By Rivkah Lewin

A few months ago, Dr. IraOustatcher received warm accoladesas the new Superintendent of EastRamapo School District. This monthat Hamaspik, a large number of con-sumers with special needs had thehonor to welcome him in person forthe very first time, and what a greatwelcome he enjoyed.

East Ramapo School Districtprovides special education to a num-ber of children who receive care andsupport services at Hamaspik ofRockland County. To brighten thefuture even more for the childrenwho are served by both Hamaspikand East Ramapo School District,the Executive Director of Hamaspikof Rockland, Meyer Wertheimer,invited Dr. Oustatcher to visit theagency and see firsthand whatHamaspik is all about.

The first step of the tour was atthe "Day Habilitation" center, where

Dr. Oustatcher was greeted by agroup of welcoming consumers,including Eliezar Friedrich, who hasa penchant for meeting with officials

and lawmakers and informing themof the needs of people with disabili-ties. One consumer, Shmiel Miller,stood up and said a few words in

honor of the special guest."It's our honor and privilege, our

pleasure," he said, to greet Dr. IraOustatcher. Miller spoke in the

name of all his friends in the day-hab. "They can't say it becausethey're not able to," he admitted."I'm able to say it, so I will say it forthem."

Dr. Oustatcher was treated to apictorial review of many trips andactivities that the boys have enjoyedrecently. He then spoke withMoishy, a consumer who graduatedfrom East Ramapo's special class onbaking and who now works in aMonsey bakery. Dr. Oustatcherasked Moishy, "So, tell me, what doyou bake?"

"Rugelach.""Do you eat some?" He

inquired."No.""Why not?""Because one is not allowed to

steal," responded Moishy, to every-one's delight.

Dr. Oustatcher visited the GirlsDay-Hab as well, one flight up,where the girls had just celebrated abirthday party for one of the con-

* * * * ** * * * *I N S I D EI N S I D E

* * * * ** * * * *Hamaspik Traumatic

Brain Injury.....E5

* * * * ** * * * *The Friedrich

Journey.........................E7* * * * ** * * * *

What's Happening in Your Health Today.......E8

* * * * ** * * * *

Hamaspik Gazette Hamaspik GazetteHamaspik Gazette Hamaspik GazetteHamaspik Gazette Hamaspik GazetteNews of Hamaspik Agencies and General HealthDecember 2005 • Issue No. 24August 2008 . Issue No. 50

The American Academy ofPediatrics released new guidelinesabout cholesterol screening for chil-dren, issuing official an recommen-dation to screen the cholesterol lev-els of "children and adolescents witha family history of high cholesterolor heart disease" and those "whosefamily history is unknown or whohave other factors for heart disease,including obesity, high blood pres-sure or diabetes."

High cholesterol is a major riskfor heart disease for both adults and

children. Cholesterol can build up inthe walls of a person's arteries. Thisis called "atherosclerosis," the build-up of fatty deposits called "plaque,"which can cause a narrowing of thearteries. This condition begins "inchildhood and progress slowly intoadulthood," according to theAmerican Heart Association (AHA).With time, this often leads to heartdisease, the leading cause of death inthe U.S.

No one wants their children tohave unacceptable cholesterol levels.

Parents need more information tohelp keep their children healthy froman early age.

The screening, according to theAAP, should take place after agetwo, but no later than age 10. TheAAP advises that cholesterol-reduc-ing medications should be consid-ered for children who are older thaneight who have high "LDL" (the'bad' cholesterol). "Just as withadults, there are certain risk factorsin children that may call for moreaggressive treatment," the AHA saysin a statement.

Several drug trials in childrenwith a genetic tendency to have highcholesterol have shown that the useof statin (cholesterol-lowering)drugs had similar safety and effec-tiveness as in adults. Still, "It's veryimportant to recognize that the per-centage of adolescents expected to

receive statin drugs is very small,"said Dr. Darwin Labarthe, of theCenters for Disease Control andPrevention.

There is, however, a growingcontroversy about giving statindrugs to children.

Dr. Jatinber Bhatia, Professor inChief of Neonatology at the MedicalCollege of Georgia, said that when-ever new guidelines are issuedregarding treating children, there is"a push-back, lots of questions aboutit. But nobody can answer the ques-tion, 'What if we don't do this thing?'This is a global problem, as well.And if we can reduce morbidity asan adult by treating as a child, there'sa win-win situation."

Atherosclerosis is a childhoodprocess that progresses to adulthood,

HAMASPIK GAZETTEPublished and © Copyright August 2008 by:HAMASPIK 58 Rt. 59 Suite 1 Monsey NY 10952Telephone: (845) 503-0212 / Fax (845) 503-1212

Non Profit Org.US Postage

PAIDMonsey NY

# 50247

Leading Pediatricians Group "A.A.P." BroadensAlert on Kids' Cholesterol and Statin Medications

Continued on Page E6

Continued on Page E2

Dr. Ira Oustatcher, New Superintendent at East RamapoSchool District, Tours Large Array of Hamaspik Programs

Left to Right: Meyer Wertheimer, Executive Director, Hamaspik; Dr. IraOustatcher, Superintendent, ERCSD; Nathen Rotchild, Board President,

ERCSD; and two new board members, Moshe Hopstein and Aron Weider

At all divisions and programs ofHamaspik, confidentiality is of pri-mary importance, and the large net-work of agencies is going further,above and beyond HIPAA regula-tions, to keep pertinent informationof consumers wrapped under "topsecret" status.

"Nobody is allowed to look intoour files. We would never say thelast name of a person," explainedNechama Nissenbaum, a supervisorof Medicaid Service Coordination atHamaspik in Rockland County.

Consumer files are kept in thelocked office of Rachel Tress,Hamaspik Intake Coordinator. Those

who are approved to see records arelogged on the way in and out, shesaid, while birth certificates, socialsecurity numbers and other highlyconfidential information are alwayskept in special boxes under strongerlocked protection.

In general, however, whileHIPAA (Health Insurance Portabilityand Accountability Act) is meant toprotect the privacy of patients andtheir families, the various regula-tions may sometimes result in settingup barriers that may have nothing todo with privacy.

Take the story of the couple whowent to a hospital clinic earlier this

month, just to be greeted by a ratherterse sign on the receptionist's frost-ed window: "PATIENTS NOTALLOWED TO KNOCK ONRECEPTIONIST'S WINDOW-FORPATIENT PRIVACY REASONS-IFTHE WINDOW IS CLOSED,TAKE A SEAT AND WAIT TILLWILL CALL YOU." Would it reallyaffect patients' privacy if peopleknocked on that window?

Or take the example of anOrthodox Bikur Cholim volunteerwho visits certain hospital patientson a regular basis. A Jewish patientwho is not religious-and her family-may think of the Bikur Cholim vol-unteer as an extended-family mem-ber. The patient and her family mayask the volunteer to keep in closetouch, to doven with the family atthe patient's bedside, to connect thepatient with a rabbi, to help withfuneral plans, if the patient is in crit-ical condition, and even to attend thefuneral. Yet, when the caring anddevoted volunteer calls the nurses'station from outside the hospital tocheck on the patient's condition, thenurse may refuse to give any infor-mation, citing HIPAA limitations.

But mostly, of course, patients'or consumers' privacy truly needs tobe protected. HIPAA provides for

severe punishment for doctors orhospital staff who release privateinformation. It is important thatpatients-especially the elderly-fillout a HIPAA Release Consent Formto name the close relatives and otherindividuals whom they chose toallow access to their private infor-mation.

If the patient doesn't fill out thisform, the relatives-even the patient'sspouse, parents or children-may notget the information they need. It canbe very painful, for example, whenchildren ask the doctor or hospitalfor more details on their father's con-dition, or want to see the medicalrecords, and find out that they musthave their father's written consent. Ifthe father unknowingly didn't givehis consent-no access.

Back at Hamaspik Intake, par-ents sign the Privacy Notice-Acknowledgment of Receipt and theNotice of Privacy Practices.Protected Health Information (PHI)includes the consumer's name,address, birth date, social securitynumber, medical information,"Individualized Service Plan" (out-lining the services the consumerneeds), photographs and other dataabout the consumer's care atHamaspik.

When the need arises, Hamaspikis authorized to disclose PHI to alimited number of parties who pro-vide care for the consumer, such asdoctors, nurses, psychologists, socialworkers, qualified mental retardationprofessionals, and developmentalaides. Outside this narrow group ofprofessionals, no one is allowedeven a glimpse to "top secret" mate-rial.

"Many times, people don't wantothers to know details of their child'scondition, even more so when theremay be a genetic factor," said Tress,the Intake coordinator.

"People may not be privy to asto where each special child is attend-ing school, how the child is doing. Ialways tell people when I meet withthem, if they come in with some-body else - they may choose to comewith a close family member, acousin, an aunt - I'll explain to theaccompanying person, 'You're herebecause that person brought you, butif you call me tomorrow or nextweek about the consumer, I will notdiscuss this with you.' If a relative orfriend or, for that matter, anybodycalls in regards to a consumer, wewill not discuss an issue with them -only with the parents, the legalguardian."

adds Bhatia. If the two conventionalrecommendations of diet and exer-cise don't work for children, he said,

"Then statins may be an option,since the safety and efficacy ofthem, at least in short-term studies,has been shown to be safe."

Skeptics maintain that so faronly data from the short-term effectsof using such drugs on children havebeen gathered. "True," said Bhatia,"but start somewhere, because withone-out-of-three children now con-sidered obese or overweight, this isgoing to be a worse problem in adecade." Meanwhile, there is also nodata that says that using such drugsin children is harmful, he added.

Concerning fears about sideeffects from Pravastatin, a statindrug approved by the FDA for chil-dren, the same side effects that occurin adults could occur in children,said Bhatia. The likelihood of majorside effects is small, though, henoted, and the likelihood of benefitoutweighs the risk. Children can becarefully monitored, and if sideeffects occur, the medication wouldbe stopped. "It's not as if it's an irre-versible side effect," Bhatia asserted.

Other doctors said the recom-mendation would distract from com-mon-sense changes in diet and exer-cise, which are also part of the newguidelines.

"To be frank, I'm embarrassedfor the A.A.P. today," said Dr.Lawrence Rosen of HackensackUniversity Medical Center in NewJersey, vice chairman of an academypanel on traditional and alternativemedicine. He added: "Treatmentwith medications in the absence ofany clear data? I hope they're readyfor the public backlash."

Part of the concern that manyhave about statin use in childrenstems from the fact that there is stillcontroversy about how widespreadtheir use should be in adults. Statins,which are the most prescribed drugsin the world, have been shown tolower risk for heart attack and death

in middle-aged men with existingheart disease. But there is little evi-dence they prolong life in healthymen, women or people over 70. Andsince statins have been around onlysince the mid-1980s, there is no evi-dence to show whether giving statinsto a child will lower his or her riskfor heart attack in middle-age.

To be sure, the statin recommen-dation does not apply to most chil-dren. "Among the vast majority ofchildren, this will not even be anissue," said Dr. Daphne Hsu, a chiefof pediatric cardiology at Children'sHospital at Montefiore.

Parents Should Help Children

Parents should guide youngerchildren with elevated cholesterollevels to reduce their weight, to

exercise and to receive nutritionalcounseling so they will eat healthyfoods and eliminate non-healthyfoods and drinks from their diets.

The AAP even recommends thatchildren as young as one year of age,in cases where overweight is a con-cern, should be given reduced-fatdairy products, such as two-percentmilk, although many mothers andsome nutrition experts clearly dis-agree on that point. Historically,low-fat milk has been discouragedfor very young children because fatis essential to brain development.

"Preventing and treating highblood cholesterol includes eating adiet low in saturated fat and choles-terol and high in fiber, keeping ahealthy weight and getting regularexercise," according to the CDC.

The AHA prescribed that "chil-dren age two years and older should

be encouraged to eat at least fiveservings of fruits and vegetablesdaily as well as a variety of otherfoods low in saturated fat and cho-lesterol." Such a healthy diet willhelp children maintain normal cho-lesterol levels and promote cardio-vascular health.

What cholesterol levels areacceptable in children two-to-19years old? If the doctor screens achild and gives his parents theresults, what do the results mean?The American Heart Associationprovides the guidelines in this chartto explain what the doctor may not:

"Total cholesterol" is the totalmeasured cholesterol in a person'sblood. This number includes alltypes of cholesterol, including HDLand LDL. "HDL" means "high-den-sity lipoprotein" cholesterol, referredto as "good cholesterol," because ithelps carry cholesterol away fromthe other organs to the liver, where itcan be removed. To help youremember, "H" stands for "high" andhigher HDL cholesterol is good.

"LDL" stands for "low-densitylipoprotein" cholesterol. The LDLcholesterol is sometimes called "badcholesterol," because it is linkedwith a higher chance of heart dis-ease. Remember that "L" stands for"low" and it's best to help childrenmaintain lower levels of LDL cho-lesterol for the benefit of their healthand future.

E2 August '08 | Hamaspik Gazette

At Hamaspik, HIPAA Compliance Wraps Pertinent Consumer Information under "Top Secret" Blanket

Leading Pediatricians Group "A.A.P." BroadensAlert on Kids' Cholesterol and Statin Medications

Continued from Page 1

Category Total Cholesterol LDL Cholesterol

Acceptable Less than 170 Less than 110

Borderline 170-199 110-129

High 200 or greater 130 or greater

E3Hamaspik Gazette | August '08

E4 August '08 | Hamaspik Gazette

He was known as one of thehardest consumers in the entireHamaspik network of agencies. But- no more, by far.

Taking care of him meant aheavy duty workload, not only

because of the severe developmentaldisabilities, or very challengedbehavior, but the consumer also waspsychiatrically involved, diagnosedwith psychosis.

"David (not his real name), was

extremely agitated and couldn't sitstill for a short moment," Joel Rubin,Residence Manager of Hamaspik'sGrandview Briderheim group-home,related. "The boy would break stuff.He suffered frequent tantrums, and

would try to injure others and evenhimself." In short, he was nearlyuncontrollable.

At a loss, his family and advo-cates reached out to Hamaspik, toask for help. "So Baruch Hashem,David came to us," said Rubin. "Wegot a psychiatrist to assess him andprescribe treatment. He has goodstaff and appropriate monthly goals.He's now a kid who makes his ownbed, is brushing his teeth, goes to thebathroom. He has improved beyondanyone's expectations."

"David," said Rubin with satis-faction, "is one of the most calm andbeautiful kids we have."

In terms of medical care, Rubinrelated, "We took David to top qual-ity specialists, who work only on thebasis of up-front payment." The con-sumer, he said, a young adult, hasbeen in the Grandview Briderheimgroup-home for three years and is"like a new person."

Medication was another impor-tant key to taking care of David.

"The physicians we worked withdevoted overwhelming time andeffort to control his medications,"Rubin explained. "They wereassessed and measured on a dailybasis, up and down, until we wereable to get to a point where he wascalm and stable."

The Right EnvironmentFor David, being in the right

environment for his spiritual makeupwas also crucial. "Because he's aJewish kid, he needs to be in a sametraditional community setting," saidRubin. "In the group-home, staffmembers of the same faith are caringfor him with compassion. He's in aYiddishe heim," a true Jewish home,in an environment like his familyand community.

Success didn't come so easily,though. David needed to attendschool, but it was hard to find theappropriate setting. Now, since hehas improved so much, David is nowenrolled in a solid school programand "Baruch Hashem, he's doinggreat," Rubin declared. "He's gettingbetter and better."

Indeed, now the consumer iseven able to join the other boys onoutings. In the past, even when theywent out for enjoyable times, hewould throw himself on the floorand wouldn't go. Recently, thegroup-home went on a week-longvacation and David was able toenjoy the rides. "We really had a lotof fun and he didn't show anytantrums, which was great," Rubinsaid, adding that he hopes in thefuture to bring him "to a functioningstate where he should always becalm and happy."

Rubin and his staff, at last, haveturned a child whom no one elsecould help into "a good boy, one ofthe best boy we have."

A Success Story:

Caring and Persistence Turn Hamaspik Consumer from

"Very Severe" into "Best Boy"

E5Hamaspik Gazette | August '08

Moishy* was a man in his earlyforties (not his real name), living aregular, independent life, with theexpectation that things would con-tinue as usual from day-to-day. Oneday, unfortunately, he was struck in aserious motor vehicle accident thatleft him with a permanent braininjury.

His life was changed forever. Moishy found himself dependent

on others, in need of help witheveryday life issues that he used tomanage on his own.

Finally, not a day too soon, help

arrived. His family was put in touchwith a special program underHamaspik, named “TBI”(“Traumatic Brain Injury” MedicaidWaiver).

Now, through TBI, Moishy has aService Coordinator, Mr. IsraelRosenberg, who is personallyinvolved to closely assist him withmany aspects of his daily needs andto advocate for him when herequires a helping hand.

Like a concierge, a ServiceCoordinator wears many hats andmust use a variety of professional

skills with compassion and devotionto lighten the burdens of a personwith brain injury and those of hisfamily. Like a diplomat, he coordi-nates all of the different services thatthe participant in Hamaspik’s TBIProgram receives. He uses leader-ship skills to gain the cooperation ofvarious parties, meet the require-ments of numerous agencies, andwork with doctors and therapists. Hewould coordinate every aspect of theparticipant’s needs, making sure tobe organized and keep accuraterecords.

Mr. Rosenberg works persistent-ly to relieve Moishy of the emotion-al strains and financial burdens ofhis life. For example, Moishy’s land-lord refused to return his securitydeposit to him, and Mr. Rosenbergquickly restored the peace. WhenMoishy tried to return a used com-puter screen that didn’t work to thesecond-hand shop he bought it from,the salesman wouldn’t give him hismoney back, but he hastily changedhis mind after the Service Coor-dinator put in a single phone call.

Moishy can hardly walk, so hehad applied for a motorized wheel-chair. The application has beenstalling, though. When he applied toa program that pays phone bills forpeople with TBI, he was refused. Healso heard that Hamaspik group-homes get a discount from a certainbookstore to purchase quality litera-ture for the consumers, and he hopedto receive an equivalent offer fromthe retailer. Mr. Rosenberg hasstepped in, as always. Moishy hasgotten the discount from the book-store, and the service coordinatorcontinues to work on the other issuesfor smart and smooth solutions.

Millions Affected byTBI in the U.S.

Moishy, of course, is not alonein his need for support. Every year,about 1.4 million people in the U.S.sustain traumatic brain injuries.Among children up to age 14, thereare 435,000 emergency room visitsfor TBI each year. The Centers forDisease Control estimates that atleast 5.3 million Americans needhelp to perform daily living activi-ties as a result of TBI.

No wonder so many need assis-tance. TBI can affect thinking, mem-ory and reasoning and cause notice-able personality changes. TBI suffer-ers may experience difficulties incommunicating and understanding,as well as depression, anxiety,aggression, and socially inappropri-ate behavior.

TBI should be treated early, saidTom Constand, Board Member of

the Brain Injury Association ofAmerica, based in Vienna, VA. Butit’s not easily detected at first, hesaid. Symptoms may not manifestthemselves for weeks, months, oreven years after the injury.

“Many times TBI is misdiag-nosed and people are put into nurs-ing homes [or psychiatric wards],when in fact, if it’s diagnosed early,the sooner a person goes for physicaland cognitive therapy, the bettertheir chances are of recovery tosome degree,” Constand said.

One stumbling block is insur-ance companies that won’t pay forthe cost of post-acute therapy, whichcan devastate a family’s finances. InMichigan, said Constand, there are55 treatment centers, because of thestate’s no-fault insurance law. Sincecar accidents are one of the biggestcauses of TBI, no-fault insurancecovers the necessary treatment thatpeople desperately need on a timelybasis. However, most states don’thave no-fault insurance, so insur-ance may only pay for a wheelchair,when in fact extensive physical andcognitive therapy, including traumacare and then post-acute rehabilita-tive treatment, are crucial.

Participants can get Hamaspik’sTBI services as long as they live athome, not in a nursing home orgroup home. “Our program providesthe best services for the participant,”said Rosenberg, as well as allowing

the participant to live at home ratherthan in a nursing home. The TBIProgram thus saves the family andthe government the exorbitant dailycosts of keeping a participant in anursing home.

In addition to living at home, toreceive TBI Program services, peo-ple must be Medicaid recipients andbe diagnosed with Traumatic BrainInjury. They must be between age 22and 64 and be in need of nursingfacility level of care. (For minorswith TBI, contact OMRDD.) Theymust also be capable of living safelyin the community with the help andservices that the TBI programprovides.

The TBI Program vastlyimproves not only the participant'squality of daily life but also his fam-ily's. "TBI can help with rent subsi-dies, food stamps and other socialservices as needed," said Rosenberg,coordinator of the Hamaspik TBIprogram.

The family's participation alsohelps the participant, he observes.Regarding a woman participant wholives on her own, Rosenberg related,"We're involved with her brother,with her married son and her daugh-ter-in-law. They always call and seewhat we can do to help her condi-tion. They know more what sheneeds, and Hamaspik TBI providesfor her needs as best aswe can."

Hamaspik’s TBI Program Offers Wide Range ofServices for People with Traumatic Brain Injury

Say “NO” to Brain Trauma by Taking Protective MeasuresThe elderly, adults and children can be protected from TBI if pro-

tective measures such as those recommended by the CDC are takenand constantly maintained. The leading causes of TBI are falls andmotor vehicle accidents.

* Always wear seatbelts whenever driving or riding in amotor vehicle. Buckle children into car seatbelts or into child safetyseats or booster seats, depending on the child’s height, weight andage.

* Switch children to booster seats when they outgrow theirchild safety seats (usually when they weigh about 40 pounds). Fastenthem into booster seats until the lap and shoulder seatbelts fit proper-ly, typically when children are 4’9” tall.

* Adults and teenagers should never drive under the influ-ence of alcohol or medications that cause drowsiness.

* Adults and children should always wear a helmet wheneverriding bicycles or scooters.

* Remove tripping hazards from the home, such as throwrugs. Always keep walkways and stairs free of clutter and toys.

* Install window guards to keep young children from fallingout of open windows.

* Install safety gates at the top and bottom of stairs. * Check the playgrounds where your children play to make

sure the surfaces are made of shock-absorbent material.* Use non-slip mats in the bathtub and on shower floors. * Install grab bars for seniors next to the toilet and in the tub

or shower and handrails on both sides of stairways. * Maintain a regular exercise program, including improving

lower body strength and balance to prevent falls. * Improve lighting throughout the home.

• Participants in Hamaspik’s TBI Program may receive avariety of services, including:

• Independent Living Skills Training to help increase inde-pendence in performing chores such as cooking, laundry, personalhygiene, shopping, and banking.

• Intensive Behavioral Program, which provides directtraining for participants with challenging behaviors, such as fre-quent anger.

• Service Coordinator, a Hamaspik staff member whobecomes personally involved with the participant to advocate on hisbehalf and to identify and directly pursue resources to help with hisneeds.

• Home and Community Support Services Worker, whospends one-on-one time with the participant overseeing his shop-ping, cleaning and other daily activities.

• Environment Modification for wheelchair-bound people,including installation of ramps, lifts, special bathtubs, widening ofdoors and other modifications for the home.

• Medicaid Transportation to appointments.• Waiver Transportation to non-medical destinations or

recreation.• Housing Subsidy, which pays a portion of the rent for

Medicaid-eligible participants who don’t have Section 8.• Respite, which provides relief for family caregivers.

E6 August '08 | Hamaspik Gazette

Dr. Ira Oustatcher, New Superintendent at East RamapoSchool District, Tours Large Array of Hamaspik Programs

sumers. Balloons and decorationswere hanging from the wall, alongwith a special red-white-and-bluesign they had made to welcome Dr.Oustatcher, who was so pleased withthe beautiful poster that he askedthem if he could take it home - towhich they happily agreed, ofcourse. Later, as Dr. Oustatcherdeparted after the entire Hamaspiktour, he was personally carrying theposter to his car.

Dr. Oustatcher was then directedto Fosse Shvesterheim IRA, a group-home for girls. The girls were yet toget home, and staff were preparing acolorful selection of watermelon,cantaloupe, and honeydew for"snack" to greet the girls imminentarrival. The superintendent wasgiven a tour of the beautiful group-

home by Shaye Wercberger, Directorof Residential services, and Mrs.Landau, the Residence Manager. Hesaw the living room, dining room,the consumers' private rooms, andhow beautifully designed and deco-rated they all are for the girls' specialneeds. Dr. Oustatcher also saw howorderly the medication closet waskept, properly sorted with easyaccess for the staff, and strictlylocked as regulations require.

The official tour then closed into its highlight, as Dr. Oustatcherand his hosts arrived at Hamaspikheadquarters in Monsey. He firstvisited the "Central Intake" office,which is kept separate from the otheroffices, so that when parents firstcome in they don't have to mix withemployees and can feel comfortable,with their privacy protected. Thisoffice has its own separate confer-

ence table so parents don't even haveto use the bigger conference room,where they would possibly be seenwhen the staff walks by. Dr.Oustatcher visited Mr. Wertheimer'soffice and then the staff offices,where he greeted the employees andwas warmly received.

A Luncheon in the Ballroom

Many staff members then gath-ered in the Hamaspik Terrace, anexquisite ballroom, which was espe-cially prepared to welcome thesuperintendent.

The President of the Board ofEducation for over a decade, Mr.Nathan Rothschild, together with Dr.Oustatcher and two newly electedBoard members, Mr. Aron Weiderand Mr. Moshe Hopstein, highlight-ed the event. Mr. Weider opened theevent with well-delivered remarks towelcome Dr. Oustatcher, andexpressed his good hopes for all stu-dents in the district.

Mr. Wertheimer welcomed Dr.Oustatcher and spoke about his abil-ity to create an improved budget forEast Ramapo, his ability to stabilizetaxes in the district, and his activitieson behalf of special needs children.

Dr. Oustatcher, in turn, thankedHamaspik for the warm welcome.He spoke about his observation ofthe needs of special consumers inthe community, and appealed to allinvolved to work well together toimprove East Ramapo schools and

special education in the district. Mr. Wertheimer than warmly

greeted the President of the schoolboard, Mr. Rothschild, who isrenown as a devoted communityleader and a longtime member of thelocal volunteer fire corps. Mr.Rothschild expressed his commit-ment to every child in the district,the mainstream as well as the specialeducation child, and his hopes of

enhancing their education.Dr. Oustatcher shared some per-

sonal words about Mr. Rothschildand thanked him for honoring theHamaspik luncheon with his pres-ence, as it was a special honor forthe superintendent.

The superintendent, in conclud-ing with internal school board parl-ance, then quipped to the president,"Nathan, back to you."

Continued from Page 1

E7Hamaspik Gazette | August '08

Eliezer Friedrich, a Hamaspikconsumer driven by a personal mis-sion to discuss the life and needs ofdisabled people with high officialsand political figures, had a yen tomeet Borough President ScottStringer, and Hamaspik granted hiswish.

On June the 2nd, Eliezer-who isphysically handicapped and lives inthe agency's Forshay Briderheimgroup-home, in Rockland County-set down with the Borough Presidentin his downtown Manhattan office.

"I feel that he's an accomplishedman," said Eliezer about theBorough President.

"He's a humble and devoted manand he's going to do things to helpeverybody."

In fact, the Borough President's"Disabilities Task Force" is workingon a presentation called "Disabilities101," to educate the public about theneeds of people with disabilities.

The Task Force plans to give thepresentation to community boardsand other groups in the hope that itwill "stop the ongoing problem ofthe needs of the disabled community

being ignored when plans for hous-ing, parks, buildings, and streetimprovements are reviewed," said aspokeswoman for the BoroughPresident's office.

Borough President Stringer alsosupports increasing the incomethreshold for the disability rentalincrease exemption (DRIE), whichwas enacted in 2005 to protect eligi-ble renters who have disabilitiesfrom being priced out of their apart-ments as rents increase. Mr.Stronger has met with advocates todiscuss broadening the range ofneeds that are taken into account inpublic housing and other publicfacilities.

Political Ambitions Eliezer has his own improve-

ments in mind.He wants Borough President

Stringer and other elected officials tofocus on, among other things, mak-ing parks accessible to wheelchair-bound children and adults, to pro-vide special permits to make it easierfor vans carrying disabled people topark at doctors' offices and hospitals,to make it easier for handicappedpeople to vote, and to integrate moredisabled children into mainstreamclassrooms.

A Letter from President BushMr. Friedrich admits that he

would like to participate in the polit-ical scene on a higher level than just

visiting important people."I want to be in government

myself," he divulged, "and I want tohelp people and to help their greatwork. I would like to be on commit-tees and to be supporting them andcommunicate with them, to helpeverybody, not only the Chassidicand Jewish people."

Prior to his visit with Mr.Stringer, Eliezer has brought themessage of the disabled to the atten-tion of other politicians in highplaces. He has met and discussedtheir concerns with RocklandCounty Executive, C. ScottVanderhoef, and former FloridaGovernor Jeb Bush, who is thebrother of President George W.

Bush.At the meeting with Bush,

Eliezer handed him a letter meantfor the President. Days later, Mr.Friedrich's long wish came true withthe postman delivering at theForshay Briderheim a personal letterwith the hallmarks of White Housecorrespondence.

Inside, he found a letter fromPresident Bush, dated June 4, 2008.

"Your thoughtful letter reachedme in the Oval Office," wrote thePresident of the United States to anecstatic Eliezer Friedrich. "Yourstrong spirit is an inspiration, and Iam grateful for your kind words ofsupport."

What political offices will opentheir doors to Eliezer's "strong spir-it" in the future?

Stay tuned.

The Friedrich Journey:

Borough President of Manhattan, ScottStringer, Meets with Hamaspik Consumer

ELIEZER FRIEDRICH: "I WANT TO BE IN GOVERNMENT MYSELF"

HOW CHANGES INMEDICARE AFFECT

PATIENTS

The major goal of the newMedicare law passed this month –after a veto from the President waseasily overwritten – was to block ascheduled cut in fees paid to doctors.But there's also plenty in the law thatdirectly affects Medicare beneficiar-ies, including:.

• Reduces out-of-pocket pay-ments for mental-health services.

• Adds coverage of certain anti-anxiety and sleep drugs.

• Adds coverage of rehab forpulmonary problems.

• New restriction on one type ofprivate Medicare plan.

• Doctors are pushed to switch toelectronic prescribing.

The American PsychiatricAssociation, a professional group,says the increase in coverage shouldattract more psychiatrists and othermental-health-care providers intoMedicare. "It's a huge step forward,"adds Andrew Sperling, director offederal legislative advocacy for theNational Alliance on Mental Illness,a patient advocacy group. Thechange to the mental-health co-pay-ment comes as Congress aims topass another bill later this month thatwould require employers and privateinsurers to put mental-health cover-age on par with that for physicalmaladies.

Much of the new law's cost willbe paid through reducing outlays forthe private Medicare Advantageplans. These plans, which can havericher benefits or lower co-paymentsthan traditional Medicare, areoffered directly to consumers by pri-vate insurers. They also are general-ly more expensive for the govern-ment than traditional Medicare, gov-ernment analysts say.

America's Health InsurancePlans, an industry group, estimatesthe change could affect around 80%of the 2.2 million people currentlyenrolled in private fee-for-serviceplans. "There are some importantchanges in here," says Kirsten Sloan,an official with AARP, the lobbyinggroup for older people. "It's mean-ingful."

HOPE ON WAITFOR KIDNEYS

A treatment including Rituxan, adrug approved primarily to treatblood cancer, may sharply improvethe chances of successful kidneytransplants for patients at high riskof rejecting them, a new studyfound.

About 30% of the patients on thenational kidney waiting list havehigh levels of antibodies that attackforeign tissue. This means they areheavily prone to rejecting the vastmajority of available donatedorgans, and therefore rarely qualifyto receive one under the national

transplant-allocation system.The Rituxan treatment lowered

antibody levels enough to allow 16of 20 such "highly sensitized"patients to qualify for kidneys,according to the study by researchersat Cedars-Sinai Medical Center inLos Angeles.

PATIENTS CURBPRESCRIPTION SPENDING

The number of prescriptions dis-pensed by pharmacies in the U.S. isgrowing at its worst rate in at least adecade, the Wall Street Journalreports, as consumers are squeezedby both a troubled economy and thegrowing burden of out-of-pockethealth-care costs.

The pharmaceutical industry byconventional wisdom is resistant toeconomic downturns, because peo-ple need medicine in good times andbad. But data from marketresearcher IMS Health and WallStreet analysts indicate that the rateof prescription growth has fallensteadily since early last year and inrecent months.

The slowdown is happening aseconomic pressures have snowballedin the first half of the year, fromrecord-high gasoline prices to mort-gage defaults. Skyrocketing out-of-pocket drug costs and an increasingnumber of uninsured Americans aremaking this downturn especiallychallenging for the health-care sec-tor, says Kevin Schulman, a special-ist in health economics at DukeUniversity.

"The last couple months havegotten worse, and that's going tocontinue," says Dr. Schulman. "Thehealth-care industry thinks it'simmune from these macro forces butat some point it can't be."

PANEL REJECTS BAN ON DRUG FIRM GIFTS

A hotly-debated ban on pharma-ceutical companies providing giftsand meals to physicians was strippedout of proposed legislation a Housecommittee approved earlier thismonth.

The panel also removed require-ments that drug and medical device

companies report payments theymake to doctors for consulting andspeaking to other physicians and thatthe Department of Public Healthpost that information on its website.A proposed $5,000 fine per violationwas also dropped from the bill,which is expected to be voted on bythe full House later this summer.

That voluntary code would banmeals at restaurants and trinketssuch as mugs and pens bearing thenames of drug companies and prod-ucts, but still allow companies tocater lunches in doctors’ offices andhospitals, which salespeople use topromote their products directly tophysicians.

OLDER MERCURYFILLINGS MAY BE TOXIC

A health warning has beenissued by the FDA over amalgamdental fillings after it insisted foryears that they were safe. The U-turnis a victory for campaigners whoclaim that the fillings My increasethe risks of cause heart conditions,Alzheimer's disease, and other prob-lems.

Elsewhere in the world, includ-ing Norway and Denmark, it hasbeen banned from fillings.

Many dentists in the USA do notuse them and are using alternativefillings that are based on resin andglass.

LAWS REDUCE DRUNKEN-DRIVING TRAGEDIES

Two federal policies in effect inall 50 states since at least 1988 -banning purchase or possession ofalcohol by people under 21 andmaking it illegal to use false ID tobuy alcohol - to make it harder foryoung people to acquire alcoholhave significantly reduced drunken-driving tragedies, a new study finds.

Scientists calculate that the pos-session and purchase laws reducedthe fatal crashes by about 11 percent,and laws requiring an automaticlicense suspension for the use offake IDs resulted in a 7 percentdecrease.

ROTAVIRUS VACCINE

SAID TO BE WORKINGThe vaccine against rotavirus,

first offered last fall, appears to beworking, as the CDC reports amarked reduction in incidence in the2007-8 season compared with aver-age seasons from 1991 to 2006.

Rotavirus causes severe acutegastroenteritis among infants andyoung children, and results in tens ofthousands of hospitalizations everyyear. It is grueling for child and par-ent alike. “It’s different from othergastrointestinal diseases,” saidDaniel Payne, an epidemiologistwith the disease centers. “It involvesfive to seven days of high fever,vomiting and diarrhea. It only kills afew dozen a year, but it is a hugeburden.”

Compared with the average forthe seven preceding seasons, thenumber of children who had to betested for the virus fell 37 percent,and the number of positive tests was78.5 percent lower. The vaccine isadministered orally, Dr. Payne said,and it is very well tolerated.

NEW WAYS TO DIAGNOSEAUTISM EARLIER

With the number of autistic chil-dren growing, researchers are target-ing new technologies to help detectthe disorder at ever-younger ages inhopes of reversing some of autism'sworst symptoms. A Yale Universityresearch report, for example, showsan infant undergoing an eye-trackingstudy as part of a study to identifybehavior in very young children thatcould indicate a risk of developingautism.

Most autistic children currentlyaren't diagnosed until they are about4 years old, using conventionaldetection methods of observingbehavior. Although specialists areable to identify the condition startingat about 30 months, most parentsdon't seek evaluations that earlybecause they don't notice anythingunusual about their children, or don'tknow what symptoms to look for.Now, scientists are using new tech-niques to study children as young asa few months old for signs of possi-ble autism and to flag them for moreextensive analysis.

By identifying children earlywho may be at risk of developingautism, even without a definitivediagnosis, parents can consider initi-ating behavioral therapy, the mostwidely validated treatment for thecondition. Studies of autistic chil-dren indicate that preschool-age kidsreceiving intensive treatment showgreater gains in language and IQscores than children whose treatmentbegins at older ages.

STUDY FUELS LOW-FATVS. LOW-CARB DEBATE

Overweight people on low-car-bohydrate diets lost more weight andgot greater cardiovascular benefitsthan people on a conventional low-fat diet, according to a study thatendorses alternative diets publishedrecently in a major medical journal.

The study, which tracked 322Israelis for two years, surprisinglyfound that a low-carb diet, oftenassociated in the U.S. with high lev-els of meat consumption -- was bet-ter than a low-fat diet in boostingblood levels of "good" cholesterol,or high-density lipoproteins associ-ated with cardiovascular health ben-efits. It also determined that aMediterranean-style diet, whichincludes olive oil, whole grains,wine and fruits, was better than thelow-fat diet in controlling glucoselevels.

The researchers suggested thatdoctors and nutritionists could usethe findings to tailor diets individu-ally to patients with heart disease ordiabetes, stressing that these werealternatives to low-fat diets thatmany people find hard to follow.

The results also indicated thatworries that low-carb diets, in partic-ular, might cause health problems,are unfounded.

"A lot of people believe a low-fat diet is the only sanctionedweight-loss diet," said Meir J.Stampfer, an epidemiology andnutrition professor at the HarvardSchool of Public Health who wassenior author of the report, publishedin the New England Journal ofMedicine. The study found that"there are alternatives that work bet-ter."

The low-carb diet was alsofound to reduce harmful triglyc-erides, a precursor of heart disease,more than the low-fat diet. Levels of"bad" cholesterol, or low-densitylipoprotein, which is associated withthe formation of arterial blockages,didn't significantly differ among thethree diets. Barbara Howard, formerchairwoman of the American HeartAssociation's Council on Nutrition,said that the group hasn't advocateda low-fat diet in recent years. Shesaid reducing total calories and exer-cise are key to weight loss. Thegroup also urges people to avoid sat-urated fats and limit "calorie densefoods" such as fats and "highlyprocessed carbs like pastries."

E8 August '08 | Hamaspik Gazette

So, What's Happening in Your Health Today...?

Hamaspik Gazette© 2003-2008 All Rights ReservedPublished Monthly by "Hamaspik"Distributed free.USPS Presorted Non-profit Mail.Postmaster: Return service requested.

President Executive Director Managing Editor Contributing Writers & EditorsHershel Weiss Meyer Wertheimer Isaac Schnitzler Rivkah Lewin

A. J. M.Joseph LandauJoseph Gestetner

Letters or Address Change?

Tel: (845) 356-8400 ex. 212 Fax: (845) 503-1212

Mail: Hamaspik Gazette 58 Rt. 59 Suite 1 Monsey NY 10952