Friday, October 11, 2019

Traumatic Head & Spinal Cord Injury Trust Fund Program is here to help

Whether it’s from a motor vehicle accident, a fall, a near-drowning experience, physical assault or some other trauma, a traumatic head and/or spinal cord injury can be a life-changing event. This kind of event doesn’t just affect the individual — it also impacts the lives of their loved ones, who may eventually become the caregiver, assisting with daily living activities like bathing and dressing.

In Louisiana, the Traumatic Head & Spinal Cord Injury Trust Fund Program (THSCI) helps those with such injuries, who meet eligibility requirements, to return to a reasonable level of functioning and independent living in their communities. The Louisiana Legislature created the program in 1993 with Act 654. Through this act, the program is funded by imposing additional fees on motor vehicle violations in Louisiana for the offenses of driving under the influence, reckless operation and speeding.

The Louisiana Department of Health’s, Office of Aging and Adult Services administers the THSCI Program, which includes but is not limited to processing admissions to the program, paying service providers for services on behalf of eligible individuals and reviewing Plans of Care. In addition, the Brain Injury Association of Louisiana (BIALA) serves as the program’s designated resource center for people with traumatic head and/or spinal cord injuries.

Who may be eligible for assistance through the program?

Louisiana residents who have suffered a traumatic head and/or spinal cord injury may apply for program assistance.

A traumatic head injury is caused by an external physical force, such as falls, which affect the brain, producing diminished or altered state of consciousness. The injury can lead to impaired cognitive and/or physical functioning. Degenerative or congenital conditions do not meet the definition of traumatic head injury as it relates to the program. For example, a person with Alzheimer’s would not be eligible for the THSCI program.

Similar to traumatic head injury, a spinal cord injury is caused by an external force, such as a car accident. This kind of injury can lead to paraplegia (paralysis of the legs and lower body) or quadriplegia (paralysis of both the arms and legs). Degenerative and congenital conditions do not meet the definition of spinal cord injury as it relates to the program. For example, a person with spina bifida would not be eligible for the THSCI program.

To be determined eligible for services, a person must:
  • Meet the definition of traumatic head/spinal cord injury (above), per their treating physician
  • Be a resident of Louisiana and officially domiciled in Louisiana at the time of the injury and while receiving services
  • Have a reasonable expectation to gain improvement in functional outcome with assistance, per their treating physician
  • Have exhausted all other Medicare and Medicaid sources as attested to by the applicant
  • Provide proof of denial from other sources, if requested
  • Be willing to accept services from an approved facility or program
  • Complete and submit the appropriate application for services
  • Cooperate with program requirements

What services are available?

Participants work with their assigned case manager to develop a Participant Service Plan that offers flexible services aimed at improving how they function in their homes and communities as it relates to their injuries. Eligible participants may receive services including, but not limited to:
  • Evaluations and therapies
  • Post-acute medical care rehabilitation
  • Home and vehicle accessibility modifications
  • Medication and medical supplies
  • Personal Care Attendant Services
  • Equipment necessary for activities of daily living
  • Transportation for non-emergency medical appointments
  • Other goods and services deemed appropriate and necessary
  • Post-acute medical care rehabilitation
Service providers must be THSCI Program approved, with in-state facilities and programs receiving priority. All services are on a first-come, first-served basis.

Is there a cap on what I can receive?

An individual’s expenditures are limited to $15,000 for any 12-month period or $50,000 total per person per lifetime

How do I apply?

Call (225) 219-2410 or (888) 891-9441 for questions, additional information or to have an application for services sent to you. You can also download and print the application at this link. Mail the completed forms with original signatures to the THSCI Trust Fund Program, P.O. Box 2031 – Bin #14, Baton Rouge, LA 70821-2031.

Additional resources are available through the Brain Injury Association of Louisiana Resource Center, 8325 Oak St., New Orleans, LA 70118. The association also staffs a 24-hour support line at (504) 982-0685.

Friday, October 4, 2019

Stop the bleed, save a life

By DR. LACEY CAVANAUGH | Region 5 Medical Director, LDH Office of Public Health

You are driving home and a motor vehicle crash happens in front of your very eyes. Wanting to help, you pull over and immediately recognize a life-threatening bleeding situation. What do you do?

Or, maybe it is not a crash. Maybe it is a hunting accident, a power tool injury, a sporting event or a shooting. An injured person may only have minutes to live if bleeding is not controlled immediately. Uncontrolled bleeding is actually the number one cause of death after a mass casualty event.

Knowing what to do in this situation, before emergency medical services are available, can save lives.

The Stop the Bleed program is part of a nationwide movement to help laypeople possibly save a life if ever faced with life-threatening bleeding. Stop the Bleed was developed by the American College of Surgeons Committee on Trauma. The program teaches people the basic steps to stop bleeding, which include calling 911, ensuring personal safety, looking for life-threatening bleeding, then compressing and controlling bleeding using pressure, packing and/or a tourniquet. These skills are intended for field use until the injured person can be transported to a medical facility.

Hands-on learning

The Region 5 Office of Public Health, in collaboration with several community partners, held two Stop the Bleed trainings for the LSU residents, faculty and staff at the Lake Charles Memorial Hospital Family Medicine Residency
Program on August 30 and September 20.

Ted Colligan with the Louisiana Emergency Response Network was the lead instructor and several staff from other local partner organizations assisted with training the participants. The training consisted of a presentation and discussion period, followed by a hands-on practice session of newly learned skills.

The intent of this class was to train future Louisiana physicians to be Stop the Bleed trainers, so that they can then assist in training the rest of the community. This was a unique audience of mostly physicians and a wonderful example of cross-sector collaboration between partners to achieve a goal. Forty-three participants completed these two trainings and nine of them signed up to be instructors.

Representing OPH Region 5 were Public Health Emergency Response Coordinator Mike Parent, Hospital Nurse Coordinator Janet Rider, and APRN Nadine Blake. Jessica Leboeuf with the Calcasieu Parish Medical Reserve Corps, Lake Charles Memorial Hospital System RNs Rezalynn Vincent and Crystal Rollins, and Dr. Danette Null, associate professor with the LSU Family Medicine Residency Program all took part in leading two three-hour classes. We want to thank all of our partners and instructors, in addition to Lezlie Fletcher with the LSU Family Medicine Residency Program, for their assistance in making this training a reality.

For more information, to find a class near you or to request training at your facility, click here.

Friday, September 27, 2019

Opioid harm reduction: A comprehensive approach

By DR. DAVID J. HOLCOMBE | Medical Director, LDH Region 6

Opioid overdoses continue to claim over 100 American lives every day (46,029 in 2017). This slaughter now exceeds the number of annual traffic deaths (37,000 in 2017), which has benefited from gradual reductions related to improved safety in both roadways and vehicles. In an Annals of Internal Medicine article, Drs. Levine and Fraser proposed elements of a comprehensive public health response to the opioid crisis.

They established six categories to approach the crisis: (1) Leadership, (2) Partnerships, (3) Epidemiology, (4) Prevention/Education, (5) Treatment and Recovery and (6) Overdose Prevention. Some of the key elements of each category proved a framework for a coordinated approach in which public health plays a leading role.

Leadership entails the engagement of all leaders from the governor’s office down to community leaders, not only in healthcare, but also in education, corrections, social services and economic development.

Partnerships include not only those within communities, but also those between states, the federal government, faith-based organizations and health community coalitions, among others.

Epidemiology serves to create databases and dashboards available to all interested and engaged parties. The Louisiana Opioid Data and Surveillance System fulfills this valuable role by providing local data relating to specific populations.

Education and prevention involves prescribers, pharmacists and the public. This includes the state Prescription Monitoring Program, regulation of pain clinics, sanctions for over-prescribers, and working with school-based health clinics and the Department of Education to improve drug awareness.

Treatment and recovery must be enhanced with increased availability to rehab facilities, expansion of medication assisted treatment (MAT), use of telehealth in rural areas, and improved post-recovery programs addressing employment, housing, transportation and other social needs.

Harm reduction and overdose prevention must include safe syringe programs (such as one being proposed locally), increased availability of naloxone (Narcan®), and improved diagnosis and treatment of underlying pre-disposing mental health factors such as depression.

This ambitious plan reflects a multi-faceted approach and broad engagement from multiple elements of society. It recognizes the importance of social determinants such as educational level and income, as well as the necessity of addressing glaring issues of health inequity. Public health can have a primordial role in tackling the opioid epidemic, but it cannot act alone or in a vacuum. We all helped create the world of opioid addiction in one way or another, and now we must rise to the occasion to help mitigate and eradicate it.

Friday, September 20, 2019

What do we do when we think it could be Alzheimer’s disease?

By GINA ROSSI | LCSW-BACS, MHSA, LDH Office of Aging and Adult Services

There can be nothing more heartbreaking and frightening than watching a parent or loved one slowly decline with memory problems or signs that indicate they may have dementia. Ask any older person about their biggest fears and inevitably the words “Alzheimer’s disease” enter into the conversation.

Approximately every 6 minutes someone receives an Alzheimer’s diagnosis. In Louisiana, 87,000 people over the age of 65 are living with Alzheimer’s, and 232,000 family caregivers are dealing with the effects of their loved ones needing care and support.

Alzheimer’s disease is a sixth leading cause of death in the U.S.  In 2017, there were 2,188 deaths in Louisiana related to Alzheimer’s, a 170% increase since 2000. This figure is projected to increase by 23.6% by 2025. Frightening, right? Despite this, only 16% of seniors receive regular cognitive assessments during routine health checkups. If you see signs, consult your primary care physician or neurologist.

The more we talk about Alzheimer’s, the more people are educated about its symptoms. The other side of the coin is that without clear guidance and professional consultation, our fears can cause us to jump to conclusions. For this reason, the Alzheimer’s Association provides education about this disease and what signs and symptoms we should be looking for.

It is important to know that dementia is an umbrella term and while Alzheimer’s disease is the most common cause of dementia, there are many reasons why someone may be showing signs of dementia.

Know the 10 signs of Alzheimer’s
  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgement
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

The three stages of Alzheimer’s
  • Mild (early stage): The person is still able to function independently but may feel they are having memory lapses such as forgetting words or familiar locations. Friends or family who are close may notice a change. If you are a caregiver dealing with this stage, make plans now for an assessment so future plans (and support for you) can begin.
  • Moderate (middle stage): The disease has progressed and the person may no longer do routine tasks and become confused about their history. This is the longest period and the most difficult for caregivers as they have to deal with the person’s anger, frustration, and increased wandering. If you are a caregiver dealing with this stage, get support NOW.
  • Severe (late stage): In this stage, the person needs 24-hour care with daily activities and personal care. They are no longer responding to their environment and are unable to communicate, which is especially troublesome for those experiencing pain. In the final stages, death is a result of infections such as pneumonia or bed sores. If you are a caregiver dealing with someone in this stage, know that you have done the best that you can. Be kind to yourself.

Clinical trials, research and resources

It is true that there is no cure for Alzheimer’s disease, but through research we know there are ways for us to reduce the risk, including activities such as regular exercise, keeping one’s blood pressure within current healthy guidelines and engaging the brain. These small things help us maintain and protect our brain health.

While there is no cure, clinical trials continue locally and nationally. There are many important advances and efforts to help people better cope with the effects of the disease and to work toward a cure. Research also continues into how to help a person live with Alzheimer’s while focusing on the needs of the primary caregivers who experience the physical, emotional and mental burden of caring for someone who has Alzheimer’s.

Someone who is unable to care for themselves and who needs care in the home may be eligible for home and community-based services. For more information about these services, call Louisiana Long Term Care Options at 1-877-456-1146. Here are some additional places to go for help:

Friday, September 13, 2019

Be a food safety superhero

Many people have daydreamed about being a superhero. Who wouldn’t want to have the power of flight or super strength? Well, those kinds of powers may be out of our reach, but there’s one that isn’t: being a food safety superhero. With September being Food Safety Education Month, it’s a great time to learn about preventing foodborne illnesses and how to keep food safe.

Much like Batman and his familiar rogues’ gallery of villains — the Joker, Catwoman and the Penguin, just to name a few — the kitchen also has its common culprits when it comes to food poisoning and foodborne illnesses. When contaminated and consumed, these foods can make a person very sick. Let’s take a closer look at the usual suspects.

First, a little sanitation: Always wash your hands with soap and warm water before handling food and immediately after handling any raw food. Wash your counter tops, cutting boards, dishes and utensils with soap and hot water between the preparation of raw foods and cooked or ready-to-eat foods.

Chicken, beef, pork and poultry
  • The bad guys: campylobacter, salmonella, Clostridium perfringens, E. coli, yersinia and other bacteria
  • How to fight back: Never wash raw poultry or meat, since this increases the chances of spreading bacteria to other foods and surfaces. Cook your poultry and meat thoroughly to a safe internal temperature using a cooking thermometer and these charts. Don’t rely on the meat’s color or juices to tell you if it’s fully cooked. Refrigerate any leftovers within two hours of preparation at a temperature of 40 degrees Fahrenheit or colder. Divide larger cuts into small quantities for refrigeration, as this helps the meat cool quickly and prevent bacteria from growing.

Seafood and raw shellfish
  • The bad guys: Vibrio, salmonella, listeria, norovirus and other bacteria
  • How to fight back: Cook raw seafood to proper temperatures, usually an internal temperature of 145 degrees. Other ways to tell if seafood is done are if fish flesh is opaque and separates easily with a fork; shrimp, scallop, crab and lobster flesh become firm and opaque; and the shells of clams, mussels and oysters open during cooking (unopened ones should go in the trash). Don’t eat seafood if it smells sour, rancid or like ammonia. Cooked seafood should be refrigerated if it’s been out for more than two hours or for more than an hour when temperatures are 90 degrees or higher. Refrigerate at 40 degrees or colder.

Fruits and vegetables
  • The bad guys: salmonella, E. coli and listeria
  • How to fight back: Wash your hands and all utensils and food prep surfaces before and after preparation. Under running water, wash or scrub your produce and cut away any damaged or bruised areas, then dry with a clean paper towel. Keep produce separate from raw meat, poultry and seafood. Refrigerate your prepared fruits and veggies within two hours, or one hour if it’s 90 degrees or hotter outside. Store in a clean container in a refrigerator at 40 degrees or colder.

  • The bad guys: salmonella, E. coli and listeria
  • How to fight back: Cook sprouts such as alfalfa or bean thoroughly to kill off any germs.

Raw milk, raw milk soft cheeses and other raw milk products
  • The bad guys: campylobacter, cryptosporidium, E. coli, listeria and salmonella
  • How to fight back: Choose products that have been pasteurized — if the label says “pasteurized,” it’s safe to consume. These products include milk, yogurt, ice cream and soft cheeses like queso fresco, queso blanco, brie, Camembert and feta. Pasteurization is a process that heats raw milk to a specific temperature just long enough to kill off germs. This process doesn’t destroy enough of the nutritional benefits of raw milk to make raw milk worth the risk. Refrigerate milk products at 40 degrees or colder. Keep your eye on the expiration date. If a product is past this date, throw it out to reduce your chances of getting sick.

  • The bad guy: salmonella
  • How to fight back: Buy and use pasteurized eggs and egg products from stores and suppliers, and never buy cracked or dirty eggs. Cook your eggs thoroughly, until the whites and yolks are firm. If your recipe calls for raw or undercooked eggs, such as Caesar salad dressing or eggnog, make sure you only use pasteurized eggs and egg products. No matter how tempting it may be, do not taste or eat raw batter or dough that contains eggs. Eggs and any foods containing eggs should be refrigerated shortly after cooking. Refrigerate eggs at 40 degrees or colder.

Raw flour

  • The bad guys: E. coli and other bacteria
  • How to fight back: Most flour is a raw agricultural product, which means it hasn’t been treated to kill bacteria. When you cook with flour, the heat from cooking kills off the bacteria. That’s why you shouldn’t eat raw dough or batter. It’s delicious, but it’s not worth the risk. Just don’t do it.

Now that you’re armed with information, you can take the fight to foodborne illnesses. It’s in your power to protect yourself and your loved ones from sickness.