Monday, February 16, 2009

News Clipping Archives

 

Maryland / Regional

Safety Activists Hopeful About Drunken Driving Bills (Washington Post)

Drug, alcohol abuse rampant among Garrett residents 19 to 21 years old (Cumberland Times-News)

Raw milk debate (Baltimore Sun)

Many doctors advise wait-and-see approach on low-grade prostate cancer (Baltimore Sun)

Perimenopause symptoms differ among women (Baltimore Sun)

Rx for healthy babies (Baltimore Sun)

Registered sex offender resigns from school (Annapolis Capital)

National / International

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Opinion

Framework for reform (Baltimore Sun Editorial)

Our view: Preventive care would help reduce number of low-weight infants, save state dollars  (Baltimore Sun Editorial)

Ban a neurotoxin dangerous to kids (Baltimore Sun Letter to the Editor)

 
 

Maryland / Regional

 

Safety Activists Hopeful About Drunken Driving Bills

 

Washington Post

Monday, February 16, 2009

 

Some Maryland safe-driving advocates say they are more optimistic than they've been in years that the legislature will pass laws to curb drunken driving, particularly among repeat offenders and drivers younger than 21.

 

For the first time in 20 years, the advocates say, five bills submitted to the General Assembly are supported by a state task force with a broad range of viewpoints. In addition to police and judges, the panel's 23 members included defense lawyers and the state's restaurant and beer wholesaler industries. The bills also took on a high profile when Gov. Martin O'Malley (D) included them in his legislative agenda.

 

State Highway Administrator Neil Pedersen, who chaired the panel, said it "did a very comprehensive review of the entire DUI problem." The group collected data showing which laws and programs were most effective throughout the country, he said.

 

"We wanted to have research results that showed what actually resolved the problems," Pedersen said.

 

One of the legislative proposals would automatically suspend for six months the driver's license of anyone younger than 21 who is convicted of possessing alcohol illegally. An offender without a license would have to add six months to the time it takes to get one.

 

Pedersen said 37 states have such "use and lose" laws.

 

"Studies show the one thing young people tend to value more than anything is their driver's license," Pedersen said. "The threat of losing their license does change behavior."

 

Another bill would allow people arrested on drunken driving charges to be eligible for probation before a court judgment every 10 years. Such court findings are now permitted every five years.

 

A Probation Before Judgment ruling allows someone to avoid a conviction -- and the driver's license points that can lead to higher insurance rates -- if he or she completes treatment or other requirements of probation. The proposal is aimed at allowing fewer repeat offenders to escape appropriate punishment and treatment, the task force said.

 

Another bill would require police to request alcohol testing of all drivers involved in life-threatening or deadly crashes. The data could not be used in court but would help researchers studying the involvement of alcohol and other drugs in fatal crashes. Drivers would face no penalty for refusing.

 

Police now must conduct sobriety tests in serious crashes only when they think a driver is under the influence of alcohol or drugs, a Montgomery County police official said.

 

The proposals, which are scheduled for committee hearings Tuesday and Wednesday, would help Maryland keep up with other states that are doing more to crack down on drunken driving, the task force said.

 

The state needs to do a better job tracking drunk drivers as they proceed through an "overtaxed" court system that many prosecutors and police view as "cumbersome" and unable to stop repeat offenders, the panel's 98-page report said.

 

The proposals make up the most comprehensive legislative package aimed at drunk drivers in about seven years, said Kurt Erickson, president of the nonprofit Washington Regional Alcohol Program.

 

Erickson, whose group had a member on the task force, said safety advocates are concerned that the number of people killed in drunken driving crashes in Maryland has remained steady. Between 2004 and 2007, the state maintained an annual average of about 220 alcohol-related fatalities, according to the task force's report.

 

Erickson said groups such as his that pushed the General Assembly to establish the task force in 2007 were inspired by a Virginia panel that helped toughen that state's laws in 2004. A similar task force reviewed Maryland's laws about 20 years ago.

 

"Other states have been more aggressive in prosecuting drunk driving," Erickson said. "Maryland needed a kick-start."

 

The legislation's toughest hurdle might be its first: getting out of the House Judiciary Committee, where similar bills have died.

 

Del. Kathleen M. Dumais (D-Montgomery), a member of the task force and the Judiciary Committee, said she is hopeful that the scientific evidence presented by the task force will help the legislation through.

 

The bills "come with a research-backed task force report that says why these five initiatives are important and can make a difference," Dumais said.

 

Most of the task force's recommendations -- 42 in all -- would not require new laws. They would establish programs or administrative rules to increase awareness, better identify problem drinkers and improve anti-drunken driving lessons in schools and drivers education classes.

 

Chris Flohr, a board member of the Maryland Criminal Defense Attorneys' Association and a task force member, said he was pleased that the panel recognized that many offenders need help with serious addictions.

 

"Alcoholism and drug abuse are the reigning champs of what drives the criminal justice system," said Flohr, a lawyer in Anne Arundel County. "When you're dealing with drunk driving cases, it's easy to demonize these people, but it's the perfect opportunity in many cases to deal with the treatment issue."

 

Copyright 2009 Washington Post.

 

Drug, alcohol abuse rampant among Garrett residents 19 to 21 years old

 

Cumberland Times-News

Monday, February 16, 2009

 

County agencies try to reach group with no idea where they are going OAKLAND Drug and alcohol abuse as well as other issues for those between the ages of 19 and 21 continue to be not only a topic of discussion, but also a challenge for Garrett County agencies.This is a whole group of kids with no idea where they are going, said Madonna Pool, clinical supervisor for the Garrett County Health Department Substance Abuse Program. One clear message we have to get across is We hear you. We dont want you to be lost in our community. Theyre hopeless and helpless, the largest growing age group in drugs and alcohol.Members of the Drug and Alcohol Abuse Council met Wednesday, and as part of their meeting, they held a Local Management Board needs assessment, focusing on this age group. Members said the age group is one of the harder ones to serve because they are no longer in the school system.

 

Bob Stephens, director of behavior and family health, said this age group seems to have the greatest problem with health insurance. He said after they finish high school, they are off the Maryland Childrens Health Insurance Program, and often do not find work that can provide health insurance until they are nearing 24 or 25.

 

Danny Stiles, a student with AmeriCorps, said that he has concerns in the steady rise in depression among those in this age group.

 

Renee Page of the Maryland Department of Juvenile Services said that one of the other concerns is a carry-over from high school age, with how young people deal with relationships, particularly violence in romantic relationships.

 

She also said that while there are many who believe that the tourism market brings the drugs into the county, she finds many of the people she deals with have no contact with tourists. With or without the tourist industry, she said there would still be a problem.

 

There was some question as to whether seeing people on vacation, the amount of alcohol and partying, could have some influence.

 

Stiles said that his own friends who work as wait staff at restaurants consider alcohol to be a good thing, as it guarantees them bigger tips.

 

Members of the council were asked to propose suggestions to resolve some of the issues that were discussed. There was a lot of support for focus on wellness programs at the college level as well as increased youth programs.

 

Contact Sarah Moses at smoses@times-news.com.

 

Copyright 2009 Cumberland Times-News.

 

Raw milk debate

A Maryland bill aims to legalize the sale of the unpasteurized form, but concerns persist about safety

 

By Meredith Cohn

Baltimore Sun

Monday, February 16, 2009

 

The cows, about 75 of them, graze and enjoy an unseasonably warm day on the 260-acre Bellevale farm in Baltimore County, about 20 miles north of downtown. It's a few hours until milking time.

 

Together they produce hundreds of gallons of raw milk that is sold to organic milk producer Horizon for about $3 a gallon. It's pasteurized and turned into cartons sold at the grocery store. Part of farmer Bobby Prigel thinks that's a shame.

 

There are enough people in Maryland who would pay $6 a gallon or more for the unpasteurized, or raw, milk directly from him - if that were legal. State health officials say raw milk is dangerous because it can carry E. coli, salmonella and other nasty bacteria, and has already made many people around the state and nation sick.

 

"It would be easy for me to sell it," said Prigel, a fourth-generation dairy farmer who drinks the milk from his cows. "I wouldn't have to change a thing."

 

Raw milk consumers are a small and not-yet-mainstream faction of a larger movement of people who have turned to food grown locally, organically and unadulterated by excessive processing in an effort to lead a healthier lifestyle. They reject the safety warnings because they believe raw, also called "real" or "fresh," milk is more nutritious.

 

Many are getting it from illicit drop-off sites set up by farmers in Pennsylvania, where it's legal.

 

The demand has reached such a pitch that Del. J.B. Jennings, a Republican who represents Baltimore and Harford counties and who recently gave up cattle farming to join the military, introduced legislation Friday to make it legal for farmers to sell raw milk to consumers who buy a share in one of their cows. It's legal in Maryland to drink the milk if you own the cow, but the state has refused in the past to allow such "cow shares."

 

He is the third Maryland legislator to offer a bill in three years. He believes the bill will have more support than ever, though its prospects for passage remain slim.

 

The General Assembly has already approved a pilot program that will allow a handful of Maryland farmers to sell cheese made from raw milk as long as it's aged 90 days, a process that mimics pasteurization. Three farms are expected to begin selling the cheese in the spring or summer. A small amount of raw-milk cheese made in Pennsylvania with Maryland milk is already available in local stores.

 

"I'm not getting into the debate about whether raw milk is good or bad for you," Jennings said. "It's about choices. And people are already drinking it."

 

Jennings said the legal sale of raw milk will be a boost to a small number of Maryland dairy farmers who would want to sell it from their farms. Unpasteurized milk has a shorter shelf life and wouldn't likely be sold in retail grocery stores.

 

More immediately, it would make legal the actions of Marylanders who are using one of the 10 or so delivery sites in the region found by word-of-mouth or on the Internet. Area moms say a gallon of raw milk sells for between $6 and $10 a gallon, far more than the $3.50 a gallon regular milk was selling for at area groceries last week, but closer to the $3 to $4 a half-gallon of organic milk costs.

 

Supporters claim the heat of pasteurization kills nutrients and good bacteria, though public health experts say raw and pasteurized milk are nutritionally the same. Some supporters also believe that raw milk has other health benefits, including improved behavior in children; improved health of those with osteoporosis, cancer, asthma and allergies; and better development of fetuses and babies. Health experts say such assertions aren't true.

 

Liz Reitzig, a Bowie mother of four, is one of the believers. Mornings in her house include fruit, reading, the occasional cartwheel and, always, glasses of raw milk. She has been buying raw milk for four years and feeds it to her children, from 6 months to 6 years. The family goes through six to 12 gallons a week.

 

She declined to discuss drop-off sites in the state but said she would prefer "to buy products from the producers of my choice in Maryland."

 

That would be good for her and good for the environment, she says, because the milk wouldn't travel as far, and good for the state's economy because her money would stay here.

 

Reitzig also said she knows of no one who has been sickened by raw milk, but notes that other legal foods have caused illnesses, including packaged spinach, which was blamed for a 2006 outbreak of E. coli, and peanut butter, which has been blamed for the current outbreak of salmonella.

 

"What about deli meat or hot dogs?" she said. "You're so much more likely to get sick from those. There's a bias against fresh milk."

 

She said she'd keep working for legalization as president of the Maryland Independent Consumers and Farmers Association, which promotes local farm-to-consumer goods.

 

But the forces against raw milk are vast: the Food and Drug Administration, Centers for Disease Control and Prevention, American Medical Association and World Health Organization, among others. Many farm bureaus also oppose the sale of raw milk. Officials at the Maryland Department of Health and Mental Hygiene fret that they can't convince raw-milk drinkers that raw milk can make them sick or even kill them.

 

"It's not an argument we've been able to make," said Ted Elkin, deputy director of the Office of Food Protection and Consumer Health Services at the state Health Department.

 

"Some people think it's magical," he said. "This is like arguing about religion. But the department's stance is quite clear and consistent. We agree with the WHO, CDC, FDA. It's unsafe for human consumption."

 

Elkin said one outbreak of food-borne illnesses related to raw milk was confirmed in 2005 in the Washington suburbs. Five children were sickened and one died after consuming a raw-milk cheese called queso fresco that contained a bacteria that can cause tuberculosis. In general, it's not always possible to prove what makes people sick, so he couldn't say how many people become ill from raw milk versus deli meat, for example.

 

A CDC report showed that from 1998 to 2005, there were 45 confirmed incidents of 1,000 or more people becoming sick from raw milk across the country. Agency spokeswoman Lola Russell said most cases are not reported. In 2007, there were 1.4 million confirmed cases of salmonella from all sources.

 

Pasteurization began in the late 1800s, and in 1987 the government banned the sale of raw milk between states. Now, 29 states allow some form of raw-milk sale, mostly direct from farmers as milk or cheese. Others allow the milk to be sold as pet food. And a few, including Virginia, allow cow shares, such the kind proposed in Maryland.

 

Many who lobby for legalization of raw milk in more states also oppose state-run inspection programs, which Jennings, the delegate, had considered including in his bill. They see such programs as overzealous enforcers that end up harassing farmers rather than ensuring the safety of milk.

 

One of the groups that provides legal aid to farmers is the Washington-based Weston A. Price Foundation, named for a nutritional researcher. The group promotes raw milk's consumption, and its president, Sally Fallon, estimates that about 500,000 people are consuming raw milk across the country, many of whom started in the past couple of years.

 

"Raw milk is where organic was 20 years ago, on the fringe but poised to go mainstream," Fallon said. "Within 20 years, there won't be any pasteurized milk. It will take over as people realize the health benefits and safety."

 

For more on the dangers of raw milk, go to www.fda.gov and search for raw milk. For more on the benefits, go to westonaprice.org.

 

Copyright © 2009, The Baltimore Sun.

 

Many doctors advise wait-and-see approach on low-grade prostate cancer

Growth can be so slow that surgery or radiation are not immediately needed

 

By Stephanie Desmon

Baltmore Sun

Monday, February 16, 2009

 

When Peter Bentey was diagnosed with prostate cancer, the doctor told him that he needed surgery. So did the doctor who gave him a second opinion. And the third. And the fourth.

 

Prepared to have his prostate removed, Bentey kept an appointment with Dr. H. Ballantine Carter, a Johns Hopkins urologist and oncologist. Carter looked at Bentey's blood work and did his own biopsy. The doctor's conclusion? Bentey had prostate cancer, but the New Jersey man did not need surgery. At least not right away.

 

Bentey's cancer appeared to be growing slowly, so Carter recommended a wait-and-see approach.

 

"He said, 'You're going to die someday, but I don't think it's going to be of prostate cancer,'" Bentey recalls.

 

That was in 2002. A couple of weeks ago, Carter gave him the all-clear for another six months.

 

Nearly half of the men diagnosed with prostate cancer in the United States have what is considered a low-grade disease, which many doctors say is unlikely to kill and does not require immediate treatment, be it surgery or radiation. But just a small fraction of those men - less than 10 percent, by most estimates - delay.

 

Instead they opt for what Carter and many others say could be unnecessary treatment with side effects that can harm urinary and sexual function.

 

"The knee-jerk reaction that everyone with prostate cancer needs curative intervention may not be the best approach," Carter said.

 

Leading prostate cancer experts agree that close monitoring of the disease - a process known in some circles as watchful waiting, in others as active surveillance - probably is the best course for a large number of men. But few long-term studies have been done to confirm that, because few men are willing to participate in research in which the cancer is left untreated.

 

Even longtime proponents of active surveillance say the wrenching decision of which avenue to pursue is complicated by the fact that some of the men who wait will end up with advanced cancer - and the small possibility that it cannot be cured.

 

"It flies in the face of the American approach to disease, which is, 'I've got to do something now,'" Carter said.

 

Dr. Ian Thompson, chairman of urology at the University of Texas Health Sciences Center, agrees. "Men look at prostate cancer and they think cancer - 'the Big C.' And they think, like pancreatic cancer and lung cancer, 'I must treat it,'" Thompson said. "But it's a different disease ... than many other cancers."

 

Prostate cancer is second only to lung cancer as a killer of American men with cancer. And it is the second most common cancer among men in the United States. Only skin cancer affects more.

 

In the past two decades, the number of American men diagnosed with prostate cancer has skyrocketed - there were an estimated 186,000 new cases last year - as a blood test that looks for a protein called prostate-specific antigen (PSA) has become more routine.

 

Early detection has led to a reduction in deaths, from roughly 31,000 annually to about 27,000. But it also has led to many more surgeries. For every 20 to 100 more people treated, doctors say, one life is saved.

 

Thanks to PSA, many of the cancers being found are much smaller - and less dangerous - than those that had previously been discovered through physical exams. So the question has become: What should be done about them?

 

"That really is the big conundrum in prostate cancer, whom to treat," said Dr. Howard Parnes, chief of the prostate and urological research group at the National Cancer Institute in Bethesda. "Many more men die with prostate cancer than from prostate cancer."

 

In determining whether a patient is a candidate for active surveillance, Carter looks at a series of factors, including PSA levels, whether a tumor is palpable during a physical exam, and a score based on the microscopic appearance of cancer cells in prostate tissue, which gives an idea of a cancer's aggressiveness.

 

But Carter, like other doctors, cannot say with certainty that the cancer won't spread if the patient holds off on treatment. What he has been able to do is spot a growing cancer early enough so that the window of opportunity for cure is not closed. He has done this with a group of 700 men with low-grade prostate cancer whom he has been studying since 1995. When he broke down data on the first 562 men in his study, 35 percent went on to be treated and 2 percent died of other causes.

 

"No one has ever died of prostate cancer in this program," Carter said.

 

Carter cautions that he is "incredibly conservative" about whom he chooses for surveillance. He rarely includes men in their 50s because if he and his staff are wrong, the chances of harm are greater. Older men are more likely to have other diseases that are likely to claim them before the cancer does.

 

"More and more doctors are beginning to recognize we are grossly overdiagnosing prostate cancer in this country," said Dr. Peter C. Albertsen, a Hopkins-trained urologist and a surgeon at the University of Connecticut Health Center in Farmington. But "it's still a vast minority of patients who pick [active surveillance]. A lot of doctors don't even discuss it."

 

Studying whether treatment or observation is a better option for men with low-grade prostate cancer has been difficult. One clinical trial in the United States is having trouble recruiting enough men to participate because it has been hard to convince patients - and their doctors - that being in the surveillance arm of the trial is a safe option.

 

One Swedish study showed that the outcome after surgery was slightly better after 12 years, but no patient over 65 benefited from surgery in the trial, Albertsen said.

 

"If we could demonstrate surveillance was as safe as active treatment, the quality of life of hundreds of thousands of men would be improved, not to mention the [savings]," said Thompson, who also is studying men who have chosen active surveillance instead of surgery or radiation.

 

Much more research, these experts say, has been done on breast cancer, because women have been more willing to enroll in clinical trials that have led to better answers and better treatments. The lack of studies of prostate cancer makes it difficult for doctors to persuade men to consider active surveillance.

 

Even with men who are good candidates for waiting, "you've got to spend a lot of time talking patients out of treatment," said Dr. Peter Scardino, who heads the surgery department at the Memorial Sloan-Kettering Cancer Center in New York. "I look them in the eyes and say, 'If I had what you have, I wouldn't let anyone touch me.'

 

"Every visit you go through this again."

 

These emotional conversations often include a wife who says that she doesn't care about the incontinence or impotence that can result from surgery. "I just don't want him to die of cancer," she'll say.

 

And after all of that, Scardino says, "you can't be certain that you're right." Every urologist, he says, has had that low-grade patient who opted for surgery and then it turned out that the cancer was much worse than the doctor originally believed. Then he is left to wonder, what if the patient had been put on watchful waiting?

 

Scardino is a proponent of the surveillance approach but says he wants to be sure that patients are fully evaluated and with a repeat biopsy before they choose that route. He said doctors must be sure that a larger cancer is not lurking undiscovered.

 

Researchers are looking for better markers for which cancers will be aggressive and which will not do harm. Carter hopes that his group of patients will add to that knowledge.

 

And it is crucial that men on active surveillance stick with the program, even after five years without progression.

 

"You begin to think it is nothing," Scardino said. But because of the way this cancer can grow, it can still turn into something many years later. "With active surveillance, five years is just the beginning."

 

Bentey was 53 when he was diagnosed with prostate cancer. After consulting with Carter, he decided to buck those other doctors who had pushed for surgery. Now 60, he drives to Johns Hopkins from his New Jersey home every six months to see the doctor. Every year or so, he gets a follow-up biopsy.

 

"I feel comfortable with the decision," he said.

 

But, he added, "I've met four or five people who said I was crazy. ... I don't feel that way. So far, I've had seven very good years."

 

Bentey knows that active surveillance isn't for everyone. He referred two of his friends to Carter - and the doctor recommended surgery for both.

 

"He's not going to gamble," Bentey said.

 

Copyright 2009 Baltimore Sun.

 

Perimenopause symptoms differ among women

Expert advice

 

By Liz Atwood

Baltimore Sun

Monday, February 16, 2009

 

Perimenopause is that transitional time when a woman goes from having regular periods to ending menstruation. Dr. Howard A. Zacur, professor of reproductive endocrinology and director of the division of reproductive endocrinology and infertility at the Johns Hopkins Medical Institutions, says not all women experience the same symptoms; some may not experience perimenopause at all. At 7 p.m. Feb. 24, Zacur will speak about perimenopause and answer questions at Goucher College's Buchner Hall, 1021 Dulaney Valley Road, Towson. For more information, call 800-547-5182.

 

At what age do women typically go through perimenopause?

Since the duration of perimenopause is variable, and since some women may not even experience it, the average age remains unknown.

 

How long does perimenopause usually last, and what are the signs?

Perimenopause occurs before menopause, and if it does occur, it may last for four years or more. During this time, a woman's period may temporarily stop for several months at a time, and she also may have the classic menopausal symptoms of hot flashes, insomnia, vaginal dryness and mood changes. These symptoms tend to disappear when menses (the monthly flow of blood and cellular debris from the uterus that begins at puberty in women and ceases at menopause) resume. Not all women have these symptoms, and their degree of severity is highly varied. There is no way to predict when or if they will occur, or when and if they will all disappear.

 

How is perimenopause diagnosed?

Doctors can check hormone levels to determine whether a woman has begun perimenopause. Levels of follicle-stimulating hormone circulating in the blood may be elevated and estradiol levels may be lowered when menopausal symptoms are present. But FSH levels may fall and estradiol levels rise when the menopausal symptoms disappear. So, the practical diagnosis of perimenopause is best made when the menstrual cycle becomes irregular and the symptoms of menopause begin to wax and wane.

 

How do perimenopause symptoms differ from menopause symptoms?

Symptoms of perimenopause are the same as those of menopause, when menses do not occur. Yet the symptoms of perimenopause disappear when menses resumes. During actual menopause, the symptoms of menopause may remain indefinitely or may become less bothersome. Menopause for a normal middle-aged woman is clinically defined as not having a menstrual period for one year.

 

Are there any health risks associated with this transition phase?

As menopause nears, bone loss may accelerate. Women also tend to gain weight, which can be associated with increased risk for high blood pressure and diabetes.

 

What treatments are available to ease the discomforts of perimenopause?

Symptoms of perimenopause or menopause may be relieved through the use of hormonal therapy given either as low-dose oral contraceptive pills or as estrogen and progestin supplements. When hormone therapy is given to women during perimenopause, it will alleviate symptoms during those times when there are no menses. When these women do ovulate and secrete their own estrogen and progesterone, a state of "hormone excess" may cause abnormal uterine bleeding, as well as fluid retention and mood changes.

 

Since ovulation cannot be predicted during this time, if a woman is taking hormone replacement, she may stop the therapy if she suspects that she has begun to ovulate again. She may then restart the hormone therapy if the symptoms of menopause return, but it may take two weeks of therapy before an effect on symptoms is seen.

 

Nonhormonal therapies have been recommended by some to treat one of the most bothersome perimenopausal symptoms: hot flashes. Unfortunately, these therapies have not undergone the rigorous clinical trials required by the [Food and Drug Administration] to become approved medications for menopausal symptoms, and they have their own known as well as unknown risks of side effects.

 

Are there risks associated with hormonal treatments?

Hormonal therapy for menopausal symptoms is FDA-approved, and large clinical studies have identified some risks. The relative risk of deep venous thrombosis and stroke has received attention and caused alarm, but the absolute risk of these side effects from hormone therapy is small overall. Increased risk of breast cancer has also received attention. ... Some women may be at higher risk than others for hormone-therapy side effects, so all women should be evaluated by a knowledgeable medical practitioner before beginning such treatment.

 

Online

Read more about perimenopause at baltimoresun.com/expertadvice

 

Copyright © 2009, The Baltimore Sun.

 

Rx for healthy babies

Our view: Preventive care would help reduce number of low-weight infants, save state dollars

 

Baltimore Sun

Monday, February 16, 2009

 

Only 9 percent of babies born in Maryland weigh less than 5.5 pounds, which doctors consider a normal birth weight for healthy infants. Yet that relatively small proportion of infants accounts for more than half of all spending on births in the state - $166.6 million, as opposed to $140 million spent on the other 91 percent of babies, according to a recent study by the nonprofit Advocates for Children and Youth, which lobbies for child welfare issues.

 

Much of the high cost of low-birthweight infants is born by state and federal governments through the Medicaid program that funds health care for low-income residents.

 

Babies born with low and very low birth weights cost, on average, 36 times more than normal-weight babies, and they stay in the hospital 15 times longer. In 2007, the average hospital charge for a very-low-birthweight baby (under 3.3 pounds) was $83,995, compared with just $2,308 for a normal-weight baby.

 

And while advances in neo-natal care have allowed more low-and very-low birthweight babies to survive, they often suffer from serious health problems at birth and lasting disabilities, all of which add to the long-term costs paid for with tax dollars by the government.

 

Maryland could significantly lower its Medicaid spending for these poor birth outcomes by working to reduce the number of low-birthweight babies born in the state. Since maternal health is a major risk factor, preventive health care programs for women who have had at least one poor birth outcome could help them avoid another. Advocates for Children and Youth estimates that redirecting $4.4 million of current Medicaid spending toward prevention would reduce the state's bill for poor birth outcomes by $5 million a year, saving $600,000.

 

State legislators this week will review a package of preventive measures that have been proved effective in reducing low-birthweight births. In tough times like these, every dollar saved counts. At the least, the state should institute a pilot program to see whether the projected savings materialize. A preventive strategy aimed at improving birth outcomes among women without regular access to health care could also significantly impact the state's infant mortality rate of eight deaths for every 1,000 live births, one of the highest in the nation.

 

The savings to Maryland could be substantial, and they shouldn't be counted just in dollars but also in the lives and well-being of its most vulnerable citizens - its children.

 

Copyright 2009 Baltimore Sun.

 

Registered sex offender resigns from school

 

Annapolis Capital

Monday, February 16, 2009

 

BETHESDA, Md. (AP) — A registered sex offender hired by a church that operates a Bethesda nursery school has resigned.

Bethesda Cooperative Nursery School leaders say 33-year-old Travis Buffington has left his job as a maintenance man and is no longer living in a house provided by the Church in Bethesda. The nursery school is housed in the church building.

 

Records show that Buffington is registered as a sex offender after a conviction for possessing child pornography.

 

Pastor Todd Thomas defended his 2008 hiring of Buffington, saying he didn't believe the man was a threat.

 

In a statement Sunday, school officials say Buffington will remain a member of the church's congregation, but won't be allowed on church grounds during school days or school-sponsored activities.

 

Officials say the church also plans to strengthen oversight of its hiring practices.

 

Copyright 2009 Annapolis Capital.

 

National / International

 

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Opinion

 

Framework for reform

Our view: A standard for hospital charity care should help keep Maryland's unique system operating in the best interest of both patients and hospitals

 

Baltimore Sun Editorial

Monday, February 16, 2009

 

A state proposal to set income standards for charity care that Maryland hospitals provide - and are reimbursed for by the state - is welcome and overdue. A report on how Maryland hospitals provide treatment for indigent and uninsured patients found that collection policies on unpaid patient bills vary widely and are unclear. And that needs to change.

 

A series in this newspaper last year detailed the lengths some hospitals will go to collect bills despite the state reimbursements. That included placing liens on the homes of people with few assets but for the house they live in. The practice left many patients at the mercy of collection agencies. The Baltimore Sun's investigative reporting also raised questions about whether hospitals were getting paid twice, through Maryland's rate-setting system that ensures no patient is turned away from a hospital and as a result of lawsuits. The state hospital association denies that hospitals are double-dipping, but the present system doesn't provide a mechanism to check that.

 

As a result of the series, Gov. Martin O'Malley ordered a review of the charity care system. A report on that review by the Health Services Cost Review Commission was released last week. As part of its work, the commission has initiated special audits to verify hospitals' claims that they aren't being paid twice for care provided to poor patients. That was the right call. Some mechanism should be in place to ensure that hospitals are paid only once for uncompensated care.

 

State Health Secretary John M. Colmers is supporting the commission's charity care standard. It would require hospitals to provide free care to patients whose incomes are less than 200 percent of the federal poverty guideline. That means $44,100 for a family of four. The recommendation would be a more generous standard than the voluntary guideline used by most hospitals now. But it recognizes that despite the state's expansion of the Medicaid program to cover more families, there are working poor people who still don't have the means to pay significant hospital bills, costs that can bankrupt individuals. The state's unique rate-paying system has achieved many dividends for Maryland beyond ensuring hospital care for all patients regardless of ability to pay. It has helped keep the state's hospitals' costs below the national average. The health services commission report provides a reasonable framework to discuss needed reforms, while preserving the benefits of the system. As Maryland lawmakers review the panel's recommendations and other relevant legislation, they should strive to shape a fair, equitable system that serves patient and hospital alike.

 

Copyright 2009 Baltimore Sun.

 

Rx for healthy babies

Our view: Preventive care would help reduce number of low-weight infants, save state dollars

 

Baltimore Sun Editorial

Monday, February 16, 2009

 

Only 9 percent of babies born in Maryland weigh less than 5.5 pounds, which doctors consider a normal birth weight for healthy infants. Yet that relatively small proportion of infants accounts for more than half of all spending on births in the state - $166.6 million, as opposed to $140 million spent on the other 91 percent of babies, according to a recent study by the nonprofit Advocates for Children and Youth, which lobbies for child welfare issues.

 

Much of the high cost of low-birthweight infants is born by state and federal governments through the Medicaid program that funds health care for low-income residents.

 

Babies born with low and very low birth weights cost, on average, 36 times more than normal-weight babies, and they stay in the hospital 15 times longer. In 2007, the average hospital charge for a very-low-birthweight baby (under 3.3 pounds) was $83,995, compared with just $2,308 for a normal-weight baby.

 

And while advances in neo-natal care have allowed more low-and very-low birthweight babies to survive, they often suffer from serious health problems at birth and lasting disabilities, all of which add to the long-term costs paid for with tax dollars by the government.

 

Maryland could significantly lower its Medicaid spending for these poor birth outcomes by working to reduce the number of low-birthweight babies born in the state. Since maternal health is a major risk factor, preventive health care programs for women who have had at least one poor birth outcome could help them avoid another. Advocates for Children and Youth estimates that redirecting $4.4 million of current Medicaid spending toward prevention would reduce the state's bill for poor birth outcomes by $5 million a year, saving $600,000.

 

State legislators this week will review a package of preventive measures that have been proved effective in reducing low-birthweight births. In tough times like these, every dollar saved counts. At the least, the state should institute a pilot program to see whether the projected savings materialize. A preventive strategy aimed at improving birth outcomes among women without regular access to health care could also significantly impact the state's infant mortality rate of eight deaths for every 1,000 live births, one of the highest in the nation.

 

The savings to Maryland could be substantial, and they shouldn't be counted just in dollars but also in the lives and well-being of its most vulnerable citizens - its children.

 

Copyright  2009 Baltimore Sun.

 

Ban a neurotoxin dangerous to kids

 

Baltimore Sun Letter to the Editor

Monday, February 16, 2009

 

The General Assembly should pass Del. James W. Hubbard and state Sen. Mike Lenett's bills to ban a powerful neurotoxin found in many televisions and couches.

 

The toxic chemical flame retardant known as Deca-BDE threatens children's ability to learn and memorize. Research also links it to behavioral problems such as hyperactivity.

 

Sony, Apple and Ikea are just a few companies that no longer use Deca as a result of its health risks. However, some companies continue to sell consumers their toxic-laden products.

 

Maryland has been a leader in reducing our exposure to another neurotoxin - lead.

 

We should not pick and choose which hazardous chemicals to keep away from our children.

 

Let's remain consistent and pass the House and Senate bills to ban Deca. Fielding Huseth Baltimore

 

The writer is a policy advocate for the Maryland Public Interest Research Group.

 

Copyright 2009 Baltimore Sun.

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