Little bit on the Carriage House. This is a little odd, but i want to talk about our variance request. About a month ago, after more than a year of processing, staff told us it may not or that it is disinclined to grant our rear yard variance request for the Carriage House on the grounds that it can be approved as an a. D. U. With a waiver from the Zoning Administrator. And respectfully, this is not something the project sponsor supports for a few different reasons. First, it would prohibit this unit from being available for someone to buy. While that may not sound like much, the Carriage House is a unique Home Ownership opportunity, nearly all new 800 square foot homes are in multiunit buildings. This would be a stand alone home, allowing someone who wouldnt be able to afford a home, that opportunity. This would aban awkward a. D. U. Unit. Would be an awkward a. D. U. Unit. Finally and most importantly for the Zoning Administrator, converting the rear garage into a dwelling unit meets
Hints that in fact there could be a military aspect to this program. The fact that assuage International Concerns about possible military uses of technology that the iranians have been developing ask they have been sending inspection teams in 20 check up on all aspects of the program. China and germany is the plus one. A big group on our side. Their issues have to do with really trying to get a handle on these big visible signs that iran may be heading towards a military program. I talked about enrichment capacity and trying to get the enrichment capacity shrunk way down and looking at the heavy water reactor that they have been using to produce Nuclear Weapons. Lots of questions of those kinds. Its not a negotiation im in charge of, but it has been run by sec ter kerry has wrestled with the negotiation. And there a lot of heavy hitters trying to get progress. The big of heavy lifting is on the political side. Will they take the political decisions to bring the negotiation home. We wil
So to give you a sense of why that really diminishes the incentives, if you think about an aco increasing spending during a Contract Period, medicare shared savings program, aco for example that isnt facing any Downside Risk, they are penalized for doing that. And it increases their benchmark for the following Contract Period and then they can receive a shared savings bonus for doing nothing. Under the pioneer program, they are penalized for doing more, but again theres that offsetting effect by the benchmark going up and the subsequent Contract Period, so for pioneer acos the incentives are more akin to fee for service with a lag. Then, thinking about the fixed costs of investing in systems to actually control spending, the rebasing is that much more of a problem because it may be hard for acos to recoup their investments of investing in the right systems. So that is one challenge. And i know sean and his team is working hard on a revamped proposed rule for the shared savings program.
We were able to cut down readmission rate dramatically and our emergency room rate dramatically. The only thing that went up in our database was primary care visits. Once again, not necessarily perfection but i think as a Clinical Study it was shown to be effective. And once again the reimbursement and the savings bears out that case. We also initiated some relatively interesting demonstration projects. We identified our congestive Heart Failure patients who were having problems with frequent readmissions. We did something very simple. We put scales in their house that automatically sent their weights directly to the doctors Electronic Medical records. Not a very expensive proposition. As soon as it was greater than a one pound change in the patients they got a phone call to find out what had changed and whether or not they were being noncompliant with either medication or diet or what changes had occurred. And in patients who routinely would have four or five hospital admissions in a
Ashley Fraise is a 40-year-old cancer survivor who was born and raised in Fort Madison. She currently lives in Denmark, which is seven miles north of Fort Madison, and has