Friday, December 26, 2008

NYS Can Save Millions Creating Healthier Toothier New Yorkers


Submitted by Sally Stride on December 17, 2008 - 5:08pm.

New York State's Governor Patterson is proposing extensive tax increases to offset revenue shortfalls. But I have a better idea. Stop fluoridation.

This win-win decision would save multi-millions of dollars and benefit every New Yorker – except maybe legislators beholden to special interest groups.

Science shows ending fluoridation saves teeth, money, preserves health and will reduce the carbon footprint, to boot, but it would irk organized dentistry. That’s the rub.

After 60 years of water fluoridation (adding cavity-preventing fluoride chemicals into water supplies) and over 50 years of fluoridated toothpaste, tooth decay is epidemic in the United States because 80% of dentists refuse to treat Medicaid patients and over 108 million Americans lack dental insurance (1). Children have died from untreated tooth decay. (2)

Diverting attention from their greed and heartlessness, dentists focus too-willing legislators on fluoridation, as if that would solve the problem. (3)

Far from fluoridation putting dentists out of business, as was once predicted, today’s dentists work fewer hours and days doing less critical work but make more money than many physicians. (4)

Seventy-two percent of NYS is fluoridated even though statistics show it’s failing to thwart cavities. (5) New York City, alone, spends approximately $14 million or more yearly on fluoridation chemicals, equipment and manpower.(6) Yet, NYC residents have among the highest cavity rates in the nation. (7)

Unfortunately, organized dentistry’s PAC money and political might speaks louder than science.(8)

One might argue that stopping fluoridation will cause higher dental costs. But studies show that, when fluoridation ends, cavities actually go down. (9) And the most highly fluoridated states have the highest rates of tooth loss. (10) Cavity crises are occurring in most fluoridated cities and states (See: http://www.FluorideNews.Blogspot.com )

Modern science shows that fluoride ingestion confers no benefits as early fluoridationists thought. Besides, today fluoride is in virtually all foods and beverages, (11) almost all toothpastes, some medicines, many dental products and is now a known component of air pollution.

No one disputes that too much fluoride is a bad thing. And there’s loads of evidence showing that Americans are over-fluoridated. For example, the Centers for Disease control reports that 48% of 12 - 15 year-olds have dental fluorosis – white spotted, yellow, brown and/or pitted enamel – from too much fluoride ingestion when their teeth were forming. (12) We can’t see what fluoride is doing to their bones. (13)

For this reason, both the CDC and the American Dental Association advise that infant formula NOT be mixed with fluoridated water.

The National Kidney Foundation also advises kidney patients to avoid fluoridated water as malfunctioning kidneys can allow a toxic build up of fluoride in bones causing them to weaken and break. (14)

New York State is not spending the money to get this information out. Fluoridation is outdated, unnecessary and harmful. It must be stopped.

Contact your local and state legislators and tell them wasteful, ineffective fluoridation must stop

On the National level, tell Congress you want fluoridation stopped and to hold hearings about why federal officials continue to promote fluoridation in the face of growing evidence of harm and ineffectiveness here: http://congress.FluorideAction.Net

END

References:

1) http://www.surgeongeneral.gov/news/pressreleases/pr_oral_52000.htm

2) “For Want of a Dentist,” by Mary Otto, The Washington Post, February 27, 2007
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html

3) How California Deceptively Passed a Statewide Fluoridation Mandate http://www.edhtelegraph.com/detail/89290.html

Louisiana Mandates Fluoridation Despite Evidence of Harm http://www.bio-medicine.org/medicine-news-1/Louisiana-May-Mandate-Fluoridation-Despite-Evidence-of-Harm-20853-1/

4)”New Drill - Tale of Two Docs: Why Dentists Are Earning More,” by Mark Maremont, The Wall Street Journal, Monday, January 10, 2005
http://www.flapsblog.net/2005/01/new-drill-tale-of-two-docs-why.html

5) NYS Department of Health statistics show that fluoridation fails to reduce tooth decay. See chart: http://tinyurl.com/NYSchart

6) Fluoridation Does Not Save Money or Teeth
http://fluoridedangers.blogspot.com/2005/11/fluoridation-does-not-save-money-or.html

7) Evidence that Fluoridation Has Failed New York
http://www.freewebs.com/fluoridation/fluoridationfailsnewyork.htm

8) “Open Wide for $25K” NY Daily News, by Elizabeth Benjamin, July 12, 2008
http://www.nydailynews.com/blogs/dailypolitics/2008/07/open-wide-for-25k.html
“In Rift Among Dentist Groups, a Tale of Political Clout.”
By Sam Roberts, New York Times, June 23, 2008
http://www.nytimes.com/2008/06/23/nyregion/23dentist.html?_r=2&pagewanted=print&oref=slogin

9) When Fluoridation Ends So Do Cavities
http://thyroid.about.com/cs/relatedconditions/a/flushot.htm

10) More Fluorde = Less Teeth
http://www.freerepublic.com/focus/f-news/1002581/posts

11) USDA Fluoride Database 2005 http://www.ars.usda.gov/Services/docs.htm?docid=6312

12) http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/s403a1t23.gif

13) http://groups.google.com/group/Fluoridation-News-Releases/browse_thread/thread/20b328821b24dcc4/9882f8d2ce4caad5?lnk=gst&q=fluorosis+fractures#9882f8d2ce4caad5

14) National Kidney Foundation, “Fluoride Intake in Chronic Kidney Disease,” April 15, 2008
http://www.kidney.org/atoz/pdf/Fluoride_Intake_in_CKD.pdf

Saturday, December 20, 2008

States Can Save Millions Creating Healthier Toothier Americans


Posted by: SallyStride

New York State's Governor Patterson is proposing extensive tax increases to offset revenue shortfalls. But I have a better idea. Stop fluoridation.


This win-win decision for all states would save multi-millions of dollars and benefit every American – except maybe legislators beholden to special interest groups.


Science shows ending fluoridation saves teeth, money, preserves health and will reduce the carbon footprint, to boot, but it would irk organized dentistry. That’s the rub.


After 60 years of water fluoridation and over 50 years of fluoridated toothpaste, tooth decay is epidemic in the United States because 80% of dentists refuse to treat Medicaid patients and over 108 million Americans lack dental insurance (1). Children have died from untreated tooth decay. (2)


Diverting attention from their greed and heartlessness, dentists focus too-willing legislators on fluoridation (adding unnecessary fluoride chemicals into water supplies in a failed effort to prevent tooth decay), as if that would solve the problem. (3)


Far from fluoridation putting dentists out of business, as was once predicted, today’s dentists work fewer hours and days doing less critical work but make more money than many physicians. (4)


Seventy-two percent of NYS is fluoridated even though statistics show it’s failing to thwart cavities. (5) New York City, alone, spends approximately $14 million or more yearly on fluoridation chemicals, equipment and manpower.(6) Yet, NYC residents have among the highest cavity rates in the nation. (7)


Unfortunately, organized dentistry’s PAC money and political might speaks louder than science.(8)


One might argue that stopping fluoridation will cause higher dental costs. But studies show that, when fluoridation ends, cavities actually go down. (9) And the most highly fluoridated states have the highest rates of tooth loss. (10) Cavity crises are occurring in most fluoridated cities and states (See: http://www.FluorideNews.Blogspot.com )


Modern science shows that fluoride ingestion confers no benefits as early fluoridationists believed. Besides, today fluoride is in virtually all foods and beverages, (11) almost all toothpastes, some medicines, many dental products and is now a known component of air pollution.


No one disputes that too much fluoride is a bad thing. And there’s loads of evidence showing that Americans are over-fluoridated. For example, the Centers for Disease control reports that 48% of 12 - 15 year olds have dental fluorosis – white spotted, yellow, brown and/or pitted enamel – from too much fluoride ingestion when their teeth were forming. (12) We can’t see what fluoride is doing to their bones. (13)


For this reason, both the CDC and the American Dental Association advise that infant formula NOT be mixed with fluoridated water.


The National Kidney Foundation also advises kidney patients to avoid fluoridated water as malfunctioning kidneys can allow a toxic build up of fluoride in bones causing them to weaken and break. (14)


New York State can’t afford the money to get this information out. Fluoridation is outdated, unnecessary and harmful. It must be stopped.


The remedy: Dentists have unfairly influenced our legislators to pass laws that benefit themselves (15) while neglecting those that need them the most. In return, Dentists must be required to treat a certain percentage of patients for free, on a sliding scale basis or accept Medicaid payments.


Tell your local and state legislators you want fluoridation stopped.


Tell Congress you want fluoridation stopped and Congressional hearings held about why federal officials continue to promote fluoridation in the face of growing evidence of harm and ineffectiveness: http://congress.FluorideAction.Net

Friday, December 12, 2008

Why an NHS dentist is as rare as hen's teeth


By Cassandra Jardine
Last Updated: 1:46PM GMT 12 Dec 2008

My children hardly ever go to the dentist any more. This is not because they have good teeth – as half of their genes come from me, they may be destined to a life time of shoring up and pulling out yellowing stumps. Of course I take them if they ever complain of any pain, but they aren't getting regular check-ups for the simple reason that our dentist has stopped working on the NHS.

Millions of people are in the same position. The latest figures show that 1.2 million fewer people were seen by an NHS dentist last year because they are all going private. In fact, I was quite surprised to see that just over half of the population had managed to make an appointment with an NHS dentist at all because, around my area of south London, they are as rare as hen's teeth.

I feel cheated by the health service's failure to look after the nation's teeth. The Government doesn't has a responsibility to give us all sparkling California-style gnashers, but it should at least provide a service which will prevent decay, pain and further complications. There is a strong link between gum disease and heart disease – yet three out of four adults suffer from gum disease because we aren't going often enough to dentists and dental hygienists – mostly because we can't afford to. A specialist periodontal examination at my local once NHS, now private practice cost "from £150" – an open-ended proposition that leaves me faint with financial anxiety.

Even on the NHS, free dentistry long ceased to feel like the payback for our National Insurance stamps. Long before our dentist went private, he was charging over-18s for 80 per cent of their treatment, with the Government only picking up a tiny slice of the bill. Treatment for children was theoretically free but, if I upgraded from a mercury amalgam filling to a white one – desirable on both cosmetic and health grounds – it was time to get the cheque book out.

I have a solution, of sorts. Near us an eminent dental academic, keeps his hand in by practicing informally at weekends. He charges, but modestly. The reason he can do so is that he has dispensed with a lot of the flummery that inflates dentists' costs. He operates two chairs simultaneously and dispenses with the services of a dental nurse who would be, in my experience, sitting around doing nothing all day except for pressing a button on the computer and, occasionally, stirring up some filling mixture.

Sunday, December 7, 2008

Unsung Hero Helps Create Smiles


CARTERVILLE--When people lose their job, they often lose their insurance.

Some never had coverage to begin with and are forced to ignore their medical needs, including a visit to the dentist.

That's where the Create a Smile Dental Foundation steps in.

Carla Fletcher has a lot to smile about these days. About a month ago, she was fitted with a new set of teeth.

"People say I look about 10 to 15 years younger than I used to. And I smile more," said Carla.

The Create a Smile Dental Foundation helped make it happen. The group pays for dental work for people who have no insurance.

Over the last five years, the foundation has provided dental assistance to nearly 40 people in southern Illinois.

"I've had dental problems, my wife has had dental problems. So many people have dental problems, they don't have insurance. We figured it would be a good thing to help people because we enjoy helping people," said founder John Flora.

He says they're able to pay for the dental work thanks in part to this thrift store in downtown Carterville.

Dentists also help by doing some procedures at a reduced price.

"But it still costs lots of money to get that dental work done."

Carla says before she got her new teeth, she spent almost 15 years with broken teeth and exposed roots.

She can smile again without feeling self conscience.

"It's just a wonderful feeling you know. I think a lot of prayer must have went into it. I went in to get my teeth pulled one day and the new ones the next. They were just healing like they should."

Applications can be picked up at the thrift store on Division Street in Carterville.

by Kevin Hunsperger
khunsperger@wsiltv.com

Monday, December 1, 2008

Options for people with diabetes


(CL) — It’s estimated that almost 2.5 million Latinos in the U.S. will be affected by diabetes by 2020. Of those, 44 percent will be over the age of 65. Just within the Hispanic community, the effects of diabetes are vividly present. While Medicare can cover medical services, the coordination and monitoring of those services is particularly critical to managing complicated medical conditions.
It’s widely known that diabetes is a debilitating disease requiring careful and consistent medical attention. What may not be as clear, however, are the solutions to manage the multiple needs of the disease that can range from juggling multiple physicians and treatment plans to coping with the demands of a hectic pace in a fast-food society.

“Diabetes is the seventh leading cause of death listed on U.S. death certificates,” said Dr. Ana Fuentevilla, Evercare medical director. Furthermore, diabetes is the leading cause of kidney failure and new cases of blindness, as well as a strong influencer in the cases of high blood pressure, dental disease, heart disease, strokes and amputations.
To ensure the proper management of diabetes, it’s important to follow the specific treatments prescribed by the primary health care provider and specialists because failure to adhere to them could severely jeopardize one’s health. To facilitate the management of what may turn into a multitude of treatments, doctor’s appointments

Friday, November 28, 2008

Dental Clinic getting big response


By Lisa Carolin
The Livingston Community News

It's been just a bit more than two months since the VINA (Vision, Integrity, Need, Action) Community Dental Center opened to offer affordable dental care to residents without dental insurance.
The demand for services grows daily.

"There are a lot of people who need us," explains office manager Cindy Gates, who is the only employee of the Brighton clinic. "There is clearly a high need in Livingston County for affordable dental care."

Gates says the office is working with a call list of dentists who volunteer their time based on availability. Clients who meet the criteria are placed on the list on a first-come, first-served basis.

Currently there are 11 dentists volunteering at the clinic along with eight dental hygienists and 10 dental assistants.

"We could still use more dentists as well as monetary donations," says Gates, who adds that some of the volunteer dentists include periodontists and oral surgeons. "If someone needs more than we can offer, we direct them to the University of Michigan Dental Clinic in Ann Arbor. We are seeing people from all over Livingston County and all ages from 18 and above."

The clinic does not see children because there are a number of dentists in the county who participate with the Healthy Kids program through the Department of Human Services.

"We're getting a darn good response, and people are deeply appreciative," says volunteer dentist Dr. Harry Davis. "Our patients have just been clobbered. They've lost jobs and lost their dental insurance, and many have just skipped going to the dentist."

Davis says that because of the lack of regular dental care, they're seeing patients with severe gum decay and periodontal disease, and many who are in pain.

"We do the best we can to save teeth and eliminate pain," says Davis. "We fill teeth, extract teeth, clean teeth and educate people about brushing and dietary control to try to help them help themselves."

"What's surprising is that demographically who we are treating has turned out to be the working poor," says volunteer dentist and oral surgeon Fred Bonine. He also is the fundraising chairman for the clinic.

"Chronic neglect is a huge problem, as well as a lack of information such as the fact that soda pop can destroy peoples' mouths," he says.

Bonine says the clinic's goals are to expand its hours, increase the number of volunteers, and to continue to raise money. The clinic will have a major fundraiser in February.

A Valentines Ball is planned for Feb. 14, 2009, at Lakeland Country Club, "which we hope will be an annual event," says Jana Walther, who is on the clinic's fundraising committee.

Walther says the clinic needs donations to continue to operate and has been helped by grants from Blue Cross Blue Shield, Delta Dental, and the Michigan Dental Foundation.

The clinic now has liaisons with dental schools at the U-M and the University of Detroit, both of which will be sending dental students and faculty to volunteer at the clinic.

The purpose of the VINA Community Dental Clinic is to provide service for Livingston County residents who have no dental insurance and have an income at or below 200 percent of the federal poverty level. The clinic offers exams, cleanings and fillings as well as services for pain and infection, oral cancer screenings, and dental and general health education materials.

Lisa Carolin can be reached at lcarolin@livingstoncommunitynews.com or at 810-844-2010.

Monday, November 10, 2008

Nonprofit giving twins gift of a new smile


VISTA – Twins Stephanie and Ramses Villa, both 16, are on track to graduate from high school in the next two years. Stephanie wants to work with children eventually, maybe as a child psychologist, while Ramses is thinking about becoming a firefighter.
One thing is for certain: Whatever they'll be doing, it will be with a sparkling smile.

The twins, who live in Vista, were born with an uncommon genetic defect called amelogenesis imperfecta, which prevents the development of tooth enamel. Without enamel, teeth become especially vulnerable to cavities and dramatic deterioration, which can interfere with eating, regular dental hygiene and smiling.

Over the next two years, the nonprofit organization Fresh Start Surgical Gifts will correct their condition, providing the twins with at least $30,000 in free dental care. The Carlsbad-based organization facilitates dental care for children whose families can't afford it.

Recently, Stephanie reclined in a dental chair at La Boca Fina clinic in Encinitas as her dentist, Al Fallah, prepared a bubblegum-pink and toothpaste-green mixture that he would use to create an impression of her teeth.

Saturday, November 1, 2008

Dentist To Offer Services Free Of Charge


Douglas Roth says he was inspired by a TV special in June about a doctor who was hosting free clinics for the poor in South America.

By Kyle Martin

Hernando today

Published: October 29, 2008

Brooksville - A downturn in the economy and a lack of dental insurance has many people trying to live with painful toothaches.

That's not right, says Dr. Douglas Roth.

On Nov. 22, Roth will open the doors of his Brooksville dentistry practice to anyone in pain or who needs an immediate fix on their teeth — free of charge.

Roth was inspired by a TV special in June about a doctor who was hosting free clinics for the poor in South America. Lately though, the ranks of the unemployed and uninsured have begun to swell stateside and fewer are receiving the care they need, Roth said.

The program "tweaked my sense of duty," Roth said.

On the day of the clinic, Roth and his staff will show up without punching in the clock and get started around 8 a.m. Several teenage volunteers will help direct traffic and parking at the Oak Walk Park, a shopping plaza just west of the Powell Road intersection with Broad Street. Clients will be helped in the order they arrive.

Roth isn't sure exactly what to expect, though he said it will probably entail a lot of tooth pulling. He asks that people use their conscience to decide if their case is truly urgent and deserving.

Roth, 62, said he gained a sense of community by growing up in small town Pennsylvania. He chose dentistry to follow in his father's footsteps and has been peering into mouths across America since 1973.

Now a year and a half into his "semi-retirement" in Brooksville, Roth is looking forward to the upcoming clinic.

Reporter Kyle Martin can be reached at 352-544-5271 or kmartin@hernandotoday.com.

Monday, October 13, 2008

Voters want solutions as health insurance costs rise sharply


By SUZANNE KING
Special to The Star

Working two jobs isn’t exactly the way Dave Coffman envisioned his retirement.

But that’s how it’s turning out.

“I’m working basically because of health care,” said Coffman, 62, a retired school principal who lives with his wife in Lee’s Summit.

Until they qualify for Medicare, they have to buy private coverage. For now, their insurance bills amount to around $1,000 a month — including long-term care insurance, dental insurance and a health plan that has a $2,500 deductible. If he weren’t working two part-time jobs, Coffman said, there would be no way he could afford it.

“I never once thought about health insurance before I retired,” Coffman said.

Now it’s never far from his mind.

Like many Americans, Coffman says that health care will be a top concern as he casts his ballot in November.

“I know that each of the parties has a (health care) plan, but definitely we need something to help provide insurance,” Coffman said.

Coffman doesn’t want to see socialized medicine, but he wants to see a government that forces health care providers to hold the line on costs and helps the people who can’t afford them pay their health care bills.

At a time when 45 million Americans lack health insurance, Coffman is hardly alone. Even people who are insured are paying more all the time. In the past four years, according to a report in the New England Journal of Medicine, insurance premiums have climbed 35 percent, to $4,400 for an individual policy and $12,000 for a family policy.

“When people say they’re worried about health care, they’re not worried about where they’re going to find a decent doctor or medical care — they’re worried about paying for it,” said John McDonald, senior state director for AARP Missouri.

Certainly health care is on the agenda of Democrat Barack Obama and Republican John McCain.

Both candidates want to see a system that provides more affordable coverage to more people. And both talk about the need to cut costs; to improve efficiencies, partly through the use of information technology; to promote preventive care; to reduce errors; and to rein in medical malpractice lawsuits.

But the candidates’ fundamental approaches are vastly different.

Under McCain’s plan, individuals, not employers, would carry the responsibility for choosing and paying for health care.

Obama wants to shore up the current employer-based system by mandating more coverage and providing more subsidies.

“It’s a choice between adjusting the financing mechanism or a system of mandates,” said Maggie Nelson, manager for federal government and industry relations with Cerner Corp., the North Kansas City-based health care information technology company.

The McCain plan

Experts agree that McCain’s proposal is the most radical.

The senator from Arizona proposes eliminating the current tax exemption for employer-paid health insurance premiums — meaning people with job-based coverage would pay income tax on the premiums their employers pay, which are tax-free today. In exchange, he would provide a $2,500 tax credit to individuals and a $5,000 tax credit to families to buy their own insurance.

McCain’s camp argues that the system would give consumers more control, allowing them to keep insurance as they move from job to job, for example, while at the same time making them more aware of the true cost of going to the doctor.

Tuesday, September 23, 2008

Teeth cleanings without the dentist


By Kelly Gadzala


He’s never had a cavity, but that hasn’t prevented Allan Levine from getting his teeth cleaned.

Still, the 30-year Yonge and Eglinton resident says he’s only ever spent a few minutes with his dentist while the rest of his dental checkup is spent with a hygienist.

“I have yet to understand why I see a dentist,” Levine says.

Levine recently tried out a teeth cleaning at the new flagship location of Independent Dental Hygiene Centres on Yonge St. at Eglinton Ave., which was performed by one of the centre’s dental hygienists.

As of September 2007, dental hygienists in Ontario can practice without being supervised by a dentist. They are qualified to perform procedures like teeth cleaning, polishing and whitening but cannot fill cavities or diagnose dental conditions.

“The hygienists were theoretically and practically practicing without the dentists anyway,” says co-founder Brian Price. “All our company is doing is enabling hygienists to be independent.”

Price says when the change was made, he called former business partner Howard Rocket and asked him to come out of retirement. Both dentists turned entrepreneurs, Price and Rocket founded the Tridont Dental Centres in the 1980s, which had 107 locations across Canada mainly in malls.

This new venture, Price says, will build on the accessibility and conveniences of the former business model, but will offer lower prices.

The centre is open evenings and weekends for a total of 70 hours a week, Price says. Subsequent centres will be built along the subways lines — six along Yonge and the remaining five along the Bloor line, he adds.

Hygienists like working in the new-style clinic as it allows them to spend more time educating their patients about how to take care of their teeth.

“So far I feel I can practice dental hygiene the way it was meant to be practiced,” says Amina Zaidi, senior hygienist with the centre.

She has been in the dental field since 1995, including six years as a hygienist in a private practice.

“We’re not bound by a tight schedule or a production mentality,” she says, adding that, though not discussed openly, some dentist offices have quotas per hour.

Levine, who is without dental insurance, says he was attracted to the concept primarily because of the cost. But at his appointment, he says he appreciated the relaxed environment and the fact that he could watch a computer screen mounted on the wall that showed what the hygienist was doing.

He also left with specific instructions about which teeth he needs to floss better instead of just a general reminder to do it, he says.

“It’s rare you go do something like this and actually remember it.”

Tuesday, September 16, 2008

Smile Please !


The morale of healthcare employees can directly affect the quality of service and customer care being provided. However, have Indian hospitals started to view morale boosting measures as seriously as they need to? Finds out Sonal Shukla

In an interesting study done by largest research organisation in the world specialising in mental illness, the US based National Institute of Mental Health, at least one in four employees in healthcare endure an episode of significant psychological illness during their prime working years and in any given year, more than one in 10 will experience clinical depression. Moreover, for some occupational categories the risks are even greater. Physicians, nurses, chiropractors, health technologists and dentists have higher-than-average suicide rates. Health technologists, licensed practical nurses, clinical laboratory technicians, nurses aides, registered nurses and dental assistants had among the highest rates of hospitalisation for mental disorders in one study of 130 job classifications. While there are no official estimates for Indian healthcare employees, but indeed they would indeed share the same story.

As levels of competition have grown manifold, there is a pressing need to give a lot of emphasis on the quality of service which has translated into greater stress for all healthcare staff. The uniqueness of this industry is that employees are forced to face the stark realities of life and death, 24x7, under tremendous physical exertion, irrespective of time, date or day or of any turbulence in their own personal lives. Any lack of effective and timely efforts in keeping employee spirits and morale high therefore leads to a steady dip in their performance. Says Dr BK Rao, Chairman, Sir Ganga Ram hospital, New Delhi, "HR managers, particularly those responsible for healthcare facilities, face a major daily challenge in boosting the morale of all staff. Research on motivation has shown us that if you want to improve the experience of patients and the reputation of your service, pushing already motivated people to become even more so is crucial."

However, an averagely intelligent HR audit can immediately diagnose this drop in productivity, according to Shrabani Basu, Management Consultant and Corporate Trainer, This is because, it is only to a certain extent, possible to truly 'cure and care' for a patient in all its entirety, only by technical brilliance. A huge chunk of the patients' well being largely depends upon the mental and emotional makeup and well being of the employees of a hospital, that are directly reflected in their concerted emotional and behavioural efforts towards patients. "We all know, in hospitals, it is very important that a patient has to be taken to a high level of 'feel good' domain, which actually affects his responses to drugs and clinical processes towards recovery. To attain this very difficult task of making a patient feel very assured of being well taken care of clinically, is actually largely dependant on his emotional well being along with clinical excellence," she adds.

Pressing Need

The healthcare staff constantly faces tremendous physical and emotional pressure and the nature of the industry makes it even more extracting. Doctors and healthcare staff are not only under pressure from a professional point of view but also psycho-socially as patients and their family members share with them their concerns and grief. While this kind of interaction does give a special dimension to the relationship, but the fact remains that it takes a heavy toll on doctors and healthcare workers. Malcontent employees can even create a sense of gloom and doom in the workplace. In many cases their negative attitude can get transferred to other staff members and bring about low productivity. "The morale of all healthcare workers is especially important since they are dealing with human lives. It also has a direct impact on patients who are already in a troubled state of mind and tend to be more susceptible and affected by the attitude of the healthcare worker dealing with them. Hence, morale boosting becomes extremely essential for a healthcare worker," states Suyash Borar, COO, BM Birla Heart and Research Centre (BMBHRC), Kolkata. Incidentally, healthcare workers, irrespective of their professional stream, are trained and mentored from inception to keep a safe distance from letting the impact of this relationship affect their professional judgment and thereby their overall productivity. However according to experts demarcation between the beneficial involvement with the patient and/ or family for treatment and rehabilitation purposes and cross over to the limit which affects the healthcare staff itself is quite thin; and it is here that they have guard themselves against such possibility." Generally, the care provider scheduling, is done in such a manner that person's duty schedule should avoid building any disturbing relationship between him/ her and the patient. However it is easier said than attained. After all, the staff are also human, it is the humane angle which is playing a predominant role at this juncture." opines Dr Praneet Kumar, Chief Operating Officer, Fortis Escorts Hospital, Jaipur and Director - Quality Assurance, Fortis Healthcare Limited. Therefore in addition to scheduling, seniors in each stream who are sensitive and mature enough to sense any such situation very early, usually intervene. The intervention could be just a simple counseling session(s) for the affected staff to removing the employee from the care giver team or even forced leave of absence at times. All the above actions help prevent or at least minimise any chances of productivity decrease of the individual staff. "What is more important here is the quality of decision making that needs to be protected and therefore it becomes important to institute mechanisms that do not allow the staff to drift into developing emotional relationships that can be counterproductive," adds Dr Kumar.

Morale boosting methods also can go a long way in helping retain the staff. "Issues like attitude of managers towards their subordinates, working conditions, pay, safety, feeling of unfair treatment, lack of recognition, fear of superiors, if all these issues can be dealt intelligently we will definitely be able to retain our employees," feels Anthony Handa, Manager— Personnel, Ruby Hall Clinic. While it is a reality that healthcare staff is currently suffering from a sort of 'compassion fatigue,' not many groups are focusing towards morale boosting. But nevertheless, there are Groups who have taken a small yet positive step forward in this direction. Jaipur based Fortis Escorts Hospital is a case in point. It has created social forums that outline and formulate indoor and outdoor sports activities that are regularly utilised by all, without any differentiation between staff categories. While, this helps in de-stressing the staff, it also helps team building and bonding. The hospital initiated ten day sports meet from this year which the staff managed to attend even after performing their primary duties. Similarly, the entire staff of the hospital was gifted a souvenir— a silver coin with the name of hospital and date of first anniversary as a token of remembrance. "These are few of the activities that we have undertaken that affects the entire staff. Actually, morale boosting activities or for that matter any such intervention for development of soft skills has to remain responsive to changing dynamics and we at Fortis Group invest a lot of time and resources to enable it," shares Dr Kumar. Like Fortis Escorts, there are others like Kolkata-based BM Birla Heart Research Centre, Jaslok Hospital and Research Centre, Mumbai; P D Hinduja Hospital, Mumbai; KG Hospital and Post Graduate Medical Institute, Coimbatore, Max Healthcare in Delhi, Bangalore based Global Hospitals who feel that morale boosting in healthcare is the need of the day and have taken steps to implement some noteworthy measures in this area.

Wednesday, September 3, 2008

New clinic will offer vital dental services to low-income families


Winchester — Uninsured children with teeth full of rot will soon get the relief they need from a new downtown dental clinic.

“New” is relative, though — the clinic will operate in the same space as the Free Medical Clinic of Northern Shenandoah Valley at 301 North Cameron St.

Because the free clinic cannot receive financial compensation under Virginia by-laws, a separate nonprofit called the Dental Clinic of Northern Shenandoah Valley was created so that the dental clinic could receive Medicaid.

The dental facility will begin examining patients from Winchester, Frederick County, and Clarke County at the end of September.

The dental clinic’s ability to accept Medicaid will provide sustainable funding for services previously unavailable to most uninsured families in the area, said Vicki McClelland, executive director of both the Free Medical Clinic and the new dental clinic.

Previously, low-income individuals with severe pain could find help only on Thursday nights at the Free Medical Clinic. Volunteer staffing was limited, and even emergency cases needed to be scheduled in advance.

The new dental clinic will alleviate some of the backlog, allowing dentists to serve “true emergency cases” more easily, McClelland said.

Most private dentists don’t accept Medicaid or FAMIS — Virginia’s health insurance program for children — because of low reimbursement.

The need for the Dental Clinic of Northern Shenandoah Valley has gone unanswered for years in area, McClelland said.

She called the existing situation a “crisis” for local uninsured, low-income families who have been unable to find their children a dentist who accepts Medicaid.

The majority of these families have seen dental care as a luxury that simply wasn’t available to them when rent and food bills were due.

“People are falling through the cracks,” McClelland said. “They’re desperate. Even when parents are educated in preventive dental care, if they don’t have access to it, they’re going to go without.”

Soon, dental services at the Free Medical Clinic will be offered five days a week instead of one, and the dental clinic will be able to serve 100 people each week instead of eight.

About 2,000 adults and children will be served by the dental clinic at one time or another during the year, McClelland said.

It will be open Monday through Friday from 8 a.m. to 5 p.m., with a capacity for about 5,000 total visits per year.

A full-time dentist, two dental assistants, and an office manager will operate the facility Monday through Thursday, treating as many as 10 children and six adults per day. Volunteer dentists will staff the clinic on Fridays.

The dentists will perform preventive dentistry such as teeth cleaning, fluoride application, sealants, oral hygiene, and nutritional counseling, as well as restorative dentistry such as fillings and extractions.

The clinic will not provide dentures or partials, crown or bridge work, braces, or extensive oral surgery.

For the foreseeable future, volunteers will continue to treat adult patients Thursday evenings at the Free Medical Clinic’s Acute Dental Clinic. The “Keep That Smile” clinic will still operate on Fridays.

Dr. Alfred Phillips, 77, has volunteered at the Free Medical Clinic for 12 years. In 2003, he designed the dental space that the new clinic will be using with the vision that it would be “as good as any dental office, if not better.”

And it seems to have worked. The space is sleek and modern, complete with three chairs, a full array of dental equipment, and shiny tile floors.

“Everybody needs quality care,” he said, “regardless of their ability to pay.”

As a volunteer at the Free Medical Clinic, Phillips used to visit schools to examine students’ teeth. “It wasn’t unusual,” he said, “to see 5-, 6-, 7-year-olds with their primary [baby] molars rotted to the gumline.”

“These are kids that have been in pain — they can’t eat, they don’t get to sleep, and consequently that affects school work,” he said.

The Free Medical Clinic started out with a mobile van for dentistry in 1989, but it was discontinued because there wasn’t money to support it.

Before the grand opening of the new dental facility, the clinic’s staff hope to make the space more “children friendly” by bringing in some donated toys, puzzles, hanging mobiles, and a corner play area.

About 60 percent of the clientele will be 18 or younger, McClelland said.

Dr. Richard Taliaferro, chairman of the board for the dental clinic and a Free Medical Clinic volunteer for more than 17 years, said the new dental facility is “something we’ve dreamed about for a long time.”

“And it looks like it’s finally going to become a reality,” he said.

Families with children enrolled in Medicaid, FAMIS, or FAMIS PLUS can call 540-536-1684 for a screening at the Dental Clinic of Northern Shenandoah Valley.

Adults with an annual income of $12,000 or less for an individual, or $24,000 or less for a family of four, may also be eligible for the dental clinic’s services at a nominal fee.

...www.fmcwinchester.org

Wednesday, August 27, 2008

Away from the city


Theresa Fowler was up and dressed for work early Aug. 15, the day the mobile food pantry from Second Harvest Gleaners of West Michigan rumbled into the parking lot of Fifth Reformed Church on M-120 to pass out free food.

Fowler, who had a 10-hour work day ahead of her at the Wesco gas station on Maple Island Road outside Fremont, was in the Gleaners' line by 7 a.m.

The 46-year-old works 40 hours a week, extra if she can, and always on holidays when the pay is higher. Yet, to make ends meet, she has to rely on charity once a month to help put food on the table.

"I'm standing in line because I need help," Fowler said.

She had taken special care to get dressed that morning. Her shirt was pressed; her blue jeans rolled to capri-length; her hair already moussed and spiked into place.

"Can't be late for work," she said.

Her presence, the fact she was in a work uniform, waiting for food, preached a sermon all its own about the plight of Muskegon County's working poor -- people who have jobs but are struggling financially.

"Everyone here's got a story," Fowler said.

She looked up and down the line growing in number, everyone clutching a basket or empty box to fill with food. Some had been in line since before 5 a.m. Fowler was No. 61 in a line that grew to 218 by 10 a.m.

Gleaners trucks, filled with free food, make as many as 10 stops each month in Muskegon County -- but the one on Aug. 15 was unique. Most of the August sites were in the county's urban core. The one at Fifth Reformed Church, located at 2330 Holton not far from the U.S. 31 interchange, was "the farthest out" geographically. It drew residents from Dalton and Cedar Creek Townships, Twin Lake, Holton and homes considered on the "outskirts" of Muskegon County.

"It's tough," Fowler said. "Look around, nobody's job is safe anymore. People are struggling in the city, and out here, too."

Suddenly overcome with emotion, standing in the midst of so much apparent need, Fowler leaned on the shoulder of her next-door neighbor, Diane Blondeel, with whom she had come to the food truck -- and, for a few minutes, she cried her heart out. Her tears prompted a stranger to give up her place in line ahead of Fowler in order to comfort her.

"It's OK. You're a good person," the stranger said, patting Fowler on the shoulder.

Fowler worked to regain her composure, find her voice again.

"That's hard to say; hard to admit. I've always worked, always taken care of myself and my family," she said. "Saying it out loud: I need help. That's hard."

Fowler is caught, squeezed, forced by circumstances into a growing population of the "near" or "working poor." At least one-fifth of Muskegon County residents find themselves in a similar situations, unable to stretch paychecks already strained to the breaking point in precarious economic times.

Fowler, who has two adult children and a grandchild living with her, brings home about $250 a week. Her job includes health, dental and vision insurance "which keeps me going. I don't know what I'd do without that," she said.

"But I'm caught in the middle," Fowler said. "I work, so I don't qualify for (public assistance) from the state, but I don't make enough to get what I need, either."

Like a reliable vehicle, for instance, to get back and forth from work.

Fowler lives in a subdivision in Cedar Creek Estates on River Road in northeastern Muskegon Township on the border of Cedar Creek Township -- "where it's not quite city, but it's not country, either," she said. She doesn't have access to public transportation where she lives. No Muskegon Area Transit System buses go anywhere near her house. She has to drive wherever she goes -- to the grocery store, the drug store, the doctor, to work, even to the Gleaners truck delivery -- which quickly drains her pocketbook in an era of $4 a gallon gas prices.

She drives 30 miles round-trip to her job in an aging, unreliable Jeep she cannot afford to replace, even though the gas gauge is broken, and the engine is suspect. She cannot shift the car into reverse, so she has to carefully plot out her day's travels, or else waste time and gas.

At the same time, she cannot afford to move from her duplex in Creekwood Estates because her rent is determined on a sliding pay scale, "otherwise I don't know what I'd do," she said.

Divorced after 20 years of marriage, Fowler worked three jobs -- a 14-hour day was commonplace -- when her children were younger, just to support them.

"I've always stood on my own two feet," she said. "It's my pride that's hurt ... to have to ask for help now. I've never had to rely on anyone. I always said no matter what it took, even if it meant living in a tin can, I was going to support me and my kids. That's my job. I'm the mom."

Jane Johnson, director of Muskegon County's Department of Human Services, who has worked in the social service sector for more than 30 years, hears stories similar to Fowler's every day. They are the stories behind the statistics of a "nation in crisis," Johnson said. The majority of DHS clients receiving food, day care or emergency utilities assistance are employed.

"We're seeing people asking for help who've never been here before," Johnson said.

Fowler makes too much money to qualify for government assistance, but she cuts corners wherever she can, shopping yard sales. And once a month when the Gleaners' truck is scheduled to stop at Fifth Reformed Church, not far from where she lives, she stands in line for three hours -- or more -- with Blondeel, who is on disability, to receive whatever surplus food they have.

On Aug. 15, she went home with a laundry basket filled with bread and fresh cabbage, surplus sweet corn and tubs of sour cream, lettuce and a carton of soy milk. It is the only Gleaners' stop Fowler frequents. The others are simply too far away to seek out.

Living outside of Muskegon's urban center presents what Johnson called "complicators of distance," challenges that go beyond the skyrocketing cost of propane gas or fewer food pantries in the country.

Think of all the kids who take school buses home -- because there is no other transportation in the family -- and so they can't take part in after school activities. Think of the kids whose parents are having a tough time paying the electric bill, let alone finding the money for field trips, pay-for-play sports or driver education classes.

Saturday, August 23, 2008

Steve Danielsen


Delta Dental of Oklahoma, the state’s first, largest and leading provider of group dental programs, announces the addition of Steve Danielsen as director of sales.
Danielsen has extensive experience in the dental benefits industry. He previously served as regional vice president with Delta Dental of Missouri, and was also a founding partner of an insurance brokerage firm in Kansas City.

A native of Independence, Missouri, Danielsen holds a degree in business management and marketing from Northwest Missouri State University.

“We are very pleased to welcome Steve to the Delta Dental of Oklahoma team,” Delta Dental of Oklahoma Vice President of Sales and Marketing Ken McGuire, said. ”There is no doubt that our growing base of broker representatives, clients and subscribers will benefit greatly from his breadth of knowledge and background in the insurance industry.”

Monday, August 18, 2008

Pennsylvania Farm Bureau Offers Wide Variety of Activities during Ag Progress Days


CAMP HILL — Pennsylvania Farm Bureau (PFB) has planned numerous activities, including the popular kiddie tractor pull contests, along with information and displays on a wide variety of agricultural issues and programs as part of Ag Progress Days, which takes place from August 19-21. PFB’s exhibit building is located at East Fifth and Main Street on the Ag Progress Days cite in Rock Springs, Pennsylvania.

PFB is also hosting a special comprehensive session focusing on oil and gas leasing issues in Pennsylvania. The session entitled: “Natural Gas Leasing: Legal, Tax and Business Aspects for Property Owners” will take place on Tuesday, August 19 from 12:15 p.m. to 1:30 p.m. in the College of Agricultural Sciences Exhibits Building Theatre located on West 10th Street on the Ag Progress Days grounds.

The session will include a general overview of the typical oil and gas lease for those landowners contemplating signing a lease along with practical and technical suggestions that can be used in the lease negotiation process. Meanwhile, landowners who have already signed leases can receive information on income tax, estate tax, inheritance tax and real estate tax issues focusing on oil and gas leases. Finally, planning alternatives for the distribution of land subject to an oil and gas lease will be discussed in the context of the succession planning process for a landowner who wants to transfer real estate to the next generation of farm and non-farm children. Gary J. Heim, an attorney servicing the PFB Legal Service Plan for more than 25 years, will host the session.

Listed below is a breakdown of all the activities at PFB’s exhibit building:

Governmental Affairs and Communications Staff – Pennsylvania Farm Bureau staff will be on hand to answer questions on current issues impacting state agriculture.

Gas Leasing – Exploration and leasing of blocks of land for drilling has heated up in Pennsylvania as energy companies hope to tap into huge reserves of natural gas believed to be contained in the Marcellus shale formation beneath the state. Information on landowner rights and the leasing process will be available at the PFB exhibit building.

Health Insurance – A PFB Health Services representative will be at the show with information on group health care insurance available to members. Options include PPO (Preferred Provider Organization) plans, comprehensive major Medical plans, Health Savings Accounts, Medicare plans and Dental and Vision insurance. Veterinarians in some areas of the state and dog breeders and boarders statewide are now also eligible for PFB’s health care coverage.

MSC Business Services – Farm Management Service account supervisors will be available to discuss the many business services available through PFB including recordkeeping, tax planning and preparation; farm accounting software and computer leasing; and a no-hassle payroll service that takes the headaches out of payroll preparation.

Young Farmer & Rancher ¬– Members of PFB State Young Farmer & Rancher Committee will be at the exhibit area to discuss the leadership development and fellowship opportunities available to young farm families through YF&R programs.

Nationwide Insurance ¬– Find out about the member discounts available to PFB members on farm insurance from Nationwide. Agents will be present to also discuss savings for members on auto, ATV, motorcycle, snowmobile and boat insurance, plus discounts on long-term care insurance.

Women’s Leadership Committee – An interactive display on farm safety and other safety information will be featured at the Women’s Leadership Committee booth.

Member Benefits—Beltone will be offering free hearing screening to visitors. Members can receive a 15% discount on hearing aids. Amerigas will have a representative on hand to talk about the five-cents per gallon discount and other benefits available to members. Members can save 10 – 50% on products, supplies and repair parts from Grainger with free shipping on Internet purchases. A representative will be at the show to talk about products available. Representatives will also be at the show to talk about savings to members on internet services through PA Online, no-annual-fee credit cards through Farm Bureau Bank with credit rebates on purchases. In addition, you can find out more about savings on select Dodge vehicles and Case IH tractors as well as other member benefits.

For the youngsters: Kiddie Tractor Pulls and the “Dairy Dare” – The “kiddie tractor pull” contests will take place daily on Tuesday, Wednesday and Thursday, beginning at 10:30 a.m. and 1:30 p.m. Youngsters between the ages of five through ten will compete in three age categories, with prizes for tractor pull winners sponsored by PFB’s Young Farmer & Rancher Committee. Meanwhile, the Pennsylvania Friends of Agriculture Foundation will host a “Dairy Dare” learning booth for young visitors to PFB’s Ag Progress Days building. Children will learn to identify parts of a cow in a fun, interactive exercise.

Pennsylvania Farm Bureau’s exhibit building at Ag Progress Days will be open from 9 a.m. to 5 p.m. on Tuesday, August 19 and Wednesday, August 20; and from 9 a.m. to 4 p.m. on Thursday, August 21. Pennsylvania Farm Bureau is the state’s largest farm organization with a volunteer membership of more than 44,000 farm and rural families, representing farms of every size and commodity across Pennsylvania.

Tuesday, August 12, 2008

Losing sight


By Bill Coates, bill.coates@azcapitoltimes.com

Shortly before noon, diners line up at the Capitol Café. On busy days, the line spills out into the hallway of the Executive Tower basement. The daily special is written in grease pencil on a small portable sign.

On this day, it’s roast turkey for $4.59.

One of the cashiers is Mike Feeney, wearing wraparound sunglasses. He runs the business.

He’s also legally blind. And that’s no coincidence. Feeney operates the Capitol Café under a federal law known as the Randolph-Sheppard Act. In Arizona, this is administered through the Arizona Business Enterprise Program, part of the Department of Economic Security.

As Feeney rings up the customers, he’s pleasant. He’s efficient.

But, under the surface, not all is well with AzBEP. Among its 30 or so blind operators, some complain DES runs the program with a heavy hand. Others say agency red tape makes it difficult for them to make simple repairs or replace worn-out equipment. And, they say, DES has dragged its feet in opening up new sites — including inside state prisons.

DES has its own side of the story. Kathy Levandowsky, program administrator for Rehabilitation Services Administration — AzBEP’s parent division — says she is just asking operators to follow state procurement policies. And that new business sites will be available soon.

As for the operators, the undercurrent of dissatisfaction surfaced last April, when they met as the Arizona Participating Operators Committee (APOC), a representative group required by federal law. At the meeting, members voted to seek the removal or reassignment of two DES administrators, both of whom work for Levandowsky. The vote was non-binding. It was also unanimous.

Henry Grijalva recalls the atmosphere in the room leading up to the vote. It transcended the usual business of discussing new inventory controls and hearing from wholesalers — including one who gave a Starbucks coffee taste test.

“In the back of our minds, we knew something was going to hit the fan,” says Grijalva, 55.

One day he sat at the dining table of his Glendale home, sporting a T-shirt soaked in sweat. He had just finished mowing his lawn, which he does blind. He has been visually impaired from birth. Under AzBEP, Grijalva services vending machines at interstate highway rest stops. An employee drives.

There was little discussion about the vote, Grijalva says. The minutes of the meeting offered few specifics.

But there were undercurrents. And there was Robert Smith.

Smith, the riptide

Smith’s case was the riptide. For many operators, Smith was the victim of an agency that failed to play by the rules. AzBEP policy is set by DES with input from the operators.

The 61-year-old Smith runs Trebor’s, an AzBEP cafeteria at the Maricopa County court complex in Mesa. Trebor, he points out, is Robert spelled backward. He takes a visitor to a small office in the back. He is an outgoing, affable man, as well as a plain-spoken ex-Marine.

He lost his sight in an industrial accident.

“I’m blind as a bat,” he says.

His complaints against DES are both philosophical and personal. On the philosophical side, he says the Randolph-Sheppard Act comes with a built-in conflict.

Created in 1936, the New Deal program offered blind people a chance to run their own businesses on federal and state property. As amended, Randolph-Sheppard gives blind operators priority in setting up cafeterias and vending-machines in federal facilities. Under AzBEP, they also operate food services in state, county and city buildings. Arizona law also gives them priority.

Operators must first undergo six months of training. Right now, about half-dozen newly trained operators await an opening.

Like businessmen, operators hire employees, pay overhead and seek to make a profit.

But unlike most businessmen, they’re wedded to a state bureaucracy. For Smith, it’s like an unholy alliance between government and private enterprise.

For the most part, it works. He says AzBEP has given him a livelihood he would not have had otherwise. But there’s always room for improvement.

“I feel very strongly about this program, and I’m just irritated to death it is so screwed up,” he says.

Then he hands a visitor a stack of papers. He can’t read them, but he knows what order they’re in. They’re a record of his complaint against DES, which goes back to early in the year when Joni Spinka put in a bid to take over a snack bar at the Phoenix Indian Medical Center.

At the time, Spinka operated the Capitol Café in the Executive Tower basement. After she received the go-ahead for the Indian Center, Smith put in a bid for Capitol Café.

A winning bid requires approval from two committees. Each committee has four members, two from the agency and two operators. The first, the qualifying committee, screens applicants. The selection committee makes the final choice among qualified applicants. Candidates take a test and undergo a face-to-face interview.

“The final analysis is what your gut instinct is — who’s going to be the most successful in an operation,” Smith says.

The qualifying committee gave Smith a pass in his bid for the Capitol Café. The selection committee chose him over other candidates, including Mike Feeney, who operated a cafeteria at the Desert Schools Federal Credit Union in east Phoenix.

Randolph-Sheppard administrator Ed House, however, overturned the decision. The agency has final say, but Smith says House was wrong in this case. Smith filed a grievance against DES.

He says the case hinges on $50,000 he borrowed to make payroll after he took over a cafeteria about eight years ago at Fort Huachuca. Most operators — upon taking over a business — get a few a hundred dollars in the cash drawer, in addition to the inventory.

He had five years to pay off the debt, he says. But a massive heart attack put matters on hold. He doesn’t dispute the debt, and says he had paid off most of it. But he had no record of what he still owed, and couldn’t find out, he adds.

Grijalva was on Smith’s selection committee. No one from DES told the qualifying committee that Smith had stopped making payments, he says.

“Robert did do his homework, and he asked the office if he owed any money, if he was all right — if there were any issues. There were none,” Grijalva says.

Debt itself doesn’t disqualify an applicant. But the operator has to arrange payments. DES administrator Levandowsky says privacy issues bar her from discussing individual operators.

Sorting it out

The agency did make its case before Administrative Law Judge Richard Woodlock in early June, however. Woodlock held what amounted to a preliminary hearing to sort out the facts.

Assistant Attorney General Kevin Smith told Woodlock that House had acted properly in denying the bid. In addition, Robert Smith had a payment plan, but he wasn’t paying.

“If he had been in conformance with that payment plan, they would not have rejected the recommendation,” Kevin Smith said at the hearing.

Robert Smith acknowledged the debt, but says the agency never gave him an exact figure.

“I made every attempt to discover how much was owed,” Smith told Woodlock.

A full hearing on Smith’s case is set for Aug. 14.

Generally speaking, Levandowsky says, DES does not send out statements.

“Once they made that arrangement, then they’re responsible for just making monthly payments,” she says.

Most operators go into debt, she says, because they fall behind on payments to what’s known as a set-aside. Each operator pays the agency 20 percent of net profit. On a $50,000 profit, for example, the operator pays DES a $10,000 set aside. The money benefits the operators.

This year’s total set aside comes to roughly $465,000. Of that, two-thirds goes toward operators’ health and dental insurance. About 10 percent guarantees a minimum wage for operators whose profits fall short. Another $108,000 draws in federal matching funds, totaling $400,000 to replace and repair equipment.

The set-aside varies from state to state. Arizona has one of the highest, says Kevan Worley, president of the National Association of Blind Merchants, an advocacy group headquartered in Colorado Springs, Colo.

He doesn’t see a problem, he adds, if it’s money well spent.

Levandowsky says it is.

“Some states require operators to pay for their own maintenance and repairs,” she says.

In Arizona, a new case-management system should make it easier to track set-aside debt, as well as inventory.

“That will help them to see what their balance is,” Levandowsky says.

What’s more, DES provides a debtor list at each APOC meeting. Smith says his name never appeared on that list.

Aside from Smith’s complaint, operators have other issues on their plates, including timely replacement and repair of equipment. Red tape has hampered that, they say.

Levandowsky says it’s not red tape; it’s policy. She insists that operators use DES contractors. It’s required by the procurement code, she says. She adds she understands operators’ frustrations, suggesting they were taken out on the two DES officials who report to her.

That would be RSA administrator House and AzBEP program manager Otis Stevenson, targets of the APOC no-confidence vote in April.

Despite the vote, Levandowsky has no plans to back down.

“I can’t go against policy. And I don’t want my staff to go against policy,” she says.

DES declined to make House or Stevenson available for comment.

No time to wait

Allan Curry, past APOC president, says operators don’t always have the luxury of waiting for DES to approve an equipment order.

“If you’re at the Capitol and your ice machine goes down, and you got to spend $9,000 on a new machine, and you have to wait several days or weeks for that, that puts a hardship on the operator,” says Curry, who runs the Rain or Shine cafeteria at the main Phoenix post office.

Curry, 44, has his own hardship story. His cafeteria could use a new sandwich-prep counter.

“The one I have is broken, and it costs too much to repair it. So they’ve got to replace it,” Curry says. “I’ve been waiting for that for six months.”

Levandowsky, however, says emergency repairs have been streamlined.

“They call it in, and then we request emergency procurement authority from our DES procurement office,” Levandowsky says.

Curry says the emergency plan is helpful, if not perfect. But he gives the AzBEP consultants — who advise the operators — an “A” for effort.

“They’re trying the best they can,” Curry says.

For Grijalva, DES remains heavy on the stick and light on the carrot.

“Here in this state, unfortunately, I think we got more of a police program than a proactive program,” he says.

For one thing, he’d like DES to do more to expand AzBEP’s reach. He cites the agency’s inability to set up vending machines in visitation rooms at state prisons.

“We should be able to do all the vending machines in the prisons,” he says.

Levandowsky says she has been talking to prison officials.

“We’re trying to work with the Department of Corrections,” she says.

But security arrangements don’t mesh easily with the requirements of Randolph-Sheppard, she adds. Among other things, operators need access to the machines.

“We’ve got to work through those, so we make sure the operators get behind the gates,” Levandowsky says.

A DOC spokesman had little to add, except to say no agreement has been reached.


More to come

Levandowsky says other facilities are opening up, however. In addition to a new snack bar at Phoenix parks senior center, a coffee shop is going inside Phoenix Burton Barr Central Library. AzBEP is spending about $450,000 to build and equip the facility, with the city paying for utility hookups.

“It should be open at the end of August, the first of September,” Levandowsky says.

In addition, DES seeks to set up more businesses outside the Phoenix and Tucson areas, Levandowsky says.

“We’re going to be sending out a letter that that says, ‘You may not be aware of the BEP program. We’d like you to know what our services are, and what our program is about,’ ” she says.

Even as AzBEP expands, Randolph-Sheppard has hit a rough patch nationwide, says Worley, president of the Blind Merchants Association.

“I think it’s no secret that the program nationally is struggling a bit,” he says.

Every state but Wyoming has a Randolph-Sheppard program.

But business for many of the nation’s 2,500 blind merchants is down for a number of reasons, Worley says. One is the outsourcing of federal work to the private sector. That means fewer employees in federal buildings, where cafeterias are located. Then there’s the growing popularity of the four-day workweek. Business might be good Monday through Thursday, but bad on Friday.

Many state employees already have “flex time,” allowing them to work longer days in exchange for Friday, or every other Friday, off. This appeared to hit home in the cafeteria at the Department of Education, run by Joy Winston. Ordinarily, the lunch business is brisk and booths are hard to come by. On a recent Friday, though, the seating was wide open.

What’s become a frustrating trend for AzBEP operators — there are more than a half-dozen in the Capitol area — could get worse. Gov. Janet Napolitano is looking into a four-day workweek for many state employees to cut commuting costs and pollution.

All the same, AzBEP operators have to make a profit to stay in business. At minimum, an operator is expected to make a profit of $25,000 yearly. Below that, an operator could not make a living, Levandowsky says. For any operation, net revenue should run 12 percent above expenses.

When Grijalva earned only 6 percent on his own operation, he was disqualified for a bid on another site in 2007. He filed a grievance. The administrative law judge found in his favor, ruling out negligence and mismanagement as possible reasons for Grijalva’s poor showing. His business suffered from circumstances beyond his control, the judge wrote.

Grijalva says he had trouble finding labor and had asked AzBEP for help.

“I had multiple requests for assistance, and it wasn’t coming,” he says.

Despite the battles with bureaucracy, Grijalva has no plans to give up on Randolph-Sheppard anytime soon. It has given him steady, stable work since 1979. Many, if not most, operators have been in the program job for years.

“It has been the most effective employment tool ever devised,” says Worley, who operates a cafeteria on a Colorado military base.

Emilio Mosca, 59, agrees, in a measured, low-key way while sitting across from a visitor in a booth at his cafeteria, Emilio’s — on the second floor of the Arizona State Compensation Fund building near uptown Phoenix.

Mosca says simply that AzBEP is a good program. And, though he understands the complaints against it — in his 18 years as an operator, he’s heard them all before.

With a memory that stretches beyond experience, he adds: “They’re the same issues we’ve been hearing for 25 years.”

Sunday, August 10, 2008

Dental benefits widen, waiting lines grow


Two years into the state's bold healthcare experiment, its early success in expanding dental coverage may be threatened by a shortage of dentists willing to treat newly insured patients.

Since getting free or subsidized dental coverage in 2006, more than 200,000 low-income adults have climbed into Massachusetts dentists' chairs for work on their long-neglected teeth. But increasing numbers of patients are expected to seek care, and advocates fear the wait for appointments, now three months at community health center clinics, will grow.

The problem is that just 17 percent of dentists statewide have been willing to see these newly insured patients, despite reforms intended to boost their ranks. Even some of these dentists are limiting the number of state-subsidized patients they will treat.

Dentists say the state's reimbursement rate for adults covers only about half their costs, and they also cite payment delays and burdensome paperwork.

Without more dentists, said Kerin O'Toole, spokeswoman for the Massachusetts League of Community Health Centers, patients will not be able to get timely preventive care and "we risk treating people with more expensive and serious health issues."

As part of the healthcare law's goal of extending insurance to nearly everyone, dental benefits were restored to roughly 540,000 low-income adults who had lost nearly all dental coverage under Medicaid budget cuts in 2002. The law also expanded eligibility, prompting another 140,000 to sign up through Medicaid or the newly created Commonwealth Care subsidized program for the previously uninsured.

Suddenly, thousands of patients who had not opened wide in years were calling for appointments, and the number of Medicaid patients who saw a dentist more than doubled in the first full year, from about 15 percent of adults to 35 percent, state data show.

Among the newly insured is Pam Anasoulis, a 48-year-old telemarketer from Beverly who has also wired helicopter engines and fixed conveyor belts to make ends meet. For her, entree to the dentist after years of oral neglect was bittersweet. The mother of two grown children, she had broken a front tooth in 2004 and had gone to a dentist who filed down several of her front teeth to make a temporary bridge.

But Anasoulis said she couldn't afford health insurance and could not afford to go back to have the work completed. The bridge broke, decay set in, and Anasoulis was left with stubs for front teeth.

"You really don't think, when you look at someone with missing teeth, how much they're hurting inside," she said. "I got so depressed I didn't go out."

When she finally found her way to the Lynn Community Health Center dental clinic in 2006, many of Anasoulis's front teeth had to be extracted. But Dr. Herlivi Linares, the clinic director, was able to save some of her teeth and make her a partial denture.

Tuesday, July 29, 2008

Kalamazoo County boosts dental clinic's budget by $500000


Posted by Chris Killian | Special to the Kalamazoo Gazette

KALAMAZOO -- A Kalamazoo County program aimed at keeping the mouths of schoolchildren and low-income residents healthy may expand its services.

A one-time increase of $500,000 to the Kalamazoo County Health and Community Services Dental Clinic budget has been proposed to county commissioners by Finance Director Bill Dundon. The money would be part of the 2009 budget.


A group of county health officials will be assembled to discuss how best to spend the $500,000. Commissioners will begin budget deliberations in the fall.

Commissioner Brian Johnson said there is support on the board for the clinic and expects the $500,000 to hold firm in the budget process.

"(The clinic) is one of the most important things we can do from a public health standpoint," he said.

Every month, 325 scheduled patients and 80 walk-ins receive services at the clinic, ranging from tooth cleaning and extractions to dental examinations and fluoride treatments.

A mobile clinic provides services to 1,000 schoolchildren in the county each school year.

But about 30 people seeking services are turned away each day because of lack of staff and space, said Linda Buzas, Kalamazoo County health and community services director.

On the first Monday of every month, clinic officials begin taking appointments for the month. Within three hours, the month's appointments are booked, she said.

The clinic operates with an annual budget of $900,000, employing three dentists, three hygienists and six other support staff. It has six dental chairs.

"There is always going to be more need out there than we can accommodate," Buzas said.

Health-care providers have long stressed that maintaining dental health is important to overall health.

To be eligible for clinic services, a person must be a county resident and on Medicaid or not have dental insurance.

"We're at a point where we need to sit down and figure out what we should do with the dental clinic because it is such a highly demanded service," Buzas said. "Right now, we cannot add anymore capacity, and that is leading to some vastly unmet needs."

Sunday, July 20, 2008

Charity Begins at Home - U.S. Physicians Volunteer


One of the biggest crises facing the United States today is healthcare. There are approximately 47 million people in the United States who have no medical insurance. Millions more have inadequate insurance coverage, cannot afford their premiums or deductibles, and have no access to dental care.

In the wake of recent international disasters (Myanmar and China to name the most recent), much publicity has focused on foreign aid. The U.S. spends billions of dollars every year to help those less fortunate in other countries.

But are they doing enough for their own citizens?

Friday, July 18, 2008

Dental Clinic Opens To Uninsured Patients


By Jeremy Hunt

HARRISONBURG - Marion Messmer was close to retiring from dentistry earlier this year, but then she heard about the Harrisonburg Rockingham Dental Clinic.

"I didn't have any intention of doing this," said Messmer, who recently moved to Harrisonburg after practicing dentistry for 20 years in the Arlington area. "Once I learned about this, I thought, ‘You know, they really need help with this.'"

The dental clinic needed a professional to get the program started, and Messmer took the job.

The Harrisonburg Rockingham Dental Clinic began seeing uninsured patients Monday.

It was formed by the Harrisonburg Rockingham Free Clinic, located at 24 W. Water St., to provide low-cost dental care to uninsured and Medicaid patients.

The dental clinic, which operates in the same building as the free clinic, is open three days a week from 8 a.m. to 4:30 p.m., alternating between a Monday-Tuesday-Wednesday schedule and a Wednesday-Thursday-Friday schedule.

A basic dental care visit costs $30. For major dental work, such as root canals and crowns, the clinic will refer patients to local dentists at reduced costs, said Rich Sider, executive director of the free clinic.

To qualify for dental service, patients must be residents of either Harrisonburg or Rockingham County, have no dental insurance, and earn up to 200 percent of the federal poverty level. The poverty level is an annual income of $10,400 for one person and $21,200 for a family of four.

The dental clinic is waiting for Medicaid approval to begin seeing those patients, including uninsured children, Sider said.

The free clinic estimates that 60 percent of Medicaid recipients in Harrisonburg and Rockingham County don't have access to dental care, and most of them are children.

In April, the clinic estimated about 300 of the 900 people it treats each year have some kind of dental problem.

Sider said the dental clinic should be approved for Medicaid around the end of the month.

The staff consists of Messmer and two assistants, but as the program develops, the clinic will hire more people, Sider said.

The clinic will eventually be open five days a week as the staff grows, he said.

Although she is the only dentist on staff, Messmer said she has a lot of support from others in the community.

"I don't feel like I'm in this by myself," she said. "There are people who will be there to assist me."

Messmer said uninsured people are likely to ignore problems until they're no longer tolerable, but that's something she wants to change with her work at the clinic.

"There's gonna be a lot of difficult work here," she said. "What I want to try to do is focus on prevention ... and saving your teeth and how."

Contact Jeremy Hunt at 574-6273 or jhunt@dnronline.com

Saturday, July 12, 2008

Taking a bite out of dental costs


By: Adrianne Flores

GREENSBORO – While routine check-ups are something that every child needs to stay healthy, they aren’t always in the budget for many parents. The Guilford County Department of Public Health tried to offer some help with the problem on Tuesday.



Taking 6-year-old Jaylen to the dentist Tuesday wasn't exactly in Michael Clapp’s plans, or the budget. But thanks to the department’s new low-cost dental clinic, Clapp was able to take his son.



"He fell and chipped his tooth. And he said his tooth was hurting. So I brought him here for them to check it out, make sure there ain't nothing damaged,” explained Clapp of his son. "It's a help when you ain't got the money to come out your pocket… when you need that money for food or something else."


This new low-cost program is for families who don't qualify for Medicaid or N.C. Health Choice -- the state's health insurance program for children. Dr. Lad Landau says these children often don't get to see a dentist until it's too late.



"They've got other problems and dentistry is put on the side until there's a toothache,” explained Landau. “And then it really becomes much more of a problem for us to treat."



The clinic offers a variety of routine services including $15 exams, and $25 cleanings. The clinic is open Monday through Friday, 8 a.m. to 4:30 p.m.



For more information about the program, or to make an appointment, call the Greensboro office at (336) 631-3152. In High Point that number is (336) 845-7733.

Wednesday, July 2, 2008

Porcelain vs. Bonding


Today’s cosmetic dentists are not only focused on the oral health and well-being of their clients, they put a lot more energy and creativity into the overall appeal of a person’s smile.

Your smile says a lot about who you are and is often the very first impression someone will take in and remember about you. Why not put forth the best you can possibly offer? Which is better, porcelain or bonding?

For Appearances

Porcelain veneers are the most attractive of the two alternatives. They are translucent, which means they can be seen through and are able to reflect the light naturally, just the way your own teeth do.

Bonding, on the other hand, is opaque and reflects the light off of the tooth’s surface. This may give less of a natural appearance to the treated teeth. Overall, porcelain remains the most natural in its appearance and is often the best choice for this reason.

Cost
The cost of porcelain is much higher than it is for bonding, so bonding is more likely to be paid for by dental insurance, if proven to be a needed procedure.

Convenience - Porcelain cannot be completed in one visit to your cosmetic dentist’s office, so this raises the cost and requires at least two visits to complete.

Durability - Porcelain can tend to be brittle and is a bad choice for someone who may grind their teeth. The porcelain can actually break under the pressure of a strong bite and is not as easy to repair as bonding. Alternately, porcelain resists stains much better and is easier to keep clean.

For more help in deciding whether porcelain or bonding is best for you, contact Dr. Spinner’s cosmetic dentistry clinic today.

Monday, June 30, 2008

Teeth whitening is usually better with dentists' help

Area dentists offer a variety of options for those seeking a whiter smile.

“We do the overnight process with custom-fitted trays, but the Zoom! treatment is very popular now,” said Dr. Shabbir Hashim of Westgate Dental Arts in Toledo. The process lasts about 40 minutes, and Zoom! can make teeth eight “shades” whiter.

“Before we start, we don't give an exam, but we do a screening to check for decay,” Hashim said. “We go over the medical history to make sure we won't cause any allergic reaction. Then we apply a liquid dam to the gum tissue, which hardens and keeps the whitening material from touching it.”

Hashim then applies a carbamide peroxide to the mouth and turns on a bright, non-UV light to activate the material.

He said since trained assistants perform the procedure, his firm is able to keep costs low, about $400 to $500 per treatment.

“But I like to check in after the procedure,” he said. “We take a ‘before' and ‘after' photo.” The traditional process, using the custom trays for a few weeks of overnight treatments, costs $250 to $300 at his firm. Over-the-counter whitening strips cost $20 to $50, but most dentists agree they are not as effective as “chairside” treatments or custom trays from the dentist. Some dentists offer professional-strength whitening strips.

Hashim said sensitivity of the teeth and gums is a common side effect of the whitening treatment, but it is “transient.”

Dr. Jon Frankel, who has offices in Toledo and Maumee, said his office uses a light-activated whitening system similar to Zoom! called BriteSmile.

“After an in-office treatment, though, we still recommend the tray whitening,” Frankel said.

Frankel said whitening treatment from retail stores “definitely whitens teeth,” but dentists offer products with a higher concentration. Frankel offers the tray whitening as well, and the various treatments cost $200 to $600.

“There's no one who whitens who doesn't love it,” Frankel said.

Patient Michael Carroll owns Carroll Insurance in Maumee and has rewarded four employees with whitening at Frankel's practice.

“It's been a huge home run,” Carroll said, noting that he has had his teeth whitened by Frankel, too. “I brush, I floss but teeth get stained and lose a little of their natural whiteness, especially for those of us who enjoy Diet Cokes and blueberries. Everyone wants to look well.”