www.spinalcord.ar.gov

New Staff Joins ASCC

ASCC welcomes new Little Rock staff Jamie Deere (left), Desireé Kelly (middle) and Allison Martinez (right)!

Over the past few months several new faces have appeared at the Arkansas Spinal Cord Commission’s Little Rock office. Three new staff members have arrived to provide much needed support and now the Little Rock office is again at full force.

You may hear a new voice answering the phones when you call the Little Rock Case Management Office. Allison Martinez began her duties in January as Arkansas Spinal Cord Commission (ASCC) Case Management secretary. She will be providing support to Case Manager Doug Fish and Intake Coordinator Bernie Quell.

Allison has an Associates degree of Applied Science in Health Information Management, with an emphasis in medical transcription. Allison and her two children, Blake, age 7, and Alli, age 14 months, have recently moved to North Little Rock from Mountain View. Taking care of two active children does not leave much time for hobbies but, as Allison stated, “If and when I get any free time, I enjoy reading and shopping.”

Jamie Deere also recently joined the Little Rock Case Management office. She is a Licensed Social Worker and has obtained a Master’s degree in Human Resource Development and Public Administration from Webster University in St. Louis.

She has a strong background in medical social work, case coordination and discharge planning. Jamie was most recently employed as a Social Worker with the Hot Springs Rehabilitation Center and ASCC feels this experience will be a definite asset to the agency.

Jamie’s area will include parts of Pulaski and Saline counties. This area was previously covered by Mack Welch, who recently left the agency for the private sector. Jamie completed her training and orientation in February and has begun meeting the individuals on her caseload.

When asked about what she does while not at work, Jamie said, “I really enjoy cooking, traveling and completing home improvement projects.” Also, she loves taking care of her three dogs, a cat and a ‘menagerie’ of animals on the farm outside of Benton.

Desireé Kelly joined our staff in a part-time position as the Health Educator for our Split Second Decision prevention education program in December. She holds a degree in Health Education from University of Memphis and a Master’s degree in Kinesiology from UCA.

Desireé brings a great deal of enthusiasm, as well as new ideas to the project. She has already been successful in getting presentations set up at several colleges and is working with MADD on a high school prom promotion. She also assists our Case Managers in setting up programs.

Practicing what she preaches, in her free time Desireé works out, reads and is involved in her church. She and her husband Arthur live in North Little Rock.

The Commission members and staff of ASCC feel fortunate to have such qualified individuals join our agency. Welcome aboard, Allison, Jamie and Desireé!!!

AR Medicare/Medicaid Fraud Patrol

In 1995, the Office of the Inspector General determined that approximately 14 cents of every dollar spent on Medicare was being lost to fraud, waste, abuse or errors. These results prompted many actions by Congress, including the creation of a Medicare and Medicaid anti-fraud effort, using retired Medicare beneficiaries as volunteers to educate their communities about the cost of fraud and how to take action. Today there are 57 such projects, known as the Senior Medicare Patrols (SMP), including the Arkansas Senior Medicare/Medicaid Fraud Patrol (ASMP).

ASMP has developed regional partnerships with local agencies. These local partners recruit retired professionals and ASMP provides intensive training with continuing education opportunities. These trained volunteers go into their local communities and speak to groups, participate in health fairs and provide one-on-one counseling at designated locations, such as senior centers and agency offices.

Fortunately, most providers are honest, but the few that are not cost the system billions of dollars on a national basis each year. Many complaints phoned in to the ASMP hotline are errors where Medicare, Medicaid, private insurance or the beneficiary made payments in error. Recovery of these improperly paid dollars is important. When fraud or abuse is suspected, ASMP refers the case to the appropriate investigative agency.

Programs like ASMP and similar programs in other states have contributed to the government’s success over the past five years in recovering $5.7 billion dollars from health care fraud cases. The premise of these projects is straightforward: the more that the people who benefit from Medicare and Medicaid understand what a bite out of their benefits fraud, waste, abuse and errors takes, the more active they will be in monitoring payments made on their behalf and reporting discrepancies to the appropriate agencies.
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For Medicaid, there is no statement of paid services. If a Medicaid client suspects that there may be fraud, waste, abuse or errors with services being paid on their behalf, they can do the following:

• Request an Explanation of Medicaid Benefits (EOMB) from the state Medicaid agency. To request a Medicaid Statement, call 1-800-482-5431 or 1-800-482-8988, or write to DHS-DMS, PO Box 1437, Slot S-401, Little Rock, AR 72203.
  
  
• Say that you want to receive a “Paid History” and give the following information: 1) your name; 2) your Medicaid number, 3) the types of services, equipment or supplies involved; 4) the dates of service; and 5) any other information that would make the request more specific.

ASMP has a web site, www.arkansas.gov/dhs/aging/asmp.html, as well as a toll-free hotline,
1-866-726-2916. Contact them for any questions you may have about questionable payments on your behalf.

If you are interested in becoming a volunteer with the project, you can contact Sharon Marcum at 501-682-8504 or by e-mail at sharon.marcum@arkansas.gov.

Deadline for Applications Fast Approaching!

Dear Editor:

The 2005 Ms. Wheelchair Arkansas Pageant will be held June 16-18 at Arkansas State University Fowler Center in Jonesboro, AR. This is not a beauty contest, but is judged on advocacy, skills and abilities. Those who are interested in participating in the event need to get your applications in by April 30, 2005. For an application or for further information, please contact me at 501-296-1637 or by e-mail at idaesht@yahoo.com.

Ida Esh’t, State Coordinator
Ms. Wheelchair Arkansas Pageant

From the Director

By Cheryl L. Vines, ASCC Executive Director

Everyone knows that living with a spinal cord disability is expensive. Well, at least everyone who has lived with one, or has known someone who does, knows this. Besides the expected things like medical costs, medical supplies, wheelchairs, cushions and ramps, there are those ‘hidden costs.’ Like manual wheelchairs that don’t fit well in a subcompact and power chairs that require a van. In these days of $2 plus for a gallon of gasoline, that can total up. Then there’s the wear and tear on clothes, carpets and furniture. Not to mention extra equipment—a ‘wheelchair bike’ costs ten times that of an everyday one. Studies by the National Spinal Cord Injury Statistics Center at University of Alabama, Birmingham find the ‘average’ yearly expenses for a person with paraplegia is $25,394. That’s a lot of money!

State and federal programs help with some expenses, but there are still costs that most of us cannot afford. The members of the Arkansas Spinal Cord Commission have grappled with these problems and needs. This year they took action.

The Arkansas Spinal Cord Foundation was established in December 2004. The mission of the Foundation is to promote the health, well-being and quality of life of Arkansans with spinal cord disabilities. We are in the process of establishing a ‘not for profit’ status and beginning fundraising efforts. This ‘not for profit’ arm to our Commission will allow us to provide additional services.

But we will need your help! If you know of someone who may want to be part of the foundation board or who may want to contribute, please contact one of our Commission members or me.

Enjoy the spring—take time to smell the flowers!

With Thanks

Donations this quarter from:

Jennifer Cates
Grover Evans
Tanya Kruse

In memory of Michael Earnheart
Paula Henderson

In honor of the birth of LeRoy Akridge IV
Ann and Bill McDonald

In honor of Donald Hughes
Jewell and Ray Hughes

ASCC accepts tax deductible donations. The generosity of the many individuals and families, who over the years have made memorial donations, is greatly appreciated. Contributions are used to assist our clients through purchases of equipment and educational resources.

If you would like to make a contribution, please contact the Commission at 501-296-1788 / 1-800-459-1517 (voice) / 501-296-1794 (TDD), or send your donation to:

AR Spinal Cord Commission
1501 N. University, Suite 470
Little Rock, AR 72207

New Northeast AR SCD
Peer Support Group

Beginning April 21, 2005, northeast Arkansas can boast of a new spinal cord disability (SCD) peer support group. The first meeting will be held at 2:00 p.m. at the HealthSouth Rehabilitation Hospital in Jonesboro. Subsequent group meetings will be held on the third Thursday of each month at the same location and time.

There are a number of different support groups related to various issues in northeast Arkansas. However, there has not been one specific to individuals with SCD. According to Jonesboro ASCC Case Manager Russell Henry, “Confidentiality laws have made it more difficult to help clients in getting in touch with each other.”

“An example of this is when a newly injured or diagnosed individual asks if there is anyone with the same problem that they can talk to about the experience,” Russell confirmed. “As a case manager, I may know of other individuals in the same community, yet I cannot provide any names or other information.”

“Prior experience . . . in facilitating group therapy sessions has taught me that peer support and feedback are powerful assets,” he added. “Individuals who share a common experience are better able to understand and relate to each other. A group tends to possess a joint wealth of knowledge, which can benefit all of the group’s members. Group members can be a good source of encouragement as well.”

Russell stated, “Several clients have asked about such a group. Hopefully, this group will meet an identified need in the community. The success of the group is, however, dependent upon attendance and participation.” Be a part of the group and make the new northeast Arkansas SCD peer support group a real asset to the community!

HealthSouth Rehabilitation Hospital in Jonesboro is located at 1201 Fleming Avenue. This is off of Matthews Avenue, between Caraway Road and St. Bernard’s Hospital. Please use the lower entrance into the hospital. This entrance will be on the right as you enter the hospital. This may change at a later date as construction projects are completed.

For additional information you can call Russell Henry at 870-268-0425 or e-mail him at rhenry@spinalcord.org, or call Toney LeQuieu in HealthSouth’s Recreational Therapy Department at 870-932-0440 or e-mail toney.lequieu@healthsouth.com.

Spina Bifida Survey to Start in April

ASCC Case Managers will begin this month to survey Arkansans with spina bifida in order to determine the prevalence of secondary conditions. The study will also investigate the development of secondary conditions over time and the impact of such conditions on quality of life. Results of the survey will be used to develop health and wellness interventions to improve to the quality of life for children with spina bifida and their parents.

Individuals eligible to participate in the survey are those aged 10 to 29, who also participated in the ASCC spina bifida survey in 1993. ASCC will contact those individuals and parents who are eligible. All participants’ identities will be kept in strict confidence, with only code number identifiers used in any reports.

Each individual with spina bifida participating in the study will receive a $30 gift certificate and parents will receive a $20 gift certificate.

The survey will start in April and run until September.

SBAAR News

April 22-24, 2005, the Corvette Club of Central Arkansas will hold their annual spring Corvette Car Show benefiting the Spina Bifida Association of Arkansas (SBAAR). “The Corvette show is the primary source of support for SBAAR’s yearly events, such as the Christmas party, Fall Festival, family support, scholarships, educational activities, and other programs and services,” according to SBAAR spokesperson Vicki Rucker.

“This year the Corvette Car Show will be held at the Old Train Station in Hot Springs. Owners of Corvettes from all over the Midwest and South are expected to attend the show,” stated Vicki. She went on to say, “We are needing volunteers to help man the tables on Saturday from 8:00 a.m. to 3:00 p.m.” All volunteers should call Vicki at 501-978-7222 for details.

In addition, Vicki announced that SBAAR now has a new web site: www.sbaar.typepad.com. The web site will feature announcements of upcoming events and articles and postings of interest to persons born with spina bifida and their families and friends.

Be sure to visit this exciting new web site!

Sepsis or Septicemia

By Tom Kiser, M.D., ASCC Medical Director

This is a topic that was suggested by someone who contacted the Arkansas Spinal Cord Commission and asked me to address this subject. If there are other topics of concern, please write or call to let us know. We want to address the medical issues that concern you, the reader of Spinal Courier.

Sepsis (or septicemia) is the third leading cause of death in individuals with spinal cord injury (SCI). Persons with SCI are 64 times more likely to die of septicemia than individuals from the general population having the same age, sex, and race.

Septicemia is the spread of aggressive bacteria from a local seat of infection to the rest of the body via the bloodstream. It usually starts out small, as a pressure sore, respiratory infection (such as pneumonia), or a urinary tract infection. Once the bacterial count in the sore, the lungs, or the bladder gets out of control, however, things can get very serious. The first barrier of defense at the site of the local infection has been breeched, and the infection spreads to the rest of the body through the bloodstream.

The bacteria attract the response of the immune system, which is called on to fight the infection. The immune system releases inflammatory products and antibodies to kill the bacteria. This immune response is often very exuberant and causes the signs and symptoms of sepsis.

To the physician, the signs of impending sepsis are an increase in the heart rate, a drop in blood pressure, an increase in body temperature, and a patient who clinically looks very sick, with a change in skin color and possibly mental status changes as well. The symptoms noted by the family and/or friends are usually lethargy, mental status changes, fever, and a loved one who looks sick.

The first line of treatment is intravenous antibiotics and hydration. Antibiotics help kill off bacteria and allow the patient’s immune system to catch up and respond. There are two difficulties, however:

1. Usually the physician is initially unaware of the exact type of bacteria that is causing the problem; therefore, he can only make an educated guess about which antibiotics will be most effective in treating the infection. Usually blood cultures will be drawn prior to actually giving antibiotics. The culture is then tested against a variety of different antibiotics to determine which antibiotic should be used. This culture process can take up to 48 hours and sometimes 72 hours.
   
   
2. The immune system, in persons with SCI, has been found through research to be suppressed. Thus, the clinical response to infection in the individual with spinal cord disability may be decreased. On top of this, if the patient usually has had multiple urinary tract infections (UTI’s), or is on chronic antibacterial suppression for UTI’s, the chance that the individual will not respond to the first choice of antibiotics is increased due to the emergence of antibiotic resistant strains of bacteria.

Because of the decreased ability of the individual with spinal cord disability to respond to infection, I feel it is prudent for the individual with SCI to take some proactive and precautionary measures to minimize infections.

a. Take extraordinary measures to prevent pressure sores (you all know the preventive measures, but I cannot stress enough the importance of frequent pressure relief, a protective sitting surface, frequent skin checks, good nutrition, etc.).

b. Decrease the risk of pneumonia with an annual flu vaccination, and a pneumococcal vaccination at least every ten years.

c. Decrease the risk of bladder infections by using good catheter techniques; avoid the over use of antibiotics if possible; and maintain routine follow-up with your urologist.

Visit the Presidential Center!

So you are visiting Little Rock and looking for something to do, something that allows you the freedom to explore history and the opportunity to view the city from a new perspective. You should check out the Clinton Presidential Center and Park. This newest Little Rock attraction provides the visitor with many options.

Photo by Timothy Hursley for the William J. Clinton Foundation courtesy of www.clintonfoundation.org

The Clinton Presidential Library stretches out over the Arkansas River.

If you have traveled through Little Rock on I-30 you likely have noticed this big jumbo box of a building. As you approach the building, as a pedestrian, you are awed by the immense size and towering presence. The building is very user-friendly for the visitor, whether on foot or using some type of mobility assistance. Inside, you will find the many library volunteers are all ready to offer help or information.

As you move about within the building you tend to forget you are in a building. You literally have a bird’s eye view of so much around you. A developing park is in the immediate area around this building. A spectacular view of Little Rock allows the visitor a sense of how this city is on the move. The Arkansas River carries your view from west to east.

Photo courtesy of www.clintonfoundation.org

A view from inside the Clinton Presidential Library with the Railroad Bridge to the left outside.

Your perspective changes as you move within the building and go from floor to floor. The displays offer you the opportunity to read, to listen, and to visualize so much of America, and the world. You hear voices on tape, and voices of tourists next to you commenting on certain events. You hear the taped declaration from a time not too long past, “It is not enough to tolerate our differences. We must celebrate our differences.”

This library welcomes everyone.The displays are approachable. Elevators and escalators carry you between the floors and the flooring is wheelchair friendly. The restrooms, also, are accessible. As a recent visitor observed, “You likely will be ‘taken-in’ with your visit, but you will not be able to take in everything with just one visit.”

The only possible downside is the parking area signage. There are signs for Van Only parking for the disabled slots; however, cars with disabled plates were in some of these spots. There are over 300 free parking spots and there is a drop off area near the front entrance of the Center.

When the weather is hospitable, the park and River Market beg you to visit. Get out of the house and check it out!

For more information to any of your questions in planning your visit call 501-374-4242 or go to www.clintonfoundation.org on the internet to view the exhibit floor plans, the days/hours the Center is open to the public, admission charges and much more

Have Fun at the Arts Festival

On Friday, May 6, 2005, 10:00 a.m. to 1:00 p.m. the annual Therapeutic Recreation Arts Festival, Bringing Out the Best in Me!, will be at the Little Rock River Market Pavilions, 400 President Clinton Avenue. The festival is specifically held for children and adults with special needs, but is open to everyone.

The festival will feature music, arts, crafts and lots of fun hands-on activities, such as: paper bag puppets, face painting, snag golf, beaded necklaces/bracelets, sand art, caricature artist and much more. Admission is free and refreshments will be provided.

For more information, please contact Cindy Covey, Therapeutic Recreation Coordinator of Little Rock Parks and Recreation, at 501-244-5489, or e-mail her at ccovey@littlerock.state.ar.us.

Up Close and Personal:
Russell Henry

This is the sixth in a series of articles profiling the ASCC Case Managers.

My name is Steve and I have had a low-level incomplete spinal cord injury for many years. Not too long ago on a nice warm evening while I was four-wheeling down in a wooded hollow, my ATV caught fire.

I was able to get off my ATV in time to keep from getting burned but my ride was gone, no one knew where I was and it was starting to get dark.

Since I am not able to walk or crawl, I spent the next two miserable hours slowly “back stroking” my way up the hill to a paved road. My heels took quite a beating because my shoes would not stay on my feet—so I used them as mittens to protect my hands.

It was nighttime by then and a few cars had passed me by before a very appreciated “Good Samaritan” stopped to help a very rough and dirty looking man sitting beside the road with his shoes in his lap.

I learned the importance of a cell phone, a Jay Protector strap-on cushion (which saved my butt), good footwear and open communication of my travel plans.

I am finally all healed up and active again—and a little wiser for the experience.

Published quarterly by Arkansas Spinal Cord Commission

Cheryl L. Vines, Executive Director

Thomas L. Farley and Dee Ledbetter, Coeditors

Commission Members: Jimmy Ashley, Chair, R. Doug Foster, M.D., James Miller, Joe McNiel and Sandra Turner

The Arkansas Spinal Cord Commission does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.

Visit our website at: www.spinalcord.ar.gov or e-mail us at: courier@arspinalcord.org