BY VICKI HAYWOOD DOE and VICTOR M. BOZIS
Special to the Metro Monthly

According to the National Institute of Environmental and Health Sciences, there are approximately 9 million children under the age of 18 who have been diagnosed with asthma.

According to the National Center for Health Statistics, asthma is much more prevalent among urban and low socioeconomic status children. Several factors may contribute to this disparity. These children may have higher exposure to both indoor and outdoor allergens such as dust, cigarette smoke, automobile exhaust, and air pollution.

Socioeconomic status plays a role, but successful asthma care depends on regular maintenance and poor urban children have less reliable access to doctor’s offices and clinics. Instead, many families rely more on emergency room visits for treatment.

Childhood asthma has reached the level of public health concern. For reasons that are still unclear, the prevalence of childhood asthma in the United States is increasing. There has been an increase in missed school days, emergency department visits, hospital admissions, and children’s deaths due to this chronic illness.

In the past decade, the direct cost of providing care for children with asthma had increased to $6.2 billion and the indirect costs were $1 billion.  The national health-care objective is to reduce asthma morbidity in children and to develop and improve more effective treatment and prevention strategies. Therefore, public health programs and initiatives have been set forth to raise the awareness of childhood asthma among parents and doctors to help reduce exposure to allergens in homes and schools and to improve the quality of care for children.

The first and most important step is for parents to know and understand this common chronic disease. The better parents and their children understand asthma and its treatment, the better they will be able to control it. Asthma is a chronic inflammation of the airway passages of the lungs.  As a result, the lungs are easily irritated by airborne allergens, tobacco smoke, air pollution, furry pets, house dust mites, viral respiratory infections, or even strenuous exercise. 

When lungs become irritated, the airways swell, and mucus blocks the flow of air throughout the lungs.  The muscles surrounding the airways contract which tightens airways and makes it very difficult to breathe. 

This reaction creates a variety of asthma symptoms such as: coughing( especially at night); wheezing ; fatigue and lack of energy; tightness in chest; and shortness of breath.

Some asthma symptoms are easy to detect, however, other symptoms may be quiet and less obvious. If you think your child has experienced these symptoms, you should talk with your child’s doctor.
It is possible to control asthma and help your child to live without symptoms; however, it takes a lot of planning, learning and communicating. It can be a lot of work.

The National Institute of Health and other health organizations have issued tips and guidelines that are helpful to parents in dealing with the care of asthmatic children.

Here are six important tips:

Communicate. Parents should keep track and report symptoms to the child’s doctor. This will help with accurate and complete diagnosis and treatment for the child.

Monitor your child’s progress. Parents should check for signs of symptoms becoming more severe, or child using fast-acting rescue medicines more frequently, these may be warning signals and should be reported to the doctor.

Develop an asthma action plan. Parents should along with doctor develop an action plan that will help them to know when to use a controller medicine, when to add a fast-acting medicine or when to get help immediately!

Learn and avoid your child’s asthma triggers. Parents should know what environmental allergens or even food allergies that induce asthma and try to avoid them.

Join a child/parent asthma support group. Parents should find and join a support group. Caring for a child with asthma can be challenging. If you join a support group, you can meet and connect with other parents and professionals.

Educate family, friends, and caregivers. Parents should educate family, friends, and caregivers so that they can give help when needed.

Caring for a child with asthma can be a handful. However, with proper education and successful communication between parents and doctors, children can have quality of life and keep asthma under control.

Vicki Haywood Doe, M.A. A.B.D., HFS, is a clinical exercise physiologist and health fitness director for Vicki Doe Fitness, LLC in Niles. Victor M. Bozis is an exercise specialist and college intern for Vicki Doe Fitness, LLC and a student pursuing a degree in exercise science from Youngstown State University.

U.S. to provide $338 million for health centers

The U.S. Department of Health and Human Services in late March announced the release of $338 million to expand services offered at the nation’s community health centers. The money was made available by the American Recovery and Reinvestment Act and comes as more Americans join the ranks of the uninsured.

“More Americans are losing their health insurance and turning to health centers for care,” said Health Resources and Services administrator Mary Wakefield, Ph.D., R.N. “These grants will aid centers in their efforts to provide care to an increasing number of patients during the economic downturn.”

The grants -- titled Increased Demand for Services grants – will be distributed to 1,128 federally qualified health center grantees. Health centers will use the funds over the next two years to create or retain approximately 6,400 health center jobs.

Grantees submitted plans explaining how the IDS funds would be used. Strategies to expand services may include, but are not limited to, adding new providers, expanding hours of operations or expanding services. The funds will provide care to an additional 2.1 million patients over the next two years, including approximately 1 million uninsured people.

Health centers deliver preventive and primary care services to patients regardless of their ability to pay; charges for services are set according to income. Health centers served more than 16 million patients in 2007, about 40 percent of whom had no health insurance.

The IDS awards are the second set of health center grants provided through the Recovery Act. On March 2, President Barack Obama announced grants worth $155 million to establish 126 new health centers. Those grants will provide access to health center care for 750,000 people in 39 states and two territories.

To see a list of grantees by state, go to http://www.hhs.gov/recovery/programs/hrsa/idsgawards.html.To find a health center near you or to learn more about health centers, visit http://bphc.hrsa.gov/.

The activities described in this release are being funded through the American Recovery and Reinvestment Act. To track the progress of HHS activities funded through the ARRA, visit www.hhs.gov/recovery. To track all federal funds provided through the ARRA, visit www.recovery.gov.

The Health Resources and Services Administration is part of the U. S. Department of Health and Human Services. HRSA is the primary federal agency responsible for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.

For more information about HRSA and its programs, visit www.hrsa.gov.

CVS pays $2.25 million to settle HIPAA case

From the Department of Health and Human Services

The U.S. Department of Health and Human Services and the Federal Trade Commission announced in late March that CVS, the nation’s largest retail pharmacy chain, will pay the U.S. government a $2.25 million settlement and take corrective action to ensure it does not violate the privacy of its millions of patients when disposing of patient information such as identifying information on pill bottle labels.

The settlement, which applies to all of CVS’ more than 6,000 retail pharmacies, follows an extensive investigation by the HHS Office for Civil Rights for potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.

In a coordinated action, CVS Caremark Corp., the parent company of the pharmacy chain, also signed a consent order with the FTC to settle potential violations of the FTC Act.

OCR, which enforces the Privacy Rule, opened its investigation of CVS pharmacy compliance with the Privacy Rule after media reports alleged that patient information maintained by the pharmacy chain was being disposed of in industrial trash containers outside selected stores that were not secure and could be accessed by the public. At the same time, the FTC opened an investigation of CVS.

OCR and the FTC conducted their investigations jointly. This is the first instance in which OCR has coordinated investigation and resolution of a case with the FTC.

“OCR is committed to strong enforcement of the HIPAA Privacy Rule to protect patients’ rights to privacy of their health information. We hope that this agreement will spur other health organizations to examine and improve their privacy protections for patient information during the disposal process,” said Robinsue Frohboese, acting director of OCR. “Such safeguards will benefit consumers everywhere.”

The Privacy Rule requires health plans, health care clearinghouses and most health care providers (covered entities), including most pharmacies, to safeguard the privacy of patient information, including such information during its disposal.

Among other issues, the reviews by OCR and the FTC indicated that:
CVS failed to implement adequate policies and procedures to appropriately safeguard patient information during the disposal process; and
CVS failed to adequately train employees on how to dispose of such information properly.

Under the HHS resolution agreement, CVS agreed to pay a $2.25 million resolution amount and implement a robust corrective action plan that requires Privacy Rule compliant policies and procedures for safeguarding patient information during disposal, employee training and employee sanctions for noncompliance.

HHS and FTC also will require CVS to actively monitor its compliance with the resolution agreement and FTC consent order. The monitoring requirement specifies that CVS must engage a qualified independent third party to conduct assessments of CVS compliance and render reports to the federal agencies. The HHS corrective action plan will be in place for three years; the FTC requires monitoring for 20 years.

The HHS Resolution Agreement and Corrective Action Plan can be found on the OCR Web site.

OCR has posted new FAQs that address the HIPAA Privacy Rule requirements for disposal of protected health information. They can be found on the OCR Web site at http://www.hhs.gov/ocr/privacy/index.html.

Information about the FTC Consent Order agreement is available at http://www.ftc.gov.