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Dr Lyle Rapacki

Arizona Today 09/09/21 – Medical Intelligence Briefing Regarding Illegals and Refugees

Page 1 of 13 SENTINEL INTELLIGENCE SERVICES, LLC LYLE J. RAPACKI, Ph.D. CONSULTANT AT: Behavioral Analysis and Threat Assessment.

Protective Intelligence and Assessment Private-Sector Intelligence Lyle@Sentinelintelligenceservices.com.  Intelligence Briefing/Healthcare Issues Medical Time Bomb – Illegals and Refugees flowing into the United States CONFIDENTIAL – RESTRICTED DISTRIBUTION: MEMORANDUM: TO: Mr. Donald J. Trump Republican Nominee for President of the United States Dr. Ben Carson Senior Advisor to Republican Nominee Donald Trump RE: Medical challenges spreading across the United States traced to illegals and Refugees DATE: September the 9th, 2016.

While the rhetoric regarding illegal crossings flowing into America and the concomitant influx of Middle Eastern “Refugees” into targeted States rages, the intelligence contained in this Briefing Summary transcends the debates, issues of political correctness, and politics in general. The content herein stated is already at a critical stature, and could quickly spiral out-of-control and represent a pandemic set of circumstances. You will receive unvarnished candor about the growing concerns health care professionals already are confronting in over twelve states, and multiplying. This memorandum stems from a formal closed-door Intelligence Briefing I provided at the Arizona State Senate on August 17th, 2016. We are now about one month later, and the conditions in multiple states, including the Border States of Arizona, California, and Texas are reportedly more challenging, and purposefully kept under the public radar.

Page 2 of 13 CONFIDENTIAL – RESTRICTED DISTRIBUTION: SENTINEL INTELLIGENCE SERVICES, LLC Intelligence Briefing/Healthcare Issues RE: Illegals and Refugees September the 9th, 2016 Continued.

Among the most remarkable acute diseases arriving with illegals are: scurvy, measles, chicken-pox, acute explosive diarrhea with third-world bacterial agents, and unknown bacteria and parasites attempting to resist antibiotics, as well as pernicious and new forms of lice and worms. It is well known, but concealed and not reported to local and State health officials by the Federal Government, large segments of the unaccompanied children coming into America are seriously ill coupled with remarkable malnourished syndrome.

Additionally, numbers of TB cases are increasing rapidly, including treatment resistant TB. The Federal Government has now increased the speed and volume of third-world populations into the United States; interestingly, especially into politically conservative states. The calculated work of the Feds has led to Muslims by the thousands from mostly terribly underdeveloped and deteriorating Muslim countries, including those Islamic Nations hostile to the United States, now arriving. The U.S. Senate Subcommittee on Immigration and the National Interest has presented official figures depicting a massive spike in Green Cards for Middle Easterners; most notably, Afghanistan, Iraq, Pakistan, Syria, and Iran. In 2014 (the most recent year for which data is available) the U.S. awarded Green Cards to 103,901 immigrants from Middle Eastern countries entitling the holder to permanent legal status, federal benefits, and a direct path to US citizenship.

This is a 32% increase from the 78,917 given the year prior. These numbers do not reflect the numbers of illegals and Middle Easterners successfully entering America from our unsecure southern Border. There are unknown numbers of third-world humanity stemming from Haiti, Central America, and South America.  The influx of humanity that is being discarded by these third-world Muslim countries is astounding, and fearful. 

Page 3 of 13 CONFIDENTIAL – RESTRICTED DISTRIBUTION: SENTINEL INTELLIGENCE SERVICES, LLC Intelligence Briefing/Healthcare Issues RE: Illegals and Refugees September the 9th, 2016 Continued. 

These people bring nothing of value with them; no skills, no education, no work ethic or even moral framework. In point of fact, the preponderant majority of these people are hardened criminals, many purposefully released from prisons, and warriors who have only known civil war and strife by opposing gangs and warlords. Their health conditions are terrifying which will demand a response to stem the epidemic. For the first-time, medical professionals this past June found a person in Pennsylvania carrying a bacteria resistant to antibiotics. This finding is highly disturbing, and health officials are sobered and alarmed.

In the past two weeks, a high school in Manhattan, Kansas experienced an outbreak of unknown type of bacteria or parasite creating bloody diarrhea, coughing and fever in over 150-students. Parents were asked to collect specimens from their children for lab exams. Refugees dumped in Vermont, North Dakota, Nebraska, Maryland have acute TB. This past week in Riverside, California, two suspected cases of Leprosy have now been found on grade-school age children; Lab samples were sent to a specialty lab in Louisiana for confirmation but it will take 2-weeks for a definitive diagnosis. Here in Arizona, over 100-cases of chlorine resistant bacteria were discovered in a couple of city operated pools. At the federal level there is silence coupled with denial.

At the state level, for at least upwards of fifteen states, there is horror as to what they are challenged with now, and concerned with in months ahead. The Center for Disease Control (CDC) and other agencies coordinating mass refugee resettlement are quick to reassure the public that NO problems exist, that speculation is merely politically motivated. But data from health services in the States of Florida and Indiana belie that claim. These two states have aggressively been combating the out-of-control refugee resettlement program fully underway in America. The health services in these two states have confronted the political hogwash and typical political speak oxymoron spilling out from various federal agencies, especially the CDC. 

 Page 4 of 13 CONFIDENTIAL – RESTRICTED DISTRIBUTION: SENTINEL INTELLIGENCE SERVICES, LLC Intelligence Briefing/Healthcare Issues RE: Illegals and Refugees September the 9th, 2016 Continued

As an example, State of Florida Health Officials caught the CDC officially listing refugees as diagnosed with TB as, “Active Tuberculosis – noninfectious.” Among the most serious responsibilities an Elected Official has upon being sworn into office is the responsibility to provide for the protection and welfare of the citizens to whom he/she serves. A ticking medical time bomb exists across America with the ever increasing rise of illegals from third-world countries, and the refugee relocation program sponsored by the Washington establishment. A Clear and Present danger that knows no political ideology or party or candidate, but is stealthily spreading seeking new places to hide is about to take up residence. The chance for contracting a vicious disease mentioned in this report becomes ever significant, and this statement is NOT political rhetoric. Respectfully submitted, Lyle J. Rapacki,Ph.D LYLE J. RAPACKI, Ph.D. Protective Intelligence and Assessment Specialist Consultant at Behavioral Analysis and Threat Assessment Private-Sector Intelligence Analyst U.S. Border Intelligence Group ASIS International Association For Intelligence Officers Association of Threat Assessment Professionals – Arizona ATAP International Association Law Enforcement Intelligence Analysts.

Page 5 of 13 Intelligence Briefing/Healthcare Issues 

Illegals and Refugees September 9, 2016 Medical Time Bomb NOW in America We are exposed to viruses, bacteria and parasites that the average American has not been exposed to previously. Doctors have not been trained to identify or treat some of these new diseases. We have NO antibiotic arsenal to defend against these superbugs especially CRE (Carbapenem-resistant enterobacteriaceae) and certain drug resistant TB. Centers for Disease Control estimates as many as 2 million antimicrobial-resistant infections occur in the U.S. each year resulting in 23,000 deaths. Unscreened refugees are being brought into our country and are being integrated into our communities: – NO background checks as to country of origin – NO previous medical history recorded – NO formal medical screening conducted – NO education on sanitation and basic hygiene practices Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, and its failing! Wake-Up America and get ready for major illnesses.

A little known disease sweeping across the Middle East, Cutaneous Leishmaniasis leaves thousands disfigured and/or severely scarred. This disease is caused by a parasite found in the blood and is now showing up in America. No vaccines or drugs to prevent infection are available. Diseases can also be transmitted through infected livestock through the food chain to humans. Diseases are spread by more than 20 parasites, bacteria and worms associated with animals. Vast quantities of antibiotics are given to livestock and E-coli is becoming drug resistant. – Ground-breaking new research has revealed soaring levels of antibiotic resistance on beef, pork and chicken.

Overuse of antibiotics in farming is contributing to deadly drug resistance – a crisis predicted to kill one person every 3 seconds by 2050. Page 6 of 13 TB Statistics: More than 100 countries have reported individuals with TB, which is resistant to all or nearly all first- and second-line TB drugs. – The average cost for a hospital stay principally for a typical TB case was $20,100 – According to the CDC, care of patients with drug-resistant TB, costs many times more – $134,000 for a multidrug-resistant patient and $430,000 for an extensively drug-resistant patient – The uninsured and Medicaid accounted for a disproportionate share of TB hospitalizations In 2015, the largest number of refugees arriving in the United States were resettled in Texas (11 percent, or 7,479 persons) and California (8 percent, or 5,716). Large groups were also resettled in New York (6 percent, or 4,052), Arizona (5 percent, or 3,137), Michigan (4 percent, or 3,022), and Ohio (4 percent, or 2,989). Thirty-eight percent of all refugees were resettled in these top six states.

This data does not account for the 10,000 refuges that just arrived in the US nor the 86,000 Obama/Clinton want to relocate into America by January 1, 2017. The public isn’t being told all the information required to make informed decisions for their towns, communities, counties or states. Indiana – in 2015 – 400+/- migrants with latent TB settled in Indiana. In July 2016, refugees with ACTIVE TB are being permitted entry and quietly treated with your tax dollars. Indiana has a (26 percent) rate of TB infection among recently arrived refugees. Idaho – Seven refugees with active tuberculosis (TB) were diagnosed shortly after their resettlement in Idaho, according to the Idaho Department of Health and Welfare. 90% of the 4,650 refugees resettled in Idaho between 2011 and 2015, were medically screened within the first three months of their arrival, according to the Idaho Department of Health and Welfare.

Of those screened, 21 percent (896) tested positive for TB. Minnesota – 150 cases of TB in 2015, a (22 percent) rate of TB infection among recently arrived refugees. Page 7 of 13 Oklahoma – Oklahoma Rep. Jim Bridenstein was denied access last week to the HHS facility at Fort Sill – another facility run by BCFS. Vermont – Department of Health concealing the number of refugees with contagious active tuberculosis a month after it was reported that more than one-third of Vermont’s resettled refugees test positive for TB. Arizona – Active TB disease reported in Arizona totaled 198 in 2015. Of the 222 cases of active tuberculosis infection (TB) …reported among Arizona’s refugee populations…were caused by latent tuberculosis infections that became active…,” according to the state’s Department of Health. Eighteen percent “of all refugees resettled in Arizona arrive with a latent TB infection. Kentucky – 73 percent of recently arrived refugees who tested positive for LTBI did not successfully complete a treatment program, reported in 2013 study published by the University of Kentucky. Tennessee – (27 percent) rate of Latent TB infection among recently arrived refugees. Catholic Charities of Tennessee’s Office for Refugees, have failed to make to make public critical information on refugee tuberculosis (TB) health care. California – An estimated 2.5 million Californians have latent infection with tuberculosis; most are unaware of their infection and are untreated. 2,145 cases were reported in 2014. The estimated direct cost for active TB cases in California for 2014 was $51 million. Texas – Amarillo Mayor, “We’ve been trying to figure out the numbers for refugees and diseases for years,” Harpole said. “We’ve fought to get information from the (U.S.) State Department and (Texas) Health and Human Services. We got no help.”

New Hampshire – Governor Maggie Hassan has requested a temporary halt to the refugee program until she gets assurances and details from the federal government regarding its process for resettling them or for vetting them, which she said is currently veiled in secrecy. Kansas – More than two dozen cases of tuberculosis were detected at an eastern Kansas high school after coming into contact with an infected student. After widespread screening, state and county health officials announced Wednesday Page 8 of 13 the testing revealed 27 new cases of TB that hadn’t progressed to the contagious stage. North Dakota – Dr. John Baird, Health Officer for the Fargo Cass Public Health Dept. confirmed diagnosing and treating refugees with active TB barely a month after Lutheran Social Services denied that any refugees it has resettled in ND have been diagnosed with active TB. Additional states have experienced unique medical evidence of the spread of TB and other diseases in their states based on preliminary data. However, since it is not conclusive, those states were not listed in this briefing. [THIS SPACE LEFT INTENTIONALLY BLANK] Page 9 of 13 SENTINEL INTELLIGENCE SERVICES, LLC LYLE J. RAPACKI, Ph.D. ____________ CREDENTIALS: Dr. Lyle Rapacki is a Private-Sector Intelligence, Behavioral Analysis and Threat Assessment Specialist. Since June of 2010, Dr. Rapacki has provided selected members of the Arizona Legislature Intelligence Briefings on Border Security and threats to Arizona sovereignty. Lyle also receives, analyzes and disseminates critical intelligence from and to law enforcement, intelligence, and governmental communities. He is the author of dozens of White Papers, bulletins and briefings many of which have received distribution to and by local, state, and federal law enforcement, intelligence and public safety agencies. Dr. Rapacki is the owner of Sentinel Intelligence Services, LLC which carries out these functions, as well as provides consultations to elected officials in and out of Arizona, and clients in industry on threat potentials. Lyle earned a Bachelor’s Degree in Political Science and Master’s Degree in Counseling from Northern Arizona University, and his Doctorate from Clayton College of Natural Medicine specializing in the treatment of psychological disorders. He holds a Post-doctorate Diplomate in Forensic Counseling and another in Behavioral Psychotherapy. Dr. Rapacki taught in the Criminal Justice Department at Wayland Baptist University, Phoenix campus, and at Grand Canyon University where he also held the position of Director for the Public Safety Administration, Homeland Security – Crisis Management programs. He was a member of the FBI InfraGard Program, and currently is Vice President for the Association for Intelligence Officers AZ Chapter; Executive Board Member to the Association for Threat Assessment Professionals in AZ, and member of the International Association Law Enforcement Intelligence Analysts. He is a Charter Member of Oath Keepers, and Constitutional Sheriffs and Peace Officers Association. He also serves as Vice Chairman for the Coalition of Western States (COWS), which Page 10 of 13 SENTINEL INTELLIGENCE SERVICES, LLC LYLE J. RAPACKI, Ph.D. CREDENTIALS: Continued – page two ____________ is comprised of elected officials and public citizen leaders from six western states, and Texas. Dr. Rapacki is most privileged to provide intelligence as a Watchman to the Christian community nationally, and to write a regular commentary for The Olive Branch Report, an online Christian publication. His commentary is then carried by about 25 additional publications nationally, as well as numerous individual blogs. Page 11 of 13 Jean Rice, RN, BS/BA P.O. Box 30983 Phoenix, AZ 85046 jeanrice3@centurylink.net www.linkedin.com/in/jeanrice PROFILE HEALTHCARE INDUSTRY CONSULTANT Cost Containment, Managed Care, Utilization Review, and Reimbursement Expert Healthcare Leadership Executive with 30+ years’ experience as leader in utilization and case management, medical device reimbursement, hospital bill claims review and healthcare consulting. Developed and implemented (5) companies in healthcare and (6) years’ experience directing health plans and provider network operations. People-centric, collaborative leader who leverages strengths of others to guide best practices and navigate challenges. CORE COMPETENCIES – Healthcare Consulting – Healthcare Regulations – Process Improvement – Managed Healthcare Leadership – Market & Clinical Research – Staff Management – Strategic Planning & Implementation – Operations Management – Client Relations – Financial & Business Analysis – Project Management – Entrepreneurship PROFESSIONAL EXPERIENCE HEALTHCARE CONSULTANT, LLC, Phoenix, AZ 2012 – Present President / CEO Selected projects:  Assisted insurance companies set up a Patient Advocacy Program for their clients.  Implemented a Prior Authorization System for a Non- Emergency Medical Transportation company.  Performing hospital bill reviews and negotiations upon request.  Consulting with Brokers who require clinical or managed care expertise and knowledge in their presentations to potential clients.  Perform Independent Reviews to determine Medical Necessity for Appeals.  Multiple projects writing Security and HIPAA Policy and Procedures.  Project development and implementation for international claims cost containment company. ACTION HEALTHCARE MANAGEMENT, INC., Phoenix, AZ 1995 – 2012 Best in Class Medical Management Services President / CEO Planned, developed and implemented an independent medical management business for companies that self-fund their employees’ healthcare benefits. Supervised 6 direct and 29 indirect FT employees, with a budget of $2.5M+/- annually. Sustained 100% retention rate of clients. Grew from overseeing 10,000 insureds to more than 125,000 insureds.  Communicated organizational objectives with staff for both internal and customer companies, as well as with various regulatory and oversight agencies.  Oversaw budget, client reports, client communications, and marketing. Identified business improvements. ADVANCED MEDICAL REVIEW, INC., Phoenix, AZ 2002 – 2012 Medical Billing Consultative Services President / CEO Pioneered a cost savings system to reduce irrelevant hospital-billed charges.  Trained nurse auditors to evaluate patient charts and billing documents to determine areas for savings.  Ensured evaluations were well documented for quality assurance and appeal purposes. Used a combination of specialized reporting, data mining and technology integration to check for quality control of nurse auditors’ hospital bill reviews. Page 12 of 13 MEDTECH REIMBURSEMENT, LLC, Phoenix, AZ 2009 – 2012 Medical Device and Procedural Reimbursement President/CEO Envisioned and developed a unique methodology for obtaining reimbursement for new FDA approved medical devices and procedures for device manufactures and physicians. Achieved 100% success obtaining reimbursement by predeterminations and following the appeals process.  Cultivated strong relationships with prospective clients while strengthening existing accounts.  Oversaw internal and external statistics, budgeting, time submissions, and contact with Attorney Generals’ Offices or Department of Insurance in multiple states. AHCCCS Blue Connection, Phoenix, AZ 1994 – 1995 Wholly Owned Subsidiary of BC/BS of AZ Director of Medical Services Implemented, hired, trained, and oversaw the Precertification, Concurrent Review, Discharge Planning, Case Management, Pregnancy Management, and Provider Relations Departments. Developed policies and procedures following State of AZ Regulations and Statutes.  Communicated with physicians and contracted medical services vendors. Set up pertinent committees i.e. CM and UM Committees, Policy and Procedure Committee, Provider Network Committee, Pharmacy and Therapeutics Committee. Served as Health Plan Liaison with State ACHCCCS Medical Director’s Office. PRIOR WORK HISTORY Operating Room Director, Various Hospitals, Arizona and Nevada  Planned, Implemented and Directed – (2) Major hospitals’ Open Heart/Cardiovascular Teams Director of Medical Services Department, (2) Arizona Medicaid Health Plans Director of Medical Services – Utilization and Case Management Departments, PPO Networks Director of Fraud and Abuse Medical Bill Review Program – PPO Network and Medical Management Company PROFESSIONAL AFFILIATIONS Founded and Executive Director of Central AZ Chapter of the Case Management Society of America (CMSA). Grew organization from 30+/- members to over 450+ case managers and social workers statewide. Provided continuing education credits for social workers and nurses as well as offering scholarships to nurses and social workers to continue their education.  Member – Phoenix 100 Rotary Club  Board Member – New Life Society of Arizona (Organ transplant education and outreach program)  Advisory Board & Contributor – The Hertel Report  Usher and Hospitality Greeter – Blessed Sacrament Catholic Church EDUCATION & LICENSURES Licensed & Registered Nurse AZ (active), CA & NV (inactive) Bachelors of Science in Business Administration – Health Care – University of Phoenix, Phoenix, AZ Associates of Science in Nursing – RN – San Joaquin Delta College, Stockton, CA ADDITIONAL ACOMPLISHMENTS  Presented at the National Association of Health Underwriters Conference on “Health Care Cost-Containment Programs”  Appeared before the State of California Utilization Review Nurses Association discussing the “Nurses’ Role in a Managed Care Environment to Control Utilization”  Appeared before the Healthcare Financial Management Association on “Improving Medical Management through Disease and Predictive Management Programs”  Appeared before the Southern California Brokers’ Association on “Managing Your Health Care Claims Effectively” Page 13 of 13  Listed in “Who’s Who of American Women” as well as in “Who’s Who of Managed Healthcare Executives”  Speaker, Arizona Senate Healthcare Sub-Committee on numerous managed care issues, Arizona Senate Briefings  Invited to speak on “The Future of Managed Healthcare” at the American Bar Association National Conventions – Chicago, New Orleans and San Francisco [END]

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