Wednesday, November 25, 2009

Flu shots benefit pregnant women and their babies

Two new studies show that pregnant women who are given flu shots during their pregnancy can reduce the risk of having children born prematurely or with low birth rate. [The studies did not include women vaccinated for the H1N1 (swine flu) virus.]

An article in Science News, November 21, 2009, entitled Flu shots for moms-to-be benefit babies, reports on research conducted in Georgia and Bangladesh.

Saad Omer of Emory University in Atlanta identified over 4,000 pregnant women of whom 15% had received a flu shot. Those who received the flu shot were overall 40% less likely to have a baby born prematurely and 70% less likely to have a premature baby if the mother received a flu shot during peak flu season.

The second study was conducted by Mark Steinhoff at Cincinnati Children’s Hospital Medical Center and a Bangladeshi team. They found that babies born to flu-vaccinated women in Bangladesh were less likely to get the flu in their first year of life. On average, women who didn’t get flu shots gave birth to babies weighing about a half-pound less than those born to women getting the shot.

The article goes on to say that flu vaccination rates in the United States are "dismal". Only 15 -21% of pregnant women receive flu shots during flu season.

Thursday, November 19, 2009

Update on WCHO vocational programs

See update here.

Developmentally disabled consumers in vocational and skill-building programs in Washtenaw County can expect these programs to continue, although some consumers receiving supported employment services will be working through another provider.

At the November 17, 2009 meeting, the Washtenaw Community Health Organization (WCHO) Board voted to discontinue the contract with CHS, a provider of supported employment services, and reassign consumers receiving supported employment services to Workskills, another supported employment provider, and Community Supports and Treatment Services (CSTS). The CSTS skill-building programs (day programs and PACE groups) will continue as is. No consumers will lose vocational and skill-building services.

The programs provided by CSTS were threatened earlier in the year by drastic lay-offs and cuts by the Washtenaw County Board of Commissioners in order to plug a $30 million hole in the county budget. The County renegotiated labor contracts with county employee unions, saving $5.2 million over the next two years and 120 - 150 county jobs at CSTS.

The WCHO, which contracts for services from CSTS, will be able to fund the vocational and skill-building programs by consolidating some programs and using increased Medicaid funding from the federal government.

All three of the supported employment service providers (CSTS, Workskills, and CHS), had few complaints from
recipient rights or customer services, but CHS is having serious financial problems. [It was noted at the meeting that there have been complaints about the choice of jobs available through supported employment programs.] The WCHO Board decided that the option of maintaining the contract with Workskills and CSTS would least disrupt consumers and still be cost-effective.

Changes are expected to be implemented by March 1st, 2010, which will allow time for adequate communication and negotiation with providers and adjusted work at CSTS.

Wednesday, November 11, 2009

Autism moms experience stress!

Who would have thunk it? The mothers of adolescents and adults with autism experience chronic stress.

Disability Scoop, an on-line source of news on disability issues, reports that a study published in the November issue of the Journal of Autism and Developmental Disorders has found that mothers of autistic adolescents and adults have stress hormone levels consistent with soldiers in combat.

Researchers also found that:
  • Autism moms spend significantly more time care giving than moms of those without disabilities.
  • On any given day they are twice as likely to be tired and three times as likely to have experienced a stressful event.
  • These moms were interrupted at work on one out of every four days compared to less than one in 10 days for other moms.
  • On a day-to-day basis, the moms experienced more stressful events and have less time for themselves compared to the average American mother.

On the bright side, the autism moms were just as likely to have positive experiences each day, volunteer or support their peers as those whose children have no developmental disability. I assume this occurs after the moms' antidepressants kick in.

In conclusion, we really need to do more to support autism moms.

I don't know whether to laugh or cry. Just file this away under "Duh".

Free dental exams, November 14, 2009

I received this information from the University of Michigan Dental school. Just so you know, before attempting to participate in this, the Dental School does not treat people with unusual medical or behavioral problems. If you have a DD family member who is able to cooperate during the exam you might give it a try. They are only giving exams to the first 150 people who show up, so there may be lines.

This is available to anyone over the age of 5 regardless of income. If you know someone who needs a dental exam, whether they have a disability or not, let them know about this opportunity. This is just an exam - X-rays, oral cancer screenings, and oral hygiene instruction. Treatment is not being offered.


Each year, the University of Michigan School of Dentistry Student Council sponsors Dental Health Day, offering free dental screenings to Ann Arbor and surrounding communities. Because of the increasing cost of dental care, lack of information about dental services and changes in insurance coverage, many people refrain from seeking dental evaluation and service until they are experiencing pain, or find themselves in an emergency situation. Dental Health Day was designed to allow more people, who would otherwise refrain from seeking dental treatment, to receive basic dental health care, free of charge, reducing risks of emergencies.

This year, the 2009 Dental Health Day will be held on November 14. Individuals regardless of income, and as young as five, can participate in the program between 9:00 a.m. and 2:00 p.m. An appointment is not necessary. However, patients will be seen on a first-come, first-served basis. Treatments will not be provided. Registration will start at 8:30 and will continue until 12 noon or until 150 patients have been evaluated. All participants will receive FREE oral exams, FREE oral cancer screenings, FREE dental x-rays and FREE oral hygiene instruction.

For more information, contact the School of Dentistry at (734) 763-6933 or by e-mail (

Kate Ratliff
Dental Health Day Chair
University of Michigan School of Dentistry
Student Council

University of Michigan School of Dentistry
1011 N. University
Ann Arbor
Please enter the School of Dentistry at the North University Avenue entrance. Parking will be available at the Fletcher Street parking structure.

Monday, November 9, 2009

Class action lawsuit to compel Michigan to restore Medicaid dental benefits to adults

In July 2009, Michigan's Governor issued an executive order to discontinue funding for Medicaid dental benefits for adults over 21 years old. Preventive dental care was eliminated and treatment was limited to emergencies to treat pain and/or infection only. After the state legislature failed to restore funding for preventive dental care during budget negotiations in October, a class-action lawsuit was filed on behalf of 400,000 adults on Medicaid to "ensure that their federally-protected rights to a certain minimum level of medical services are protected."

A statement by Dykema, the law firm handling the suit, claims that "Michigan is violating key federal regulatory and statutory mandates". These claims include:

  • Michigan has failed to adopt and maintain programs and policies that operate to make dental care available for Medicaid beneficiaries throughout Michigan;
  • The state is acting in violation of the efficiency. economy, and quality of care provisions of Medicaid;
  • Michigan has failed to properly notify the federal Medicaid program that Michigan has discontinued providing dental services to adult Medicaid recipients.

Revenues for the state have declined precipitously over the last year, and the reduction in Medicaid services was part of sweeping cuts to services funded by the state. The actions of both the Governor and the state legislature have probably aggravated the state's budget problems. To "save" $5 million for dental benefits out of a total budget of more than $8 billion, the state will forego $16 million in federal matching funds from the federal government to fund Medicaid dental services.

The suit was filed October 28, 2009, in the U.S. District Court for the Western District of Michigan in Grand Rapids.

Medicaid dental benefits denied to adults in Michigan

Cutting off Medicaid dental benefits to adults with developmental disabilities is no small matter. In May of 2009, Governor Granholm did just that in an executive order in response to budget-wrecking declines in state revenues.

The cuts eliminating Medicaid-funded preventive dental care for adults over 21 years old, took effect on July 1st, 2009. They are described in changes to the state's Medicaid Provider Manual : "The adult dental benefit is limited to the following emergent/urgent services for the relief of pain and/or infection only... Routine examinations, prophylaxis, restorations, and dentures will not be covered. " In short, if you go to an emergency room with a toothache, Medicaid will pay for X-rays to diagnose the problem and for an extraction and maybe some painkiller, but will not pay to treat the underlying problem (such as periodontal disease), to fill a cavity, or to prevent the problem from occurring again.

For anyone who was already authorized for treatment of a dental problem before July 1st, 2009 and has a prior authorization on file, "providers have 180 days from the date the PA was approved to complete the services, according to existing Medicaid guidelines."

There are both short and long-term consequences to neglecting the dental health of people with severe disabilities: in the short-term, a tooth or gum infection that goes undiagnosed can result in pain, misery, infection, the loss of teeth, and even death. Ignoring gum and tooth disease may result in more expensive emergency room visits that fail to treat the cause of the problem. In the long-term, a lack of preventive dental care has also been implicated in the development of chronic diseases such as diabetes and heart disease.

As a parent, I mostly worry about someone like my Danny, who can't tell you that he is in pain or why he is uncomfortable. He can only show you in vague ways that something is the matter: he might have more seizures, be unable to sleep, scream (more than usual), or not want to eat. How do you rule out dental problems unless he has routine examinations, X-rays, and cleanings to diagnose problems early and either fix them or keep them under control? And what about people who have to be anesthetized for even routine dental evaluations? How bad will the problem have to be before Medicaid will authorize treatment or hospitalization or, in emergency situations, a dentist will have any confidence that a procedure will be covered by the person's Medicaid benefits?

There has been at least one death in Michigan since Medicaid adult dental benefits were substantially eliminated. According to The Grand Rapids Press in a story by Kyla King, Northern Michigan woman's death raises calls to restore adult Medicaid dental benefits, 10/22/09, a severely developmentally disabled woman from Alpena died reportedly from an untreated infection in her mouth. The woman had been scheduled for surgery in June 2009, but had other problems that postponed the surgery. Because of her severe disability, she needed to be hospitalized and anesthetized for the procedure. The dentists at the clinic in Cheyboygan, Michigan, were going to perform the procedure without charge, but the woman died while waiting for Medicaid approval of the $5,000 in hospital charges. The Michigan Department of Community Health admits that the death was indeed tragic and is looking into confirming the circumstances of the death.

The story in the Grand Rapids Press did not explain why there was a problem getting approval from Medicaid for the procedure when it was already scheduled for June, but was postponed. Was there not already authorization to do the surgery that would have covered the procedure for 180 days? Regardless of the details of the story, it is chilling that an infection in the mouth of a severely disabled woman could have resulted in death while awaiting Medicaid approval of coverage for a procedure that might have saved her life. How many more preventable deaths will it take before funding is restored for Medicaid preventive dental care?