Monday, April 13, 2009

News Clipping Archives

 

Maryland / Regional

Budget problems will persist (Baltimore Sun)

O'Malley says federal help avoids fiscal trouble (Daily Record)

Rabies vaccine is best way to protect pets (Salisbury Daily Times)

Maryland awarded nearly $1M for electronic health records (Baltimore Business Journal)

Testing the waters (Baltimore Sun)

Our Say: Hospice official's work improved our community (Annapolis Capital)

EPA grant to help clean groundwater (Baltimore Sun)

Produce-linked food poisonings on the rise (Baltimore Sun)

 

National / International

Stimulus Opening Doors in Health Care IT (Washington Post)

Handling questions about your special needs child (Baltimore Sun)

Taking a Page, and a Pen, From Makers of Medicines (New York Times)

 

Opinion

Addiction Behind Bars (New York Times)

Finding and Treating Depression in Teenagers (New York Times)

 

 

Maryland / Regional

 

Budget problems will persist

Deficits loom in Maryland's future

 

By Laura Smitherman

Baltimore Sun

Monday, April 13, 2009

 

Maryland lawmakers plan to wrap up work Monday on a $14 billion budget after months of agonizing over how to plug an enormous shortfall caused by deteriorating revenues and mandated spending growth.

 

But all that effort still won't put the state on solid, long-term financial footing.

 

Even with the influx of federal stimulus money, the General Assembly will reconvene in nine months facing a budget gap that analysts expect will reach more than $1 billion.

 

And, some would argue, it might be the worst possible time for Gov. Martin O'Malley and lawmakers to make unpopular cuts that could include layoffs or curtailing services.

 

After all, it will be an election year. The governor is expected to seek a second term, and all 188 General Assembly seats will be on the ballot.

 

"Next year is going to be enormously challenging, and that's an understatement," said Warren G. Deschenaux, the legislature's chief fiscal analyst, who has pointed out to lawmakers that the next budget they craft will take effect four months before they face re-election.

 

O'Malley, a Democrat, said in an interview that the fast-approaching election was not a factor in budget decisions, and he has blamed a national recession for "one big wave of red ink crashing over our bow."

 

Still, again this year, many of the most difficult decisions were delayed. While incorporating a raft of spending reductions, the state budget masks an underlying imbalance between revenues and expenses by relying on federal dollars and a series of transfers.

 

"There are some who say, 'Why don't you just get ahead of this?' " O'Malley said. "But if getting ahead of it means cutting into core services, if getting ahead of it means contributing to the economic woes by laying people off ... how do you do that?"

 

Some in Annapolis say the governor's strategy reflects his upbeat attitude about government.

 

"He's an optimist; he's hoping for the best," said Senate President Thomas V. Mike Miller, a Democrat representing Calvert and Prince George's counties. "He regards the state as being benevolent, as being a force of good that can assist people in times of need and help move the economy forward."

 

But others call the approach foolhardy.

 

"Much of what's being counted on is hope," said Sen. David R. Brinkley, a Frederick County Republican and longtime budget committee member. "They are just crossing their fingers that the economy gets better instead of dealing with the problem."

 

An economic recovery could reverse a precipitous decline in income and sales taxes, but budget forecasters predict that the economy will continue to slow over the next year.

 

In fact, the economy would have to rebound significantly - growing 5 percent next year and 10 percent the year after that - to erase impending shortfalls, Deschenaux said.

 

"I think we're all hoping that at some point things will stabilize," said Del. John L. Bohanan Jr., a St. Mary's County Democrat on the Appropriations Committee. "Regardless of a looming election, the No. 1 priority is to remain in balance and maintain our AAA bond rating."

 

Maryland is one of a handful of states that have received the top ranking from credit-rating agencies, which enables the state to obtain lower interest rates and therefore save taxpayers money.

 

The fiscal outlook only gets worse, according to current projections. After federal stimulus funds run out the year after next - a time that legislative analysts refer to as "the cliff" - the state budget shortfall is projected to be $1.8 billion.

 

That's more than the gap that prompted O'Malley to call a special legislative session in late 2007 to raise taxes by $1.3 billion and legalize slot-machine gambling to boost the state's coffers. Voters ratified the slots plan in November, but bidders sought licenses to operate only a portion of the machines authorized, meaning the program might not reach its financial goal.

 

Over the next several months, O'Malley could be in the position of taking more budget cuts to the Board of Public Works, which also includes Comptroller Peter Franchot and Treasurer Nancy K. Kopp. While lawmakers had originally envisioned leaving a cash balance of as much as $400 million for the budget year that begins July 1, they settled on a cushion one-fourth that size.

 

Then the legislature reconvenes in January, potentially facing another round of painful budget decisions after having pared spending for local government aid and other programs this year, and after state workers have been required to take furloughs.

 

O'Malley and Democratic leaders have insisted they would not pursue tax increases during the 2010 election year, and they might have little ability to tap into reserves after transferring hundreds of millions of dollars from those funds to keep the operating budget afloat this year. That leaves one chief option: more budget cuts.

 

"It does seem like every year we have this situation," said Sen. James E. DeGrange Sr., an Anne Arundel County Democrat on the Budget and Taxation Committee.

 

Copyright 2009 Baltimore Sun.

 

O'Malley says federal help avoids fiscal trouble

 

Associated Press

Daily Record

Monday, April 13, 2009

 

ANNAPOLIS — Gov. Martin O'Malley has been up against difficult financial problems since taking office. But for his third full legislative session, the challenges were so extreme the Democrat is at a loss to say what he would have done without federal stimulus funding.

 

The 700 state employee layoffs O'Malley considered in January when he submitted his budget proposal were avoided. He also was able to steer clear of a $69 million cut in education assistance that was in the budget he first proposed.

 

"I can't imagine how we would have gotten through this session without the federal help that came to us, thanks to President Obama and our congressional delegation," O'Malley said in an interview just days before the General Assembly was to adjourn Monday. Maryland received more than $2 billion in federal help for fiscal years 2009 and 2010.

 

But even with the help, it's been difficult to balance the state's books. Lawmakers on budget conference committees agreed Friday on a slimmer $13.8 billion operating budget that includes cuts to local governments, including $162 million in local road maintenance, snow removal and road paving.

 

O'Malley is preparing for more bad news as the recession grinds on.

 

"Probably, when this session adjourns, the Board of Public Works will go back to making even more cuts, as we had before, until, with President Obama's leadership, we're able to get this economy out of the ditch," O'Malley said.

 

To critics who point to a structural deficit of more than $1 billion in coming years, O'Malley said Maryland is in better shape than many other states because of cuts and tough tax increases since he took office in 2007. The governor also hopes Maryland is in a better position to climb out of the recession's throes.

 

"I know it doesn't feel like it, but we actually are ahead of it when, in relative terms, when you compare how we are faring to other states," O'Malley said.

 

Meanwhile, O'Malley is ready to sign whichever bill the General Assembly is able to negotiate between two different measures on restricting driver's licenses for illegal immigrants.

 

He initially indicated support for ending a policy of giving licenses to illegal immigrants, then said he preferred a compromise bill that creates a two-license system. The plan allows illegal immigrants who already have licenses to renew them and receive a separate ID that can't be used to board planes or enter federal buildings.

 

Republicans accuse O'Malley of a bait-and-switch. They compare him to former New York Gov. Eliot Spitzer, who backed and then dropped a two-tier license system there after residents revolted.

 

O'Malley says the Maryland proposal isn't a two-tier system, but a "phase-out" plan because the state wouldn't issue new licenses to undocumented residents.

 

"There's a certain logic and a certain practical merit to grandfathering in people who have already been issued licenses," O'Malley said.

 

The governor has pushed for a tuition freeze at in-state public colleges and universities for a fourth consecutive year — and into a gubernatorial election year, and it's looking like the University System of Maryland will follow through with the plan.

 

"It's not an easy time for them either, and they'll have to make adjustments, but I'm confident that if the legislature upholds its part of this effort — namely leaving the dollars in the budget to forestall a tuition increase — that the Board of Regents will act accordingly," O'Malley said.

 

Legislation backed by O'Malley to allow speed-monitoring cameras near schools and highway work zones cruised to passage.

 

But O'Malley has had his share of problems this session, even outside the budget.

 

A measure he backed relatively late in the session to put Maryland back on track to re-regulate power companies has run into trouble. While the Senate approved the bill, the House looks unlikely to plunge into its complexities in the waning days of the session.

 

"At the outset, we did not anticipate that there would be that degree of nervousness in the House," the governor said. "But a lot of members of the House are very nervous about voting for any change in the regulatory framework unless they understand A-to-Z, absolutely, exactly what they're voting for, and it's understandable."

 

O'Malley legislation that would have created civil penalties for Medicaid fraud was rejected in the Senate after heavy lobbying from doctors' associations, hospitals and drug companies.

 

O'Malley also had to settle for a compromise on his effort to repeal capital punishment. A divided Senate amended the bill, agreeing only to limit its use to murder cases with biological evidence such as DNA, videotaped evidence of a murder or a videotaped confession.

 

Copyright 2009 Daily Record.

 

Rabies vaccine is best way to protect pets

 

By Calum McKinney

Salisbury Daily Times

Monday, April 13, 2009

 

SALISBURY — Maryland law requires all cats, dogs and ferrets to have a current vaccination against the rabies virus. Yet every year, dozens of pets in the state are needlessly euthanized due to exposure to the incurable disease.

 

According to Wicomico County environmental health officials, “Rabies vaccination is the best way for pet owners to protect the animals they love.”

 

From Old Yeller to Cujo, images of foam-mouthed dogs have long been associated with the disease. But according to a 2008 Centers for Disease Control and Prevention report, far more cats than dogs are diagnosed with rabies each year. The number of cases of rabies in cats is second only to infections in that ubiquitous Eastern Shore inhabitant, the raccoon.

 

Regardless of whether you own a cat, dog or any other mammal, there is no treatment available once it has been exposed to rabies. If your pet does not have a current rabies vaccination on record, the consequences of exposure are severe. State law requires that an unvaccinated pet be euthanized or complete a 180-day strict isolation quarantine after contact with a suspected or confirmed rabid animal. If your animal’s vaccination is current when it has exposed, then it only needs to receive a booster vaccine and complete a more relaxed 45-day observation period.

 

Vaccination is a simple, easy process. For more information on getting your pets vaccinated or to report animal bites or scratches, call the Wicomico County Health Department, Environmental Health Division at 410-546-4446 during business hours or 410-543-6996 after hours.

 

Copyright 2009 Salisbury Daily Times.

 

Maryland awarded nearly $1M for electronic health records

 

By Sue Schultz Staff

Baltimore Business Journal

Monday, April 13, 2009

 

Maryland health clinics will receive up to $951,000 this year in federal funds to pay for new electronic health records.

 

Funding for the project was part of a $410 billion Omnibus Appropriations Act signed by President Barack Obama last month. The legislation funds the operations of the federal government through Sept. 30.

 

U.S. Congressman C.A. “Dutch” Ruppersberger, a Maryland Democrat, is slated to announce the funds Tuesday at the Chase Brexton Health Service center in Randallstown.

 

The technology will be used at eight health centers in Maryland. In the Baltimore region, centers with the technology will serve Baltimore City, Baltimore, Anne Arundel and Howard counties.

 

“This electronic patient record system is the future of health care by improving overall patient care while at the same time reducing costs,” said Ruppersberger in a statement released Monday.

 

Health information technology is also a funding priority in the American Recovery and Reinvestment Act signed Feb. 17. Nearly $19 billion of the $787 billion in federal stimulus package is slated for electronic health records nationally.

 

The state of Maryland has made its own push toward electronic health records. State lawmakers earmarked $250,000 grants for two projects last year studying how to build a statewide health information exchange. And Maryland doctors are eligible for federal incentives and greater reimbursements from insurance carriers such as CareFirst BlueCross BlueShield for installing and using electronic health records.

 

All contents of this site © American City Business Journals Inc. All rights reserved.

 

Testing the waters

A new study says swimming lessons for very young children can reduce the risk of drowning, perhaps easing some long-standing concerns

 

By Stephanie Desmon

Baltimore Sun

Monday, April 13, 2009

 

Christopher Ward is only 3 years old, but already he is a swimmer, making his way the entire length of the pool at the Ellicott City Y and then, after a little break, back again.

 

His mother, Colley, signed him up for his first lesson when he was 6 months old. As he got older, she knew she had to keep enrolling him in classes. "My child's a daredevil. When he was 2, he'd just jump in, no matter how many times I said, 'Don't do that,' " she said.

 

He would have to learn how to swim or he could hurt himself or worse. "Now I feel more confident with him in the water," she said. "I know he has basic skills at this point."

 

A National Institutes of Health study published in last month's Archives of Pediatrics and Adolescent Medicine found that providing very young children - like Christopher - with swimming lessons appears to significantly reduce their risk of drowning.

 

The study is the first of its kind, and researchers hope the findings will ease concerns of pediatricians. Many have long felt that giving swimming lessons to children ages 1 to 4 might actually increase their drowning risk by making parents less vigilant when children are near the water and by decreasing children's natural - and healthy - fear of the water.

 

Still, concluded the authors: "Parents and caregivers who choose to enroll their children in swimming lessons should be cautioned that this alone will not prevent drowning and that even the most proficient swimmers can drown."

 

Parents often ask Dr. Robert Ancona, chief of pediatrics at St. Joseph Medical Center in Towson, whether their infants and toddlers should take swimming lessons. "Overall, we kind of advise against it," he said.

 

He worries that everyone involved - parents, caregivers, the children themselves - may develop a false sense of security from formal lessons. Parents may pay less attention to their little ones around the water. Children might wander off alone to a pool, believing they know how to swim. The results can be deadly.

 

Ancona says that while swimming lessons might be fun, the skills taught are "not to be relied on" as a way to prevent drowning, especially in children younger than 4.

 

"You're getting them used to the water, they may learn to float, but they're not going to learn the Australian crawl," he said. "That stuff is all OK, but the parent needs to understand they're not really swimming lessons. They're entertainment."

 

The American Academy of Pediatrics has been divided on the issue of swimming lessons for very young children. A 2000 policy on swimming states that "generally children are not developmentally ready for swimming lessons until after their fourth birthday," while a later policy on drowning prevention says that "ultimately, the decision of when to start a child in swimming lessons must be individualized."

 

Drowning is the second-leading cause of death of infants and young children in the United States, with roughly 4,000 dying each year. Many more are badly injured.

 

Harvey A. Barnett, who has been preaching about the benefits of swimming lessons for decades, says what is missing in the research is any explanation of which types of swimming lessons save the most lives.

 

Barnett is the founder of a Florida company called Infant Swimming Resource, which teaches a type of lessons that can be characterized more as a survival skill than as a fun 30 minutes getting acquainted with the water.

 

The goal of his program, which is taught at various pools across the country, is to teach a baby, as young as 6 months old, how to roll over on her back and float as soon as she has been put into the pool.

 

Once the infant is proficient at that, she is put in the pool with her clothes on to simulate an actual dangerous situation. That way, she can learn to roll over and float in soggy, heavy clothing, because a child who accidentally falls into a pool will likely be fully dressed and will need to learn how to roll over with that impediment.

 

Barnett said that babies who are exposed to more traditional swimming lessons, during which they may be held by their mothers and taught to kick their legs and maybe blow a few bubbles, will associate the water with love, nurturing and a "play environment."

 

"They have no skills," Barnett said. "I would think that child has a higher risk of drowning than a child who has been exposed to a program that has taught them to roll onto their backs."

 

Supervision, though, remains the key to keeping young children safe around the water, most experts agree. And it's the No. 1 rule in Anna Banyas' Ellicott City backyard.

 

"I have a 6-year-old," Banyas said. "She swims very well but she doesn't go in the pool by herself."

 

She started all three of her children in swimming lessons at the age of 1, including 4-year-old Peter, whom she was watching as he took a class at the Ellicott City Y's pool the other day. Peter and the four other little boys in the water with him could each swim a lap of the pool without flotation devices or much help from their instructor, Megan Lehane. In the class being taught in the next lane, a group of older kids were clearly less skilled in the water.

 

"The longer you wait," Banyas said, "it seems like the harder it comes."

 

"I am a firm believer in lessons at an early age," said Lehane, the Ellicott City Y's aquatics coordinator. "I see some confidence growing in them when they start younger - but I think that's a good thing."

 

She wants her young charges to be able to put their faces in the pool and blow bubbles, not to be scared of the water. Most of the beginners wear flotation devices and learn to use their arms and legs to get more horizontal in the water. And there is plenty of talk of safety. "A lot of times, we'll say, 'If you kick your feet, you won't sink,' " she said.

 

During a recent class, she encouraged 3-year-old Christopher, his goggles over his eyes, to keep moving across the pool. "Let me see your big, strong muscles," she said, shouting over the din. "When you're swimming, I don't get to see them because they're under the water. So let's get those arms out. Face in and arms out."

 

Before the boys were dismissed, it was time to go over the pool rules. "Can you ever swim without a lifeguard?" Lehane asked. "No," the boys said.

 

"And you always have to have a swim teacher or a parent, right?"

 

about the study

The researchers analyzed medical examiner and coroner records and interviewed families of children who drowned in Maryland, North Carolina and more than a dozen counties in four other states between 2002 and 2005. The researchers compared characteristics of each child who drowned to another child of the same sex and the same geographical area who did not drown. Of the 61 children ages 1 to 4 who drowned, only two had received swimming lessons. Of the 134 1 to 4-year-olds in the control group who did not drown, 26 percent (35 children) had taken swimming lessons.

 

Dr. Ruth A. Brenner of the National Institute of Child Health and Human Development said the data suggest swimming lessons provided some protection against drowning. "We are confident that swimming lessons do not increase drowning risk in this age group," she said.

 

Copyright © 2009, The Baltimore Sun.

 

Our Say: Hospice official's work improved our community

 

Annapolis Capital Editorial

Monday, April 13, 2009

 

Of the many ways of measuring a society's compassion, one of the best yardsticks is how it cares for the ill - particularly the terminally ill.

 

Erwin Abrams, president and chief executive officer of Hospice of the Chesapeake, has been working hard to boost that care ever he since he took the reins of the local nonprofit agency in 1993.

 

Abrams announced recently that he will be stepping down from his position at the end of the year, although he will continue as a consultant. This region - and particularly many families caught up in the heartbreaking struggles of dealing with a dying loved one - owe him a lot.

 

The hospice program served 40 people a day when Abrams arrived in 1993; now it's 260. During his tenure, the organization built the first hospice center in Linthicum, opened a second facility in Harwood and expanded its service area into Prince George's County.

 

Hospice care, Abrams explained in a Capital story in 1995, is "not about dying … (it's) about living to the absolute fullest degree possible."

 

Many more people have been able to do that because of Hospice of the Chesapeake. While this wouldn't have happened without community support, and without the extraordinary dedication that hospice workers show every day, it also wouldn't have happened without Abrams. For that, we're all in his debt.

 

Copyright 2009 Annapolis Capital.

 

EPA grant to help clean groundwater

 

By Timothy B. Wheeler

Baltimore Sun

Monday, April 13, 2009

 

The state has received $3.7 million from the Environmental Protection Agency to clean up soil and groundwater contamination from leaking underground fuel tanks in 70 sites across Maryland - about half of them in the Baltimore area.

 

Horacio Tablada, chief of waste management for the Maryland Department of the Environment, called the EPA funds "a shot in the arm" for his agency's efforts to clean up contamination caused by leaking underground fuel tanks at some 800 locations around the state.

 

The contaminated sites targeted for cleanup with the federal funds are mostly small, Tablada said, but have not been remediated yet because those responsible for the leaks cannot be found. Any wells fouled by the leaks have been equipped with filters or replaced by public water hookups, so no one is drinking contaminated water, the official said.

 

"None of them is like ExxonMobil in Jacksonville," Tablada said, referring to the state's largest underground gasoline leak, discovered three years ago at a service station in Baltimore County. State officials hope to be able to complete work on all these sites in the next two years, whereas the Jacksonville cleanup has been estimated to take another five to seven years. It has cost the oil company $38 million for cleanup, plus $4 million in fines and a $150 million civil verdict recently announced. Estimated costs for dealing with the new sites range from $3,000 for some well sampling to $200,000 to find and take care of an unknown source of contamination.

 

The funds, announced last week by EPA, are part of $197 million being distributed nationwide to deal with underground fuel leaks. The money is part of the economic stimulus spending bill passed by Congress.

 

Copyright 2009 Baltimore Sun.

 

Produce-linked food poisonings on the rise

 

Associated Press

Baltimore Sun

Monday, April 13, 2009

 

Americans didn't suffer more food poisoning last year despite high-profile outbreaks involving peppers, peanut butter and other foods, according to a new government report.

 

Rates of food-borne illnesses have been holding steady for four years. They had been declining from the mid-1990s until the beginning of this decade, mainly because of improvements in the meat and poultry industry, some experts say.

 

But produce-associated food poisonings have been increasing, and the nation is no longer making progress against food-borne disease rates, said Elliot Ryser, a professor of food science at Michigan State University.

 

"I was not surprised," Ryser said, referring to the new report from the U.S. Centers for Disease Control and Prevention.

 

The report looks at the occurrence of 10 leading food-borne illnesses in 10 states that participate in a federally funded food poisoning monitoring system. CDC officials believe it's nationally representative, based on the sample's mix of geography and demographics. The research appeared in last week's issue of a CDC publication, Morbidity and Mortality Weekly Report.

 

Salmonella remained the most common cause of food poisoning, causing more than 7,400 lab-confirmed illnesses in those states. That translates to a rate of about 16 cases for every 100,000 people. Most experts say those numbers are lower than reality, however, because only a fraction of food-poisoning cases get reported or confirmed by laboratories.

 

Copyright © 2009, The Baltimore Sun.

 

National / International

 

Stimulus Opening Doors in Health Care IT

 

By Kim Hart

Washington Post

Monday, April 13, 2009; A10

 

Breaking into the health-care industry can be daunting. Doctors, hospitals, insurance companies and patients speak different languages and have vastly different needs.

 

But more than $19 billion in stimulus money intended to revamp the nation's health system has piqued the interest of some local tech companies that have in the past shied away from the complex industry. And for companies with expertise in the business, stimulus dollars mean new opportunities.

 

"Health care is thought to be a safer place right now because more money is coming from the government, and it's not really something anyone can cut back on," said Michael Slage of Arlington, founder of HealthEngage, a firm that develops applications that help patients manage conditions such as diabetes and asthma. "Everyone senses that there's all this money out there."

 

The Obama administration is pushing to digitize health records; electronic records depend on fast data networks, interoperable software systems and devices to enter and track patient data.

 

FreightDesk Technologies of McLean has built its business by tracking international cargo for the U.S. Food and Drug Administration and the Department of Homeland Security. Chief executive Rob Quartel now sees the opportunity to deploy similar software for health organizations to track Medicare spending, insurance claims and other data. The company is hiring people with expertise in the field.

 

"It's now a much more receptive environment to new approaches to health technology," Quartel said.

 

That doesn't mean there's not some apprehension. Doctors and hospitals typically have been reluctant consumers. New technology often can be expensive and time-consuming to use. And the lack of specifics about government standards and patient privacy rules has discouraged some from moving forward, said David Wain, partner at the McLean law firm Pillsbury Winthrop Shaw Pittman.

 

"Many are saying, 'If we take government money, does that mean the government will take control of our processes or require our IT systems to have certain components? What strings will be attached?' " he said.

 

The answers to such questions "will define the industry for many generations," said Wain, who coordinates monthly meetings of the Healthcare Technology Network of Greater Washington, a discussion group for industry players.

 

Still, he said, membership has been growing.

 

There's also the issue of money. Companies trying to get into the health-care field say their technology would help industry players save costs, in the long run, by making their work more efficient.

 

But few hospitals, clinics and private practices have the funds to pay for new technology, especially when the savings from doing so may not materialize for several years, said Beverly Bell, partner in the Global Health Services practice at Computer Sciences Corp., based in Falls Church.

 

As part of the stimulus bill, doctors and other health-care providers would receive payments from the government after they effectively utilize new technology systems.

 

"Loans and grants will be coming available, but the incentives all come later," she said. "It's difficult for them to make that kind of up-front investment."

 

Firms that are established in the health business say their expertise and connections have made them quite popular these days.

 

"Health care is a cash-based business," said Bill Schafer, chief executive of Digital DME in Rockville, which manages the distribution of equipment that patients take home with them, such as knee braces and oxygen tanks. "Doctors have to see an immediate benefit to the service you're providing."

 

RollStream, a Fairfax company that manages communication between big companies and their vendors and customers, has helped Johnson & Johnson and Cardinal Health connect with suppliers. Chief executive Kristin Muhlner said she is putting more resources into the health-care area of the business.

 

"The stimulus bill poses substantial challenges for hospitals trying to implement these systems in short time frames," she said.

 

Some firms are hoping to be a part of the push into health care IT without directly going after stimulus funds. Ozmosis, a newly launched social network for doctors, expects to draw members as physicians get used to the idea of sharing information on the Web, founder Joel Selzer said.

 

Slage of HealthEngage said he hopes to benefit from the general increase in spending within the industry.

 

"During the gold rush, most people didn't make money right away, but the people supplying the shovels and picks made a fortune," he said. "We want to be the one selling the shovels."

 

Kim Hart writes about the Washington technology scene every Monday. Contact her at hartk@washpost.com.

 

Copyright 2009 Washington Post.

 

Handling questions about your special needs child

 

By Kate Shatzkin

Baltimore Sun

Monday, April 13, 2009

 

You'll remember that Jenn asked for help dealing with stares and intrusive comments she sometimes gets from both children and adults when her special-needs son acts out in public. For today's Consult, Mary Snyder-Vogel, a licensed clinical social worker who is assistant director of social work at Kennedy Krieger Institute, offers these tips:

 

"--Take a couple of deep breaths to steady yourself.

 

"--Try not to assume the worst about why a person is staring, meddling or giving advice. You could say: “My son has special needs and we are getting professional help. Please don’t make judgments about us. We are doing our best.”

 

"--Use the interaction as a 'teachable moment.' When stares or comments come from children (or adults), encourage them to ask questions. You could say: “I noticed that you were staring at my child. I know that sometimes people don’t know what to say, but do you have a question? I’d be happy to try to answer it.” Tell them a little bit about your son’s diagnosis.

 

"--Keep your sense of humor and concentrate on the positive gains your child makes. Tell everyone about them, even strangers. The more you can keep a positive perspective, the better you’ll feel.

 

"--Get to know other parents of children with special needs. Include them in your support network, share your experiences and learn other ways of coping with these situations."

 

Copyright 2009 Baltimore Sun

 

Taking a Page, and a Pen, From Makers of Medicines

 

By Anemona Hartocollis

New York Times

Monday, April 13, 2009

 

When Sharraine Franklin, a New York City health department worker, wanted to be nice to the driver of a double-parked truck who pulled away to let her out of a parking spot, she reflexively jumped out of her car and handed him a pen.

 

Squinting at the health department logo on the pen, the driver laughed and shouted: “New York City! New York City don’t give nothing away!”

 

Free pens — bearing the names of drugs like Viagra and Januvia rather than the letters NYC — litter doctors’ offices all across New York, part of an often-criticized strategy by drug company sales representatives known as detailers, who traditionally go from waiting room to waiting room giving gifts to entice doctors to prescribe their products.

 

Now in New York, there is a new kind of detailer: people like Ms. Franklin, who are part of a campaign by the city to use pharmaceutical industry marketing savvy to spread the word about healthy practices to doctors in neighborhoods where patients often have the least access to the latest news in health care.

 

During the last month, the city has sent detailers to doctors’ offices in the South Bronx, Harlem and north and central Brooklyn to tutor doctors and their staff in spotting signs of domestic violence and coaxing women (and men) to seek help. In the last 10 months, the city has spent nearly $900,000 on half a dozen detailing campaigns, including ones about influenza and pneumococcal vaccine distribution and education, colon and rectal cancer screening and smoking cessation.

 

Some agency workers have gone to stores to tell merchants about the penalties for selling cigarettes to minors.

 

“We use the health department brand to market a product line of lifesaving initiatives to doctors,” said Dr. Thomas R. Frieden, the city’s health commissioner. If pharmaceutical companies are spending billions of dollars on detailing, he said, “it must work.”

 

The city’s efforts echo a movement called academic detailing, sometimes called counter-detailing, in which insurance companies, nonprofit groups and universities train clinicians to visit doctors and offer independent information on the latest drugs. (Since January, the pharmaceutical industry has put a voluntary moratorium on branded gifts, like pens and tongue depressors.)

 

“The idea of academic detailing programs — or I assume New York City’s public health program — is that your bottom line is promoting good practices, and not necessarily return to shareholders,” said Allan Coukell, director of the Pew Prescription Project, a nonprofit effort that focuses on prescription drug policy, drug effectiveness and safety.

 

An executive with the drug maker Pfizer advised the health department on detailing training, and the director of the city’s program, Laura Wedemeyer, spent a decade as a detailer for Merck, another drug maker, pitching cardiovascular drugs like Prinivil and Zocor.

 

Doctors, Ms. Wedemeyer said, are often more receptive to the city’s detailers than to drug company detailers because they recognize that the city is not trying to enlist them as part of a sales campaign.

 

The city has also formed consumer focus groups with the help of a communications expert at Mount Sinai Medical Center. In a focus group on domestic violence, some participants asked to keep palm cards printed with a hot line number and messages like “Nobody deserves to be afraid” and “The cycle stops with me. Get help — for your children’s sake.”

 

“One woman called them her prayer cards,” Ms. Wedemeyer recalled. “They were small and discreet, yet had this affirmation message. You could take them with you if you were not ready to call the hot line, or give them to somebody else.”

 

While the city, unlike the pharmaceutical industry, has not made a practice of hiring former cheerleaders as detailers, most of the detailers at a recent staff meeting were, as it turned out, attractive, vivacious women, often wearing low-cut necklines.

 

Among them was Ms. Franklin, who on a recent visit to doctors in the South Bronx wore pin-striped stockings, a knee-length skirt and a buttoned-up blouse.

 

She had memorized a script that she repeated with small variations and occasional improvisation at every office. “Who do you screen for intimate partner violence?” she began.

 

“All married couples,” replied Dr. Muhammad Sanni Adam, an internist who was the first doctor she visited.

 

“How often?” Ms. Franklin continued.

 

“Every visit,” Dr. Adam said.

 

After listening to the answers, Ms. Franklin launched into the educational part of her presentation. She told Dr. Adam that every year about 4,000 women and 900 men were treated in city emergency rooms for violence committed by a partner, and that almost half of the women killed in New York City each year were killed by their partners. She said that if abuse is undetected it can lead to the misdiagnosis and mismanagement of associated health problems like depression, stroke and heart disease.

 

“We want you to screen all your patients for intimate partner violence,” she told Dr. Adam.

 

“Young people?” he asked.

 

Yes, she said. “It’s about power and control.”

 

Dr. Adam told of a patient who complained bitterly that her husband was going back to Africa to take a new wife, then angrily rejected Dr. Adam’s offer to intervene because in her view, Muslim tradition permitted polygamy.

 

“All you can do is just be there to support her, you cannot force her,” Ms. Franklin said.

 

“So am I helping?” Dr. Adam asked.

 

She reassured him that he was, and recommended putting the poster with the hot line number in a bathroom, where patients could write it down in private.

 

Ms. Franklin tries to develop long-term relationships with the doctors she works with, just as drug detailers do, visiting them again and again, plying them with information, props, posters and, of course, pens.

 

One of the city’s most popular detailing campaigns, officials said, was its anti-obesity campaign, which came with doodads like a plastic bottle filled with 17 teaspoons of sugar, the amount in a 20-ounce soda, and a nine-inch paper plate branded with the NYC logo and showing appropriate portions of protein, starch and vegetables.

 

Many of the doctors visited by city detailers have patients who can barely afford their co-payments, making them grateful for any resources they get.

 

At another of Ms. Franklin’s stops, a small medical office in a tenement building at 1715 University Avenue in the Bronx, almost everything in the office was branded. The paper cover on an examining table was stamped with the words Crestor and Nexium, and an eye chart advertised Nasonex and Clarinex.

 

Steve Trikounakis, a physician assistant, welcomed Ms. Franklin into an examining room. “We all love the pens,” he said. He considered the new domestic violence poster. “Umm, do you have these in larger sizes?” he asked.

 

As Ms. Franklin left, she was delighted to spot a bowl of NYC-branded condoms on the reception desk.

 

“You’re running low,” she said, and promised to bring more.

 

Copyright 2009 The New York Times Company.

 

Opinion

 

Addiction Behind Bars

 

New York Times Editorial

Monday, April 13, 2009

 

The United States must do more to curb the spread of diseases like AIDS and hepatitis C in prison, where infection rates are high and inmates can easily spread disease through unprotected sex or by sharing needles.

 

Drug treatment in prison is clearly part of the solution. But by some estimates, fewer than one in five inmates who need formal treatment are actually getting it. That’s alarming, given that about half the prison population suffers from drug abuse or dependency problems.

 

Addicted prisoners cause problems outside the walls. After they’re freed, addicts with H.I.V. or AIDS can infect spouses and lovers. They feed their addictions by returning to crime, which lands them back in prison and starts the terrible cycle over again.

 

The most effective programs provide inmates with high-quality treatment in prison and continue that treatment when prisoners return to their communities. Such programs have been shown to reduce both drug use and recidivism.

 

But good programs are rare, according to a report earlier this year in The Journal of the American Medical Association. Prisons typically rely on the abstinence-only model, which fails miserably with heroin addicts. Moreover, prison officials are notoriously hostile to methadone maintenance and other chemically based therapies that have long been a standard for people addicted to opiates.

 

Prison treatment is particularly disastrous in New York, according to a new report from Human Rights Watch. Imprisoned addicts, the authors say, are typically shut out of treatment until their sentences are nearly over because of ill-conceived policies that give priority to those who are about to be released.

 

New rules created earlier this month should help address these problems. The rules give oversight responsibility for prison treatment programs to the State Office of Alcoholism and Substance Abuse Services, an agency that develops treatment programs and licenses treatment providers.

 

The agency will be required to make sure that prison drug treatments are tailored to inmates’ needs. It will also monitor the programs, filing annual reports to the governor and Legislature. Drug-policy advocates hope that the new arrangement will improve treatment and provide timely help for addicted inmates. That would be good for public health. It could reduce crime, too.

 

Copyright 2009 The New York Times Company.

 

Finding and Treating Depression in Teenagers

 

New York Times Letters to the Editor – 2 total

Monday, April 13, 2009

 

To the Editor:

 

Re “Depression Tests Urged for Teenagers” (news article, March 30):

 

The article about a government task force’s call for primary care screening and treatment of teenage depression overlooks a valuable partner in addressing children’s mental health needs: schools.

 

Locating mental health services in schools has proved both effective and cost-effective. The article cites the lack of specialists available to treat children and teenagers, yet many schools have professionals trained for just such work. Research has documented the efficacy of prevention of depression and other psychiatric disorders through cognitive behavioral approaches, a natural fit for school settings.

 

Students would clearly benefit if educational institutions combined teaching of math, science, history and literature with promoting the critical life skills for coping, stress management and emotional resiliency. Without government financing and support, however, the logical notion of offering medical and mental health services where children spend most of their waking hours cannot become a reality.

 

Rona Milch Novick

New York

March 30, 2009

 

The writer is director of the Fanya Gottesfeld Heller Doctoral Program at the Azrieli Graduate School of Jewish Education and Administration of Yeshiva University.

 

***

 

To the Editor:

 

The United States Preventive Services Task Force suggests routine depression screening for teenagers because the disorder has become so widespread. If it is indeed true that 6 percent of American teenagers, or close to two million adolescents, are clinically depressed, the solution is not more screening. The only thing this will accomplish is more diagnoses of even mild cases of the blues, more prescriptions for drugs, and more hours on the therapist’s couch.

 

We should be focusing our money, time and resources on finding out why so many teenagers are depressed. Instead of pulling kids out of the proverbial river one by one, let’s focus on what is pushing them downstream in the first place.

 

Leeat Granek

Toronto

March 30, 2009

 

The writer is a researcher at Princess Margaret Hospital and Sunnybrook Odette Cancer Center in Toronto.

 

Copyright 2009 The New York Times Company.

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