, in Goodlettsville, Tenn.
Via OtherWords.org
BOSTON
President Biden recently walked a picket line in solidarity with striking auto workers. An amazing sight.
What could he do for an encore? He could stand before another major American corporation — Dollar General — holding a simple two-word placard saying “For Shame.”
Thanks to United Auto Workers members and the attention their strike has attracted, Americans now know a bit about the pressures that auto workers face. As a nation, unfortunately, we know next to nothing about life for Dollar General workers.
With more outlets than Walmart and Wendy’s combined, Dollar General has become “America’s most ubiquitous retailer,” Bloomberg reported recently, and may now be the “worst” retail employer in the country.
Bloomberg sums up Dollar General’s corporate ethos this way: “Build as many stores as possible, pack them with tons of stuff while using as little warehouse space as possible, and spend as little as possible on everything else.”
That means spending as little as possible on basic store upkeep.
Businessweek investigators have “found expired products on Dollar General shelves,” from chicken soup in Louisiana to doughnuts in Illinois. In one Oklahoma store, birds nested in the ceiling and pooped down on the merchandise.
And as little as possible on safety.
Government inspectors have reported “fire extinguishers blocked by boxes” and “shaky, leaning towers of product” as high as nine feet tall. The Occupational Safety and Health Administration last year tagged Dollar General a “severe violator” of federal workplace-safety law.
And, of course, Dollar General spends as little as possible on wages and workers.
One of every four Dollar General employees makes less than $10 an hour. Over half make under $12. Meanwhile entire stores go hours every day with only one employee responsible for an average of 7,500 square feet of retail space.
This brutal approach has paid off handsomely for investors and executives. Dollar General’s stock price has quintupled since 2009. And the company reports that its CEO, who hauls in $16.6 million a year, makes 935 more than a “median” Dollar General employee.
Officially, the typical Dollar General worker makes just $17,773 a year. But even that measly figure may be an overstatement.
Researcher Rosanna Weaver reports that the company recently changed its median-pay calculations by “annualizing” the wages of permanent employees who didn’t work a full year. Meanwhile, Dollar General actually understates CEO pay. The company’s executive compensation can run much higher than first reported once executives actually cash out their stock.
One example: After cashing out on a huge chunk of his stock awards, former CEO Todd Vlasos actually made nearly 4,500 times the annual pay of his 163,000 employees. He essentially made more in a single weekday — $328,000 — than his median employee could earn in 18 years.
All this “success” for Dollar General executives rests on a half-century of ever-greater American inequality. For two generations now, a shrinking share of U.S. income and wealth has gone into the pockets of America’s working families.
Thanks to this shrinking share, tens of millions of American families today couldn’t get by without the “bargain-basement” prices that dollar stores like Dollar General offer — at the expense of their customers’ health and safety and the economic security of their workers.
Moreover, that discounted food — often sold in “food-deprived areas” — comes highly processed, offers little in the way of nutritional value, and sits packaged within toxic, chemical-laden wrappings.
“Dollar General’s practices have an immense impact on communities across the country,” note advocacy attorneys Sara Imperiale and Margaret Brown, “especially communities of color and low-income communities.”
The U.S. economy isn’t delivering for American families — and that failure is delivering for corporate investors and executives. You’ll never find them doing their weekly food shopping at Dollar General.
How about a general strike against Dollar General?
Sam Pizzigati, based in Boston, co-edits Inequality.org at the Institute for Policy Studies. His books include The Case for a Maximum Wage and The Rich Don’t Always Win.
The soothing properties of water
“Pond Reflections,’’ by Susan Bailey, in the fall group show at Arts3Gallery, Manchester, N.H. She says: “Yes! I am often asked how I can paint realistic still lifes at the same time as abstracted landscapes”.
Seal of Manchester, N.H. Note the references to the city’s role as one of America’s first great industrial centers.
Lunching with The Prince
Adapted from Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
The recent death at 75 of Gennaro Castellano, former captain of downtown Providence’s well known Capriccio restaurant, brought back cinematic memories of a few lunches I had there with Vincent “Buddy” Cianci in his heyday as mayor and “Prince of Providence’’ in the ’90’s. The lunches were very long, and he wasn’t averse to drinking stuff stronger than water during them. Considering that Cianci allegedly had a good-sized city to run, he seemed in no hurry to get back to work even as we approached 3 p.m. Indeed, it was I who became increasingly anxious to get back to my job running The Providence Journal’s commentary pages, with its not very forgiving deadlines.
Buddy would say as I kept looking at my watch: “Relax! Nice place, eh?”
The waiters were very able, if obsequious, as if they feared the mayor, with his semi-mobster persona. They probably had good reason to.
Of course, being mayor of a good-sized city has always involved various degrees of show business. Consider besides Buddy, such flamboyant examples as New York Mayors Jimmy Walker and Fiorello LaGuardia (see the musical Fiorello!) and Boston Mayor James Michael Curley (read the novel The Last Hurrah).
‘Tis only a mirage’
“But this beauty of Nature which is seen and felt as beauty, is the least part. The shows of day, the dewy morning, the rainbow, mountains, orchards in blossom, stars, moonlight, shadows in still water, and the like, if too eagerly hunted, become shows merely, and mock us with their unreality. Go out of the house to see the moon, and 'tis mere tinsel; it will not please as when its light shines upon your necessary journey. The beauty that shimmers in the yellow afternoons of October, who ever could clutch it? Go forth to find it, and it is gone; 'tis only a mirage as you look from the windows of diligence.’’
— Ralph Waldo Emerson (1802-1882), American essayist, poet, philosopher and a leader of the cultural luminaries based in Concord, Mass.
Hard work
“Soledad/Solitude” (Indiana limestone), by Boston-based sculptor Nora Valdez, in the show “Rock Solid XXIII,’’ at Studio Place Arts, Barre, Vt. (“Granite Capital of the world”).
— Photo courtesy of Studio Place Arts
Studio Place’s exhibition features the work of 20 New England artists who have created a variety of stone artwork and assemblages. Each work highlights the unique qualities of stone as a medium.
The Barre World War 1 Memorial, "Youth Triumphant", by C. Paul Jennewein, one of the many local granite sculptures.
A beautiful exit
Near the mouth of the Goose River, at Rockport Harbor, Maine.
Autumn in Maine’s Hundred-Mile Wilderness
— Photo by Andythrasher
The blood of maples on the autumn sky,
And dead leaves drifting, drifting to the sea:
Now, to the year Time makes his old reply,
Nothing on earth shall live immortally.
The burst of glory on a dying face,
Of one who sees beyond, some haven far,
Lit with the spring-light of another place
And silver winds blown from another star.
Now beauty burns in gold on every hill
And changes not her warm imperial way:
There is no sadness here, whate'er men say—
Beauty departing is yet beauty still.
‘‘October on a Maine River,’’ by Kenneth Slade Alling
'Portraits' of 'witches'
Installation view of Barbara Broughel’s show ‘‘Requiem,’’ at the Krakow Witkin Gallery, Boston, through Oct. 14.
The gallery explains:
“Barbara Broughel’s ‘Requiem’ portraits consists of brooms and other modest household objects of early American design, each one a ‘portrait’ of a person accused, convicted, and/or executed as a ‘witch’ in 17th Century America. Based on court transcripts, each ‘portrait’ is reconstructed from elements detailing the victim’s life and the ‘spectral evidence’ (whereby an ill-fated event was considered to be caused indirectly through the supernatural powers of a person not present) used to convict them.’’
Salem wasn’t the only place in New England with murderous persecutions. Consider this.
Enough to start working on a canoe?
Painting by Elaine Farmer, the Amherst, N.H., based painter who owns White Birch Fine Art.
Birchbark canoe at Abbe Museum, in Bar Harbor, Maine
— Photo by Billy Hathorn
At the Amherst, N.H., common, with the sort of Civil War statute you see in so many New England towns.
Chris Powell: Misappropriating flagpoles for proselytizing
The “Christian flag’’ at issue
A “Rainbow” or “Pride’’ flag promoting LGBT interests
MANCHESTER, Conn.
Misappropriation of government flagpoles for political purposes continues in Connecticut. Torrington Mayor Elinor C. Carbone has approved a request to fly a Christian flag at City Hall for two weeks. It's part of a national campaign to urge people to go to church, particularly Christian churches.
This has commandeered the government for religious proselytizing, the sort of thing done in medievally totalitarian countries.
Of course, most recent flag controversies in Connecticut have involved commandeering the government to celebrate certain sexual orientations, as if sexual orientation isn't as much a personal matter as religion and as if Connecticut law doesn't already guarantee freedom of sexual orientation as well as religion.
Such use of government flagpoles is said to advance "inclusiveness" but it is actually divisive. Not everyone is Christian and no one needs to be told by government to go to church. Such an intrusion into personal matters is offensive.
As for the sexual-orientation flags -- “pride” flags -- their advocacy extends far beyond equal rights. They are construed to support transgenderism and the overthrow of gender privacy in bathrooms and equal opportunity for women in competitive sports. Most people oppose those things.
Additionally, as Torrington and many other municipal governments should know, courts have ruled that if government allows outside groups to use its flagpoles, it may not discriminate. If a government grants one request, it must grant all requests, as any refusal is unconstitutional censorship. This is how manger displays on town greens and public parks at Christmastime have compelled acceptance of atheist displays.
What will happen when someone wants to fly a Ku Klux Klan or a Nazi flag at City Hall, or flags advertising car dealers, supermarkets, or political candidates? The Trump 2024 flags are ready to go.
The only flags that can be "inclusive" on government flagpoles are government's own -- flags that fly for everybody.
xxx
Also being misappropriated in Connecticut are the electricity rates charged by utility companies.
At the direction of the state Public Utilities Regulatory Authority, the state's two major electricity distributors -- Eversource and United Illuminating -- are offering discounts to poor customers who are receiving financial support from state government like Medicaid insurance and food subsidies.
Norwich Public Utilities, the electric company owned by that city, is considering its own program of discounted rates for poor customers, the discounts to be determined according to household size and income.
Such discounts will be financed by customers who don't get discounts.
The intent here isn't necessarily objectionable but the method is. For these discounts will be public welfare expenses and as such they should be borne plainly through general taxation, not hidden in the bills of other electricity customers.
Already 15 to 20 percent of the charges to electricity customers in Connecticut arise not from the cost of providing electric power but from various social programs and policies state government has decided to finance through electricity bills so resentment will fall on the utility companies rather than elected officials. Connecticut faces nearly the highest electricity costs in the country in large part because state government hides so much of its own costs in electricity bills.
This doesn't mean that electric utilities shouldn't economize. It means that elected officials are grossly hypocritical when they accuse the utilities of overcharging even as state government does more overcharging for electricity than the utility companies do.
PICKLEBALL TAKES PRIORITY: Amid brazen crime and worsening poverty, mental illness, drug addiction and homelessness, Connecticut seems to be falling apart, as does the country itself. But last week Gov. Ned Lamont took a break from those problems to help open the four new pickleball courts in Glastonbury.
The courts were financed with state and federal money, as well as municipal money. Glastonbury, prosperous and well-insulated from social problems by its zoning regulations, could have covered the whole cost itself, without state and federal aid, if the courts were really essential to the town's well-being. But setting humane and sensible priorities in government can be such a drag.
Chris Powell has written about Connecticut government and politics for many years. (CPowell@cox.net)
Fall fishing outing
Close-up of smelt for sale at a seafood market
—Photio by ChildofMidnight
Adapted from Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
September and October remind me of smelt fishing with a bamboo pole and two hooks on a spreader on a dock in the harbor down the wooded hill from our house. The sky always seemed to be clear, and the cool wind from the east included a whiff of the marsh along the channel to the harbor.
It was an exhilarating early fall ritual coming as the maples started to turn bright colors and the apples were at their peak.
Smelt are delicious fried with a little corn meal, lemon and butter.
Hit this link for a few pointers.
Bumping bikes
“Propelled” (pastel), by Plymouth, Mass.-based Jory Mason, in the group show “Signature Strokes,’’ at the South Shore Art Center, Cohasset, Mass., through Oct. 28., in collaboration with the Pastel Painters Society of Cape Cod and juror Lisa Flynn.
The arts center says the show features pastel artwork of “everything from natural scenes of plants, water and delicate flowers to subjects including men at work repairing a city street and the rough moorings of a ship.’’
Recreation of Plimoth Plantation, at Plymouth
— Photo by Marco Almbauer
Trying to keep up grand appearances at years roll by
In Boston’s Back Bay neighborhood, an old house is draped while being repaired.
Old building materials, new insulation standards and consistently wet summers can spell trouble for many of Boston's historic homes, contractors and experts said, so property owners need to be on the lookout now for warning signs.
Neighborhoods like the Back Bay, Beacon Hill and South End are known for historic brownstones and rowhouses, but buildings from a century ago weren't constructed according to current codes.
In particular, lintels which support walls above doors and windows, may have been made with steel, but what was state-ofthe-art then is woefully out of date now, according to John Holland of Holland & Co., who has decades of construction and rehab experience.
"When steel lintels were introduced in the turn of the century, they were new material, but they weren't galvanized," Holland said, noting that kind of metal is susceptible to rust and water damage, and that can lead to significant repairs as water freezes and expands over time, damaging stone, and lintels.
To read the whole article, please hit this link.
View (1858) from the Massachusetts State House westward along the Mill Dam (now Beacon Street), which separated Back Bay (left) from the Charles River. The Mill Dam and the Cross Dam (in distance is the modern Massachusetts Avenue-Kenmore Square area, with mills barely visible near juncture with the Mill Dam). They were part of an attempt to derive power from tides. Trees along north-south waterline represent western boundary (now Arlington Street) of the Boston Public Garden.
The Back Bay was built on land reclaimed from the Charles River basin. Construction began in 1859, as the demand for luxury housing exceeded the availability in the city at the time, and the area was fully built by around 1900. It remains one of Boston’s richest neighborhoods
The quiet way
“Raking leaves can be totally Zen,’’ by Adam Blue, in his show “Adam Blue: Astroexplorer — A Guide to the Heavens,’’ at Maine Street Museum, White River Junction, Vt., through Nov. 18.
The museum says:
The exhibition provides concise and sometimes blunt discourse on current environmental, political and social issues, as well as pop culture.
Lillian Gish on the White River, at White River Junction, being filmed for the 1920 silent film Way Down East.
White River Junction in 1989. It was a major railroad center.
Llewellyn King: The folly of Biden on the picket line
The Cambridge Assembly building, which started as a Ford Motor Co. factory in Cambridge, Mass., which opened in 1913. It had the first vertically integrated assembly line in the world. It was replaced in 1926 by the Somerville Assembly. The plant was later reused by Polaroid Corp., once Greater Boston’s high-tech star, and is now owned by the Massachusetts Institute of Technology.
This is a revised version of a column posted earlier this week.
WEST WARWICK, R.I.
The United Auto Workers strike against the Big Three U.S. automakers, Ford, General Motors and Stellantis, formerly Chrysler, no matter the merits of the workers’ yearnings, shouldn’t have happened. Once it got going, it shouldn’t have lasted. The White House should have spoken.
Already there is damage. Ford has “paused” plans to build a $3.5-billion battery plant in Michigan. If the strike drags on, or if the industry bows to the most damaging demand in the union’s wish list (a 32-hour work week), then the production of EVs and battery leadership will be ceded to other countries. U.S. automakers’ dependence on China — the world ’s top battery maker for EVs — will continue.
The U.S. auto industry is starting its EV surge behind others, and it will suffer mightily if the UAW doesn’t return to work.
In this circumstance, with so much at stake, it would be reasonable to expect President Biden to have both sides closeted at Camp David and to be “knocking heads together.”
The president is the ultimate arbitrator, the one we look to for guidance and to tell us what is best. Yet, instead of bringing both sides together in the national interest, Biden has chosen sides, and chosen to walk the picket line.
Even Steven Rattner, the Democrats’ mechanic when it comes to auto issues, has said this is wrong.
Rattner — whom I caroused with when he was reporter at The New York Times, before he became fabulously rich on Wall Street — is through-and-through a Democrat and one of the party’s intellectuals. In 2009, he authored the rescue plan for the auto industry. At that time, it looked like General Motors and Chrysler were headed for permanent closure.
What was Biden thinking? Why did he abandon the high ground of the presidency?
How can Biden now sit down and bring both sides to the table to negotiate in good faith? He has already declared his allegiance to one.
I believe in the value of unions: guarantors of middle-class life for many. I am not just saying that. I have lived it.
I was once the president of the Washington-Baltimore Newspaper Guild. I am very proud of the financial settlement we got on my watch for reporters and editors at The Washington Post. It was a breakthrough: a 67 percent pay raise over three years.
The newspaper industry was very prosperous at the time, whereas reporters and editors were poorly paid. It was long before the internet would crush the industry, reducing it to its present state of poverty and collapse. We were asking for some of the goodies we had created. There was no danger of The Washington Post moving to China.
Sadly, the unions have been slow to adjust to new realities. They are stuck in a mindset of the days when we were a country of industrial robber barons and industrial unions made sense. Now we are mostly a service economy desperately seeking to reindustrialize. EVs are important in that effort.
I ran into outdated union thinking head-on at the Washington-Baltimore Newspaper Guild. Although we were largely autonomous, we were a chapter of the American Newspaper Guild, our head office.
I had a proposal for simplifying work schedules for editorial staff. My proposal was that editorial staff work three days — 10 to 12 hours a day — and have three days off. My colleagues loved it, The Washington Post management saw it as a solution to overtime and weekend staffing problems. I had seen it work well at the BBC in London, where it was standard practice.
The ANG head office went berserk: It was a betrayal of union history and the “model” contract, written by the legendary reporter, columnist and ANG founder, Heywood Broun, in 1935. In ongoing negotiations with The Post, I dropped the proposal to everyone’s regret. That kind of legacy thinking is what has been killing unions and unionism.
There is a backstory to the Hollywood writers’ strike and the auto workers’ stoppage: artificial intelligence. It will change lives and is a threat to the kind of work unions have protected.
Biden might well have chosen the strikes as a chance to bring about settlements, but also to begin a national dialogue on AI.
Instead, Biden walked a picket line, resolving nothing.
Llewellyn King is executive producer and host of White House Chronicle, on PBS. His email is llewellynking1@gmail.com and he’s based in Rhode Island and Washington, D.C.
At the University of Southern Maine, ethics training in artificial intelligence
The McGoldrick Center for Career & Student Services, left, the Bean Green, and the Portland Commons dorm at the University of Southern Maine’s Portland campus.
— Photo by Metrodogmedia
AI at work: Representing images on multiple layers of abstraction in deep learning.
— Photo by Sven Behnke
Edited from a New England Council report:
“The University of Southern Maine (USM) “has received a $400,000 grant from the National Science Foundation to develop a training program for ethical-research practices in the age of artificial intelligence.
“With the growing prevalence of AI, especially such chatbots as Chat-GPT, experts have warned of the potential risks posed to integrity in research and technology development. Because research is an inherently stressful endeavor, often with time constraints and certain desired results, it can be tempting for researchers to cut corners, leaning on artificial intelligence to imitate the work of humans.
“At USM’s Regulatory Training and Ethics Center, faculty are studying what conditions lead to potential ethical misconduct and creating training sessions to make researchers conscious of their decisions and thoughts during their work and remain aware of stressors that might lead to mistakes in judgment. Faculty at USM believe this method will allow subjects to proactively avoid turning to unethical AI assistance.
“‘We hope to create a level of self-awareness so that when people are on the brink of taking a shortcut they will have the ability to reflect on that,’ said Bruce Thompson, a professor of psychology and principal at the USM ethics center. ‘It’s a preemptive way to interrupt the tendency to cheat or plagiarize.’’’
Anxiety in New Haven
“Toward the Forest “ (colored woodcut), by Norwegian artist Edvard Munch (1863-1944), in the show “Munch and Kirchner: Anxiety and Expression,’’ at the Yale University Art Gallery, New Haven, Conn., Feb. 16-June 23, 2024.
“Head of Dr. Frédéric Bauer’’ (colored woodcut), by German artist Ernst Ludwig Kirchner (1880-1938).
The gallery says:
“Featuring more than 60 works on paper, this exhibition is the first to examine the prints of Edvard Munch alongside those of Ernst Ludwig Kirchner, elucidating the fascinating overlaps in their creative output and personal biographies and demonstrating how these artists suffered from—and attempted to cope with—the anxieties of their age.’’