IGH Rochester #180 August 20

PRICELESS

AUGUST 2020 • ISSUE 180

GVHEALTHNEWS.COM

BACK TO SCHOOL The fall semester will be like no other in recent memory.

We spoke with local experts.

See what to expect P. 8

Use of Alcohol, Drugs Up During Quarantine P. 16

Meet Excellus BlueCross BlueShield CEO-Elect New Excellus CEO-elect James Reed lives in Skaneateles, is a proponent of work-life balance and 18 months ago adopted a mostly plant-based diet. P. 18

Parmesan

Find out why parmesan cheese is such as nutritional powerhouse P. 11

Mask Up! Don’t Let Down

Your Guard Against COVID-19 P. 4

More People Are Dying During the Pandemic – and Not Just From COVID-19

M

ore people in the United States are dying during the COVID-19 pandemic, but not just because of the coronavirus.

One reason, experts say, is people with other ailments may not be seeking help.

That conclusion is emerging from new research showing deaths are increasing from causes such as heart disease, stroke and diabetes — while emergency room visits for those conditions are down.

“One factor that could be contributing to the increase is that people are afraid to come in for care,” said physician Steven Woolf, professor of family medicine and population health at Virginia Commonwealth University in Richmond. “We need to assure them that the danger of not getting care is greater than the danger of getting exposed to the virus.”

Woolf led a study published July 1 in JAMA that examined the number of deaths reported in the U.S. in March and April, when the pandemic began to take hold, compared with preceding years.

The nationwide data showed there were 87,000 “excess deaths” — that is, more than would have been expected during the two-month period — but only two-thirds of the total were attributed to COVID-19.

In 14 states, more than half of the excess deaths were from causes other than COVID-19.

Moreover, the JAMA study found huge increases in excess

deaths from underlying causes such as diabetes, heart disease and Alzheimer’s disease in Massachusetts, Michigan, New Jersey, New York and Pennsylvania — the five states with the most COVID-19 deaths in March and April.

New York City experienced the biggest jumps, including a 398% rise in heart disease deaths and a 356% increase in diabetes deaths.

Other research underscores the findings. A new study published in JAMA Internal Medicine analyzed data from March through May and calculated that 22% of excess deaths were not attributed to COVID-19.

Although data is still being gathered, “Upward trends in other causes of death (e.g., suicide, drug overdose, heart disease) may contribute to excess deaths in some jurisdictions,” the Centers for Disease Control and Prevention said.

Woolf said he is certain those trends are continuing, and offered two explanations. The first is that COVID-19 did contribute to many of the deaths even though it was not listed on death certificates and people may not have been tested for the virus.

“We now know that the virus is not just a respiratory problem,” he said. “It causes other physical responses, such as damaging the immune system, blood clotting and arrhythmias. It’s possible some of these spikes (in excess deaths) were caused by COVID-19 and the doctors

didn’t realize it.”

The other factor, Woolf said, is some people may be avoiding or delaying treatment for medical conditions, as well as mental health or addiction problems. The CDC reported in late June that in the 10 weeks after the pandemic was declared a national emergency on March 13, hospital emergency department visits declined by 23% for heart attacks, 20% for strokes and 10% for uncontrolled high blood sugar in people with diabetes.

“It seems like people are afraid of getting the virus, or maybe they’re

afraid of adding to the burden on the doctors and the hospital,” said physician Mitchell Elkind, professor of neurology and epidemiology at Columbia University in New York.

“They think, ‘I don’t want to bother anybody, and I’ll be OK. Why don’t I just stay home and take care of this myself?’

“But obviously, especially for serious conditions like heart disease and stroke, that is the wrong thing to do,” he said. “Just like before the pandemic, they should seek help, call 911 or get to the emergency room right away.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

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August 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 3

Meet

Your Doctor

By Chris Motola

Eric Wilcox, D.O.

Telehealth visits at Rochester Regional Health dramatically up, says family medicine physician who leads the program

Mask Up! Don’t Let Down Your Guard Against COVID-19

E

ven as the United States reopens, it’s crucial that people wear face masks when they can’t maintain proper social distancing, experts emphasize.

“While it’s tempting to view [things] as being back to normal, that’s simply not the case,” said Patrick Gavigan, a pediatric infectious disease physician at Penn State Children’s Hospital.

“The virus is still out there.

We still have cases every day,” he said in a Penn State Health news release.

In fact, 36 U.S. states were seeing increases in COVID-19 infections as of mid July, with Texas, Arizona and Florida posting record-breaking case counts in recent days. Much of that increase is being fueled by younger people testing positive for COVID-19, experts note.

Wearing a face mask, social distancing and hand-washing are essential defenses against transmission of the coronavirus, the U.S. Centers for Disease Control and Prevention says.

Face masks or other face coverings are especially important because research shows that people become contagious before they start having symptoms or feeling ill. And some people who test positive never have symptoms.

Face masks should be worn by anyone 2 years and older whenever and wherever social distancing measures are not possible, the CDC advises.

“It’s easy to get mask fatigue and fatigue from all of the COVID-19 restrictions across the nation,” Gavigan said. “But we can’t let our guard down. Masks right now and for the foreseeable future remain a key part in keeping us safe...”

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Q: I heard your office now has more telehealth visits in a day than you had in all of previous years.

A: Yeah, that’s true. In 2018 we piloted video visits for Rochester Regional Health. We had about 32 for the year. This year we’re on track for maybe around 400,000. So there’s been a huge increase. Obviously the demand is there for mitigating the risks of COVID. So I think it was one of those things where we were in a decent position to offer video visits, because we’d already been using them in some capacity. So it went relatively smoothly. We also have the benefit of having 90% of patients online and engaged with our portal, so having that percentage connected has been a huge benefit.

Q: So most of your patients aren’t having any issues with the tech involved?

A: That’s a great question. When we look at our patient population, we have a wide variety of technical skill levels. We range from IT people who are obviously very familiar with it and would even prefer to do it online to the elderly, some of whom haven’t embraced technology on the same level. But across the board, I’d say we’ve been very successful.

We’ve had very few people who can’t do it. I can probably count them on one hand, in which case we can fall back on a telephone visit.

The first telehealth visit can sometimes be a bit cumbersome, but now that we’ve been doing it for four months, many patients have had multiple visits, and they’ve pretty much gotten the hang of it.

Some of them even prefer it.

and then runs it by us as to whether the patient needs to be seen, and put it on our schedules. We would then evaluate them by video visit. There was always at least one provider in the office who was also doing video visits, so if we decided the person needs to be seen, that provider could see them in person. The other two providers would be doing video visits from home. The idea there is to minimize our footprint in the office and provide quality of care without putting anyone needlessly at risk.

Q: What are you able to do through video?

A: There’s a number of things.

It gives us a little bit more information than a phone call, and quite a bit more than an email. We’re able to see the patient and gauge the stress the patient is under. Most cameras are high enough quality that you do a good skin exam. Knowing the patient’s history can help when you’re seeing the patient visually to get a sense of how they’re feeling. We’re limited at this time — we can’t check the heart and lungs, we can’t palpate the abdomen. My hope is that in the future digital peripherals will be available, which can add benefits to visual visits and improve the quality of care we can deliver remotely.

Q: What role did you play in developing the policy?

A: Our telehealth policy has been formulated by myself and our office staff, in conjunction with the lead nurse and other providers. We developed a policy that was really intended to keep things as close to 100% remote as we could.

When a patient calls, they’re triaged by nursing

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

Q: Do you feel the crisis has made you more efficient?

A: More efficient? Yes. We’ve been

able to see patients quickly without having them commute into the office.

That said, we’re not at the point where a video visit is equivalent to an in-person visit, so in my view there’s a little bit of a loss of quality of care. So, while they are efficient and safe, the quality of the visit isn’t the same; there’s no hands-on and you also lose a bit of that personal touch. I think that’s one of the things we need to keep in mind as we move forward. So efficiency is great and beneficial, but inefficiency can also provide opportunities for that important personal touch.

Q: Did your experience in private practice help you develop some of the policies?

A: After my fellowship, I opened my private practice in Pittsford.

That’s 13 years ago now. It was just me and a computer and a phone. I was using a patient portal, which is pretty much asynchronous telemedicine to practice more efficiently and cut down on paper and phone calls.

So when we talk about efficiency, my attitude is it’s good to be efficient at all times except when you’re with the patient. At that point, you want to be sure you’re addressing the patient’s needs.

Q: With the lockdown winding down, at least for the moment, what do you see sticking around, and what do you think will be discarded?

A: I think we’ve done a great job mitigating the COVID risks. Because of that our levels right now are low.

I don’t believe it’s going to stay that way. I think we may, by the fall, be looking at a situation similar to the one we had in March and April. My hope is that we’ll continue to promote those behaviors and continue to mitigate those risks. As a practice, we’ve started the reopening process and have been seeing patients in person since June. We’ll continue to see patients as appropriate while using video visits through fall until there’s an immunization, treatment and point-of-care testing. My hope is that insurance companies will continue to agree with that.

Lifelines Name: Eric Wilcox, D.O. Position: Lead physician at Rochester Regional Family Medicine Hometown: Rochester Highlights: Precepts physician assistant students from Rochester Institute of Technology. Was one of the original members of the telemedicine steering committee and is a current member of the RRH/NTID (Rochester Regional Health / National Technical Institute for the Deaf) partnership steering committee to assess the needs and initiatives for deaf and hard-of-hearing patients. He’s also the telemedicine provider for the JCC Wolk Children’s Center and School Age programs, which went live in July.

Education: Touro University College of Osteopathic Medicine-Mare Island Affiliations: Rochester Regional; Unity; Strong Memorial Organizations: American Board of Family Medicine Family: Mary-Beth, wife: Children: Kelsey, Quinn, Torin, Everett Hobbies: Reading, basketball, woodworking, innovative medicine

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It included about 8,000 people without cancer whose physical activity over seven days was assessed using a tracking device. They were then followed for five years, according to reports.

During that follow-up, the least active people had an 82% higher risk of dying from cancer than those with the highest levels of physical activity, according to the study in the journal JAMA Oncology.

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However, she added that replacing at least 30 minutes of sitting with either light, moderate or vigorous physical activity may reduce the risk.

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Company Gets $1.6 Billion From U.S. Government for Coronavirus Vaccine accine maker Novavax will receive $1.6 billion from the U.S. government to provide 100 million doses of a coronavirus vaccine by early 2021, the Maryland-based company said recently.

This is the largest deal announced by the Trump administration to date as part of its attempts to provide coronavirus vaccines and treatments to Americans as soon as possible, The New York Times reported.

The $1.6 billion is coming from a “collaboration” between the Health and Human Services Department

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and the Defense Department, according to a Novavax spokeswoman.

In May, the Trump administration said it would give up to $1.2 billion to British drugmaker AstraZeneca, which has said it could have a vaccine available by October.

Federal funding has also been given to four other companies — Moderna Therapeutics, Johnson & Johnson, Merck and Sanofi — for their experimental coronavirus vaccines, The Times reported.

Novavax has never brought a product to market, the Times reported.

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Protect Your Nest-Egg & Your Family

Two Lysol Products Can Kill Coronavirus: EPA

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wo Lysol products are the first to be approved by the U.S. Environmental Protection Agency as able to kill the new coronavirus on hard, non-porous surfaces.

The EPA said laboratory tests found that Lysol Disinfectant Spray and Lysol Disinfectant Max Cover Mist destroy the virus two minutes after contact, according to reports.

The agency says there are 420 disinfectant products that are effective against “harder-to-kill” virus-

es than the new coronavirus, but the two Lysol are products are the first to be tested directly against the virus and be able to kill it.

A recent U.S. Centers for Disease Control and Prevention survey found that Americans said they were cleaning more often because of the coronavirus pandemic, but only about half said they actually knew how to clean and disinfect their home safely, CNN reported.

Serving Monroe and Ontario Counties A monthly newspaper published

by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.

In Good Health is published 12 times a year by Local News, Inc. © 2020 by Local News, Inc. All rights reserved.

P.O. Box 525, Victor NY 14564.

Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Payne Horning, John Addyman, Kimberly Blaker, Jennifer Faringer, Mark Simpelaar, Tracy Tambe • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Page 5

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Top 10 Reasons to Get Good at Living Alone . . . During the COVID Pandemic “Why in the world would I want to get good at living alone?” scowled my discontented divorced friend, weary of sheltering-in-place and longing to be married again. “I want to meet someone new and settle down. I want my old life back!”

Understanding where she was coming from, I reassured her that the two were not mutually exclusive. In fact, I said with conviction, getting good at living alone could very well help her realize her dream of remarriage and reclaiming her life.

Whether you want to get married or remarried or to stay single, there are plenty of compelling reasons to find contentment on your own during and beyond COVID-19.

Below, I’ve assembled my Top 10 best reasons for getting good at living alone. Like conquering any challenge, mastering the art of living alone has its rewards, even if it’s just for a year or two ... or a lifetime.

REASON 1 — Living alone gives you the chance to determine who you really are and what you really want for your life. No “shoulds” or other people’s agendas. Those of us who live alone have the gift of abundant time to ourselves. And we have even more time these days.

Used wisely, this time can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment.

Take this precious time to ask yourself what really matters to you. How you want to spend your time?

And with whom?

REASON 2 — When you exercise acceptance and fully embrace your newfound independence, you have the chance to be a role model for others and to be of service.

Inspired by your good example, a divorced friend, a widowed parent or an adult child who is still single can find strength, hope and comfort in seeing firsthand how contentment can be found on one’s own.

REASON 3 — Living alone affords you the opportunity to become more self-sufficient and resourceful. No more “his and her” division of duties: It’s all yours!

Learning to master things around the house — from minor repairs to hiring a roofing contractor, from planting a garden to making lasagna from scratch — can be a real source of satisfaction and self-pride.

REASON 4 — Finding contentment on your own will help you avoid entering into unhealthy relationships out of loneliness or desperation.

s d i K Corner

Does Having a Dog Make for Well-Adjusted Kids?

I

f you’ve hesitated to get a dog because your kids are very young, new research suggests that the preschool years might be a good time to add a furry friend to the family.

The study found that preschoolers with dogs at home had fewer problems with their peers or other behavior problems compared to youngsters without a family dog.

“Young children who walked or played with their family dog were more likely to have pro-social behaviors, such as sharing and cooperating,” said study senior author Hayley Christian. She’s an associate professor and senior research fellow at the Page 6

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University of Western Australia and Telethon Kids Institute.

Christian added that past research has shown that pets may be helpful for children’s self-esteem, autonomy, empathy, trust and confidence.

“For many children, pets are a source of unconditional love and loyalty. They can be social enablers and help teach children about responsibility through caring, training and looking after their pet,” she said.

The Australian study used data from a survey of more than 1,600 families with children aged 2 to 5. Many — 42% — of the families

Maybe no other reason to get good at living alone is as important as this one. And it goes for both sexes.

The inability to survive a Friday night alone, to prepare and eat a meal by yourself, or to overcome feelings of inadequacy make you easy prey for a suitor with dubious intentions.

It’s a risky place to be.

Getting good at living alone will improve your chances of meeting someone who values and appreciates your strengths, not your weaknesses.

REASON 5 — Glorious time to yourself! Living alone gives you a chance to enjoy peaceful, meaningful you time.

With the ability to control your schedule and find uninterrupted time to yourself, you can accomplish all those things you’ve been meaning to get to do, large and small, from finishing that good book, to clearing out the clutter, to updating your will, to learning to play pickleball. There’s no stopping you.

REASON 6 — Living alone is a real motivator, especially when it comes to managing your money. When you live alone you don’t have a choice.

You’re it. And, frankly, that’s a good thing, because ignorance around money matters can put you at a real disadvantage.

The good news is that there are plenty of excellent resources out there to help you put your financial house in order.

With increased knowledge and self-confidence, you’ll be less vulnerable and in a better position to protect your future, whether you remain single or get married.

REASON 7 — Taking care of yourself enables you to take care of others. If you’ve got kids at home or elderly parents who count on you, you’ll be better able to focus on their needs if you are successfully managing your own life.

had dogs. The surveys were done between 2015 and 2018. The findings were published July 5 in Pediatric Research journal.

Compared to children who didn’t have dogs at home, the researchers found that those with a family pooch were: • 23% less likely to have problems with emotions and social interactions, • 34% more likely to practice kind behaviors like sharing, • 30% less apt to engage in antisocial behaviors, • 40% less likely to have issues interacting with other kids.

Youngsters who went on dog walks with their family at least once a week were about one-third less likely to have poor social and emotional development than those who didn’t go on at least one weekly walk. Kids who played with their dog three or more times a week upped their odds of regularly engaging in considerate behaviors by 74% versus youngsters who played with their dog fewer than three times each week.

Christian noted that although the researchers considered factors in their analysis such as children’s age, sex, sleep habits, screen time and parents’ education levels, the study couldn’t prove a definitive causeand-effect relationship.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

REASON 8 — Getting good at living alone also looks good on you.

When you’re at peace with yourself and are making the best of your circumstances, it shows and people notice. You will radiate vitality. And that’s intriguing. It will open up your world and draw people to you (at a safe distance, of course).

REASON 9 — Besides boosting your self-esteem, getting good at living alone can help boost your immune system. Eating healthy, enjoying a good night’s sleep, getting regular health check-ups and exercising are all within your control and will contribute to feeling good and alive.

REASON 10 — And finally, my top reason for getting good at living alone? You can leave dishes in the sink, eat ice cream for dinner or turn the A/C down to 74°, if you like. No matter what, there’s nobody there to second-guess you.

I’m kidding, of course. But there’s a lot to be said for the freedom of expression that living alone affords you. You can be you — fully you — when you live alone. Take note and enjoy the autonomy that comes with being in charge of your own life.

Living alone can be a valuable period of self-determination. Embrace it with enthusiasm. Get good at it. And reap the rewards!

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women, and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

Psychologist Lori Kogan, a professor of clinical science at the College of Veterinary Medicine and Biomedical Sciences at Colorado State University, said the findings are exciting.

“I’m an advocate for research on the positive benefits of people and animals working together. And here it looks like in families that have a dog, their young children may benefit in many ways from having and walking with the dog,” she said.

Christian said that in school-age children, having any pet helps prevent social and behavioral problems.

But, she wasn’t aware of any research with cats and preschool-age children.

She noted that the social and behavioral benefits seen in the latest study appeared to stem from playing and walking with dogs, which could be hard to duplicate with a cat.

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Healthcare in a Minute

By George W. Chapman

Hospitals Struggling Big Time

W

hat tends to get lost in all the headline-grabbing news related to the pandemic (PPE shortages, morbidity, testing, lingering long term effects, potential vaccines, opening and closing businesses and schools, etc) is the ongoing financial crisis facing our underappreciated frontline combatants — the hospitals. Prior to the pandemic, NYS hospital bottom lines were already barely profitable, averaging a razor thin 1% to 2%. If you exclude non-operating revenue or non-patient fees like grants, donations, and interest on investments, hospitals would run in the red. A stand-alone mid-sized hospital, 200 to 300 beds, will need hundreds of millions in bailout money from the federal government. Larger hospital systems will literally need billions in recovery funding. And hospitals are nowhere near being out of the woods yet. The number of cases and deaths related to the virus continue to spike in many states (not New York) primarily due to people ignoring safety recommendations. There is a $3 trillion hospital bailout bill being proposed by the House of Representatives, but its fate is not good. There are approximately 5,000 hospitals in the U.S. and that number is sure to shrink by the time we have defeated or at least controlled COVID-19.

End-stage renal dialysis The pandemic is already being considered a “black swan” event, or something that ends up creating significant change in the world.

Past examples of black swan events would be WWI, the internet, personal computers, the breakup of the Soviet Union, and 911. COVID-19 will undoubtedly make virtual medicine a staple in the delivery of healthcare. The pandemic black swan event also signals a change in dialysis. To minimize the chance of an already compromised dialysis patient getting the virus, Medicare is enhancing payments for home dialysis machines to encourage patients to stay home for treatment. There are 750,000 people a year affected by end-stage renal disease (ESRD) and 85% of them have to trudge to a dialysis center, often hours away, for treatment four to five hours a day, three days a week. Home dialysis

would be a huge improvement in the quality of their lives. ESRD patients are 1% of the Medicare population, but 7% of Medicare expenses. ESRD creates all kinds of other medical problems other than dialysis. 100,000 people are on the kidney transplant list every year, but there are typically only 21,000 kidneys available. The need for donor kidneys is increasing 8% a year.

Harbinger of healthcare If you want a reliable clue as to where we are headed, follow the money. Digital healthcare startups raised a record $5.4 billion in just the first half of this year, far exceeding amounts raised in the first half of any year since 2011. While the pandemic is driving this, one can clearly see where we are headed shortly and well beyond the end of the pandemic. “On demand” services, (just like streaming entertainment on TV), and August 2020 •

digital remote monitoring of chronic diseases like hypertension, diabetes, cardiac arrhythmia, etc. lead the way with the lion’s share of investment.

Digital behavioral health startups raised almost $600 million the first half of this year as the virus has created a significant increase in depression, anxiety and abuse.

ACA and birth control While the future of the entire Affordable Care Act is expected to hit the Supreme Court sometime next year, the court recently ruled that any employer, not just churches, can qualify for the birth control exemption based on religious or moral convictions. The removal of birth control coverage from an employee’s benefit package will have minimal if any impact on premiums. Interestingly, the Supreme Court vote was by gender with the three dissenters being the three female justices: Bader Ginsberg, Kagan and Sotomayor.

Opioid epidemic?

It’s back, but buried in the avalanche of COVID-19 pandemic news.

Opioid-related deaths are spiking again in 30 states. Opioid-caused deaths are up almost 17%. The increase in drug abuse is most likely related to the stress and anxiety created by the pandemic. “Verily” is the science arm of Google parent company Alphabet. They are opening digital treatment and learning centers called “OneFifteen” to combat the crisis that just won’t go away. The curious name is derived from the fact that an average of 115 people died every day of an opioid overdose in 2017.

‘Retailization’ of healthcare Walmart is getting into health-

care insurance. Yes, Walmart.

Walmart Insurance Services will start selling Medicare plans this August in the Dallas-Fort Worth area market.

Walmart also owns clinics that offer primary care, dental, vision, mental health and wellness services in Georgia. Walmart clinics charge a flat fee regardless on the patient’s insurance.

Not to be outdone, Walgreen’s plans to open 500 to 700 primary care clinics, called VillageMD, over the next five years. The plan is to employ 3,600 primary care providers. Half of the clinics will be located in federally designated medically underserved areas. It remains to be seen how this will impact the private practice of medicine and hospital systems that also employ providers in remote, off campus facilities.

Telemedicine claims up

As further evidence of the pandemic “black swan” event, provider claims for telemedicine increased a staggering 8,300% in April 2020 compared to April 2019. Fueled by COVID-19 concerns and increased reimbursement from all insurers, to the equivalence of an in-person office visit, telemedicine is quickly becoming a more acceptable and doable tool for delivering healthcare.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Back to School Despite COVID Local schools ready to go with several back-to-school plans in the works

By Deborah Jeanne Sergeant

P

lanning for back-to-school isn’t easy as the pandemic and its effects drag on.

School administrators have had to wait until they received guidance from a variety of sources (CDC, state government) before even drafting plans that will require revision before they’re implemented. Though these are guidelines — not legal requirements — school administrators want to keep children safe.

Dan Domenech, executive director of the American Association of School Administrators (AASA) in Virginia, told In Good Health in mid-July that his organization has been working on reopening plans.

The organization’s taskforce of 27 supervisors from a variety of sizes of school districts have been drafting a plan that follows the guidelines of the Centers for Disease Control and Prevention. These include social spacing of optimally six feet minimum.

Considering the size of most school classrooms, “it’s not possible for all the students to attend,” Domenech said. “The model is a hybrid or blended model: there would be a number of students in the building who can be accommodated with social spacing. Those who cannot will be at home.”

The student body would cycle in and out of the school, two days in school and three days of remote learning at home per week.

But Domenech said that the cost involved would be high, as the school would need to pay for more frequent cleaning, equipment to take temperatures, personal protective equipment for the staff, and additional bussing expenses, “because a 70-passenger bus accommodates 12 to 13 students now,” Domenech said.

The AASA estimates that it will cost an average school district of 3,700 students $1.8 million annually in just these costs to adhere to the CDC’s guidelines. That’s an aver-

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age of $490 per student. For larger districts, it would surge to the scores of millions.

“The districts don’t have that money,” Domenech said. “They’ve had their budgets reduced because of the economy. They have to make additional cuts somewhere. There are attempts to lobby Congress to provide a bill that will provide additional dollars.”

About 85% of the average school budget is personnel costs, according to Domenech. But laying off teaching staff at a time when schools need smaller class sizes presents a problem.

Because of these issues, another back-to-school model considered is the one Domenech calls “Come one, come all, or don’t come at all.” He said that schools in states such as Texas, Alabama, Florida and Georgia are considering disregarding social distancing and masks at school and anyone uncomfortable with it may educate at home.

“That disregard for guidelines is dangerous,” Domenech said. “We’re seeing right now what happens: the infection rate goes sky high. I’d

hate to see what would happen in a school.”

Typically, schools in New York tend to open after Labor Day, Sept.

7 this year. This is later that many schools in the South, which usually go back to school by mid-August.

These districts may provide a foreshadow of what Northern schools can expect; however, by then it may be much more difficult to alter plans.

“The teachers’ associations and unions are saying if the environment isn’t safe, they’re not going to teach,” Domenech said. “A lot are saying they’re going to retire or quit. Some have potential issues that could put them at risk. It’s another factor.”

Remote teaching requires “incredible coordination and planning,” he added. Teachers and students must have the equipment, high speed internet access and familiarity with how to use both to participate fully.

He said that one-third of students don’t have a computer or

internet in their home.

“The money isn’t there to provide every child with a laptop,” Domenech said. “Not all parents can afford the internet.”

Those in rural areas may not have a high-speed connection available.

“The pandemic has made internet connectivity as necessary as every home having water and electricity,” Domenech said.

Some districts have outfitted school busses with a Wi-Fi hotspot connection so school personnel can bring connectivity to pupils lacking it.

For education at home to succeed, parents must also be willing and able to participate in educating their children at home. Domenech said that a much larger percentage of parents wants their children to learn at school, not home. A large piece of that lies in the quandary of dual-income households. Who will watch the children if both parents work?

Local Schools Rochester City School District Superintendent of Schools Lesli Myers-Small tentatively made plans in July while awaiting a final decision from Gov. Cuomo. The school’s COVID -19 Task Force meets weekly.

In addition to Cuomo’s direction, plans for re-opening include input from Monroe County Executive Adam Bello, and County Health Director Michael Mendoza.

Myers-Small said that the school anticipates plan options to include continuing with remote, online learning; a hybrid model with some students attending school in person and some working remotely; and a model where all students return to school in person with the CDC’s social distancing guidelines.

Greece Central School District’s School Reopening Task Force is

“Every question [about bringing kids back to school] leads to 10 more questions. There are no perfect answers. I don’t think there’s a way to bring all the children back at the same time and guarantee they could stay six feet apart all day long.”

Greece Central School District’s School Reopening Task Force head Mike Zaffuts

Wearing a mask during school time is part of what administrators are planning for the fall semester as a way to contain the spread of COVID-19.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

headed by Mike Zaffuts, assistant superintendent for Student Achievement and Educational Services, who in mid-July anticipated submitting a restart plan by July 31 to be finalized

by Aug. 7.

“We have spent our time thus far to look at our core values and how we identify ourselves and how the closure has impacted some of our more vulnerable and marginalized populations, particularly families of color and students with disabilities,” Zaffuts said.

He added that these groups have experienced more academic setbacks during the disrupted spring semester.

The district has provided devices for distance learning to almost all of its students, which Zaffuts thinks help lay a framework for remote learning this fall.

“We have a tremendously dedicated staff and leadership who are all very involved in the instruction effort,” he said.

Some students become more engaged with their education and others were discovered to be less engaged, which may be a problem if the school goes with a hybrid model. Zaffuts also thinks that should the schools take the hybrid route, they need to provide “maybe more streamlined or consistent and predictable communication and instruction.”

Among the 17 schools in the Greece district, the teachers used different methods and platforms of communication, which Zaffuts said caused some parents to feel overwhelmed.

“By and large, we did a great job in serving our community and looking out for the needs that exist for food service, distribution stations, meals and instructional materials provided. We did a lot of things well.

But it was our first effort.”

At this point, it appears a hybrid model represents the safest, most sensible way to go to meet both educational and safety needs. It’s not an easy decision to make.

“Every question leads to 10 more questions,” Zaffuts said. “There are no perfect answers. I don’t think there’s a way to bring all the children back at the same time and guarantee they could stay six feet apart all day long.”

As for activities like chorus, instrumental music, physical education and sports, “I’m not ready to guarantee what will be restricted over another,” Zaffuts said.

“We want to bring as many students back to school as safely as possible,” he said. “There’s no substitute for in-person instruction and the experience students get when they come to our schools. That’s the goal in the end. But we have to do it safely.”

Ultimately, it may be a matter of balancing the risk between health considerations and long-term negative academic effects.

“I want people to know we really care and we’re doing our best with what we have,” Zaffuts said. “People are emotional right now. Their emotions are real and we want to be sensitive to that and that the decisions we make honor those emotions in our learning community, whether with students, parents, staff and school leaders. The pandemic and everything that’s happened with the racial injustice and protests have been a lot. People need to recognize that we’re trying to consider all of that with the reopening.”

School Support

The COVID-19 pandemic may keep your children at home for some of their education this fall. Here are some great resources to use

By Deborah Jeanne Sergeant

W

hile the school district will provide the materials you need for any of the time your children will spend learning at home, it’s up to you to keep them motivated and to fill their extra time, as most extra-curricular activities will likely not happen.

The following websites can help support your educational efforts and provide some learning opportunities that don’t need your direct attention (sites are free unless indicated.

Games and puzzles www.bbc.co.uk/science/humanbody/ sleep/sheep/reaction_version5.swf These games test reaction time as a welcomed study break. www.starfall.com The site offers many educational games and activities that require student participation — not just passive videos — and much free content for children pre-K through fifth grade.

It’s $35 a year for unlimited access.

Starfall also has a phone app. www.abcya.com Play free educational games and entertaining games for ages 5 through 10. www.primarygames.com Complete educational puzzles for primary-grade children. www.puzzle-maker.com Easily make your children educational puzzles using spelling words or other themes as a fun way to study.

Printable materials www.moneyinstructor.com/play.asp Print play money and print lessons on counting and money.

www.eduplace.com/ss/maps/ Explore maps of all sorts—perfect for geography and as a visual aid for history.

www.apples4theteacher.com Search through a variety of printouts for the elementary grades.

Other resources

www.abcmouse.com Children aged 2 through 8 can learn through more than 10,000 activities in language arts, math, natural science, art and more. The site tracks children’s progress. $9.95 per month for unlimited use. www.XtraMath.com After you sign up, children can practice math drills that gradually increase in difficulty. The site displays children’s progress through the drills.

M

August 2020 •

Virtual tours/lessons/live streaming www.bbc.co.uk/teach/live-lessons The site offers educational lessons and videos on a variety of subjects—perfect for audio/visual learners. tion

www.gcv.org/explore/online-collec-

Tour the Genesee Country Village & Museum’s online collections of historic artifacts. (Better for teens than younger children.) www.nysm.nysed.gov/resources Take New York State Museum tours. The site includes activities, too.

www.quizlet.com Create your own quiz or select from 350 million premade quizzes on a variety of subjects to test knowledge and prepare for tests.

https://nationalzoo.si.edu/animals/ news/bringing-zoo-you-march-2020-edition Enjoy the animals at the Smithsonian National Zoo right from your computer.

www.kidsworldfun.com A mix of on-screen activities and printable sheets teach children through third grade.

https://whatson.cmog.org/ events-programs/live-streaming Feel like a guest at Corning Museum of Glass.

https://kidshealth.org Find health articles for kids, along with print-outs and activities.

www.americandairy.com/news-andevents/dairy-diary/virtual-farm-tourswhile-your-stuck-at-home.stml Tour a New York dairy farm from home, thanks to American Dairy Association Northeast. Three videos are available for three age ranges of children.

www.mapofus.org Maps and interactive videos of maps help teach geography. www.calculatorsoup.com Use any of a huge variety of calculators, which also show the work so you can help your children with even complex math problems. https://826digital.com Receive prompts for budding writers. www.brainpop.com Check out the quizzes of all sorts. www.learnathome.scholastic.com $5.99 per month for membership.

The Long-Term Harm of Missing School issing lots of school between kindergarten and eighth grade may have consequences when kids grow up, a new study suggests.

When they reached their early 20s, frequent absentees were less likely to vote and more likely to have economic problems and poor educational outcomes, researchers found.

The results suggest early school absenteeism should be taken seriously.

“There’s this misconception, especially among parents, that it doesn’t matter as much if kids miss school early on — that it only becomes important when they get to middle or high school,” said lead

Get general educational resources for children aged 4 through 10.

author Arya Ansari, an assistant professor of human sciences at Ohio State University. “This study shows that those early absences do matter, and in ways that many people don’t consider.”

Ansari’s team reviewed government data on nearly 650 students from 10 U.S. cities who were followed from birth through young adulthood.

The review found that school absenteeism had no effect on criminal, risky or deviant behavior, but it did have associations with political engagement and educational and economic success.

While the research did not prove a cause-and-effect link, students who

Reading and reading materials https://bookadventure.com The site doesn’t supply reading materials, but offers motivation to support reading with comprehension. www.gutenberg.org Read any of 45,000 free ebooks. www.roccitylibrary.org Log in with your library card for ebooks and other online resources. were often absent from school were nearly 5 percentage points less likely to have voted in 2012.

The absentees also reported having trouble paying bills and were more likely to use government assistance, such as food stamps. They had lower high school grade averages, were less likely to go to college and were less likely to have a job.

Not showing up for school may set a bad precedent, researchers said.

“If you start out being disengaged with school, you may end up being less engaged with society more broadly. You’re less likely to vote, less likely to go to college, less likely to be employed,” Ansari said in an Ohio State news release. “We believe disengagement may be one of the key mechanisms linking early school absences to poorer outcomes in early adulthood.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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5

Things You Need to Know About Menopause

By Ernst Lamothe Jr.

M

enopause is the time that marks the end of a woman’s menstrual cycles. Most women can experience menopause anywhere from their late 40s through their early 50s. It will affect their lives for nearly two decades. As a woman ages, her hormones and fertility decrease. It’s typically diagnosed after a woman goes 12 months without a menstrual period. While it is a biological process, there is information and misinformation that experts want to clear up.

“Women can experience menopause in so many varying ways and there is the misconception that everyone experiences the same symptoms and feelings,” said physician James R. Woods, professor of OBGYN at the University of Rochester Medical Center. “Even the window for menopause can be far wider than the one year without a menstrual period which is the official term for menopause that women are told.”

For Woods, the term menopause “often generates a great deal of misunderstanding and frustration among those women who enter that chapter of their lives.”

Woods offers five essential facts about menopause.

1.

Symptoms Menopause is best understood as a decrease in ovarian estrogen and especially estradiol which regulates the body’s inflammation state. Even though each woman may encounter different issues with menopause, there are some common symptoms that begin months or years before menses cease.

Some symptoms include irregular

Page 10

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periods, vaginal dryness, hot flashes, chills, night sweats, sleep problems, mood changes, weight gain and slowed metabolism, thinning hair and dry skin or loss of breast fullness.

“Women should be aware of these warning signs because many of these symptoms can alter a person’s quality of life,” said Woods.

2.

Hot flashes While it can be caused by other issues, there is a link between menopause and hot flashes. A hot flash is the sudden feeling of warmth in the upper body, which is usually most intense over the face, neck and chest.

It can cause both sweating and chills because a woman’s temperature center may oscillate a degree each way.

“Essential hormone regulators during the reproductive years keep your body quite calm. But when you have a decrease in the estradiol in your body, you can lose the ability of your body to regulate your body temperature.”

3.

Painful sex can be a symptom Because one of the common menopause changes is a thinner and less elastic vaginal wall, menopause can lead to vaginal dryness and painful intercourse. The pain may have a sharp or burning quality. The loss of estrogen also can affect the bladder, making sex uncomfortable and urinary issues more common.

“Women should be comfortable to talk about painful sex and [be aware of] the resources that are available to reduce that risk,” said Woods.

4.

Bones may weaken During menopause, as the anti-inflammatory properties of estradiol are lost, many women experience a natural decrease in bone density, called osteopenia.

That is because during the reproductive years bones are engaging in a balanced, continuous process of remodeling; laying down new bone while eliminating old bone. If bone loss is progressive, some women will encounter osteoporosis, where bone density is so low that bones become brittle and can break easily.

“The reason why this is so important is because if a woman falls and breaks her hip, it can dramatically affect her quality of life and lead to other health conditions,” added Woods.

Hormone therapy has also been proved to help reduce bone loss and fracture in postmenopausal women

5.

Hormone theory While women might think menopause and all its negative side effects are simply their lot in life, medical experts believe something can be done to make that part of a woman’s life tolerable if not exceptional. Woods recommends hormone replacement therapy for many women that can lessen or reverse these menopausal symptoms.

Natural hormones, called bioidentical hormones derived from plants such as estrogen, testosterone, and progesterone, are normally produced in various glands throughout the body during the reproductive years, said Woods. These hormones regulate a wide range of bodily functions.

After proper counseling, a physician may prescribe a customized treat-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

Physician James R. Woods, professor of OB-GYN at the University of Rochester Medical Center: “A woman should never have to hear the words ‘you are just getting older so deal with it,’ because there is something that can be done,” he says. ment plan that could include hormone creams, lotions, injections, gels, or tablets.

“I have seen many women who had serious menopause symptoms that were reversed with proper hormone management. Unfortunately, there remains a lot of misinformation where women were taught hormones were the enemy, and that is simply not true,” said Woods. “We have the ability to put hormones back in a woman’s body safely. A woman should never have to hear the words ‘you are just getting older so deal with it,’ because there is something that can be done.”

SmartBites

The skinny on healthy eating

Why Parmesan is a Nutritional Powerhouse

By Anne Palumbo

F

rom nutritionists to cheese connoisseurs to sports trainers, parmesan cheese is favored by many and here’s why: It promotes bone health; it’s virtually lactose-free; it rocks with complete protein; and it’s loaded with flavor.

True parmesan cheese (officially called Parmigiano-Reggiano) is a hard Italian cheese with a gritty texture and a complex fruity-nutty taste.

Many artisanal and large cheese producers here in the U.S. also make decent parmesan.

What makes this cheese stand alone (no matter its origin) is its lengthy aging process — a process

that results in unique nutritional benefits.

Time spent in the cellar helps protein develop, causing parmesan to have a higher percentage of this valuable nutrient compared with most cheeses. Thanks to its long aging, parmesan’s protein is easily digested, making it a good choice for infants and toddlers, seniors and others with delicate digestive systems. Likewise, this ready protein is favored as a quick energy source for marathon runners and weekend athletes alike.

Parmesan contains virtually no lactose, which is deliriously good news for those who are lactose-intolerant. Once again, parmesan’s

lengthy ripening process contributes to this welcome benefit.

Bones and teeth appreciate parmesan because it’s a decent source of two essential minerals: calcium and phosphorous. An ounce of this nutrient-dense cheese (roughly the size of your thumb) delivers about a third of your daily needs for calcium and a fourth for phosphorous. Both minerals help to keep bones and teeth healthy and strong. Interestingly, studies have suggested that eating harder cheeses like parmesan as the final food in your meal will help to reduce cavities. Chewing cheese stimulates saliva flow, which helps neutralize the acids that break down enamel.

One heaping tablespoon of shredded parmesan has around 22 calories and 1.5 grams of total fat, most of which is saturated fat. Since saturated fat raises blood cholesterol levels, which may then increase your risk of heart disease and stroke, the American Heart Association recommends no more than about 13 grams a day. The good news is, parmesan’s intense flavor steers us toward moderation.

Chicken Caesar Salad with Grated Parmesan For Salad:

Serves 4

3-4 skinless, boneless chicken breasts 3 romaine lettuce hearts, washed and torn into bite-size pieces ½ cup or more shredded parmesan cheese For Dressing: 2 garlic cloves, minced ½ teaspoon Worcestershire sauce 2 tablespoons fresh lemon juice 2 teaspoons balsamic vinegar 2 teaspoons mayonnaise 1½ teaspoons Dijon mustard ½ teaspoon salt

¼ teaspoon coarse black pepper 1 teaspoon anchovy paste (optional) 4 tablespoons olive oil Preheat grill to medium high.

Salt and pepper chicken breasts. Grill for about 10-12 minutes, flipping at the halfway point (meat is done when thickest part registers 165 degrees). Let cool; slice crosswise into strips.

Make dressing: In a small bowl, whisk everything together but the olive oil. Slowly whisk in the olive oil until well blended.

Assemble salad: In a large bowl toss together lettuce and half of the parmesan. Drizzle with desired amount of dressing and toss again.

Plate, top with several slices of grilled chicken, and sprinkle each portion with remaining parmesan.

Helpful tips

If you’re after authentic Italian parmesan look for the branding on the rind: Parmigiano-Reggiano or Grana Padano. For best flavor, buy a wedge from a wheel rather than pre-grated cheese. If buying pre-grated parmesan, look for American producers with good reputations, such as Sartori and BelGioioso. Store leftover cheese in a small zipper-lock bag and squeeze out as much air as possible before fastening seal.

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Eating Before Bedtime Might Pack on the Pounds

I

f you have a late dinner and then head to bed, beware: You may gain weight while you sleep, a new study suggests.

That’s most likely because your metabolism slows, boosting blood sugar and other chemicals that contribute to weight gain and Type 2 diabetes, researchers say.

“It’s not just what you eat, but when you eat that may be a factor in promoting conditions like obesity,” said study author Jonathan Jun, a physician and associate professor of medicine at Johns Hopkins University in Baltimore. “You might eat the same number of calories in that 24-hour period, but your body will handle those calories differently depending on what time you eat them.”

For the study, Jun’s team asked 20 healthy volunteers to eat the same dinner at 6 p.m. or 10 p.m. Both groups went to bed at 11 p.m. and got up at 7 a.m.

Before the study, participants wore activity trackers. During the study, blood samples were taken hourly and sleep studies were conducted. The volunteers also had scans of body fats and ate foods

containing compounds that allowed researchers to track fat burning.

The upshot: Late diners had higher blood sugar and burned less fat.

On average, their peak blood sugar level after a late dinner was about 18% higher, and the amount of fat burned about 10% lower, compared with eating earlier, the study found.

These effects might be even greater for people who are obese or have diabetes, Jun said.

What’s not clear is whether it’s the interval between eating time and bedtime that accounts for the difference, he said.

For example, if you have dinner at 10 p.m. but retire at 3 a.m., is that biologically the same as dinner at 6 p.m. and bed at 11 p.m.?

And, Jun said, the effects of eating and sleeping might differ for each person based on their personal metabolism or body clock.

“Instead of getting fixated on what time is late or what time it is on the clock to start or stop eating, we need to recognize that it is very dependent on the individual,” he said.

August 2020 •

Samantha Heller, a senior clinical nutritionist at NYU Langone Health in New York City, reviewed the findings.

“It makes sense that eating close to bedtime alters glucose and fat metabolism, because you are sleeping and not physically active,” she said, adding that sleep has its own processes that involve cellular and molecular mechanisms to help the body stay healthy.

Heller noted that people often get stuck in a routine of eating before dinner, eating dinner, and then snacking until bedtime — which

means they have been eating for several hours.

“It is an easy way to pack on the pounds,” she said. “We eat at night for many reasons, including stress, boredom, loneliness and anger.”

To help manage nighttime munching, Heller suggests planning an afternoon snack like hummus and carrots, so you are not starving by dinnertime, and enjoying a balanced, more plant-based dinner. Then close the kitchen.

The findings were published online June 11 in the Journal of Clinical Endocrinology & Metabolism.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

COVID-19

Miss Manner’s Quick Tips

Etiquette in the Age of COVID

n Don’t shame someone who isn’t following public health safety guidelines. “Reforming strangers only works when it assumes mistaken good will and allows them to comply without enduring public embarrassment, even if they deserve to be ashamed of themselves.”

‘Miss Manners’ talks good contagion behavior in new book

By Payne Horning

E

ven as quarantine orders in all parts of the country are being eased, the Centers for Disease Control and Prevention remains steadfast in its recommendation that people wear face coverings when in public. But that message clearly is not getting through to everyone.

On a recent trip to the store, I noticed several individuals cavalierly shopping without any kind of face mask. Even some of those who were wearing coverings had them on below their nose and mouth. I suppressed the urge to say something to them after having seen several outrageous videos on social media where people who were confronted for not wearing masks lashed out at those around them.

How to address these and other awkward situations that arise in a contagion is the subject of a new book “Miss Manners’ Guide to Contagious Etiquette.” Judith Martin, author of the famous Miss Manners advice column on etiquette that is published in more than 200 newspapers around the world, said she decided to write the book after being flooded with letters from readers.

“People seem to be thrown, understandably, by a world that we’re totally unfamiliar with,” Martin said.

In the book, Martin offers readers creative and refined ways to navigate social interactions in a time of social distancing.

For example, how does one confront those who are being careless about safety guidelines? Rather than telling someone to back off when they are standing closer than six feet from you, express your concern about ‘our’ ability to follow the CDC guidelines on social distancing. Rather than telling someone to sneeze into their elbow, offer them a tissue.

The key, Martin says, is to avoid shaming people publicly.

“Basic law of diplomacy: if you want to persuade someone to do something, you give them a face-saving way to do it,” She said. “You don’t just vilify them.”

Martin’s contagion dos and don’ts guide also addresses how to properly inform guests about a postponed wedding, whether handwritten thank-you notes are still acceptable, how to politely get out of social interactions in a time when you cannot use the excuse that you’re not at home, even how much toilet paper one can display in their bathroom before it becomes gauche due to the product’s limited supply.

Martin, who has been writing

Judith Martin, author of the famous “Miss Manners” advice column. about etiquette for nearly 40 years, said this isn’t the first time she’s had to adapt her advice to fit new terrains. There have been other significant cultural changes, like the advent of technology, that put her skills to the test. Regardless of the circumstances, though, the principles Miss Manners espouses remain the same.

“It comes down to how you treat other people and how you wish to be treated,” Martin said. “Decency, good manners, consideration.”

Although good manners may not be something people think they have much time to pay attention to nowadays, Martin said minding one’s manners may actually be more important now than ever. The past few months of quarantine have forced families and roommates to spend more time with each other than ever before. And perhaps more importantly, Martin said kindness and consideration are all the more important in

n Lead by example. For example, when others are walking toward you on a narrow sidewalk and you hope to keep six feet apart, “First, move as far as you safely can.

Then smile and perform the gesture that a theatrical headwaiter would have to accompany his saying, ‘This way, please, Madam/Sir.’” n Make the most with the many tools we have at our disposal. For example, if you want to thank neighbors and friends who dropped off food and supplies when you were ill, get creative. “Miss Manners is no more suggesting that you scare people by popping up at their doors than she is that you thank them in French. But you can propose to arrange a virtual visit.”

times of stress.

Miss Manner’s Guide to Contagious Etiquette is available as an e-book. For those hungry for more, “Minding Miss Manners in an Era of Fake Etiquette” is also now available in audio, e-book and hardcover.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

other questions.

Monroe County ordinarily employs a handful of specialists. Because of the pandemic, about 30 are doing case investigation, including redirected employees and volunteers, and another 50 are working on contacting, all of whom were trained for these duties.

In addition, New York State Department of Health hired workers to assist local health departments in the work.

A tracer isn’t necessarily a clinician, though training in community health work or healthcare is helpful. Mendoza said that since many of their conversations involve life-changing health diagnoses, it’s beneficial if the candidate has experience in working with people.

“They have to be calm, good at explaining scientific information and building rapport and trust so they can give the names of their friends and family members,” Mendoza said.

“You need to be very empathetic and a good listener. I’m a physician and we’re typically time-oriented. At visits, we’re firing question at people.

“Tracers need to take the time to talk with people, and listen to them.

We can reduce and minimize the number of people who need to go to the hospital.”

Tracers should also feel concerned about the common good.

Kate Ott, director of preventive services at Ontario County Public Health, said that the role of contact tracing is part of the job duties of the communicable disease nurse. Ontario County has 2.5 positions dedicated to communicable disease reporting.

In addition to pausing all its other preventable disease programming, the department now has nine other employees dedicated to working on tracing, plus state-hired employees.

Careers in Healthcare

Contact Tracers Track COVID and Other Illnesses

By Deborah Jeanne Sergeant

W

hile “contact tracers” — more formally known as disease investigation specialists, case investigators or other titles — have gained the public eye tracking down the contacts of people diagnosed with COVID-19, it’s actually a position that’s long been part of public health.

In many health departments, the specialists track 40 reportable illnesses — things like mumps, rubella, salmonella and the like — to the state health department and also work with people who have sexually transmitted diseases to minimize its spread.

These days, specialists have turned their focus on COVID-19.

“They talk with patients about isolation,” said physician Michael D. Mendoza, commissioner of public health with Monroe County Department of Public Health. “That’s separating a person who’s actively sick.”

Those who have come in contact with the sick person are notified so they can remain in quarantine at home for two weeks. This connection also helps the health department identify a hotspot such as a gathering or business.

The specialist also explains resources from the health department and sets up any supports such as grocery and medication delivery.

The specialist follows up with text messages about symptoms and any

Once someone has been diagnosed with COVID-19, people who have had face-to-face contact for 10 minutes or more at a point 48 hours previous or less will be notified by the health department that they need to quarantine at home for two weeks.

Ott said that the team follows up with them and also with those who are ill.

For the latter, the isolation lasts 10 days.

“We contact them twice a day, by phone and someone drives to their house and sees them through the window or door so we know they’re in their home,” Ott said.

In Ontario County, the regular contact tracers are bachelor’s trained nurses; however, that’s because they perform other tasks for the health department. Ott said that in general, employees experience less stress working for the health department than in typical nursing environments such as emergency medicine. They also work more regular hours than many nurses; however, the pay is lower, between $25 and $35 per hour.

While advancement isn’t a big option, Ott said that the department is always open to lateral moves.

The Bureau of Labor Statistics lists “epidemiologist” as the closest job title to the contact tracer; however, that’s a position that typically requires a master’s degree. The requirements required for contract tracing depends upon the hiring entity, whether a particular county’s health department for a long-term or short-term position or the state, as it’s hiring temporary workers during the pandemic.

Anyone interested in volunteering to help with contact tracing should contact their county’s department of health.

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August 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

UR Medicine’s Nurse-in-Chief

Two years into her tenure, Chief Nursing Executive Karen Davis has heard the voices of her 3,500 nurses to improve processes and culture at UR Medicine

By John Addyman

K

aren Davis joined the University of Rochester Medical System two years ago, charged with establishing consistent and outstanding practices. And getting and keeping great nurses.

She was walking into a big job.

In June, she and her staff completed the second year of a five-year strategic plan to accomplish those goals — achieved primarily, Davis said, by listening carefully to the 3,500 nurses working with her at Strong Memorial, Golisano Children’s Hospital, the Wilmot Cancer Center, and Highland (Rochester), Jones Memorial (Wellsville), Noyes Health (Dansville), St. James (Hornell) and Thompson (Canandaigua) community hospitals.

A 30-year veteran of the Johns Hopkins University Medical System based in Baltimore, Davis started her career as a clinical nurse, earned her master’s degree in nursing, became a nurse manager / assistant director and, after achieving her Ph.D., vice president and chief nursing officer.

She earned status as a board-certified nurse executive, and was prepared to take on a system-wide job, managing a multiple-hospital nursing program.

That’s what she found at URMC, and her route to Rochester and that system-wide job began in 2014.

After she finished her Ph.D., “I needed the experience and title of CNO [chief nursing officer] if I was ever going to lead at a system level,” she said. That took her to a Johns Hopkins-affiliate, the Howard County Community Hospital, as the CNO. “Now I had the social work staff, the chaplaincy, the gift shop employees under me,” she said, “not just the nursing staff. I learned a lot about managing different groups.”

At Howard, she was charged with “improving the patient experience, systemization and alleviating crowding in the emergency room.”

“The emergency department [at Howard County Community Hospital] was at a bottleneck,” she explained. “The nurses told me how to work on processes. I put all the stakeholders in a room, had them look at the data compared to other hospitals. The solution is always with the people who do the work — when you put all the right people in the same room.”

She spent her first months at the hospital being everywhere her nurses were.

“I put on scrubs and spent shifts with the nurses. I wanted to be with a bedside nurse for the shift, following them, observing and seeing what was going on, see what the care was, and what opportunities for change were there. I have to get out there and see — you see the unspoken things nobody will tell you about.”

Davis also brought her experience with the academic “mother ship” of Johns Hopkins to Howard.

“Sometimes a community hospital

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doesn’t know how to access the resources back at the mother system.”

Three years into her stay at Howard County and due for a promotion, Davis got a phone call.

“It was my old boss, asking me if I had seen the chief nurse executive posting at the University of Rochester Medical Center. Hopkins had sponsored me for a two-year fellowship at the Health Management Academy. I wanted to do oversight of multiple hospitals. A headhunter contacted me and the next thing I knew, I was interviewing.”

She said she fell in love with the executive team at URMC and was impressed that a staff nurse was on the search committee.

Davis went back to Maryland and told her college-age kids Maeve and Grace that they might want to think about Upstate New York in the near future. The family had relatives in Skaneateles.

“They told me, ‘Go for it, mom!’”

“I came two years ago and it’s been a great ride,” Davis said. “I never looked back, but I miss my colleagues at Hopkins — I was there for 30 years.”

When she came to Rochester, people at Strong knew something was different right away.

Davis had started again by walking complete shifts with her nurses.

“At first, people thought I was crazy — ‘You want to work a Saturday night in the ER?’ It’s a very different place here on the weekend and at night. It was much more enlightening for me to spend a Friday night than a Wednesday at 7 a.m. when all the

businesspeople are here.

“When you observe and see what’s going on, you see how care is and what opportunities are. I feel like I have to go out there and see — you see the unspoken things nobody will talk to you about. That was time well spent and I’d still be doing it if I haven’t had to deal with COVID. “I asked nurses, ‘How long have you been here? What’s kept you here?’ ‘What gets in your way?’

‘What are your biggest challenges in taking care of a patient?’ ‘What gets in your way when you’re trying to give optimal care?’

“My job is to remove those barriers and I have to know what they are first.

“This is how I got to know people. I could sense the different cultures of each shift. And you have to sense it — nobody hands you a book.

I did that for my first six months at URMC, shared what I learned with my leadership team, then launched the strategic plan.”

In March, fate threw a knuckleball into Davis’s strategic plan.

“It feels like we’ve been dealing with COVID-19 for seven years, but we’re not going to let it get in our way. It has challenged all of us, whether you’re in a leadership role or a frontline caregiver. I feel we’ve all grown. I’ve learned so much about change momentum and communication through a crisis.

“COVID – I look at what’s been positive about this. We have a skillset now. None of us had any experience with a pandemic; now we have a skillset. This has built teams — teams that never were before. People have

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

stronger respect for each other’s skills and abilities — we were all hands on deck, so we had pediatric nurses working with adults. This taught me how flexible people can be.”

Because of her experience at Howard, “I can really relate to the CNOs at our five community hospitals,” she said.

One of her goals at URMC was to bring a more systemic approach and she involved the CNOs quickly and directly.

“We need to have not just pockets of excellence here there, we really have to have a coordinated, sustainable optimized process for our health system.” Davis said. “Some of our CNOs had never met one another. Wellsville is two hours away and there was nobody pulling this together.

“I gathered up the CNOs, we meet monthly, and we formed a council. We travel to each other’s hospitals. It’s important that we get out to everybody’s campus, tour everyone’s hospital, and know the physical limitations. Each CNO hosts a meeting.”

Davis appointed people to have system-wide responsibilities. “For instance, I now have a chief nursing informatics officer who is a nurse focused on technology and nursing informatics. When I hired her, I hired her for the whole system.

“We also have regional educators across the system and we have new ways to implement things. If there’s a new policy, say on heart failure, that starts to get rolled out from the CNO council and then to all the affiliates.

That’s a new way for us to work as an organization.

“COVID has been a perfect example of how we work as a system — making sure everybody had adequate supplies, PPE, up-to-date information. We already had those lines of communication set up, so it was easier to deal with the pandemic. Well, not easy — but now we are organized, we know how to communicate, we know what people need and we could run through those structures.

“I was grateful I had a year and a half under my belt before I had to handle a pandemic because it would have been really hard to do that having not known the system and who the players were and not having put any structures in place.”

Davis is looking for good nurses.

URMC has a “magnet” designation, a seal of approval that it’s a great place to work for nurses. And she has some criteria.

“One of the things I’ve stood for and people know about me — I ask nurses to be compassionate and vulnerable with patients. For us, it’s not about checking the box and giving meds and the physical care: the important thing is to emotionally connect with — and be emotionally available – when our patients need us, and boy, has that been a test during COVID because our nurses had to provide emotional support when families couldn’t see their loved ones.”

After her two years, Davis believes URMC nurses have seen a change in the leadership — and leadership opportunities for them. “We as a nursing group have become more flexible and more focused on retention. If you have great leadership, that drives retention and when you foster an environment of flexibility, anything is possible.”

Addiction

My Drug Addiction, and How to Kick the Tobacco Habit

By Kimberly Blaker

I

woke up this morning and felt the agonizing withdrawal symptoms washing over me. It’s a persistent anxiousness that doesn’t cease until I get my fix.

I slipped on my robe and slippers, poured a cup of coffee, and frantically headed to the garage, where I try to keep the substance from my family. As always, my habit is waiting to greet me.

As I take a hit, a peaceful feeling washes over my body and mind. I can now begin my day feeling alive once again.

Yet as the day wears on, I feel the chemicals drain. Every hour or so, this drug starts calling me, unrelentingly, and I continue to replenish my body with the chemicals I so desperately need.

Every worrisome or sad thought or happy reminiscence drives me to another fix. Even tiredness, hunger, and boredom can be eased through this addiction of mine.

Now, as I lie in bed, I reflect on it. It’s my best friend and my worst enemy. I deliberate on how much it’s costing me, not just financially, but the toll it’s taking on my body.

It’s stealing the rug from under my feet. It’s draining my energy and making my heart race through life.

I can’t catch my breath. My skin is aging, and the substance leaves my body with a repulsive odor. I think about the diseases it puts me at risk for, such as cancer, heart disease, and emphysema. I don’t want to die that way. I want to live a full life.

I tell myself to go to sleep, and tomorrow I’ll start anew. I’ll dry up and go straight. But as I drift closer to sleep, I know tomorrow will go unchanged, for the craving is already creeping in again. I’m dependent in this love-hate relationship. I look forward to my next drag off a cigarette. Nicotine is my life — and will probably be my death.

Three years later

Fortunately, this relationship finally soured and came to a screeching halt. I kicked the habit and slammed the door behind. Through the years, I tried relentlessly to cut my ties with this shadow that seemingly couldn’t be shed; quitting cold turkey, cutting back, New Year resolutions, patches, gum, Zyban. All were temporary at best. But I never gave up.

Today I wake up to the smell of the fresh summer breeze rather than the stench of stale cigarettes that once drenched my body. My skin glows,

Do Apps Really Help in Assisting Those in Recovery?

By Deborah Jeanne Sergeant

I

t seems there’s a few phone apps available to address every difficulty of life. Numerous apps address the many facets of substance abuse, from accountability to isolation.

But are apps really helpful in assisting those in recovery?

Joel Yager, executive director of Huther Doyle Addiction Medicine in Rochester, said that apps do help, but only if people use them — and use them correctly.

“It’s one more thing in the toolbox they can use, but it can never

replace a therapist,” Yager said. “People get really excited initially, but you really need the human experience.”

Some apps connect individuals to therapists or peers. Should those using the app reach a different person each time, that may not provide the best experience, according to Yager.

“Our clients keep everything pretty close to their chest,” he said.

“Building a new relationship takes an enormous amount of time.”

He said that his organization’s August 2020 •

and my heart is calm. My midnight cough is long gone. Walking up the stairs doesn’t leave me breathless.

My energy soars, and I look forward to the once dreaded pleasures of life.

Now I can enjoy a vigorous peddle through the park or a spirited hike in the woods. Best of all, the diseases I could almost feel setting in have mostly erased from my body and mind. I now feel an inner peace I could never leave behind.

Ways to Help Quit

If you don’t think you can quit cold turkey, try one of the following nicotine replacement methods or medications, most approved by the FDA for quitting smoking.

• Nicotine Patches: These come in a 16-hour and 24-hour patch and don’t require a prescription. Manufacturers typically suggest eight weeks, though the FDA recommends three to five months.

• Nicotine nasal spray: By prescription only, nasal spray delivers a quick dose of nicotine to the bloodstream. Recommended use is three to six months.

• Nicotine gum: No prescription is required for nicotine gum, which comes in two strengths. It can be used for up to six months, though one to three months is the usual recommendation.

• Nicotine lozenges: These should not be confused with tobacco lozenges. Tobacco lozenges are a form of smokeless tobacco and have not been proven a successful cessation aid. Nicotine lozenges, on the clients do well when they meet in small groups of peers so that they can readily identify with one another’s struggles. They feel safer talking with peers and doing so in a non-clinical setting.

Some apps work by allowing the app user to note high-risk geographic locations where they experience a trigger. Once they get close to that area, the app sends a message to the person’s counselor. Yager said that these seem too intrusive to clients.

“They feel violated,” he said.

“They stop using it. Building trust takes so long. When you say, ‘Here’s this app so “Big Brother” watches where you’re going,’ it can make them feel isolated more.”

Since substance abuse already bears stigma of shame, guilt and trauma, piling on more through the app isn’t helpful.

“We do non-intrusive care, based on what they want to tell us when they want to tell us,” Yager said.

“People progress slowly, but when they do, they really get it. Nothing goes quickly. It’s a chronic condition, but we treat it like there’s an end to it. People say, ‘It’s all fixed’ but it’s a chronic condition people suffer from with continued use.”

Brigid Sboto, marriage and family therapist in private practice in Rochester, said that especially during the pandemic, but also in general, “structure keeps [patients] going from one step to the other successfully. Now, it’s like what do I do with my time? We’ve never seen anything like this.”

Phone apps can help those in recovery reach out and connect better, which can help them continue in the right direction despite a lack of daily

other hand, have been approved by the FDA for quitting smoking.

• Nicotine inhalers: These can be used for up to six months and are by prescription only.

• eCigarettes: Electronic cigarettes and vaporizers have become the latest success story in helping millions of people to quit smoking.

While useful for quitting smoking, there is much debate on their safety as they have not been around long enough for any conclusive studies.

• Bupropion: An anti-depressant, also known as Zyban, requires a prescription. It doesn’t contain nicotine, yet affects brain chemicals that lead to nicotine cravings.

• Varenicline: Chantix is a drug developed for smoking cessation. Studies have shown a high success rate with Varenicline. Some studies have found it to have higher success rates than Bupropion.

• Hypnosis: This method is useful for some smokers. Ask your doctor to recommend a hypnotist.

Kimberly Blaker is a freelance lifestyle writer.

She’s also founder and director of KB Creative Digital Services, an internet marketing agency, at kbcreativedigital.com. structure.

“Disconnect is what creates poor coping mechanisms,” Sboto said. “In that connection is where you’ll find the support.”

Improving self-care is also vital for recovery.

Maria Panitsidis, licensed clinical social worker at Blue Lotus Psychotherapy in Rochester, said that apps for relapse prevention might include those that proSboto mote healthful coping mechanisms, such as apps that guide breathing exercises, track moods and enable journaling.

“There are so many apps that kind of will help you put you in a positive place,” Panitsidis said.

She recommends SoberTool, WEconnect, and the apps from Alcoholics Anonymous —they have several available.

“Many have features that help you connect with others who are in the same boat as you,” Panitsidis said. “It helps keep you social. I think anything that has to do with getting therapeutic tools is very important.”

Everyone’s unique, so it’s important to remember that no one app will work for everyone.

“It takes time to find what you like,” Panitsidis said. “If it’s helpful, you can use it on a regular basis.”

She also encourages people in recovery to seek online AA meetings for support until in-person meetings open up.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Addiction

Alcohol, Substance Abuse Up During Pandemic

By Deborah Jeanne Sergeant

T

he rates of substance abuse disorders have risen because of the pandemic — and the effects of this increase may be long-lasting.

The Recovery Village, a Florida-based organization, reports that in recent months, 36% of respondents reported an increase in illicit drug use. Alcohol use is also on the rise.

Among the states of New York, New Jersey, Massachusetts, Rhode Island and Connecticut —those hardest hit by the pandemic — 67% of survey respondents reported an increase in alcohol consumption, with 25% reporting a significant increase.

As to why their consumption increased, respondents replied that: • 53% were trying to cope with stress • 39% were trying to relieve boredom • 32% were trying to cope with mental health symptoms, such as anxiety or depression Joel Yager, executive director at Huther Doyle Addiction Medicine in Rochester, said that the quarantine period presented difficulty for patients in recovery.

“We’ve seen the alcohol use rate skyrocket,” Yager said. “The social drinkers have crossed the line.

They’re home all the time so happy hour starts earlier. The spouses they’re home with are noticing how much their partner drinks and are calling the counseling center, saying, ‘I think my wife or husband has a problem.’ This has surfaced in so many ways.”

Just as organizations like Huther Doyle had helped get the opioid epidemic stabilized, the pandemic hit, threatening to cause those rates to skyrocket. Yager said that quick action to help connect clients to new, remote services has helped clients cope.

Numerous factors related to the

pandemic contributed to an increase in substance abuse, including prescription drug misuse, illicit drugs and alcohol. Keeping people apart was necessary for reducing infections of COVID-19; however, the circumstance made life more difficult for people in recovery.

“People are very social beings,” Yager said. “Isolation is a part of chemical dependency.”

A lack of routine also hampers recovery. Many people were furloughed from work or laid off entirely. Their spouse and children may have been home more as well. Some still do not have their regular work schedule restored. Any regular activities like going to the gym, church or club or meeting a friend for coffee ended for a time. Special events such as weddings are delayed or curtailed.

While many social aspects of life are available once again, they’re still not the same, as managers of public spaces still enforce social distancing, encourage wearing masks and limit patrons at a time. It’s all an obvious reminder that life pre-pandemic won’t be back soon. To some people, the hassle and stress may drive them into self-enforced isolation.

Brigid Sboto, a licensed marriage and family therapist in private practice in Rochester, said that virtual support meetings have been very helpful for those able to connect to them, particularly younger people accustomed to connecting through social media.

“Some really need face-to-face accountability,” Sboto said. “For them, it’s been tragic. It doesn’t take much to look across the span of social media and see comments on starting the cocktail hour earlier and earlier.

The alcohol business is the only one doing well.”

She also noted that increased social drinking is on the rise. With more

people at home, no one is around to judge daytime drinking, for example.

“Whether it turns out to be chronic and considered a continued problem, we won’t really know for a while,” Sboto said. “It’s been very difficult. We’ve seen an increase of suicidality and suicide behavior and a decrease in people seeking treatment altogether in hospitals because of fear of COVID. This will have a very long-term impact on many communities.”

Sboto believes that poor public perception of the safety of medical facilities have hampered people in seeking help for substance abuse issues.

She said that the sweeping changes in everyday life add to the struggle of recovery.

“It’s really stressful,” Sboto said.

“That leads to the need to cope and that leads to whatever your copings methods are, whether alcohol or something else. You will see people who are in recovery a very long time who are falling out of it because there is a lack of connection. Connection is the center of wellbeing. Feeling needed and necessary and the ability to give and help.”

Maria Panitsidis, licensed clinical social worker at Blue Lotus Psychotherapy in Rochester, calls substance abuse “a social isolation disease.

Being away from your supports has definitely been a huge issue for a lot of people during this time.”

Those who have been in recovery longer are better equipped with tools to avoid relapse. Pantisidis thinks it’s helpful build a longer list of

Alcohol Consumption During the Pandemic

By Jennifer Faringer

E

xcessive alcohol use is responsible for approximately 88,000 deaths annually in the United States and over $249 billion in economic costs, including costs associated with health care, crashes, accidents, loss of productivity — just to name a few.

How does the Centers for Disease Control and Prevention define excessive use?

• Binge drinking (four or more drinks per occasion for women, five or more drinks for men) • Heavy drinking (consuming eight or more drinks per week for women, 15 or more per week for men) • Any drinking by pregnant women or those under 21 Combine the already rising rates of drinking across all age groups with the stressful environment of the

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pandemic and you have a potential recipe for disaster, for the individual and affected family members.

We have been asked to remain physically distant, to wear masks, to home school our children and to work remotely. Each of these necessary precautions have helped our community and our state drive down the infection rate from the highest in the nation to one of the lowest.

Early in the pandemic, alcohol accessibility was deemed essential which altered the way it could be purchased and delivered. The increased access fostered a pattern of both increased/bulk purchasing and consumption. More individuals were consuming greater quantities than they had consumed before the pandemic in part to numb the stressfulness of the unknown. Fears and misconceptions fostered the myth that consuming high levels and high

strengths of alcohol could somehow kill the virus.

Instead, we know from decades of research that high consumption of alcohol is associated with an increased risk of alcohol-related diseases and rates of mortality. Heavy consumption is especially dangerous during this time as it increases the risk of virus transmission by decreasing the effectiveness of the immune system, decreasing lung function and increasing the likelihood of risky behavior that in turn increases exposure.

What can you do?

• Choose not to binge or drink heavily and encourage friends and family to avoid it as well.

• If you choose to drink, do so moderately (moderate drinking is defined as no more than one drink a day for women, no more than two drinks a day for men).

• Support efforts by community

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

alternatives to substance abuse, such as calling a friend, going on a walk, performing a breathing technique, or otherwise redirecting their attention.

Throughout the pandemic, in-patient treatment centers have remained open, such as John L. Norris Addiction Treatment Center in Rochester.

Edison Alban, director of communications for the center, said that the organization has worked to provide telehealth services, continued to offer medication assisted treatment and worked with local providers to facilitate home delivery for people isolated because of quarantine or lack of transportation.

“OASAS recognizes the potential consequences of isolation during the pandemic and how it relates to the possibility of increased alcohol and substance use,” Alban said.

Area and statewide resources • Anyone in need of help can contact the NYS HOPEline (1-877-8-HOPENY or text 467369) which operates 24/7 to help direct people to the treatment and other services.

• Available addiction treatment including crisis/detox, inpatient, residential or outpatient care throughout New York State can be found using the NYS OASAS Treatment Availability Dashboard at FindAddictionTreatment.ny.gov or through the NYS OASAS website.

groups to raise awareness around the crash risks of drinking and driving as well as the health risks of binge/ heavy drinking.

• Do not serve alcohol to those under 21 or those who have already consumed too much.

For more information on preventing substance abuse, visit the National Council on Drug and Alcohol Dependence-Rochester Area (NCADD-RA) at ncadd-ra.org or on Facebook at www.facebook.com/ NCADDRA/.

Jennifer Faringer is director of DePaul’s National Council on Drug and Alcohol DependenceRochester Area.

Meet Your Provider Rochester Lifestyle Medicine Institute Organization devoted to establishing lifestyle medicine as the foundation for health and the healthcare system Q. What is the nature of your organization and its mission?

A. Rochester Lifestyle Medicine Institute (RLMI) developed out of the medical practice known as Rochester Lifestyle Medicine (RLM). Both nonprofits help individuals move toward a healthier lifestyle. RLM works with individuals, while RLMI provides essential programs, including the very popular “15 Day Whole Foods PlantBased Jumpstart,” the award-winning “Complete Health Improvement Program (CHIP),” the fascinating neuro-scientific “LIFT Project,” and the engaging “6-week Plant-Based Nutrition Course on Lifestyle as Medicine” (with 12 continuing medical education credits). All programs run virtually during COVID-19.

Q. What about its mission?

A. RLMI’s mission is to establish lifestyle medicine, especially the adoption of whole-food plant-based nutrition, as the foundation for health and the healthcare system.

Within this mission, we advocate

nine pillars of health: plant based nutrition, activity, avoidance of toxic substances, adequate sleep, stress reduction, time outdoors, finding joy and purpose.

Q. Can you tell us more about your history and how you came to be?

A. A staggering 45% of Americans suffer from chronic lifestyle diseases, including Type 2 diabetes, heart disease, obesity, high blood pressure and high cholesterol. It has been proven that lifestyle choices can reverse and prevent these and other chronic diseases.

To address these health issues, Dr. Ted Barnett, an interventional radiologist and board-certified lifestyle medicine practitioner, founded RLMI, a 501(c)(3) non-profit, to serve as a scalable model for lifestyle medicine.

RLMI works closely with community members and medical practitioners globally to achieve life-saving and lifechanging benefits, such as reversing chronic illnesses and reducing medications.

Q. What would others find different about you that would be helpful to know?

A. Our practice is about lifestyle medicine, a holistic approach to health.

You, as an individual, are evaluated as a whole person. A chronic problem such as high blood pressure, high cholesterol, diabetes, rheumatoid arthritis, or excess body weight can develop for a combination of reasons.

Changing patterns in your lifestyle can bring about positive health effects — both physical and psychological. We evaluate individuals and teach them key strategies and techniques to create positive and lasting health changes.

Skills, not pills.

As a member of the RLM medical practitioner team, I see many patients with chronic illness. Through simple lifestyle changes, my patients have eliminated their need for high blood pressure and cholesterol medicines, insulin for high blood glucose, pain medications, as well as stimulants, for gastric reflux and bowel medication.

Jane Dorsey is a family nurse and boardcertified lifestyle medicine practitioner, with a specialization in sleep disorders.

With basic adjustments in eating, activity and stress management profound change is common.

Q. What are your aspirations for the future?

A. I thoroughly enjoy talking with people interested in the process of healing, and guiding them to selfempowerment. I will continue working with the RLM team to conduct research, treat chronic illness and teach people how to live a healthier, happier life by taking personal responsibility for their own health, and reaping the benefits of lifestyle medicine.

For more information, Call 585-484-1254 or Visit www.roclifemed.com

NYS Ends the Use of Tobacco Coupons, Multi-pack Discounts American Lung Association and the Tobacco Action Coalitions of New York applaud new state laws taking effect July 1

D

iscounts on the sale of all tobacco products, such as coupons and multi-pack price promotions, are prohibited in New York state beginning July 1. The law was passed as part of the state’s fiscal year 2021 budget.

“We know that higher tobacco prices are linked to lower smoking rates. Putting an end to the tobacco industry’s ability to circumvent New York’s high taxes on tobacco products is a win for public health statewide,” said Joseph Potter, director at the Tobacco Action Coalition of the Finger Lakes.

The Surgeon General has called raising prices on cigarettes “one of the most effective tobacco control interventions” because increasing price is proven to reduce smoking, especially among kids.

“Tobacco use remains the No. 1 cause of preventable death and disease in the United States,” said Michael Seilback, the American Lung Association’s national assistant vice president for state public policy.

“In New York state we can attribute 480,320 deaths to smoking annually — and the economic costs of smok-

ing to New York state is $10.3 billion.

We applaud Gov. Cuomo and the state legislature for doing away with dangerous discounts that put money in the pockets of tobacco companies, while costing New Yorkers their lives.”

A number of tobacco control measures passed as part of the state’s fiscal year 2021 budget, including a new law that stops the shipping or delivery of e-cigarettes and vape products to private residences beginning July 1, providing another important protection for youth.

Earlier this year on May 18, the state ended the sale of all tobacco products in pharmacies as well as the sale of flavored e-cigarettes statewide.

The average age that teens first start smoking in New York state is 13 years old, and 90% of adult smokers first tried smoking by age 18. According to the New York State Youth Tobacco Survey, nearly 40% of high school seniors in New York state use e-cigarettes, and 27% of all high school youth vape.

August 2020 •

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Succession at Excellus BlueCross BlueShield New Excellus CEO-elect James Reed lives in Skaneateles, is a proponent of work-life balance and 18 months ago adopted a mostly plant-based diet

By Lou Sorendo

T

rue leaders often step up to the plate during times of crisis.

For Excellus BlueCross BlueShield, newly named president and CEO-elect James Reed is doing just that.

Reed, who joined Excellus in 1996, succeeds Christopher Booth, who will retire on May 1, 2021. Reed most recently served as executive vice president of marketing and sales.

“Health care is such an important part of our community, and so my previous experience in working closely with many different stakeholders has provided me with a much deeper understanding of the challenges that we all face,” Reed said. “It really provides me with a great foundation for going into this new role.”

Reed has been working with Booth for the past 10 years.

“This is really a great opportunity for the next 10 months or so to really continue to work collaboratively on transitioning during that time period,” he added.

The staff at Excellus has been working remotely from home since March 17 due to the coronavirus pandemic.

“Fortunately prior to the pandemic, we had a really robust business continuity plan,” Reed said.

“While I don’t think anyone could have predicted what has happened so far this year, we did have a plan in place. Through various simulation exercises that we have done, it really put us in a good position to respond.”

When the crisis hit, the Excellus leadership team quickly focused organizational efforts on several priorities.

“The first one was servicing our customers. This is a pandemic, and the mission of our company is to provide access to high-quality and affordable health care,” he said. “If any of our customers are impacted by the virus, we need as a health plan to be there for them. We need to focus on servicing our customers.”

The company also sought to protect its finances.

“There has been so much uncertainty that has been introduced because of the pandemic in terms of costs, the economy and customers’ ability to pay their premiums,” he said. “We need to make sure that with the uncertainty, we have the financial wherewithal to continue to serve our mission.”

Another priority for Excellus was to protect the jobs of its employees.

“We took necessary steps at the very start of the pandemic to make sure we were doing our part in tightening our belts,” said Reed, noting this included a hiring and promotion freeze, as well as holding on merit Page 18

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situations,” he said.

Although requested rate increases are typically due to annual increases in the cost and utilization of medical care, Excellus’ rate requests to the state Department of Financial Services for next year remained among the lowest in Upstate New York, Reed noted.

This occurred despite including a 0.5% increase for anticipated increased expenses from the unprecedented COVID-19 pandemic, he added.

As for 2021, Excellus has submitted its request to the Department of Financial Services and is among the lowest rate adjustments filed for small group and individual products in New York state, he noted.

“We want to be as competitive as possible on our prices,” he said.

For four years in a row, Excellus’ premium requests have been below the state average for what competitors were asking, Reed said.

He said the most important variables that will affect 2021 insurance premiums involve the number of members and number of claims.

In 2019, for example, Excellus added more members and saw higher claims, Reed noted.

Its medical loss ratio (MLR), meanwhile, went from 86% in 2018 to 88% in 2019.

The MLR is the percent of premium dollars an insurer spends on medical services and quality improvements.

James Reed started working at Excellus BlueCross Blue Shield in 1996. Most recently, he served as executive vice-president of marketing and sales, and as regional president in the Central New York market. raises this year.

“We made sure we were as conservative as we could be knowing that our overall objective is servicing our customers, making sure we continue to service our mission and protecting the jobs of our employees,” he said.

Premium increase Excellus BCBS is a nonprofit, mission-based organization that strives to help people in the community enjoy healthier and more secure lives through access to high-quality and affordable health care.

“The decisions that we make align to the mission of the company, and that’s the key to our long-term success,” Reed said.

Excellus has responded to the pandemic by taking measures such as increasing reimbursement rates for telehealth; waiving out-of-pockets costs for telehealth; expediting payments of hospital claims, and imple-

menting a 20% increase in reimbursement for COVID-19 admissions, all to reduce the administrative burden to the provider community; and providing employer group support to make sure people understand that if they are out of a job, they need to enroll in COBRA or need to understand what options are available in the individual marketplace, whether that is Medicaid or a qualified health plan.

The coronavirus outbreak is expected to cost the U.S. health system a lot of money, which analysts suggest might mean dramatic increases in insurance premiums next year.

Reed shared his thoughts in regards to what Excellus BlueCross BlueShield customers can expect in terms of premium increases in the future.

“Periodic rate adjustments are necessary to enable our health plan, or any insurer, to produce sufficient revenue and reserves to ensure that the health care needs of our members are met, for both current health care needs and potential catastrophic cost

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

Striving to be the best Reed said his philosophy for the past 25 years at Excellus has been fairly simple.

“I really focused on doing the best job I could in the role that I was in, making sure I would seek to understand the big picture and understand the industry I was working in,” he said.

Reed said his philosophy also involves knowing what his role is and where that role fits into the overall success of the company.

From a philosophical perspective, Reed said he is a believer in focusing on the organization’s goals and not individual success.

For Reed, that involves the desire and willingness to work on himself.

“I think personal development is a lifelong journey, and if you are self-reflective and willing to improve yourself, then I think you’ll be well positioned to continue to grow inside the organization,” he said.

Reed said 25 years ago when he started with Excellus, he didn’t quite envision becoming CEO someday.

“But I think with each different step along the journey of my career, I made sure I was true to those core

values and that leadership philosophy,” he said.

With every new opportunity that came along, Reed began to see that as he continued to work, grow and be a beneficial member to the organization, good things continued to happen.

Reed sees the personal development piece as probably the most important.

He said nobody is perfect as a leader or simply as a human being.

“If you understand that and are willing to self-reflect, learn and continue to grow, then I think that is the key for anybody to be a good leader,” he added.

Plant-based lifestyle In terms of reaching a healthy work-life balance, Reed said it is important for any leader to recognize the need to attain this goal.

“It is maybe more important to actually model the behaviors that lead to better balance,” he said. “It’s one thing to say, ‘we want to make sure our employees have balance’, but if you don’t model the behavior yourself, then what unintentional signals are you sending to folks who you work with or who work for you?”

That behavior includes making sure to eat a healthy diet, getting enough sleep, exercising, and spending time with family and friends, Reed said.

“This has resulted in me being able to be involved with my kids through coaching youth sports,” said Reed, noting he coached each one of his three children through the seventh- and eighth-grade levels in different sports that they engaged in.

“To me, it means playing golf with friends, making sure I am home for dinner as much as possible and cooking dinner with my wife and spending good quality time there, regularly taking walks and taking my dog out for walks,” he said.

“It is really the behavior that you would probably think most people should be doing,” he said.

At times over the years when Reed feels stressed out about what is

happening at work, he takes the time to self reflect.

At that point, “I can see that I have not been focusing on any one of those things, whether that is sleep, eating health, spending time with family or exercising,” he said.

“To me, a good healthy balance includes a little bit of all those things,” he said.

About a year and a half ago, Reed took on a challenge generated

by Excellus employees to convert to a mostly plant-based lifestyle.

“For the past 18 to 19 months, I have pretty closely stuck to that lifestyle. I’ve seen tremendous benefits from it in terms of energy level and evidenced by my different biometric screening results and numbers overall,” Reed said. “In general, through eating mostly a plant-based diet, I have tremendously benefitted from it.”

“It’s challenging and does take discipline, but it’s not has hard as I thought it would be or as people might think it is,” he said.

The availability of resources as well as access to folks who are on a similar journey is helpful, he said.

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Lifelines Birthplace: Elmira Current residence: Skaneateles Education: Bachelor of Science in business administration from Le Moyne College, Syracuse; Master of Business Administration from Le Moyne College Affiliations: Reed is active on numerous local boards, including CenterState CEO, Greater Rochester Chamber of Commerce, HealtheConnections, Syracuse Stage and the Make-A-Wish Foundation of Central New York.

Awards: Reed is a 2008 recipient of the Greater Syracuse “40 Under 40” award and the 2020 YWCA Champion of Diversity Award.

Personal: Married with three children Hobbies: Cooking, coaching his children’s sports

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‘Having everyone home brings some challenges’ Excellus BlueCross BlueShield CEO-elect James Reed and his wife Theresa, residents of Skaneateles, are parents of three near-adult children, and the pandemic and subsequent lockdown meant significant adjustments as all family members lived and worked from home.

Two adult children are college students while the other is in high school.

Reed said the challenge was in the logistics of accommodating everyone’s needs in terms of workspace and access to resources.

“It was a tough one having never experienced anything like this. Having everyone home brings some challenges,” he said.

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with my near-adult children in a way that probably would not have happened had it not been for the pandemic.

“We probably won’t have this opportunity again after we come out the other side of this.”

“The opportunity to have dinner at home over an extended period of time during the more shelter-in-place time period does definitely have some benefits to the family,” he said.

Reed earned bachelor’s and master’s degrees in business administration from Le Moyne College in Syracuse. He serves on boards of directors for Centerstate CEO, the Greater Rochester Chamber of Commerce, and HealtheConnections.

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Page 19

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Aloe Vera Provides Many Benefits

By Deborah Jeanne Sergeant

A

loe vera is an evergreen succulent that has been a popular houseplant for decades. In addition to its attractive, serrated leaves, the plant also provides practical uses. Aloe vera has been used medicinally for thousands of years.

“It has a lot of benefits,” said physician Az Tahir, who practices holistic medicine in Rochester. “A lot of people use it for burns or skin issues. It’s a very good healer for the skin. It’s very, very safe.”

Simply cutting off a leaf, slitting it lengthwise and directly applying the juice of the plant to skin offers instant relief for minor burns and cuts. Commercially cold aloe vera gel is another way to benefit from its healing properties.

In addition, some people ingest aloe vera juice as a beverage.

“It’s especially helpful for internal healing, such as for constipation,” Tahir said.

He said that people receiving chemotherapy find that consuming aloe vera juice promotes stomach health. The therapy usually causes stomach upset as it attacks healthy cells in the stomach lining.

Kasia Cummings, owner of Buffalo Gal Organic Skincare in Williamsville, said that in the majority of her skincare products, aloe is the first ingredient.

“It’s great at healing the skin and helps retain moisture so we like to use it on a regular basis,” Cummings said.

In addition to using it straight from the leaf for a burn or other injury, she said that it can be used for balancing the oil in the skin, as it’s safe for any skin type.

Cummings likes aloe vera’s natural anti-inflammatory properties, which she said can soothe the skin.

She likes to make a mask of it by “filleting” a leaf from the plant, rubbing it on the skin and allowing the goo to dry. Once it dries, rinse it off.

For a sunburn treatment, she said that a mask of aloe, honey and plain, non-sweetened yogurt “really helps the skin to cool down and regenerate,” Cummings said. “It will help it from not peeling after the burn subsides. You can do it at home and you don’t have to buy a product. Then you rinse it off afterwards.”

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loe vera can be raised as a houseplant; however, as a succulent, its needs are a little different from more commonplace plants.

Follow these tips from Gardeningknowhow.com: • “Realize that this plant is a succulent. Like cacti, succulents do best in dry conditions. When growing aloe vera plants, plant them in a cactus potting soil mix or a regular potting soil that has been amended with additional perlite or building sand. Also, make sure that the pot has plenty of drainage holes. Aloe vera plants cannot tolerate standing water.

• “Aloe vera plants need bright light, so they do best in south- or west-facing windows.

Page 20 Hart • Hearing IN GOOD HEALTH1 – Rochester / Genesee Valley Healthcare2/8/20 Newspaper • August 2020 Spring2020 Good Health.indd 4:56 PM

• “The soil of the aloe vera plant should be allowed to go completely dry before being watered.

When the aloe plant is watered, the soil should be thoroughly drenched, but the water should be allowed to drain freely from the soil. The most common reason an aloe plant dies is that the owners water too often, or do not allow the water to drain.

• “You can fertilize your aloe vera plant, but aloes generally don’t need to be fertilized. If you decide to add fertilizing to part of your aloe vera plant care routine, aloe vera plants should be fertilized once a year in the spring. You can use a phosphorus-heavy, water-based fertilizer at half strength.”

By Jim Miller

RV Travel Tips in the Summer of COVID Dear Savvy Senior, Can you write a column on RV travel for novices?

My husband and I have been cooped up all spring and summer because of the coronavirus and would like to take a trip using a rented RV but could use some tips and want to be safe.

Recently Retired

Dear Recently, Recreational-vehicle (or RV) travel has become a very popular option among U.S. retirees over the past few decades and is probably one of the safest and most convenient ways to get away this season.

Because it’s a small home on wheels, RV travel will allow you to distance yourself from crowds of people and reduce your risk of COVID exposure that comes with other forms of travel, i.e. air/train travel, hotel/Airbnb lodging and eating in restaurants. But there are still risks — especially in public places like gas stations, shared restrooms and picnic areas — so exercise caution. If you’ve never traveled by motor home or RV, here are a few tips to consider.

Renting an RV To help you determine the RV size and model you need for your trip, consider your budget, destination and the number of travelers. If it’s just you and your husband, and you’re visiting several locations and driving lots of miles you may want a smaller motor home with better fuel economy. But if you’re taking other family members or friends, you may want a larger RV with slide outs and more sleeping areas. See GoRVing. com for a breakdown of all the different types of RVs available today.

To locate an RV rental dealer near you visit CruiseAmerica.com, one of the largest RV rental companies in the world or search the Recreation Vehicle Rental Association at RVRA. org. Or use peer-to-peer RV rental sites like RVshare.com or Outdoorsy. com, which are usually a little cheaper.

Rental costs will vary greatly depending on what you choose and how far you drive, ranging anywhere from $50 up to $500 per day.

When renting a rig, be sure you get detailed instructions from the owner or rental company on how to use the RV’s systems, including the

generator, air-conditioning, leveling, slide outs, electric and entertainment, as well as how to empty waste tanks and refill fresh water.

You should also know that because of COVID-19, most RV rental companies are vigilant about cleaning and disinfecting their units. But if you want to be extra safe, the CDC offers tips at CDC.gov/COVID19 — type “Cleaning and Disinfecting Your Home” in the search bar.

Trip Planning Tips It’s always wise to map out your trip route and reserve your campgrounds in advance, especially now during the pandemic, because some campgrounds and RV parks, as well as local, state, and national public parks may be closed or operating with restrictions.

A free tool that can help you plan your trip is Roadtrippers.com, which lets you plot out routes, calculate mileage and travel time, and will identify RV campgrounds, points of interest and restaurants along the way.

You should also consider becoming a Good Sam Club member (GoodSam.com/club, $29/year), which provides access to its webbased trip planner, camping and fuel discounts, and a copy of the Good Sam Guide Series that features detailed information on more than 12,000 private RV parks and public campgrounds.

Most RV parks rent spaces on a nightly or weekly basis with rates typically ranging from $30 to $50 per night, however some in city and country parks may be $10 or even free.

RV parks can also range from rustic facilities with limited or no utility hookups, as are more often found in state and national parks, to luxury resorts with amenities that rival fine hotels.

For first-time RV renters, staying at a fully loaded RV park or campground with full hookups, a dump station, and staff on site is highly recommended. Look at Kampgrounds of America (KOA.com) or ReserveAmerica.com to browse the accommodations.

And for more safe travel tips this summer, visit Coronavirus.gov — click on “specific resources for travelers.”

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

Ask St. Ann’s

Ask The Social

Security Office

From the Social Security District Office

Social Security: 85 Years of Serving People Like You

W How Does Pet Therapy Benefit Healthy Aging?

By Mark Simpelaar and Tracy Tambe

W

agging tails. Wet noses.

Warm cuddles. Spending time with a friendly pet is a sure-fire way to receive a daily dose of unconditional love, connection and companionship. Best of all, this mutually beneficial relationship supports healthy aging.

Often referred to as the “pet effect,” the bond between humans and animals calms our minds and lifts our spirits. It promotes the release of endorphins to help reduce stress, anxiety and depression, and increases positivity and socialization.

Scientific research suggests that our interactions can reduce one’s blood pressure, improve overall cardiovascular health and alleviate pain.

As the healthcare community continues to shift toward a person-centered delivery model, involving animals in the therapeutic and social care of people is an essential strategy. An animal’s presence can improve the relationship and communication between patients and the healthcare provider to support the best outcomes.

The recognized forms of pet therapy are: • Animal-Assisted Therapy (AAT), more commonly referred to as pet therapy, provides formal and structured interactions with a healthcare professional, a trained animal and the animal’s handler to help an individual reach a specific healthcare treatment goal.

• Animal-Assisted Activities (AAA) are casual meetings where an animal and its handler interact with one or more people for comfort or recreation. Senior living communities often welcome families and friends to bring their cats, dogs and other pets for visits, as well as invite them to participate in pet shows for their residents.

Cats, cockatiels, doves, guinea pigs and rabbits are a few of the resident pets at St. Ann’s Community. Members of the Life Enrichment team care for the pets and facilitate interactions with residents as part of Page 22

•

their care plans. The positive mood shifts and increase in energy and joy displayed by the residents are palpable.

In addition to pet visits, more facilities welcome pets to live alongside their owners in long-term care settings to support their overall well-being.

Two senior felines, Lily and Mollie, recently moved to the second floor of St. Ann’s Home to help a new resident adjust to his sudden need for skilled nursing care. Floor staff rallied to establish a care plan to accommodate the resident’s cat as well as adopt a second cat — bringing comfort and companionship to everyone living and working on the second floor.

Bringing your pet along when you visit a loved one in a healthcare facility is a great way to brighten everyone’s day. Before your first visit, be sure to ask about the protocol you should follow to keep everyone safe and healthy. Typically, senior living communities ask for signed documentation from your veterinarian stating that your pet has up-to-date vaccinations, is in good health, and has a good temperament.

Mark Simpelaar is a recreational therapist and life enrichment advocate at St. Ann’s Community. Contact him at msimpelaar@ mystanns.com or 585-697-6498.

Tracy Tambe is a nurse manager at St. Ann’s Community.

Contact her at ttambe@mystanns. com or 585-6976098. Learn more about St. Ann’s Community in Rochester at www. stannscommunity. com.

e take pride in having provided vital benefits and services to this great nation for 85 years. America has a diverse population with a variety of needs.

With our diverse population in mind, we’ve created webpages that speak directly to groups of people who may need information about our programs and services. These pages are easy to share with friends and family or on social media. Here are just a few that might speak to you or someone you love.

We proudly serve wounded warriors and veterans. They made sacrifices to preserve the freedoms Americans treasure. Many of them do not know they might be entitled to disability benefits from Social Security. Share our resources with them to make sure they get the benefits they deserve. www.ssa.gov/people/ veterans.

Social Security plays an important role in providing economic security for women. Nearly 55% of the people receiving Social Security benefits are women. With longer life

Q&A

Q: A few years ago, I lost my Social Security card. Now my credit report shows that someone might be using my Social Security number. I’m afraid they might ruin my credit. What should I do?

A: Identity theft and fraud are serious problems, not just for you, but for the financial integrity of our agency. It also puts our national security at risk if someone dangerous is using your number to obtain other forms of identification. It’s against the law to use someone else’s Social Security number, give false information when applying for a number, or alter, buy, or sell Social Security cards. Keep in mind, you should never carry your Social Security card with you.

If you think someone is using your Social Security number fraudulently, you should report it to the Federal Trade Commission (FTC) right away.

You can report it at www.idtheft. gov or you can call FTC’s hotline at 1-877-IDTHEFT (1-877-438-4261) TTY (1-866-653-4261).

Q: I served in the military, and I’ll receive a military pension when I retire.

Will that affect my Social Security benefits?

A: You can get both Social Security retirement benefits and military retirement at the same time. Generally, we don’t reduce your Social Security benefits because of your military benefits. When you’re ready to apply for Social Security retirement benefits,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

expectancies than men, women tend to live more years in retirement and have a greater chance of exhausting other sources of income. A woman who is 65 years old today can expect to live, on average, until about 87, while a 65-year-old man can expect to live, on average, until about 84. Also, women often have lower lifetime earnings than men, which usually means lower benefits. Women need to plan early and wisely for retirement and we’re here to provide valuable information to help. Share this page with someone who needs this information and may need help planning for their golden years. www.ssa.gov/people/women.

Do you know someone who is just starting their career? Now is the best time for them to start preparing for retirement. The sooner they begin to save, the more they’ll have at retirement. Share this page with a young worker you know. www.ssa. gov/people/earlycareer.

These are just a few webpages that are tailored to a specific group’s needs. If you didn’t see your own, check out our People Like Me home page at www.ssa.gov/people.

go to www.socialsecurity.gov/applyonline. This is the fastest and easiest way to apply. For your convenience, you can always save your progress during your application and complete it later. We thank you for your military service!

Q: I have a 38-year-old son who has been disabled by cerebral palsy since birth. I plan to apply for retirement benefits. Will he be eligible for benefits as my disabled child?

A: Yes. In general, an adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because we pay it on the parent’s Social Security earnings record.

The “adult child” — including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild — must be unmarried, age 18 or older, and have a disability that started before age 22.

Q: I applied for disability benefits, but was denied. I’d like to appeal. Can I do it online?

A: Yes. In fact, the best way to file a Social Security appeal is online.

Our online appeal process is convenient and secure. Just go to www. socialsecurity.gov/disability/appeal to appeal the decision. For people who don’t have access to the internet, you can call us at 1-800-772-1213 (TTY 1-800-325-0778) to schedule an appointment to visit your local Social Security office to file your appeal.

Stretching Tips to Help Seniors Gain Flexibility and Reduce Pain

By Jim Miller

O

f all possible exercises, stretching tends to be the most neglected, yet nothing is more vital to keeping an aging body limber and injury free.

As we age, our muscles naturally lose their elasticity if you’re not active, which can make common dayto-day activities like reaching down to tie your shoes or looking over your shoulder to back your car out of the driveway, difficult.

But the good news is, by incorporating some simple stretching exercises into your routine (at least three times a week) you can greatly improve your flexibility, as well as enhance your balance, posture and circulation, relieve pain and stress, and prevent injuries. In addition, stretching is also important as a warm-up and cool-down for more

vigorous activities, and leg stretching is an excellent way to prevent nighttime leg cramps too.

Simple Stretches Stretching exercises should focus on the muscles in your neck, shoulders, arms, chest, back, hips, thighs, hamstrings and calves. If you’ve had hip or back surgery, you should talk to your doctor before doing lower-back flexibility exercises.

While stretching, it’s very important to listen to your body. You want to stretch each muscle group to the point where the muscle feels tight. If it hurts, you’ve gone too far.

Back off to the point where you don’t feel any pain, then hold the stretch for 10 to 20 seconds. Relax, then repeat it three to five times, trying

to stretch a little farther, but don’t bounce. Bouncing greatly increases your chance of injury.

It’s also a good idea to warm up a little before you start stretching by walking in place and pumping your arms. And remember to breathe when you stretch. Also, keep in mind that muscles that have not been stretched in a while take time to regain their flexibility. So be patient and go slow.

If you don’t have much experience with stretching, the National Institute on Aging offers a free guide that provides illustrated examples of flexibility exercises to help you get started. Go to order.nia.nih.gov, and type in “Exercise & Physical Activity: Your Everyday Guide from The National Institute on Aging” to view it online.

There are also senior fitness programs, like SilverSneakers (silversneakers.com) and Silver&Fit (silverandfit.com), that are currently offering online flexibility and balance videos that can guide you through a series of stretching exercises you can do at home during the pandemic.

There are also a wide variety of stretching exercise DVDs or videos you could purchase at sites like CollageVideo.com or Amazon.com.

Yoga and Tai Chi Another great way to improve your flexibility is through gentle yoga or chair yoga. In chair yoga you replace the yoga mat with a chair where most poses can be duplicated.

This is much easier on tight, inflexible muscles. Tai chi and qi gong are also great exercise options for improving balance and flexibility.

To get started, there are many DVDs and videos that offer instructions and routines for seniors you can do at home. The YMCA has also launched a new series of free, online health and fitness videos at YMCA360.org that includes gentle yoga, chair yoga and tai chi videos.

Jim Miller is the author of Savvy Senior column, published every issue in In Good Health.

Foundation awards more than $19,000 in community grants

T

he F.F. Thompson Foundation is awarding 11 area nonprofit organizations with Mary Clark Thompson Grants ranging from $500 to $2,500.

The foundation is the philanthropic arm of UR Medicine Thompson Health. Each year, its grants committee reviews applications from nonprofit organizations offering programs that improve the health and wellness of the community within the Thompson service area. This year, given the current economic uncertainty faced by many local organizations, the foundation expedited the process to quickly award a total of more than $19,000 in funding.

This year’s recipients are as follows: • Benincasa, to assist with the replacement of hospital beds used by patients of the two-bed home for the terminally ill.

• Bridges for Brain Injury, to provide 50 people who have brain injuries with emergency preparedness training and emergency kits.

• Bristol Volunteer Fire Department, to purchase a new automated external defibrillator (AED) for the department’s community room, as well as an AED cabinet and spare adult and pediatric electrodes and batteries.

• City of Canandaigua Fire Department, for a laptop, projector, screen and speakers to be used for delivering fire safety and life safety education in facilities that do not have audio/visual equipment.

• Family Promise of Ontario County, Inc., to help fund vehicle maintenance and insurance for a 14-passenger mini-bus to transport clients who are receiving supervised temporary lodging as well as assistance in securing permanent and sustainable housing.

• Happiness House, to purchase an AED for the new Golisano Autism Center.

• Mercy Flight Central, to fund training and professional development opportunities that will help the air medical crew maintain required certifications.

August 2020 •

• Ontario ARC, to cover the cost of having up to 150 staff members medically screened to wear N-95 masks.

• Serenity House of Victor, Inc., to purchase deck furniture for residents receiving end-of-life care and their families.

• Sonnenberg Gardens, Inc., to purchase seeds, plant materials and fertilizer for its Kitchen Garden, where volunteers grow vegetables that are donated to Gleaners Community Kitchen in Canandaigua.

• Thrive to Survive Organization, Inc., to support local cancer patients through support groups, survivor wellness programs and yoga classes.

Local philanthropist Mary Clark Thompson founded F.F. Thompson Hospital in 1904, in memory of her husband, Frederick Ferris Thompson.

Her spirit of community-minded philanthropy was the motivation behind the creation of the community health grants. To review the guidelines for applications — which are due each spring — visit www.

ThompsonHealth.com/Foundation.

Hearing Loss Association Names Scholarship Winners

S

even Rochester-area high school graduates are going on to the next step of their careers with a boost from the Rochester Chapter of the Hearing Loss Association of America (HLAA). The local HLAA chapter recently announced the winners of its annual scholarship award.

The 2020 winners are: Julia Carboni of Aquinas Institute; Emma Doughty of Hilton High School; Bridget Gates of Greece Odyssey Academy; Gianna Leone of Victor High School; William Pietarinen of Palmyra-Macedon High School; Chloe Reber of Penfield High School; Meghan Taylor of Webster Thomas High School.

The Rochester chapter of HLAA has awarded scholarships annually since 1996. To date it has supported 137 students with an award for their first year of college or vocational training, providing a total of $121,500 in scholarships.

“In past years we have seen strong applications from the hearing loss community, but our 2020 winners are really raising the bar on what young people with hearing loss can accomplish, and what goals they can set for themselves in the next part of their education and careers,” according to scholarship organizers. Nancy and Doug Meyer.

Hearing loss is only one aspect of who these talented young people are. Some of their ambitious goals include becoming a disability lawyer to advocate for those who are marginalized; working in interior design; becoming a dietitian that works with the deaf community; using biomedical science to create virtual reality models with infectious disease; using skills of a communications degree with business and theater to help connect community members with their creativity; and becoming a speech pathologist.

According to the organization, young people with a hearing loss have many options for support in their education: some use a sign language interpreter; some have a note taker which allows them to focus more on receiving instruction through the teacher and interpreter; some use special sound systems; some use hearing aids; some use a cochlear implant.

“All of the students from whom we received applications had one solid thing in common: grit and perseverance,” said LAA Chapter President Suzanne Johnston. “They saw what they wanted to achieve and learned to advocate for themselves to get the education and support they needed to achieve their goals.

They did not give in to ‘status quo’, but instead persevered so that they could be successful.“ More information about HLAA Rochester can be found at www.hearinglossrochester.org.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 23

H ealth News Excellus Makes Major Donations to Food Banks, Pantries Excellus BlueCross Blue Shield is providing $600,000 in financial support to food banks and food pantries across Upstate New York as part of its response to the COVID-19 pandemic.

“The ability to earn a paycheck and feed a family are at risk for many people because of the coronavirus,” said Excellus BCBS President and CEO-elect James Reed. “This is leading to a growing number of people in our community experiencing food insecurity. Good health begins with good food. We saw an opportunity to help by providing needed support to food banks and food pantries that are under pressure because of an increased need in our communities.”

Food is the most basic of all needs. Prior to the COVID-19 outbreak, nearly 14% of New York households struggled with hunger, and at least 1 million New York children lived in households that did not have regular and consistent access to food, according to the New York State Anti-Hunger Task Force.

Over the last few months, as New York state’s unemployment rate increased, the ability for many families to regularly have food on the table was compromised. Local food banks and pantries are straining to meet the new demand.

The $600,000 donation from Excellus BCBS will support food banks

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and food pantries across the nonprofit health insurer’s 39 county Upstate New York service area. In the Rochester region, that includes $160,000 to support Foodlink, Inc. in its efforts to provide food for people in need.

“Foodlink is a proud partner of Excellus BlueCross BlueShield in our effort to help build healthier communities across Rochester and the Finger Lakes region,» said Julia Tedesco, President & CEO of Foodlink. «Excellus BCBS understands the vital importance of food and nutrition in helping our region recover from this pandemic, and we›re grateful for their significant investment in our ongoing response to this public health crisis.»

This donation to food banks is part of a larger commitment by Excellus BCBS to spend more than $162 million to help its members, health care providers and communities respond to the pandemic.

“We are a nonprofit health insurer with 3,500 employees who call Upstate New York home,” said Reed.

“Improving the health and quality of life of our communities is what we’re all about.”

For the latest information on the health plan’s response to the COVID-19 crisis, members, providers and employers are encouraged to visit www.chooseexcellus.com/covid19.

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Architectural rendering of the proposed emergency department at Clifton Springs Hospital.

Clifton Springs Hospital & Clinic to Build New Emergency Department Break ground on the $2.2 million project scheduled for January 2021 with completion by early 2022

A

new emergency department with more capacity, the latest technology and additional space for one of the most comprehensive behavioral health programs in the state is in the works for Rochester Regional Health’s Clifton Springs Hospital & Clinic.

The organization recently announced plans and released conceptual drawings for the new 6,500 square-foot emergency department.

They plan to break ground on the $2.2 million effort in January 2021 and open the facility by the beginning of 2022.

“Rochester Regional Health continues to invest in Clifton Springs Hospital, Newark-Wayne Community Hospital, and facilities like our Geneva Medical Campus.

Bringing a new emergency department to Clifton Springs is the next step we’re taking to transform health care in the Finger Lakes,” said physician Dustin Riccio, president of Clifton Springs Hospital & Clinic and Newark-Wayne Community Hospital.

The new emergency department at Clifton Springs will support more patient visits with additional treatment rooms, triage space, and easier access to the facility. The design will support the integration

of new diagnostic and treatment technologies, and provide patients and their loved ones with greater comfort and dignity as they seek emergency care.

The construction marks an additional investment on top of the ongoing $32 million Medical Village project already taking place at Clifton Springs Hospital. This spring, the hospital completed Phase 2 of the Medical Village, which featured a new patient access center and operating suite, including two of the most technologically advanced operating rooms in upstate New York.

Along with the emergency department, this latest construction effort will coincide with the previously planned project to expand the hospital’s Comprehensive Psychiatric Emergency Program (CPEP) space.

“The CPEP program at Clifton Springs is the only one of its kind in the Finger Lakes,” Riccio explained.

“The next closest ones are in Rochester and Syracuse. This program is critical because people need local access to this kind of emergency mental health care.”

Philanthropy will be the main source of funding for the emergency department project.

DRIVERS WANTED To distribute copies of In Good Health, Rochester’s Healthcare Newspaper, in offices and other high traffic locations in Monroe County. Great for active retirees or at-home moms in need of some extra cash.Not a regular job. Work only one or two days a month during office hours (9 to 5). $11.80/h plus 30 cents per mile —it amounts to about $150 - $200 per month. The paper is distributed at the beginning of the month, usually on Mondays and Tuesdays.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

H ealth News RRH and St. Lawrence Health reach affiliation agreement The boards of directors of Rochester Regional Health (RRH) and St. Lawrence Health System (SLHS) have reached an affiliation agreement between the two health systems.

“Our patients deserve nothing less than leading-edge health care.

Partnering with Rochester Regional will allow St. Lawrence Health System to continue to elevate the standard of care delivered throughout St. Lawrence County,” said David Acker, president and CEO of St. Lawrence Health System. “The lengthy and collaborative due diligence process allowed both health systems to fully appreciate the synergies that exist, and to confirm our shared vision of bringing the highest quality health care to those who need it.”

Rochester Regional Health’s strong reputation as a regional and national leader in quality care and innovation, coupled with its focus on civic connection to the communities it serves, made RRH the clear choice for a strategic affiliation partner, Acker said.

“The agreement affirms our shared commitment to preserve and expand the high quality primary and specialty care needed in the communities St. Lawrence Health System has been serving so well for generations,” said physician Eric Bieber, president and CEO of Rochester Regional Health. “Embracing innovation, smart growth and strong fiscal performance are among the many attributes Rochester Regional Health and St. Lawrence Health System have in common.”

The affiliation agreement was approved by the boards of directors of both health systems. Next, regulatory filings will be submitted to the New York Department of Health.

Rochester Regional Health is an internationally recognized integrated health services organization serving the people of Western New York, the Finger Lakes, and beyond. The system includes five hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses, and immediate care facilities; comprehensive senior care; behavioral health services; and ACM Medical Laboratory, a global leader in patient and clinical trials. It has nearly 20,000 employees.

St. Lawrence Health System, formed in 2013, runs three hospitals — Canton-Potsdam Hospital, which includes a Level III trauma center; Gouverneur Hospital; and Massena Hospital. In addition, St. Lawrence operates an extensive network of outpatient facilities in Brasher Falls, Canton, Colton, DeKalb Junction, Edwards, Gouverneur, Louisville, Massena, Norfolk, and Potsdam. The largest employer in St. Lawrence County, with 2,025 employees, St. Lawrence Health System has 195 full time medical staff members and estimated annual net operating revenue of $300 million.

Thompson names medical director of urgent care UR Medicine Thompson Health recently named physician David E. Baum its new medical director of urgent care.

This is an expanded role within Thompson for Baum, a Honeoye Falls resident who has served as the health system’s senior vice president for medical services since 2014 and is also its chief medical officer.

Thompson has urgent care locations in Canandaigua, Farmington and Newark. In his new role, overseeing the three sites, Baum replaces Thompson’s longtime medical director of urgent care, physician David R. Carlson. Carlson, who remains the medical director of occupational medicine for the health system, is credited with overseeing the creation and expansion of the three urgent care centers.

“Thompson Health is excited to have Dr. Baum expand his responsibilities within our leadership team. In this ever-changing healthcare environment, we are confident that his commitment to providing excellent health care to our community will build on the strong foundation set in place by Dr. Carlson and his team, providing a satisfying patient experience at our urgent care sites,” said Thompson Health Executive Vice President/COO Kurt Koczent.

A graduate of Albany Medical College, Baum first joined Thompson Health in the late 1980s, as an attending physician in the emergency department (ED). After completing his juris doctorate at Cornell Law School, he returned to Thompson’s ED in 1998. In addition to his administrative roles within the health system, he remains an attending physician in the ED.

Expanded role for Janczak at M.M. Ewing CCC UR Medicine Thompson Health recently named Mathew Janczak assistant administrator of the M.M. Ewing Continuing Care Center, Thompson’s 178-bed skilled nursing facility in Canandaigua.

A Farmington resident, Janczak first joined the facility’s leadership team in 2013, when he became coordinator of its rehabilitation services department. He transitioned to manager of the department in 2018 and currently serves as the chairman of M.M. Ewing’s associate safety committee.

With occupational therapist August 2020 •

Mary Grace Lucas taking on the role of the rehabilitation services department’s clinical coordinator, Janczak will continue to oversee the department while serving as M.M. Ewing’s assistant administrator. His new role is for a period of two years and coincides with his pursuing a New York State Nursing Home Administrator license.

“Matt has been a valued member of our leadership team for seven years and is known as an effective manager who cares deeply for both the staff and the residents. We are thrilled to see him step into this new role and to know he is pursuing licensure as a nursing home administrator,” said Vice President of LongTerm Care Amy Daly.

A Canandaigua Academy graduate who obtained a bachelor’s degree in systems engineering from the United States Naval Academy, Janczak had three combat deployments while in the U.S. Navy, earning two Air Medals in support of Operation Iraqi Freedom. He received a doctorate in physical therapy from the University of Pittsburgh in 2012 and joined Thompson’s staff as a physical therapist in June of that year.

URMC gets award to further intellectual disabilities research The University of Rochester Medical Center has been designated an Intellectual and Developmental Disabilities Research Center (IDDRC) by the National Institute of Child Health and Human Development (NICHD).

The award recognizes the medical center’s national leadership in research for conditions such autism, Batten disease and Rett syndrome, and will translate scientific insights into new ways to diagnose and treat these conditions, and provide patients and families access to cutting edge care.

The IDDRC at the University of Rochester will be led by John Foxe, Ph.D., director of the Del Monte Institute for Neuroscience, and physician Jonathan Mink, Ph.D., chief of child neurology at Golisano Children’s Hospital. The designation is accompanied with more than $6 million in funding from NICHD. “The new center will span research from molecule to mind and elevate and accelerate the pioneering work that our scientists and clinicians are undertaking in this field,” said Foxe. “This recognition will enable us to not only strengthen and expand the scope of research, but also attract new scientists, clinical researchers, and students, and accelerate the process of moving discoveries from the laboratory bench to the clinic in the form of new therapeutics and interventions.”

“Improving the health and wellbeing of people with intellectual and developmental disabilities has long been one of the core missions of URMC and is woven into our

history dating back to the founding principles of the School of Medicine and Dentistry and the creation of the biopsychosocial model, which revolutionized the approach to complex physical and mental conditions,” said Mink. “This designation will build upon this foundation and help improve the lives of patients with these conditions.”

URMC will be one of 14 NICHD-designation IDDRC institutions in the U.S. Combined with previous awards as a University Centers for Excellence in Developmental Disabilities Education, Research, and Service (UCEDD) and Leadership Education in Neurodevelopmental and Related Disabilities (LEND), this designation places the Medical Center among a small group of institutions recognized for their leadership in IDD research, training, care, and community partnership.

Rochester Regional brings specialists to Geneva It just got a lot easier for residents of Geneva and the Finger Lakes area to see some of Rochester Regional Health’s top specialists. Rochester Regional Health (RRH) opened its new Geneva Medical Campus at 875 Pre-Emption Road.

Through a significant renovation, Rochester Regional took the building, already home to RRH Finger Lakes Bone & Joint and the only open MRI in the region, and added space for several new specialists, including many who were not previously available in the Geneva area.

“The outpatient setting is where most people receive the majority of their health care,” explained physician Dustin Riccio, president of Newark-Wayne Community Hospital and Clifton Springs Hospital & Clinic.

“Visits to your primary care provider, consultations with specialists, diagnostic imaging scans and lab visits are all critical to staying healthy and they need to fit easily into people’s lives. Through the Geneva Medical Campus, we are providing more people with convenient, local access to a wide range of services. One of the most important things we do is make sure people have the care they need close to home.”

The following specialties are now available at the Geneva Medical Campus: primary care – Geneva Family Medicine; allergy and rheumatology; ear, nose and throat; endocrinology, diabetes and nutrition counseling; general surgery – Rochester Regional Health General Surgery Finger Lakes; neurosurgery; open MRI; orthopedics and orthopedic urgent care – Finger Lakes Bone & Joint; and vascular surgery.

Later this year, the campus will add a gastroenterology practice.

In addition to following through on commitments to bring new services to the Finger Lakes area, Rochester Regional Health has taken extra measures to make sure all locations are safe for people to visit during the COVID-19 pandemic.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 25

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2020