August 11, 2008

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MMA Senior Section Meets Thursday on "Volunteers Working in Emergency Preparedness"

The Maine Medical Association's Senior Section, founded by Buell Miller, M.D., has scheduled its third meeting for this Thursday, from 11 a.m. to 2 p.m. at the MMA headquarters in Manchester, Maine.  Senior and retired physicians are encouraged to join your colleagues in this forum for exchanging ideas on continuing to contribute your considerable skills for the betterment of society1

Since its establishment in 2007, the MMA's Senior Section has conducted two meetings for organizational, educational, and social reasons that have been very well received by senior members.  On Thursday, August 14, 2008 from 11 a.m. to 2 p.m., the Senior Section will hold a third luncheon meeting with a program entitled, Volunteers Working in Emergency Preparedness.  The speakers for the program will be:

  • Lawrence B. Mutty, M.D., M.P.H., a retired psychiatrist and MMA Past President from Castine who has been very involved in the development of state policies on emergency preparedness,
  • Kathy Knight, R.N., Director, Northeastern Maine Regional Resource Center & Center for Emergency Preparedness,
  • Rayna B. Leibowitz, Planning & Research Associate with the Maine Emergency Management Agency, and
  • Andrew B. MacLean, Deputy EVP, MMA

Approximately 30 physicians already are registered and space is still available.  If you would like to attend, please contact Lisa Martin at or by phone at 622-3374, ext. 221 so that we may have an accurate count for lunch.

Don't Miss Maine Warden Service Chaplain Kate Braestrup at MMA Annual Session!

The MMA's 155th Annual Session is scheduled for Thursday, September 4 through Sunday, September 7, 2008 at the Samoset Resort in Rockport, Maine.  Among 3.5 days of great programming is Saturday's luncheon keynote by the Reverend Kate Braestrup, Chaplain of the Maine Warden Service.  Kate will give a talk entitled, Communicating Bad News.

Kate Braestrup grew up in Washington, D.C. and is the daughter of the noted writer/journalist (editor of The Wilson Quarterly)Peter Braestrup (1929-1997).  Kate's grandfather, Carl Bjorn Braestrup (1897-1982), worked on the Manhattan Project and co-invented a cobalt-therapy machine used for cancer treatment.

Kate met her husband, James Andrew 'Drew' Griffith, when they were both students at the Corcoran School of Art (now the Corcoran College of Art + Design).  They were married in 1985 and moved to Maine in the late 1980s when the Maine State Police hired Griffith.  In 1996 he was killed in a vehicle accident while on duty.

Braestrup has published two books:

Onion (1990): The title is the nickname for Owen, the 13-month-old son of the main character in this novel, a woman who plans to become a feminist theologian.  She has, however, put her plans aside to be wife to her police officer husband and mother to Owen.

Here If You Need Me (2007), about losing her husband, a Maine state trooper, in an accident and becoming a Unitarian Universalist chaplain on search-and-rescue missions.

Braestrup lives now in Lincolnville with husband, Simon van der Ven, an art teacher at Camden Hills Regional High School, and their six children.  She is a graduate of Bangor Theological Seminary and a community minister affiliated with the First Universalist Church in Rockland (where she was ordained in June 2004) and serves as Chaplain for the Maine Warden Service.

You can register for any portion of the MMA Annual Session on the web at

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MMC and the Maine Board of Licensure Present "Prescribing Opioids for Chronic Pain," September 12

Maine Medical Center Department of Family Medicine
In Cooperation with the Maine Board of Licensure in Medicine

Prescribing Opioids for Chronic Pain: Pearls and Pitfalls - Strategies and Options, September 12, 2008

~  National Faculty ~
Dan Alford, MD, Boston University & John Hopper, MD, Wayne State University
6.0 hours AMA PRA Category 1 Credit

The presentation will be at the Maine Medical Center Dana Education Center, and also available at the following sites by video-conference:

Miles Memorial Hospital
Cathy Cole, Director of Educatiom,, 207-563-1234

The Aroostook Medical Center
Linda Menard, CME Coordinator, 207—768-4186

Calais Regional Hospital
Pam Ivey, CME Coordinator,, 207-454-9281

Franklin Memorial Hospital
Karen Rogers, Education Department,, 207-779-2575

Millinocket Regional Hospital
Donna  Kelly,, 207-723-7232

For full brochure and information, click here [pdf] [return to top]

Commonwealth Fund Report Says Americans Ready for Overhaul of U.S. Health Care System

The Commonwealth Fund, through its Commission on a High Performance Health System, recently contracted with Harris Interactive to conduct a poll of more than 1000 adults about their views on our current health care system.  The results published in a report entitled, Public Views on U.S. Health Care System Organization:  A Call for New Directions, suggest that the public believes that our system requires fundamental change.  Among the findings are:  

  • 90% believe that the presidential candidates should propose comprehensive health care reform plans;
  • 32% believe that the system needs to be completely rebuilt;
  • 50% think it needs fundamental changes;
  • 73% reported difficulty making timely doctors' appointments, receiving phone advice, or getting after-hours care without visiting an emergency room.

A second report entitled, Organizing the U.S. Health Care System for High Performance cites fragmentation as the principal cause of high cost and inefficiency in our system.  It makes the following recommendations for improvement:

  • payment reform, including bundled systems that reward "coordinated, high-value care and expansion of pay-for-performance programs to reward high-quality, patient-centered care;"
  • incentives for patients to choose quality, high-value systems;
  • regulatory changes that would allow physicians to better share information;
  • accreditation programs for providers and health systems; and
  • an acceleration in adoption of health information technology.

The reports are available on the web at[return to top]

Overview of McCain/Obama Visions of Health Care Reform

The national Democrats and Republicans will be gathering soon for their party conventions and will be formally disclosing their party platforms, including positions on health care reform.  The Democratic Convention is scheduled for August 25-28, 2008 in Denver, CO and the Republicans will meet in Minneapolis-St. Paul, MN from September 1-4, 2008.  The following overview of the presidential candidates' positions on health care reform was prepared by Richard Kraft, Jr. of the Bureau of National Affairs from information gained from the official campaign web sites.

Overall Approach 

Senator McCain wants to provide families with a direct refundable tax credit of $2500 for individuals and $5000 for families to offset the cost of insurance.  He wants the private sector to be involved in health insurance while giving the consumers more options and choices when it comes to making decisions about health care.  This also would involve the use of health savings accounts.  He also wants families to be able to purchase health insurance nationwide, across state lines.

Senator Obama wants to provide affordable, comprehensive, and portable health coverage to every American and wants the public sector to have more involvement in health care.  His plan establishes a new public insurance program, available to Americans who neither qualify for Medicaid or SCHIP nor have access to insurance through their employers.  Self-employed and small businesses also will be able to purchase insurance in this plan. 

Access/Universal Coverage 

Senator McCain proposes allowing families and individuals to make key health care decisions to meet their needs.

  • Proposes establishing private Health Savings Accounts to supplement employer-based coverage.
  • Proposes letting individuals choose their insurance plans.
  • Proposes using competition among insurance plans to keep costs under control, improve quality, and provide portability.
  • Proposes allowing individuals to purchase health insurance across state lines.

Senator Obama proposes to mandate health coverage for children.

  • Wants all employers to be required to contribute towards health coverage for their employees or towards the cost of the public plan.
  • Wants new public plan to include coverage of all essential medical services, including preventive, maternity, and mental health care.  Coverage will include disease management programs, self management training, and care coordination for appropriate individuals.
  • Wants no one to be denied coverage because of illness or pre-existing conditions.


Senator McCain wants to develop Guaranteed Access Plans (GAP).

  • Wants to create high risk pools that help individuals who cannot obtain private coverage because of pre-existing medical conditions or no previous group coverage.
  • Wants one approach that would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs.
  • Wants reasonable limits on premiums; and assistance would be available for Americans below a certain income level.
  • Wants to promote greater access through walk-in clinics in retail outlets to promote quick, simple care.

Senator Obama seeks to create the National Health Insurance Exchange.

  • Wants the Exchange to act as a watchdog and reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible.
  • Wants participants in the new public plan and the Exchange to be able to move from job to job without changing or jeopardizing their health care coverage.
  • Wants the Exchange to require that all the plans offered are at least as generous as the new public plan and meet the same standards for quality and efficiency.
  • Insurers would be required to justify an above-average premium increase to the Exchange. 

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Public Health Committee to Finalize Resolutions at August 27, 2008 Meeting at MMA

The Public Health Committee has identified the following issues for resolutions to be presented at the 155th Annual Session of the Maine Medical Association:  1)  Immunizations – address the education issue and work with self-insurers, private insurers, etc.;  2) Environmental Health –  address the link of known and suspected medical consequences with an adequate chemical policy in Maine to safeguard human health and the environment;  and, 3) Overweight/Obesity Resolution – which will refer to the Health Policy Partners public policy strategies.  The committee also discussed the need to draft two additional resolutions on Domestic Violence Physician Education and another on Health Disparities.

The MMA Public Health Committee is working to ensure that our member physicians have access to the necessary clinical tools for their patients.  Fall 2008 marks the date for the newly developed public health web page (at to be unveiled to provide that needed one-stop search for the most up to date tools to deal with childhood obesity, immunization issues, and environmental health in the clinical setting.   For more information, contact Kellie Miller, Director of Public Health Policy at or 622.3374, ext. 229.

The PHC committee will meet again August 27, 2008 from 4-6 pm at the MMA to finalize its resolution concepts, as well as to broaden its collective knowledge of Health Disparities, to review the progress on the Health Weight Initiative Survey, and to review the draft concept for the Public Health Web page section on the MMA’s website.  All members are welcome to attend in person or via conference call at 1-800-989-2842; PassCode:  6223374.  For more information, contact Kellie Miller at MMA at or 622-3374, ext 229.


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Medicaid Advisory Committee Update

MMA staff attended the August meeting of the Medicaid Advisory Committee (MAC), and below is a brief synopsis of the meeting.

1) Citizenship verification - the percentage of  MaineCare recipients that still need verification is down to 20%.  The department is not yet taking a hardnosed approach in cutting members off  The major issue with this initiative, was the fact there wasn't a deadline, so members consistently ignored the notices. At the next MAC meeting, department  staff indicated they would have the # of closed cases and the # of denials of initial applications due to lack of verification of citizenship.

2) Non-categoricals - The enrollment is currently closed and there is a waiting list of 7,000. There are 13,500 members currently enrolled and staff indicated that they think the cap is now up to 17,900.

3) The Mainecare 18 question Survey recently was rolled out to 107,000 members. Preliminary results may be available at the next meeting. This survey has been in use for approximately 7 years and the consistent top issues have been: a): an understanding of the rules, b) concerns on the cutbacks with dental care being the biggest concerns, and c) that it takes 3 months or longer to be seen by a primary care provider.

4) Much of the discussion centered on the confusion regarding the Katie Beckett eligibility and payment schedule. Currently, there are 1200 children enrolled in this program. There is a new payment schedule and it has been extremely confusing, even for those who are in the child advocacy business.  A work group will be convened to discuss the Gould screening/assessment for infants, which uses criteria for developmental delay, that's impossible for an infant to meet, thus infants who need early intervention are being denied. Brenda McCormick will serve as the  lead staff on convening the group. [return to top]

Maine CDC Launches Public Health Information Inventory Website

The first release of the Maine CDC/DHHS Public Health Information Inventory website was launched last Friday.  This webpage provides the user with a central location to search for public health data and data-related information published by the Maine CDC.  It contains nearly 500 recently published documents as well as links to useful public health data websites.  It can be found from our homepage ( or directly at:

The webpage is the first step in to achieve the goal of providing an electronic centralized repository of Maine CDC public health data and public health data-related information that is easily accessible to the public.  Meeting this goal is a high priority of the Maine CDC, and was identified by a number of Maine's public health stakeholders and is included in the State Health Plan, part of the Governor's Dirigo initiative. 

This work was accomplished through the efforts of the multidisciplinary Maine CDC Data Access Workgroup.  The workgroup will continue its work to determine the next steps in the project, and connect with their divisions and partners to make major enhancements to the site.  The Maine CDC wants to continue improvements to the site and encourages your input for later versions of this website to be sent to Lisa Tuttle at:

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Course on EMS Medical Direction Scheduled for October in Waterville

National Association of EMS Physicians®  National EMS Medical Direction Overview Course™
Saturday, October 11, 2008
MaineGeneral Medical Center – Dean Auditorium, Thayer Campus (149 North Street), Waterville, ME

This one-day course is designed to serve as an “awareness” course, to provide the student with information regarding the scope of components of medical oversight activities, their implications, and methods of incorporation into decision making in EMS systems.  At the conclusion of the course, the student will understand the basic principles of EMS medical oversight, and will be able to address many of the tasks facing EMS medical directors.

This course is designed to provide all physicians, regardless of specialty training, with the general knowledge base to move into the role of EMS Medical Director or other roles in medical oversight activities.  The program will also be valuable to the many non-physicians involved in providing medical oversight.

For more information, or to register, click here [pdf] [return to top]

NQF Endorses National Consensus Standards Promoting Accountability & Public Reporting

On August 5, 2008, the National Quality Forum (NQF) endorsed 91 new measures through its National Voluntary Consensus Standards program.  The measures are used primarily for the purposes of public reporting.  With these additional measures, the total approved measures now stand at 463.  The newest measures address infectious diseases, cancer care, and nonphysician professional care, facility-level standards in surgery and anesthesia, stroke, and flu and pneumococcal immunization. [return to top]

For more information or to contact us directly, please visit l ©2003, Maine Medical Association