Care for All When It s Needed, and Where

Hamaspik Gazette December 2005. •Issue Issue Sept. 2010 No.No. 75 24 News of Hamaspik Agencies and General Health Care for All When It’s Needed, and...
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Hamaspik Gazette December 2005. •Issue Issue Sept. 2010 No.No. 75 24

News of Hamaspik Agencies and General Health

Care for All When It’s Needed, and Where Hamaspik Home Care now available to Medicaid, Medicare recipients; Fidelis’ Social and Environmental Supports program also added Going home is terrifying. But we’re not talking about the daily return commute, or coming back from a business trip or vacation. We’re talking about leaving the hospital after a brush with serious illness—one that can leave one feeling less enabled and less in command than ever before. That’s why Hamaspik and other Licensed Home Care Services Agencies, or LHCSAs, exist—to provide the widest possible range of therapeutic services once one gets back home to make one’s life as livable as possible. Whether young or old, or victims of accident or disease, patients can be reduced to overwhelming vulnerability and fragility—cautionary real-life tales that one dare not take for granted good health—or all of life’s blessings, for that matter. But with LHCSA services— Home Care for short—recipients can be divested of discomfort and restored to dignity, and right in the comfort of their own homes.

Home therapeutic home Hamaspik’s unflagging efforts to build upon its “Center for Human

Services” namesake have yet again borne fruit. This time, however, that growth is two-fold: its young Home Care

program is now available to Orange and Rockland County New York Medicaid and Medicare recipients— and the agency is providing the new

Where the Home Care is: Hamaspik reinforces the bastion of reassurance anew

Giving an Agency a Good Name OMRDD officially becomes OPWDD; Paterson signs “R-word” ban into law On July 13, 2010, the historymaking OMRDD made history again, as its name was officially changed from the Office of Mental Retardation and Developmental Disabilities to the OPWDD, or Office for People With Developmental Disabilities.

The official change was just part of a watershed bill signed into law that day by New York Governor David Paterson. The bill strikes the increasingly distasteful “R-word,” long considered hurtful and insulting to individuals with special needs and their families, from all official New

York State documentation (excluding clinical references). In an upbeat letter dispatched to New York’s special-needs community that very same day, outgoing OPWDD Commissioner Diana Jones Ritter celebrated: “It’s official!” The name change comes on the heels of months of activism on the part of public servants and private citizens alike. The Empire State’s change is itself backed by years of grassroots national progress in eliminating and replacing all

forms of the word “retardation” in public life. In New York State, a significant part of that shift came in 2007, when Albany passed the People First language law that required statutory language to emphasize the individual, not his or her disability. A brief review of special-needs history actually reveals close to a century of progress. A number of words today considered universally derogato-

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Social and Environmental Supports long-term care program from regional health care giant Fidelis too. A few months ago, Fidelis partnered with Hamaspik’s then-brandnew Home Care initiative to deliver its bevy of home-based services to the agency’s wide-ranging, evergrowing client base in the greater Hudson Valley region. Said services include case management, nutrition therapy, occupational therapy, physical therapy, speech therapy, feeding therapy, home health aides, personal care aides, nursing care visits and socialwork sessions—all custom-tailored to each consumer’s individual circumstances with Hamaspik’s trademark touch. Medicaid and Medicare recipients, however, could be forgiven for feeling a bit left out. Until now. With the new development, beneficiaries of those integral publiclyfunded health care programs can

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I N S I D E * Rockland County keeps up Hamaspik PACE — E2

* ObamaCare, in Plain English — E2

* Public Health and Policy — E8, E9

* What’s Happening In Your Health — E12

Hamaspik’s PACE Program Poised to Expand Pioneering program secures new five-year contract with Rockland County; County’s new voice recognition system in use Hamaspik’s PACE program is currently on the cusp of its newest expansion. The trailblazing Personal Assistant Consumer Empowerment program is Hamaspik’s version of the New York State ConsumerDirected Personal Assistance Program, or CDPAP, which provides assistants to home-based individuals with chronic health needs. Hamaspik has maintained a CDPAP provider contract with the Rockland County Department of Social Services for quite a few years now. The renewal, which authorizes Hamaspik to purvey the PACE program for the next half-decade, affirms Hamaspik’s track record of quality service delivery. The decision was based on Hamaspik’s leading position of service to Rockland County’s diverse demographics, which includes several ethnicities, a large immigrant community and numerous young and growing families. Hamaspik was among the county’s first voluntary agencies to convey the county’s CDPAP program to consumers, and remains the largest. The popular community-based

program allows seniors, children with special needs and worthy others in need of all-around help in the house to not just benefit from a much-needed personal assistant, but to find and retain the caring, responsible individual who works best with them. Hamaspik handles all the paperwork, leaving consumers with nothing but results and satisfaction. The PACE program has grown beyond all expectations since its launch eight years ago, having served and/or employed hundreds to date.

tant, is anything but an impersonal orderly begrudgingly working a day job—wedding the County’s socialjustice imperative to Hamaspik’s trademark humanity, the Hamaspik PACE program puts a friendly personality and a genuinely caring heart in every home it serves. Because of the program’s wideranging scope—personal assistants may be called upon to assist with anything from personal hygiene and

Keeping pace at PACE As long as serious health problems are duly established, infants, great-greatgrandfathers and anyone between who receives Medicaid, or who resides in Rockland County, may benefit from Hamaspik’s PACE program under the auspices of the Rockland County Department of Social Services. The program’s central feature, the personal assis-

Up to speed: The Hamaspik PACE

non-professional medical care to short shopping trips and constitutional walks outside the house—the Department of Social Services maintains rigorous oversight of the personal assistants under its command. And to eliminate paperwork and maximize efficiency to the extent possible, the Department will be shortly implementing a new hightech voice-recognition system that will gradually do away with the old paper-based sign-in and signout systems for all CDPAP staffers under its purview. Instead of engaging in tedious manual recordings of times of arrival and departure at their assigned residences of service—a procedure highly susceptible to human error and hence billing discrepancies—personal assistants will now simply call in when they start and finish their shifts. A sophisticated voice-recognition software system will identify their unique voice profiles, virtually eradicating punch-in and punch-out office errors—or, worse, fraud or abuse.

In another first for Hamaspik, the agency will be among the County’s first voluntary agencies to be using the new voice-recognition system.

Dignity for all For Hamaspik’s part, the PACE program is just one facet of the organization’s fastest-growing wing— Home Care. The multi-faceted Home Care initiative, which comprises a Licensed Home Care Services Agency (LHCSA) and the state’s Nursing Home Transition/Diversion (NHTD) program, and, as mentioned, PACE, strives to meet the home-based quality-of-life needs of as many deserving consumers as possible. Unlike many other Home Care programs, however, Hamaspik’s PACE program takes full advantage of the CDPAP’s permitting of close relatives (excluding parents, children or siblings) to act as personal assistants. For those Hamaspik’s constituents in which sprawling, multigenerational families are the blessed norm, this provision allows grandchildren and even great-grandchildren to simultaneously honor their elders and maintain a respectable form of employment. For more information about the PACE program, please call Central Intake at 845-503-0200.

How ObamaCare Affects You, in Plain English A review of where health-care reform stands now—and what will happen soonest A lot has happened in the four months since the Chief Executive stepped into a White House chamber to intone, “I’m doing this for my mother,” then sign a law that would, among other changes, kill the lifetime coverage limits that allegedly consigned Ann Dunham to death. Among other things, a federal lawsuit has been joined by quite a few states, checks have been mailed, private health insurers have been quietly jockeying for compliance— and employers and employees alike are still trying to figure the whole thing out. At the same time, much of the fog has cleared. Here, the Gazette reviews the big news so far with the Patient Protection and Affordable Care Act, otherwise known—reverentially to some, snidely to others—as simply “ObamaCare.”

New health insurance laws for new plans Getting a new insurance plan? Good for you—all new health insurance plans purchased after September 23, 2010 must abide by the following rules: • 100% coverage by insurers on any form of preventative care doctor visits like certain cancer screenings, cholesterol blood tests and recom-

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mended immunizations—no copays, co-insurance, cost sharing or any payments by consumers • No raising of premiums past certain levels • Coverage of dependent family members up to age 26 An under-the-radar Act fact is that the new age-26 requirement, and the rest of the Act, for that matter, does not apply to the military’s TRICARE health insurance system—cutting 9.6 million militaryfamily members out of health reform.

Grandfathered plans This is where there is huge industry and political debate over the Act. If you already had the insurance before March 23, 2010, the day the Act was signed, your insurance plan does not have to adhere to the above rules. This is because existing plans are grandfathered (pre-existing). However, as soon as those same grandfathered plans make certain changes, they are no longer considered grandfathered and are legally the same as new plans—and then the new rules do apply. Much of the quiet riot in Capitol Hill’s halls of power and behind closed doors has revolved around

Sept. ‘10 | Hamaspik Gazette

what changes void plans’ grandfathered status. The private insurance industry, and much of the private sector, continues to argue that plans make changes all the time—and that these normal changes should not force them to comply. Their argument is that the new rules make them cover more and thus pay for more, which hurts their profits and makes it harder for them to stay in business. Indeed, a report in Time noted that “by the Obama administration’s own estimates, 39 to 69 percent of employer plans will have voided their grandfathered status by 2013.” The Obama administration, on the other hand, is pushing for the highest-possible quality and quantity of coverage as part of its overarching mission of social justice.

The Individual Mandate: the law to have health insurance The “Individual Mandate” of the Act, at the center of the lawsuit against it by over 20 states, mandates that all U.S. citizens have health-care coverage starting in 2014—or face the shared responsibility penalty, a new tax that is either 1 percent of income or a $95 flat one-time payment. The penalty will

slide up to 6.5 percent of income over the next several years. Interestingly, President Obama opposed the individual mandate concept during his 2008 campaign. He apparently changed his mind because making everyone have insurance would—at least on paper—allow insurance companies to make more money and thus not have to raise premiums because they’re earning less money from their fewer customers.

The Pre-Existing Condition Insurance Plan By 2014, the Act will bar all private insurance companies from refusing coverage to people with pre-existing conditions altogether. In the meantime, a flagship immediate change was officially rolled out on Thursday, August 1, 2010, with applications being accepted in 21 states for the PreExisting Condition Insurance Plan—which, in plain English, is a new government health insurance plan that covers people who are sick or have medical problems before they get insurance. About $5 billion was allocated by the bill to be used by all 50 states and the District of Columbia. These monies are for states either to create their own Pre-

Existing Condition Insurance Plan or let the HHS set up and run one. Its drawback is that the funding could be exhausted by 2011 or 2012 and only will cover up to 400,000 individuals nationwide, or 10 percent of those denied by private insurers due to pre-existing conditions. Twentyone states have elected to have HHS run their plans; 29 states and D.C. have chosen to do it alone

The Early Retiree Reinsurance Program The Act includes the Early Retiree Reinsurance Program (ERRP), which provides $5 billion for reimbursements to employers to allow their retired workers 55 and up, and their families, to retain private insurance plans through their jobs until they qualify for Medicare at age 65. The ERRP began accepting employer reimbursement applications in early July. Reimbursements will be available for 80 percent of medical claims costs for health benefits between $15,000 and $90,000. Program participants will be able to submit claims for medical care going back to June 1, 2010.

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Enhancing Integration Hamaspik of Rockland County expands Early Intervention program Ask any special education specialist or child therapist nowadays what the overarching mission of their specialties is, and you’re most likely to hear one word: “integration.” Whether it’s physical therapy, speech therapy, occupational therapy or even feeding therapy, the goal of modern intervention services is not just to bring the lagging child up to his or her peers’ level to the extent possible, but also to foster integration—that sense of inclusion and belonging that says, “I’m not any different than anyone else.” That was the spirit behind the Hamaspik of Rockland County Early Intervention Program’s newest improvement: the introduction of several age-appropriate children to its classrooms. Hamaspik’s EI program, currently located on the premises of the Ramapo Freshman Center public school in Ramapo, is now a bustling beehive of activity, as children with minor delays mingle and play with

those with more serious challenges—serving as role models that help the more involved children integrate. With the expanded programming, the Early Intervention program complemented the existing efforts of professional therapist Mrs. Reizy Weichbrod by hiring teacher’s aide Mrs. Bracha Deutsch, an expe-

rienced teacher also fluent in three languages. Hamaspik’s community-oriented, multilingual staffers are one of the reasons for Hamaspik’s considerable success over the years. In Rockland County, for example, community members whose children are deemed qualified for therapy services by the East Ramapo School

District can get occupational therapy (OT), physical therapy (PT), speech therapy, play therapy or family training from a number of Hamaspik’s professional therapists. The expanded new program, only in existence since July 5, is already seeing positive results. “The goal here is to provide a setting where children with special

The environment to succeed: Hamaspik EI’s fully-equipped classroom

needs can learn how to interact in an age-appropriate peer group while facilitating their advancement into a least restrictive or mainstream setting,” says EI Director Mrs. Lalouch, commenting on the benefits conferred to both levels of attending students. “We want our students to be around other kids who can act as socially appropriate role models for them to learn how to participate in a group and contribute in a group setting,” she says of children with significant delays. As for the more advanced students, “they are receiving the same educational instruction” they would get in a mainstream school, continues Mrs. Lalouch, only here “in a smaller setting where they have access to a colorful array of toys and equipment specifically geared toward helping any child attain their ultimate highest level of success.” For both groups of students, it’s a win-win situation. But for the significantly-delayed students, the Hamaspik of Rockland County Early Intervention Program is not just a solution for a developmental program, but, most importantly, a thriving, therapeutic model of social integration too.

Hamaspik Beats the Heat Agency IRA residences keep their cool amid record temperatures What’s the hottest city in the United States? You’d probably guess Phoenix, Arizona or other such population center in America’s arid Southwest. But if you were on the East Coast for the post-July 4th week, you’d be forgiven for calling New York “the Baked Apple.” Like other Atlantic Seaboard cities, the Big Apple was veritably

broiled in sustained temperatures topping 100 degrees Fahrenheit during that record-breaking heat wave. Downtown Manhattan recorded a sidewalk-searing 103 on Tuesday, July 7, while historic Williamsburg, Virginia measured the mercury at a flaming 106 degrees. But if you were a Hamaspik residential consumer, you were one cool customer throughout the wave

OPWDD Advisory Panel Recruits Hamaspik Founder Hamaspik founder and Executive Director Meyer Wertheimer was recently appointed to join the Hudson Valley DDSO’s Advisory Panel. Each New York State DDSO region now maintains an Advisory Panel, created by the state OPWDD several months ago, to serve as a Community of Practice, or COP. The Community of Practice groups advise each DDSO’s Division of Quality Management on ideas for new individualized services, rating and improving existing services, and streamlining OPWDD’s quality management.

On July 19th, Mr. Wertheimer visited the Hudson Valley DDSO’s offices in Thiells, New York to attend the OPWDD’s statewide live DQM webinar attended virtually by all statewide Community of Practice panels. The Advisory Panels consist of regional “stakeholders:” DDSO leaders, provider agency representatives, disability advocates, consumers and other industry community members. Hamaspik is the state’s leading voluntary-agency provider of the OPWDD’s Family Care program.

that sent waves of consumers of another variety rushing into their local A/C retailers. The Hamaspik group home network beat the heat all through that week with an eclectic variety of activities, many (you guessed it!) water-based. While New York City opened 400 cooling stations and turned fire hydrants into neighborhood sprinklers, Hamaspik consumers took to pools both in backyards and at local venues. Residents of the Forshay Briderheim were pleasantly surprised to meet their Wannamaker peers at the Rockland Community College aquatics facility. And on days during the wave when pools were not in the schedule, Forshay consumers enjoyed frolicking in their front and back yards—with the sprinkler system going full blast. “That cooled them down somewhat!” quips Forshay Briderheim Manager Mrs. Sarah Fisher. Several consumers across the Hamaspik network, diagnosed with the sun-sensitive seizure disorder, were kept indoors for obvious health and safety reasons. But staying under shady, cool roofs hardly meant boredom—consumers were kept busy with therapeutic indoor games and activities. At the Acres Briderheim, for example, consumers used their extra heat-beating indoor time to work on their photo albums, putting together

Chilling out: Orange County “Day Habbers” in indoor study visual records of various personal milestones like birthday parties, family reunions and the like. And at the Dinev Inzerheim ICF (which just successfully passed its latest state evaluation—see “Confirming Competence” elsewhere in this issue), the more medically involved consumers were properly sheltered from the sweltering sun. “The main goal was to keep them safe,” says Dinev Home Manager Mrs. Weiss. Chances are that not only were temperature records broken in New York State, but also the record for most air conditioning units purchased within a seven-day period in New York State—a figure that the Wannamaker Briderheim humbly bolstered by the number 1. Asked how his “boys” coped with the giant oven that the summer outdoors had become, Wannamaker Manager Moshe Tamber rattles off the usual activities—running through the sprinklers and water balloon games. “We also bought a new A/C for the kitchen,” he says. What did Wannamaker do in its

cool new kitchen (or is that “newly cool kitchen”)? “We made pizza!” Tamber shares. Consumers of the Seven Springs Shvesterheim, decked out in sunscreen, baseball caps, visors and other protective gear, hit an Orange County lake for a short but enjoyable round of paddle boating before retreating to cooler conditions. And down in Brooklyn, whose storied brownstones were veritably baked in the week-long heat wave, South 9th Shvesterheim consumers found themselves suddenly enjoying activities they otherwise would not have had. These included splashing around the backyard kiddie pool, visiting their local library as part of their recently-expanded literacy program, and a short excursion to their nearest J.C. Penney department store to get their professional photo portraits done. Summing up her group home’s reaction to the historic heat, South 9th Manager Mrs. Cziment aptly captured the entire Hamaspik network’s effective approach: “They were busy… but not hot.”

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A Community Remembers Tom Morahan Albany achiever never lost his grassroots touch Tom Morahan was a busy man, but not too busy for Hamaspik consumer Eliezer Friedrich. The Forshay Briderheim IRA resident and political activist for the disabled called upon his State Senator one fine day a few years ago, visiting his office to discuss issues of concern to him, not to mention the hot topics of the day. As always, Morahan was graciously accommodating. That’s because, in a life of serving his family, his community, and his country, Tom Morahan never forgot his gritty All-American roots. Born and raised in the Bronx to a proud Irish family, the Senator’s conservative values were etched into his ethos early on. Later in the Army, Morahan distinguished himself in the Korean War, patriotically serving his country as it sent its boys to defend another country. “He didn’t care if you were a Democrat, Republican, liberal or conservative,” reminisces Bob Terry,

First Vice President of the New Citybased Korean War Veterans Association of Rockland County, of which the Senator was a member. “He worked for the people, not for the party, and if we had more people like him in our government, national and local, we would be so much better off.” Morahan had lived in Clarkstown with his family since 1963, about a block-and-a-half from Terry. The Korean War veteran recalls an affable, approachable man who was just “Tom” to the neighbors, a regular guy. “He always had time to say hello,” Terry remembers. “I don’t think I ever saw him and he wasn’t smiling. As a matter of fact, I don’t think I ever saw him mad in all the time that I knew him.” “I liked him right away,” remembers longtime public servant Ilan Schoenberger, currently representing Rockland County’s Legislative District 4. Schoenberger recalls how, despite “powerhouses”

In Memoriam

State Senator Thomas Patrick Morahan, 1931-2010 It was with great sorrow that the entire OPWDD community received the news of the passing of State Sen. Thomas Morahan this past Monday, July 12. The Korean War veteran had represented the State Senate’s 38th District, which comprises all of Rockland and part of Orange County, after winning a special election in 1999 to complete the unexpired term of his predecessor, State Sen. Joseph Holland. Senator Morahan launched his career of public service in the 1970s, first serving on Clarkstown’s Zoning Board of Appeals and winning election to the Rockland County Legislature in 1977. He won his first seat in Albany as a State Assemblyman in 1980. He returned to the Rockland County Legislature in 1984, elected as that body’s Chairman in 1996 and staying on until 1999, when he moved on to the State Senate. In the State Senate he earned the respect of Republican and Democratic colleagues alike, quickly winning a name for himself as a tireless champion of what was right regardless of political expediency. His principled stances on numerous issues initially earned him his detractors, but fellow Republicans and opposing Democrats soon came to universally respect the man for his dogged consistency and refusal to toe any party line when it contradicted his beliefs. In over a decade as a State Senator, Morahan emerged as a defender of disabled rights, earning him the coveted Chairmanship of the Senate’s Committee on Mental Health and Developmental Disabilities. His sponsorship of 230 bills included several which helped improve the lives of individuals with disabilities in New York State. These included Timothy’s Law, which requires insurance companies to cover mental-health services, Jonathan’s Law, which put stringent new protections of state-agency consumers in place, and, most recently, the change of OMRDD to OPWDD. In May of 2010, Morahan announced he was not seeking reelection for a 6th term, preferring to focus on battling his recently-diagnosed leukemia. Sadly, after a six-month fight, Senator Morahan succumbed to his terminal illness at New York Presbyterian Weill Cornell Medical Center, with his beloved family at his side. He was 78. It is particularly poignant to note that Senator Morahan passed away the very day before that momentous change, an improvement the Senator had so fiercely championed. Conversely, Governor Paterson’s signing the change into law the very day after his death gives Thomas Morahan a most fitting legacy.

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Sept. ‘10 | Hamaspik Gazette

The people’s office: Sen. Morahan, here with Eliezer Friedrich, made all feel welcome dominating the county’s political dynamics at the time, Morahan was “always a force in government.” “He was a man who clearly commanded respect from those around him,” concurs Rockland County Legislator Alden Wolfe, who first met Morahan in 2006. “If there’s one word that comes to mind when I think about Senator Morahan, it’s that he was a gentleman.” Wolfe highlights Morahan’s strong advocacy for people with disabilities, a fighting stance that the Senator assumed repeatedly in sponsoring and spearheading numerous measures that bettered the lives of New Yorkers with special needs, and the laws that protected them. Among these were the landmark Timothy’s Law, which required insurers to cover mental health, and Jonathan’s Law, which tightened oversight of state-run care facilities. “Timothy’s Law took some heavy lifting in Albany,” notes Wolfe. “When someone takes the time to care for those in need of that special something, it’s commendable. It shows who a person is.” Upon becoming a State Senator, Morahan wasted no time taking an activist approach, diving headfirst into a public-service career that would churn out 231 bills, many of which were oriented towards the special-needs community. Thirteen of these are still pending. “His unique quality was to bring people together,” says Ron Levine, communications director at Morahan’s office, asked what might be the Senator’s legacy. “He was a great team builder.” That team-building ability came especially to the fore when it came to individuals with special needs, a cause particularly close to the Senator’s heart due at least in part to a relative with disabilities. Hamaspik Executive Director

Mr. Meyer Wertheimer recalls seeing the Senator many times at events and occasions involving developmental disabilities. Mr. Wertheimer met him in person for the first time at Morahan’s office, where the public servant provided a letter of robust support for certain Hamaspik services. “Whenever we needed his support or phone calls on our behalf, he would gladly do that,” remembers Mr. Wertheimer, looking back over the years. “He had a special, special touch for these people [with special needs]. He was taken by them.” “There was no need for advocacy to get his assistance for a family or person with special needs,” Mr. Wertheimer adds. With the Senator’s unusually keen compassion, advocates for individuals with special needs needed not engage in any protracted presentation to warrant the Senator’s attention. Recognizing the statesman in their midst, both Democrat and Republican alike repeatedly elected Morahan as the Senate’s Mental Health Committee Chairman, a responsibility he tended to with reverence and results. In the last six months of his life, as leukemia closed in, Terry remembers how the Senator never forgot his responsibilities to his people, calling a local radio station every Wednesday morning to update constituents on Albany goings-on as long as he could, even when he was feeling significantly under the weather. On July 12, Thomas Patrick Morahan passed away. As always, he had fought to the end. Condolences were not long in coming from across the political and special-needs spectrum. “He was a true advocate for the people of Rockland County and shaped our history with his many initiatives and laws,” said

Clarkstown Supervisor Alex Gromack. “In the 30-plus years I had the pleasure of knowing and working with Tom Morahan, he was always a gentleman who was devoted to public service and to helping all people from all walks of life,” said Schoenberger. “I learned a lot from him and I am going to miss him.” “Tom Morahan was an incredibly devoted leader in Rockland who put people above politics, and worked with everyone no matter what their background was,” said Ramapo Town Councilman Daniel Friedman. “His work helped numerous organizations and causes in our community that benefitted the people of Ramapo, and will continue to for a long time.” “We’re really very saddened to lose our champion. Over the last few years, he really has helped move a number of important initiatives,” Harvey Rosenthal, executive director of The New York Association of Psychiatric Rehabilitation Services, told the Hudson Valley Journal. Glenn Liebman, head of the Mental Health Association in New York State, also quoted in the Journal, said Morahan’s death is a great loss. “He was a wonderful advocate for people with psychiatric disabilities and he was a man of great compassion.” Thomas Patrick Morahan, beloved husband, father and grandfather, patriotic American and proud New Yorker, passionate public servant and indomitable friend of people with special needs, is survived by wife Helen, seven daughters and 17 grandchildren. He will be deeply missed. “If it wasn’t right, he’d tell ya. He didn’t beat around the bush,” concludes Terry. “I don’t know who’s going to take his place ... they’re going to have one awful big pair of shoes to fill.”

Confirming Competence At exacting annual review, Hamaspik’s first residential home scores big again Running a residential group home isn’t easy—which is exactly why the New York State OPWDD conducts reviews in the first place: to ensure that every that’s supposed to be done, is being done. After all, when you’re working with children and young adults with special needs, there’s no doing things the easy way. This is especially true for the very involved consumers residing at an Intermediate Care Facility (ICF), who have needs—and protective regulations—of a category all their own. But Hamaspik’s authoritative command of special-needs conventions came under the limelight once again this summer, as OPWDD reviewers meticulously scrutinized the full operations and records-keeping at the Dinev Inzerheim ICF, Hamaspik’s first and oldest statefunded residential facility. Besides finding no violations, reviewers once again encountered a facility in a state of perpetual compliance, not unlike the ‘round-theclock scramble readiness of Cold War-era U.S. air bases. As reviews approach, agencies might find themselves hurtling at a scramble of a different sort. With rigorous legwork put in every day by its team of diligent professionals, however, Dinev greeted the reviewers’ visit with confidence. But the perfect score garnered by the two-day review reflected more than just the professionalism of a single set of staffers. With the 18year-old Dinev being Hamaspik’s very first project, its review-passing adherence set not only its own standards from the get-go, but also those of the entire organization in the ensuing years.

Lawful order As mentioned, ICFs operate at a level considerably more regimented than the standard Individualized Residential Alternative, or IRA. Residential consumers at ICFs often have serious and life-threatening physical or genetic conditions which greatly limit the environments to which they can be exposed. Many also suffer from significant cognitive impairment, or low function in industry parlance, some severely so. As a result, ICF training and staffing is far more exacting and complex. Unlike IRAs or other facilities, ICFs are legally required to meet the protocols of the state’s stringent Life Safety Code. An ICF must have a registered nurse available whenever needed around the clock, a capacity capably filled by Dinev’s very own Mrs. Sussholtz, RN. Numerous (and often redundant, for guaranteed results) safety mechanisms must be

in place, including elaborate automatically-activating fire doors, sprinklers, alarms and even fireresistant carpeting. And staffers must receive special consumer care training in addition to standard skills certification. Detailed daily consumer histories must also be maintained. Scrutinizing an ICF for proper operations is likewise an exercise in methodical, almost microscopic inspection, reviewing each consumer’s record as required. State staffers interview group-home staff, and consumers able to speak, at length, with the goal of eliciting in the course of informal chats mention of any ICF shortcoming. Logs of daily operations, including meal menus and administration of medication are also closely perused.

On the front lines During their two-day visit, reviewers witnessed first-hand how staffers lovingly prepared able-bodied consumers for their day shortly

after they rose in the morning, seeing them off to Hamaspik’s Day Hab program or, as is the case with older consumers, special-education school. With those consumers away, reviewers turned their attention to the books, spending hours examining Dinev’s record-keeping, both of the medical and financial categories. Reviewers also observed staffers greeting residents upon their return home from their daily outings. Said consumers were treated to nutritious, tasty snacks, and, under the OPWDD’s watchful eyes, were later individually served their dinners. Bedtime routines, which for most consumers can be fairly elaborate, were likewise observed, administration of medication included. But above all, reviewers were on hand to see what a well-oiled ICF looks like—a proficient operation where everything is done as it should be done. That kind of operation doesn’t spring into being overnight, however—it takes diligence, devotion and

Where compliance lives: the Dinev Inzerheim, winter 2009 dedication by a team of inspired staff who give it their all day in and day out. That staff includes Home Manager Mrs. Weiss and her team of Direct Care Workers: Mrs. Melamed, Mrs. Rotenberg, Mrs. Rosenberg, Mrs. Freund and Mrs. Friedman. Also contributing to Dinev’s ongoing success is its team of night, weekend and kitchen staff: Mr. and Mrs. Naftali Brach, Mr. and Mrs. Joel Goldberger, Mr. and Mrs. Menachem Levy, Mr. and Mrs. Nesanel Friedman, and Mr. and Mrs. Joel Schnitzer.

Backing them up are professional staff psychologist Ezra Gampel, Ph.D., social worker Mrs. Lustig, and Maintenance Manager Samuel Falkowitz, who keeps the facility in impeccable shape. Overseeing overall operations are venerable ICF Program Director Mrs. Brach, as well as Joel Weiser, Director of Residential Services at Hamaspik of Orange County. For the reviewers and Dinev staff, it was another routine day. But the smiles of contentment and comfort on the faces of the consumers made it worth it all.

Hamaspik Scores Audit Triple-Header Three agency bodies proficiently pass government inspection Besides being part of the greater Hamaspik community, three agency entities now have another thing in common: they all passed state audits within the same six-day period, and superlatively so. The spate of good news began with results from the Concord Briderheim IRA’s most recent state survey coming in this past Wednesday, July 28. That group home review found no deficiencies. Thursday, July 29 followed with a second “home run” in as many days, this at Hamaspik of Rockland County’s Day Habilitation program. Staffers’ diligent professionalism at that Day Hab program, which relatively recently expanded to a second, spacious facility, garnered top marks at their first-ever Day Hab and Day Hab Satellite Survey.

Bringing up the rear of the triumphant trio was the Forshay Briderheim, where the ongoing hard work of managers, Direct Care Workers and staff earned the IRA a flawless report on Tuesday, August 3, including no regulatory deficiencies found and positive good practices and findings recorded. As always, teamwork remains an open secret at Hamaspik. At the Forshay Briderheim, that winning team is: Direct Care staffers Nachman Ciment, Yitzchok Loeffler and Eliezer Tzik, and live-in couple Mr. and Mrs. Ayalon Mauda, captained by the capable Residence Manager Mrs. Fisher. That team’s peers at the Concord Briderheim consists of Direct Care Workers Mr. and Mrs. Joel Schwartz, Mr. and Mrs. Zvi

Weinberger, Mr. and Mrs. Yoel Loeffler, and live-in couple Mr. and Mrs. Sholom Felberbaum, currently also guided by Mrs. Fisher, filling in for Mrs. Goldberger (whom Hamaspik wishes a complete recovery from recent major surgery). Credit goes out as well to the well-oiled machines that are the Hamaspik of Rockland County Day Hab teams. Under the stewardship of Day Hab Manager Pinchas Knopfler, Direct Care Workers Yisroel Abelesz, Eliezer Appel, Chaim Ausch, Chaim Feldman, Leib Frankel, Moshe Fried, Eliezer Gertner, Yoel Moshe Hershkowitz, Shimon Kreisel, Chezky Levy and Mordechai Newhauser tend diligently to their daily duties. Competent counterparts Ms.

Allison, Ms. Halberstam, Ms. Kind, Mrs. Lefkowitz, Ms. Shechter, Mrs. Margereten, Mrs. Meyerowitz, and Mrs. Reisman, led by Day Hab Manager Mrs. Kresch, also underscored the “Care” in “Direct Care Workers,” delivering compassion not as a job but as a calling. Backing up all three teams is authoritative agency psychologist Alan Blau, Ph.D., experienced Registered Nurse Mrs. Werzberger, hardworking Maintenance Managers Israel Katina and Zalman Stein, adept Director of Day Services Zishe Lowy, and energetic Director of Residential Services Shaya Wercberger, providing as they do all necessary leadership and support services to ensure seamless daily operations and loving, therapeutic care. Many things can be said about great teams, including the oft-heard observation that “they make it look easy.” And the contented faces and clean facilities at Hamaspik programs may seem almost given. But behind such scenes of success, each culminating with audit after highscoring audit, lie success-driven staff—and drivingly hard work. While the three audits may communicate top scores, and the great teams producing them, the real winners are the consumers. And the victory is the shared mission of the OPWDD and Hamaspik.

Home compliant home: the Forshay Briderheim IRA

Hamaspik Gazette | Sept. ‘10

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5

In the Know All about… Deafness and Hearing Loss

In dozens of American cities and hundreds of suburbs, citizens have long been plagued by a constant acoustic fog of loud construction, noisy traffic, booming car stereos, shrieking emergency vehicle sirens, thundering low-flying aircraft and even pesky cell phones. But these noises don’t just diminish quality of life—they can also cause long-term hearing loss. At wedding bandstands, where youngsters tend to congregate at live musicians’ feet, Hofstra University audiologist and hearing-loss authority Dr. Levi Reiter, Ph.D. reports sustained levels of 110 decibels or more; OSHA (Occupational Safety and Health and Administration) standards’ maximum legal daily exposure to 110 Db is 30 minutes. (See side bars.) “They stand there for hours,” he laments. Dr. Reiter’s findings for wedding halls’ further reaches, where less musically mesmerized guests take sensory refuge from the pounding sounds, are hardly better. “You know the older guys who sit at the corner tables talking?” the career college educator rhetorically asks. “Over there I got 100, 105 decibels.” With attendance of several weddings a week, often at the same halls and even the same bands, guests are exposing themselves to serious hearing damage unawares, he warns.

But noisy nuptials are just one facet of a major unaddressed chronic health problem facing America and much of developed society: noise pollution, or secondhand noise. An estimated 15 percent of Americans between 20 and 69 have some kind of hearing loss, according to the National Institutes of Health. In this article, the Gazette takes a look at a problem you may have not realized is that common. However, there’s good news too: While there’s much more deafness and hearing loss out there than one would think, so too are there more solutions to existing deafness—and simple preventative strategies—then you’d expect. Here are the basics.

Symptoms Signs and symptoms of hearing loss may include: • Muffled quality of speech and other sounds • Difficulty in understanding words, especially against background noise or in crowds • Frequently asking others to speak slower, clearer and louder • Needing to turn up the volume of electronic devices • Withdrawal from conversations • Avoiding some social settings Symptoms are different for kids. If your child does not yet talk, you

need to look for the following signs of an ear infection, which in turn may indicate a hearing loss problem: • Tugging at ears • Crying more than usual • Ear drainage • Trouble sleeping • Balance difficulties • Hearing problems

Causes Introduction Doctors believe that heredity and chronic exposure to loud noises are the main factors that contribute to hearing loss over time. Other factors, such as earwax blockage, can prevent your ears from conducting sounds as well as they should. One of the most tragic facts about deafness is that most people who have it live with it for years without diagnosing it or even doing anything about it. In plain English, most people with hearing loss don’t know they have hearing loss. How the ear works To understand hearing loss, you must understand how the ear works. Hearing occurs when sound waves reach the structures inside your ear, where their vibrations are converted into nerve signals that your brain recognizes as sound.

Your ear consists of three major areas: the outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum, part of the middle ear. The eardrum and three small bones of the middle ear—the hammer, anvil and stirrup—amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in the cochlea (pronounced COKE-lee-uh), a snailshaped structure in the inner ear. Attached to nerve cells in the cochlea are cilia, thousands of tiny hairs that help convert sound vibrations into electrical signals that are transmitted to your brain. The vibrations of different sounds affect these tiny hairs in different ways, causing the nerve cells to send different signals to your brain. That’s how you distinguish one sound from another. What causes hearing loss For some people, the cause of hearing loss is the result of a gradual buildup of earwax, which blocks the ear canal and prevents conduction of sound waves. Earwax blockage is a cause of hearing loss among people of all ages. For the most part, this is reversible. In most cases, however, hearing loss results from damage to the inner

Deducing and deducting your dose of daily decibels What’s your daily exposure? Compare noises around you to these sounds and their safety levels—and adjust your environment accordingly. COMMON SOUNDS

DECIBEL (Db) LEVELS MAX. DAILY LEGAL EXPOSURE Safe range: comfortable hearing levels are 60 Db and under Whisper 30 n/a Normal conversation 60 n/a Washing machine 70 n/a Risk range: hearing damage begins with 8-hour daily exposure to 85 Db; daily exposure to 100 Db+ for over one minute risks permanent hearing loss City traffic, garbage disposal, hair dryer 80-90 8 hours of 90 decibels Motorcycle 95 4 hours of 95 decibels Loud wedding band 110 1 hour of 105 decibels Injury range: threshold of pain begins around 125 decibels Chain saw 110 to 140 30 minutes of 110 decibels Ambulance siren 120 15 minutes or less of 115 decibels Loud car stereo 145 Adapted from the National Institute on Deafness and Other Communication Disorders, 2008; the National Institute for Occupational Safety and Health, 2009; the Occupational Safety & Health Administration, 2005; and the American Tinnitus Association, 2009

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Sept. ‘10 | Hamaspik Gazette

e a r. Aging and prol o n g e d exposure to loud noise, like noisy careers or hobbies, may cause wear and tear on the hairs or nerve cells in the cochlea. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted as efficiently, and hearing loss occurs. Higher pitched tones may become muffled to you. It may become difficult for you to pick out words against background noise. Heredity may make you more prone to these changes. Some drugs can damage the inner ear. Temporary effects on your hearing—ringing in the ear (tinnitus) or hearing loss—can occur if you take very high doses of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs or loop diuretics. Illnesses that result in high fever, mainly ear infections or meningitis, may also damage the cochlea. Trauma or a ruptured eardrum may also result in loss of hearing. Additionally, abnormal bone growths or tumors of the outer or middle ear can cause hearing loss.

Diagnosis There are two primary types of hearing loss. One happens when your inner ear or auditory nerve is damaged. This type is permanent. The other kind happens when sound waves cannot reach your inner ear. Untreated, hearing problems can get worse. Tests to diagnose hearing

loss may include: General screening tests Your doctor may ask you to cover one ear at a time to see how well you hear words spoken at various volumes and how you respond to other sounds. Tuning fork tests Tuning forks are two-pronged metal instruments that produce sounds when struck. These simple tests can help your doctor detect hearing loss. A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear, damage to sensors or nerves of your inner ear, or damage to both. Audiometer tests During these more-thorough tests conducted by an audiologist, you wear earphones and hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear the sound. Each tone is repeated at faint levels to find out when you can barely hear. The audiologist will also present various words to determine your hearing ability. Upon completion of your diagnosis, the audiologist will provide you with an audiogram—a sort of personal hearing “fingerprint” that reports the exact sound ranges and frequencies, and decibel levels, that have been impaired or lost by your hearing system, if at all. The audiogram will later be critical to the custom fitting and tuning of a hearing aid to your specific hearing loss. Oto-acoustic emissions tests For infants, young children or other patients who otherwise would be unable to cooperate with other hearing tests, or for individuals with serious hearing loss, audiologists will sometimes use the oto-acoustic emissions test. The OAE test uses a painless probe inserted into the ear to cause certain cells to move in certain ways; the probe takes less than a minute to record their movements and obtain a precise, objective review of hearing function.

normally take exactly 1/1,000th of a second to pass to the 8th Nerve and onward; even the tiniest delay will be detected by the ABR test—indicating a brain-stem lesion.

Treatment Wax removal Earwax blockage is a common reversible cause of hearing loss. Your doctor may remove earwax by loosening it with oil and then flushing, scooping or suctioning the softened wax out. Hearing aids If your hearing loss is due to damage to your inner ear, a hearing aid can be helpful by making sounds stronger and easier for you to hear. (See side bar.) An audiologist—a professional who specializes in hearing loss and hearing aids—and can discuss with you the potential benefits of using a hearing aid, recommend a device and fit you with it. Cochlear implants Cochlear implants are for individuals who cannot be helped with standard or even advanced hearing aids. These surgically implanted devices compensate for damaged or nonworking inner-ear parts by bypassing them completely, converting acoustic sounds into electrical pulses that directly stimulate the auditory nerve. Your auditory nerve then signals the brain, which recognizes the signal as sound. An audiologist can complete an evaluation to determine if you are a good candidate for a cochlear implant. If you are, your audiologist will discuss the risks and benefits as well as potential costs with you. Cochlear implant surgery, equipment and follow-up can be expensive. However, notes Dr. Reiter, with hearing aids’ quality today, most hearing-loss patients will not need these implants. He also notes the profound differences between deafborn infants provided with cochlear implants who will never grow up knowing what normal speaking is like, in contrast to individuals who undergo damage later after a lifetime of normal talking and hearing.

Prevention Bone conduction tests The bone conduction test fires painless, harmless vibrations into the skull directly behind the ear and compares results against the more standard ear conduction test. Different results reveal sensory-neural problems and/or the possible presence of a tumor. ABR tests Because audiograms and other tests will not reveal damage to the 8th Nerve, a key nerve connecting your hearing system to the brain, audiologists will use the ABR test. The Auditory Brain-stem Response test uses electrodes pasted to the patient’s head, much like the EEG test, to measure the brain’s relaying of electrical sound signals. Electrical signals from the cochlea

Have your hearing tested Consider regular hearing tests if you work in a noisy environment. Regular testing of your ears can provide early detection of hearing loss. Knowing you’ve lost some hearing means you’re in a position to take steps to prevent further hearing loss. Workplace protection Specially designed earmuffs that resemble earphones can protect your ears by bringing most loud sounds down to an acceptable level. Foam, pre-formed, or custom-molded earplugs made of plastic or rubber also can effectively protect your ears from damaging noise. Avoid recreational risks Weddings can easily be over 100

HOW TO CHOOSE THE RIGHT HEARING AID So you’ve seen your doctor about hearing loss. You’ve even gone to an audiologist. You’ve been diagnosed: You have hearing loss. And now you need a hearing aid—but but you’re worried about how it will look or what people may say. Firstly, hearing-aid technology is advanced enough today to produce tiny device that most people wouldn’t notice in the first place. Secondly, most people will be tactful enough to not say anything in the first place when you start appearing in public wearing a hearing aid. As for those who do, you’re always within your rights to politely tell inquirers, even close family and friends, “I’d rather not talk about it.” Your audiologist will compassionately walk you through all your options as he or she takes an impression of your ear canal, helps you choose the most appropriate hearing aid and adjusts the device to fit and work well. However, be sure that any audiologist you visit is state-licensed and certified by ASHA (the American Speech and Hearing Association) and/or the AAA (American Academy of Audiology).

most visible type of hearing aid, though some new versions are smaller, streamlined and barely visible; and amplifies sound more than other device styles. Half-shell A larger version of the in-the-canal hearing aid, the half-shell is custom molded and fills the lower portion of the bowl-shaped area of your outer ear. This style is appropriate for mild to moderately severe hearing loss. A half-shell hearing aid is a little easier to handle than smaller hearing aids; includes features like directional microphones and volume control; and fits most ears. In the ear (full shell) An in-the-ear (full-shell) hearing aid is custom made and fills most of the bowl-shaped area of your outer ear. This style is helpful for people with mild to severe hearing loss. An in-the-ear hearing aid is more visible; may pick up wind noise; includes features that are easier to adjust; is generally easier to insert into the ear; and uses larger batteries, which typically last longer and are easier to handle.

Hearing aid types

Before you buy

Digital hearing aids Most hearing aids today are digital—analog devices are being phased out. In recent years, hearing aid makers have made great strides in developing digital hearing aids custom-based on audiograms. These are far more effective for high-frequency hearing loss. With digital technology, a tiny computer chip in the hearing aid turns incoming sound into digital code, then analyzes and adjusts the sound based on your hearing loss, listening needs and the level of the sounds around you. The signals are then converted back into sound waves and delivered into your ears. The result is sound that’s more finely tuned to your hearing loss. Digital hearing aids are available in all styles and price ranges. Open fit Open-fit hearing aids are very small behind-the-earstyle devices that have become popular for cases of high-frequency hearing loss. Sound travels from the instrument through a small tube or wire to a tiny dome or speaker in the ear canal. These aids leave the ear canal open, so they are best for mild to moderate highfrequency losses where low-frequency hearing is still normal or near normal. An open-fit hearing aid is less visible and doesn’t plug the ear like some other styles. Completely in the canal (CIC) Completely-in-the-canal hearing aids are custom molded to fit inside your ear canal and can improve mild to moderate hearing loss in adults. A CIC hearing aid is the least noticeable in-the-ear hearing aid; is less likely to pick up wind noise; is easy to use with phones; uses smaller batteries, which don’t last very long; and generally doesn’t offer volume control, microphones or other features, but often comes with a remote. Behind the ear Behind-the-ear hearing aids hook over the top of your ear and rest behind the ear. The hearing aid picks up sound, amplifies it and carries the amplified sound to an ear mold that fits inside your ear canal. This type of aid is appropriate for almost all types of hearing loss and all ages. A behind-the-ear hearing aid is the largest,

Db—bad for adults and kids, and even worse for the babies that wedding-goers frequently bring along. Leave them home or plug their ears. Permanent damage can be caused by popular electronic devices—most “earbud” in-the-ear headphones do not seal the ear canal to keep all external noise out. This makes listeners turn up the volume to drown out all surrounding sounds, making the hearing damage worse.

Ask about a trial period A trial period for new hearing aids is legally mandated by most states, including New York, which gives you 45 days. It may take you a while to get used to the device and decide if it’s useful. Have the seller put in writing the cost of a trial and whether this amount is credited toward the final cost. Most come with a 1-2 year warranty and a 1-year loss and damage plan. Beware of misleading claims Hearing aids can’t restore normal hearing or eliminate all background noise. Beware of advertisements or salespeople who claim otherwise. Plan for the expense Hearing aids can cost several hundred to several thousand dollars. Professional fees, remote controls and other hearing aid options may cost extra. Talk to your audiologist about your needs and expectations. If cost is an issue, good instruments are still available at reasonable prices. Some private insurance policies cover part or all of the cost of hearing aids, but you need to check with your policy to be sure. Medicare doesn’t cover the cost of hearing aids.

After you buy: Breaking it in When first using a hearing aid, remember that hearing aids won’t restore hearing to normal. Getting used to a hearing aid takes time. It may take several weeks or even months. Your listening skills should improve gradually as you become accustomed to amplification. The sound you hear is different because it’s amplified. Even your own voice will sound strange. But the more you use it, the more quickly you’ll adjust to amplified sounds. Though it may be awkward at first, over time you’ll adjust to the device and enjoy your enhanced ability to hear and communicate in a variety of situations. By wearing your hearing aid regularly and taking good care of it, you’ll likely notice significant improvements in your quality of life.

Wearing hearing protectors or taking breaks from the noise during loud recreational activities can protect your ears. Turning down the volume when listening to music can help avoid hearing damage. Also, if you’re a regular electronic device user, get custom earbuds—they’re inexpensive and they’ll allow you to hear the music well without having to crank up the volume.

Summary When it comes to deafness and hearing loss, the old adage, “an ounce of prevention is worth a pound of cure” holds ever true. So take care of your ears and hearing today—so that your doctor doesn’t have to tomorrow. Diligently avoid loud noises, use ear plugs and/or lower the volume appropriately— and chances are you’ll remain sharpeared for years.

Hamaspik Gazette | Sept. ‘10

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Public Health and Policy

Next-generation smallpox vaccine being stockpiled A Danish company has delivered the first 1 million doses of a next-generation smallpox vaccine to the U.S. national stockpile, a vaccine reserved for people with weakened immune systems. The federal government has ordered 20 million doses of Bavarian Nordic’s Imvamune, a vaccine developed in part with U.S. research money as part of the nation’s preparations in case of a bioterrorist attack. The government has long stockpiled smallpox vaccine against such a possibility. But the conventional vaccine, made with a live virus that’s a relative of smallpox, isn’t safe for people with weakened immune systems. Imvamune is made of a different strain of the virus, targeted for the immune-compromised because it cannot multiply in human cells.

AG Cuomo investigating health care credit cards

Rite Aid Agrees to Pay $1 Million Rite Aid Corporation (RAC) and its 40 affiliated entities have agreed to pay $1 million to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, the U.S. Department of Health and Human Services (HHS) announced. In a coordinated action, RAC also signed a consent order with the Federal Trade Commission (FTC) to settle potential violations of the FTC Act.

FDA puts partial hold on Avandia safety study No new patients will be permitted to enroll in a safety study of the controversial diabetes drug Avandia until further notice, the U.S. Food and Drug Administration announced on July 21. But under the partial clinical trial hold, those patients already enrolled in the TIDE (Thiazolidinedione Intervention With Vitamin D Evaluation) trial will be allowed to continue to participate, the agency said in a news release. An FDA advisory panel ruled the previous week that Avandia does boost users’ heart risks, but it also decided that the drug should stay on the market because there’s no definitive evidence of an increased risk.

Family suing after father falls off operating table The family of a 300-pound Minnesota man who died of a stroke in March 2010, a month after falling off an operating-room table in S. Paul’s S. Joseph’s Hospital while awaiting routine surgery, is now suing the facility. The Velcro straps restraining Max DeVries apparently failed.

Arizona health officials warn of hot pavement dangers Health officials reminded Arizonans in mid-July to be wary of paved roads and sidewalks in triple-digit heat. In America’s hottest state, officials say roads can become “streets of fire” when temperatures reach 115 degrees

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and can cause second-degree burns to human skin. Burn center surgeon Dr. Marc Matthews says it’s critical that parents and caregivers realize the dangers of hot pavement and be extra watchful of children.

hardware problems that can lead to the dropside rail partially detaching from the crib. When that happens, it can create a dangerous “V”-like gap between the mattress and side rail where a baby can get caught and suffocate or strangle.

Report: Amputations without anesthesia in North Korea

Dengue fever update

North Korea’s health care system is in shambles with doctors sometimes performing amputations without anesthesia and working by candlelight in hospitals lacking essential medicine, heat and power, a human rights watchdog said. North Korea’s state health care system has been deteriorating for years amid the country’s economic difficulties. Many of its 24 million people reportedly face health problems related to chronic malnutrition, such as tuberculosis and anemia, Amnesty International said in a report on the state of the health care system. A 24-year-old defector from northeastern Hamkyong province told Amnesty that a doctor amputated his left leg from the calf down without anesthesia after his ankle was crushed by a moving train when he fell from one of the cars. The report was based on interviews with more than 40 North Koreans who have defected, mostly to South Korea, as well as organizations and health care professionals who work with North Koreans. Amnesty researchers did not have access to North Korea, one of the world’s most closed countries.

U.S. health officials say an estimated 5 percent of the population of Key West, Fla., showed evidence of recent exposure to dengue virus in 2009. Scientists at the Centers for Disease Control and Prevention and the Florida Department of Health conducted a study after three initial cases of dengue were reported in 2009. No cases of dengue were reported in the continental United States from 1946 to 1980 and Florida had not reported an outbreak since 1934, the report said. “We’re concerned that if dengue gains a foothold in Key West, it will travel to other southern cities where the mosquito that transmits dengue is present, like Miami,” Harold Margolis, chief of the dengue branch at CDC, says in a statement. In early August, Miami-Dade County health officials reported the first suspected local case of dengue fever. Dengue is the most common virus transmitted by mosquitoes worldwide and causes some 50 million to 100 million infections and 25,000 deaths each year, the report says.

82,000 drop-side cribs recalled by Pottery Barn

Use of physical restraints in nursing homes decreases

The Consumer Product Safety Commission announced the recall of 82,000 cribs from popular retailer Pottery Barn Kids, saying the cribs could pose a suffocation or entrapment risk to young children. The recall involves all Pottery Barn Kids drop-side cribs regardless of model number. The company is offering free kits to immobilize the drop-side rail of the cribs. Drop-side cribs, around for decades, have come under scrutiny in recent years because of

The use of physical restraints on U.S. nursing home residents decreased by half from 1999 to 2007, says a federal report. During that time, the percentage of nursing home residents who were kept physically restrained went from 11 percent to 5 percent, says the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). Restraints include belts, vest and wrist ties or bands, and special chairs or bedside rails that keep people seated or in bed.

Sept. ‘10 | Hamaspik Gazette

New York State Attorney General Andrew Cuomo has launched an investigation into health care credit cards after receiving hundreds of complaints from consumers who were convinced by doctors and dentists to sign up for them. Investigators will look into financial incentives providers receive for promoting the cards that can leave patients struggling with overcharges and high interest rates, Cuomo said. “You can’t wear two hats in the operating room,” the attorney general said. “You can’t have the hat of a doctor and the hat of a financing agent at the same time. That’s a conflict of interest.” Subpoenas have been issued to 10 providers, some with multiple offices, that promote GE Money’s CareCredit card, Cuomo said. Meanwhile, medical associations that endorse the card, including the American Dental Association and American Society of Plastic Surgeons, are being asked to explain their support. Cuomo’s office also issued subpoenas to learn how three other health care card programs are run: Chase Health Advance, Visa Health Benefits and Citibank Health Card. Cuomo said providers have been urging cardholders to finance procedures including dental work, cosmetic surgery and veterinary services not covered by insurance and even when they can pay in cash. He said CareCredit, for instance, charges providers a fee to offer the card and rebates part of the fee based on how much business the providers get consumers to charge. Providers are paid within two days of the charge, giving them even more incentive to push the cards, Cuomo said. “Health care debt is the number one cause of individual bankruptcy and this scheme is contributing to the economic burden being felt by consumers,” Cuomo said. GE Money, a subsidiary of Fairfield, Conn.-based General Electric Co., received a subpoena to provide its customer list. The card is accepted by more than 125,000 health care practices nationwide.

A prescription for prison A Baltimore pharmacy owner was sentenced in early July to over four years in prison for health care fraud, aggravated identity theft and conspiracy to misbrand drugs.

Florida stops unauthorized health plans Health insurance plans sold by the Association of Independent Managers are unauthorized and could leave Floridians without insurance when they need medical care, state insurance regulators warned this past week. The state’s Office of Insurance Regulation issued a cease and desist order to the company, which may already have sold 1,800 policies. The Department of Financial Services has received complaints from about 100 consumers involving 49 agents selling health benefits provided by AIM. None of the insurance-plan brand names or company names used by AIM are authorized to do health insurance business in Florida.

Ramapo facility settles hearing-discrimination case Following an investigation of a disability discrimination complaint by the U.S. Dept. of Health and Human Services’ Office of Civil Rights (OCR), the Ramapo Manor Center for Rehabilitation and Nursing in Suffern, New York entered into an agreement with the OCR to provide equal access to deaf patients, including interpretation services when necessary for effective communication. The OCR had determined that the Center had discriminated against a deaf patient on the basis of disability when it revoked the patient’s admission to its facility after learning that he would need interpreter services. OCR also found that the Center discriminated against the patient based on his disability when it denied his request for interpreter services. OCR’s investigation was conducted under Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination on the basis of disability by recipients of federal financial assistance. In the agreement, the Center will no longer exclude anyone from its program based on the person’s disability or need for an auxiliary aid or service, such as a sign language interpreter. The Center also agreed to provide auxiliary aids and services that are necessary for effective communication, assess and consult with patients to determine the appropriate auxiliary aid or service, provide notice of its nondiscrimination and auxiliary aids and services policies to patients and referring facilities, and develop a grievance procedure for patients to file complaints. The OCR Director, Georgina Verdugo, noted that this case illustrates how basic the right to access can be: “It is important to ensure that entities that receive HHS funds not only provide the required aids and services to a patient with a disability in their care, but also, in the first instance, simply open the door to let that person in. Without that, the right to an equal opportunity to participate in federally funded programs means nothing.”

New RNs find job market tight Even as a national nursing shortage looms, many newly graduated registered nurses can’t find jobs because the recession has delayed retirement of experienced nurses, regulators and health care associations say.

ICU deaths more likely on weekends Patients admitted to an intensive care unit over the weekend may be more likely to die than those admitted at other times, perhaps because of reduced staffing, found a research review in the July issue of the journal Chest. However, one participating researcher

observed that people who enter the hospital over the weekend may be sicker than those who come in during the week.

Varmus resumes NCI leadership Nobel Prize winner Harold E. Varmus, M.D., became the National Cancer Institute’s (NCI) 14th director on July 12. The NCI is one of the 27 Institutes and Centers that comprise the National Institutes of Health (NIH). Varmus was director of NIH from 1993 until the end of 1999.

NYC DOE paying for special-ed private school

rals, United violated federal anti-kickback laws.

Champion of seniors’ health dies at 83 Founding director of the HHS’ National Institute of Aging and lifelong seniors’ health advocate Dr. Robert Butler died this past Sunday, July 4 from complications due to acute leukemia. He was 83. Butler had helped found the American Association for Geriatric Psychiatry, the Alzheimer’s Disease Association and the International Longevity Center. His 1975 book, “Why Survive? Being Old in America,” earned him a Pulitzer Prize.

Calif. whooping cough epidemic continues

About $116 million was spent by the New York City Dept. of Education last year on tuition—and lawsuits—related to special-education students whose parents sued the DOE on the grounds that city public-school specialeducation options were inadequate. There were over 4,000 such claims against the DOE last year, up from less than 3,000 in 2006.

The number of whooping cough cases continues to rise in the Golden State. Over 900 cases of pertussis, as it is medically known, were reported by mid-June; that number is now well over 1,500. At least five deaths have been reported, all in the Latino community.

Egging on food safety

E-coli spinach recall

The FDA’s new food safety requirements for large-scale egg produce became effective on July 9, 2010, through a rule for egg producers having 50,000 or more laying hens, or about 80 percent of production. Among other things, it requires them to adopt preventive measures and to use refrigeration during egg storage and transportation.

California-based Ready Pac Foods has recalled 702 cases of the Baby Spinach variety of Spinach Temptations due to possible E. coli 0157:H7 contamination. The recall extends only to products with sold in California, Washington and Arizona. No illnesses have been reported.

Schumer calls for kids’ drinks investigation New York Sen. Charles Schumer is urging the Federal Trade Commission to investigate the marketing of flavored alcoholic beverages with caffeine that appear to be explicitly designed to attract underage drinkers. In a letter to FTC Chairman Jon Leibowitz, Schumer said that the colorful cans are also designed to befuddle parents and police with labels that resemble nonalcoholic energy drinks.

McNeil recall continues The January recall of children’s medicines continues to give headaches to the McNeil consumer pharmaceutical giant. Select new lots of Benadryl Allergy Ultratabs, Children’s Tylenol, Motrin, Extra Strength Tylenol and Tylenol PM have been recalled in July for continued possible contamination.

Docs deliver cancer diagnosis poorly A study by the U.S. National Cancer Institute found that only 54 percent of cancer patients learned they had cancer in person in a doctor’s office. Eighteen percent learned over the phone, while the remaining 28 percent were told in various hospital locations, often with little privacy.

Chicago clinics hit with $7.3 million penalty The Office of Inspector General (OIG) for the Department of Health and Human Services entered into a settlement agreement with United Shockwave Services, United Prostate Centers, and United Urology Centers (collectively, United), all based in the Chicago, Illinois area. The agreement settles charges that, by soliciting and receiving payments from hospitals in exchange for patient refer-

New York State gets $13 million medical-surge grant

tiveness “cannot be assured and they should not be used.” The items’ lot numbers are: 9ZP2255-NDC 0173-0696-00 and 9ZP3325NDC 0173-0697-00.

Texas to slash mental health services by 10 percent An increasingly deficit-ridden state budget has driven Texas Gov. Rick Perry to order the Texas Department of State Health Services (DSHS) to cut its 2012-2013 proposed budget by 10 percent, in addition to the five-percent cut in the current DSHS budget.

AU summit: economy, infant mortality linked The African Union’s 15th continental summit, which began July 25th in Kampala, Uganda, focused on reducing maternal and infant mortality by improving member countries’ economies. Death rates among African new mothers and their babies remain among the world’s highest.

Britain to overhaul public health care While the U.S. hugely expands government health bureaucracy and spending, Great Britain’s new government is planning the opposite after decades of huge health bureaucracy and spending. A new proposal would drastically revamp Britain’s National Health Service socialized-medicine machine by letting doctors dictate patient medical spending and cutting thousands of NHS jobs.

Common waterborne diseases have high health costs

In July, the Empire State was provided $13 million out of a $390.5 million HHS allocation to improve the nation’s hospital preparedness and emergency response capacity in the event of major-scale natural disaster, attack or accident. The funds will help create interoperable communications systems and available hospital-bed tracking systems, among other things.

Hospitalizations for three common waterborne diseases—Legionnaires’ disease, cryptosporidiosis and giardiasis—cost the U.S. health care system as much as $539 million a year, according to a new study.

AHRQ releases handy hospital release guide

Washington State to ensure equal access

Taking Care of Myself: A Guide for When I Leave the Hospital is a new guide for patients to help them care for themselves when they leave the hospital just released by the Agency for Health Research and Quality, a division of the U.S. Dept. of Health and Human Services. The easy-to-read guide can be used by both hospital staff and patients during the discharge process and provides a way for patients to track their medication schedules, upcoming medical appointments, and important phone numbers. For a free copy, contact the Gazette’s editor.

A joint effort by Washington State’s Department of Social and Health Services (DSHS) and HHS’ Administration for Children and Families (ACF) and Office for Civil Rights (OCR) has led to Washington’s voluntary reorganization of the Seattle-based Office of African American Children’s Services (OAACS). An OCR compliance review of the state agency, which has since been renamed the Martin Luther King, Jr. Office, had uncovered racial discrimination concerns.

Your doctor’s notes on screen

Disabled Americans and their families celebrated the 20th anniversary of the watershed Americans with Disabilities Act this past July 26th. The sweeping, wide-ranging bill that enshrined numerous disability-rights changes into federal law was signed by President George Bush on July 26, 1990. The legislation established a clear and concise national mandate for the elimination of discrimination against disabled individuals. Over 50 million Americans, or 1 in 5 people, are living with at least one disability, and most Americans will experience a disability some time during the course of their lives. These Americans are protected under the Americans with Disabilities Act (ADA), which has helped remove or reduce many social and physical barriers for people with disabilities.

A nationwide year-long study involving three hospitals, over 100 doctors and about 25,000 patients is testing the OpenNotes system, which allows patients to read doctors’ visit notes via computers. However, some fear that the notes’ medical technicalities would burden patients with too much information and doctors with too many questions.

Crime doesn’t pay—or heal Cargo theft is a problem facing medical industries too. With some of the 25,600 Advair Diskus asthma inhalers filched last summer now popping up in some pharmacies, the FDA is warning that their safety and effec-

ADA celebrates 20th Anniversary

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So, What’s Happening in Your Health Today...? Health advisory: Measles in Westchester County The New York State Department of Health and Bureau of Immunization issued an alert on July 28, 2010 that a single case of measles was discovered and properly isolated in Westchester County recently. The case was a 32-year-old Italian tourist who had never received the measles, mumps, and rubella (MMR) vaccine.

Paralyzed man blinks to doctors: “Don’t pull plug” Richard Rudd lay comatose on life support in a British intensive care unit last year after a horrendous motorcycle accident left him seemingly unconscious and a quadriplegic. The 43-year-old former bus driver and divorced father of two teenage girls had watched a friend deal with paralysis and told his parents he would never want to live that way. But when they took him at his word and asked doctors to take him off the life support machine, Rudd began to blink his eyes. They soon realized their son was in a “lockedin” state, able to think, feel and hear, but unable to speak. An intensive care specialist worked to get Rudd to communicate with his eyes, answering simple questions for weeks after that, asking him repeatedly if he wanted to live. Rudd blinked that he did. Today Rudd has been moved to a hospital that specializes in rehabilitation for spinal injuries. He can move his head an inch either way and smile or grimace and has regular visits from his children and parents.

Microbe transplants? University of Minnesota gastroenterologist Dr. Alexander Khoruts saved the life of a patient suffering for close to a year from an infection of Clostridium difficile, a dangerous bacterium, by ditching standard antibiotics that weren’t working and instead “transplanting” some of her husband’s natural stomache bacteria into hers. With new natural microbes in place, her body went to work destroying the invaders; she was cured within days. The treatment, done in 2008, and others like it, has since helped put bacteriotherapy back on the front burners of modern medicine. The human body is host to millions of harmless, and critical, foreign microbes.

Rules seek to expand diagnosis of Alzheimer’s For the first time in 25 years, medical experts are proposing a

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major change in the criteria for Alzheimer’s disease, part of a new movement to diagnose and, eventually, treat the disease earlier. The new diagnostic guidelines, presented in mid-July at an international Alzheimer’s meeting in Hawaii, would mean that new technology like brain scans would be used to detect the disease even before there are evident memory problems or other symptoms. If the guidelines are adopted in the fall, as expected, some experts predict a two- to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it. The Alzheimer’s Association says 5.3 million Americans now have the disease.

Damp houses linked to kids’ risk of nasal allergies Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests. Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period. Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold. In the study, published in the American Journal of Epidemiology, 16 percent of children whose parents reported dampness in the home went on to be diagnosed with allergic rhinitis over the next six years. That compared with just under 12 percent of children whose parents reported no dampness problems—that is, no visible signs of water damage to the ceilings, walls or floors, and no visible mold or mold odor in the home.

Chronic drooling drug approved The U.S. Food and Drug Administration has approved Cuvposa (glycopyrrolate) Oral Solution to treat chronic severe drooling caused by neurologic disorders in children ages 3 years to 16 years. Drooling is normal in infants. But a significant proportion of the developmentally disabled population experiences drooling caused primarily by neuromuscular dysfunction that makes it hard to swallow. Cuvposa reduces drooling by lowering the volume of saliva produced.

Dietary supplements pose health risks Just because a supplement is

Sept. ‘10 | Hamaspik Gazette

labeled natural, doesn’t mean it is safe, according to an investigation by Consumer Reports. The report lists 12 ingredients found in supplements which are linked to serious side effects and which haven’t been shown to do what they claim to do. They are: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, country mallow, germanium, greater celandine, kava, lobelia and yohimbe. The FDA says it hasn’t been able to determine what scientific basis Consumer Reports is using for their warning. FDA spokesperson Siobhan DeLancey says the agency has cautioned consumers or provided articles and case studies about possible side effects for 7 of the 12 supplements listed by Consumer Reports (aconite, chaparral, colloidal silver, comfrey, germanium, kava and yohimbe). “It is important to note that these potential adverse events are based in large part on a degree of exposure and the duration of that exposure,” said DeLancey. In other words, a specific amount of the ingredient over a specific amount of time. Still Consumer Reports is famous for its authoritative homework—something to think about.

Sub-hearing sound, related syndrome investigated What you can’t hear can’t hurt you… right? Wrong. At least if you ask scientist Alec Salt, Ph.D., a researcher at Washington University in S. Louis who studies the inner ear. Dr. Salt’s work is supported by the National Institute for Deafness and Communications Disorders (NIDCD), a division of the National Institutes of Health (NIH). Most recently, Dr. Salt and his team have been investigating infrasound, or sound below the human ear’s range of normal hearing. The lowest pitch that most people can hear is about 20 Hertz (Hz). Dr. Salt has been looking at infrasound in the 5 Hz range—specifically, the infrasound produced by the turbines of increasingly popular electricity-producing wind farms—and rising anecdotal evidence of “turbine syndrome,” or headaches, irritability and other illnesses reported by people living near the gigantic propellers. Salt’s research has found that outer ear cells, part of the ear’s cochlea, respond differently to infrasound than they do to humanly-audible sound. What remains to be seen now, is whether this causes the sicknesses reported by wind-farm neighbors, and if so, how and why. “The biggest problem people complain about is lack of sleep,” says Salt, but they can also develop headaches, difficulty concentrating, irritability and fatigue, dizziness, and pain and pressure in the ear.

In the meantime, Dr. Salt recommends that wind turbine rotors be placed further from the poles that hold them up, thus largely eliminating the infrasound they produce.

patients’ immune cells. The finding may help identify other transplant recipients who could safely reduce or end their use of harsh drugs that block rejection.

Clean-water swimming risks

Artificial blood may save soldiers

A study by the University of Miami of 1,300 South Floridians found that the ostensibly pollutionfree waters of sub-tropical beaches still pose elevated risks for causing gastrointestinal and/or respiratory illnesses in swimmers. Those waters, despite having no known pollution or contamination from sewage or runoff, can still contain microbes that can cause stomach and respiratory problems. Study participants were divided into swimmers and non-swimmers, with the swimming group nearly twice as likely to report having a gastrointestinal illness, more than four times as likely to develop a respiratory illness or fever, and almost six times more likely to contract a skin illness. The study press release included the following microbe-avoiding suggestions: • Do not swallow water while swimming • Wash hands with soap after swimming before eating • Ensure that small children have restroom access to when visiting public beaches • Shower before/after swimming • Avoid swimming altogether when sick

Cleveland, Ohio biotech firm Arteriocyte, with DARPA funding, has produced a single unit of labproduced human blood with mass production for battlefield casualties in mind. Currently, the average wounded soldier needs six units in trauma treatment; current donated blood supplies are either too old or not enough.

Personal genetic tests can dangerously mislead Technology sometimes outraces regulatory law—with new tests and devices becoming popular before any government watchdog can determine whether it’s good or safe for you. That’s why the National Society of Genetic Counselors is now warning that consumers should get the advice of a professional genetic counselor or clinical geneticist before taking a genetic test themselves. “Genetic tests can reveal life-changing information, both positive and negative, but misinterpreting test results can be dangerous,” Elizabeth Kearney, president of the NSGC, said in a society news release.

Common genetics found in non-organ-rejecting cells Most kidney transplant patients have to take immunosuppressants for the rest of their lives, or their body’s immune systems will attack and destroy the kidney. But in rare cases, the kidney survives without immunosuppressants. NIH-funded scientists have now found a distinctive gene activity pattern in these

New drug fortifies baby brain cells University of Texas researchers have found a drug that can extend new brain cells’ lives and said their study may lead to ways to improve experimental Alzheimer’s drugs. The research builds on findings that humans generate brain cells throughout their lives, most of which die; the drug, P7C3, helps more new cells survive to become functioning brain cells.

Lipodissolve warning The FDA is cautioning the public about lipodissolve, a cosmetic procedure in which people are given a series of phosphatidylcholine (PC) and deoxycholate (DC) injections with the intent of dissolving pockets of fat in the body. The injections, also known as lipozap, lipotherapy, mesotherapy and injection lipolysis, have no credible scientific backing and have caused injuries.

Certain AQUA+FLEX Humidifiers Recalled Teleflex Medical is recalling some of the company’s AQUA+FLEX Hygroscopic Condenser Humidifiers, passive humidifiers used during mechanical ventilation to warm and humidify inspired gas, after receiving complaints that the flex tube connector may not fit securely inside the endotracheal tube connector, and that could cause these components to come apart.

Warning on liver injury with Propylthiouracil In a new boxed warning, FDA is reminding healthcare professionals about the risk of serious liver injury, including liver failure and death, from propylthiouracil. This drug, which is used to treat hyperthyroidism, is considered second-line therapy when compared with methimazole, another anti-thyroid drug that poses less risk of liver damage.

So, What’s Happening in Your Health Today...? New cellular immunotherapy for advanced prostate cancer

sure. Fructose is a natural sugar found mainly in fruits and corn syrup.

The FDA has approved a new therapy for certain men with advanced prostate cancer called Provenge (sipuleucel-T), manufactured by Dendreon Corporation. It is intended for men with asymptomatic or minimally symptomatic prostate cancer that has metastasized and is resistant to standard hormone treatment.

Circle lenses illegal, dangerous

Post-stroke complications shorten lives Complications from stroke like pneumonia or secondary strokes can shorten patients’ lives by an average of two years, South Korean researchers reported after following over 1,200 first-time stroke patients. About 34 percent suffered a complication within four weeks of their stroke.

Tinnitus increased by cell usage A recent Austrian study published in Occupational and Environmental Medicine linked tinnitus, or ringing in the ears, to prolonged cell phone use. The study indicated that cell-phone users were 37 percent more likely four years later to develop tinnitus than nonusers—and that users of more than 10 daily average minutes were 71 percent more likely to have the condition.

Anxiety may increase heart disease Dutch research published in the July issue of Archives of General Psychiatry indicates that generalized anxiety disorder was associated with a 74 percent increased risk of cardiovascular events. The study of over 1,000 people over five years found a 9.6 percent heart-disease rate among 106 patients with generalized anxiety disorder, but only 6.6 percent among the other 909.

PSA test saves lives An ongoing 14-year Swedish study of 20,000 men has found that men screened for prostate cancer every two years with the prostatespecific antigen (PSA) test had 44 percent less prostate cancer deaths than an unscreened control group.

Fructose might raise blood pressure Research in the Journal of the American Society of Nephrology scrutinized data on about 4,500 Americans, finding that the more fructose in their diets, the more they were likely to have high blood pres-

Oversized “circle” contact lenses are not only useless but dangerous too, the FDA warns. The mostly Asian-made clear lenses, whose colored rims cover eye whites to create a doe-eyed look, are not FDAapproved (thus illegal) and likely unsanitary too. Eye infections can destroy vision.

Lung problems? Avoid vog Ever hear of vog (volcanic smog)? Most Gazette readers live nowhere near volcanoes, but with the recent Icelandic eruption, European officials have been concerned about vog—sulfur dioxide and other volcanic gases mixed with oxygen—which can be inhaled deep into lungs where acidic particles can create problems, especially for people with asthma and other lung conditions.

Lower back pain? Glucosamine doesn’t help A new University of Oslo study has found that sufferers of chronic lower back pain caused by osteoarthritis fared no better with glucosamine. “The study answers the question, ‘I have suffered low back pain for a long time—will a six-month intake of glucosamine help me?,’” said lead researcher Philip Wilkens, “and the answer according to this study is no.”

Obese? Check that neck A study of over 1,000 kids by the University of Michigan at Ann Arbor found that most children with obese-level BMI (body mass index) readings, the most common obesitygauging technique, also had large neck circumferences. Researchers are seeking more accurate obesity screening methods like “neck checks” because BMI only indicates height/weight ratio, not body fat level.

Excessive inulin can upset stomach Don’t overdo the inulin—unless you want stomachaches. A study funded by foods maker Cargill, Inc. found that over five or ten daily grams of the carbohydrate fiber, increasingly added to popular foods because it can mimic flavors, can cause “gastrointestinal discomfort.” Does your snack contain inulin? Check the ingredients for chicory root, its primary source.

Mind over back pain An Australian study bolstered a belief long known to modern medicine but difficult to scientifically measure: health literacy, or the patient’s ability to find, understand and use health information, dramatically improves outcomes and lowers chronic pain. The study of 56 adults with lower back pain (LBP) found that the lower the health literacy, the higher the disability.

Eye implant corrects MD California biomedical firm VisionCare has won FDA approval for its Implantable Miniature Telescope, a tiny device that replaces the eye’s macula, or natural lens, after damage by macular degeneration, or MD. The condition, which mainly hits seniors, can cause serious vision loss.

A prescription for danger? Did you know that doctors can legally prescribe medications for non-approved usages? That’s the case with Qualaquin, an anti-malaria drug prescribed mostly for… nighttime leg cramps. But with close to 40 serious Qualaquin reactions recently reported, including two deaths, the FDA is warning the public to discuss other treatments with their doctors if taking Qualaquin for cramps.

Touch affects unrelated decisions College researchers recently asked random passersby to rate resumes on heavy or light clipboards. The heavy-clipboard resumes were deemed better. Passersby were also asked to complete smooth- or rough-surfaced jigsaw puzzles and then judge a social interaction. “Rough puzzlers” deemed it harsh. The experiments indicate that weight and roughness affect thinking.

Army developing bionic running foot Try this for futuristic: the West Point-SpringActive Bionic Foot, which just allowed a soldier who lost his lower leg to run on a treadmill at 8 mph, became the world’s first prosthetic leg to achieve motorized running. The computerized device, in development since 2006, is slated for combat readiness—and full natural running capacity on one daily charge—as early as 2012.

Cognitive woes may portend Alzheimer’s A 1.9-year study of 85 mild cognitive impairment (MCI) patients ages 55-90 conducted across 50 U.S.

and Canadian hospitals found that 28 patients with abnormal PET-scan and episodic-memory-test results also later developed Alzheimer’s, indicating possible future countermeasures against the disease using those same tests. The PET scans’ costs are prohibitive, however.

1/2300 seizure risk? Not my kid! A Pediatrics-published study of 459,000 kids’ measles vaccine records showed that 1 out of every 2,300 kids ages six months to five years had a febrile, or fever-caused, seizure after getting the measles/mumps/rubella/varicella (MMRV) combo vaccine, in contrast to separate MMR and varicella shots which produced even less than that. Still, Washington pediatrician Dr. Wendy Sue Swanson reports parents’ typical reaction upon being informed of the virtually non-existent risk: “I would say, ‘There’s a new report out that says seizures are twice as likely with this combination vaccine, but they’re still really rare,’ and every person chose to separate the vaccines,” she says. “One in 2,300 is nearly nil, but it’s not entirely nil. And nobody wants their child to be that one.”

Antivirals apparently top HCC liver cancer According to Thomas Jefferson University medical professor Dr. Hie-Won Hann, the most common form of liver tumors, known as single hepatocellular carcinomas, or HCCs, are caused by a virus—and that HCC patients taking antiviral drug lamivudine have high survival rates.

FDA warns about Chinese capsules “Slimming Factor Capsule” Que She, advertised as “an all-natural blend of Chinese herbs,” has been found after an FDA analysis to contain a cocktail of dangerous drugs including fenfluramine, a drug banned in 1997 because it causes serious heart valve damage.

Rabid dogs kill 78 in Indonesia A rabies epidemic has gripped Bali, an Indonesian island of 3 million people and one of Asia’s top tourist destinations. Seventy-eight deaths have officially been logged in the past two years, and many other deaths have likely gone unreported. The Indonesian government says it’s overwhelmed, with more than 30,000 dog bites reported in just the first half of this year across Bali. In a highly criticized move, officials killed about 200,000 dogs, instead of initially conducting mass vaccina-

tions as recommended by the World Health Organization.

FDA tracking rare “Pine Mouth Syndrome” In rare cases, eating pine nuts can cause a metallic, bitter aftertaste after eating anything; it is known medically as metallogeusia and usually vanishes in 1-4 weeks. First documented in Belgium in 2001 and having only hit the U.S. in the past two years, the FDA only began tracking it in February of 2009. It has since learned of over 50 cases.

Car seats for cars, not houses Car seats keep children safe— except when those seats aren’t in the car. Parents who park babies in car seats inside the home put their children at risk of falls and head injuries, according to new research from Cincinnati Children’s Hospital Medical Center.

Anti-smoking campaign pays U.S. cancer death rates are falling, with big decreases in major killers such as colon and lung cancer, the American Cancer Society said recently. The improvement, according to the Society, was credited to a decline in smoking, better treatment and earlier detection.

2010-2011 flu shot strains selected The strains to be protected against in next year’s flu-season vaccine have been selected after a complex international joint effort. Scientists from the U.S. Centers for Disease Control, the World Health Organization, the FDA and other expert bodies study virus samples and patterns collected worldwide to predict which strains are most likely to proliferate in the upcoming season. The annual vaccine’s contents are then compiled and mass-produced. Next season’s vaccine will protect against the California H1N1 2009 strain of Influenza A, the Perth H3N2 2009 strain of Influenza A, and the Brisbane 2008 Influenza B strain.

Specialty running shoes no better A U.S. Army study of 1,400 U.S. Marine recruits with and without common gait problems revealed that about 43 percent of recruits wearing standard shoes during basic training reported injuries—while a statistically equal 39.5 percent got injured while wearing specialty shoes.

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Care for All Continued from Page 1 now also enjoy the same excellent at-home services delivered through Hamaspik to Fidelis members—particularly at hospitalization discharges back home.

The environment to thrive At the same time, Hamaspik has been tapped by Fidelis to provide its brand-new Social and Environmental Supports service too. The helpful new component of Fidelis’ long-term care insurance program covers the costs of minor quality-of-life home improvements for individuals who become disabled, like installing wheelchair ramps and handrails or doing light electrical or remodeling work. By capitalizing on Hamaspik’s reputation as a well-trusted, leading community agency with considerable experience in Access to Home, E-Mods (Environmental Modifications) and other disabilityrelated home-renovation programs, Fidelis was able to bring the valuable new service to an important demographic. And with its position, it was only natural for Hamaspik to bring the exacting professionalism of its Early Intervention, IRA, Res Hab, Respite, PACE, Family Care and

Good Name

other worthy programs to the burgeoning field of long-term care as well. Considering the ever-mounting flow of daily calls to Hamaspik for Home Care-related services, the need for a competent home care provider agency, and competent staffers, providing those services is coming into ever-clearer focus.

Making the right call Whether inquiring about Medicaid- or Medicare-covered services or Fidelis member benefits, every potential Hamaspik consumer is received with respect and a sense of duty. Central Intake professionals, followed by assigned Service Coordinators, will walk each inquirer, whether by phone or in person, through their rightful entitlements. Once duly qualified programs are secured, Hamaspik’s energetic, attentive Medicaid Service Coordinators take up the reins of case management, diligently handling all home care programs, and the therapists and professionals who execute them, with devotion and professionalism. Whatever the Home Care question or necessary information may be, Hamaspik staffers are standing by to respond with compassion and genuine loving care. Just call!

Continued from Page 1 ry and unprintable were once, clinically, regularly and popularly to describe the developmentally disabled over the past ten decades. In March of 2010, a diverse group consisting of OPWDD employees, parents of special-needs individuals, disabled-rights activists, voluntary-agency leaders and others was convened by the then-OMRDD to choose a new name; “OPWDD” emerged the front-runner. In notifying the agency and affiliates of the still-fresh ink on

ObamaCare Continued from Page 2

Helping seniors To help Medicare-receiving seniors spending more than $2,830 a year for their prescription medications, the Dept. of Health and Human Services, with funding created by the Act, sent $250 checks to thousands of said seniors nationwide in early June. About four million seniors are expected to receive the $250 checks by the end of 2010.

Hamaspik Sends Out Annual Survey to Parents and Providers Agency keenly awaiting responses; anonymous comments welcome Hamaspik’s proficient teams of Medicaid Service Coordinators, or MSCs, are good at their job. But part of being good at your job is knowing that there’s always room to improve. For that reason, Hamaspik of Kings County and Hamaspik of Orange County recently sent out their annual MSC performance questionnaires to all consumer parents and Family Care providers—to pinpoint exactly where their capable MSCs are at optimal performance, and where they could get even better. And for the same reason, Hamaspik’s MSCs and supervisors alike are eagerly awaiting responses—to happily tackle any problems and/or complaints raised, thus raising the bar to an even higher standard of impeccable service. “We really do appreciate the response,” says MSC Supervisor Mrs. Nechama Nissenbaum of Hamaspik of Rockland County, which will be sending out its own surveys as usual this coming November. For his part, Hamaspik of Kings County supervisor Shlomo

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Reichman had this to say: “Our MSCs are not only good at their jobs, they are the best.” Parents and providers are welcome to provide as much contact information as they wish upon returning the forms to Hamaspik— or to simply respond anonymously. Either way, Hamaspik welcomes the forms, which may be returned by

Paterson’s desk, Ritter pointed out that “This historical legislation not only removes the words ‘Mental Retardation’ from the name of our agency, but also from State statute[s] and regulations… It eliminates the stigmatizing language which was part of the agency’s name and instead reflects this Office’s #1 guiding principle of ‘Putting People First.’ ” Ms. Ritter also noted that the wording wielded semantics—namely, the capitalized “With”—to avoid the possible acronym “OPDD,” which would have been “Office for

People with Developmental Disabilities.” That title might have been confused for “Office for PDD,” or Pervasive Developmental Disorders, an autism-spectrum diagnosis. “I am so pleased to have been a part of this vital change, which is the culmination of our partnership and all the work you have done to advocate for the respect and dignity of people with developmental disabilities,” concluded Ritter, whose stewardship career at the state agency ended that week with a triumphant achievement. The change was welcomed by Hamaspik, which has long advocated for maximum community sensitivity towards individuals with special needs.

fax, mail or in person, with open arms and completely non-judgmental acceptance. For any question regarding the annual survey, if you have not received the form and/or if you would like to receive it by mail, simply contact your Hamaspik MSC or MSC Supervisor.

Tax credit for small businesses Too small a business to afford private health insurance for your employees? If you have less than 25 full-timers and pay each $50,000 or less on average—and if you buy them private insurance and pay their premiums, the Act will give you a tax credit for 50 percent that amount. So: pay $6,000 a year per employee? You get a one-time $3,000 tax credit. Same idea if you have ten or fewer employees and pay them $24,000 or less—you get a 35-percent tax credit. The bad news is that owners don’t count as employees.

Mending Medicare and Medicaid Beginning January 1, 2011, the Act requires Medicare to cover annual wellness visits. Also beginning that date, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services—including that annual wellness visit. To help make sure that Medicare beneficiaries have better access to primary care doctors, the Act will raise payments to Medicare doctors by 10 percent in 2011 and to the same level as that paid to Medicaid doctors in 2013 and 2014.

However, the Act will cut Medicare benefits by $500 billion over the next four years. In 2014, the Act will expand Medicaid to include everyone who earns less than 133 percent of the poverty line, which is $14,400 this year for individuals.

State insurance exchanges You may have heard a lot about state insurance exchanges, government-approved individual and small group plans with ostensibly cheaper premiums than today’s private plans. But the exchanges will only be launched in 2013 at the earliest.

Where reform is still needed The Act was passed by a Democratic Congress considered friendly to trial lawyers opposed to tort reform, and does not include liability reform that caps malpractice awards, though it does include a relatively insignificant $50 million grant to develop, implement and test medical liability reform initiatives. Also, despite the numerous changes, private health-insurance costs are still expected to rise in 2011 by at least 9 percent and probably more.

Summary

Hamaspik Gazette © '003-'010 All Rights Reserved Published Monthly by “Hamaspik” Distributed free USPS Presorted Non-profit Mail Postmaster: Return service requested President

Executive Director

Editor

Hershel Weiss

Meyer Wertheimer

Mendy Hecht

Sept. ‘10 | Hamaspik Gazette

Writers and Editors Isaac Schnitzler Joseph Landau

The $1 trillion, ten-year health care remake puts the nation on a path to coverage for all. Starting in 2014, everyone in the U.S. will be required to have health insurance. The government will provide tax credits to help middle-class people not covered at work buy a policy through new competitive health insurance markets called exchanges. Medicaid will be expanded to help low-income people. The plan is paid for through a combination of Medicare cuts and tax increases. Public approval/disapproval rates of the Act have remained roughly 50/50 since its signing.