Hamaspik Gazette December 2005. •Issue Issue Feb. 2011 No.No. 80 24

News of Hamaspik Agencies and General Health

Adding Light: a Special Report Chanukah holiday activities brighten Hamaspik consumer lives Winter is warm—on the inside. For the Orthodox Jewish contingent of Hamaspik’s constituency, the cold of the season is directly contrasted by the warmth of Chanukah, the so-called “Festival of Lights”— family dinners, visits, parties and all. Chanukah was observed this year December 1st through the 8th. Thanks to Hamaspik’s tireless team of Direct Care Workers, Home Managers, program Directors and other worthy staffers, consumers across the agency’s network of group homes and Day Habs soaked up the holiday heat too. Here’s how Hamaspik marked Chanukah.

Like all other group homes, Mr. Lebowitz takes note of the spiritualized aura that enveloped the home at menorah-lighting time, what with the “boys” dressed in their Shabbos

finest to kindle the sacred flames. Chanukah at Arcadian was also marked by a birthday party for consumer Avraham “Avri” K., which included a colorful birthday cake,

birthday hats and all the trimmings and decor. Photos later received by the Gazette shows the consumers having a great time.

Still chattering about their exciting late-October trip to the Big Apple Circus in Manhattan and their November viewing of the spectacular Disney on Ice show at Newark, New Jersey’s Prudential Center, the Seven Springs “Shvesterheimers” were full of energy as Chanukah rolled in. On top of that, the pre-holiday excitement was only compounded with four consumers attending the weddings of nieces, nephews and even a brother in the days before the holiday arrived, with staff ensuring that the young ladies looked their very best at each. As the holiday progressed, the consumers enjoyed a holiday addition to each night’s dinner, be it a special dessert or a unique dish, Home Manager Mrs. Heilbrun tells the Gazette. They also participated

Arcadian Briderheim Speaking to the Gazette by phone, Arcadian Briderheim Manager Shlomo Lebowitz communicated a Chanukah replete with customary light and warmth, including latkes and jelly doughnuts added to the menu at each dinner, rounds of the traditional dreidel spinning-top game, Chanukah songs and, of course, nightly menorah lightings.

Seven Springs Shvesterheim

A little light dispels much darkness: Basking in the Chanukah glow, a consumer contemplates the holiday glory

The Road to Healthcare Reform A round-up of recent Affordable Care Act news

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I N S I D E * Hamaspik HHA

The Patient Protection and Affordable Care Act continues to grab headlines. Here’s the latest: The Act has thus far endured 11 lawsuits brought by individuals and even by Liberty University. All were dismissed.

Additionally, two conservative organizations and the Virginia Attorney General separately sued the federal government with claims of unconstitutionality. Specifically, their lawsuits centered on the Individual Mandate—the Act’s

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requirement that U.S. citizens get health insurance or get a fine. The first two court decisions found that the Mandate is constitutional. The third, handed down on Monday, December 12 by Richmond, Virginia federal judge Henry Hudson, ruled it is not. Hudson found that in enacting the Mandate, Congress violated the key Commerce Clause, which constitutionally empowers Congress to regulate interstate commerce. Meanwhile, the class-action lawsuit against the Act, being brought by 20 states in a Florida court, proceeded with oral arguments on Thursday, December 16. This lawsuit challenges not the Individual Mandate but the Act’s requirement that Medicaid be expanded to cover

Americans whose incomes are at or below 133 percent of the federal poverty level (about $14,000 in 2010 for a person living alone).

Public opinion unchanged Kaiser Family Foundation’s latest tracking poll shows the public still divided in its views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent say the opposite. But opposition from seniors seems to be on the decline. The share of those aged 65 and up hold-

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Training Program — E2

* DDSO Director Kirschmer Visits Hamaspik — E3

* Arcadian IRA Marks Bar Mitzvah — E4

* A Mishnah Milestone — E12

Hamaspik Care Secures HHA Training-Program Approval Home-care agency now state-authorized for professional in-house training Training is where every job starts. Regardless of career, profession or industry, to know what you’re doing, you’ve got to undergo training first. (There’s even a moral requirement to provide training—the Talmud obligates fathers to teach their sons decent trades.) For some jobs, on-the-job training works. For most, however, you’ll need some instruction—and the more complex the job, the more training you’ll need. That’s why, as of December 1, 2010, Hamaspik Care has its own HHATP, or Home Health Aide Training Program. The Hamaspik Care HHA, or Home Health Aide, is the front-line face of the organization. Like a Hamaspik Care PCA (Personal Care Aide) or nurse, the agency HHA is the interface between Hamaspik

Care and the individual in need, allowing him or her to get the competent care he or she needs, at whatever level needed. New York State’s Department of Health rigorously oversees the training of all Home Health Aides within the Empire State, ensuring a uniform standard of care quality and protecting the health and safety of individuals receiving HHA services at home. “The DOH is very specific and very focused on what they want” in an approved HHATP, says Mrs. Lauren Wieder, Hamaspik Care’s Field Nurse. That’s why anyone seeking to become an HHA must undergo an approved program at a state-certified HHA training provider. And that’s also why Hamaspik Care sought to not just provide HHAs from the getgo but to set up its own certified HHA training program too—because

the more you do in-house, the more efficient the effort and the better the outcome. “When you have your own [HHA training] program, you know what you’re putting out there: the best quality workers,” comments Mrs. Wieder. “I know that when we send our HHAs out, they are going to do a thorough job.” Hamaspik Care’s HHA Training Program consists of two weeks of day-long sessions at Hamaspik of Rockland County’s administrative offices. By program’s end, trainees will have to have passed several written tests as well as pass a meticulous physical demonstration to satisfactorily prove command of their new training. Hamaspik of Rockland County Director of Operations Yoel Bernath explains that an in-house HHA training program allows Hamaspik Care

Newest Hamaspik IRA Passes First Audit Youngest member of group-home family continues winning streak The 38th St. Shvesterheim, dedicated in January 2010, is the youngest of Hamaspik’s network of Individualized Residential Alternatives, or IRAs, across three counties—and now, the bearer of Hamaspik’s newest group-home operations approval too. Thanks to its first-ever on-site survey, or in-person review of the premises and the consumers residing within by an OPWDD official, the young new Shvesterheim—actually two separate, function-delineated group homes on two separate floors—is certifiably up to par. The milestone, news of which arrived December 1st, was attained thanks to Shvesterheim staffers’ hard work ‘round the clock, day in and day out, under the leadership of Home Manager Yomtov Malik. “It’s not even a year since the grand opening and we’re at a level of organization and stability good enough to pass an audit,” said Hamaspik of Kings County Executive Director Joel Freund. “It’s wonderful.” Quality assurance and auditing for state-funded group homes in the New York City area, like the Shvesterheim, are under the discerning jurisdiction of New York State OPWDD (Office for People With Developmental Disabilities)— specifically, its Manhattan-based downstate regional office. That office keeps strict oversight of con-

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sumers’ ongoing care, wellbeing and progress, as well as the compliance and competence of all IRA Direct Care Workers and staff. In post-survey documentation, state inspectors didn’t just write that they found no problems, but also stated that the group home is wellestablished and that the residents receive all necessary services. Credit for the impressive outcome, as mentioned, is due Mr. Malik, along with the Shvesterheim’s Direct Care Worker team: Davidowitz, Friedman, Grossman, Gruber, Halperin, Hirsh, Horowitz, Landau, Lax, Link, Malik, Miller, Nove and Rosenthal. Special mention is also due to experienced 61st St. Briderheim Manager David Mizrahi for his invaluable assistance in helping his fellow Hamaspik of Kings County IRA meet and exceed expectations. The positive outcome is also creditable to Hamaspik of Kings County IRA Nurse Shalva Sashitsky, for her professional and diligent care of the Shvesterheim’s consumers. State surveyors also expressed satisfaction with the consumers’ MSCs (Medicaid Service Coordinators). As is always the case following successful audits, a congratulatory internal e-mail to the 38th St. Shvesterheim team went out to all Hamaspik staff state-wide. For the symbiotic community that is the OPWDD and its numer-

Feb. ‘11 | Hamaspik Gazette

ous voluntary-agency partners, it was just was another day. But for the 38th St. Shvesterheim—and its growing consumers and grateful parent body—it was yet another milestone on the road of effective care and therapeutic progress.

to fine-tune its HHA trainees, handpicking job applicants who show the greatest potential of both realizing the agency’s care standards on the “front lines” and contributing their own personal touches of added care. It was thus no small celebration when Hamaspik Care received

approval for its new Home Health Aide training program this past Friday, December 3, with the official letter from the DOH crossing Bernath’s desk just before employees left for the weekend. Notification of the approval was shortly sent by Bernath via e-mail to all Hamaspik Care staff, with an accompanying message of appreciation and thanks for the team effort. As Bernath puts it, the HHATP approval represents “another milestone in helping people in need”—a milestone along a path of caring that, at Hamaspik, continues on forever toward the horizon.

When horsing around is good Hamaspik Kings MSC taps real horsepower to help consumer What do horses have in common with Hamaspik? They help individuals with special needs, particularly children, that’s what. Riding a horse for therapeutic reasons may sound strange at first. But the discipline is growing across the United States, and it works—at least if you ask Hamaspik of Kings County MSC Mrs. Zelma Feldman. When friends suggested therapeutic horseback riding to the parents of a four-year-old consumer, the mother and father passed it on to Mrs. Feldman, who in turn did her homework. The hardworking MSC, a Hamaspik mainstay, found a program that funded horseback riding, successfully applying for ten weekly sessions for the little boy with global delays. Though his last session ended

in September, Mrs. Feldman reports the benefits are still visible. “He’s standing taller, his gait is improved, he sits up straighter, and he’s been walking straighter since then,” says Mrs. Feldman. “It seems to have done a world of good for him.” With no less than four therapists at the boy’s sides—one for each hand and foot, Mrs. Feldman explains—the child improved his muscle tone while perched upon Peter Pan the Horse, the unlikeliest of therapists. “He was amazed to be able to sit on the horse to be able to guide him,” Mrs. Feldman says of his sessions at Seaside Therapeutic Riding. Turns out that horsing around isn’t so bad after all.

Anti-Fraud Compliance at Hamaspik Goes High-Tech In-house programmer compiles code for blazing exclusion-list checks No stranger to the latest technology, Hamaspik has done it again— even if that means creating technology that previously didn’t exist. In response to a recent governmental ramp-up of compliance regulations, these requiring monthly checks on vendors’ and employees’ status, Hamaspik maintained its record of adherence by creating its own new custom software program. The formidable new data-matching application, a programming achievement in its own right, compares all staff and vendors against OMIG, OIG, and FSA “exclusion lists,” completing the data-intensive task in record speed.

Furthering cost-efficiency, the high-tech tool is the work not of a high-priced external contractor but of talented staffer Mrs. M. Heilbrun, who by day and night serves as Manager of Hamaspik’s Seven Springs Shvesterheim IRA in Orange County—and who, on a recent Sunday, used her professional certification in the ethereal art of computer programming to craft the compliance program out of code. Working out of Hamaspik of Orange County’s administrative offices, Mrs. Heilbrun compiled a sophisticated program that compares the three government-supplied databases against databases on the sys-

tems of Hamaspik—data on every employee ever paid and every vendor ever used. The custom program, according to Mrs. Heilbrun, will save Hamaspik time and money for one elemental reason: “It would be impossible to check each and every company once every 30 days. They would have to hire an employee do to it all day,” she explains, adding that Hamaspik, to her knowledge, is one of the first voluntary agencies to create such a program. And how will it ultimately benefit Hamaspik consumers? Simple: “They’ll be in compliance with the law.”

Hudson Valley DDSO Director Mike Kirschmer Visits Hamaspik Long-time agency friend greeted by consumers helped years ago Michael Kirschmer is no stranger to Hamaspik, and to the OPWDD veteran, the voluntary agency is no new kid on the block. It’s been over 17 years since Kirschmer first made Hamaspik’s acquaintance, fast becoming a staunch ally of the agency and the families it served—an alliance that has only deepened with time. That full-fledged friendship remained intact when Kirschmer took the director’s reins at the Hudson Valley DDSO, the Developmental Disabilities Services Office serving the Orange, Rockland and Westchester Counties of the Hudson Valley region. Kirschmer oversees the region that is home to the greatest number of Hamaspik consumers—and the Monday morning, December 13 visit to Hamaspik’s Admin/Day Hab Building in Kiryas Joel was a homecoming of sorts for the OPWDD’s highest-ranking regional executive. Kirschmer met Hamaspik Executive Director Meyer Wertheimer at the door as a handful of Hamaspik staffers stood by and then entered the building’s first-floor central dining area, where consumers eagerly awaited at orderly attention. Upon the Director’s appearance, the crowd burst into earnest cheers. Kirschmer then had the opportunity to “work the rope line,” exuding genuine warmth as he personally greeted consumers, several whose wellbeing he has keenly followed since their infancies, in fact. Guided proficiently by Hamaspik of Orange County Day Hab Manager Mrs. C. Niederman, the Director then toured the building, taking in the various classrooms, activity rooms and their contents, wall art and commemorative pictures. * Ambling along the Admin/Day Hab Building’s corridors, Mike Kirschmer absorbed the ongoing progress at an agency he knows and knows well. The Director will tell

you himself that Hamaspik has held a special place in his heart for close to 20 years, going back to the days when Hamaspik’s entire existence was nothing more than an idealistic dream—a vision that Kirschmer, then serving under the first Governor Cuomo, had a critical hand in bringing to reality. Though slowly rising as the years progressed through the ranks of what today is the OPWDD, Kirschmer remained at Hamaspik consumers’ right sides throughout. From the days before Dinev Inzerheim, Hamaspik’s first group residence, opened its doors to today’s multiplicity of Hamaspik homes and even broader health and home-care programs, and from Kirschmer’s earliest tenure as a state employee to his appointment to the DDSO directorship he holds today, Hamaspik and Kirschmer have nursed a robust relationship built around the betterment of innumerable consumers’ lives—and those of their families and communities. That affable cordiality could be felt throughout the entire visit. As one veteran Hamaspik staffer put it: “Everyone felt right at home.” * Breaking bread followed as Hamaspik next hosted Kirschmer for breakfast. After a few minutes of “down time,” Hamaspik of Kings County MSC Supervisor Shlomo Reichman, serving as emcee, introduced Hamaspik’s Executive Director. “It is my honor and privilege to welcome… an old and best friend, Mike Kirschmer,” Meyer Wertheimer began to robust applause. Mr. Wertheimer proceeded to share a bit of ancient wisdom from the Talmud, to Kirschmer’s amusement. Opening meetings with a Judaic anecdote is a long-standing informal tradition between the two. “The Talmud, the interpretation of the Torah, says somebody who helps another person is being blessed six times—but someone who helps another person with passion,

Old friends: As staff look on, former child consumer Gershy (r), now a young man, greets the Director

In good company: Kirschmer (c) with Hamaspik hosts with a smile… is being blessed eleven times,” offered Wertheimer in appreciation of Kirschmer’s contributions. Mr. Wertheimer next dwelled briefly on the birth of the agency close to 25 years ago, particularly Hamaspik’s first residential project, the Dinev Inzerheim. Though the ICF may now be merely another member of the Hamaspik group-home family, it was Hamaspik’s “firstborn” then—coming into existence throughout “unimaginable” difficulties, Wertheimer said. With a veritable mountain of work looming over the fledgling residence at the time, Wertheimer confessed to having felt like giving up. Though parents’ pleas were heartfelt, the project “wasn’t moving,” Wertheimer said. Mr. Wertheimer also took the moment to invoke the memory of the late Rabbi Nachum Laskin, of blessed memory, who served as Dinev’s first Program Director. (Rabbi Laskin, who later earned renown as the Jewish chaplain to the Otisville federal correctional facility in upstate New York, passed on a scant few days before Kirschmer’s visit.) Still, the Hamaspik founder continued, it was Kirschmer’s bold, pioneering work—and a sympathetic smile no matter what the circumstances—that played the critical part in finally opening the trailblazing Inzerheim. Wertheimer specifically thanked the director for being the reason one Dinev Inzerheim consumer “exceeded all life expectations.” In closing, Wertheimer thanked the agency’s staff members for

standing on the front lines of helping individuals with special needs all through the agency’s growth across the greater New York area. The Executive Director also thanked Special Projects Coordinator Brenda Katina and her entire team for putting together the wonderful morning, as well as several Hamaspik leaders. * Director Kirschmer then rose to share a few words. Kirschmer first thanked Hamaspik for its kind words. “I do value our friendship over these many years,” he began. “We have traveled some smooth roads, we have traveled some rough roads together—but it has always been together, and I value that.” “Again, to see how Hamaspik has grown from a thought, from an idea, to the vibrant program it is today, is just… an outstanding accomplishment,” he continued. “It’s a tribute to Meyer and it’s a tribute to all of you and a tribute to your community that you have just embraced such a warm vocation: Helping other people.” Mr. Kirschmer then reminisced about meetings in the OPWDD’s Middletown office years ago with Mr. Wertheimer and now-retired colleague Jack Fenton. “Jack and I would always be very curious about different aspects of the Jewish culture,” he began. He then related how a pattern had developed: As each meeting began, the public servants would ask a Judaism-related question and Hamaspik’s Executive Director would “very patiently and very enthusiastically provide us the answer,” Kirschmer recalled. However, Kirschmer shared, as

the sixth such consecutive meeting was about to begin, Mr. Wertheimer joked that it couldn’t start because the twosome hadn’t asked him a question. “And I have valued that as well,” continued Kirschmer. “We are all engaged in life-long learning, and Meyer has been such a patient and valued teacher for me as well, not just with regard to the Jewish culture but he has certainly also taught me the value of caring for other people as well by his words and by his actions.” The Director segued from there into the theme of caring even when the battle is uphill, touching on looming budget difficulties and his own bouncing back within the OPWDD despite being laid off in 1993. “People ask me, ‘How do you like your job?’ I tell them, ‘It’s a very difficult job, a very challenging job, but it’s a job I love,” concluded Kirschmer. “I truly do—because I have the opportunity to work with … so many agencies across the district dedicated to do so much for so many people… And I’m just glad that I can be a part of being the support network to help you do what you need to do each and every day.” “So again, for your hospitality, for your warm words, for your kind welcome this morning… thank you all so much.” After a group photo, a few friendly chats and goodbyes, the DDSO Director headed out on his way back to work—and so did Hamaspik’s staff, returning to their daily duties of lightening the loads on precious souls and their loved ones.

Hamaspik Gazette | Feb. ‘11

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Arcadian Celebrates Consumer’s Bar Mitzvah Home Manager, staff joined by family Hamaspik employees for gala Hamaspik philosophy has long been a study in optimism. Incoming consumers—and even long-time group-home residents and beneficiaries—are regularly lavished with the spunky idealism of the rookie therapist, a positivity- and potential-oriented culture that continues to defy statistics. That’s why the recent Bar Mitzvah celebration for Zalman B., one of the residential consumers at Hamaspik of Rockland County’s Arcadian Briderheim IRA, was cause for significant joy. From Home Manager Shlomo Lebowitz and devoted staff through the lad’s special-education teachers in Kiryas Joel and his greater family and Hamaspik friends, the event united a community in hailing the arrival of one of their own to the ranks of

Jewish adulthood. But it was so much more than that: It was a statement of success, an affirmation that the OPWDD human-services model works. Considering how far Zalman has come since his joining Arcadian’s residential ranks, one teacher attending the event told the Gazette: “We just witnessed a miracle.” The event began as do most Bar Mitzvahs at the Hamaspik Terrace: Family members and staff socializing while a live band played light music, then guests slowly finding seats and clustering around tables in twos and threes. By the time 5:30 p.m. on the evening of Monday, December 13 rolled around, several dozen attendees found themselves amiably chatting around tables in the gilt-edged

hall, drinks and appetizers at hand. A festively adorned dais occupied one side of the room. The Bar Mitzvah bochur (young man), flanked by Mr. Lebowitz and others, would soon be seated at its center. With his arrival a few minutes later and the crowd at its near-peak, Hamaspik Director of Community Affairs Joseph Landau took to the corner podium to open the event. As the crowd of about 100 souls, including the entire Arcadian consumer and staff-member body, listened, Mr. Landau greeted the family, staff and guests on behalf of the agency and shared a few inspirational words. He concluded with a hearty “Mazel tov!” to Zalman and his loved ones on behalf of Hamaspik. The young man, the hero of the

A voice heard: DCW Feish Horowitz (l) helps Zalman hour, was then given the microphone to deliver his p’shetl: A brief commentary on a Torah subject per ageold Bar Mitzvah tradition.

Cutting-edge Orientation at Hamaspik of Rockland County Training video keeps employees compliant Walk down the hall of Hamaspik of Rockland County’s administrative offices any day, and you’re likely to hear the resonant voice of Peretz Eichler coming from a side room. But chances are you’ll hear him saying the same thing over and over. That’s because it’s not him, but a video recording of him—specifically, Mr. Eichler’s performance as Hamaspik spokesman in the agency’s official Corporate Compliance Law training video. That short tutorial is now in almostdaily use what with Hamaspik’s constant hiring of new employees, especially those affiliated with Hamaspik Care, its new home care services agency. Hamaspik has long prided itself on an exacting level of professionalism and discipline, an almost-militaristic corporate culture that continues to impress new hires as much as it positively struck this writer at his coming on board a little over a year ago. Employees interact like clockwork. Offices are neat and organized. Duties are discharged with precision. The entire agency performs like a vast machine, Direct Care Workers, secretaries and staffers its gears and managers, supervisors and directors its pistons and shafts. In complementary contrast to the exactitude, however, is that breezy atmosphere so critical to good interemployee relationships and a great, even fun place to work. All of those elements are in ample abundance in Hamaspik’s Corporate Compliance Law Training Video, whose viewing, along with

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The picture of compliance: The training room mandatory fingerprinting and background check, is de rigueur for all new employees per recently-effective New York State law. In the professionally-produced, approximately ten-minute video, Mr. Eichler first introduces viewers to the agency and then introduces the Corporate Compliance Law. New York State’s Corporate Compliance Law is an outgrowth of the federal Deficit Reduction Act (DRA) of 2005, created by Congress to trim the federal deficit by cutting wasteful government spending—and requiring states to rein in and police their own spending. New York State’s Corporate Compliance Law, which kicked in several months ago, applies to state agencies that bill for over $500,000 each year in Medicaid services, like Hamaspik, explains Mr. Eichler on screen—ensuring that state funding is properly and not wastefully spent. “The Corporate Compliance Law also legally requires employees

Feb. ‘11 | Hamaspik Gazette

of such agencies to be fully versed in its Corporate Compliance Rules,” new employees learn. “That’s why you’re watching this video!” While the Law requires agencies to maintain compliance, it does not specify method of employee instruction, points out Hamaspik Direct of Community Affairs Joseph Landau. To streamline and professionalize its employee-compliance efforts, not to mention save time and effort, the agency created the video, Landau explains. With footage of active Hamaspik employees and workspaces as its background, the instructional video proceeds to clearly and concisely define “fraud” and “abuse.” It then outlines how employees in all three Hamaspik branches can anonymously report fraud or abuse via phone messages or e-mails to assigned Corporate Compliance Officers. Employees next learn that they are legally required to report any fraud or abuse discovered at

Hamaspik—as well as legally protected from retaliation in any form, like firing, demotion, or failure to consider for promotion, should they report fraud or abuse. “Hamaspik is serious about fighting fraud or abuse,” intones Mr. Eichler. “If you report any fraud or abuse, Hamaspik will take your report seriously.” That commitment, new employees learn, includes firing corrupt employees, pressing charges, and cooperating with law enforcement. New employees emerge from their orientation with the sense that working for Hamaspik is not just another job but membership on a team, and a relentlessly professional one at that—down to the letter and spirit of the law.

Considering how far Zalman’s communications skills had come thanks to years of therapy, his ability to speak, let alone proffer a speech, was a subject of most-welcome wonder to all. Home Manager Lebowitz, a proud “father” in many ways, next took the floor to share some of his reveries and thoughts on the Bar Mitzvah boy and his remarkable progress. Mr. Lebowitz took note of the “devoted” work of Zalman’s Direct Care Workers at Arcadian, and thanked the lot of Zalman’s teachers and therapists on hand to celebrate with Hamaspik. Hamaspik Executive Director Meyer Wertheimer briefly addressed the crowd following Lebowitz, extending congratulations to young Zalman and his family and thanking the entire Hamaspik team for making the day possible. Wrapping up the elegant gala, a family member rose to thank Hamaspik for hosting the event, and for bringing their beloved Zalman to his current station in life. At the behest of the band, the crowd then took to the dance floor to celebrate further… with Arcadian staffers dancing with a noticeable spring in their step.

Reflecting: Zalman, Lebowitz (r) and staff (in mirror)

Chanukah Report Continued from Page 1 in a small Chanukah game or activity each night after dinner. For the holiday’s climax, however, the consumers embarked on a minor shopping expedition to the nearby Wal-Mart on Sunday, December 5, where they browsed the aisles for themed plastic cutlery, paper goods and other disposable party supplies, including streamers, “to get it more festive,” Mrs. Heilbrun says. After all, that very night would be Seven Springs’ main Chanukah party—and when you party on Chanukah, you must party right.

Forshay Briderheim The nondescript yet elegant house on Monsey’s Forshay Road, home to the Forshay Briderheim, was brimming with excitement and anticipation at the arrival of Chanukah, reports Home Manager Mrs. Sarah Fischer. Duddy H., one Forshay consumer, “came home every day of [Jewish-calendar month] Kislev reminding us that Chanukah was approaching,” Mrs. Fischer informs the Gazette. With menorahs unpacked, polished and set up on a specially-designated table, each individual resident got to set glass oil holders into place (olive oil is traditionally used), and staff assisted with placing wicks and pouring oil into each holder each holiday night. As the number of candles mounted each night, so did the fun, with another holiday activity on each. On what might be called “Arts and Crafts Night,” for example, the consumers were allowed to individually choose creative Chanukahthemed activities, with one creating a Sand Art portrait, another assembling a dreidel, and a third crafting a dreidel of his own out of colorful beads. The night was also marked by various Chanukah games. Over the Chanukah weekend, the “boys” made a huge dreidel, as well as the word “Chanukah,” out of Clics interlocking toy blocks. But the highlight of the week was Forshay’s grand annual Chanukah Mesibah (party)— presided over by a “Rebbe” whose

loyal Chasidim, if any, are squealing children and their gratified parents: none other than Mr. Moshe Finer of Monsey, New York, a.k.a. the “Ballooner Rebbe.” “It was a great hit,” reports Mrs. Fischer. “The kids went wild over it,” adds Mr. Finer, later contacted by the Gazette. “And the thing is, I get more out of it then they do.” Mr. Finer, a professional balloon entertainer, fashioned animals and objects of all sorts—animated characters, bears, birds, fish, flowers, giraffes, rattles, spiders, tigers and even baby bottles—out of 100-percent pure unadulterated balloon. “It was amazing to watch as he blew up the balloons and twisted them into shape so quickly you could barely see his hands,” Mrs. Fischer relates. “The results were truly enjoyed by all. The staff’s children were all invited and a great time was had by all… It truly was a Chanukah to remember.”

Acres Briderheim Underscoring the beauty of simplicity, residents under the care of Home Managers Mr. and Mrs. Lipa Laufer simply enjoyed Chanukah at home each holiday night. Mr. Laufer recounts how the group home’s consumers, several of which are significantly disabled and/or non-verbal, were almost-palpably overcome by the spirituality of the moment as the entire consumer and staff body gathered around Mr. Laufer’s large menorah. (The “boys” also lit their own menorahs each night earlier, Mrs. Laufer adds.) With the eternal golden flames flickering atop gleaming silver, a hush descended upon the group as they absorbed something greater than mere metal and fire. Perhaps speaking for all, one non-verbal consumer began gently rocking back and forth in his chair while eyeing the candles, moved by something from a place beyond words. “One could see how they feel the holiness of the moment,” says Mrs. Laufer.

Wannamaker Briderheim Residents of the Wannamaker Briderheim, Hamaspik of Rockland County’s youngest IRA group home,

enjoyed a big party on the fifth night of Chanukah, or the evening of Sunday, December 5, at the Hamaspik Terrace. They were joined by their dedicated Direct Care Workers and other staff—and, most importantly, by their parents. The upbeat but formal event was marked by Chanukah gifts given to each consumer. Remarks were also shared by Home Manager Moshe Tamber and Rabbi Sholom Rokeach, the respected spiritual leader of Toras Chaim, the neighborhood synagogue/yeshivah frequented by Wannamaker consumers. A parent also shared his thoughts and feelings. The highlight of the event, however, was the inspiring video review of the past year at Wannamaker, Tamber tells the Gazette. Though homemade, the patchwork quilt of video clips and photos presented participants with a laughout-loud but inspiring picture of life at Wannamaker in all its color. “This was the highlight,” says Tamber. “It was not professionally done but it showed what the staff [members] are doing all year ‘round.”

Grandview Briderheim Chanukah at Grandview was marked in the usual way—other than inspiring menorah lightings each night accompanied by songs, dreidel games, latkes, holiday decorations and all-around heightened good cheer, there was nothing out of the ordinary. Of course, like all its fellow Hamaspik group homes, Grandview had its own grand Chanukah party, this one the night of Tuesday, December 7, complete with presents for the consumers, spirited singing, and plenty of food to eat.

South 9th Shvesterheim Most group homes offered consumers a different activity each Chanukah night, and the South 9th Shvesterheim was no different. “You name it, whatever it was under the sun,” cheerfully claims Mrs. Cziment, South 9th’s Manager, painting a picture of a group home veritably brimming with variety over eight days. South 9th’s biggest Chanukah event, however, was its grand consumer party—an hours-long kaleidoscope of all things Chanukah including gift-giving, home-made latkes and doughnuts, and, of course, lots of food. The party also featured a live performance by music teacher/singer/folk guitarist Malka Salem, whose acoustic guitar, hula hoops and other accessories had the girls having a high-energy blast for well over an hour.

Dinev Inzerheim Spirit: As Manager Lebowitz (c) looks on, Grandview IRA Manager Joel Rubin (l) gifts an Arcadian resident

Dinev Inzerheim Home Manager

Who’s having more fun? Gertner and a resident Mrs. Weiss tells the Gazette that consumers lit their own menorahs every night and received holiday treats every day, also enjoying a grand Chanukah party on Tuesday evening, the seventh night of Chanukah, and getting grab-bag gifts.

61st St. Briderheim The 61st St. “Briderheimers” had a Chanukah party of some size and shape every holiday night, reports Direct Care Work Yossi Moskovits, complete with consumers donning formal regalia for minor events that began with individual menorah lightings and ending with singing and dancing. On Sunday, December 5, consumers at the 61st St. Briderheim in Brooklyn’s Borough Park were shuttled across the borough for an enjoyable private dinner party at the Williamsburg home of Home Manager Mr. David Mizrahi. With family members and plenty of food on hand, residents took in the warm holiday cheer along with speeches by several of their fellow consumers—speeches that were spontaneous, off the cuff and truly from the heart, reports Moskovits. “We were all emotional,” Moskovits says. “We really, really enjoyed it.” The Briderheim, driven by Home Manager David Mizrahi and Moskovits, held a grand Chanukah finale in the form of hosting the entire Hamaspik of Kings County Day Hab program for a Chanukah lunch with singer Shloimy Gertner (see below).

38th St. Shvesterheim All Hamaspik group homes are as family-oriented as possible, with the 38th St. Shvesterheim’s Chanukah report to the Gazette a typical example. Home Manager Yomtov Malik stood in as a loving father figure, presenting each girl on Chanukah with a personal gift from himself and his family: high-quality garment bags personalized with their names. Mr. Malik “was very involved,” reports Direct Care Worker Mrs. R. Horowitz, noting how the Manager

attended the Shvesterheim’s central Chanukah party on Sunday, December 5 with his own family, making the consumers of the IRA’s two residential floors—two separate, function-delineated group homes in one, actually—feel they truly belonged. At that party, which also saw the attendance of the entire group-home staff, Mr. Malik also lit the menorah with the girls of the dual home looking on, boosting the family atmosphere yet further. Though the Shvesterheim marked Chanukah’s eight nights with eight different color schemes for dinner’s disposable tablecloths and napkins, the holiday was most felt where it most counted—in the hearts of the consumers. The grouphomes residents “all felt like a million dollars,” reports Mrs. Horowitz. “One girl said she felt like crying [for joy] each night because every day there was something else exciting. In her house they never had that.”

Fosse Shvesterheim “We tried celebrating every day,” says Fosse Home Manager Mrs. E. Landau—and judging from her report, the Fosse staff not only tried to inject a Chanukah spirit into the home’s air each night, but succeeded too. “Every night we did something else.” Said activities included making the customary jelly doughnuts, playing rounds of dreidel, and a chocolate dreidel-making activity. One high-functioning consumer, Breindy H., even organized a Chanukah party of her own on the premises of the Hamaspik of Rockland County Day building on Route 59. But the best part of Chanukah by far—and an event looked forward to by the consumers all year ‘round, Mrs. Landau points out—was the exclusive grand Chanukah bash for consumers and staff. Held Thursday night, December 9, it was “the most amazing party,” Mrs. Landau recounts. Besides featuring a “beautiful” kumzitz sing-a-long, as Mrs. Landau describes it, consumers were given

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Adding Light: Continued from Page 5 advance notice of an exciting game to be played at the party several days in advance. Each consumer was assigned the name of a different consumer, and a problem faced by that consumer. Each newly-renamed consumer now had to arrive at the party bearing a physical item or object that might help their namesake solve their personal problem. In the run-up to the party, each consumer was given the opportunity to go shopping for their item of

choice. “Some of them came up with some original ideas,” reports Mrs. Landau. Furthering the Chanukah spirit, consumers also collected Chanukah gifts—and joined the entire Hamaspik of Rockland County Day Hab girls division for a daytime party at a Fosse neighbor’s private home. That local resident not only played the gracious hostess, but also gave all her guests elegant costume necklaces too.

Concord Briderheim

“I wanted to thank all the special neighbors who give special attention to our boys around the year,” reports Home Manager Mrs. Shaindel Goldberger. To accomplish that, Mrs. Goldberger first called each to offer personal thanks, then asked them “to accept our boys’ own words” over Chanukah when they would pop in for just a few minutes to say “Thank you!” Further conspiring with the neighbors, Mrs. Goldberger had Hamaspik’s Chanukah gifts to consumers placed in advance in neighbors’ homes—along with fresh homemade doughnuts and thank-you

All In a Day’s Work By S. Pascal It is hard to define the exact nature of our job. Mother? Most definitely. Teacher, physical therapist, occupational therapist, social worker, nutritionist, nurse, doctor, dentist, cook, waitress, entertainer, peace-maker, driver, party planner, personal shopper? A little of each, I guess. So for a lack of a better word, they call us “Direct Care Staff.” Coming to work at the group home, one is initially greeted by the group home manager. The greeting is accompanied by a sincere smile for “her staff.” You can wake up [the home manager] in middle of the night, and she can easily rattle off the birthday, mother’s phone number, date of the next dental appointment, shoe size, and endocrinologist’s phone number of each of the girls in the home. (Well, almost.) While [the home manager] does know the girls inside out, it is so much deeper than that. She is blessed with an enormous heart with a capacity to deeply care for each girl, and the home is blessed with her. The homey, loving, nurturing, happy, upbeat, easygoing, yet efficient atmosphere in the home is without a doubt a direct result of the example she sets. There definitely are those tough days; as we do things that I’m pretty sure no other job in the world includes! Like getting eight girls showered, dressed, hair blown, fights resolved, medication given, teeth brushed, second round of fights resolved… and finally getting them on the 8:40 bus to Day Hab while simultaneously resolving the third round of fights… Customizing four different suppers for the girls that don’t like the menu. That’s when our creativity kicks in! Fire drills in the middle of the night, wheelchairs, bathrobes and all… Picking up girls from chasanas [weddings] at 1:30 a.m…. Seizures at 4:30 a.m…. The nights that staff remain on a chair beside the hospital bed of a girl, and then stay on all morning, too… Shopping and packing up eight girls for yom tov, all while trying to Pesach-clean the house and serving a chamitzdik

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[leaven-based; banned on Passover] supper. (Don’t even ask!) Dealing with the girls that constantly like to express their love by bothering the other girls… Dealing with five bad moods at once… and the list goes on. But it’s all worth it when we stop and reflect on the fact that our job includes doing chesed [acts of compassion] for 60 minutes out of every hour we are working. And it is more than that; the smile that lights up their faces when they greet us, and the genuine care that the girls have for their staff. When they ask us how our day was, they actually pause and await our answer. I remember a crisp autumn day once when we took the girls to a gorgeous park with beautiful mountains surrounding a lake. As I was walking beside the lake a girl cried out, “Don’t go so close! I still need you!” People often wonder if it is depressing to work in a group home with these young ladies. Despite the tough days, there is so much happiness in the home! Somehow there is always reason to celebrate; between birthdays, simchas [happy occasions], Rosh Chodesh [New Month] and Yom Tov [holiday]. And even when we’re not celebrating an occasion, the girls are purely celebrating the gift of life. The challenges that the staff help the girls overcome on a daily basis bring happiness, not depression. The staff have always enjoyed the great sense of humor of our girls—like the girl that was desperately trying to get in touch with President Obama to talk to him about the poor battery life of a cell phone she received from a government program. Then there was the girl that at her birthday party was wished a brocha [blessing] to live to 120. She answered, “Oh, please, that’s way too long!” And the time one of the girls said, “You know, why don’t you get married? I’ll find you a boy to marry.” She thought for a minute and said, “Actually, I can’t go out into the snow to look for a boy. And there is wind; it might blow me over!” Or, when taken to the dollar

Feb. ‘11 | Hamaspik Gazette

store, one of the girls was anxiously looking for a wedding gift for her “second to last cousin”—or, when a staff [member] was nervous about driving the big van, one of the girls reassured her, “Don’t worry, I’ll tell you when you crash!” We were essentially hired to give. Often I marvel at the home mother and my co-workers. No one can ever repay them, or for that matter, no one besides HaKadosh Baruch Hu [a colloquialism for G-d] will ever know the extent of sincere care, attention and love that they put into the girls. There is so much that can be learned from these young ladies. I often think, Halevai [if only] all of Klal Yisroel [the Jewish community] would yearn for the Geulah [the Jewish Redemption] with the sincerity and simplicity of some of these girls. How many people can say that they are “waiting for Mashiach [the Jewish Messiah] and havdalah [the post-Sabbath ceremony],” and mean the former as sincerely as the latter? On the night of Tisha B’Av [a historical mourning and fasting day] one of the girls sat down on the floor and with a sigh said, “Mashiach should come more often.” It is truly an inspiration to watch the way the girls daven [pray]. For the way one of the girls went to her room, closed the door, and said, “Hashem [G-d], can you please make Sarah a kallah [bride] already…” To the way the girls sit with their Tehilim [Psalms], and the tears that accompany their Shmoneh Esrei [a central prayer], without a doubt these tefilos [prayers] have a special place in Shamayim [Heaven]. I often reflect on the irony of the situation. It started out as a way to spend my free time, to supplement my teaching job. I saw a small ad in the paper. Hamaspik was looking for a staff member. Never did I dream that the supplementary job would remain long after my teaching job—and that that job would add so much to my life. The author is a Direct Care Worker at Hamaspik of Rockland County's Fosse Shvesterheim IRA.

notes for the neighbors themselves. Instead of Mrs. Goldberger giving consumers their Hamaspik Chanukah gifts directly, they would now be given by the neighbors. “The neighbors were more than happy to accept the deal,” says Mrs. Goldberger. “Some made special arrangements for the special moment.” For Concord’s consumers, the gifts consisted of perfectly matched towel and toiletry sets with accompanying chrome shower racks—with small cameras, and even gift certificates at a local kosher pizza parlor, thrown in to “make it more exciting,” Mrs. Goldberger notes. As for Concord’s Chanukah party, Mrs. Goldberger arranged for several exciting elements, including an aromatic popcorn machine, a captivating hot pretzel machine, and a table filled with mystery prizes for attending consumer family members. To keep everyone involved, Mrs. Goldberger had consumers’ family members decorate coneshaped popcorn holders with stickers and numbers. They would then select the corresponding prize from the table at the end of the party, also participating in a drawing for two even more exciting prizes. For entertainment, a “one-man band” keyboardist was on hand to fill the air with music—accompanied by the appearance of several members of the Brooklyn-based Mekimi Cheer-Up Squad, including one in a charming bear costume. By the end of the party, “all children, even the consumers, got to put on the bear’s head,” says Mrs. Goldberger. “It was irresistible.”

Hamaspik of Orange County Day Hab Getting into the festive holiday spirit a few days before Chanukah, the Men’s Division of the Hamaspik of Orange County Day Hab program enjoyed a special dinner on the 21st of Kislev, four days before the onset of Chanukah. That Jewish-calendar date is cause for profound celebration in the Satmar Chasidic commu-

nity that comprises a sizable part of Hamaspik’s consumer body—it marks the date on which the Satmar Rebbe, Rabbi Joel Teitelbaum, of righteous memory (1887-1979), was rescued from the Bergen-Belsen concentration camp during WWII. As for their Women’s Division counterparts, the young ladies engaged in a Chanukah art project so gorgeous you could just eat it up— quite literally. On the 7th day of Chanukah (Tuesday, December 7), the group’s consumers built a giant menorah out of wafers and fruitcereal rings. To inject regular programming with that Chanukah flavor, the Day Hab’s staff had their charges host their parents and/or siblings at their Chanukah-time Tastes of Specialty baking and life-skills workshop. The bi-weekly Tastes of Specialty program, Day Hab Manager Mrs. C. Niederman explains to the Gazette, sees consumers learning how to make a range of baked goods in the Day Hab’s spacious kitchen—and then learning real-life money-management skills by selling said goods at bake-sale tables set up in the Admin/Day Hab’s ballroom, aprons, real cash (and cash register!) and all. (Tastes of Specialty is projected to open to the public in the spring of 2011, when consumers’ basic finance skills are strong enough, Mrs. Niederman adds.) The “girls” also enjoyed the inter-Day Hab group party in Monsey on the last day of Chanukah (see below).

Hamaspik of Kings County Day Hab On Thursday, December 2, Day Hab consumers were treated to an outdoor ceremonial menorah lighting. With consumers basking in the sun on the sidewalk outside 293 Division Avenue, the Day Hab’s home, a six-foot-tall menorah and a giant dreidel stood at attention in front of the building, setting the

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Having a grand time: A Grandview resident sings along at his IRA’s grand Chanukah party

Continued from Page 6 event’s holiday tone. The event kicked off with consumer Yosef Chaim E. honored with lighting the menorah. Fellow consumers looked on with bated breath as the young man carefully kindled the candles as Direct Care Worker David Moshe Samuel carefully stood by. With the menorah alight, Direct Care Worker Yoel Appel took the excitement to the next level, churning out a number of popular, fastpaced Chanukah melodies on a keyboard and sound system set up on the Day Hab’s outdoor steps. Making it all the more exciting was the live microphone which allowed several consumers to step up and sing along. As part of the Talmud-based Chanukah custom of pirsumei nisa (essentially translatable as “telling the whole world about it”), not to mention thanking the DDSO for its partnership as well as augmenting consumers’ social skills, two Hamaspik of Kings County Day Hab consumers visited the offices of the Brooklyn DDSO on Friday, December 3. At the office, the consumers and their two accompanying Hamaspik staffers delivered personal Chanukah greetings to downstate OPWDD Associate Commissioner Jill Gentile, Family Support Coordinator Eric Magwood, Treatment Team Leader Michael Gilbert, Quality Assurance official Sharon Audine, Site Development Coordinator Peter DeRose and Chief Safety Officer Robert DeNicola. New York City Development Unit Supervisor Howard Wasserman of the OPWDD was also personally visited and given a holiday gift. On Monday, December 6— which also was Chanukah, Day Six—illusionist and juggler James Jacobs delivered no less than two entertaining performances on the Day Hab’s premises. Consumers and staff alike were thrilled (and confounded!) by Jacobs’ volunteerinvolving vanishing and sleight-ofhand feats, along with his outstanding juggling skills. Jacobs’ two shows were part of the two parties held that day for the Day Hab’s men’s and women’s divisions. Besides Jacobs’ interactive performance, the gentlemen enjoyed another visit by beloved folk singer and Hamaspik friend Michoel Schnitzler, who returned that very afternoon after his most recent visit a mere few weeks ago for another session of song with his special friends. The ladies, for their part, sat down to a delicious Chanukah lunch, themed tablecloth, settings and all. Popular young singer Shloimy Gertner, himself the father of a special-needs daughter who has sung for Hamaspik in the past, returned to lend his golden vocals to the agency yet again, this time at an informal sing-a-long and luncheon for Kings County Day Hab consumers, held midday on the seventh day of

Chanukah, or Wednesday, December 8th, at the 61st St. Briderheim. Backed by keyboardist Avrumi Berko and with consumers grinning from ear to ear, Gertner slowly wended his way across 61st’s spacious living room, a long wire connecting his mike to the sound system and his voice connecting his heart to the special-needs residents and participating consumers. Gertner “really went out of his way” to visit Hamaspik, notes Moskovits, also thanking Gershy Moskovits of TeeM Productions, Gertner’s co-manager (and Moscovits’ own brother), for arranging for Gertner’s visit.

Rockland County Day Hab Hamaspik of Rockland County Day Hab consumers got a jump on out-of-the-ordinary programming a week before Chanukah with the visit of Ramapo Town Councilman Daniel Friedman. Mr. Friedman, who represents several Hamaspik consumers and staff, was given a guided tour of the Men’s Division facility by Executive Director Meyer Wertheimer. Incorporating cultural norms and religious traditions into life-acclimation activities has always been part and parcel of Hamaspik’s Day Hab programs, and the theme-heavy Chanukah holiday was no different. For the Day Hab’s higher-functioning gentlemen who engage in regular study of the Mishnah and Talmud, their scheduled scrutiny of those Jewish-law compendia during Chanukah consisted of holiday-related selections, Men’s Day Hab Director Pinchas Knopfler tells the Gazette. That study actually got off to a rousing start with a siyum, the traditional party marking an academic achievement, on the first day of Chanukah. Consumers regularly working on motor skills with hands-on crafts activities also assembled and painted hand-made wooden menorahs, and poured melted chocolate into molds to form edible Chanukah-themed shapes. On Monday, December 6, like their Kings County counterparts, several Day Hab consumers visited the offices of various Rockland County officials to personally express Chanukah best wishes from their friends at Hamaspik. Public servants’ offices visited included Village of Spring Valley Mayor Noramie Jasmine, Town of Ramapo Supervisor Christopher St. Lawrence, Rockland County Executive Scott Vanderhoef and U.S. Congressman Eliot Engel. The Men’s Division also threw a grand Chanukah bash on the premises of the Day Hab on Wednesday, December 8, complete with live band, fresh food, and good holiday fun. As for the Women’s Division, “Chanukah was great!” says Manager Mrs. E. Kresch. “Every day we had something else going on.” Day Hab consumers look for-

ward to Chanukah around the year, Mrs. Kresch continues. “They love Chanukah,” she says. For that reason, and in a display of how serious Hamaspik takes its consumers, “Day Habbers” and staff actually met a few days before the holiday to plan activities, emerging with an eightday schedule chock-full of games, projects and other holiday escapades. To maximize the holiday atmosphere, and to give credit where credit is due, consumers also paid visits to numerous doctors, teachers and East Ramapo Board of Education members to thank them for helping Hamaspik throughout the year. Similar gestures of appreciation were also conveyed at local city halls, and area SEMP and E-SEMP employment providers. The Chanukah experience for the Women’s Divisions of all three Hamaspik Day Hab programs— Rockland, Orange and Kings Counties—culminated with a joint party on Wednesday, December 8 at the Hamaspik Terrace in Monsey, complete with entertainment by professional music therapist Mrs. Orna Rubinstein. “They always get excited to see their friends,” Mrs. Kresch says. And to drive the Chanukah spirit home, Hamaspik of Rockland County Direct Care Worker Ms. H. Eisenberger personally invited her friend Chana, a Day Hab consumer, to join her family at home for the Eisenbergers’ private menorah lighting, dinner and rounds of dreidel. “Staff [members] were saying, ‘She never had a real Chanukah,’ ” Ms. Eisenberger tells the Gazette. “She lives right near my house, so I thought, ‘Why not?” ” “The whole family was very involved,” points out Mrs. Kresch. “They really made her feel very welcome.” “Every activity was exciting” over Chanukah at the Day Hab, concludes the Manager. “There was nothing they didn’t look forward to.”

A “bearable“ holiday: A consumer enjoys the decor ers, many of which who preside over sizable families of their own, took time away from their daily duties for a bit of Chanukah-themed rejuvenation on Chanukah’s final day.

Adding light Light is a metaphor for so many things: Happiness. Joy. Good. Justice. Morality. Spirituality.

Progress. Achievement. Completion. And all across Hamaspik, adding light on Chanukah meant so much more than just lighting another candle. For individual consumers taking steps in the right direction, in the infinite nooks and crannies of their daily lives at Hamaspik, Chanukah meant all of these things.

Family Care Provider party In appreciation for their lives of daily sacrifice and devotion, Hamaspik of Rockland County’s Family Care program, under which several dozen consumers receive loving care, threw a private Chanukah party at Hamaspik Terrace for the compassionate stay-athome moms who form the backbone of the program. The hard-working moth-

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10

In the Know All about… ADHD

“We have all had one of these experiences at one time or another. Perhaps it was at the grocery store, watching frustrated parents call their children’s names repeatedly and implore them to ‘put that down.’ Maybe it was a situation at school with a child who could not seem to sit still and was always in motion. Maybe we noticed a child who appears always to be daydreaming in class—the student who will not focus on an activity long enough to finish it. We all puzzle over these challenging behaviors.” “Attention Deficit Hyperactivity Disorder (ADHD) has many faces and remains one of the most talkedabout and controversial subjects in education. Hanging in the balance of heated debates over medication, diagnostic methods, and treatment options are children, adolescents, and adults who must manage the condition and lead productive lives on a daily basis.” —Identifying and Treating Attention Deficit Hyperactivity Disorder: a Resource for School and Home (U.S. Dept. of Education report, 2008) The mental disorder once derided by a nationally-respected educator as “a designer disease” is increasingly in the news as researchers solidify its scientific building blocks and zero in on its causes and treatments. But by its very nature, AttentionDeficit/Hyperactivity Disorder (ADHD) is still often confused with the unpredictable antics and behavior of ordinary, healthy children. That’s why, in this article, we’ll

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focus on the difference between daydreaming or wild behavior and real ADHD: what ADHD really is, how to tell whether your child really has it, and what to do about it.

Definition Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurological condition defined by two primary symptoms: inattention and hyperactive-impulsive behavior. Both of these are “developmentally inconsistent with the age of the child,” as the abovementioned Dept. of Education report puts it—in plain English, meaning that the kid’s daydreaming or wild behavior is not like the daydreaming or behavior of other kids his age. ADHD has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it describes both primary aspects. The condition was known as ADD until 1994, when it was officially changed to ADHD. Today, any child with only inattention, or only hyperactivity, is given the ADHD diagnosis. While many children with ADHD tend more toward one category than the other, most children with ADHD have some blend of both. Children with ADHD may also struggle with low self-esteem, troubled relationships and poor school performance.

Symptoms and Diagnosis Diagnosis of ADHD is anything but a simple visit to the doctor or a few quick tests. To be diagnosed with ADHD, a child must first show several specif-

Feb. ‘11 | Hamaspik Gazette

ic behaviors spelled out in the authoritative Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV)—and consistently over a period of six months—exactly as carefully worded below: “Inattention 1. Six (or more) of the following symptoms of inattention that have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: a. Often fails to give close attention to details or makes careless mistakes in school work, work, or other activities b. Often has difficulty sustaining attention in tasks or play activities c. Often does not seem to listen when spoken to directly d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) e. Often has difficulty organizing tasks and activities f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) g. Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) h. Is often easily distracted by extraneous stimuli i. Is often forgetful in daily activities” “Hyperactivity 2. Six (or more) of the following symptoms of hyperactivity-impul-

sivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: a. Often fidgets with hands or feet or squirms in seat b. Often leaves seat in classroom or in other situations in which remaining seated is expected c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings or restlessness) d. Often has difficulty playing or engaging in leisure activities quietly e. Is often “on the go” or often acts as if “driven by a motor” f. Often talks excessively g. Often blurts out answers before questions have been completed h. Often has difficulty awaiting turn i. Often interrupts or intrudes on others (e.g., butts into conversations or games)” If both Criteria 1 and 2 are met for the past six months, the child has ADHD, Combined Type. If Criterion 1 is met but Criterion 2 is not met for the past six months, the child has ADHD, Predominantly Inattentive Type. If Criterion 2 is met but Criterion 1 is not met for the past six months, the child has ADHD, Predominantly HyperactiveImpulsive Type. Getting the actual diagnosis You may now be wondering, “I just read all this and I think my Chaim has ADHD. What do I do now?” First, make a doctor appointment. Your child’s pediatrician will

start collecting information to determine whether your child actually has ADHD. He or she will speak to you and your child’s teachers at length to determine the child’s specific behaviors and whether any other illness or condition may be causing them. Because ADHD children frequently have a variety of other disorders, a thorough examination for any such coexisting condition is usually a part of any evaluation. For example, about half of ADHD kids also have dyslexia, at least 35 percent also have Oppositional Defiant Disorder (ODD), and about 25 percent have some form of anxiety disorder. Collecting information about symptoms from several sources helps ensure that the information is accurate. As such, the pediatrician will reach out to psychologists, occupational therapists, speech therapists, social workers, doctors and other caregivers as necessary. He or she will likewise review both the child’s previous medical history as well as his or her school records. Your child will then undergo one of several behavioral evaluations, like the Conners Parent Rating Scale (CPRS). Next, several educational evaluations—which include direct classroom behavior observation and review of academic productivity— will assess the extent a child’s ADHD symptoms impair school performance. Classroom observations are used to record which ADHD symptoms the child exhibits in the classroom, and how often, comparing them to other children. Finally, your child will undergo a medical evaluation.

Normal behavior vs. ADHD: How to tell Most healthy children are inattentive, hyperactive or impulsive at one time or another. For example, parents may worry that a three-yearold who can’t listen to a story from beginning to end may have ADHD. But preschoolers normally have a short attention span and aren’t able to stick too long to one activity. Even older children and adolescents’ attention spans often depend on their interest levels. Many teens can listen to music for hours but cannot focus on homework. The same is true of hyperactivity. Young children are naturally energetic and they may become even more active when they’re tired, hungry, anxious or in a new environment. Also, some children just naturally have higher activity levels than others. Children should never be classified as having ADHD because they’re different from friends or siblings. Children who have problems in school but get along well at home or with friends are not considered to have ADHD. The same is true of children who are hyperactive or inattentive only at home but whose schoolwork and friendships aren’t affected by their behavior.

Causes ADHD is not caused by poor parenting, too much sugar, or vaccines. The condition is not a disorder of attention, as had long been assumed, but rather, a function of developmental failure in the brain circuitry that monitors inhibition and self-control. ADHD has biological origins that aren’t yet clearly understood. No single cause has been identified, but researchers are exploring a number of possible genetic and environmental links. Studies have shown that many kids with ADHD have a close relative who also has the disorder. Although experts are unsure whether this is a cause of the disorder, they have found that certain areas of the brain are about 5% to 10% smaller in size and activity in kids with ADHD. Chemical changes in the brain also have been found. Although there’s still a lot that isn’t known about ADHD, researchers have identified several factors that may play a role: Altered brain function and anatomy Brain scans have revealed important differences in the structure and brain activity of people with ADHD: There appears to be less activity in brain areas that control activity and attention. Heredity ADHD tends to run in families; about 25 percent of ADHD kids have at least one ADHD relative. Parental ingestion of/exposure

to toxins Toxins contained in various drugs or tobacco increase risk of having ADHD children, because they reduce activity of the nerve cells that produce neurotransmitters. Exposure to environmental poisons like polychlorinated biphenyls (PCBs) may also produce children with symptoms of ADHD (PCBs are industrial chemicals widely used up until the 1970s). Childhood exposure to toxins Preschool children exposed to certain toxins are at increased risk of developmental and behavioral problems. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span. Exposure to PCBs in infancy also may increase a child’s risk of developing ADHD.

Treatment ADHD can’t be cured, but it can be successfully managed. Treatment typically involves behavioral strategy, drugs or both. Treatment can make a big difference, and the majority of ADHD children grow into successful adults. Once your child begins treatment for ADHD, he or she should see the doctor regularly—at least once during the month following diagnosis, and then at least every six months after that. The doctor will work with you to develop an individualized, longterm plan. The goal is to help a child learn to control his or her own behavior and to help families create an atmosphere in which this is most likely to happen. Be sure to discuss how often your child should be seen for appointments with his or her doctor. Call the doctor if your child has any medication side effects, such as loss of appetite, trouble sleeping or increased irritability. Over time some children taking stimulant medications may also lose weight or grow more slowly, although these changes are usually temporary. Most importantly, depending on where you live, having an official ADHD diagnosis can secure various publicly-funded educational services for your child as the member of a taxpaying family; contact your local social-services agency. Behavioral Behavioral strategy revolves around restructuring the ADHD child’s total environment into one most conducive for self-control, focus and learning. Such strategy consists of a united team effort on the part of parents, teachers, doctors and therapists, creating a consistent, collaborative “front” for the child in which there is zero tolerance for violations but prolific positive reinforcement. This strategy includes childmanagement skills training for parents; positive reinforcement, “time outs,” response cost, and token

economy for teachers and parents; training in problem-solving and social skills for therapists; and cognitive-behavioral treatment for the child. In general, these approaches are designed to use direct teaching and reinforcement strategies for positive behaviors and direct consequences for inappropriate behavior. Behavioral strategy may be most appealing to parents and professionals who do not want to medicate the child. Another advantage is that they can be applied in a variety of settings including school, home, and the community. Behavioral strategy may also be the only option if the child has adverse reactions to medication. Drug Drug strategy—giving your child powerful and possibly dangerous, damaging medications— remains the most common, and controversial, ADHD strategy. The decision to prescribe any medicine is the responsibility of medical—not educational—professionals, after consultation with the family and agreement on the most appropriate treatment plan. Pharmacological treatment includes the use of psychostimulants, antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers. Stimulants predominate in clinical use and have been found to be effective with 75 to 90 percent of children with ADHD. Stimulants include Ritalin, Dexedrine and Cylert. Other types of medication, like antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers are used primarily for those who do not respond to stimulants, or those who have coexisting disorders. Researchers believe that psychostimulants help the brain produce more neurotransmitters—chemical agents that help the brain respond to its environment—thus increasing the child’s capacity to pay attention, control impulses and reduce hyperactivity. Medication necessary to achieve this typically requires multiple doses throughout the day, as an individual dose of the medication lasts for a short time (one to four hours). However, slow-or timed-release forms of the medication may allow a child with ADHD to continue to benefit from medication over a longer period of time. Doctors, teachers, and parents should communicate openly about the child’s behavior and disposition in order to get the dosage and schedule to a point where the child can perform optimally in both academic and social settings while keeping side effects to a minimum. Although the positive effects of the stimulant medication are typically immediate, all ADHD medications have side effects, with some serious. Common side effects include insomnia, nervousness, headaches, and weight loss. Parents have also reported slowed growth, tic disorders, and problems with

thinking or with social interaction. Medications can also be expensive, depending upon type and usage. Stimulant medicines do not make ADHD kids “normal.” Children under treatment may still show more behavioral problems than their peers. Multimodal For many ADHD kids, the best strategy combines behavioral and drug strategies. A large study by the National Institutes of Mental Health (NIMH) found that the combined medication/behavior treatment worked significantly better than behavioral therapy alone at reducing the symptoms of ADHD. The study also found that a lower medication dosage is effective in multimodal treatments, while higher doses were needed to achieve similar results in the medication-only approach.

Tips for Home The following are some helpful suggestions for parents. Caring for children with ADHD may be challenging, but it is important to remember that these children can learn successfully. It is critical that parents remember that some of their child’s disruptive behavior is a manifestation of the disability and that the challenge is finding ways to help their child change the inappropriate behavior. Key to this is remembering to focus on the need for structure and routine for your child’s daily schedule and thereby reinforcing the importance of learning self-control and self-regulation. The following are suggestions for parents: • Reduce choice to two things (this outfit, meal, toy, etc., or that one) so that your child isn’t overwhelmed and overstimulated • Use specific, concrete rewards and consequences for appropriate and inappropriate behavior: Tangible rewards and treats, restaurant or outing night for a good week at school, removal of privileges, time-out from reinforcing activities: the child is essentially removed from situations that foster inappropriate behavior • Set a daily routine and stick to it. Bedtime and preparation for school are much easier if there is a structure already in place • Have tangible reminders: A big clock in the bedroom, charts for chores, assignment pad to record homework and a specific folder to put work in upon completion • Gain the child’s attention before speaking to him or her. Have the child repeat back directions for things that are really important • Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well—whether it’s sports, art, or music—can boost social skills and self-esteem Avoid the following: • Distractions like TV, radio and computer games, especially when

your child is doing homework • Repeating patterns of inappropriate behavior followed by ineffective punishment • Administering consequences without prior warning or without the child understanding why he or she is receiving them • Responding inconsistently to inappropriate behaviors

Tips for School The following are some helpful suggestions for teachers. A student with ADHD can present unique challenges in the classroom. Inattention, hyperactivity, or impulsivity can be the source of frustration, but there are ways teachers can help students with ADHD to improve the educational experience and control the symptoms of the disorder. It is important for teachers to be aware of coexisting conditions such as learning disabilities, as well as reinforcing the importance of classroom and instructional structure. The following are tips for teachers: • Work on the most difficult concepts early in the day • Give directions to one assignment at a time instead of directions to multiple tasks all at once • Vary the pace and type of activity to maximize the student’s attention • Structure the student’s environment to accommodate his or her special needs. For example, the student can be seated away from potentially distracting areas (such as doors, windows, and computers) or seated near another student who is working on a shared assignment

Summary Currently, the only ADHD therapies that have been proven effective in scientific studies are behavioral therapy and medications. But your doctor may recommend additional treatments and interventions depending on your child’s symptoms and needs. Some kids with ADHD, for example, may also need special educational interventions such as tutoring, occupational therapy, etc. Every child’s needs are different. A number of other alternative therapies are promoted and tried by parents including: megavitamins, body treatments, diet manipulation, allergy treatment, chiropractic treatment, attention training, visual training, and traditional one-on-one “talking” psychotherapy. However, scientific research has not found them to be effective, and most have not been studied carefully, if at all. Parents should always be wary of any therapy that promises an ADHD “cure.” If you’re interested in trying something new, speak with your doctor first. Above all, remember that although raising ADHD kids can be challenging, it’s important to remember they aren’t “bad” or being difficult on purpose!

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Public Health and Policy Nursing top trusted profession For the 11th consecutive year, nurses were voted the most trusted profession in America in Gallup’s annual survey that ranks professions for their honesty and ethical standards. Eighty-one percent of Americans believe nurses’ honesty and ethical standards are either “high” or “very high.

SUDEP rising concern Sudden Unexpected Death in Epilepsy, or SUDEP, causes up to 18 percent of epilepsyrelated deaths. The cause is unknown.

Gov’t bans drop-side cribs A ban on drop-side cribs announced Wednesday, Dec. 15 by the U.S. government comes after millions of recalls and the deaths of more than 30 infants and toddlers in the past decade. The requirement that all cribs have fixed sides takes effect next June.

Even one cigarette deadly As little as one cigarette a day, or even just inhaling smoke from someone else's cigarette, could be enough to cause a heart attack and even death, warns a report released Thursday, Dec. 9 by U.S. Surgeon General Dr. Regina M. Benjamin.

More HEAP, more heat The federal Low Income Home Energy Assistance Program (LIHEAP) allocated another $276 million this December towards New York State low-income families’ winter heating bills. Contact your local HEAP office to apply.

Obama signs Zadroga bill The Zadroga Act, a Congressional bill that provides billions in healthcare funding for 9/11 rescuers sickened by toxic debris, was signed by President Barack Obama while on vacation.

Medicare “Doc Fix” fixed… again Congress’s revolving-door Medicare “Doc Fix” problem, or the perennial—and cre-

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ative—postponement of 25-percent cuts to doctors’ Medicare-patient payments, was postponed Dec. 7 yet again—this time by raising citizens’ refund caps for 2014 health insurance tax subsidies.

Federal OIG saves billions In its most recent Semiannual Report to Congress, released Dec. 15, the HHS Office of Inspector General reported $25.9 billion cut in fraud, waste and abuse in Fiscal Year 2010. Those savings included a July takedown of a $251 million, seven-city, 94-person falsebilling operation.

Unhealthy, hungry no more President Barack Obama signed the Healthy, Hunger-Free Kids Act into law this Dec. 14. The law strives to provide healthier food to public-school kids, help reduce childhood obesity, promote more natural foods and encourage better child care.

Obesity rising everywhere Two reports released Tuesday, Dec. 14 by the U.S. National Center for Health Statistics (NCHS), a division of the CDC, show that the obesity epidemic is hitting young and older Americans across the economic spectrum.

Obama signs onto National Alzheimer’s Project A unanimous Congressional bill to create the National Alzheimer’s Project within the Dept. of Health and Human Services was signed in mid-December by President Barack Obama. Its goal, the legislation says, is to “accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer’s” and “improve the early diagnosis of Alzheimer’s disease and coordination of the care and treatment of citizens with Alzheimer’s.”

with the most special-needs family members. Not unlike Hamaspik’s Service Coordinators Family Care Liaisons, the coordinators will “help Airmen and their families to connect with community support services through information and referral to on-base, off-base, local, state and federal services before, during, and after a permanent change of station.”

CMS to use high-tech fraud analytics The U.S. Centers for Medicare and Medicaid Services will be getting high-tech software in their ongoing fight against healthcare fraud, HHS Secretary Kathleen Sebelius and Attorney General Eric Holder announced at the fourth national Medicare/Medicaid fraud summit, held in Boston this month. The software will comb existing public data sources to isolate and counteract suspect individuals and billing patterns before losses are incurred and suspects flee.

ER overcrowding growing problem One possible side effect of healthcare reform that supporters wouldn’t want you to know about is overcrowding at America’s hospital emergency rooms. A growing problem since overcrowding record-keeping began in 2002, the 19 million new people projected by the nonpartisan Congressional Budget Office to be on Medicaid by 2019 thanks to the Affordable Care Act are feared by most ER administrators as creating even more ER chaos, backlog and even what is called bypass by the industry. Bypass refers to full ERs that must turn ambulances away. A current example is the University of Chicago Medical Center on the Windy City’s South Side, which turns away ambulances more often than any other ER in Illinois—for 13 minutes each hour, on average. There are more than 120 million ER visits nationwide each year.

Hamaspik in the Air Force?!

Let’s Move Faith and Communities Launched

The U.S. Air Force’s Exceptional Family Member Program (EFMP), which assists special-needs family members of career airmen, has now put full-time EFMP family support coordinators on the 35 global USAF bases

First Lady Michelle Obama rolled out the faith- and community-organization-based wing of her signature Let’s Move program in early December, seeking their contributions in reducing local childhood obesity.

Feb. ‘11 | Hamaspik Gazette

Gov’t quietly going natural Two hundred and 50 million isn’t a lot of money if you’re Uncle Sam. But that’s the amount of cash forked over in the last decade to research whether traditional herbs and other plant-based health products actually work. (There’s even a Botanical Research Centers Program at the U.S. National Institutes of Health—bet you didn’t know that!)

Whooping cough hits vaccinated kids A Dec. 4 Tribune-Star (Indiana) article reports on four kids in one family under the age of eight who contracted less-than-fullblown but serious cases of pertussis, or whooping cough, even though only one was not vaccinated. (Two others were partially vaccinated and a third completely vaccinated.) “We do see cases of kids appropriately vaccinated who still get the disease,” state epidemiologist Angie Cierzniewski told the paper. A mild pertussis epidemic is still raging across the country, hitting California the hardest.

Quake-wracked Haiti now reeling from cholera Bad news continues to emerge from Haiti, where inept U.N. relief efforts are hardly helping quake victims, much less victims of the still-spreading cholera epidemic. For starters, a mass cholera vaccination of Haiti’s nine million citizens and their ten million Dominican Republic neighbors wouldn’t happen until spring 2011, say experts with the Pan American Health Organization, a U.N. subdivision. Haiti’s first-ever cholera epidemic, which broke out in October of 2010, has so far sickened over 100,000 Haitians, killed more than 2,000 and has begun to spread to the Dominican Republic, which has closed its borders to Haiti.

Hamaspik NHTD replicates federal success Gazette readers are familiar with Hamaspik’s successful NHTD (Nursing Home Transition/Diversion) Program, a state initiative that keeps qualifying consumers in their homes, or help them resettle back there. But a similar federal program has quietly been helping over 23,000 people at 166 locations in 29 states since the 1980s: PACE, or the Program for All-inclusive Care for the Elderly.

EPA takes saccharine off hazardous list The U.S. Environmental Protection Agency removed the common artificial sweetener saccharine from its list of hazardous substances in mid-December. Saccharin had been labeled a potentially cancer-causing substance in the 1980s.

Baltimore bans caffeinated alcoholic drinks Baltimore has barred the sale of caffeinelaced alcoholic drinks on pain of a $1,000 fine for each violation. Several tragedies have been linked to the products, which typically equal four cans of caffeinated soda and four to five cans of beer in one serving. In related news, Massachusetts banned baby bottles and sipping cups containing the chemical Bisphenol A (BPA), citing possible health risks.

So, What’s Happening in Your Health Today...? Close-knit communities healthiest

“Distracted eating” stokes hunger

A study proves what traditional cultures have known for millennia: The closer family, friends and regular venues are by foot, the happier and healthier you’ll be. (Applied Research in Quality of Life.)

Eating lunch at your desk? You’ll probably end up hungrier and eating more later because of the distracted meal. (American Journal of Clinical Nutrition, Dec. 8, 2010.)

Story Time for NICU newborns Staff at Montreal Children’s Hospital neonatal intensive care unit (NICU) had parents read to their critically ill babies—with close to 70 percent reporting feeling closer to their kids and more in control. “Reading should become an essential tool in NICUs and follow-up clinics,” said researcher Jan Lariviere. (McGill University Health Center, news release, Dec. 14, 2010.)

Surgeon creates fingers for toddlers Using metal lengthening devices, skin and bone grafts, and muscle and tendon attachments, groundbreaking orthopedic surgeon Dr. William Seitz of the Cleveland Clinic has been creating functioning new fingers for children born without them, according to an ABC News special report.

New CF drug helps lungs Denufosol, an experimental cystic fibrosis drug, appears to delay the progression of the chronic disease in children who have normal to mildly impaired lung function, according to a new study. Denufosol works by inhibiting the body’s sodium absorption that causes CF’s lung mucus; a study showed a 2 percent lung-function improvement in CF kids taking the drug. (American Journal of Respiratory and Critical Care Medicine.)

PTSD update: Crohn’s, insomnia, pills A study of nearly 600 adult Crohn’s disease patients found that 19 percent also had post-traumatic stress disorder (PTSD) at the study’s start—and that PTSD patients were 13 times likelier to suffer worsening Crohn’s symptoms. (Frontline Gastroenterology, Dec. 2, 2010.) In related news, PTSD researchers found that people kept awake at night after seeing disturbing images did not develop fearbased memories (Biological Psychiatry news release, Dec. 7, 2010). The same journal also contained a Northwestern University study indicating that medication can prevent exaggerated fear responses in mice very similar to PTSD in people, possibly paving the way for a future “PTSD pill” administered immediately after the traumatic event. The syndrome is current best treated as close to the incident as possible.

Big Brother takes on TBI Your house is watching your every move. Sounds Orwellian? Not if you’re a traumatic-braininjury-stricken soldier living in the Veterans Affairs’ futuristic Smart Home recovery residence in Tampa, Florida. The $3 million project uses dozens of sensors throughout five apartments to track the exact location and movement of up to ten recovering TBI soldiers at a time, and a system of live video prompts to help patients re-learn basic life skills like doing the laundry or emptying the trash.

group developed melanoma, the deadliest skin cancer, only 11 members of the “sunscreen group” did. Also, only three people in the daily sunscreen group developed an invasive melanoma (the hardest-to-treat form of melanoma) compared to 11 in the control group. (Journal of Oncology, Dec. 6, 2010.)

Farms, cats help kids avoid skin disease If you were wondering, now it’s official: Kids whose expectant mothers lived on farms and around cats are less likely to develop atopic dermatitis before age two. (Journal of Allergy & Clinical Immunology, news release, Dec. 2, 2010.)

Milk not a heart risk Three glasses of milk per day may lead to an 18 percent decreased risk of cardiovascular disease, found U.S. and Dutch researchers scrutinizing numerous previous studies.

Frailty: Too much Vitamin D?

Smoking update: Long-term effects

Too little Vitamin D, a nutrient that boosts the immune system and counteracts frailty, is bad for you. But a study in the Journal of Clinical Endocrinology & Metabolism shows that older women taking more than 30 nanograms per millileter—in plain English, too much—were also likelier to be frail.

If you’re a smoker or you live in a smoker’s household, things are just, well, going up in smoke: A slew of smoking-related health news filled headlines this month, and little of it good: A British study at University College London found that children with the most exposure to secondhand smoke scored lowest on a mental-health exam, particularly for hyperactivity and conduct disorder. A study in PloS Medicine found that kids exposed to second-hand smoke were twice as likely unexposed kids as to get serious invasive meningococcal disease infections. S. Diego State University researchers found that “third-hand smoke” tobacco toxins in dust, carpet and other contents of homes previously lived in by smokers—even after cleaning, repainting and months of vacancy—raised body nicotine levels in homes’ new residents. Pennsylvania State College of Medicine researchers found that menthol cigarettes—the cooling-sensation cigarettes favored by teen and black smokers—may be harder to quit because they may create higher levels of carbon monoxide, nicotine and cotinine than regular cigarettes. But if you’re a newly-former smoker, there’s some good news too: A study in Plos Medicine found that by two years after Massachusetts began providing free “quit kits” to smokers on Medicaid, 46 percent less were hospitalized for heart attacks. A German study in Science Translational Medicine has found that inhibiting the gene FGFR1 may be a new possible way to treat squamous cell lung cancer. And even the U.S. Dept. of Defense is getting in on the act, asking all active-duty and retired smokers to include quitting in their New Year’s resolutions.

Cancer-med caution A Canadian study of 12 new cancer drugs found that five of them produced serious or even life-threatening side effects within four years after FDA approval. (Journal of Clinical Oncology.)

Low serotonin possible key to SIDS Researchers of Sudden Infant Death Syndrome, or SIDS, which inexplicably kills over 2,200 U.S. infants (most between two and four months of age) each year, have found that babies who die of SIDS have lower levels of serotonin, a biochemical linked to the body’s sleep cycle. Lack of serotonin is now suspected to hamper a sleeping baby’s ability to wake up when its safety is threatened by lack of oxygen or other health hazard. The syndrome is best prevented with the “ABC” method: leaving the baby Alone on the Back in a Crib. In related news, UC S. Diego researchers found that more babies die of SIDS on New Year’s Day than on any other day of the year.

Daily sunscreen actually works After following 1,600 adults for ten years—half of which had applied sunscreen daily to the head, neck, hands and arms for five years and the other half whenever they wanted—Australian researchers found that while 22 people in the control

Cell phones cause ADHD? That’s what it seems, one study has found but not proven. Of almost 29,000 kids studied, those exposed both before and after birth to cell phones were 50 percent more likely to display behavior problems by age seven. (Journal of Epidemiology and Community Health, Dec. 6, 2010.)

Alzheimer’s update: exercise, diet Lack of nitric oxide in bloodvessel linings has long been linked with cardiovascular-disease risk. In turn, cardiovascular-risk factors have long been linked with Alzheimer’s risk. Now a study has linked low nitric oxide—and lack of exercise—with Alzheimer’s. Using mice, researchers found that lowered nitric-oxide production raised APP production. Amyloid precursor proteins, or APPs, are the building blocks of plaques, the disruptive clumps of beta-amyloid protein in the brain that are one of Alzheimer’s two known causes. But because exercise stimulates nitric-oxide production, the study may also explain previous studies linking regular exercise and lower Alzheimer’s risk in seniors. (Circulation Research: Journal of the American Heart Association.) In related news, NIH Alzheimer’s researchers found that the problem with protein in Alzheimer’s patients’ brains is not build-up but lack of removal; healthy brains constantly add and flush out proteins to maintain healthy levels, a process apparently impaired in Alzheimer’s. Other new research (Nature, Nov. 28, 2010) indicates that freefloating (not plaque-forming) proteins also cause Alzheimer’s symptoms. The proteins bind to and break down certain molecules that regulate the brain’s NMDA receptors, which help form memories. Additionally, a study has associated higher levels of “good” HDL cholesterol with lower levels of Alzheimer’s risk. (Archives of Neurology, Dec. 2010.)

For better outcome, take one pharmacist A review of 298 previous studies has found that patients have better outcomes when pharmacists are part of patient-care teams—leading to better diabetes control, lower blood pressure, lower cholesterol, and a nearly 50-percent decrease in adverse drug reactions, fewer medication errors, improved patient compliance with drug regimens, and higher overall quality of life scores. (Medical Care, news release, Nov. 29, 2010.)

Europe too fat A new report states that half the adults in the 27-nation European

Union are overweight or obese. (Health at a Glance: Europe 2010.)

OTC: Oh, the confusion?! Can’t figure out how much overthe-counter (OTC) cough syrup to give your kid? Neither can 50 percent of parents out there, according to researchers looking at 200 liquid OTC products for kids under 12— finding that dosing directions on most bottles didn’t match markings on included dosing cups or spoons, including unnecessary or missing markings. (JAMA, Dec. 15, 2010.)

Marriage: Good for men, life A Michigan State University study followed around 300 pairs of male identical twins from ages 17 through 29, finding that married twins had fewer antisocial behaviors after getting married than their unmarried identical twin brothers. The study reinforces another recent study associating marriage with a 35 percent reduction in crime. Other marriage studies have found that married people tend to be healthier than singles, live longer, be less depressed, and suffer less from heart disease and stroke. (Archives of General Psychiatry, Dec. 2010.)

Snoring may be bad for your heart A study has linked snoring with metabolic syndrome, a condition caused by any three of the following: high blood pressure, high blood sugar, low “good” cholesterol, high triglycerides and excess belly fat. Metabolic syndrome is a risk factor for heart disease. At the end of a three-year study of over 800 people, University of Pittsburgh researchers found that loud snorers had developed metabolic syndrome twice as much as non-snorers.

Army “nutritionizes” training diet In what may be its biggest change in decades, the U.S. Army will now be including healthy eating in its basic-training regimen, with drill sergeants to yell at recruits for poor protein intake as much as for poor push-up performance. The change, currently being implemented at Missouri’s Ft. Leonard Wood and a handful of other training centers nationwide, aims to not just turn out healthier soldiers in what is being called the “soldier athlete” initiative, but ultimately correct widespread civilian ignorance on proper eating and diet.

Pesticides may damage brain Career agricultural workers in France exposed to pesticides did worse on the MMSE (Mini Mental State Exam) at the end of a six-year study than did unexposed co-workers. (BMJ journals, news release, Dec. 1, 2010.)

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A Mishnah Milestone For Hamaspik consumers, scholarly achievement symbolizes integration The hall was full. The tables were set. The guests were excited. The energy was in the air. But this was no wedding or Bar Mitzvah. This was the Mishnah siyum, or completion ceremony, for the young men of the Hamaspik of Orange County Day Hab program. They had studied hard. They had mastered a tractate of the Jewish-law compendium. They had earned their triumph. And they were going to celebrate. Seated at the room’s head dais like visiting royalty, the group of consumers could feel the respect for their achievement radiating from the guests before them. Scholarship is deeply venerated in the Orthodox community, rightfully equated with status and encouraged at every turn. For well over the next hour, then, the gentlemen took in several

laudatory speeches and collected framed certificates of completion along with elegant gifts marking the milestone. Community integration is one of the Day Hab program’s desired outcomes, and as far as the consumers being feted were concerned, they had arrived at their community’s highest plateau.

A regal setting Though formalities were officially scheduled to begin at 12:30 p.m. the actual even began several hours earlier that November 28th day, as Day Hab staffers-turnedchefs, under the leadership of Direct Care Worker David Rosenfeld, took over the state-of-the-art kitchen at Hamaspik of Orange County’s Day Hab/Admin Building to put together a feast fit for a king.

Setting the stage: A banquet awaits a community

As a matter of fact, “we started a week before,” notes Direct Care Worker Hershey Lowy, who points out that the event’s signage and banners required efforts that took several days. Fresh challah loaves, crisp diced salad, oven-warm chocolate cakes and tender breaded schnitzel slowly appeared on the kitchen’s ample workstations, all under the watchful eye of Kiryas Joel’s kosher supervisors. It was, after all, an occasion fit for a feast. Guests in the form of parents, community activists and members, and Hamaspik staff began slowly trickling in at 12:30 p.m., gradually filling the elegantly set tables covered with tablecloths emblazoned with the iconic Hamaspik emblem. At the head of the room was positioned a dais, a long table intersected by a podium, with seating for about ten men. Those chairs would soon be filled by consumers, Hamaspik staff and special guests. On the wall above and behind the dais hung a huge banner heralding the special occasion. By 1:00 p.m., the tables were full, with chairs occupied with beaming parents and Direct Care Workers alike. The consumers, who had arrived only moments earlier, had taken their seats of honor at the front of the room. The first course was served. And the event began.

Integration’s the theme Emcee Mendel Rosenfeld, Hamaspik of Orange County’s Family Care Liaison, took the stand to formally welcome attendees. After his brief remarks, longtime Direct Care Worker Mr. Lipa Freund, who had led the team of DCWs in teaching their charges the completed material over many months of daily study, rose to share a few words. In his heartfelt remarks, Mr. Freund talked about the remarkable strides made by the consumers in comprehending and internalizing the tractate of Sukkah (pronounced SOO-kaw), which delineates the laws of building the religious huts used during the fall-time Sukkos holiday. Mr. Freund pointed out that the consumers were not the only ones who grew, but that their Direct Care Workers, serving as instructors, also redefined their personal limits thanks to the regular study sessions. The siyum’s main course was then brought out. The venerated Rabbi Shlomo Rubin, the spiritual leader of Monroe’s Cheshniyov bais hamedrish (study hall), was the siyum’s guest of honor. Rabbi Rubin’s inspirational keynote address, directed primarily to parents and Direct Care Workers, dwelt on the theme of actualizing potential.

Healthcare Reform Continued from Page 1 ing unfavorable views of health reform dropped to 40 percent in December, the lowest since the passage of the law.

Full repeal unlikely Given the difficulty of changing even small features of the Act—witness the failed attempted by Sen. Mike Johanns (R-Neb.) to repeal and replace the bill’s tedious businesspurchases tax form provision, which would have required 1099s sent in every time a company spent over $600—a full repeal of the entire bill is unlikely.

Graduation the 50 million currently uninsured Americans similarly affect the national economy, while opponents point out that, unlike Wickard, the healthcare bill regulates inaction, a premise more difficult to legally defend. Bottom line? The likeliest scenario is that the bill is at least partially implemented by 2014—with one if not several legal challenges winding up before the Supreme Court in the interim.

All in a day’s work: A Direct Care Worker serves

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What the future may hold If any legal challenge centered on the Individual Mandate ends up before the Supreme Court, a key verdict sure to figure in any future decision is the 1942 Wickard v. Filburn decision, which found that farmers growing too much wheat for their own chickens were subject to federal regulation under the Commerce Clause—because the resulting nonpurchase of outside wheat affected the national market price of wheat. Defenders of the bill argue that

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Hamaspik Executive Director Meyer Wertheimer then spoke briefly. Mr. Wertheimer’s comments centered on the topic of integration, noting that the event demonstrated that a siyum is hardly limited to mainstream yeshivos—that even individuals with special needs can study and achieve, as did the consumers at hand. The Executive Director also noted the significance of the event’s date, falling as it did on the same day that the Satmarer Rebbe, Grand Rabbi Joel Teitelbaum, of righteous memory (1887-1979), safely arrived in Switzerland in 1945 after a long flight from the Nazis—a day celebrated in the Satmar Chasidic community each year. Mr. Wertheimer connected the young men’s accomplishment with the village in which it was accomplished—namely, Kiryas Joel—noting that the achievement was only made possible by the Rebbe who had founded it in 1974. On top of that, Mr. Wertheimer added, Hamaspik serves as the realization of one of the Rebbe’s unfulfilled lifetime dreams: providing services to individuals with special needs, a dream which Rabbi Teitelbaum discussed as early as 1968. Hamaspik was founded in 1987, eight years after the Rebbe’s passing. Unabashed Hamaspik parent Mr. Chaim Reisman, a Kiryas Joel resident, proud father of a Hamaspik consumer and passionate integration activist, spoke next, emotionally sharing his feelings of pride at the consumers’ accomplishments, particularly those of his son. But the climax of the event, the high point the consumers had all been waiting for, was yet to come.

President

Executive Director

Editor

Hershel Weiss

Meyer Wertheimer

Mendy Hecht

Writers and Editors Isaac Schnitzler Joseph Landau

Letters or Address Change? Tel: (845) 356-8400 ex. 212

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Feb. ‘11 | Hamaspik Gazette

Bringing the excitement to a peak, Mr. Wertheimer announced that the certificates of achievement, and accompanying gifts, would now be distributed. With the poignant formality of a college graduation in the air, Mr. Wertheimer dramatically called out the name of each consumer. One by one, each rose and approached the center of the dais to receive their “diplomas”—the aforementioned framed certificates bearing their names and their accomplishments. Rabbi Cheskel Glickman, the respected dean of Kiryas Joel’s Rodchitzer Yeshivah, joined Mr. Wertheimer at the dais, glowing as he handed each student his record of achievement. As each posed for pictures, the crowd of proud fathers, family members and Hamaspik employees vibrantly cheered. A four-man live band then burst into cheery song, with the entire crowd converging on the consumers to join them in exultant dance. It was their day in the limelight, and the dancing put the finishing touches to an unspoken message delivered throughout the event: Welcome home.