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Saturday, March 7, 2009
Keeping the Medical Center Current and Fiscally Responsible By Judy Tierney Patients who go to the Block Island Medical Center for healthcare won’t usually see Executive Director Monty Stover in the waiting area. His office is on the second floor, a world away from the chest pains, sore throats, broken bones and other physical complaints that are addressed in the examining rooms. But although he is not in sight, he is almost always there, often an hour before the Center’s official opening at 9 am. And his actions shape virtually every aspect of the Center’s life except for doing handson direct care. Stover began in 1996 as the Finance Director. When he stepped up to the Executive Director position, he took the finance responsibilities with him, combining the two jobs into one, a move that saved money for the facility at a time when it desperately needed to make changes to balance its budget. Monty has a background in business, data processing and auditing. Before coming to Block Island, he worked for Blue Cross/Blue Shield in Pennsylvania for thirteen years. Here he has applied the knowledge gained in that position, streamlining the billing process by outsourcing it and providing financial oversight. “Fiscal oversight is a key aspect of the job,” Stover says. “Our cash flow is significantly less in the off season. We have to plan so we can pay bills effectively when revenue from fees is lower than in the summer. Fortunately our community
and our membership, newly organized in 2005, have responded generously with donations to help cash flow throughout the year.” Stover is the bridge between the staff and the Center’s board, translating the needs the staff identifies into undertakings financed through donations and Above: Dr. Paul Mann demonstrates some of the new grants. He has obtained xray technology available at the Block Island Medical funding from the Rhode Center. Left: Crystal Hauser and Linda Closter try out Island Foundation and the the new wheelchair lift. Champlin Foundations for Center projects. clarity and more depth than the old style For example, Linda Closter, RN, machine that used fluid to develop the mentioned to Monty that parts for the pictures. The digital X-rays have another original liquid-based X-ray system would advantage in coordinating patient care. soon become unavailable. He discussed They can be emailed to the mainland or buying a new digital X-ray system with the a CD can be burned for patients to carry board which adopted the project and began off themselves. As the dental segment is to raise funds. Stover then applied for a completed, Stover hopes to attract another Champlin Foundations grant and brought a dentist here, so that more hours of care request for money to the town. This winter will be available. Right now, dentist Dr. these efforts were realized when a grant Paul Trombly and orthodontist Dr. Robert from Champlin, probable capital funding Hayden utilize a two-chair suite. Stover from the town of New Shoreham, and has a verbal agreement from oral surgeon donations from the public enabled moving Robert Gilardetti to begin practicing here ahead with Phase I. The first installation as well. made digital medical X-rays and panoramic Stover also took on completion of the dental systems operational on February specialist rooms in the basement, as well as 9. A second phase enabling additional the planning and oversight of construction capabilities will likely occur ahead of for a wheelchair lift in the rear of the schedule over the next few months. building. The lift area also provides a back The pictures have zoom capability door and staircase to the basement offices, on an LCD monitor, yielding more
Confronting Alcoholism By Judy Tierney Dr. Robert Swift is an expert on alcoholism and addiction. As Associate Chief of Staff for Research at the Providence Veteran’s Medical Center, and a Professor in the Department of Psychiatry and Human Behavior at Brown University, he conducts both laboratory research and clinical trials into the causes and treatments of alcoholism and drug addiction. In his research, he has tested the effects of medications and the combined benefits of medication and counseling. Block Island Times reporter Judy Tierney spoke with Dr. Swift because of the widespread belief on this island that alcoholism is a leading health problem
here. The essence of that interview follows. Tierney: Many people here believe that alcoholism is more prevalent on Block Island than it is on the mainland. Do you think that could be an accurate perception, or might it be due to the microscope under which we notice everyone’s behavior in a small community? Swift: It is a problem on a lot of islands. I once got a call for help from someone on South Padre Island in Texas, which attracts a lot of tourists during spring break, but has a year-round Continued on next page
Robert Swift. MD
which allows the care providers to access their area of the building after regular hours and on weekends. In tandem with completion of the construction, Stover will continue to work on expanding specialist care at the center. These now include an acupuncturist, a chiropractor, a massage therapist, an optometrist, an ophthalmologist, a podiatrist and a psychologist. Among the many additional hats Stover wears are ones for real estate management and for social work. He oversees repairs on the doctors’ houses (buildings the town owns and allows the Medical Center to use), the Center-owned Thomas property, and the Medical Center itself. Stover also meets with patients who are unable to afford insurance or medical bills and works out an adjustment. This year, Stover says, may be a difficult one for people who are uninsured and, “We’re looking at ways we can be more compassionate.” Stover received some help to expand into his executive role through the center’s membership in the Rhode Island Health Care Center Association. The organization offers educational seminars, consultation, and strategic planning advice. He looks forward to steering the Block Island Medical Center through the coming years, to carry out plans that include researching and installing an electronic health record system, as well as building a new doctor’s house and increasing winter health visits. “We are very fortunate to have a medical staff who are highly skilled at both family medicine and urgent care. Administration of a medical center is complicated, but it is made easier with hard working staff, a dedicated board of directors, community volunteers and generous support from many sources.”
Page 2 BLOCK ISLAND TIMES March 7, 2009
Continued from previous page
population that is isolated off-season. There is not much to do during the summer season, which is their off-season, when it is hot and miserable. The overall prevalence, in figures from the World Health Association and the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, is that eight to ten per cent of the total human population has an alcohol dependency at some time during their lifetime; and at any point in time, four per cent are dependent. In the United States, that four per cent
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translates to eight million Americans. In surveys that have been conducted, 60% of individuals used alcohol during that year, and 50% in the last 30 days. 20 percent admit to heavy use. One would have to research alcohol use on the island to find out for sure whether the rate of dependency is higher on Block Island than the mainland, though. Tierney: What constitutes heavy use and how do you define dependency? In other words, how would someone recognize their own or a family member’s dependence on alcohol? Swift: For men, heavy use is five drinks at a time, and for women, four drinks at a
An article that appeared in the 1989 issue of the Providence Journal.
time, once a month. Dependency, as diagnosed by the American Psychiatric Association, has eight criteria, and the disease is diagnosed when a person meets three of the eight. However, here are four of the criteria that most people would be able to recognize: 1. A very high tolerance for alcohol, being able to drink a lot, particularly if your tolerance has gone up and it takes more to get “the buzz” than it used to. Take notice if you have a changing tolerance. And most people who aren’t dependent fall asleep if they have four or five drinks. 2. The presence of withdrawal symptoms. Even with a mild dependency, there are withdrawal symptoms if you don’t drink for a day. These include a sense of restlessness, feeling jittery and irritable, some difficulty sleeping. As the dependency deepens, the jitteriness progresses to the shakes, and sleeping is more difficult. With heavy dependence, not drinking leads to stupor and delirium tremens, which can include hallucinations or confusion. 3. A preoccupation with alcohol. If you think about your
next drink while you are working and doing other things, if you can’t wait for 5 pm when you get off work and head right out to drink, that is a preoccupation with alcohol. 4. You begin to give up your obligations because of alcohol. With a heavy dependency, the alcohol becomes more important than other things. Your dependency is more severe if your job suffers, such as losing days of work because of a hangover. It is also more severe when your relationships suffer and/or your behavior indicates you have lost control. For instance, if your doctor says you have a medical condition that indicates you should not drink, but you continue anyway. Or, you drink knowing you have to drive home, but don’t care. Tierney: What is available in the way of treatment? Many of us are familiar with Alcoholics Anonymous, but not other treatments. Swift: The new thinking about alcoholism and other addictions is that it is a disease that involves the brain. In that respect it is not different from other diseases. A comparison can be made to cholesterol or high blood pressure, which have both psychological and biological components. The biological one is that those are inherited tendencies; the psychological is that they are also influenced by diet and exercise. The best treatment is two–pronged: modify diet and exercise, and take medicine. Alcoholism and addiction also have a biological component. If you drink for a long period of time, your brain changes. It becomes dependent on the substance. Tierney: I once attended a seminar on addictions in my son’s high school. We were told that young people, teenagers, develop addictions in just a few months. Is this accurate? Swift: Young kids are sensitive to becoming dependent easily. Take smoking, for example. Five cigarettes a day are enough to cause dependency in young people. Adults would need more. Tierney: Let’s talk more about how the new thinking about addiction and its effect on the brain brought about new treatments. Swift: Recently we’ve been trying to use medications to treat the changes brought about in the addicted brain. Traditionally, treatments such as counseling and Alcoholics Anonymous try to change behavior. This works for some people. I once saw someone in treatment whose daughter said, “Daddy, I can’t love you when you are drinking.” It was enough to make him change. Continued on next page
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Founded 1970 Founding Publisher: Dan Rattiner 1970- 1982 Founding Editor: Margaret Cabell Self 1970- 1982 Publishers Peter and Shirley Wood 1982 - 1997 Jeffrey McDonough 1997 - 1999 Bruce and Peggy Montgomery 1999 - 2006 Fraser and Betty Lang 2006 - present The Block Island Times is a member of the New England Press Association, The Rhode Island Press Association, The Block Island Chamber of Commerce, and the Westerly Pawcatuck Chamber of Commerce. It is printed on 100% recycled paper by TCI Press of Seekonk, Mass, and distibuted by Special Delivery, Inc.
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Some people can respond to AA and counseling, but others can’t. We now have four medications approved by the Food and Drug Administration: naltrexone, vivitral, camprol(acomposate) and Antibuse (disulfurim). Naltrexone is an opiate blocker which is taken orally in pill form and lasts 24 hours. The action of alcohol that gives people a ‘high’ is the release of endorphins in the brain that act like opiates. The endorphins are the reason you feel good when you drink. If you block the endorphins, you don’t get the pleasure. Tierney: Does it block everyday pleasure or joy also? Swift: No, it doesn’t block the other natural release of endorphins, just artificial highs. It blocks the endorphins released from gambling and to some extent, those from smoking also. Vivitral is a once-a-month, injectable form of naltrexone. This is good for people who don’t like taking pills. Campral works on a neurotransmitter called glutamate. Alcohol acts as a sedative on the brain, and with high doses, the brain adapts to the sedative effect by producing extra glutamate to counteract it. When this tolerance occurs, if the alcohol is stopped, there is too much glutamate, which leads to the jitters, anxiety, and lack of sleep. Campral pills tone down the glutamate. It can be used in tandem with Naltrexone. The fourth medication is Antibuse or Disulfiram, which is the oldest of these medicines. Antibuse alters the way the liver metabolizes alcohol. The alcohol becomes acetaldehyde, a first cousin to formaldehyde, and is toxic. Drinking
March 7, 2009 BLOCK ISLAND TIMES Page 3 alcohol while taking Antibuse results in illness and can even lead to death. Antibuse protects people from impulsive drinking. But to take it, you need to be determined not to drink. The costs of all these FDA approved medications are covered by insurance. Naltrexone is available now in generic form. Tierney: Can people return to drinking socially once they have overcome a dependency? Swift: For the vast majority of people, once they develop a dependency they cannot go back. There’s a good chance if they do go back to it, they will develop the dependency again. Once the brain is exposed to high concentrations of alcohol, it changes. The analogy to fried eggs is often used as an example: once a raw egg is cooked, it is changed and can’t become a raw egg again. Some people who had a mild dependency might be able to if the situation is different. I knew someone once who had drunk heavily while in the Navy. When he was released, he no longer wanted to drink and stopped. Tierney: Where can people go to obtain help? Swift: The best treatment is both behavioral and biological, and they should address both. Behavioral can be addressed through counseling and/or AA. The biological side can be treated by seeing a physician. Keep in mind that people who drink may have other problems also, that are fueling the heavy drinking. They may be self-medicating depression, anxiety, or chronic pain. It is important that those issues get treated also.
ThingsChange...
Let yourself be silently drawn by the stronger pull of what you really love. ~ Rumi
Soul Food By Persephone Brown Think for a moment of a food from your past, one that makes you feel great after you eat it for no specific reason. Maybe it’s macaroni and cheese, a slowsimmered tomato sauce, ice cream cones or potato pancakes. Eating food like this, at times can be incredibly healing, even though your rational brain might not consider it highly nutritious. For years, my comfort food was soy “chicken” nuggets with biscuits, mashed potatoes and gravy. I couldn’t explain the craving, but every so often I would crave and prepare this meal, and when I did, I would enjoy every bite. It wasn’t until I was working with a mentor health counselor that I discovered the root of this craving. I grew up with divorced parents and every night I spent with my father we would go out to eat. We had about four places in our rotation and I had specific meals that I would always order at each place. About twice a year we would eat at home, and when we did, we would cook together. What did we make? Weaver’s chicken and Bisquick biscuits. Making this connection between my craving for the “chicken” and my relationship with my father was a beautiful thing. I decided that each time I would have this craving I would also call my father to say hello. Consequently, since doing this I have not craved this meal. Food has the power to impact us on a level deeper than just our physical
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well-being. What we eat can reconnect us to precious memories, like childhood playtimes, first dates, holidays, our grandmother’s cooking or our country of ancestry. Our bodies remember foods from the past on an emotional and cellular level. Eating this food connects us to our roots and has nurturing effects that go far beyond the food’s biochemical make-up. Acknowledging what different foods mean to us is an important part of cultivating a good relationship with food. At a time when we celebrate lovers and relationships, it’s important to notice that we each have a relationship with food— and that this relationship is often far from loving. Many of us restrict food, attempting to control our weight. We often abuse food, substituting it for emotional wellbeing. Others ignore food, swallowing it whole before we’ve even tasted it. What would your life be like if you treated food and your body as you would treat your beloved? With gentleness, playfulness, communication, honesty, respect and love? The next time you eat your soul food, do so with awareness and without guilt, and enjoy all the healing and nourishment it brings you. Island resident Persephone Brown is a health counselor with certifications from the Institute of Integrative Nutrition, Teachers College of Columbia University and the American Association of Drugless Practitioners.
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401-466-3161
Available at: www.blockislandyoga.com or at weekly yoga classes. For schedule see our website or the calendar in the Block Island Times.
Page 4 BLOCK ISLAND TIMES March 7, 2009
By Judy Tierney Alcohol expert Robert Swift and psychotherapist Bertram Gibbes, who practices at the Block Island Medical Center, both identify the isolation of island life in the off-season as a factor that can lead to depression. Recognizing the hallmarks of depression in yourself, or in those you love, is the first important step to obtaining help. Most of us use the word “depression” to describe a transitory feeling of sadness or dissatisfaction with events in our lives, but clinical depression is a more persistent state. Clinical social worker Marilyn Kayser Asher, South County Mental Health Center’s Manager of Emergency Services, says that in clinical depression the feeling typically lasts all day and continues for at least two weeks. “Often there are appetite changes,” Asher says. “People either eat a lot less or a lot more. Some eat to compensate for anxiety.” Other hallmarks Asher notes are difficulty falling asleep, waking at night, (this occurs particularly if anxiety is also present), and early morning awakening. A sub-group of depressed people sleep more, she says. They might stay in bed all day, causing their families to feel like they are almost hibernating. The libido drops, interest level drops and concentration can be off. For instance, Asher says, “Typically you can sit and read a newspaper, but you can’t do it anymore; or you are watching a TV show, and five to ten minutes pass without you knowing what happened.” Often people might describe themselves as “bored,” particularly children, but Asher categorizes that feeling as ahedonia, a lack of pleasure. People might also say they feel numb or ‘blah.’ The National Institute of Mental Health website (www.nimh.nih.gov/ health/publications/depression/complete-
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Depression: Too Often Ignored publication.shtml) is a good resource for learning about depression. It lists the following signs and symptoms as markers of depression: • Persistent sad, anxious or “empty” feelings • Feelings of hopelessness and/or pessimism • Feelings of guilt, worthlessness and/or helplessness • Irritability, restlessness (pacing, wringing hands, repetitive negative phrases) • Loss of interest in activities or hobbies once pleasurable, including sex • Fatigue and decreased energy • Difficulty concentrating, remembering details and making decisions • Insomnia, early–morning wakefulness, or excessive sleeping • Overeating, or appetite loss (often accompanied by changes in weight) • Thoughts of suicide, suicide attempts • Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment. The importance of getting help for someone who makes suicidal statements or attempts suicide cannot be stressed enough. Although there is a widespread belief that those who threaten suicide do not kill themselves, the opposite is actually true. People who threaten suicide or have made suicide attempts in the past are more likely to kill themselves, Asher says. She notes that wanting to go to sleep and not wake up so as not to face the world, is a form of passive suicidal ideation that can be followed by an active plan. In addition to obtaining professional help, family members should ascertain whether the depressed person has access to weapons, or is hoarding medications. Those at higher risk of suicide include those with a history of past attempts or
gestures, substance abuse problems (this can lead to both accidental or purposeful overdoses), a lack of social supports (such as living alone, especially male widowers), prior psychiatric hospitalizations, and access to weapons. The following list from the Mayo Clinic’s website www.mayoclinic.com/ health/suicide will help you recognize whether someone you love is considering suicide. The person is: • talking about suicide, including making such statements as “I’m going to kill myself,” “I wish I was dead” or “I wish I hadn’t been born;” • Insomnia, early–morning wakefulness, or excessive sleeping; • securing the means to commit suicide, such as getting a gun or stockpiling pills; • withdrawing from social contact and wanting to be left alone; • undergoing dramatic mood swings, such as being emotionally high one day and deeply discouraged the next; • preoccupied with death, dying or violence; • feeling trapped or hopeless about a situation; • increasing use of alcohol or drugs; • changing normal routine, including eating or sleeping patterns; • engaging in risky or self-destructive behavior, such as using drugs or driving recklessly; • giving away belongings or getting affairs in order; • saying goodbye to people as if they won’t be seen again; • developing personality changes, such as becoming very outgoing after being shy. Never leave a suicidal person alone, even alone in a room. Being there not only prevents impulsive destructive actions, but it gives the person an opportunity to
reach out to someone and reconsider. It will be hard for them to fight their negative feelings, but you, not being depressed, can present a view of their world that has more potential. You can make the difference between life and death, after calling for help and waiting until it arrives. The bright side of depression is that it can be treated. There is an array of medications that have been shown to alleviate depression, and several forms of psychotherapy have also proved effective. Usually, a combination of therapy and medication are recommended for treatment. However, antidepressants are not like penicillin, which starts wiping out bacteria the minute it enters your bloodstream. Antidepressants usually take two to four weeks to begin to work. Patients are still at risk for suicide during this period. Asher says, “One of the things to bear in mind is that everyone responds differently to different medications. Sometimes it requires a trial. Some medications work better for anxiety and depression, others with depression and obsessive compulsive symptoms. Everyone responds differently. Once the medication works to lift the patient’s mood, it is easier to engage them in cognitive therapy or psychotherapy. Today, people look at brief treatment, from four to twelve sessions, as more efficacious.” Block Islanders seeking treatment for depression can contact South County Mental Health Center at 401-364-7705 or 401-789-6744, or Dr. Bertrand Gibbes at 401-782-1667. South County Mental Health Center always has a clinician available for crisis intervention at the numbers listed above. At night people might reach an answering machine but should leave their name and number, and a clinician will return the call. The Center works with local police to help alleviate situations or accompany someone to safety.
“I’ve Lost My Health Insurance! What Do I Do Now?” By Jeff Sorensen With unemployment approaching 10% in Rhode Island, many people are faced with the terrifying prospect of, on top of losing their jobs, losing their health insurance coverage. While there is no shortage of laws and regulations pertaining to health insurance in Rhode Island, those laws focus on the accessibility of coverage and do little to address the issue of affordability. Unfortunately, even though coverage may be available, it is costly and may be out of reach for many newly unemployed people. What options are available if I find that I will soon be out of work? Will I lose my health insurance as well? If the terminated employee worked for a company of 20 or more employees, the employee has the option of continuing on the employer’s plan under COBRA. COBRA is the acronym for the Consolidated Omnibus Budget Reconciliation Act of 1985 that provides that qualified beneficiaries of a group health plan subject to a qualifying event, such as termination of employment, may stay on their existing group coverage for a period of 18 months. Premiums for the coverage are paid by the terminated employee and cannot exceed 102% of the actual premium paid by the company. The initial premium is due 45 days after
the election of COBRA coverage and includes all premiums due up to that date. Terminated employees can find themselves with a bill of several thousand dollars as an initial premium payment for family coverage. Subsequent premiums have a 30-day grace period from the date they are due. Employers are subject to substantial penalties from the IRS and Department of Labor for noncompliance with COBRA regulations. Coverage may be terminated if: • premiums are not paid before the expiration of the grace period; • the employer ceases to maintain group coverage; • the employee obtains other coverage unless it was obtained prior to the COBRA period or if the other coverage contains preexisting condition limitations or exclusions; • the employee becomes eligible for Medicare, unless it was obtained prior to the COBRA period. COBRA coverage is generally provided for a period of up to 18 months but in some circumstances the coverage can last up to 36 months. If the employer is not subject to COBRA regulations, then the terminated
employee’s coverage will end at the conclusion of the month of termination. Blue Cross and Blue Shield of Rhode Island offer a Direct Pay plan that can be purchased. Employees coming off a group health plan can convert to an individual Direct Pay plan without preexisting condition exclusions as long as they can show 63 days of continuous coverage. Blue Cross offers several different variations of its Healthmate plans including high deductible HSA-compatible options. HSA stands for Health Savings Account. The HSA is set up in conjunction with the high deductible health insurance plan. The HSA allows for pretax contributions that may be used to cover the deductible expenses of the health plan. People may be able to afford health insurance who would not be able to afford a traditional plan by combining a lower cost, high deductible plan with a tax advantaged HSA. If the gap in coverage is expected to be short, say less then 12 months, shortterm major medical plans are available from independent insurance brokers. These plans offer flexible options that can be used to keep premiums affordable. Such plans are easy to get; applications can be filled out online and certificates and identification cards can be e-mailed to you. Keep in mind, however, that these
types of plans do not cover preexisting conditions. If you have medical issues, you will probably be better off selecting COBRA coverage or, if COBRA is not available to you, converting to a Direct Pay plan when your group coverage ends. While coverage may be available, it may still be too costly. Certain people may be eligible for the State of Rhode Island RIte Care program. Blue Cross has a Premium Assistance Program available if you don’t qualify for certain government programs and if your income falls within its guidelines. Investigate your options carefully. Pay attention to deadlines associated with electing COBRA coverage and conversion policies, particularly if you have health conditions or take expensive prescription drugs. Jeffrey D. Sorensen, CLU, ChFC, RHU, REBC, CASL Lathrop Insurance Agency 85A Beach Street Westerly, RI 02891 (401)596-2525
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March 7, 2009 BLOCK ISLAND TIMES Page 5
Substance Abuse Treatment Partnership Phoenix Houses of New England and United Way 2-1-1 in Rhode Island launched Rapid Response Rhode Island, a threemonth initiative to increase access to substance abuse services for all Rhode Islanders and to address the needs of individuals for immediate screening. The program was announced by Patrick B. McEneaney, executive director, Phoenix Houses of New England, and Cristina Amedeo, director, United Way 2-1-1 in Rhode Island, at a press conference at United Way of Rhode Island in Providence. Effective immediately, individuals in need of alcohol or drug treatment can dial 2-1-1 and be connected to United Way 2-1-1 in Rhode Island. Information referral professionals will provide callers with contact information directing them to screening services. Individuals will receive an appointment for a substance abuse screening by a trained staff member within 24 hours of the call. Facilities throughout the state will alternate providing screening services so individuals may opt to wait longer than 24 hours in order to be seen at a more convenient location. Following screening, individuals will be referred to the agency best suited to meet their needs and will be assisted in making arrangements for treatment. For example, those in need of a mental health assess-
ment will be seen by Family Service of Rhode Island. “This initiative partnership will make Rhode Island a leader in the effort to improve access to substance abuse services for all individuals suffering from this disease,” said McEneaney. “Access to care has always been essential to recovery and taking that first step making that call to 2-1-1 is so important. This collaborative effort will have positive reverberations throughout the state for years to come.” Speaking at the press conference, Cristina Amedeo, director of United Way 2-1-1 in Rhode Island said, “We are proud to partner with Phoenix Houses of New England to make 2-1-1 accessible to the community they serve. This community includes people from all walks of life that could benefit from 2-1-1’s confidential, anonymous and nonjudgmental service.” Rapid Response Rhode Island will require no public financing and will be initially offered on a three-month trial basis. During that time staff members from Phoenix House and United Way 2-1-1 in Rhode Island, administered by Family Service of Rhode Island, will meet periodically to review and analyze the program in consultation with all partner agencies to consider extending the collaborative effort.
Rapid Response Rhode Island What?
An Innovative Partnership to Improve Access to Substance Abuse Treatment for All Rhode Islanders. Rapid Response Rhode Island ensures that individuals receive substance abuse screening within 24 hours of a request for service. Effective immediately, individuals in need of alcohol or drug treatment can dial 2-1-1 and be connected to United Way 2-1-1 in Rhode Island. Responders will provide callers with contact information directing them to screening services. Individuals will receive an appointment for a substance abuse screening by a trained staff member within 24 hours of the call. Facilities throughout the state will alternate providing screening services, so individuals at times may opt to wait longer than 24 hours in order to be seen at a more convenient location. Following screening, individuals will be referred to the agency best suited to meet their needs and will be assisted in making arrangements for treatment.
Who?
Participating Agencies: United Way 2-1-1 in Rhode Island Phoenix Houses of New England Caritas House CODAC Behavioral Healthcare Corkery House DATA (Drug and Alcohol Treatment Association) of Rhode Island Family Service of Rhode Island Gateway Healthcare/Tri-Hab The Kent Center for Human and Organizational Development The Providence Center Rhode Island Council on Alcoholism & Other Drug Dependence Rhode Island Family Life Center SSTAR of Rhode Island, Inc.
Why?
• One in four families nationally are affected by drug and alcohol abuse (American Journal of Public Health ) • Each year alcohol and drug problems cost numerous lives and as much as $300 billion. • Only 11 percent of the 23.6 million people who need treatment are able to receive it, leaving more than 21 million people nationwide without the treatment they so desperately need. (Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration) • A 2007 report stated that Rhode Island had the highest percentage of illicit drug use in the country, involving 11.2 percent of its citizens, and also found that Rhode Island is one of the worst states in terms of access to drug and alcohol treatment. (National Substance Abuse & Mental Health Services Administration)
Craig Stenning (right), Acting Director of the Rhode Island Department of Mental Health, Retardation and Hospitals. At left is Patrick B. McEneaney, Executive Director, Phoenix Houses of New England. “This initiative could not have come at a more opportune time,” said Craig S. Stenning, Acting Director of the Rhode Island Department of Mental Health, Retardation, and Hospitals. “I commend Phoenix House, United Way 2-1-1 in Rhode Island and the other partner agencies for stepping forward to address these challenges.” Rapid Response Rhode Island builds on the goals and objectives for rapid response developed by the University of Wisconsin-based national NIATx (Network for the Improvement of Addiction Treatment), and represents the first statewide service of its kind in the country. “I am delighted that Rhode Island providers have taken the NIATx ACTION Campaign concepts and joined together to make such a big step in improving access
to treatment. They have really stepped up to the plate and have created a model that we can share with other states and provider groups,” said Kimberly Johnson, ACTION Campaign Director, NIATx. Rapid Response Rhode Island represents a groundbreaking collaboration among an array of Rhode Island’s substance abuse treatment and behavioral health care agencies. Participating agencies include, but are not limited to: Caritas House, CODAC Behavioral Healthcare, Corkery House, DATA (Drug and Alcohol Treatment Association) of Rhode Island, Family Service of Rhode Island, Gateway Healthcare/Tri-Hab, The Kent Center for Human and Organizational See Partnership, Page 6
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Partnership
Continued from Page 5 Development, The Providence Center, the Rhode Island Council on Alcoholism & Other Drug Dependence, the Rhode Island Family Life Center, and SSTAR of Rhode Island, Inc. According to the Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration, each year alcohol and drug problems cost this country numerous lives and as much as $300 billion. Furthermore, only 11 percent of the 23.6 million people who need treatment are able to receive it, leaving more than 21 million people nationwide without the treatment they so desperately need. In Rhode Island the problem is particularly acute. A 2007 report released by the National Substance Abuse & Mental Health Services Administration stated that Rhode Island had the highest percentage of illicit drug use in the country, involving 11.2 percent of its citizens. The study also found that Rhode
www.blockislandtimes.com Island is one of the worst states in terms of access to drug and alcohol treatment. About United Way of Rhode Island United Way of Rhode Island has been working to improve the quality of life in Rhode Island communities for over 80 years. UWRI’s mission is to mobilize the caring power of the community to improve the lives of people in need and address the issues Rhode Islanders care most about. United Way’s goal is to create longlasting changes that prevent problems from happening in the first place. We believe that all Rhode Islanders deserve the opportunity to have a better life, as when any one of us succeeds, we all succeed. At United Way, we refer to this as advancing the common good. For more information, visit www.liveunitedri.org. About Phoenix Houses of New England Phoenix Houses of New England provides a broad array of substance abuse prevention and treatment services, safeguarding children, strengthening fami-
lies and communities, and enabling men, women and adolescents to overcome drug dependence and to start and maintain new, drug-free lives. Phoenix Houses of New England operates more than fortyfive programs in six states, serving more than 3,000 individuals annually in residential treatment centers for adolescents, comprehensive rehabilitation centers for adults, treatment programs for criminal justice offenders in prison and community settings, day and night outpatient programs, special programs for the dually diagnosed, and education programs for adolescents. Phoenix Houses of New England is affiliated with Phoenix House, the nation’s largest not-for-profit drug treatment and prevention organization, treating more than 6,000 individuals each day in Rhode Island, Connecticut, Maine, Massachusetts, New Hampshire, Vermont, California, Florida, New York and Texas. Phoenix House offers detoxification, residential treatment, outpatient services, education and prevention supported by state contracts and grants from foundations, corporations and individuals.
The Michigan Alcohol Screening Test (MAST), Revised This 22-question self-test may help you become aware of your use or abuse of alcohol. This test specifically focuses on alcohol use, and not on the use of other drugs. A separate test called ‘DAST’ focuses on non-alcohol drugs. The Mast Test is printed below to indicate the range of questions involved. In order to take the test and receive a score go to www.counsellingresource.com/quizzes/alcohol-mast/index.html. The questions refer to the past 12 months. Carefully read each statement and decide whether your answer is yes or no. Please give the best answer or the answer that is right most of the time.
1. Do you feel you are a normal drinker? (“normal” - drink as much or less than most other people)? o Yes o No
8. Has drinking ever created problems between you and a near relative or close friend? o Yes o No
2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening? o Yes o No
9. Has any family member or close friend gone to anyone for help about your drinking? o Yes o No
3. Does any near relative or close friend ever worry or complain about your drinking? o Yes o No 4. Can you stop drinking without difficulty after one or two drinks? o Yes o No 5. Do you ever feel guilty about your drinking? o Yes o No 6. Have you ever attended a meeting of Alcoholics Anonymous (AA)? o Yes o No 7. Have you ever gotten into physical fights when drinking? o Yes o No
10. Have you ever lost friends because of your drinking? o Yes o No 11. Have you ever gotten into trouble at work because of drinking? o Yes o No 12. Have you ever lost a job because of drinking? o Yes o No 13. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking? o Yes o No 14. Do you drink before noon fairly often? o Yes o No 15. Have you ever been told you have liver trouble such as cirrhosis? o Yes o No
16. After heavy drinking have you ever had delirium tremens (D.T.’s), severe shaking, visual or auditory (hearing) hallucinations? o Yes o No 17. Have you ever gone to anyone for help about your drinking? o Yes o No 18. Have you ever been hospitalized because of drinking? o Yes o No 19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward? o Yes o No 20. Have you ever gone to any doctor, social worker, clergyman or mental health clinic for help with any emotional problem in which drinking was part of the problem? o Yes o No 21. Have you been arrested more than once for driving under the influence of alcohol? o Yes o No 22. Have you ever been arrested, even for a few hours, because of other behavior while drinking? o Yes o No
About Scoring this Psychological Questionnaire This quiz is scored by allocating 1 point to each ‘yes’ answer -- except for questions 1 and 4, where 1 point is allocated for each ‘no’ answer -- and totalling the responses. (Please note that we have provided the current revised version of the MAST; the original MAST included 25 questions and used a more complex scoring method.) When your quiz is scored, one of 3 different information pages will appear to describe the results for scores in your range.
Kids and Dogs
Tips for Families Looking to Adopt a New Dog By Virginia Hanbridge Are you thinking about adopting a new family dog? Hundreds of people come to the Providence Animal Rescue League every year in search of the perfect match for their family. Over the years we have learned a few tips that will help you to pick the right furry family member. Living with a dog can be a wonderful and beneficial experience for children. Dogs can enhance their self-esteem, teach them responsibility and help them to learn empathy. However, children and dogs do not always automatically start off with a wonderful relationship. Parents must be willing to teach the dog and the child acceptable limits of behavior in order to make their interactions pleasant and safe. It is unrealistic to expect a child, regardless of age, to have sole responsibility for the care of a dog. Dogs need basic things like food, water and shelter, but they also need to be played with, exercised and trained on a consistent basis. Teaching a dog the rules of the house and helping him become a good companion is too overwhelming for a young child. While responsible teenagers may be up to the task, they may not be willing to spend an adequate amount of time with the dog, as their desire to be with their friends usually takes over at this age. If you’re adopting a dog “for the kids” you must be prepared and willing to be the dog’s primary caretaker. Once you have made the decision, here are some things to think about to help you select the right dog for your family. What age is best? Many people have a warm and fuzzy image of a puppy and a child growing up together. If you have a young child and are thinking of adopting a puppy (less than 1 year old), there are a few things you need to consider. Time and energy: Puppies require a lot of time, patience, training and supervision. They also require socialization in order to become well-adjusted adult dogs. This means they need to be taken places and exposed to new things and new people. If you have a young child who already requires a lot of care and time, you should ask yourself if you will have enough time to care for a puppy as well. Safety: Puppies, because they’re babies, are fragile creatures. A puppy may become frightened, or even injured, by a well-meaning, curious child who wants to constantly pick him up, hug him or explore his body by pulling on his tail or ears. Puppies also play pretty rough and tend to jump up on small children and knock them down. They have sharp teeth and claws with which they may inadvertently injure a small child. If you decide on a puppy, we recommend that all interactions between your child and puppy need to be closely supervised in order to minimize the chance of injuries. Consider adopting an adult dog – the advantages are many! Adult dogs require less time and attention once they’ve adjusted to your family and household routine, although you will still need to spend time helping your new dog with Continued on next page
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the transition to his new home. You can better gauge how hardy and tolerant an adult dog will be of a child’s enthusiasm and you can work with your local animal shelter to adopt a dog that has previously lived with children. As a general rule, if your child is under 6 years old, it’s best to adopt a dog that is over 2 years old. Although puppies can be a lot of fun, and it’s exciting and rewarding to help them grow into wonderful companions, they do require significantly more time to train and supervise than an adult dog.
Small dog? Big dog? What breed is best? Size: Very small breeds of dogs, such as toy poodles or chihuahuas, may not be good choices for a young child. These dogs are fragile and may become easily injured when around rambunctious children. They also tend to be more easily frightened by a lot of activity and noise. Frightened dogs may snap or bite in order to protect themselves. Larger dogs or sturdier small breeds, like pugs or beagles, are often better able to tolerate the activity, noise and rough play that are an inevitable part of living with children. Breed type: Some of the sporting breeds such as labradors and golden retriev-
March 7, 2009 BLOCK ISLAND TIMES Page 7 ers can make good pets for families with children. Breeds that have been selected for protective behavior, such as chows and rottweilers, are not usually recommended. It’s sometimes difficult for this type of dog to comfortably tolerate the many comings and goings of children and their friends who may be perceived as territorial intruders. Herding breeds, such as border collies and shepherds, are inclined to herd children, chasing and nipping at their heels. There are many mixed breeds at shelters and often these “mutts” are the perfect mix to make a great family dog. Temperament: While generalizations can be made about specific dog
breeds, it is just as important to consider a dog’s individual temperament. A dog’s personality is shaped by both past experiences and genetics. Take your time, talk to shelter staff and listen to their advice. It may take longer than you expected to find the right dog for your family but finding the perfect match is worth the wait! For more information about adopting a dog or cat at the Providence Animal Rescue League, please call 401-4211399 or visit www. parl.org.
BIVFA
Block Island Volunteers For Animals
Block Island Veterinary Service
The Offices of Lathrop Insurance
“We cover our entire community with great care.” Group Health Insurance offered through Blue Cross/ Blue Shield of RI and United Health Care.
Trapping - Neutering - Feral Cats - Pet adoption - Veterinarian Services (by appointment) - Annual Rabies Clinic
85A Beach Street, Westerly, RI 02891 401-596-2525 www.lathropinsurance.com
- Annual Tag Sale in May DoNATIoNS WelCoMe 466-5303 • PO Box 402
House calls available!
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Your local Health Center and Providers By appointment at the Block Island Medical Center
The Block Island Medical Center FAMILY CENTERED MEDICAL CARE
SURGICAL SERVICES
AL T N
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Robert S. Gilardetti, D.M.D., M.D. Oral and Maxillofacial Surgeon 401-789-9758
Dr. Paul Trombly DMD, DAAPM General Dentist
401-862-2713
Hands That Heal Practicing at the Block Island Medical Center since 1993 treating infants to seniors.
Crystal Hauser, L.M.T Massage Therapy
401-743-2497 Handicapped Accessible
Extended hours and occassional weekend hours. Emergency appointments available.
Well Child Care New diagnostic Annual Physicals equipment including GYN Exams high tech digital x-ray systems for Coordination With Specialists medical and dental. Lesion Removal Emergency Care Visiting Specialists Acupuncturist Chiropractor Dentist Massage Therapist Ophthalmologist
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Dr. James Hartigan, D.C. Chiropractor
Serving the Block Island Community at the Block Island Medical Center Call 508-620-1940 for an appointment
Newly renovated for easier handicapped accessibility.
The Block Island Medical Center
Medical Office: (401) 466-2974 Administrator: (401) 466-2125 Fax: (401) 466-5476
Janice S. Miller, MD PO Box 919 6 Payne Road Block Island, RI
Block Island Health Services, Inc. is a not-for-profit 501-(C)-3 corporation. The Block Island Medical Center is licensed in Rhode Island as an organized ambulatory care facility. Physicians are board certified family medicine practitioners
Page 8 BLOCK ISLAND TIMES March 7, 2009
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