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Home Health Care Reform

So despite having full practice as Nurse Practitioners in the state of CT and being able to work entirely without an MD after 3 years. We cannot order home health care for our patients due to federal regulations. There are currently bills in both the house and senate to address this issue. PLEASE contact your representative to ask for their support. Lets help people get the access to health care they need!!

You may be surprised to learn that health insurers will only cover home health services ordered by a physician. Advanced practice nurses (APRN) are qualified to order home care services and legally authorized to do so within their scope of practice in every state. Yet, due to Medicare law (written in 1964, before APRNs even existed), the ordering of home care services is restricted to physicians. APRNs are effectively barred from ordering this essential service, because in order to be reimbursed, home care agencies (e.g. Visiting Nurse Service) will only take home care orders from a physician. This can only be corrected legislatively at the Federal level. There is a Senate Bill for this, S.445 - The Home Health Care Planning Improvement Act. Senator Susan Collins (R-ME) is the chief sponsor. The bill has 37 co-sponsors.:

https://www.congress.gov/bill/115th-congress/senate-bill/445

S.445 - Home Health Care Planning Improvement Act of 2017 ... www.congress.gov Summary of S.445 - 115th Congress (2017-2018): Home Health Care Planning Improvement Act of 2017

In the House of Representatives, the companion bill for this is H.R.1825 - The Home Health Care Planning Improvement Act. Representative Chris Collins (R-NY) is the chief sponsor. The bill has 114 co-sponsors.

https://www.congress.gov/bill/115th-congress/house-bill/1825

H.R.1825 - Home Health Care Planning Improvement Act of ... www.congress.gov Summary of H.R.1825 - 115th Congress (2017-2018): Home Health Care Planning Improvement Act of 2017

Please call and email your U.S. Senator and ask them to co-sponsor and support the passage of S. 445, The Home Health Care Planning Improvement Act. Please call and email your U.S. Representative and ask them to co-sponsor and support H.R.1825, The Home Health Care Planning Improvement Act. Ask your family and friends to do the same. You can find contact information for both your U.S. Senator and U.S. Representative here:

http://whoismyrepresentative.com/

Healthy Tip: Diabetic Foot Care

Diabetes is a complex disease that affects many parts of a person’s body.  One of those things is the small nerves in a person’s feet.  As diabetes progresses a person’s ability to feel things, such as sharp objects, can decrease on the soles of the feet.  Because of this the person could step on something sharp and/or get a cut and never know it.  Therefore its important to regularly check your feet if you have Diabetes.  Checking for cuts and wounds is important because if these areas are left untreated then serious infections can occur.  These infections could result in the loss of a toe, foot, limb or even a person’s life.  So, if you have Diabetes, make sure you take a few minuets at the end of you day to check your feet.  A little bit goes a long way. 

Healthy Tips: Lyme

Lyme disease is something that many people who live here in New England worry about, and rightly so.  We have a large number of ticks in the area and they have the potential to carry the bacteria that causes Lyme.  So, let’s take a few moments to discuss some important things to know about Lyme.  First, let’s start with the most reassure aspect, not all ticks care Lyme and even if you have been bitten by a tick it takes 36-72hours of an infected tick being latched to a person to transmit the bacteria.  So, if you remove a tick that is still flat and hasn’t become full of blood, chances are low that you have become infected.  Now for the not so reassuring, only about 20-25% of patients with Lyme recall being bitten by a tick and only 80% of people infect will develop a bull’s eye rash.  This is why your provider may check for Lyme via a blood test if you are showing any signs or symptoms that may be related to Lyme.  Symptoms of early Lyme include: The classic bulls eye rash which will show up 7-14 days after exposure, fatigue, muscle aches, joint pain, headache, neck stiffness, poor or no appetite, and/or fever.  Basically, the same symptoms you might have if you had the flu.  Later stages of Lyme have different symptoms and can be harder to diagnosis.  These symptoms may have more nerve or heart based symptoms.  So there are lots of reasons why your provider might want to check to rule out Lyme as a possible cause, especially as in most people early treatment with an antibiotic is effective.  The best thing you can do is try and avoid tick bites by wearing long pants when out in areas that would have a large number of ticks such as wood areas.  Also, regularly check for ticks after you’ve been outside.  If you can remove the tick before or soon after latching your chances of getting Lyme are greatly decreased.  If you are worried that you might have been bitten by a tick or are concerned you might have Lyme Disease call and speak to your provider as soon as possible.  

References:

www.medscape.com

www.uptodat.com

Healthy Tips: High Blood Pressure

High blood pressure is a medical issue that affects a large number of people.  The tricky thing about it, is that until the blood pressure gets dangerously high you don’t have any symptoms.  So if there aren’t any symptoms why would we bother to treat it? Especially with medications that may not make a person feel well, such as having to run to the bathroom to pee all day.  The reason we treat it is that while you may not be feeling any symptoms that elevated blood pressure is causing all kinds of damage to you body.  Your blood is slamming into your delicate organs with so much pressure that they cannot handle it.  The organs effected the most are your kidneys, brain and eyes.  Uncontrolled blood pressure can lead to strokes, blindness, and kidney failure.  And its not like these things will happen when you are “older”. If the pressures are high enough people in their 30’s and 40’s can have significant health issues related to high blood pressure.  So if you have high blood pressure, make sure you take your medicine, watch how much salt you eat and regularly see your health care provider. 

Healthy Tips: Tanning

So how bad IS tanning?  Well, it depends on where you are tanning. Exposure to UV rays, which is what causes our skin to darken into a tan, varies depending on the location.  If you are getting a tan from working outside in the sun day after day after day its not nearly as bad for you than if you go to the beach a few times a year and get so much sun you burn to a crisp.  Studies have shown that more frequent sunburns related to infrequent sun expose are more damaging to you skin than consistent sun exposure over long periods of time.  This is thought to be related to how our body reacts to the sun and the damage to skin cells caused by sunburns.  Furthermore, tanning beds are by far the worst place to go.  They increase your risk of the rarest and deadliest form of skin cancer, melanoma, by up to 75%!  This is related to the intensity of the UV ray exposure present in tanning beds.  Due to this extreme rise in risk with tanning bed use, some states are requiring individuals to be 18 or older in order to go to a tanning salon.  Keep this in mind before you decide you need a little extra color. 

Healthy Tips: Internet

Healthy Tips

“Hey google knows!” How often do we find ourselves saying this or hearing someone else say it when we don’t know the answers to something?  The internet is an extremely valuable resource of information but anyone can put anything on the internet.  So how do we know if what comes up in our search results is accurate and can be trusted? Well what’s on top must be the best, right? Unfortunately, just because a search result is listed near the top doesn’t mean its better than any others.  All this means is that the company has managed to promote their page to being the “most popular” or paid for the privilege of being listed first.  These sites are not always the best place for getting quality health information, they may give you some of what you need to know but may not really the best place to look.  We have provided a list of some websites that are known to have more accurate health information. You can find list under our: Internet Resources for Health tap. If you know of any other good sources please let us know and we’ll be glad to add them to the list. 

Why do I need a Primary Care Provider?

Primary Care Providers are the gateway to the health care system. They can treat and manage most illness, whether chronic, lasting months to year, or acute, lasting days to weeks.  They can help you make sure your health is on the right track by regularly doing yearly physicals, blood work, and managing you medications. They also help when you have a cold or feel ill and help you get back to feeling well sooner.  If there is something going on that they can’t help with, they can help you identify it and refer you to a specialist.  Regularly seeing your Primary Care Provider helps improve health and quality of life and so much easier than going to the ER or Urgent Care when something bad happens.  Your Primary Care will get to know YOU and help you catch things before you need to go to the hospital.  So, if you don’t have a Primary Care you should find one and get the ball rolling. 

Healthy Tips: Vaccines

Healthy Tips:

So what’s the deal with vaccines? Are they safe? Should kids be getting the shots more spread out? There is still a lot of controversy circulating around vaccines and it can be hard to know who is right and what sources to trust.  Especially when a lot of public figures outspokenly disapprove of vaccines.  So here’s the down and dirty. Vaccines are safe and very important.  Study after study has been done to show that vaccines do not cause Autism.  The signs of Autism just become apparent around the same age as most vaccines are scheduled. The vaccine schedules are set up to protect the child when they need it most as well as to take advantage of when their immune system is at its strongest.  As we get older we stop making long lasting immunity.  So its best to get most vaccines when we are young.  There is absolutely no mercury in the vaccines.  Also if there are any side effects or bad reactions from a vaccine, as with all medications, they are reported and the vaccines safety is continually being checked and updated.  Because of vaccines we have eliminated so many childhood illnesses that use to result in death.  So please vaccinate your children for their health and safety. 

Healthy Tips: School Physicals

Healthy Tips:

Before you know it Fall will be here and so won’t the back to school rush.  Don’t leave your back to school and sports physicals to the last minute.  Make sure you are up to date on all your vaccinations and you are good to go to start off the school year on the right foot.  Don’t let long waits at the doctor’s office hold up your sports game or your clinical rotations at collage. 

Healthy Tips: Sun Smart

Healthy Tips:

Summer is a great time to rest and relax and enjoy the sun while it lasts.  Just make sure you don’t forget your sunblock if you’ll be outside for any length of time. You can still get a nasty sunburn on those cloudy days at the beach and the water will intensify the sun’s rays.  So stop those painful sunburns and keep the wrinkles at bay and use your sunscreen!

What is a Nurse Practitioner?

A Nurse Practitioner is someone who has been a nurse and decided they wanted to do more to help their patients.  Nurse Practitioners are able to provide the same care and treatment as a doctor and help provided greater access to health care. A Nurse Practitioner can order tests, diagnosis illness, and prescribe medications.  They may go by several different titles which makes things confusing. These titles include: APRN, NP, Advanced Practice Registered Nurse.  To help make it easier Nurse Practitioners, Doctors, and Physician Assistances are all Providers that can help you manage your health.  We might have different titles but in the end what we can do for you is the same.