MMA Participates in Event with HHS Secretary Sebelius

On Thursday, Sept. 3, the Maine Medical Association joined the AARP, the Service Employees International Union (SEIU), and the state chapter of Change that Works in hosting a health care forum featuring HHS Secretary Kathleen Sebelius.  The event was held at the Buchanan Alumni House at the University of Maine in Orono.  MMA President Stephanie Lash spoke on behalf of MMA along with five other Maine residents who told their stories to the Secretary, an array of media, and a pre-selected audience of about fifty citizens and representatives of interested stakeholder groups supporting health care reform.

The Forum was the fourth in a series of health care reform discussions MMA has hosted or participated in.  In April, the Association hosted a stakeholder forum for Senator Olympia Snowe in Portland.  In early July, the Association hosted a similar forum for First District Congresswoman Chellie Pingree at the MMA offices in Manchester.  And in late August, MMA was invited to participate in and present at a health care provider forum for Second District Congressman Michael Michaud.  A forum with Senator Susan Collins is being planned for the Fall.

On Thursday, Dr. Lash spoke of the difficulties of recruiting and retaining physicians to the state and the challenges of filling the gaps in the current system which results in nearly 150,000 Maine residents without health insurance of any kind.  And the low level of reimbursement from the public plans (MaineCare and Medicare) results in a significant cost shift to the private plans.

Secretary Sebelius, having come to Orono from a event in Portland focusing on the unique difficulties of women in the health care system hosted by the Maine Women's Lobby and the AARP, advocated for comprehensive reform and announced that Maine was one of thirteen states receiving $42.5 million each over the next five years to assist in providing health coverage to part-time, seasonal and direct care workers (see related article in this Weekly Update). 

All five members of the panel spoke of their experiences and difficulties because of the high cost of health insurance.  Attending the Forum on behalf of MMA, in addition to Dr. Lash, were President-elect David McDermott, M.D., MPH, James Van Kirk, M.D., Executive Committee member from Penobscot County, Erik Steele, D.O., active member from Penobscot County, Andrew MacLean, Esq., and Gordon Smith, Esq. from the staff.  Dr. Steele is currently serving as interim CEO of the Blue Hill Hospital, which is part of Eastern Maine Healthcare.

Congress returns to Washington this week following a month long recess.  On Wednesday evening, President Obama will address the Congress delivering what has been billed as a "major prime-time health-care address."  The President will be seeking to shift the momentum in the current health care reform debate which has badly deteriorated over the last month and put the President and supporters of comprehensive health system reform on the defensive.

MMA continues to support comprehensive reform based upon the principles established in the Association's White Paper prepared and endorsed in 2003, and supports a "public option" so long as the alternative is consistent with the approach set forth in the White Paper.  Those principles would preclude the public option reimbursing on the basis of Medicare rates or any other artificial benchmark.  The White Paper and other MMA activities relative to Health System Reform can be found on the Association's Website at  www.mainemed.com.

Join Colleagues at MMA's 156th Annual Meeting: This Weekend in Bar Harbor

The Maine Medical Association will hold its 156th Annual Session this coming weekend, Sept. 11th through 13th in Bar Harbor.  All of the events will be held at either the Bar Harbor Club adjacent to the Harborside Hotel & Marina or at the Jackson Laboratory 1.8 miles from the Harborside.  The world-class lab has partnered with MMA this year to present the CME program focusing on the topic of Personalized Medicine. 

While the room block at the Harborside Hotel is filled, MMA has a list of alternative housing offering a wide variety of pricing available.  In addition, members and other physicians living within a comfortable drive of the meeting are welcome to attend as a day guest and a reasonable daily rate for the CME program has been established.  There is no fee charged to attend the Association's annual business meeting which convenes at 7:30 am on Saturday morning, September 12th at the Bar Harbor Club.  The meeting will be presided over by Richard Evans, M.D. and will include an open microphone session for members wishing to make a comment to MMA leadership on health system reform or any other relevant issue.

Individual members and MMA committees have submitted seven Resolutions dealing with the issues of childhood immunizations, oral health prevention, the state's public health infrastructure, global warming, wind energy and public health, POLST (Physician Orders for Life Sustaining Treatment), and the public health implications of hand coughing and sneezing in an age of infectious disease.  All of the proposed resolutions are posted on the MMA website at www.mainemed.com.  All MMA members may attend the meeting and have full voting privileges.

Governor Baldacci will join members and guests on Friday evening at the opening night reception at the Jackson Lab. 

Specialty society meetings being held in conjunction with this year's Annual Session include the Maine Society of Orthopedic Surgeons, the Maine Society of Anesthesiologists, the Maine Urological Association, and the Maine Association of Psychiatric Physicians.

At Saturday evening's banquet, MMA President Stephanie Lash, M.D. will present the President's gavel and medallion to in-coming President David McDermott, M.D., MPH.   Dr. McDermott is a family physician and Emergency Department Director at Mayo Regional Hospital in Dover-Foxcroft.  Jo Linder, M.D. of Falmouth, also an emergency physician and Director of Community and Preventive Medicine at Maine Medical Center, will become President-elect.

Consider giving yourself a break and join your professional colleagues for a weekend at this critical time as the Congress and indeed, the nation, continues to debate the merits of comprehensive health care reform.  You may register for the meeting on the MMA website at www.mainemed.com.  For the alternative housing list, contact Diane McMahon at dmcmahon@mainemed.com or call the MMA office at 622-3374. 

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Cary Medical Center Named a Top Leadership Team by HealthLeaders Media

An eight-member leadership team at Cary Medical Center in Caribou has been named among the winners in the sixth annual HealthLeaders Media Top Leadership Teams in Healthcare program.  The contest was sponsored by Cejka Search, GE Healthcare, Philips Healthcare, and Waller Lansden Dortch & Davis.  The team at Cary, which has 65 beds, won in the small hospitals division. 

The Top Leadership Teams in Healthcare 2009 program recognizes teamwork that occurs in health care organizations on a day to day basis.  It looks at what makes teams successful and at best practices of the leadership teams.  Winners are judged on the team's overall leadership culture, its ability to overcome challenges, and its ability to demonstrate successes that result from outstanding leadership teamwork.  Accompanying news stories highlighted Cary's relative level of advanced technology and its successfully meeting many of the challenges of rural health care in Northern Maine as two of the primary reasons for its success.

Congratulations to CEO Kris Doody, R.N., COO Shawn Anderson, and the other members of the Cary leadership team upon receipt of this significant recognition. [return to top]

State to Receive Federal Grant of $42.5 Million Over Five Years to Assist in Providing Coverage

HHS Secretary Kathleen Sebelius announced on Thursday that Maine will be one of thirteen (13) states that will receive $8.5 million per year for five years to provide affordable health insurance coverage to individuals in three demographic groups which have traditionally had difficulty in obtaining affordable coverage.  Part-time, seasonal, and direct care workers in firms with more than 50 employees will be the beneficiaries of this effort.  The grant comes from the Department's new State Health Access Program.  Coverage will likely be provided through the Dirigo Health Agency. 

The State will be eligible to renew the grant each year for five years. [return to top]

Androscoggin County Medical Society Presents Forum on Health Care Reform: Sept. 16

The Androscoggin County Medical Society will hold a forum entitled, Health Care Reform:  Chaos or Consensus? from 5:30 pm to 7:30 pm on Sept. 16, 2009 at St. Mary's Hospital in the LePage Conference Room.

The Forum will begin with a catered dinner at 5:30 pm followed by a panel discussion beginning at 6:00 pm.  The Panel will consist of Robert McAfee, M.D., former President of the American Medical Association, Nicole Witherbee, PhD, Federal Budget Analyst for the Maine Center for Economic Policy, and Gordon Smith, Esq., EVP of the Maine Medical Association.  The panel will be moderated by Gregory D'Augustine, M.D.

There will be an extended question and answer period following the panel presentations.

Any physician is welcome to attend and is welcome to bring a guest.   There is no cost to attend but an RSVP is requested to Dr. D'Augustine at 784-2903 or to greg8888@aol.com. [return to top]

Report on Quality Counts! Board Meeting, Sept. 2, 2009

The Board of Quality Counts! met this past Wednesday at the MMA offices in Manchester  for its monthly meeting.  These meetings have now been scheduled to facilitate a meeting of the Executive Leadership Team of Aligning Forces for Quality prior to the Board meeting.

The Environmental Scan portion of the agenda consisted of a presentation by Deborah Wigand of the ME CDC's "Keep ME Well" initiative.  Presented by the Governor and enacted by the Legislature, the Keep ME Well goals are to assist Maine residents, especially those who are uninsured, underinsured, or experiencing health disparities to:

• Assess their risk for chronic diseases

• Receive feedback that promotes action to address health risks that are identified

• Link to local community resources that assist residents in taking action to lower their risk for disease and improve their health

• Link uninsured and underinsured residents to health care services at free or sliding scale cost 

A Keep ME Well website has been developed to help meet these goals.  The program consists of a health assessment survey that Mainers can complete on-line.  Based on their responses to health questions, personalized reports will be generated that positively reinforce areas of low risk, encourage the individual to take steps to improve areas of high risk, and provide links to resources that may help with disease prevention and management.

After answering a series of questions, Keep ME Well provides a downloadable health report that will share:  personalized health recommendations, links to local resources that can help residents take action to lower their risk for disease and improve their health, and links to trusted health information where residents can learn more.

At this time, the ME CDC is piloting the risk assessment tool in three areas of the state, Aroostook District, Penquis District, and Knox County Healthy Community Coalition (Midcoast District).

More information can be found at www.KeepMEWell.org.  

Other business items including a discussion of the FY 2010 Membership Drive and the need to update the QC mission and vision statements.  The following was proposed as a new Mission statement:  Quality Counts is an independent, multi-stakeholder alliance in Maine.  We are committed to dramatically improving health and healthcare through leadership, collaboration, and alignment of improvement efforts.  Further discussion to take place at future meetings.

The Board will meet next on Wednesday, October 7th at 1:00 pm at MMA.

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Maine Mushroom Course Offered at USM September 18th & 19th

The University of Southern Maine, the Northern New England Poison Center, the Maine Medical Center, and the Maine Mycological Association are joining to sponsor a course entitled, The Maine Toxic and Edible Look-Alike Mushrooms of Interest to the Health Care Provider on September 18th and 19th in Room 403 of the Science Buidling at USM.  The program has been approved for CME credit.  You can find registration materials on the web at:  http://owa.mainemed.com/exchange/andymaclean/Inbox/FW:%20Maine%20Mushroom%20Course.EML/maine%20mushroom%20course%2009%205.pdf/C58EA28C-18C0-4a97-9AF2-036E93DDAFB3/maine%20mushroom%20course%2009%205.pdf?attach=1. [return to top]

Maine CDC Director Issues Letter to Providers on H1N1 & Pregnant Women

September 3, 2009

Dear Clinicians Who Provide Health Care for Pregnant Women:

This letter has important information.  We need your help to prevent serious illness and save lives among your patients.  As you may know, pregnant women and infants are being disproportionately affected by novel H1N1 influenza virus.  Reports indicate that one-third of pregnant women with novel H1N1 influenza virus are so ill, mostly with severe respiratory distress, that they require hospitalization (Lancet, July 29, 2009).  Deaths of otherwise healthy pregnant women are also being reported.  Severe disease among pregnant women was reported from past pandemics, such as the one in 1918.

We expect an escalation of H1N1 infection this fall as well as the arrival of seasonal influenza.  Therefore, your patients may more likely encounter H1N1, and their ability to recover may be compromised if they also encounter seasonal influenza. 

One of the most important and immediate steps you can take is to register to receive H1N1 vaccine from Maine CDC.  As a health care provider for pregnant women, we want to assure you and your patients have early access to this vaccine. 

Maine CDC will be hosting a conference call for health care providers who care for pregnant women on Thursday September 17^th 12 noon – 1 pm.  The call in number is:  1-800-914-3396 and the pass code is:  473623.  The purpose of the call will be to review the recommendations below and to take your questions. 

Maine CDC Recommendations for Clinicians Providing Health Care for Pregnant Women: 

Vaccinate:

Recommend and offer H1N1 novel influenza vaccine for pregnant women and their appropriate family members as soon as it arrives, which we expect to be in mid-October. 

Register to receive H1N1 vaccine from the Maine CDC.  This requires you to fill out and submit a Provider Agreement for H1N1 Vaccine, which can be found at:  http://www.maine.gov/dhhs/boh/maineflu/h1n1/provider-agreement-2009-2010.shtml.  The H1N1 vaccine is free, will come with some supplies, and you will be able to bill for vaccine administration.  We expect to have some thimerosal-free H1N1 vaccine available for pregnant women.  Up to date CDC guidance on H1N1 influenza vaccine can be found at:  http://www.cdc.gov/h1n1flu/vaccination.

• Recommend and offer seasonal influenza vaccine for pregnant women and their appropriate family members now.  To order or find out information on obtaining seasonal influenza vaccine contact the Maine CDC’s Immunization Program (287-3746) or the Immunization Action Coalition’s website at http://www.preventinfluenza.org/ivats.  Maine CDC has some thimerosal-free seasonal influenza vaccine available for pregnant women and young children. 

Prevent: 

Educate and inform your patients.

Prepare your office for H1N1: http://www.maine.gov/tools/whatsnew/attach.php?id=76279&an=2

All pregnant women need to know the symptoms of influenza and to report to a health care provider such symptoms immediately. 

All pregnant women and their families need to know how to prevent H1N1 (frequent hand washing, covering coughs and sneezes with tissue or sleeve, and staying away from others who are sick).

If a friend or family member is ill, the pregnant woman should arrange for someone else to care for those who are sick.

Post the enclosed posters.  If you would like to receive additional copies, they can be downloaded at http://www.maine.gov/dhhs/boh/Flu%20Posters.htm or requested by emailing at disease.reportring@maine.gov. 

Antiviral Medications:

We ask that pregnant women who have suspected novel H1N1 influenza A virus be tested for influenza. 

Pregnant women who have symptoms consistent with influenza illness should receive antiviral treatment as early as possible after illness onset.  Clinicians should not wait for test results to initiate treatment. 

Symptoms of influenza like illness are a fever (100 degrees or greater) and a sore throat or cough, in the absence of another cause such as strep throat.  If novel H1N1 is prevalent in your area of the state (as it has been in southern Maine much of the past 4 months), then these symptoms should be considered to be influenza. 

Prophylaxis with an antiviral medication should be considered for pregnant women who have been in contact with someone with novel H1N1. 

Keep updated with the latest treatment guidelines for pregnant women:  http://www.cdc.gov/h1n1flu/clinician_pregnant.htm.

Report:

Clinicians should call Maine CDC (1-800-821-5821) to report pregnant women requiring hospitalization related to H1N1 or any outbreak of H1N1. 

Keep Informed: 

Clinicians can call Maine CDC 24 hours a day for clinical consultation such as questions on testing or treatment:  1-800-821-5821.

Keep educated: 

US CDC H1N1 Clinicians’ Guidance for Pregnant Women http://www.cdc.gov/h1n1flu/clinician_pregnant.htm

Patient resources: 

US CDC H1N1 Resources for Pregnant Women

http://www.cdc.gov/h1n1flu/pregnancy

US CDC H1N1 Resources for Parents

http://www.cdc.gov/h1n1flu/parents/

Keep informed:

Check the Maine CDC H1N1 Website:  www.maineflu.gov

Check the Weekly H1N1 Updates:

Check the weekly updates on H1N1 in Maine on Maine’s H1N1 website:  www.maineflu.gov.  You can subscribe to these updates via their RSS feed.

Sign Up to Receive Health Advisories:

Sign up to receive urgent updates from Maine CDC’s Health Alert Network (HAN).  The easiest and quickest way is to sign up is through the HAN Alert RSS feed at www.mainepublichealth.gov (midway down the center of the homepage). 

Follow Maine CDC’s Updates and Other Information on:

Facebook (search for “Maine CDC”),

Twitter (http://twitter.com/MEPublicHealth),

My Space (www.myspace.com/mainepublichealth), and/or

Maine CDC’s Blog (http://mainepublichealth.blogspot.com/). 

Can’t Find an Answer, Consider Calling or Emailing Us:

For health care providers:  for clinical consultation, outbreak management guidance, and reporting of an outbreak of H1N1 call Maine CDC’s toll free 24-hour phone line for health care providers at:  1-800-821-5821. 

General Public Call-in Number for Questions:  1-888-257-0990
NextTalk (deaf/hard of hearing) - (207)629-5751
Monday - Friday 9am - 5pm

Email Us Your Questions at:  Sue.Dowdy@maine.gov

Thank you very much for your attention to protecting your patients from the severe effects of novel H1N1 influenza!  Feel free to call or email us if you have any questions or concerns, and join us on the September 17^th conference call. 

Sincerely,

Dora Anne Mills, MD, MPH, FAAP

Director, Maine CDC/DHHS

State Health Officer

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