5 mates to sleep in a car overnight to experience the plight of the homeless but changed her mind after figuring the idea wouldn't fly too well with other parents. She did, however, deliver a poignant speech to her classmates, none of whom have been touched by the plight of the poor, said her teacher, Mary L. Maher. "The night before, my father was saying I should rehearse, and put together a speech, Rachel said. "I didn't.
I just did it from the top of my head." She described the circ*mstances that lead to homelessness, which can happen when a parent loses a job or ends up in divorce without a way to support himself. "Some of them didn't understand at first but got it after I explained it better," said Rachel, who wants to be a song or story writer. On Friday, Rachel's class will wrap the presents and then start other projects to help the needy, such as a clothing or food drive. "I thought it was a wonderful idea," Maher said. "You don't realize (homelessness) is that close to you.
It was a real educational experience for the children to learn and do something for kids just like them, but not as fortunate as they are." Dressed in a pink MTV T-shirt, a stone-washed flounce miniskirt and white ankle socks, Rachel considers herself a typical youngster. She wears Maddona-wanna-be bracelets and avidly follows the music of Def Leppard and Michael Jackson. And, lastly, she doesn't think her idea to help the homeless is anything out of the ordinary. 1 "My reward will be to see other kids have Christmas," she said. RECENT HOSPITAL LAYOFFS IN THE CLEVELAND AREA Vincent Charity Hospital and Health Center, which laid off 22 midlevel managers Nov.
3 and 156 workers Nov. 15. The 492-bed hospital at 2351 E. 22nd which had a full-time staff of about 1,500, cited tightening reimbursem*nt from Medicare and private insurance companies. Southwest General Hospital in Middleburg Heights, which laid off 18 workers Nov.
18 because of tightening Medicare reimbursem*nt and a declining number of patients. MetroHealth Medical Center at 3395 Scranton which laid off 122 employees Nov. 9, including of its management staff, and reassigned 20 workers to part-time jobs. The 742-bed hospital, which employs more than 4,700 people, had already cut 50 positions through attrition since July. Hospital officials said MetroHealth, owned by Cuyahoga County, had lost $1.6 million since the beginning of the year because of tougher private insurance reimbursem*nt policies and Medicare payments that did not keep pace with hospital costs.
Mount Sinai Medical which laid off 26 employees Nov. 28, citing tightening reimbursem*nt from Medicare, Medicaid and private insurance companies. Fairview General Hospital, 18101 Lorain which laid off 25 employees Nov. 29 due to tightening reimbursem*nt policies from Medicare and private insurance companies. The Cleveland Clinic, 9500 Euclid which laid off 35 employees, or of the staff, from its subsidiary in Fort Lauderdale, in early November, citing a need to pare costs.
Glenbeigh Hospital, a 100-bed substance-abuse hospital at 18120 Puritas which laid off 32 employees, more than a fifth of its workers, Nov. 21. Hospital Executive Director Allen Drum said the layoffs were a result of private insurers tightening reimbursem*nt for hospitalization for drug and alcohol treatment. Doug Lefton "How far will a hospital go before you start getting an impact on patient care? That's the question of the '90s," said MetroHealth's Gillespie. Another question is what will happen to hospitals that can't make it financially.
Already there is intense competition for the shrinking number of hospital patients. "You have to get as much business in your doors as you can," Gillespie said. In a bid to attract more Medicare patients, MetroHealth announced Nov. 17 that its doctors would "accept assignment" for all patients, meaning patients would not be billed for more than their share of Medicare's approved rates. THE PLAIN DEALER, SUNDAY, DECEMBER 10, 1989 Gifts could at' least have some sort of holiday: "I feel very sorry for them," said turned 11 last month.
"They don't get to go to school and aren't as lucky as we are." The classes, caught up in Rachel's conviction, began brainstorming ways of raising money for homeless children. They thought of shoveling driveways," going door to door in their Lake County neighborhoods to fill tin' can's with donations and adopting the Salvation Army technique of positioning themselves at local shopping malls. But because they didn't have enough time to organize such plans, the children put together an easier event: a one-day bake sale at school. The cookies, brownies, cakes and pastries that the fifth-graders baked. and sold for loose change raised $115.56.
Harvey, a truck driver who was interested in helping his daughter's fund-raising effort, pooled $100 in donations at work. The Harvey family will go out and buy the gifts, which will be distributed to area shelters by the Greater Cleveland chapter of the American Red Cross. "I guess you can say I was a hippie. back in the '60s and still believe in social causes," Harvey said. Rachel, a cherubic-faced young.
ster. who describes herself as shy, said raising the money was a good idea but it wasn't enough. She, considered asking her class- Hospitals Managers were the hardest hit. MetroHealth Medical Center laid off of its managers, including five of six associate. vice presidents.
At St. Vincent Charity Hospital and Center, 22 of 178 people laid off were midlevel managers. Managers are popular targets because they don't provide patient care and because "it's not easily demonstrable that they add to the bottom line," Buxbaum said. John Gillespie, MetroHealth's vice president for strategic planning and marketing, said, "The work force has to work harder and smarter:" The -financial pressures have forced hospitals to examine how they provide care. Mount Sinai, for example, brought in a consultant to with doctors, nurses, management and employees to study the way the hospital provided coronary artery bypass surgery.
The team discovered lab tests could be reduced and that patients could: be discharged sooner if changes were made in the way respiratory therapy was provided. These and other changes lowered the cost of the $16,000 operation by $1,000, said Nancy Wilson, a Mount Sinai spokeswoman. Mount Sinai officials said they intended to apply the same technique to other areas in the 154 Buxbaum said the layoffs were "not all bad. It means we're doing what needs to be done to tailor the services of hospitals to the needs of the communities they serve." Yet several hospital officials said they were concerned about the cost pressures ultimately cutting into a hospital's ability to maintain quality carer. one longer than is medically necessary; now, patients do more of their recovering at home.
Women who give birth through a normal vagin*l delivery, for example, are now routinely sent home after just two days. At the same time that hospital use has decreased, private insurers and: Medicare have tightened the reimbursem*nt screws on hospitals. Medicare, the federal program for the "elderly and disabled, 4 accounts for nearly of the typical hospital's revenues. Cleveland hospital executives say rate increases in the program haven't been enough to cover increases in hospital costs. Medicare payment rates to hospitals.in large urban areas increased an average of 9.3% from 1985 to 1989, according to a Medicare spokesman.
The rate increases were kept below the hospital inflation rate because the federal government believed hospitals were making excessive profits, he said. And private insurance companies, which used to pay whatever hospitals billed, have become tough negotiators for hospital rates in the past few years. Even some large companies, such as BP America have negotiated rates with area hospitals. The layoffs hit toward the end of the year because Cleveland hospitals plan their budgets for the next year in the fali, said Richard Buxbaum, senior vice president of the Greater Cleveland Hospital Asso4 ciation. Hospitals that found projected revenues for next year didn't match expenses had to lay people off, he said.
Hospital executives say that so far they had absorbed the cuts without sacrificing quality because all the people laid off did not provide direct care to patients. 3134 CARE T. CONWAY Rachel Harvey, seated, with some of her fifth grade classmates at Melridge Elementary School in Painesville Township. Cleveland area hospital use Total hospital admissions. 380,000 7 1.
360,000 340,000 4 AN. Vi. 320,000 MA 300,000 1982 1983 1984 1985 1986 1987 1988 DAYS Average length of hospital stay. 8.8 8.2 8.0 7.4 1982 1983 1984 1985 1986 1987 1988 MILLIONS Total hospital days. 3.40 1- 3.20 044 2: 3.00 1- 2.80 2.60 2.40 1982 1983 1984 1985 1986 1987 1988 MILLIONS Total number of outpatient visits to hospitals.
4 3 VANES 1 2 1982 1983 1984 1985 1986 1987 1988 Cleveland area includes Cuyahoga, Geauga, Lake, Lorain and Medina counties. Source: American Hospital Association- PD graphic Squire, president of Deaconess Hospital of Cleveland, predicted some hospitals would either close or go into related businesses, such as chemical dependency or mental health. "The buzzword now is 'behavioral he said. Grief But her life was shattered nine days ago. It was about 6 a.m.
on Dec. 1 when her nightmare began. One of Mitroff's customers called the home complaining that he had not received his bakery delivery order. Within the next 15 minutes, calls came. "I knew something terrible was wrong," she said.
She called police and several hours later filled out a missing-person report. She said her husband never var-. ied from his delivery route schedule. He arrived at work around 11 p.m., gathered his orders and made his first delivery to a catering firm on State Rd. in Parma.
His second stop was at the American Greetings Corp. at Memphis Ave. and Tiedeman Rd. She said he usually made the deliveries alone. "He made those deliveries then returned to his store to load up his van for a delivery to Royal Chef on Grant Barbara Mitroff said.
"It was his biggest order and took up all the van. He never made that delivery." Police said it appeared Mitroff was slain in the bakery. "I called the bakery and got no answer," Barbara Mitroff said: "I called his other accounts and they said he hadn't made the deliveries. I thought he may have had an accident and his van ran off the road." She said she drove to the bakery and was joined by a Cleveland policeman. "We found drag marks on the floor and all the mops were gone," she said.
"Then we found blue scrape marks on the outside brick building in the alley where the van usually pulled out. I knew somebody was driving the van that wasn't used to the narrow alley. I was scared." She said her husband rented out 10 suites above their store. "Because it was Dec. 1 and rentdue time, there should have been between $300 and $500 in the register," she said.
She said it was empty. She said the five women bakers usually left work about 10 p.m and then a hired handyman came into the shop and cleaned it for the next day. The suspects, police said, fled Cleveland in Mitroff's blue van. Somewhere between Cleveland and Kentucky, the van was spraypainted black, Barbara Mitroff said. Anthony Lozar, 18, of E.
83rd 'I still had hope in my heart. I thought maybe he had been roughed up and tied up somewhere in weeds or a Barbara Mitroff, wife of slain bakery operator gave police several addresses, were arrested near Covington last Sunday in the van. They were in Kenton County Jail in Walton, and were expected be be extradited to Cleveland within the next few days. Their arrests came on a routine check by a Kenton County patrolman. A registration check revealed the van belonged to Mitroff, and the patrolman saw blood in the van.
Pepper Pike police were notified, and they told Kentucky police the missing-person report. Lozar and Berry were charged by Kentucky authorities with receiving stolen property, theft of a registration plate and possession of marijuana. Lt. John James, Cleveland homicide chief, said a warrant was issued here seeking aggravated, murder charges. It has been over to the Cleveland prosecutor's 14 office.
James said two rifles also were confiscated from the van. When Barbara Mitroff was told that the van had turned up in Ken-: tucky, but that her husband had not been found, she hoped he was: alive. "I still had hope in my heart," she said. "I thought maybe he had been roughed up and tied up somewhere in weeds or a field." Shortly after their arrests, one suspect told Kenton County police; where the two had buried body after they had shot and robbed him, Kentucky authorities said. Barbara Mitroff's worst fears.
were realized when police notified her that her husband's body had; been found. "I collapsed," she said. "I was always worried about a war breaking out and my sons: going," she said. "I was worried, about another Korea or Vietnam." H. 0 She said police told her that the two suspects may have been under the influence of drugs.
"The drug war I didn't know," she said. "It has ruined our lives." and Wilford Lee Berry, 27, who 8.6 8.4 43 7.8 7.6 BLOODMOBILE American Red Cross Blood Serv- field Center, Heights, 1123 SOM to 8 p.m.; Center Willoughby- Mayices of Northern Ohio must collect Eastlake Technical Center, 25 Public more than 900 units of blood each Square, Willoughby, 8 a.m. to 2 p.m.; day to meet the needs of 65 area West Center Shore Ridge Red Cross Rocky office, River, 2 20335 to 8 hospitals. p.m. Anyone who is 17 or older, in WEDNESDAY: Chardon High good health and weighs at least 105 School, p.m.; 151 Brook Chardon Park Recreation 8:30 a.m.
Cen- to pounds is eligible to donate blood. ter, 17400 Holland 10 a.m. to There is no upper age limit as long p.m.; Lake County Administration as a donor is healthy. a.m. Building, to 3 105 p.m.; Main Southeast Red Painesville, Cross 9 The Red Cross bloodmobile office, 16700 Chagrin Blvd.
Shaker. schedule for the week follows. Heights, 1 to 7 p.m.; Southwest Red Cross office, 5690 Ridge Parma, 2 TOMORROW: Cleveland Cutter to 8 p.m. Reamer 12430 Alameda THURSDAY: Chanel High School, Strongsville, 9 a.m. to 3 p.m.; Cleve- 480 Northfield Bedford, 9 a.m.
to land Heights Main Library, 2345 Lee 1 p.m.; Brook Park Recreation 1 to 7 p.m.; Downtown Red Cross ter, 10 a.m. to 4 p.m.; Mentor Civic 1227 Prospect 10 a.m. to 4 Arena, 8600 Munson 1 to 7 p.m.; p.m. Shore Civic Center Red Cross office, TUESDAY: Berea High School, 165 Babbitt Rd. and E.
222nd Euclid, E. Bagley 8:30 a.m. to 2:30 p.m.; to 7 p.m. Parma High School, 6285 W. 54th 9 FRIDAY: Bay United Methodist a.m.
to 3 p.m.; Westlake High School, Church, 29931 Lake Bay Village, 27830 Hilliard 8 a.m. to 2 p.m.; 1. to 7 p.m.; Euclid Med-Net Clinic, Mayfield City School District Activity 18599 Lake Shore 8 to 11 a.m. The Health Action Council's Woods said that if hospitals were to close, the community should make sure the best ones survived. "If the shakeout has to come." he said, "let's make sure it happens quality and cost efficiency.
