As I take a respite from blogging, have a blessed Thanksgiving and safe travels.
31 Aralık 2012 Pazartesi
It's 32 Degrees Outside. Where's Your Coat?
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I am on my way to work this AM and pass a school bus stop with high school aged students waiting for their bus. What I found amazing was that none of them had a coat or jacket on; only one female was wearing a sweater and a thin one at that. The boys were dressed in basketball shorts and t-shirts and the girls were dressed in jeans and shirts. How can their parents let them out of the house like that when it's 32 degrees out? Maybe I am just getting old. But it's freezing! This was not a lower income neighborhood where affordability could be an issue, but a traditional middle- class neighborhood. What I find amazing is that the elementary school kids waiting for the bus on days like this are bundled up with hats, coats and gloves; thank you mom and / or dad. Middle school kids at least have on a jacket, but then there are the high school kids being COOL by having the least amount of clothes on as possible while waiting for the bus. A minor issue for some, but how are we as health care providers supposed to keep families healthy and out of the hospital when parents allow or ignore what their high school aged kids are doing. I guess better this than a whole lot of other bad behaviors that high schoolers could be doing.
As I take a respite from blogging, have a blessed Thanksgiving and safe travels.
As I take a respite from blogging, have a blessed Thanksgiving and safe travels.
Gender Bias, Really?
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I read an article in yesterday's USA Today regarding birth control pills. I am not a clinician, but I am a husband, a father of two adult daughters, a brother and a son. The article was actually a debate among physicians as to whether or not birth control pills should be sold over the counter. Some actually stated that it is a gender bias issue since condoms are available over the counter so why not birth control pills. Huh? Unless I am missing something, condoms are applied not ingested. Seeing what it took for the women in my life to either get adjusted to birth control pills or be informed that they were not a candidate due to risk of blood clots and stroke, in particular, is enough for me to weigh in on the side of "what are you people crazy?". It is obvious to me that a lot has to go into taking birth control pills and that not everyone is a candidate. For those arguing the gender bias issue since there is no age restriction on the purchase of condoms, the same would apply for birth control pills. So, what happens when the teenager who wants to become sexually active buys birth control pills and unknowingly is in a high-risk category for stroke? The outcome, although more the exception than the rule, is still a bad outcome. This is really not a good idea and I am surprised that some clinicians are advocating for the change.
You're Killing Us
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"You're killing us" should have been the message yesterday when hospital CEOs from around the country met in Washington, DC, for the American Hospital Association's Advocacy Day. Approximately 200 CEOs met on Capitol Hill yesterday with their Congressional representatives to warn of the impact on the access to the care for our patients through arbitrary across-the-board cuts to Medicare and Medicaid.
Between ongoing state and federal budget cuts, state initiated assessments (taxes) to fund Medicaid, the Fiscal Cliff of a 2% reduction in payments to hospitals, the jeopardy that the Maryland Waiver is currently in jeopardy due to the above-mentioned provider assessments, denied days for care that has been provided due to the picayune documentation requirements of payors, withheld monies as a result of the government's somewhat flawed Recovery Audit Contractor (RAC) process (in this case, money is withheld for care that is provided and then the care has to been substantiated in a long, drawn-out process), the financial impact of these cuts on hospitals will threaten our ability to effectively care for our patients . Simply put, WMHS waits months for monies that should have been paid but are held usually for what seems to be whatever reason the payor can think of. Eventually we get paid, but the administrative costs associated with the appeals continue to be a burden on hospitals. With health care costs running about $1.7 trillion per year in the US, hospitals recognize that change has to occur.
At WMHS, we have made great progress in keeping patients healthy and out of the hospital, ultimately reducing health care costs. But, that has happened over the last two and one-half years and we are now finally seeing results. The payors, including CMS, want us to put cost saving initiatives in place overnight and have them generating results by morning. Real long-term solutions are what is necessary in order to still provide quality patient care while reducing the cost of that care.
Between ongoing state and federal budget cuts, state initiated assessments (taxes) to fund Medicaid, the Fiscal Cliff of a 2% reduction in payments to hospitals, the jeopardy that the Maryland Waiver is currently in jeopardy due to the above-mentioned provider assessments, denied days for care that has been provided due to the picayune documentation requirements of payors, withheld monies as a result of the government's somewhat flawed Recovery Audit Contractor (RAC) process (in this case, money is withheld for care that is provided and then the care has to been substantiated in a long, drawn-out process), the financial impact of these cuts on hospitals will threaten our ability to effectively care for our patients . Simply put, WMHS waits months for monies that should have been paid but are held usually for what seems to be whatever reason the payor can think of. Eventually we get paid, but the administrative costs associated with the appeals continue to be a burden on hospitals. With health care costs running about $1.7 trillion per year in the US, hospitals recognize that change has to occur.
At WMHS, we have made great progress in keeping patients healthy and out of the hospital, ultimately reducing health care costs. But, that has happened over the last two and one-half years and we are now finally seeing results. The payors, including CMS, want us to put cost saving initiatives in place overnight and have them generating results by morning. Real long-term solutions are what is necessary in order to still provide quality patient care while reducing the cost of that care.
Let's Talk Meetings at WMHS
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Last week, we held our Let's Talk meetings for employees throughout the health system. Our focus was twofold--sharing a video that highlights our Trauma Program at WMHS and showing the importance that we have in our community, along with making sure that our staff is aware of our industry's financial challenges as health care reform continues to evolve. It is important to note that the Triple Aim of Health Reform: Better Care, Healthier Patients and Communities and Lower Total Cost of Care are all positive aspects of where health care is headed. Unlike the 60 Minutes segment last evening on one for- profit health care provider, Health Management Associates, that is accused of driving increased revenue through "do or die" admission targets.
WMHS is successfully reducing admissions and readmissions. We have also implemented measures to reduce hospital-acquired conditions such as infections, pressure ulcers and ventilator-assisted pneumonia while increasing patient satisfaction. It is true that better care equates to better outcomes resulting in increased revenue through Maryland's pay-for-performance initiative. We went from losing $1.2 million in revenue last year because our quality scores trailed other hospitals in Maryland to a turnaround of $1.5 million gain this year. We continue to shift our services by providing the right care in the right place as evidenced by our new Wound Center, our Anticoagulation Clinic, our Diabetic Medical Home, our CareLink Program, our Congestive Heart Failure Clinic and case managing our most chronic patients. At WMHS, we continue to strive to fulfill our mission of Superior Care for All We Serve through evidence based care, patient centered care, a continued focus on keeping our patients healthy and out of the hospital, collaborating with our physicians and advanced practice professionals, being innovative in all that we do and having a continued awareness of our cost of doing business. Believe or not, running a health system with annual revenues of over $325 million isn't as easy as some make it out to be, especially in this era of reform.
WMHS is successfully reducing admissions and readmissions. We have also implemented measures to reduce hospital-acquired conditions such as infections, pressure ulcers and ventilator-assisted pneumonia while increasing patient satisfaction. It is true that better care equates to better outcomes resulting in increased revenue through Maryland's pay-for-performance initiative. We went from losing $1.2 million in revenue last year because our quality scores trailed other hospitals in Maryland to a turnaround of $1.5 million gain this year. We continue to shift our services by providing the right care in the right place as evidenced by our new Wound Center, our Anticoagulation Clinic, our Diabetic Medical Home, our CareLink Program, our Congestive Heart Failure Clinic and case managing our most chronic patients. At WMHS, we continue to strive to fulfill our mission of Superior Care for All We Serve through evidence based care, patient centered care, a continued focus on keeping our patients healthy and out of the hospital, collaborating with our physicians and advanced practice professionals, being innovative in all that we do and having a continued awareness of our cost of doing business. Believe or not, running a health system with annual revenues of over $325 million isn't as easy as some make it out to be, especially in this era of reform.
Let's Talk Meetings at WMHS
To contact us Click HERE
Last week, we held our Let's Talk meetings for employees throughout the health system. Our focus was twofold--sharing a video that highlights our Trauma Program at WMHS to show the importance that we have in our community and making sure that our staff is aware of our industry's financial challenges as health care reform continues to evolve. It is important to note that the Triple Aim of Health Reform (Better Care, Healthier Patients and Communities and Lower Total Cost of Care) are all positive aspects of where health care is headed. Unlike the 60 Minutes segment last evening on one for- profit health care provider, Health Management Associates, that is accused of driving increased revenue through "do or die" admission targets.
WMHS is successfully reducing admissions and readmissions. We have also implemented measures to reduce hospital-acquired conditions such as infections, pressure ulcers and ventilator-assisted pneumonia while increasing patient satisfaction. It is true that better care equates to better outcomes resulting in increased revenue through Maryland's pay-for-performance initiative. We went from losing $1.2 million in revenue last year because our quality scores trailed other hospitals in Maryland to a turnaround of $1.5 million gain this year. We continue to shift our services by providing the right care in the right place as evidenced by our new Wound Center, our Anticoagulation Clinic, our Diabetic Medical Home, our CareLink Program, our Congestive Heart Failure Clinic and case managing our most chronic patients. At WMHS, we continue to strive to fulfill our mission of Superior Care for All We Serve through evidence based care, patient centered care, a continued focus on keeping our patients healthy and out of the hospital, collaborating with our physicians and advanced practice professionals, being innovative in all that we do and having a continued awareness of our cost of doing business. Believe or not, running a health system with annual revenues of over $325 million isn't as easy as some make it out to be, especially in this era of reform.
WMHS is successfully reducing admissions and readmissions. We have also implemented measures to reduce hospital-acquired conditions such as infections, pressure ulcers and ventilator-assisted pneumonia while increasing patient satisfaction. It is true that better care equates to better outcomes resulting in increased revenue through Maryland's pay-for-performance initiative. We went from losing $1.2 million in revenue last year because our quality scores trailed other hospitals in Maryland to a turnaround of $1.5 million gain this year. We continue to shift our services by providing the right care in the right place as evidenced by our new Wound Center, our Anticoagulation Clinic, our Diabetic Medical Home, our CareLink Program, our Congestive Heart Failure Clinic and case managing our most chronic patients. At WMHS, we continue to strive to fulfill our mission of Superior Care for All We Serve through evidence based care, patient centered care, a continued focus on keeping our patients healthy and out of the hospital, collaborating with our physicians and advanced practice professionals, being innovative in all that we do and having a continued awareness of our cost of doing business. Believe or not, running a health system with annual revenues of over $325 million isn't as easy as some make it out to be, especially in this era of reform.
27 Aralık 2012 Perşembe
Making Sense of the Newtown Tragedy
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There isn't any way to make sense of what happened Friday morning in Newtown, CT. It was an absolutely horrific tragedy for which there is no logical explanation. To be perfectly honest, I have minimized watching, listening or reading about what happened. The national electronic media has become an absolute disgrace when such horrific incidents occur. They are all looking for that edge in being the first to report an exclusive aspect of any story. In doing so, they ignore fact checking; they just run with what they have been told and don't care if they are inaccurate. The bottom line is that they were successful in grabbing our attention.
As for the gun control issue, quite frankly, the only scary thing about banning assault weapons is where will the ban stop? No average Joe needs to have an arsenal of assault weapons, even one for that matter. But, once a ban starts, where will it stop? Pamela and I own guns for our safety in this day and age and every time an incident like Friday occurs, the appropriateness of our reasoning becomes stronger. Going forward, I will make every effort to maintain that right.
In my opinion, the biggest issue from Friday is how our country is dealing with the mental health issue. Funding continues to be cut and in many cases eliminated at every level of government. We have some extremely ill individuals in this country who are freely walking among us every day. It is no longer politically correct to institutionalize those who are in need the services of mental health professionals. Some of these folks need a great deal of help, but we leave it up to them in their compromised state to decide for themselves if help is necessary.
I was encouraged by the Lt. Governor from Alaska, who attended Sandy Hook Elementary School as a child growing up in Newtown, CT. Lt. Governor Mead Treadwell spoke of what has been done in Alaska due to the crisis of mental health issues and suicide in that state. He said that what we need first and foremost is a more robust mental health system in the US. Because of Alaska's double the national average suicide rate, they have set aside funding to address their issues in Alaska. They are doing a great deal with research and new methods for treating mental illness in his state.
I hope that when President Obama said that we will stem gun violence in our schools through meaningful action that it will be an across-the-board solution and not one focused exclusively on banning guns. By the way, I applaud President Obama for going to Connecticut last evening to begin the much-needed healing in that community.
As for the gun control issue, quite frankly, the only scary thing about banning assault weapons is where will the ban stop? No average Joe needs to have an arsenal of assault weapons, even one for that matter. But, once a ban starts, where will it stop? Pamela and I own guns for our safety in this day and age and every time an incident like Friday occurs, the appropriateness of our reasoning becomes stronger. Going forward, I will make every effort to maintain that right.
In my opinion, the biggest issue from Friday is how our country is dealing with the mental health issue. Funding continues to be cut and in many cases eliminated at every level of government. We have some extremely ill individuals in this country who are freely walking among us every day. It is no longer politically correct to institutionalize those who are in need the services of mental health professionals. Some of these folks need a great deal of help, but we leave it up to them in their compromised state to decide for themselves if help is necessary.
I was encouraged by the Lt. Governor from Alaska, who attended Sandy Hook Elementary School as a child growing up in Newtown, CT. Lt. Governor Mead Treadwell spoke of what has been done in Alaska due to the crisis of mental health issues and suicide in that state. He said that what we need first and foremost is a more robust mental health system in the US. Because of Alaska's double the national average suicide rate, they have set aside funding to address their issues in Alaska. They are doing a great deal with research and new methods for treating mental illness in his state.
I hope that when President Obama said that we will stem gun violence in our schools through meaningful action that it will be an across-the-board solution and not one focused exclusively on banning guns. By the way, I applaud President Obama for going to Connecticut last evening to begin the much-needed healing in that community.
An Unauthorized Biography of Congress
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I saw a headline on another blog this a.m. stating that the infamous biographer, Kitty Kelly, is thinking about writing an unauthorized biography on Congress. The idea really struck me as being a good one. I find it amazing that the approval rating for Congress is at record lows, and yet, individual Congressional representatives are idolized. Their individualized ratings are extremely high; but as an elected body, they are abysmal. Kitty Kelly calls it a secret society. Really? I think it is pretty obvious as to what they are all about: getting re-elected. Of recent, I am involved with a state initiative that requires federal involvement. Every elected official who is involved doesn't care about the particulars of the outcome just the outcome and how can they use it to their benefit for re-election and self-promotion. Maybe, if Kitty doesn't write the unauthorized biography, I will.
Bye, Tom
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Today is the last day that I will work with Tom Dowdell, Senior Vice President and Chief Operating Officer for WMHS as he begins his new life of retirement on December 29th. Tom and I began our careers in Cumberland six weeks apart, Tom around Halloween in 1989 and I started in mid-December 1989. We never imagined that we would work together for 23 years; most marriages don't last that long. We became friends instantly with the same Black Irish sense of humor. We laughed together, cried together, but most importantly respected the hell out of each other. We served as each other's confidents; we mentored each other and on some occasions even tormented each other.
The legacy that Tom has left for us is amazing from the consolidation of the two hospitals to form the Western Maryland Health System to building a new hospital and over two decades of unbelievable accomplishments before, after and in between. I am not sure what December 31st, the next day that we would have worked together after today will be like, but I have wonderful stories and fabulous memories that will last a lifetime. God speed, Tom.
The legacy that Tom has left for us is amazing from the consolidation of the two hospitals to form the Western Maryland Health System to building a new hospital and over two decades of unbelievable accomplishments before, after and in between. I am not sure what December 31st, the next day that we would have worked together after today will be like, but I have wonderful stories and fabulous memories that will last a lifetime. God speed, Tom.
WMHS Holiday Meal
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Yesterday was our Holiday Meal at the Health System. What a great day! Management serves the meal to employees and visitors. For the first time in a while, all the servers were asked to decorate aprons with a holiday design. Included in today's blog is a photo of my apron and a photo of the executive staff donning their aprons. The aprons looked great; lots of creative designs. When I arrived at Joann Fabrics on Saturday to buy the materials for the apron, I announced that I was clearly out of my element. My apron took me all day on Sunday to make and when I was done I then napped for three hours. I also learned from previous apron design attempts when I glued my apron to carpet in the family room. Every aspect of the day was great and I now have great ideas for future apron designs.
Merry Christmas & Happy New Year
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I will be taking a blogging hiatus after today until January 2nd. For my last blog of the year, I wanted to extend a blessed holiday season to everyone. To all the employees, medical staff members and board directors--thank you for what you do for our health system throughout the year. Safe travels during the holiday season to all. I am looking forward to a healthy and happy 2013.
20 Aralık 2012 Perşembe
Red Maryland December 2012 Poll Results
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Below are the full results of the Red Maryland December 2012 Poll...
* * * * * * * * RED MARYLAND DECEMBER 2012 POLL RESULTSResult Summary for Survey:Red Maryland December 2012 Maryland GOP Survey Red Maryland December 2012 Maryland GOP Survey
* * * * * * * * RED MARYLAND DECEMBER 2012 POLL RESULTS
| 1. What is your gender? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Female |  | 26.2% | 114 |
| Male | | 73.8% | 321 |
| 2. Which category below includes your age? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| 18-29 | | 16.8% | 73 |
| 30-39 | | 20.5% | 89 |
| 40-49 | | 27.1% | 118 |
| 50-59 | | 22.3% | 97 |
| 60 or older | | 13.3% | 58 |
| 3. What county are you from? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Allegany | | 1.1% | 5 |
| Anne Arundel | | 22.1% | 96 |
| Baltimore City | | 2.8% | 12 |
| Baltimore County | | 12.0% | 52 |
| Calvert | | 1.6% | 7 |
| Caroline | | 1.6% | 7 |
| Carroll | | 2.5% | 11 |
| Cecil | | 7.8% | 34 |
| Charles | | 1.1% | 5 |
| Dorchester | | 0.7% | 3 |
| Frederick | | 7.6% | 33 |
| Garrett | | 0.5% | 2 |
| Harford | | 5.5% | 24 |
| Howard | | 8.3% | 36 |
| Kent | | 1.4% | 6 |
| Montgomery | | 10.1% | 44 |
| Prince George's | | 2.3% | 10 |
| Queen Anne's | | 2.8% | 12 |
| St. Mary's | | 1.4% | 6 |
| Somerset | | 0.5% | 2 |
| Talbot | | 1.1% | 5 |
| Washington | | 2.5% | 11 |
| Wicomico | | 1.4% | 6 |
| Worcester | | 1.4% | 6 |
| 4. How do you identify your political ideology? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Very Conservative | | 23.7% | 103 |
| Conservative | | 50.1% | 218 |
| Libertarian | | 16.8% | 73 |
| Moderate | | 8.5% | 37 |
| Liberal | | 0.7% | 3 |
| Very Liberal | | 0.2% | 1 |
| 5. Cecil County Executive Tari Moore left the Republican Party to become an independent. Should she resign her office? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Yes | | 30.8% | 134 |
| No | | 49.9% | 217 |
| I Don't Know | | 19.3% | 84 |
| 6. How satisfied are you with Maryland Republican Party Chairman Alex Mooney's job performance? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Very Satisfied | | 5.7% | 25 |
| Satisfied | | 14.7% | 64 |
| Neutral | | 32.4% | 141 |
| Unsatisfied | | 25.5% | 111 |
| Very Unsatisfied | | 21.6% | 94 |
| 7. How satisfied are you with your local Republican County Central Committee? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Very Satisfied | | 8.0% | 35 |
| Satisfied | | 19.1% | 83 |
| Neutral | | 27.8% | 121 |
| Unsatisfied | | 19.8% | 86 |
| Very Unsatisfied | | 25.3% | 110 |
| 8. How likely do you believe that the eventual Republican Candidate for Governor of Maryland in 2014 will win? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Very Likely | | 0.9% | 4 |
| Likely | | 5.7% | 25 |
| Somewhat likely | | 10.1% | 44 |
| 50/50 | | 17.9% | 78 |
| Somewhat unlikely | | 17.2% | 75 |
| Unlikely | | 26.7% | 116 |
| Very Unlikely | | 21.4% | 93 |
| 9. What issue is most important to you in the upcoming Maryland General Assembly Session? | |||
|---|---|---|---|
| answered question | 402 | ||
| skipped question | 33 | ||
| Response Percent | Response Count | ||
| Taxes | | 40.5% | 163 |
| Spending | | 41.0% | 165 |
| Regulation | | 5.5% | 22 |
| Education | | 1.5% | 6 |
| Transportation | | 0.5% | 2 |
| Crime | | 0.5% | 2 |
| Abortion | | 0.7% | 3 |
| Adoption | | 0.2% | 1 |
| Death Penalty | | 0.2% | 1 |
| Corruption | | 5.5% | 22 |
| Gambling | 0.0% | 0 | |
| Health Care | | 1.5% | 6 |
| Higher Education | | 0.5% | 2 |
| Environment | | 1.7% | 7 |
| Other (please specify) | 44 | ||
| 10. What is your opinion of the following Republican leaders? | ||||
|---|---|---|---|---|
| answered question | 435 | |||
| skipped question | 0 | |||
| Favorable | Unfavorable | Don't Know | Response Count | |
| Tony O'Donnell | 39.9% (164) | 22.4% (92) | 37.7% (155) | 411 |
| Allan Kittleman | 40.8% (164) | 13.4% (54) | 45.8% (184) | 402 |
| E.J. Pipkin | 41.1% (171) | 36.3% (151) | 22.6% (94) | 416 |
| Andy Harris | 64.2% (271) | 23.2% (98) | 12.6% (53) | 422 |
| Mike Smigiel | 28.8% (119) | 31.0% (128) | 40.2% (166) | 413 |
| David Craig | 43.2% (178) | 19.4% (80) | 37.4% (154) | 412 |
| Blaine Young | 38.4% (156) | 14.5% (59) | 47.0% (191) | 406 |
| Charles Lollar | 41.6% (170) | 25.7% (105) | 32.8% (134) | 409 |
| Dan Bongino | 78.2% (333) | 18.8% (80) | 3.1% (13) | 426 |
| Brian Murphy | 39.3% (160) | 24.1% (98) | 36.6% (149) | 407 |
| Bob Ehrlich | 55.0% (233) | 39.2% (166) | 5.9% (25) | 424 |
| Pat McDonough | 29.1% (120) | 39.7% (164) | 31.2% (129) | 413 |
| Nancy Jacobs | 54.6% (226) | 17.6% (73) | 27.8% (115) | 414 |
| John Leopold | 6.9% (28) | 53.7% (218) | 39.4% (160) | 406 |
| Richard Rothschild | 18.8% (77) | 14.2% (58) | 67.0% (274) | 409 |
| Eric Wargotz | 24.4% (99) | 39.4% (160) | 36.2% (147) | 406 |
| Alex Mooney | 31.5% (128) | 38.2% (155) | 30.3% (123) | 406 |
| Diana Waterman | 26.8% (109) | 22.4% (91) | 50.9% (207) | 407 |
| William Campbell | 27.5% (112) | 13.3% (54) | 59.2% (241) | 407 |
| Christopher Shank | 26.6% (107) | 14.2% (57) | 59.2% (238) | 402 |
| John Fiastro, Jr. | 17.6% (72) | 19.1% (78) | 63.2% (258) | 408 |
| Jeannie Haddaway-Riccio | 32.4% (132) | 13.2% (54) | 54.4% (222) | 408 |
| Ed Reilly | 28.1% (114) | 13.3% (54) | 58.5% (237) | 405 |
| Michael Steele | 40.1% (168) | 52.0% (218) | 7.9% (33) | 419 |
| Chrys Kefalas | 6.5% (26) | 15.3% (61) | 78.1% (311) | 398 |
| 11. If a Republican candidate hired a consultant that worked for an independent candidate in the 2012 election would you support that candidate's campaign? | |||
|---|---|---|---|
| answered question | 435 | ||
| skipped question | 0 | ||
| Response Percent | Response Count | ||
| Yes | | 39.3% | 171 |
| No | | 29.7% | 129 |
| I don't know | | 31.0% | 135 |
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