Health, Doctors and Common Sense

Mia Rogers, 7, holds a drawing she made of nurse Teri Pond. For the first six years of her life, Mia had undiagnosed hypothyroidism, but she’s doing well now. Pleased, Pond said: “This is why I do what I do.”

Gracie Lynn Johnson was born with devastating medical problems, to an overburdened mother with psychological issues.

It all added up to tragedy.

Gracie is dead and her mother is in the Sacramento County jail, charged with felony child endangerment.

The scenario is all too common to authorities who investigate and document child deaths in Sacramento County. “Medically fragile” children like Gracie, they said, are highly vulnerable.

Of the 67 youngsters who died of abuse and neglect between 2004 and 2008, 16 were known to be medically fragile, with chronic conditions or special health needs, according to the county’s Child Death Review Team.

“These children are 100 percent dependent on their parents” for survival, said Angela Rosas, a Sutter Health pediatrician and member of the death review team. “Because of their conditions, parents can get stressed and frustrated. Probably for that reason, these children most definitely are at greater risk of being neglected and abused.”

Yet a crucial lifeline for medically fragile youngsters is about to snap.

Starting July 1, if proposed budget cuts become reality, Sacramento County will eliminate its public health nursing program for needy parents.

Since 1998 the program, in which nurses visit families with medically fragile children, has been slashed from 30 nurses to two, said county public health officer Glennah Trochet. The remaining positions now are slated to be cut.

“As it is, we are only able to see the sickest of the sick,” said Bernice Walton, public health nursing director for the county. “We know that sending nurses to homes saves lives, and saves costs. I think we will now be looking at a higher rate of harm and death, and an increase in hospital and emergency room use by these very ill children.”

One Sacramento mother, Rene Rogers, credits the program for getting to the bottom of a health problem that could have caused brain damage or even killed her daughter Mia.

For the first six years of her life, Mia suffered from undiagnosed hypothyroidism, a hormonal disorder that left her weak and stunted her growth. Untreated, the condition can cause learning disabilities, mental retardation and even coma and death.

“She was very tiny. She would pick at her food. All she wanted to do was sleep,” Rogers said. “At school, they treated her like a little baby, and she didn’t like that.”

It was only after public health nurse Teri Pond visited last year to check on Mia’s younger brother that the girl was diagnosed and began treatment. Now Mia is a normal, if petite, 7-year-old.

“Teri pushed her way through the system and got what we needed,” said Rogers, who has six children at home. “We are so grateful.”

Gracie Lynn Johnson was not so lucky. Nearly a month after authorities found the infant girl’s decomposing body in a Rancho Cordova apartment, it remains unclear whether her family was getting any help or monitoring.

The family was targeted to be seen by Child Protective Services, but a communication snafu between that agency and the Sheriff’s Department delayed an investigation into possible neglect. By the time a CPS social worker went into the home, it was too late.

The baby’s mother, Jennifer Blanchette, needed psychological help, said a relative who declined to talk in detail. Her home was in disarray, the Sheriff’s Department said, signaling that she was overwhelmed by her circumstances.

The family may have qualified for at least one of several programs designed to help parents care for children with medical challenges. Gracie, the Sheriff’s Department said, was born with severe defects including hydrocephalus, or water on the brain.

When a child is born with serious medical issues, hospitals typically assign a social worker to the family. The social workers can refer parents to the county for assignment to a public health nurse, said Walton. In recent years, however, the program has had to accept only the most pressing cases, with each nurse juggling as many as 40 at a time.

The nurses regularly visit family homes, assessing the child’s condition and development, monitoring nutrition and growth and teaching parents critical tools such as feeding and basic medical care.

If the family needs more help, the nurses can help them connect with programs such as the state’s Regional Centers, which offer care to infants and toddlers with disabilities or developmental delays. Another program, California Children’s Services, arranges and pays for medical care, equipment and rehabilitation for children whose families are unable to pay.

Authorities said that, because of privacy issues, they were unable to discuss whether Gracie Lynn Johnson’s family was taking advantage of any programs.

But they pointed out that programs cannot be imposed upon parents unless abuse or neglect is suspected.

“Services are voluntary, and a parent cannot be forced to accept them,” said Nancy Lungren of the state Department of Developmental Services.

Rogers, the Sacramento mother, said she jumped at the chance to get help for Mia and her younger son Essiah, who also had developmental delays. A house full of kids, she said, can be stressful.

At first, she said, Pond “was just someone new in the house, a stranger. But after a while we couldn’t wait to see her. It was so much easier for her to come to us, instead of having to put all of the kids in the car” and go to a doctor’s office or agency, she said.

Mia is a “miracle,” said Pond, who gave the girl a hug and a new doll on a recent visit. “This is why I do what I do.”

But as budget cuts continue to take a toll on social service programs across the state, Walton said, she worries that more children will end up like Gracie Lynn Johnson.

Seven-year-old Mia Rogers receives a hug from Sacramento County public nurse Teri Pond earlier this month while Mia’s mother, Rene Rogers, looks on. Pond played a key role in having Mia diagnosed with and treated for a life-threatening thyroid condition that is now under control. Sacramento County is poised to eliminate its nursing program for parents of “medically fragile” children.

Sacramento County public health nurse Teri Pond, left, talks with mother Rene and daughter Mia earlier this month in the Rogers’ Sacramento home. Pond helped Mia get diagnosed for a hormonal disorder that left her weak and stunted her growth. “Teri pushed her way through the system and got what we needed,” said Rogers, who has six children at home. “We are so grateful.”

Tags: Abuse And Neglect, Bernice, Child Death, Child Deaths, Child Endangerment, Chronic Conditions, County Jail, County Public Health, Fragile Children, Gracie, Hypothyroidism, Lifeline, Medical Problems, Pediatrician, Psychological Issues, Public Health Officer, S Child, Sacramento County, Special Health, Sutter Health

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Kaiser Permanente reached a tentative agreement with 96,000 of its workers on Friday, ending weeks of tense negotiations and union pickets.

The agreement with the coalition of 32 unions across the country would provide 3 percent raises in each year of the two-year contract, according to the Service Employees International Union-United Healthcare Workers West, which accounts for about half of the covered workers.

Dave Regan, an SEIU-UHW trustee in Oakland, called the pact “a remarkable achievement in a tough economy.”

It came early Friday after a 3 1/2 day marathon bargaining session.

Over the past few months, health care workers have been staging rallies at Kaiser hospitals to pressure the nation’s largest health maintenance organization for a new labor pact.

Kaiser had sought concessions from its unions on health care benefits to reduce its costs. Health insurance fees and deductibles were raised earlier this year on managers and nonunion employees.

In addition to raises, union members will keep their current benefits package and will have expanded rights to cash out unused sick leave.

The agreement, which mostly covers employees in technical and nonprofessional functions, is subject to a rank-and-file vote this summer.

If ratified, the contract and initial raise will go into effect Oct. 1.

While Kaiser and its union were coming to terms, the University of California hospitals remained at odds with the California Nurses Association.

The union said it was prepared to hold a strike on June 10 at hospitals across the UC system, including UC Davis Medical Center, because it was dissatisfied with the progress over its own contract negotiations.

How the university will respond remains unclear because no talks have been scheduled.

“What we’ll do is look at what the impact will be if the strike goes forward,” said Carol Robinson, the chief nursing officer for the UC Davis Medical Center. Services could be reduced if the center’s 1,700 registered nurses walk out, she said.

As many as 13,000 California nurses could take part in the strike, if the union follows through with its threat to protest staffing policies at university hospitals. Nurses in Minnesota – 12,000 of them – are scheduled to strike on the same day.

The unions say the walkouts could be the largest nurses strike in U.S. history.

Tags: California Hospitals, California Nurses Association, Carol Robinson, Contract Negotiations, Dave Regan, Davis Medical Center, Health Care Benefits, Health Care Workers, Health Maintenance Organization, Insurance Fees, Kaiser Hospitals, Kaiser Permanente, Labor Pact, Medical Center Services, Nursing Officer, Registered Nurses, Remarkable Achievement, Tense Negotiations, Uc Davis Medical Center, Union Pickets

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More than a fourth of all hospital patients were readmitted within two years for the same conditions that prompted their initial hospitalization, according to a new federal study.

The study released Wednesday by the U.S. Agency for Healthcare Research and Quality adds to a growing body of research suggesting that revolving-door admissions are adding billions of dollars, perhaps unnecessarily, to the country’s growing health care costs.

Last week, California’s Office of Statewide Health Planning and Development issued its own study saying that more than a third of patients hospitalized in California are readmitted within a year.

But unlike the state’s study, which did not distinguish the reasons for repeat hospital visits, the federal study looked at readmissions based on the originating ailment.

The federal study analyzed data on 15 million patients in 12 states, including California in 2006 and 2007. The study focused particularly on chronic ailments, such as asthma, diabetes, high blood pressure and hardening of the arteries.

“High rates of repeat patient visits to the hospital,” the report states, “may indicate deficiencies in the health care delivery system.”

Both state and federal researchers found that patients on the government’s two biggest insurance programs – Medicare and Medicaid, referred to as Medi-Cal in California – had the highest rates of readmission.

Also, the federal study showed that the poor also had higher readmission rates.

Tags: Ailment, Care Delivery System, Chronic Ailments, Federal Researchers, Growing Health, Hardening Of The Arteries, Health Care Costs, Health Care Delivery, Health Care Delivery System, Health Planning, Healthcare Research, High Blood Pressure, Hospital Patients, Hospitalization, Insurance Programs, Medi Cal, Patient Visits, Readmission Rates, Report States, Statewide Health

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Thomas Hicklin, a longtime addict and Medi-Cal patient who is stable on methadone, said he doubts he could afford $300 or more a month for methadone should the state budget proposal become reality.

It is a craving so powerful that addicts will do almost anything to satisfy it.

For thousands of people hooked on heroin and other opiates, a daily swallow of methadone tames the demon and opens the door to a normal life.

But soon the synthetic narcotic, which for decades has been used as a controversial treatment for addiction, no longer may be an option for thousands of Californians.

As part of the effort to dig the state out of its massive budget hole, the Schwarzenegger administration has proposed cutting off Medi-Cal funding for “methadone maintenance” and other treatment programs to most addicts, saving the state $53 million.

Advocates who believe that methadone saves lives and lowers crime committed by society’s most hard-core addicts are vigorously protesting the proposed cuts. Today, former federal drug czar Barry McCaffrey and others will try to convince lawmakers that slashing the program would backfire on the state.

“Dumping tens of thousands of opiate addicts back on the street would be an immediate disaster to law enforcement, and to the families of people who have become stable, functioning adults” thanks to methadone, said McCaffrey, who has a consulting firm and serves on the board of directors of an organization that treats chemical dependency.

Dr. John McCarthy, a psychiatrist who has treated opiate addicts for more than three decades, estimated that about 2,000 people are enrolled in methadone maintenance programs in the Sacramento area, and 70 to 80 percent are Medi-Cal patients.

“This is very serious,” he said of the proposed cuts. “There is obviously a lot of panic about what we are going to do” if benefits are slashed. “We might be able to cut back on the counseling component of treatment, but we have to find a way to preserve the medication for many patients who are very ill.”

Thomas Hicklin, 59, a longtime addict who is stable on methadone, is one of those Medi-Cal patients. Hicklin, who has diabetes and hepatitis C, among other health problems, said he doubts he could afford $300 or more a month for methadone should the cuts take effect.

“It would be devastating to me, and a lot of other addicts who won’t get the chance to have a normal life,” he said.

The budget proposal calls for eliminating Medi-Cal funding for methadone treatment to everyone except pregnant women and minors. More than 35,000 Californians would be affected, opponents of the cuts estimate. The cuts, effective in October, would mean a loss of more than $60 million in federal funding, they said.

The proposed cuts “are not in any way a statement of the lack of importance” of drug treatment for addicts, said state Finance Department spokesman H.D. Palmer. “They are important. But we’ve got to focus on closing a $19.1 billion budget gap,” and just about everything is on the table, he said.

Methadone is legally prescribed to addicts as a safer substitute for opiates, including heroin and OxyContin. Studies have shown that it helps curb cravings and withdrawal symptoms such as anxiety, nausea and chills without producing an intense “high.”

For some, like Amber Castorena, it can provide the control and serenity to lead a normal life.

Castorena, 38, said she lost her job, family and home during more than 20 years of serious drug addiction. She committed crimes to feed her heroin habit, she said. Her singular focus was getting her fix.

“It brings you to your knees,” she said of heroin.

Castorena tried inpatient treatment programs, without success, she said. Within a month of starting on methadone more than three years ago, “I was off the streets,” Castorena said. “I got my life, my kids, my family back. I do volunteer work, so I’m giving something to society instead of taking.”

But methadone maintenance has its skeptics. Some question whether it is wise to allow addicts to substitute one narcotic for another, and believe patients would be better served by programs that focus on weaning them from all drugs.

“My professional opinion is that methadone is good for chronic pain and for detox, but maintenance needs scrutiny,” said Dr. Eric Voth, chairman of the Institute on Global Drug Policy.

“The greatest problem I have seen is that addicts shift back and forth from other street drugs to methadone, and nobody holds their feet to the fire to get straight,” Voth said. “I think there needs to be rigorous supervision and expectations to accompany methadone’s use.”

Withdrawal from opiates, said McCarthy, can trigger potentially life-threatening physical and psychiatric symptoms. Addicts suddenly deprived of methadone likely will flood emergency rooms, and ultimately will be tempted to commit crimes or abandon their families to feed their cravings for the drug, he predicted.

Helen Camp, 28, who once was hooked on prescription opiates including Vicodin, said she became a different person when she was chasing her high.

“I had always been the responsible one,” she said, but when she became addicted she stole from her family and nearly lost custody of her daughter. Her life is back on track, she said, now that she is in a methadone program.

“It scares me to death to think I might not be able to get it anymore,” Camp said. “I don’t want to go back to where I was before.”

Tags: Barry Mccaffrey, Californians, Chemical Dependency, Consulting Firm, Controversial Treatment, Dr John, Drug Czar, Heroin, Hicklin, John Mccarthy, Massive Budget, Medi Cal, Methadone, Methadone Maintenance Programs, More Than Three Decades, Opiate Addicts, Opiates, Psychiatrist, Sacramento Area, State Budget Proposal

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While he waits for a medical checkup, Lovensky Alexandre, 7, examines the scar left from the surgery that closed a hole in his heart. Doctors at Sutter Medical Center in Sacramento donated their services after a Sacramento fire captain, volunteering in Haiti after the quake, met Lovensky and his mother.

Lovensky Alexandre, a tiny boy with a hole in his heart, came to Sacramento from the devastation of the earthquake in Haiti.

The frail 7-year-old showed up in March with an eager grin and a will to live. In a little more than five weeks, he went from chattering in Creole to speaking in excited bursts of English, playing Wii games on a big-screen TV and devouring pizza.

He gleefully chucked a pitch at a River Cats game, where he was publicly honored as a story of courage and survival.

Now Lovensky and his mother, Roselene Ducelus, are back in Haiti. They returned May 12, 26 days after Lovensky underwent successful heart surgery at the Children’s Center of Sacramento’s Sutter Medical Center.

In Sacramento, he savored days in a spacious Elk Grove home with elegant furnishings and a wonderland of electronics.

In Haiti, he would move into a tent behind his cousin’s single-room cinder-block house.

His experiences in Sacramento changed Lovensky. Going home would not be so easy.

Roselene Ducelus says Lovensky, the youngest of her four children, “was born sick.”

He spent much of his early life in Haitian hospitals, put into oxygen chambers for frequent pneumonia. He was so weak, Ducelus said in Creole, she carried him “like a baby” until he was 3.

The boy grew up with a hole in his heart that grew as wide as a quarter. Ill-equipped doctors in Haiti, the poorest land in the Americas, told Ducelus she would need to get out of the country to save him.

There was little hope for that – until Jan. 12, when a powerful earthquake jolted Haiti. It collapsed government buildings, schools and vast shantytowns into rubble and carnage. As many as 250,000 people were killed.

And one boy got a chance at an extended life.

Their house destroyed, Ducelus and her thin, wheezing child made their way to a makeshift clinic set up by Relief International in Carrefour, a hillside neighborhood southwest of Port-au-Prince.

There, they met a Sacramento fire captain with flaming red hair and fiery determination. Sacramento Metropolitan Fire District Capt. Barbie Law arrived at the crowded clinic in January to volunteer as a paramedic.

“I met Barbie and she promised she would do whatever she could,” Ducelus said. “When she said that, I knew it was God’s will.

“I knew it was going to happen.”

• • •

Through her father, a Sacramento physician, Law found Dr. Hessam Fallah, a pediatric cardiologist who works with Sutter Medical Center. Fallah persuaded the medical center and fellow doctors to donate services for Lovensky’s surgery.

Law accompanied Lovensky and his mother on an 18-hour flight to Sacramento, ultimately spending nearly $10,000 of her own money on travel, travel papers, passports and clothes for mother and son.

But the boy wasn’t physically ready for the operation.

“He looked very thin, very frail,” said Sutter heart surgeon Dr. Teimour Nasirov. “He had continued episodes of coughing and bouts of pneumonia. We had to postpone surgery.”

During the wait, Lovensky jumped into a new culture.

Sutter Medical Center called on Pierre LaGuerre, its Haitian-born, Creole-speaking emergency room admissions supervisor. He invited the boy and his mother to his five-bedroom Elk Grove home, filled with suburban American comforts.

In little time, Lovensky was holding a Wii controller and blasting away at monsters in Super Smash Brothers on a high-definition TV with LaGuerre’s son, Jepsen, 10.

He put on nine pounds, savoring hot dogs, french fries, chicken strips and chocolate milkshakes. He went to Chuck E. Cheese.

LaGuerre’s wife, Carmelle, delighted in watching him gain strength.

It was bittersweet.

In Haiti, her cousin, a teacher, died in the quake when his school in Pétionville collapsed.

“After the earthquake, we wondered how we could help,” Carmelle said. “When the opportunity came along” with Lovensky, “it was a blessing.”

• • •

The surgery took place April 15.

For three hours, surgeons worked to repair a ventricular septal defect that likely would have taken Lovensky’s life by his teenage years.

They kept him alive with artificial heart and lung machines – and shut down his damaged, beating heart. They took tissue from the pericardium, a thin membrane that surrounds the heart, and used it as a patch to close the hole.

Lovensky was in good spirits before the surgery and when he awakened afterward.

“He wasn’t scared or anything,” Nasirov said. “He told his mom he knew he would have a good result.”

As word of his surgery spread, the boy was showered with gifts. A backpack and Tyreke Evans bobblehead from the Sacramento Kings. A light-flashing, sirens-blaring toy car from a Sacramento police officer. A SpongeBob SquarePants game and cartoon DVDs.

The once weak little boy recovered with a happy fury. Within two weeks, the fissure on his chest was healing and melding with his skin.

His feel-good story got him invited to Raley Field, where he was to throw out a pregame pitch at a River Cats game. In a post-surgical checkup, Nasirov told him to throw the ball gently – and underhand.

The tiny boy stood at the lip of the pitcher’s mound as the stadium announcer said, “We are honoring him for his bravery and courage.” And then he heaved the baseball – overhand. It sailed a good 50 feet, kicking up dust in front of home plate.

The media swarmed him.

“Go Cats!” he said in English.

“Thank you very much.”

• • •

Barbie Law, a woman not prone to sentimentality, said some moments of Lovensky’s journey brought tears to her eyes.

She was moved by “the smile on his face, him playing with Jepsen, eating a peanut butter sandwich, just the little things he never experienced.”

She laughed when he showed up at a doctor’s visit in tanning goggles.

“He is a different kid, emotionally and physically,” Law said.

That presented a problem.

Doctors cleared Lovensky for travel, but he didn’t want to go back to Haiti. His mother was even more adamant about remaining in the United States.

Although she had three older sons waiting with relatives in Carrefour, she said she believed Lovensky was better off here.

In Haiti, before the quake, Roselene Ducelus was a street peddler, selling shoes, rice, beans, oils and other necessities. Her earnings fed the family.

After the disaster, she said, “The place is destroyed. Everybody is living on the streets. People are stealing things all over. There’s no way I can have a business.”

Relatives in Florida suggested she find a way to stay in the United States.

But Law, a legal permanent resident from Canada, said Ducelus and her son needed to obey the terms of their stay, which was granted temporarily for emergency medical care.

Law made the airline reservations. Three days before the flight, she sat down with Ducelus at a coffee table at the LaGuerre house. She handed her a Creole-language brochure from a micro-finance bank in Haiti that works to lift women out of poverty by helping them start small businesses.

With Pierre LaGuerre translating, Law described the flight itinerary. She said it was time to go home.

Ducelus was upset. She said it was too soon.

“It is what it is,” Law said.

• • •

The Sacramento chapter of the United Nations Association donated a 16-by-16-foot military tent as the family’s new home.

And on May 11, Law and volunteers hauled the 144-pound package to the American Airlines counter at Sacramento International for the first leg of the two-day journey home.

Lovensky showed up with his ever-present smile, a River Cats hat and his purple Kings backpack adorned with a Sacramento police badge sticker.

Ducelus, her hair freshly permed, was dressed in new jeans and a pleated shirt. She wore spiral earrings, a gift from Carmelle LaGuerre.

Her spirits had brightened. She hugged Law and spoke in Creole. Pierre LaGuerre translated.

“She wants you to know she loves you,” he said. “She says, ‘Thank you.’ It will be a thank you that will never end.”

• • •

His ailing heart mended, 7-year-old Lovensky flew back to Haiti and into a different realm.

From the airport in Port-au-Prince, the SUV for Relief International ferried Lovensky, his mother and Law through streets teeming with people, dust and horn-blaring buses. It passed squalid outdoor markets, where merchants peddled goods beneath tarpaulins and pigs feasted in debris.

The two-hour drive to Lovensky’s hometown of Carrefour wound through destruction, the dust and rubble of what once had been homes.

Lovensky arrived to a joyous reception at his cousin’s cramped cinder-block home. He bounded out. The adults hugged and cried. His older brothers excitedly donned firefighter hats from Sacramento.

Beneath a corrugated metal roof, the group shared stories of two cultures. A volunteer hauled the family tent to the backyard.

Challenges lay ahead. But the long journey of mother and son to Sacramento and back delivered an enduring gift: a boy expected to live a full, healthy life.

“It’s absolutely amazing – amazing and very humbling,” said Nasirov, the heart surgeon at Sutter Medical Center. “It gives you gratification, a feeling that you affected someone’s lifetime. It’s just a drop in the suffering. But we’ve got to start somewhere.”

Tags: Big Screen Tv, Cats Game, Cinder Block, Elegant Furnishings, Elk Grove, Fire Captain, Government Buildings, Heart Doctors, Heart Surgery, Little Hope, Medical Checkup, Oxygen Chambers, River Cats, S Center, Shantytowns, Single Room, Sutter Medical Center, Tiny Boy, Wii, Wii Games

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News this week that Sacramento ranks 89th for allergy problems among the 100 largest metropolitan areas in America had some residents scratching their heads. And noses. And eyes.

“I completely doubt the results of the study,” said Curtis Blankenship, 45, of Orangevale, who’s having a particularly bad season of sneezing. “My allergies in L.A. and San Francisco were almost nonexistent compared to my allergy problems here.”

The Asthma and Allergy Foundation of America released its annual rankings Monday on which cities are best and worst as far as spring allergy suffering. Knoxville, Tenn., is the “Spring Allergy Capital,” according to the group, followed by Louisville, Ky., Chattanooga, Tenn., Dayton, Ohio, and Charlotte, N.C.

In California, according to the foundation’s rankings, Sacramento is actually a less irritating place to live, in terms of allergies, than San Francisco (ranked 63rd), Modesto (64th), San Jose (67th) and Stockton (86th).

Over the years, Sacramento’s rank has bounced around in the survey, from 43rd in 2003, to eighth in 2006, to 87th in 2009.

Coming in 89th this year rang just plain false to many residents in the region – where “I never even had allergies until I moved to Sacramento” is a common refrain.

To all those suffering this spring: You’re not crazy.

“I don’t think it’s a scientific survey,” said Estelle Levetin, a professor at the University of Tulsa and a member of the American Academy of Allergy, Asthma & Immunology.

The foundation’s “Allergy Capital” rankings are based on three factors. The first and most heavily weighted involves pollen counts; the second involves the number of prescription and over-the-counter allergy medications bought per person; the third reflects the number of allergists per 10,000 patients.

One skewing factor may be the allergist count, because cities can attract allergists for reasons that have nothing to do with actual allergy levels, Levetin said.

In addition, she said, “It doesn’t make sense that the coastal cities in California would be higher than Sacramento on the list.”

In coastal cities, clean air blows in from the ocean. Not so in Sacramento.

“Oftentimes, winds get trapped here in the Valley,” said Peter Van De Water, an assistant professor in the earth and environmental sciences department at California State University, Fresno. “And when the winds relax, all that pollen in the atmosphere drops back down on top of us.”

Another reason for Sacramento’s allergy problems: climate. The mild, wet winters mean grasses grow like weeds. The region is in the midst of grass pollination season, which will last through June.

“The reactions induced by grass pollens are by far the worst,” said Dr. Arif Seyal, an allergist at Kaiser Permanente in Rancho Cordova.

It doesn’t help, of course, that Sacramento is the city of trees. Their bad pollen season ended last month.

So are allergies actually worse in Sacramento than in other parts of the country? Should we at least have been ranked in the top 50 of bad places to breathe?

It’s hard to say.

The federal government doesn’t compare allergy problems by region. And experts interviewed Wednesday said there are too many factors to make an easy call. Year-to-year weather makes a huge difference, for example. As do the types of plants that flourish; whether the environment is mold-friendly (one problem Sacramento does not have); air quality; even human genetics.

“It just changes drastically. Not only does the number of people being affected change, but the timing changes,” said Gerry Kress, vice president at SDI, a company that tracks health data and operates the Web site pollen.com.

He did offer one bit of comfort: This year, allergy season is bad just about everywhere.

Tags: 100 Largest Metropolitan Areas, Allergists, Allergy Asthma, Allergy Foundation, Allergy Medications, Allergy Problems, American Academy, Asthma Allergy, Asthma And Allergy, Asthma And Allergy Foundation Of America, Blankenship, Chattanooga, Dayton Ohio, Knoxville Tenn, Largest Metropolitan Areas, Louisville Ky, Noses, Orangevale, Refrain, University Of Tulsa

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The founding director of the UC Davis Center for Health and Technology was lauded this week for his work in promoting telemedicine.

Thomas Nesbitt, associate vice chancellor for strategic technologies and alliances for the UC Davis Health System, was given the 2010 Leadership Award for the Advancement of Telemedicine by the American Telemedicine Association, UCD officials announced.

The UC Davis center provides medical consultations to patients and doctors at rural hospitals and clinics. Already, the center has provided 22,000 video consultations statewide.

Tags: Alliances, American Telemedicine Association, Associate Vice Chancellor, Caina, Calvan, Davis Health System, Doctors, Health Official, Health Technology, Leadership Award, Medical Consultations, Nesbitt, Rural Hospitals, Strategic Technologies, Uc Davis Health, Uc Davis Health System, Ucd

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Because cases of H1N1 flu are still being reported and some groups of individuals have experienced higher hospitalization and mortality rates as a result, the Yolo County Health Department will continue to hold free vaccination clinics through June.

Clinics are scheduled from 3 to 5 p.m. Thursday in the Migrant Head Start Building classroom, 39839 County Road 17A, Woodland, and from noon to 3 p.m. May 27 at the Broderick Christian Center, 110 Sixth St., West Sacramento.

Free vaccines are also offered regularly at the Yolo County Health Department, 137 N. Cottonwood St., Woodland. The clinic is open from 2 to 5 p.m. Mondays and Wednesdays.

For more information, go to www.yolohealth.org or call (530) 666-8645.

Tags: 17a, Broderick, Cottonwood St, County Health Department, Flu, Free Clinics, Free Vaccines, Hospitalization, Migrant Head Start, Mortality Rates, Vaccination Clinics, Wednesdays, West Sacramento, Yolo County Health Department

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Kaiser Permanente allergy technician Maryann Hall writes a number to identify one of the 32 allergens Mary Loffin is being tested for Thursday in Rancho Cordova. Allergens are pricked into the skin; development of a red, itchy bump shows an allergic reaction to the substance.

Sacramento ranks 89th out of the 100 most challenging metropolitan areas for allergy sufferers, according to analysis from the Asthma and Allergy Foundation of America released Monday.

Knoxville, Tenn., is the “Spring Allergy Capital,” followed by Louisville, Ky., Chattanooga, Tenn., Dayton, Ohio, and Charlotte, N.C.

In California, San Francisco ranked 63rd, Modesto 64th, San Jose 67th, Stockton 86th and Los Angeles 92nd.

Last year, Sacramento ranked 87th. In previous years, Sacramento has consistently landed toward the bottom of the top 100 metro areas.

The AAFA ranks metropolitan areas based on their pollen levels, the number of residents using allergy medications and the number of allergists per capita.

For more information, visit www.allergycapitals.com

Tags: Aafa, Allergens, Allergic Reaction, Allergy Foundation, Allergy Medications, Allergy Sufferers, Asthma Allergy, Asthma And Allergy, Asthma And Allergy Foundation Of America, California San Francisco, Dayton Ohio, Kaiser Permanente, Knoxville Tenn, Maryann, Metro Areas, Metropolitan Areas, Pollen Levels, Previous Years, Rancho Cordova, Skin Development

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More than one in every three people hospitalized in California winds up being readmitted within a year – a revolving-door pattern that adds billions of dollars to health care costs, according to state data.

Many of those readmissions could have been avoided, said researchers at the Office of Statewide Health Planning and Development, which issued a study Monday using 2005-06 data.

“Readmissions are an important issue because they are expensive, can involve additional difficulties for patients and caregivers, and often can be preventable,” said Dr. David Carlisle, the agency’s director.

While the report did not include a hospital-by-hospital analysis, researchers found that hospitals in the Los Angeles area had the highest rate of readmissions (1.73 per person per year), while hospitals in the state’s mountain counties had the lowest (1.49).

The Sacramento Valley region had the second-lowest rate of readmissions among the six areas studied by the state – 1.53.

The study found that 1.7 million people were admitted to California hospitals in 2005. Within a year, 36 percent of them came back.

With mounting pressure to contain health care costs, the agency hopes its report will spur discussion not only about medical bills but about the quality of patient care.

Already, the federal Centers for Medicare and Medicaid Services is looking for ways to cut costs – including the possibility of reducing government reimbursement to hospitals with high rates of readmissions.

The state researchers found that readmissions added $31 billion to the charges billed to Medicare, amounting to half of what the federal insurance program pays for all hospital admissions in California.

Readmissions accounted for 49 percent of Medi-Cal hospital costs, accounting for nearly $10 billion in expenditures.

Patients with private insurance had a lower rate of readmissions – and also paid less for their initial hospital stay.

The study’s lead author, Mary Tran, declined to offer an explanation, saying certain findings were ripe for further exploration.

“This is just a starting point,” said Tran. “The whole purpose of this was to provide a broad background and understanding of readmissions in California. … We wanted to see the lay of the land.”

For its report, OSHPD culled hospital discharge data for 2005, the latest year mortality information was available, and tracked patients into 2006 to gain insight into readmissions.

Among the other findings:

• Older patients were more likely to be readmitted, but the average number of readmissions was higher for younger adults.

• Those on Medicare and Medi-Cal were readmitted more frequently.

• Readmission was more likely for patients initially admitted for ailments stemming from chronic conditions, such as heart failure, emphysema and kidney failure.

Over the years, cost-conscious employers and insurers have emphasized prevention and wellness programs to cut down on chronic ailments. And hospitals have tried to become more diligent in keeping patients out of the hospital.

“Research shows that efforts to educate patients and follow up with them shortly after returning home can help prevent those patients from needing to go back to the hospital. This has serious implications for overall health outcomes and the cost of health care for all Americans,” said Patrick Johnston, president of the California Association of Health Plans.

Last year, Sutter Health put in place new patient protocols designed to improve follow-up care and reduce the risk of patients needing further hospitalization.

As part of the health system’s Transitions of Care program, registered nurses periodically check on recently discharged patients via telephone.

“We’ve been very aggressive so our patients don’t fall through the cracks,” said Michael Avriette, the utilization management executive for Sutter Health’s Sacramento Sierra Region.

He noted that Sutter’s rate of readmissions for Medicare patients within the first month of discharge is between 7 percent and 9 percent – less than half the national average of 18 percent.

“Readmissions are expensive,” he said, adding that “bad care is expensive care.”

Tags: California Hospitals, Centers For Medicare And Medicaid, Centers For Medicare And Medicaid Services, David Carlisle, Dr David, Federal Insurance Program, Government Reimbursement, Health Care Costs, Health Planning, Hospital Admissions, Medi Cal, Medicaid, Medical Bills, Mountain Counties, Patient Care, Private Insurance, S Mountain, Sacramento Valley Region, State Researchers, Statewide Health

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