HHS to withhold some bonus pay earned by laid-off employees
"If the savings from the layoffs were pennies from the HHS budget, this is hundredths of a penny," one current federal health agency employee said of the move.
While bonus payments usually go out in April to high-performing federal employees, the department had stalled them from being deposited. Now payouts are scheduled to go out after June 2, under the new decision.
This timing prevents the money from being paid out to people who were laid off or took buyouts or early retirement. Most of the workers laid off at the department are still on paid leave under federal policies, ahead of an official "separation" date scheduled for June 2.
"We apologize to those of you who were expecting bonuses and truly wish we could have delivered them," human resources officials wrote to the staff of one HHS agency, in an email obtained by CBS News.
An appeal sought by some agency officials was "unsuccessful in having it overturned," according to the email.
"That's f****d up. They worked hard all last year for those awards," a federal health agency employee said in a message.
The decision applies to all agencies and divisions that rely on the department's central human resources office, the Staffing and Recruitment Operations Center, under Health and Human Services Secretary Robert F. Kennedy Jr.
This includes laid-off employees of the Substance Abuse and Mental Health Services Administration, as well as a number of standalone offices within the department.
A handful of larger agencies where human resources offices are not directly controlled by the department, like at the National Institutes of Health, were able to pay out the bonuses.
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Yahoo
12 hours ago
- Yahoo
Judge dismisses ACLU's lawsuit against West Virginia over Morrisey's vaccine executive order
Aubrey Sparks, legal director for ACLU-WV, argues in support of their lawsuit against the state Wednesday in front of Kanawha County Circuit Judge Kenneth Ballard. The judge dismissed the lawsuit on procedural grounds. (Lori Kersey | West Virginia Watch) A Kanawha County judge has dismissed a legal action filed against the state Department of Health over its compliance with Gov. Patrick Morrisey's executive order requiring it to issue religious exemptions to the state's school-required vaccinations. Circuit Judge Kenneth Ballard dismissed the suit — filed by plaintiffs represented by the American Civil Liberties Union of West Virginia and Mountain State Justice — on procedural grounds without addressing the merits of the case. He agreed with an attorney representing the state that the ACLU had failed to meet a requirement that it notify the state 30 days in advance of filing the lawsuit. 'I think I'm jurisdictionally barred,' Ballard said from the bench Wednesday. 'I think that the petitioners here failed to satisfy the requirements of West Virginia Code 55-17-3 which requires either a …30-day notice or a pleading of injunctive relief.' The judge said the ACLU's complaint and arguments sought a writ of mandamus with little discussion of a request for injunctive relief. 'I don't think you appropriately sought this injunctive relief, I think you only interjected it at the end in an effort to get around this rule,' Ballard said. The ACLU and Mountain State Justice filed the lawsuit May 23 against the state Department of Health on behalf of Marisa Jackson, of Kanawha County, and Dr. Joshua Hess, of Cabell County. Jackson and Hess are both parents of immunocompromised students. Hess is also a pediatric hematologist and oncologist practicing at Marshall Health's Cabell Huntington Hospital. The petition asked the court to compel the state's Department of Health and Bureau for Public Health to stop complying with the executive order requiring the state to allow religious exemptions for vaccine requirements. The state is one of only five in the country that has not allowed religious or philosophical exemptions to school required vaccines. Despite Morrisey's executive order, the state Legislature earlier this year voted down Senate Bill 460, which would have established those religious exemptions in state law. The state Board of Education voted recently to direct county boards of education not to allow religious exemptions. In a separate legal action, a Raleigh County parent whose child was issued a religious exemption by the Department of Health is suing the state and county school boards for not accepting the exemption. A hearing is scheduled for Thursday in the Raleigh County lawsuit. On behalf of the state, attorney Holly Wilson argued that the case can be dismissed for 'myriad reasons,' including that the plaintiffs did not offer pre-suit notice or meet a burden to show standing. 'But if this court decides that it wants to reach the merits or that it should reach the merits, petitioners lose,' she said. 'They can't show a clear legal right. They can't show a legal duty and certainly they can't show a legal duty that's non-discretionary.' The state and Morrisey argue that the state's vaccine laws taken together with a 2023 Equal Protection for Religion Act require the state to allow religious exemptions. Aubrey Sparks, legal director for the ACLU, argued that the ACLU was not required to give the state 30 days notice because of an exception in the law when parties are asking for injunctive relief. Ballard dismissed the case without prejudice, meaning that the ACLU could re-file the lawsuit. Sparks told reporters after the hearing Wednesday it's too soon to say whether the legal advocacy organization would do so. 'It's an open question about what our next steps are because I know that there's a lot of other lawsuits pending on this issue,' Sparks said. 'We want to understand what happens in those but we do feel fundamentally that what the state is doing here is unlawful. But then more concerningly, what the state has argued in this case is so profoundly unconstitutional that we all should be concerned. 'What they functionally came into this courtroom and said is that an act of the governor can just unilaterally swipe off the table any law that he thinks could burden someone's religious exercise, and that's just not supported and not permissible under our constitution.' In a post on the social media platform X Wednesday, Morrisey called the judge's ruling the 'first skirmish of a longer fight.' 'But the ultimate outcome — whether resolved via litigation or a change in statute — is not in doubt,' he said. 'West Virginia is a radical outlier when it comes to onerous vaccine mandates — one of only 5 states in the nation without a statutorily-based, religious exemption. We have an EO based upon our state's religious freedom law that is very strong and must be given meaning. Sadly the state school board is ignoring this important law — they are over reaching and need to be stopped!' SUPPORT: YOU MAKE OUR WORK POSSIBLE Solve the daily Crossword
Forbes
15 hours ago
- Forbes
Yes, You Should Brush Your Teeth For 2 Minutes, Twice A Day. Here's Why.
Maintaining good oral hygiene practices is key to keeping your teeth and gums healthy—and spending two minutes brushing twice a day is a crucial part of any routine. This may seem like a simple mandate, but there are several factors to keep in mind when you're brushing for optimal results: Technique, toothpaste, pacing and more will make a difference. The ultimate goal of brushing your teeth is to remove bacteria, which can otherwise build up to cause decay and disease. '[For] oral disease, whether that's cavities or whether that's gum disease, reducing the amount of bacterial load in the mouth is a critical piece of that prevention measure,' says Jennifer Cullen, clinical assistant professor at the University of Michigan School of Dentistry. We spoke to three dental experts to learn the best tips and tricks for keeping your teeth sparkling ... More clean. Illustration: Forbes / Photos: Retailers To help you make the most of your two-minute toothbrushing sessions—and learn why we should brush at this cadence in the first place—I spoke to three dental experts to get their advice: Mark S. Wolff, DDS, PhD, Morton Amsterdam dean and professor of the division of restorative dentistry at the University of Pennsylvania; Jennifer Cullen, clinical assistant professor at the University of Michigan School of Dentistry, and director of the division of dental hygiene; and Matthew Messina, DDS, associate professor, clinical and clinic director at the Ohio State University College of Dentistry, and ADA spokesperson. These experts shared their insights on how to brush most effectively, and why brushing teeth is important, to help you stay motivated. Here are the tips and techniques they recommend. Multiple clinical studies show that brushing for two minutes is key to removing plaque so you can keep your teeth and gums healthy. 'There's clinical studies that have shown two minutes of brushing to be highly effective in reducing [tooth] decay,' says Dr. Wolff. A key reason for the two-minute mandate is so you can actually reach the surface of every tooth in the mouth with your brush, and tackle all of the plaque on your teeth. Cullen explained that there are multiple layers of plaque on teeth, and that the longer you brush, the better you can get to the bottom-most, stickiest layers. The experts I spoke with maintained that thoroughly brushing the surface of every tooth takes time: You want to make sure you get the cheek and tongue surface and the back and front of each one. Wolff advises softly placing the bristles right at the gumline to start brushing. How can you ensure you're getting each tooth? 'Brush methodically, not randomly,' says Wolff. Approaching each quadrant of the mouth in 30-second intervals can help you hit all the areas of your mouth, too. Some of the best electric toothbrushes we've tested, like the Oral-B iO Deep Clean + Protect, our pick for the best smart electric toothbrush, and the Philips Sonicare 9900 Prestige, our pick for best splurge electric toothbrush, not only buzz at 30-second intervals to move you along but also have apps that track your brushing to show you any spots you're missing. Let Fluoride Do Its Job The other crucial reason to brush for two minutes twice a day is to let the fluoride in toothpaste take effect to help prevent tooth decay. Cullen notes that hygienists and dentists recommend that people use some sort of fluoridated toothpaste, and that 'there is evidence for the benefits of that increased duration with respect to fluoride delivery.' The experts I spoke to said that fluoride is key to protecting tooth enamel, and that longer exposure to fluoride makes it harder for bacteria to build back up on the tooth. 'It's actually making the enamel less soluble to acids,' says Wolff. Many of the best electric toothbrushes have timers to track your brushing. Some, like the Oral-B iO Deep Clean + Protect, display time clearly on the brush's LED interface and offer cartoon faces (ranging from a frown to starry-eyed smile) to indicate where you stand with your time goal. This brush also works with an app to help you track time, and uses a buzzer in 30-second increments to cue you to move around your mouth. Other brushes use an automatic shutoff feature, or similar buzzing notifications, to let you know when you've reached your full two minutes. Timers And Apps There are multiple ways to time your brushing. Cullen suggests a sand timer for kids or patients with special needs. Dr. Messina recommends using a timer on your phone. He also notes there are apps that are especially helpful for kids to guide them to brush around their mouth over the course of two minutes. Break It Up By Quadrant To break up the two minutes, you can also count for 30 seconds while brushing each quadrant of your mouth, if you don't have an electric toothbrush that does this automatically. This can help keep track of time while making sure you're getting to every tooth. Sing A Song Both Cullen and Messina suggest one way to track your time is to either sing or play a favorite song that lasts around two minutes. This can help gamify your brushing—and make it more enjoyable, a technique that can be especially helpful for kids. Be Gentle Though it's important to be thorough while brushing, experts advise against brushing too hard. 'You don't want to wear the teeth away by scrubbing like this is a floor,' says Wolff. Brushing too hard can actually damage your teeth and gums. To avoid that, opt for a brush with soft bristles. Many electric toothbrushes also have pressure sensors to indicate if you're brushing too aggressively, or if you're hitting the sweet spot. In our electric toothbrush tests, we preferred the easy-to-see sensor on the Oral-B iO Deep Clean + Protect, which uses a light around the neck of the toothbrush to flash green, white or red to indicate pressure. Other brushes can have pressure sensors that will buzz or light up to tell you to ease up. Don't Forget To Floss Brushing is just one key component of a great oral hygiene routine; it can't act alone. Flossing is crucial to reach every surface of the tooth to remove food and debris. 'Brushing itself only reaches 60% of your tooth surfaces,' says Cullen. 'Everywhere a tooth touches another tooth, that toothbrush can't get to.' She recommends floss or an adaptive aid to help get into those hard-to-reach spaces. We've also tested the best water flossers at Forbes Vetted, and these devices can help reach in between teeth to clear debris. The Waterpik Aquarius Water Flosser won as best water flosser overall in our tests. Water flossers may be especially useful for people with orthodontia or those who have difficulty using traditional dental floss. Consider The Swish, And The Social Brush All the experts I spoke to recommended brushing at least twice a day—but what if you want, or need, to brush more frequently? In general, that's fine, and some people may need to brush more frequently due to medical conditions or orthodontia. Wolff advises being mindful of not brushing too hard, however. 'There's nothing wrong with too much or too frequent brushing, as long as you do it gently and you don't wear away the gums [or] damage the tooth with a hard toothbrush,' he says. He also warned of compensating with frequency versus technique. 'Doing it three times a day badly does not make you less likely to get cavities or less likely to have gum disease,' he says. If you don't have access to a sink or brush after every meal, there are still easy things you can do to help keep your mouth cleaner. Cullen and Messina both advise swishing your mouth with water after eating to neutralize the pH of the mouth (when the environment of the mouth is more acidic, it becomes more hospitable to cavity-causing bacteria). Messina also recommends what he calls a 'social brush,' or a quicker brush to clear the mouth of food—for example, after eating a pungent meal like a hamburger with onions— that's less thorough than your twice-daily toothbrushing geared toward deeper cleaning and hitting every surface of the tooth. Remember That Every Patient Has Different Needs Though brushing your teeth for two minutes twice a day is the standard, every patient has different needs; some people may need to brush more frequently or require assistance with brushing. Cullen spoke to how a 10-year-old who isn't snacking frequently or drinking sweet drinks could brush just twice a day, while someone with Parkinson's disease may need to brush more frequently and with assistance. Sometimes electric toothbrushes can help people brush more effectively, but other assistive devices, like a universal cuff, can also help with holding a toothbrush independently. Cullen also said that caregivers may need to give patients breaks or adjust the location for brushing. 'If you're a caregiver, maybe you're doing it at the kitchen table,' she says. 'Maybe you're able to brush for 60 seconds and that person needs a break.' Check in with your hygienist, dentist and care team for the most relevant advice for your needs. Some Brushing Is Better Than None Building new habits like brushing your teeth for two minutes twice a day takes time, and starting a new routine can be intimidating. Messina notes that some patients can feel overwhelmed by the guilt of not brushing enough, and encourages people to do the best they can. Brushing isn't all or nothing; even if you can't reach the full two minutes, Messina says it's still helpful to brush in the first place, no matter how long the duration. 'I know if you start small, that you'll realize how much better it feels and then you'll do more and more,' he says. And remember, brushing is key to overall health. 'It seems like such a small thing to brush your teeth twice a day, but I think people should be encouraged that they're really making a big impact on their overall health when they do that small thing,' says Cullen.
Forbes
15 hours ago
- Forbes
20 Hurdles For Healthcare Tech Startups In Scaling Solutions
A healthcare startup may launch with a bold and innovative idea, but turning that idea into a scalable solution that works across hospitals and complex health systems is rarely straightforward. From integrating with legacy infrastructure to navigating strict compliance requirements and diverse stakeholder priorities, even the most agile teams can struggle to scale effectively. Left unaddressed, these challenges can stall adoption, drain internal resources and limit a product's long-term impact. Below, members of Forbes Technology Council highlight some of the most common hurdles healthcare startups must be ready for and share their expertise on breaking into and succeeding in this challenging sector. 1. Finding Client Champions To scale solutions within a health system or payer organization, you need to engage a team of internal champions who can understand, justify and prioritize your platform. Organizations evaluate dozens if not hundreds of companies each year. Champions help articulate your value, often leveraging their professional credibility to advocate for it. Finding and 'winning' them is essential to scaling. - Graham Gardner, Kyruus Health 2. Navigating Integration Requirements Across Hospital Systems One of the biggest hurdles is navigating the complexities of integration requirements across different hospital systems. Healthcare startups frequently underestimate the time and resources needed for integrations. Success requires building flexible APIs from day one and having dedicated integration specialists who understand healthcare IT infrastructure, not just general software development. - Ted Kail, Cority Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify? 3. Gaining Traction In A Risk-Averse Environment Most healthcare organizations are risk-averse and don't want to be early adopters. They look for proven, well-established companies and products, making it difficult for healthcare startups to get traction, even when they have clearly better solutions. Partnering and delivering real value to that first set of clients is critical in scaling early on. - John Bou, Modio Health 4. Integrating With Insurance Systems Health insurance companies amplify the interoperability challenge by adding another layer of complex, often siloed, data and systems that healthcare tech startups must integrate with. This makes the negotiation and implementation of business associate and HIPAA agreements more complicated, given the data types, security requirements and shared liabilities that arise from integrating with both providers and payers. - Ajai Paul, Affirm Inc. 5. Understanding The Complex Stakeholder Ecosystem Healthcare startups often make the mistake of viewing the U.S. healthcare system with a 'singular' point of view. It is an integrated ecosystem where each stakeholder is affected by the others, which means multiple interests must be aligned when adopting new technologies. - Raghav Ramabadran, Intelligine Technologies 6. Building Custom Integrations For Each Customer Healthcare startups' challenges include integrating with electronic health record systems, which is not a 'plug and play' process. Each hospital or system has its own highly customized version of an EHR, with unique workflows, data fields and security protocols. This lack of standardization means startups must build a new integration for nearly every customer. - Chris Ciabarra, Athena Security Inc. 7. Developing Strong Governance From The Outset Healthcare startups often wait to build full product depth until after landing their first client, but healthcare's high-risk, structured environment demands strong governance from day one. Change control, release management and a deep understanding of current operations, especially when replacing legacy systems, are essential before customizing. Building depth late risks delays and failure! - Trisha Swift, Mula Integrative Health & Wellness 8. Maintaining HIPAA Compliance With Digital Content One challenge healthcare startups face when scaling tech is managing digital content while staying HIPAA-compliant. Hospitals need more than stock photos and shared drives—they expect secure, role-based access to branded visuals that convey authenticity and protect patient privacy. Without a digital asset management strategy, startups risk falling short on compliance, credibility and growth. - Andrew Fingerman, PhotoShelter 9. Ensuring Consistent Performance And Compliance Across Disparate Systems Healthcare startups often struggle to scale because hospital environments vary widely in terms of infrastructure, workflows and data systems. Without a unified data architecture, real-time metrics, and built-in security and governance, it's hard to ensure consistent performance—or meet privacy requirements like HIPAA and business associate agreements governing protected health information. - Dave Albano, Diliko 10. Working Within Complex Pricing And Claims Rules One of the challenges is the integration of new tech into strict hospital billing and compliance processes. Hospitals have complex pricing and claims rules, and startups must work within these rules. They can't disrupt revenue or patient data safety. Doing this right builds trust and helps a solution scale faster. - Abhishek Sinha, Accenture 11. Processing Both Structured And Unstructured Health Data Integrating structured data (EHRs; lab results) and unstructured data (clinical notes; imaging; video) can be a major challenge. Healthcare startups must ensure their tech can process both, all while adapting to varying data and privacy standards across systems, which further complicates scaling and interoperability. Fortunately, generative AI is making this easier to do. - David Talby, John Snow Labs 12. Balancing Accuracy And Transparency With Scalability The healthcare and life sciences sector faces rigorous accuracy and transparency requirements that cannot be sacrificed and must be built into products from the start. Balancing this with scalability—which is really code for 'solving problems you don't have yet'—is a constant challenge—especially for startups, which often place a key focus on agility and speed. - Martin Snyder, Certara 13. Maintaining A Consistent, Accurate Record Of Core Assets One key challenge healthcare startups face when scaling tech solutions across systems is the inability to maintain a consistent and accurate record of core assets—such as patients, providers and devices—due to the absence of a robust master data management strategy. This causes data fragmentation, which in turn hinders decision-making, innovation and seamless integration across platforms. - Somnath Banerjee 14. Keeping Up With A Range Of Regional Norms And Laws Key challenges include a wide range of compliance requirements, regulations, cultural norms, and data privacy and region-specific laws—making a one-size-fits-all solution impractical, even within a single organization. Startups often rely on business rules engines that lack user friendliness. Agentic AI offers a more adaptable and intuitive alternative. - Koushik Sundar, Citibank 15. Working Within Legacy Hospital Systems One major challenge healthcare startups face when scaling tech solutions is integration with legacy hospital systems. Many hospitals rely on outdated EHRs or siloed IT infrastructure, making interoperability difficult. Startups must ensure compliance, data security and seamless integration to gain trust and adoption at scale. - Srikanth Bellamkonda 16. Clearly Demonstrating ROI And Pathways To Reimbursement Healthcare startups often struggle to clearly demonstrate a return on investment and secure reimbursement pathways. Without established billing codes or tangible cost-savings data, hospitals hesitate to allocate budget. Startups must invest heavily in economic validation, health economics and outcomes research, ensuring payers and finance teams see sustainable revenue models before adoption. - Manav Kapoor, Amazon 17. Creating An Internal COE Establishing an internal center of excellence with deep industry experience in scaling healthcare systems is vital, but costly. A key challenge lies in selecting vendors that align with the company's DNA. Bridging the gap between emerging tech and the unique demands of healthcare requires thoughtful planning and a nuanced understanding of both innovation and patient-centric outcomes. - Hari Sonnenahalli, NTT Data Business Solutions 18. Overcoming Resistance To New Tech I've regularly observed the challenges clinical sites face when adopting new technologies. There is often reluctance or resistance to change; staffing shortages further exacerbate these issues. A more effective approach may be to 'mirror' site-level data. This would allow AI-driven platforms to build a harmonized system that enables forward progress without disrupting existing workflows. - Rachel Tam, Bristol Myers Squibb 19. Accounting For Integration Issues When Building Solutions The biggest hurdle to overcome when scaling tech solutions across hospitals or healthcare systems is not technical; rather, it is integration—into provider workflows, clinical practice guidelines, financial models and revenue cycle management programs. Unless the issues around integration are considered and covered when building the solution, scaling will not occur. The landscape is littered with misaligned HealthTech startups. - Mark Francis, Electronic Caregiver 20. Completing Vendor Risk Documentation Post-ransomware, hospitals demand extensive vendor risk audits with hundreds of security controls, SOC 2/HITRUST docs, and custom BAAs. Completing these lengthy questionnaires stretches sales cycles to 18 to 24 months, burning cash and pulling engineers from product work to compliance, blocking scale. - Mohit Menghnani, Twilio
