House Republicans want to terminate a scheme in which unions collect dues from federal subsidies to people cared for by relatives, reports Fox News . "Even though the Supreme Court has spoken, we're still seeing a lot a states deducting dues from benefit checks from people who do not want or need a union," notes F. Vincent Vernuccio at the Mackinac Center for Public Policy. "Nobody is telling the providers who see the value of unions to stop paying dues. But let the providers get their money, then write a check. This way, they're making their own decision." House GOP officials estimate up to $200 million is diverted from caregivers to unions annually, and they argue this is not what Medicaid is supposed to do. Critics claim some caregivers are unaware that the money is being deducted from their checks and that opting out of the process remains burdensome. House Republican Conference Chairwoman Rep. Cathy McMorris Rodgers (R-Wash.) is prepping legislation to halt the dues skimming practice in all 50 states. "This is robbing our nation's most vulnerable who need Medicaid the most," her office says. "Every dollar that is diverted from a caregiver to a union hurts that family's ability to care for their loved ones." McMorris Rodgers' proposal does not attempt to make structural revisions to Medicaid.

The White House announced on Jan. 12 that President Trump plans to nominate John Ring, a labor lawyer and partner at a firm that has advised him and the Trump Organization on taxes since 2005, as his pick to fill a vacant seat on the National Labor Relations Board (NLRB), reports Reuters . Ring would succeed former NLRB Chairman Phil Miscimarra, whose term ended on Dec. 16. Ring's appointment, which must be confirmed by the Senate, would mark the restoration of a GOP majority at the NLRB, which currently has two Democrats and two Republicans. Under the Trump administration, lawyers and business groups had expected the board to rescind a series of decisions and policy reforms adopted during the Obama administration. In the week leading up to the conclusion of Miscimarra's term, the NLRB overruled five decisions that were widely viewed by companies and trade groups as favoring unions, concerning issues such as when companies are liable for legal violations by contractors, staffing agencies, and franchisees, as well as the validity of workplace rules and whether proposed bargaining units are appropriate. The website of Morgan Lewis, where Ring leads its Labor & Employment Practice Group, says Ring "represents management interests in collective bargaining, employee benefits, litigation, counseling, and litigation avoidance strategies." Morgan Lewis notes if confirmed, Ring would begin a five-year term dating from Dec. 17, 2017.

The National Institutes of Health's All of Us Research Program, which aims to gather data from at least 1 million volunteers globally, is soliciting ideas for research questions the program might address, reports the National Heart, Lung, and Blood Institute (NHLBI) . This input will help the program identify new features that might be included within the All of Us platform as it continues to expand its database and make the platform as advantageous as possible to participants, scientists, and the overall population. It is the goal of the program to clear a path for the discovery of more personalized approaches to healthcare. The effort will gather data over many years from the volunteers who enroll, and researchers will be able to access participants' de-identified data for various studies to learn more about the biological, behavioral, and environmental variables that influence health and disease. The program is in beta testing, with a national launch expected for this coming spring. All of Us will be compiling ideas using an online tool known as a "use case" to describe a health problem or research question of interest. Once compiled, the ideas will be considered at a Research Priorities Workshop in March and will help the program identify ways to better support research across various health topics. Wide-ranging input from the NHLBI community is a must, and participants may supply input through February 9. More information can be found here .

House Speaker Rep. Paul Ryan (R-Wis.) said on Jan. 12 that he doubts the House will pass Social Security or Medicare reform in 2018, reports CNBC . His remarks follow President Trump's Jan. 11 comments to the Wall Street Journal that he thinks Congress will transition to a bipartisan infrastructure plan before moving on to welfare reform. Senate Majority Leader Sen. Mitch McConnell (R-Ky.) stated earlier that he does not think the Senate could pass a welfare reform bill on a partisan basis, as Republicans would have to gain nine Democratic votes to override a likely filibuster.

Some U.S. employers are supporting "mental health first aid" initiatives to train employees to help co-workers in need, reports Bloomberg . The National Council for Behavioral Health (NCBH) calculates that about 40 employers have trained more than 1,300 people over the last two years, and this year it plans to train 6,000 employees via company-sponsored courses. "There's a growing recognition that mental health and addiction problems are having an impact in many ways, driving up healthcare costs and absenteeism," notes NCBH's Betsy Schwartz. "Companies know that's true." Aetna, George Washington University, Lendlease Group, Cerner, and Netsmart Technologies have sponsored workshops for their workers. More than 25 percent of employees reported some level of depression or anxiety in a 2015 poll by the American Psychological Association (APA), but the most common workplace solution — employee assistance programs — is highly unpopular. "That challenging piece is really creating a culture where the organization is tuned in to employee well-being," says David Ballard, who directs the APA's Center for Organizational Excellence. In one course, instructors teach an acronym called Algee, a mnemonic device intended to help trainees assess risk, listen non-judgmentally, give reassurance and information, encourage people to get appropriate professional help, and encourage self-help and other support strategies.

Although access to transportation for older adults in rural areas can make the difference between good care and declining health, all too often such services are unavailable, reports Next Avenue . Luckily, organizations throughout the U.S. are stepping up to provide this service. "While rural areas face numerous obstacles in providing transportation that meets the health needs of older adults, many innovative programs have been initiated that help address these challenges," notes Carol Wright Kenderdine with the Federal Transit Administration-funded National Aging and Disability Transportation Center (NADTC). In 2017, the NADTC awarded six grants of up to $50,000 each to "increase accessible transportation options for older adults and people with disabilities" who do not live in retirement communities. "Many rural transit providers require a minimum of 24 hours reservation in advance," Wright Kenderdine says. "It's very seldom in a rural area that you have spontaneous transportation. It's tough to schedule, and you have to have multiple buses available. In some small communities, they only have one or two buses running." Some programs provide travel training programs, including an Idaho initiative where volunteer community members ride buses for free and wear identifiable apparel, looking out for fellow passengers who may need help understanding how to navigate the system. Other programs leverage local wellness fairs or county fairs for travel training events.

A new study published in the American Journal of Psychiatry suggests a link between elevated amyloid beta levels and the exacerbation of anxiety symptoms, which supports the theory that neuropsychiatric symptoms could be an early sign of Alzheimer's disease in older adults, reports EurekAlert . "Rather than just looking at depression as a total score, we looked at specific symptoms such as anxiety," says Nancy Donovan at Brigham and Women's Hospital. "When compared to other symptoms of depression such as sadness or loss of interest, anxiety symptoms increased over time in those with higher amyloid beta levels in the brain. This suggests that anxiety symptoms could be a manifestation of Alzheimer's disease prior to the onset of cognitive impairment. If further research substantiates anxiety as an early indicator, it would be important for not only identifying people early on with the disease, but also, treating it and potentially slowing or preventing the disease process early on." Study participants included 270 community living, cognitively normal men and women, between 62 and 90, with no active psychiatric disorders. Individuals also received baseline imaging scans and yearly assessments with the 30-item Geriatric Depression Scale. The researchers determined higher brain amyloid beta burden was associated with heightened anxiety symptoms over time in cognitively normal older adults, implying that worsening anxious-depressive symptoms may be an early predictor of elevated amyloid beta levels, and preclinical Alzheimer's disease.

A new Glassdoor survey of 750 managers in the U.S. and the U.K. estimated more then 33 percent of HR and hiring managers expect more employees to leave their organization over the next year, while 45 percent named salary as the top reason for employees changing jobs, followed by career advancement opportunities, benefits, and location, reports Human Resource Executive . In addition, 64 percent of respondents felt their own organizations do a satisfactory/very satisfactory job at setting pay and benefits expectations within job postings. However, fewer than 10 percent of online job listings post pay data in the description. Several years ago, Forbes contributor Liz Ryan wrote that employers have a negotiating advantage by withholding salary information, yet they also routinely ask job candidates to detail their own pay history as part of the interview process. Ryan contended companies should include salary range data in every job description so that people who refuse to work for that salary level will avoid wasting their time and the employer's time applying for the job. Meanwhile, Glassdoor CHRO Carmel Galvin says disclosing pay can save employers unwanted turnover. "Recruiters and hiring managers need to manage expectations and use all channels available to them to communicate with potential candidates to ensure pay realities meet expectations," she notes. Employers also should be mindful that although wage is important in getting desired talent, culture is a larger determinant of long-term retention.

University of California, Berkeley Professor Morten T. Hansen says corporate leaders should strive to make company meetings more robust, citing a study of 5,000 managers and employees that found top performers are good at generating rigorous discussions in team meetings, reports the Harvard Business Review . To lead a vigorous debate in meetings, Hansen first suggests leaders begin by asking a question rather than voicing their opinion. A second tip is to help quiet team members express themselves while ensuring the loud talkers do not dominate the discussion. "When you get people to speak in meetings, you benefit from the group's collective wisdom, so people can build on one another's comments and ideas," Hansen notes. His third suggestion is to make meetings safe for taking risks by creating the appropriate climate. "To create such a climate, lead by example; support those who try; and sanction those who ridicule others," Hansen advises. Taking the contrarian view is the fourth recommendation, which Hansen says forces people "to have really solid arguments for their views." Hansen's next tip is to dissect the three key assumptions about the discussion to make sure they are on solid footing. His final suggestion is to foster transparent advocates and reject those who promote confirmation bias. "You can combat this tendency by forcing people to show the negative," Hansen writes.