Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Ex Input:
Paragraph: The Office of Inspector General on Friday released two reports that look into the longstanding challenges of the 28 hospitals directly operated by the federal Indian Health Service. The OIG, which acknowledged that reports of inadequate health care services for Native Americans have been of concern to the federal government for almost a century, criticized the agency’s limited oversight regarding compliance with federal regulations and quality of care, detailing how the agency’s regional administrators have few sources of information to assess the services provided at the facilities. The Indian Health Service, commonly referred to as IHS, is responsible for providing health care services to enrolled tribal members as part of the government’s treaty obligations to Native American tribes. But the agency has faced challenges for decades, and within the past year it has been under increased scrutiny from Congress after inspections of hospitals in the Great Plains uncovered severe deficiencies. The OIG says IHS’s eight regional offices conduct activities to monitor the quality of the facilities, but those efforts are minimal in some areas. One of the reports states that the primary source of information that the regional offices use to detect quality problems is a small number of complaints and patient harm reports. “However, according to hospital administrators, most patient complaints relate to customer service and wait times, rather than medical care,” according to the report. “Further, most hospitals (20 of 28) receive fewer than 100 complaints per year for inpatient and outpatient visits combined, averaging about 1 complaint per 1,000 patient visits. ... Considering the quantity and subject matter of complaints and patient harm reports, they are unlikely to provide hospital staff with the breadth of information needed to identify and diagnose systemic quality or compliance breakdowns.” The OIG, which gathered the information for the reports between April and October 2014, also said that only half of the regional offices conducted mock inspection surveys that could provide insight regarding the facilities’ quality practices. The watchdog also faulted the IHS for staggering findings of outdated facilities and the weekslong process that job applicants must follow, even when the physician vacancy rate was 33 percent at the time the information for the reports was gathered. According to the report, in 15 of the 28 hospitals, administrators reported that aging or inadequate physical environments affected their ability to give quality care. Corroded pipes in one hospital caused sewage to leak into the operating room. The IHS has now been under scrutiny for more than a year after inspectors from the Centers for Medicare and Medicaid Services, known as CMS, found several quality-of-care deficiencies at hospitals in South Dakota and Nebraska. At one facility, the alarming conditions of its emergency room led officials to close it for seven months. The OIG on Friday recommended that CMS inspectors survey IHS facilities more frequently. The IHS in a statement Friday concurred with recommendations made by the OIG, including the need for more training for staffers and new ways to monitor hospital quality. The IHS also said it began a mock survey initiative at 26 hospitals in May 2016 to assess compliance with the standards that facilities must meet to be able to participate in the Medicare program. The IHS’s statement also highlighted a team that was formed in February 2016 “to ensure that dependable, quality care is delivered consistently across IHS facilities.” ___ Follow Regina Garcia Cano on Twitter at https://twitter.com/reginagarciakNO ___ Associated Press writer James Nord contributed to this report from Pierre, South Dakota. Claim: Watchdog: Staff issues affect care at reservation hospitals.

Ex Output:
The internal watchdog of the U.S. Department of Health and Human Services says the often-substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources and difficulty attracting and keeping skilled staff.


Ex Input:
Paragraph: The Idaho State Journal reports that last year there were nearly 6,600 STD cases, including HIV, up from fewer than 6,300 in 2016. Cases are also up nationally, with Centers for Disease Control and Prevention announcing last week that nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the United States in 2017. Kimberly Matulonis-Edgar of the Idaho Department of Health and Welfare says experts in the state and across the country are struggling to understand what’s driving the increase. The most prevalent STDs reported nationally and in Idaho are gonorrhea and chlamydia. State health officials say that the rate of reported gonorrhea cases in Southeast Idaho fell about 14 percent from a year ago, but jumped more than 200 percent in south-central Idaho. ___ Information from: Idaho State Journal, http://www.journalnet.com Claim: Health experts alarmed by jump in STDs in Idaho.

Ex Output:
A jump in reports of sexually transmitted diseases in Idaho has health experts worried.


Ex Input:
Paragraph: "While the rest of the nation celebrated Mardi Gras on Feb. 12, official Washington was transfixed by a different spectacle: delivery of President Barack Obama’s yearly State of the Union speech. Newly elected Congressman Dave Joyce watched the hour-long oration on the House of Representatives floor with his House and Senate colleagues and was up the next morning to discuss it with radio talk show host and Plain Dealer columnist Mike McIntyre on WCPN’s ""The Sound of Ideas"" call-in program. The Russell Township Republican told McIntyre he heard plenty of familiar themes in Obama’s speech, and said many of the president’s solutions to problems ""seemed to involve more big government."" But Joyce said he was intrigued by Obama’s call for providing high school students with a more technical education that will help them get better jobs after graduation. During the speech, Obama highlighted a school in Brooklyn, N.Y. that graduates students with both a high school diploma and an associates degree in computers or engineering. ""We need to better prepare our workforce for the jobs that we have,"" Joyce said. ""There are three million jobs that go vacant each month in this country, so the idea of trying to better prepare our children for the workforce by reforming high schools and stressing technical degrees in engineering, that is something that intrigues me. It’s something that people in other districts hear from their people, who said we have difficulty finding competent workers."" PolitiFact was intrigued by Joyce’s assertion that three million U.S. jobs go unfilled every month. Could that be  that a nation with a 7.9 percent unemployment in January, 2013 actually has so many job openings? Joyce’s press secretary referred us to monthly job openings reports produced by the Bureau of Labor Statistics. A Feb. 12 report that covered statistics from December 2012 said there were 3.6 million job openings on the last day of the year, a number that varied little throughout 2012. The report said that during 2012, hires totaled 51.8 million and separations totaled 50.0 million, yielding a net employment gain of 1.8 million. Reports the office issued for previous months in 2012 indicated there were 3.8 million job openings in June, 3.7 million job openings in November, October , July,   May and March,  3.6 million openings in September and August, 3.5 million vacancies in January and February, and 3.4 million unfilled jobs in April,  So why are there so many unfilled jobs? Employers maintain there’s a skills gap, while some labor economists say that skilled workers desire more pay than employers want to provide. A Bloomberg.com article on the subject said U.S. companies have reported more than 3 million job openings every month since February 2011. The article quoted Anthony Carnevale, who heads the Georgetown University Center on Education and the Workforce in Washington, D.C., saying there’s a demand for workers with highly specific skills. The article described a growing skills gap as a global problem, quoting a McKinsey Global Institute study that said employers worldwide could face a shortage of 85 million high- and medium-skilled workers by 2020. It also highlighted a Cincinnati Children’s Hospital Medical Center program that helps unskilled workers train for better paid, skilled jobs in fields such as nursing. ""‘Qualified’ used to mean a high school degree,"" Carnevale told Bloomberg. ""Now the qualification level has gone up so they’re pressing for better people."" A Nov. 11 segment on CBS News’ ""60 Minutes"" said that manufacturers nationwide say the lack of skilled workers is the reason for hundreds of thousands of unfilled jobs. But it quoted management professor Peter Capelli of the University of Pennsylvania’s Wharton School of Business saying that if companies paid better, they might be able to get the higher skilled workers they say they need. ""This is a market. And so, you know, if you're not willing to pay more, don't expect to get better quality people,"" Capelli said. ""One of the things we know now is wages are not going up. In fact, they've been stagnant and some cases even declining over time. So where is the shortage?"" Capelli also noted that a generation ago, companies provided workers with the training they needed. ""Companies are now saying, for all kinds of reasons, ""We're not going to do it anymore,"" Capelli told ""60 Minutes."" ""And maybe they're right, they can't do it. But what they probably can't do is say, ‘We're not going to do it, and it's your problem. It's your problem to provide us with what we need, Mr. and Mrs. Taxpayer. You need to pay for this for us."" Alcoa Inc. CEO Klaus Kleinfeld provided a counterpoint to Capelli’s views. Kleinfeld said he believes manufacturing jobs pay ""very, very well,"" and that Alcoa is making efforts to fill the skills gap as are many other businesses. Asked why there’s still a skills gap if manufacturing is attempting to close it, Kleinfield replied: ""This is not a society where you can tell somebody what - where to go, or where to - what education to get, right?’  Joyce’s claim that 3 million jobs go vacant each month is accurate." Claim: There are 3 million jobs that go vacant each month in this country.

Ex Output:

Rep. Dave Joyce says millions of U.S. jobs go unfilled each month