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Volume 5, No. 3, March 2007
From Your Colleagues
Amy Groom, Albuquerque
Q&A vaccines, safety contraindications, allergies: Children’s Hospital of Philadelphia site
The Vaccine Education Center - To provide complete, up-to-date and reliable information about vaccines to parents and healthcare professionals, The Children's Hospital of Philadelphia created the Vaccine Education Center. The Children's Hospital of Philadelphia, the nation's first children's hospital, has been a center of vaccine research and education for over 125 years. For example, the rubella vaccine, a vaccine that prevents what was at one time the most common cause of birth defects in the United States, was developed at The Children's Hospital of Philadelphia and the Wistar Institute of Anatomy and Biology.
The Vaccine Education Center, through its Web site, videos, informational tear sheets and speakers programs, provides information on every vaccine.
The Center has also established the Parents PACK program to develop a dialogue with parents, provide frequent vaccine information, and establish a place for parents to get up-to-date information and answers to questions about vaccines. Visit the Parents PACK site or sign up for the monthly newsletter by going to Parents PACK home.
Other Resource:
Guide to Contraindications to Vaccinations, CDC http://www.cdc.gov/nip/recs/contraindications.htm#Check
Wonder what the status of HPV vaccine is in your state legislature?
After Texas Gov. Rick Perry's executive order mandating that sixth-grade girls be vaccinated for the sexually transmitted human papillomavirus, Kaiser Daily Reports gives an update on the most active states entitled “State Politics & Policy | HPV Vaccine Legislation Introduced in Colorado, Connecticut, Kansas, Michigan, Wisconsin; Maryland Bill To Be Withdrawn”
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=42648
Burt Attico, Phoenix
Consumer Reports has withdrawn its study on infant safety seats
This story appeared in the Feb 2007 issue of the periodical and was noted in the CCC Corner. The CR press release states that a “substantive issue” affecting results was brought to their attention by NHTSA. NHTSA reports that side impact tests conducted by Consumer Reports did not simulate 38.5 mph as stated in the report, but instead simulated speeds in excess of 70 mph. When NHTSA tested the same seats at a simulated 38.5 mph, seats did not detach from their bases. Both Consumer Reports and NHTSA stress that car seats are the safest place for infants in automobiles. http://www.consumerreports.org/cro/cu-press-room/pressroom/2007/2/0702_eng0702ccs.htm
Gordon Belcourt, Montana Wyoming Tribal Leaders
Cervical Cancer in America
96 page national update on distribution of disease, economic burden, 1 page state-by-state reports, Women In Government is a national 501(c)(3), non-profit, bi-partisan organization of women state legislators providing leadership opportunities, networking, expert forums, and educational resources to address and resolve complex public policy issues. Women In Government leads the nation with a bold, courageous, and passionate vision that empowers and mobilizes all women legislators to effect sound policy. Suggested Citation:
Women In Government. Partnering For Progress 2007: The “State” of Cervical Cancer Prevention in America. Washington, DC, 2007.
To request free copies of this report or to send inquiries, contact:
Women In Government
HPV & Cervical Cancer Policy Resource Center
Toll free: 1.888.333.0164
E-mail:resourcecenter@womeningovernment.org
Web:www.womeningovernment.org/prevention
Scott Giberson, HQE
Ryan White HIV / AIDS Treatment Modernization Act of 2006
New Language may improve AI/AN opportunities and clarify linkages of care
The Ryan White CARE Act (RWCA) was reauthorized (12/19/2006) as the “Ryan White HIV/AIDS Treatment Modernization Act of 2006 (RWMA)”. The language is particularly remarkable for the Indian Health Service (IHS) and AI/AN in that it establishes opportunity for more seamless access to HIV/AIDS care and treatment. Although the intent of previous RWCA language was to assist AI/AN in access and eligibility to treatment and care of HIV/AIDS, this specific and reauthorized language certainly aims and succeeds in augmenting that intent.
The following RWCA provisions in the reauthorization affect the IHS and AI/AN population:
- AI/AN individuals are/were always eligible for RWCA services if certain requirements were met (as any other person infected/affected by HIV/AIDS would need to meet various requirements – dependent upon the State of residence).
- IHS federally operated Health Facilities will now be eligible to apply for services under Title III and IV through the RWMA (in addition to previously authorized Urban Programs and 638 Tribal Facilities under RWCA):
http://hab.hrsa.gov/programs/CapacityDevelopment/
http://hab.hrsa.gov/programs/PlanningGrant/
http://hab.hrsa.gov/programs/EarlyIntervention/
http://hab.hrsa.gov/programs/women/
- IHS facilities are exempt from the “Payer of Last Resort” restriction for Titles I, II and III. Although RWCA grantees are the payer of last resort, this amendment exempts I/T/U facilities from reimbursement, regardless of referral. In the past, RWCA grantees were asked to coordinate reimbursement of such funds with the tribes and with the IHS.
- The new legislature supports access for all AI/AN under RWMA regardless of I/T/U utilization/affiliation or geographic location. (Previously, HRSA Policy 00-01 stated that AI/AN could not be turned away from RWCA services, but still held RWCA grantees as Payers of Last Resort. So, if patients were referred from IHS, RWCA grantees could technically go back to IHS for funding (whether or not this actually happened). Now, the RWMA codifies (that IHS is exempt from the Payer of Last Resort restriction) this language into law.
- Planning council representation should include members from federally recognized Indian tribes as represented in the population.
- Language surrounding AIDS Education and Training Centers (AETCs) now specifically names “Native Americans” as person(s) to be trained.
Editorial Comment: IHS HIV/AIDS Principal Consultant
It is a privilege to note that this revised language is due in large part to the hard work, diligence, and passion of community members and organizations that came from within our AI/AN communities. Some additional explanation may be helpful:
- The changes of eligibility as a grantee for Titles III and IV affect our IHS sites, but did not affect the eligibility that was already offered to Urban and 638 facilities. Here are links to services provided under Title III and IV
- Although I/T/U sites are eligible for Titles III and IV, this does not mean I/T/U sites are automatically grantees; they must go through the application and approval process. I am gathering information as best possible including information about grant application process or timelines. For now, you may visit http://www.grants.gov/
- Previous RWCA language did not specify Native Americans or AI/AN when referring to AETCs ; however we have been working with the AETC leads at HQ for quite some time (prior to RWMA language) and are continuing this activity by integrating resources and ideas to maximize the benefit within our population.
We are working diligently with leadership from HRSA to discuss ramifications and implementation of this language and to disseminate the message of these changes to help with care of our AI/AN persons at risk and living with HIV/AIDS. Additionally, we hope to focus current and future initiatives and collaborations with HRSA around RWMA opportunities and efficient models and linkages of care between our clients, I/T/U facilities, and Ryan White grantees, service providers, and services. We are in the process of renewing and enhancing a Memorandum of Agreement (MOA) between IHS and HRSA that will speak to any potential opportunities and care that may come with the new RWMA Titles I, II, III, and IV. These ‘services’ (via RWMA) also include but are not limited to, AETCs, Special Projects of National Significance -SPNS, the AIDS Drug Assistance Program-ADAP, etc.). We will also be working with HRSA to identify and clarify each agency’s comparative advantage in collaborating on this language to best assist AI/AN.
Given these provisions, it is imperative that all AI/AN clients and facilities eligible for these provisions are made aware and assisted in removing any barriers to effective and seamless access and care. It may be advisable for each health facility to contact a RWMA grantee in your respective area/state to link this new language to an action plan and discuss potential linkages or improve existing ones. If there are any significant needs or anecdotal evidence (from the field) that illuminates a specific challenge of implementation with RWMA grantees or services, comments are welcome and appreciated. The HRSA RWMA grantee website can be found at http://careacttarget.org/community.htm and technical assistance center at http://careacttarget.org/. If you would, please assist in passing this information along to appropriate personnel
Reference:
The Library of Congress. December 19, 2006.
Found at: http://thomas.loc.gov/cgi-bin/query/z?c109:h.r.6143.enr
March 21st marks the first annual observance of National Native HIV/AIDS Awareness Day
According to CDC data, over the past 6 years, prevalence of HIV/AIDS has either continued to remain stable or has increased. When population size is taken into account, the American Indian / Alaska Native (AI/AN) population ranks third in the US (among all ethnicities) in rates of HIV/AIDS cases. It is now present in both urban and rural populations. We also do not use all of the opportunities we could to screen for HIV, yielding a large portion of the population that remains untested. Given these risks and trends, we must persevere even more diligently against HIV/AIDS.
Some time ago, I found a quote (by Ralph Emerson, 1952) in a book that said, “I am an invisible man. Invisible, understand, simply because you refuse to see me.” Although it seems to speak on the individual level, it certainly could speak to the complacency sometimes observed over the entire HIV/AIDS pandemic and epidemics within indigenous cultures, minorities, and underserved populations. Let us make it a goal in our population to avoid this. We are challenged to eliminate any potential complacency, be proactive in the fight, continue our ongoing HIV/AIDS initiatives and commence new programs that demonstrate this resolve.
It is necessary that each of us attempts to take on the role of an advocate, supporter, facilitator, or provider of prevention and care against arguably the most critical global healthcare issue of our time. To mark this day, there are a number of AI/AN HIV/AIDS activities and events in multiple geographic areas. In accordance with this and to mark this day, it is a privilege to announce the March 21st release of our first IHS HIV/AIDS website. Although still under development, it will serve as another medium to gather information, share resources, provide links and update personnel on the IHS HIV/AIDS program and its activities. Additionally, this HIV/AIDS Listserv has now grown to hundreds of members and serves as a way for this office to communicate pertinent HIV/AIDS information to I/T/U personnel working in this and related fields. I want to personally thank the Native communities who advocated for this day. Please utilize the attached Save-the-Date postcard and Awareness Day Toolkit to alert others and encourage people to raise their awareness and have knowledge of their status. Without perseverance against this particular virus, risk could turn to reality.
It is with much appreciation and thanks for prior and continued efforts against HIV/AIDS that this email is distributed.
Sincerely,
CDR Scott Giberson
National IHS HIV/AIDS Consultant
More information on this Day can be found athttp://www.happ.colostate.edu/ or http://www.ihs.gov/MedicalPrograms/hivaids/
Favian Kennedy, Northern Plains Tobacco Prevention Project
Northern Plains Tobacco Policy Workshop March 8th and 9th, 2007
Dear Colleges,
The Aberdeen Area Tribal Chairmen’s Health Board would like to invite you to participate in a Northern Plains Tobacco Policy Workshop, March 8th and 9th, 2007. The Workshop is being co-sponsored by AATCHB and the National Native Tobacco Prevention Network and will cover a variety of topics from policy planning to enforcement. Anyone interested in learning more about policy change is encouraged to attend.
There are a limited number of travel scholarships so register and request a scholarship today. Registration forms can be faxed to the attention of Terry Salway or completed online at www.tobaccoprevention.net. Click on “whats new.”
Favian Kennedy, MSW
Northern Plains Tobacco Prevention Project
Rapid City , SD
(605) 721- 1922 ext 112
Sunnah Kim, American Academy of Pediatrics
2007 Native American Child Health Advocacy Award
The AAP Committee on Native American Child Health will be accepting nominations for the 2007 Native American Child Health Advocacy Award. The award will be presented at the 2007 AAP National Conference and Exhibition in San Francisco, CA to recognize an individual who has made a major contribution to promoting Native American child health. If you know of a health professional who merits this recognition, please submit a letter of nomination, along with the candidate's contact information to:
Committee on Native American Child Health
American Academy of Pediatrics
141 Northwest Point Blvd
Elk Grove Village , IL 60007
Fax: 847/434-8729
Oral Health AIAN Preceptorship Award RFP
Partnership to Reduce Oral Health Disparities in Early Childhood ---2007 American Indian/Alaska Native Preceptorship Program Award----Request for Proposals American Academy of Pediatrics
The award of up to $2,000 will be given to cover expenses (eg travel, meals, incidentals, training materials, etc). The preceptor will work with AAP staff to arrange for their travel accommodations and training material. The money will not be distributed directly to the practice receiving the award.
Preference will be given to practices/sites that:
-Are an IHS/Tribal/Urban Indian program
-Demonstrate willingness to train other health care professionals in oral health risk assessment, conduct mother/caretaker interviews, and apply fluoride varnish when appropriate
-Bring together community child health professionals for training (e. g., family practitioners, physician assistants, dental hygienist, dentists, etc)
Completed application should be sent ELECTRONICALLY to wnelson@aap.org by March 9, 2007 as well as signed copy of the application postmarked no later than March 16, 2007 to:
Wendy Nelson, Manager Oral Health Initiative
American Academy of Pediatrics
Department of Practice
AI/AN Preceptorship Awards
141 Northwest Point Blvd
Elk Grove Village , IL 60007-1098
Large data Catalog Available: Health / Well-Being of AI / AN, and Other Native Americans
ASPE has recently completed a report entitled: Data on Health and Well-Being of American Indians, Alaska Natives, and Other Native Americans: Data Catalogue. This report includes a description of 67 data sources that include AI/AN/NAs. http://aspe.hhs.gov/hsp/06/Catalog%2DAI%2DAN%2DNA/
Registration is now open for the 2nd International Meeting on Indigenous Child Health!
The 2nd International Meeting on Indigenous Child Health will be held on April 20-22, 2007 in Montreal, Quebec, Canada. Building upon the successes of the first International Meeting held in April 2005, the proposed conference will focus on the unique health needs and culturally effective health care delivery models of the indigenous child populations in the US and Canada.
The goal of this dissemination conference is to bring together community-based practitioners involved in the health care of indigenous children (ie. American Indian, Alaska Native, First Nations, Inuit, and Métis) to focus on solutions, rather than problems. Solutions will be specifically geared toward reducing health disparities that currently exist, and providing community-based practitioners with practical tools and strategies that can be implemented within their own communities. The conference will have a strong emphasis on the identification of model programs and research that have been successful at the community level, and disseminating these findings to other professionals.
Please see the attached conference brochure for additional details, or visit
www.aap.org/nach/2InternationalMeeting.htm
For on-line registration, visit
http://www.pedialink.org/cme/_coursefinder/CMEdetail.cfm?aid=32391&area=liveCME
Hope to see you in Montreal!
Roberta Ward, Anchorage
Wonder what that rash is?
Here is an article with great pictures
Common Skin Conditions During Pregnancy
Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., melasma); and hair, nail, and vascular changes. Preexisting skin conditions (e.g., atopic dermatitis, psoriasis, fungal infections, cutaneous tumors) may change during pregnancy. Pregnancy-specific skin conditions include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. Pruritic urticarial papules and plaques of pregnancy are the most common of these disorders. Most skin conditions resolve postpartum and only require symptomatic treatment. However, there are specific treatments for some conditions (e.g., melasma, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, pruritic folliculitis of pregnancy). Antepartum surveillance is recommended for patients with intrahepatic cholestasis of pregnancy, impetigo herpetiformis, and pemphigoid gestationis. Am Fam Physician 2007;75:211-8. http://www.aafp.org/afp/20070115/211.html
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OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
