Westchester County January 2018 ebook

Healthcare news January 2018

Westchester County

HealthcareNewsMagazine.com

NEW YEAR NEW YO U

Healthy Eating Habits

Beat the Winter Blues

Set your Health & Fitness

Included in every issue:

Boomers & Beyond

Goals

Boomers &Beyond January 2018

Westchester County

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January, 2018

Healthcare News - Westchester

Healthcare News - Westchester January, 2018

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January, 2018

Healthcare News - Westchester

Morgan Stanley, Big Brothers Big Sisters of Family Services of Westchester Present…

Morgan Stanley partnered with Big Brothers Big Sisters of Family Services of Westchester to host The Really Big Show, a charitable fundraiser and variety show in the tradition of the Ed Sullivan Show. This great night of entertainment took place on November 4, 2017 at The Performing Arts Center at Purchase College.

Headlining this year’s event was actor and comedian, Jay Leno, with an additional guest performance by Broadway star, and two-time Tony Award nominee, Norm Lewis.

Joining Leno and Lewis were singers, songwriters, ensembles and more, with former New York Giants Running Back Tiki Barber, serving as emcee. At The Really Big Show, all artists exemplify the power of mentoring today’s youth for tomorrow’s success.

"The Really Big show is an unforgettable evening of music and entertainment that reminds all of us about the importance of community and how vital it is for us to give back. Our first show at the Capitol Theatre was an incredible success and we couldn't be more thrilled to be delivering such an exciting show at the Performing Arts Center in Purchase,” said Richard Franchella, Managing Director—Wealth Management and Manager of Morgan Stanley’s Central and Eastern Pennsylvania Complex.

Family Services of Westchester (FSW) is a non-profit organization operating in Westchester County, NY since 1954. With over 50 innovative programs, FSW provides mental health and social services that strengthen and support families, children, and individuals in every stage of the life cycle.

Big Brothers Big Sisters (BBBS) is a youth mentoring program operated under the umbrella of FSW. Since 1958, its mission has been to help children realize and reach their potential through professionally supported one-to-one mentoring relationships.

Operated under the Big/Little model, matching adult volunteers (Bigs) with children (Littles), meaningful and enduring relationships have proven to positively impact youth throughout their lives.

Nancy Sorbella, General Manager, Healthcare News and comedian, Jay Leno at The Really Big Show.

Richard Franchella, Managing Director— Morgan Stanley, creator/major sponsor of The Really Big Show.

ATTORNEYS AT LAW

Many Years of Experience Protecting the Legal Interests of the Elderly & Special Needs Populations Advising Families about:

• • • • • • • • •

Medicaid Asset Protection Planning Estate Planning & Administration Special Needs Home Care Long Term Care Health Care Proxies Powers of Attorney Guardianships See more information on page 12

Client Testimonials Ariel Rosenzveig is an exceptionally courteous, diligent and thorough eldercare lawyer. Sensitive to the task at hand and leaving no stone left unturned, he supported our family as he maneuvered through our family’s elder care and estate planning needs. I would highly recommend Ely J. Rosenzveig & Associates, PC, to family and friends.

– Briana E.

Navigating all the overwhelming details and complexities in my mother's case was handled with the utmost efficiency and sensitivity.

The expense and endless sharing of information and paperwork resulted in an outcome that is totally beneficial to my mother.

– Arlene L.

Westchester Financial Center 50 Main Street, Suite #1000 White Plains, NY 10606 Email: Info@ejrosenlaw.com

Tel: (914) 816-2900 www.ejrosenlaw.com

Attorney advertising • Prior results do not guarantee a similar outcome

ELDER LAW • TRUSTS & ESTATES • TAX ADVOCACY • MEDIATION • EMPLOYMENT LAW

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January, 2018

OUR VIEW

ADVERTISER INDEX Company

Burke Rehabilitation Hospital

Page

7

Business Card Directory

23

Keystone Financial Services

25

Resource Directory

26

28

ColumbiaDoctors MedWise

11

Rob’s Poultry Supplies & Chicks

17

Ely J. Rosenzveig & Associates, PC

5,12

Simone Development Companies

2

Tranquility Spa

3

The Wartburg

Westchester Community College

Westchester County Medical Society

Healthcare news

Healthcare News - Westchester

27

19

20, 21

845-534-7500 • (fax) 845-534-0055 Info@HealthcareNewspaper.com

PUBLISHER

Joseph P. Belsito

By Nancy Sorbella

GENERAL MANAGER

Here at Healthcare News we say “New Year, New View”. It is our way of looking at a healthy start to 2018 through a new lens. In this issue we share fresh ideas for living your healthiest best life here in Westchester. What worked for you last year? What didn’t? We think that starting the year off with goals is the perfect place to start. Change your routine and you will be pleasantly surprised at the results. Fight the winter blues with a restorative visit to your local spa. We have several favorites that are convenient and offer something for every age, budget and desire. Take advantage of all that your neighborhood has to offer; walk in a different direction, try a new exercise class, sample some of the amazing creative food choices that every town has to offer. Wind down from the frenetic pace of the holidays by taking stock of your life from the perspective of wellness.

There are so many small yet impactful ways to stay or get healthy. In this issue we encourage you to organize your office and paperwork so that you are prepared for tax season and feel better prepared to face each day.

Don’t procrastinate! As our columnist and procrastination coach, Dr. Christine Li, PhD. encourages us to take those little steps by not putting things off; she has proven to us that we feel better when we are decisive.

Columnist Carolyn Winuk, PT, SSF, TCR continues to inform and advise us on living with arthritis in part 2 of her informative column.

Every month we are grateful for you, your engagement, your feedback and your questions. Please stay in touch; let us know what matters to you most. We are committed to bringing you robust content, tips, trends and healthy news that you can actually use in this and every issue.

Contact us at info@healthcarenewspaper.com.

Visit Westchester Healthcare News on Facebook to get updates on local health and wellness

INSIDE

Joe@belsito.com

••• GENERAL MANAGER

Nancy Sorbella

Nancy@healthcarenewsmagazine.com

••• MARKETING DIRECTOR

Gregory W. Buff Greg@belsito.com

•••

MANAGING EDITOR

Cathryn Burak

Cathy@healthcarenewsmagazine.com

•••

SENIOR SALES CONSULTANT

Maureen Rafferty Linell MRLinell@charter.net

••• CIRCULATION

Michelle Belsito

Michelle@healthcarenewsmagazine.com

CORPORATE INFORMATION

Healthcare News - Westchester, New York edition Vol. 11 No. 1 - is published monthly, 12 times a year

by Belsito Communications, Inc., 1 Ardmore Street, New Windsor, NY 12553. Postage Paid at New Windsor, NY and additional mailing offices. Postmaster: Send address changes to Healthcare Newspaper, 1 Ardmore Street, New Windsor, NY, 12553. No financial responsibility is assumed by this newspaper to publish a display, classified, or legal ad or for typographical errors except of reprinting that part of the ad which was omitted or in error. Omissions or errors must be brought to the attention of the newspaper during the same month of publication.

845-534-7500 • (fax) 845-534-0055 Info@Belsito.com

Next Month in Healthcare News American Heart Month

“Go Red for Women”

Saving women’s lives and beating heart disease Happy and Healthy Valentine’s Day Healthy options for romance Couples massage at the spa African Heritage and Health Week

Really BIG Show Presented by Morgan Stanley, Big Brothers Big Sisters of Family Services of Westchester Page 4

Burke Rehabilitation Hospital Launches Outpatient Physician Practice Page 7

In Sickness and In Health Arthritic Joint Treatments

By Carolyn Winuk, PT, SSF, TCR Page 13

Monthly Book List Page 18

Tax Season and your Business MDR Administrative Services LLC

By Renee DeVincenzo Page 22

Burke Rehabilitation Hospital launches Outpatient Physician Practice Healthcare News - Westchester January, 2018

Physicians available to treat outpatients on the White Plains campus

Burke Rehabilitation Hospital has launched a new Outpatient Physician Practice on its White Plains campus (785 Mamaroneck Avenue), providing expanded services and offering the same qualified, compassionate care that Burke is known for. Patients will now be able to schedule appointments with board-certified Burke/Montefiore doctors for a variety medical conditions requiring physical rehabilitation in an outpatient setting.

“Burke is responding to the growing need for outpatient services by offering patients comprehensive medical evaluations and treatment with the same level of patient-centered, care that Burke has been providing for over a century,” said Jeffrey Menkes, Burke’s President and CEO. The Burke physician practice team will be comprised of doctors able to treat and manage complications related to stroke, spinal cord injury, brain injury, cardiac disease, pulmonary disease, orthopedic surgery, amputations, musculoskeletal disorders, chronic pain, dementia, arthritis and other debilitating conditions that do not need to be treated in a hospital.

“Burke is responding to the growing need for outpatient services by offering patients comprehensive medical evaluations and treatment with the same level of patientcentered, care that Burke has been providing for over a century.”

Jeffrey Menkes, Burke’s President and CEO

“Burke’s renowned outpatient physicians can work in coordination with Burke’s inpatient and outpatient treatment teams or a patient’s current physician to develop an individualized treatment plan to optimize recovery in the shortest time period possible,” added Menkes.

These physicians have expertise in a wide variety of specialties, including pain injections, EMG and other diagnostic testing, general physiatry,

NEED A REHABILITATION PHYSICIAN? Burke Will Get You Back to the Life You Love Introducing the New Outpatient Physician Practice at Burke If you’ve recently been discharged from the hospital or need ongoing care for a chronic medical condition, Burke’s outpattient physicians are here to help.

The new outpatient physician practice at Burke offe ers patients the same renowned rehabilitave care we hav ve been providing for more than a century.

Call (914) 597-2332 for more information or visit burke.org/physicianpractice.

Services include: • Acupuncture • Electromyagrams (EMG) • Facet Injections • Neurological Rehabilitation • Oncology Rehabilitation • Orthotics • Prosthetics • Spasticity Treatment

785 MAMARONECK AVE. BUILDING 8 W H ITE P L A I N S, N Y O N TH E B U R KE (888) 99-BURKE CAMPUS! W W W.BURKE.ORG

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interventional spine treatments, neuro-rehabilitation, oncological rehabilitation, orthopedic rehabilitation, prosthetics and orthotics and sports rehabilitation. The practice brings together these renowned physicians in one convenient setting, making it easier for patients to have access to world-class outpatient care close to home.

For more information about Burke’s outpatient physician practice, or to schedule an appointment with a physician, please call (914) 597-2332. To learn more, visit www.burke.org/physicianpractice.

Burke Rehabilitation Hospital is a not-forprofit, acute rehabilitation hospital in White Plains, NY. Founded in 1915 through an endowment from philanthropist John Masterson Burke, it is the only hospital in Westchester County dedicated solely to adult rehabilitation medicine. As of 2016, the hospital is now a part of the Montefiore Health System, Inc. Burke offers both inpatient and outpatient programs for those who have experienced a disabling illness, traumatic injury or surgery. For additional information, please visit burke.org.

New Year’s resolution PAGE 8

January, 2018

Healthcare News - Westchester

OK, so you’re an absolute fitness beginner who has little or no idea about the pleasures and pains of healthy, active living. However, if you feel it’s time to get off your behind and improve the state of your mind and body, it might be prudent to adopt some of the following healthy and active New Year’s resolution tips to enjoy a healthier lifestyle: • Eat more fruit & vegetable portions every day This is a simple yet highly effective New Year’s resolution that could really boost your day-to-day health. Try to eat the recommended portions of fruit and vegetables each day to keep your body energised with nutrients, vitamins and minerals.

Beginners

• Join a gym or health club – If you really want to fight the flab, joining a gym or health club could be ideal for burning fat and improving your body shape. With a variety of membership types available to suit all your needs, joining a gym has never been easier!

ideas for F I T N E S S

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Healthcare News - Westchester January, 2018

You may be a long-term health and fitness convert, but that doesn’t mean you can afford to rest on your laurels just yet! Even if you have the body of a supermodel or the stamina of a stallion, it could be well worth adopting some of the following New Year’s resolution tips if you really want to lead a fresh and varied lifestyle: • Find more time for relaxation – Fitness fanatics are all the same; they work so hard and exercise so long that sometimes they meet themselves coming back! However, if you really want to live a long and healthy life, make sure you don’t overdo it. Trying to squeeze as much out of each day is one thing but missing your sleep just so you can spend an extra hour at the gym is just plain silly. Resting from exercise is vital if you want to avoid illness so make sure you get some!

Fanatics

• Cut down on your daily salt intake – High salt consumption can lead to a variety of health problems, including raised blood pressure and heart disease.

As a result, there really is no need to make every meal taste like the Dead Sea. • Try a new sports activity – If you want to boost your fitness levels but feel the gym isn’t right for you, a new sports activity could provide a fun yet fit alternative. With clubs offering everything from karate classes through to skydiving tutorials, it could be time to get sporty and enjoy a healthier future!

• Curb your drinking habits – As all those festive hangovers may have hinted, heavy alcohol consumption can entail serious health consequences, with long-term implications including weight gain, depression, chronic sickness, and an empty wallet! While the occasional social drink is perfectly acceptable, it might be time to reassess things if you frequently binge drink. So curb your alcohol intaketoday and you may just save more than a little money in the process.

• Broaden your knowledge – While it’s important to maintain your physical fitness, it’s equally vital to exercise your mind if you want to enjoy a healthy and happy life. If you feel you don’t always maximise your brain power, why not take part in evening classes (or even further education) to broaden your knowledge and offer a work-out to those sleeping brain cells?

• Try an extreme sport – If you’re getting tired of the same old sporting activities, why not sign up for an extreme sport?

Whether skydiving, white water rafting or even attempting a desert marathon, extreme sports will make your life feel exciting and adventurous, while taking your fitness to another level.

• Spend more time with your family – Another way of boosting your mental wellbeing is to enjoy more family-friendly activities. Whether playing a board game, day tripping or cooking with the kids, a supportive family environment will make you appreciate the simple pleasures in life more readily.

So think twice before saying yes to that overtime and enjoy some quality family fun instead!

• Vary your stretches – Stretching for a sports or gym workout is essential in preventing serious injury, so try out a variety of stretches in the new year, to prepare all your muscles for physical exertion.

• Enjoy regular spa therapies – Treating your body after exercise is essential if you want to prevent injuries and feel fresh the morning after. So don’t skimp on your down-time, make spa therapy a regular habit this year!

• Use your fitness knowledge to support others – You may be a prime example of a healthy athlete but that doesn’t mean you shouldn’t support others who might not enjoy the same fitness benefits. Why not use your fitness knowledge to advise your friends and family members who are just starting out in the world of healthy living? They’ll certainly feel better for it, and so will you!

Source:www.realbuzz.com/

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January, 2018

Healthcare News - Westchester

National Winter Sports TBI Awareness Month

National Winter Sports TBI Awareness Month is a public health and awareness campaign for highlighting the dangers of traumatic brain injury and the importance for taking precautionary measures when engaging in winter sports like skating, tobogganing and skiing. TBI stands for Traumatic Brain Injury which is a common result of injuries that involve the head. Every year, there are approximately 1.7 million head injuries in the United States according to the American Physical Therapy Association. More importantly, about 52,000 people die every year due to TBI. It is commonly caused by falling or crashing into another person or objects while skiing or skating. Many of these accidents lead to head injuries like concussions and traumatic brain injury.

The awareness campaign exists because TBI is usually misdiagnosed which often causes complications or the death of the patient. Thus, it is important to spread knowledge of the symptoms among medical professionals and the public. These symptoms may be experienced immediately after the accident or days/weeks thereafter.

Purpose of National Winter Sports TBI Awareness Month

The Johnny O Foundation hopes that the National Winter Sports TBI Awareness Month will raise awareness of the health risks (specifically concussions and traumatic brain injuries) ordinary individuals and athletes face when they participate in winter sports. It also highlights sports safety and preventive measures for avoiding concussions and TBIs. The main goal of the public awareness campaign is to reduce* TBIs in the country.

It is the mission of the Johnny O Foundation to educate the American public regarding the seriousness of traumatic brain injuries, dementia and Alzheimer’s disease among the American population through strategic research initiatives and improved* public awareness for accomplishing their objectives. The Winter Sports TBI Awareness Month is only one among the numerous initiatives of the Johnny O Foundation.

Source:ConsumerHealthDigest.com

Healthcare News - Westchester January, 2018

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Special Tips on National Winter Sports TBI Awareness Month

Here are simple tips for preventing head injuries when participating in winter sports:

• Wear approved, properly fitted and well-maintained safety equipment like helmets

• Stipulate safety rules like no direct hits to the head or other dangerous play

• Encourage safe playing techniques and encourage individuals to strictly follow rules of play during winter sports activities It is also important to take immediate action in case of suspected concussion. Here are the steps that should be taken when a concussion is suspected during winter sports activities:

• The first step is to remove* the individual from play.

• Make sure that he/she is evaluated by an experienced medical care professional in the evaluation of concussions.

• Inform the family/friends of the individual regarding the possibility of a concussion and give them informative materials about concussions.

• Keep the individual out of play until he/she has been thoroughly evaluated by an experienced medical care professional and given permission to return to play.

Source:ConsumerHealthDigest.com

Who Advocates for Your Medical Benefits?

A couple of weeks ago, I read about a man Further, nothing is stopping an insurance company from who stayed with an employer because of his reques ng employers require employees to rely on the sole Human Resources Medical Benefits Advocate. representa on of the insurance company's representa ves to The advocate knew the ins and outs of the seek and appeal for coverage in exchange for a lower rate.

This is a flawed agreement. This creates an appeal medical benefits contracts the system with no outside oversight. I urge employers employees had with the medical Since star ng my to carefully review the agreements they are insurance provider and when prac ce in January 2012, entering and offering their employees. The only an employee was seeking I have recovered over way to avoid these types of clauses is to seek out­ medical care and needed the $1,000,000 per year in side representa on to review the contracts and insurance company to pay for it the advocate medical expenses that advocate for the rights of your employees. would assist ge!ng all of the paperwork together insurers tried to block from the necessary par es and ensured that bills covering or healthcare Nego a ng the medical coverage of employees were being paid. providers erroneously and ourselves cannot be something that the charged. government, employers or insurance companies Too often, employers are now relying on the are left to understand and discuss alone. The advocate provided by the insurance company to represent their employees. The issue with an employee of the insured must be protected. If a service is not covered the insured insurance company being the sole representative of the are the ones who are stuck with the bill and paying out of insured is the underlying conflict of interest in the posi on. pocket. As consumers of medical services and insurance policies The employee of the insurance company, has a duty to act we should be aware of ways to lower medical bills. within the best interest of the insurance company, instead of ac ng in the best interest of the insured. Therefore, coverage is being requested and denied by the same business en ty and the rights of all contrac ng par es are not truly represented.

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January, 2018

Healthcare News - Westchester

Westchester Financial Center 50 Main Street, Suite #1000 White Plains, NY 10606 Email: Info@ejrosenlaw.com

Tel: (914) 816-2900 www.ejrosenlaw.com

The law firm of Ely J. Rosenzveig & Associates, PC, achieves impressive results for clients in the areas of elder law, trusts and estates

Ely J. Rosenzveig and his son, Ariel, are proud to lead a respected elder law firm in White Plains serving families throughout the tri-state area.

However, the family feel extends past father and son. The law firm of Ely J. Rosenzveig & Associates, P.C treats every client like family.

“My dad and I are very involved in our clients’ lives, especially during difficult times,” Ariel Rosenzveig said. “We become close to them and we enjoy the relationships that we build. We value those relationships and are always attentive to our clients to help them with all of their needs. We take special pride in being there for our clients and their families through thick and thin.”

Ely J. Rosenzveig & Associates practices in all areas of elder law, including trust and estate planning, administration, and litigation, tax counsel, asset protection and special needs planning, Medicaid, Medicare, and Social Security disability benefits, guardianships, long term care planning, Medicaid spousal recovery claims, and Medicaid lien resolutions.

Father and son pride themselves on an unyielding commitment to the advocacy of their clients’ interests. Estate planning is one of the most important steps any person can take to make sure that their final property and health care wishes are honored, and that loved ones are provided for in their absence. A comprehensive estate plan can resolve a number of legal questions that arise whenever anyone dies.

The firm has achieved impressive results for clients on a host of Medicaid related issues, from getting Medicaid approvals for coverage of home care and institutional care benefits, to very accommodative resolutions of Medicaid spousal recovery claims, where the office of Medicaid aggressively pursues a claim for reimbursement for Medicaid benefits provided from the non-institutionalized (i.e., or “community”) spouse.

“Our firm has a thorough understanding of Medicaid and the experience to advocate aggressively and effectively for you and your family,” said Ely Rosenzveig, who has been an attorney for nearly thirty (30) years. “It is very rewarding work and we work tirelessly for our clients.”

Elder law is very important. Appropriate estate and asset-protection planning can help preserve assets, reduce taxes, and help individuals qualify for Medicaid.

As you or your loved one grows older, the quality of care you receive becomes increasingly important. At some point, it becomes necessary to make plans for the future to make sure that your needs and desires are met.

When this time comes, it is important to enlist the experience of Ely J. Rosenzveig & Associates, so the process of planning for the future is stress-free for your family.

This can be critical in the process of maintaining the well-being of you or your loved one.

At Ely J. Rosenzveig & Associates, father and son have the opportunity to help clients plan across the span of many years. Often, it leads to advising multiple generations of the family, which Ely and Ariel Rosenzveig find rewarding. Over the course of time, they help clients as their lives and needs change, from naming the guardians of their minor children in their Wills, to planning for retirement, to protecting assets when in need of a skilled nursing facility or home care.

Ely J. Rosenzveig & Associates builds a relationship with clients, which is built upon years of assisting them, often in difficult times in their lives, and helping them move beyond those times and provide them with peace of mind and financial security.

Our firm is certainly proud to build these types of relationships with families such as yours.

Attorney advertising • Prior results do not guarantee a similar outcome.

Healthcare News - Westchester January, 2018

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In Sickness and In Health Arthritic Joint Treatments Carolyn Winuk, PT, SSF, TCR

The pain and joint restriction associated with arthritis can greatly interfere with the ability to perform everyday tasks.

In fact, the drive to find relief, improve quality of life and normalize function can become an all-consuming mission.

But, controlling arthritis pain is not a “one size fits all” approach. Healthcare providers must consider many details in order to individualize treatment. The type of arthritis and the joint(s) involved, lifestyle, overall health and fitness levels, weight, age, profession, leisure activities and a host of other factors influence an arthritis sufferer’s plan of action. A pain management team may be comprised of multiple health, wellness and fitness professionals that could include primary care physicians, orthopedists, rheumatologists, physiatrists, osteopaths, physical and occupational therapists, nutritionists and dieticians, acupuncturists, massage therapists, nurses, mental health specialists, trainers, yoga and tai chi instructors, podiatrists, homeopaths and/or naturopaths.

In order to classify a type of arthritis, a healthcare provider may find it necessary to perform specialized diagnostic tests such as x-rays, blood work, MRI, CT scans or ultrasound. He or she may initiate pain management by discussing medication options to help lessen symptoms. Analgesics (pain killers) modify pain without reducing associated inflammation, and NSAIDS (nonsteroidal anti-inflammatory agents) reduce pain while also reducing inflammation. Many of these medications are available overthe-counter, such as acetaminophen and ibuprofen, but others may be classified as narcotics, and require a physician prescription. Corticosteroids, DMARDS (disease-modifying antirheumatic drugs) and biologics (genetically engineered

Part 2

drugs that have a more specific target in immune system modification) are classes of drugs most often used in the treatment of systemic, inflammatory arthritis. All medications will require instruction for safe usage, potential adverse reactions and contraindications.

In addition to medication, management of mild to moderate arthritis symptoms may include use of thermal relief (ice or heat) and/or topical counterirritants, which interfere with the perception of pain at the site of application; regular exercise to keep supporting musculature strong and flexible; weight loss to reduce pressure on affected joints; adaptive splinting and assistive devices to aid walking and/or activities of daily living; and massage, acupuncture, and physical and occupational therapy to reduce inflammation, restore joint range of motion and promote optimal functioning.

Unfortunately, not all arthritic joint pain is responsive to conservative therapies, and a more aggressive treatment approach may be necessary. Those not yet in need of surgery may opt for joint injection, either with substances used to lubricate and cushion the joint, or to reduce pain and inflammation. Arthrocentesis, which is the removal of synovial fluid from a joint, may be necessary to test for the presence of bacteria and/or to assist in diagnosis.

When all other viable options have been exhausted, surgical intervention may be necessary for pain relief and restoration of function. In some types of inflammatory joint conditions, such as rheumatoid arthritis, a synovectomy can help to reduce overgrowth of the synovium, or joint lining. This may be done via a minimally invasive arthroscopy, which can also be used to remove damaged

Carolyn Winuk, PT, SSF, TCR is a practicing physical therapist, an ISSA certified Specialist in Senior Fitness and a Tai Chi for Rehabilitation instructor. An active member of the American Physical Therapy Association, Ms. Winuk is currently pursuing her doctorate in physical therapy.

Since moving to Mahopac in 1998, Ms. Winuk has served on the Board of Trustees of the Mahopac Public Library, and has been a member of the Mahopac Central School District’s Health and Wellness Council for over a decade. The former owner/founder of Moms In Motion Physical Therapy, PC, a women’s health physical therapy practice, Ms. Winuk now devotes her time to providing physical therapy services for older adults in long term care and assisted living environments.

cartilage or to “clean up” bone fragments and joint surfaces. Joint replacement, if needed, can be partial or total. In a partial joint replacement, a singular, eroded compartment of the joint is replaced, while retaining intact portions.

Total joint arthroplasty involves completely replacing damaged joint surfaces with artificial components.

Choosing the right path to successfully manage arthritis symptoms requires a patient to be a proactive member of his or her own team. Fortunately, there are many effective treatment options available, and numerous healthcare specialists who can provide support and care along the way.

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January, 2018

Healthcare News - Westchester

Winter

Blues?

You’re Not Imagining Them When not enough light makes a difference.

Healthcare News - Westchester January, 2018

PAGE 15

Do you dread the winter? For a long time, people were considered a bit wacky if they insisted that the weather affected their moods. Then Norman Rosenthal, MD, in his 1993 book Winter Blues, explained the connection between depression and the darker days of winter. Following the publication of Winter Blues, the symptoms of Seasonal Affective Disorder (SAD) were taken more seriously. Today, approved treatments for SAD (medication, therapy, and light) are often warranted, although SAD is generally a time-limited condition.

Answer the following questions to see if you have the symptoms Dr. Rosenthal ascribes to SAD. Do you— • Have less energy than usual?

• Feel less productive or creative?

• Need more sleep?

• Feel down or depressed?

• Have less control over your appetite?

So what causes SAD symptoms? Dr. Preston explains, the amount of bright light entering the eye plays a role in regulating mood and can cause mania. So it makes sense that less sunlight entering the eye may increase depression symptoms.

Thus, it is important to keep sunlight steady year round. But how is this possible when it may be really dark in the winter where you live, and quite sunny in the summer? The good news is that it is possible to decrease SAD symptoms.

It just takes having a plan before the days get really dark.

Diet and exercise make a difference A solution is to watch your diet carefully and make sure you get exercise in the morning when the light is better.

It is tempting to use junk food and caffeine to get out of the afternoon slump. And it makes sense that you have no desire to exercise when there is no sun.

Eat a protein-rich breakfast. Take a multivitamin that is rich in B vitamins. Have a snack ready to eat as soon as you feel your energy decrease. Opt for a natural (not too much sugar) protein bar. While it’s not nearly as tasty as a candy bar or a donut, you will be amazed how it helps your mood.

More positive steps to take Diet is just the first step to combating SAD symptoms, however. It’s also important to know what you say, think, and do when your mood begins to darken. In this way, you can treat the depression before it becomes really serious.

Here are some suggestions: • Take a walk in the morning when it’s brighter outside. Get someone to go with you.

• Don’t take a coffee or sugar break when you feel down. Instead, break for a walk and eat an apple.

• Eat really spicy, low-carb foods for lunch. Doing so will increase endorphins.

• Take a fun class, or meet friends during your tough hours.

• Go to a bright gym after work. If you don’t work outside the home, make sure to stay busy throughout the day.

• Think of what you love to do, then do just that to counteract SAD symptoms.

This can be singing, meeting a friend at a cheerful cafe, or going to a light-hearted movie.

• Create a bright living space and work space with full spectrum lights, bright colors, and plants.

• Teach your family and friends exactly what to do when you “get down.”

• Talk with your employer about SAD. Request an office with a window, if feasible.

SAD symptoms are real and need to be taken seriously. If SAD symptoms are not addressed, the depression can become much worse and you may have to go to the hospital. Anytime suicide is a risk, action needs to be taken by yourself, your friends and family, and especially, your health-care professionals. Don’t wait until your SAD symptoms get worse. Take care of them before it gets really dark and dreary.

Source://www.bphope.com/

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January, 2018

Healthcare News - Westchester

Winter Blues?

Try these 10 food tips to help ease symptoms alter your diet, improve your mood Seasonal affective disorder (SAD) is a type of depression that’s believed to be caused by the changing seasons.

Typically, symptoms begin to worsen around fall and peak during the winter months. Symptoms of SAD are similar to other forms of depression, including feelings of hopelessness, lack of concentration, social withdrawal, and fatigue.

Treatments for SAD include medication, talk therapy, exercise, and eating a healthy diet. Use our moodboosting recipes and meal ideas to help you fight off SAD with your fork.

3. Berries Keep berries in your bag to combat stress when it hits. Blueberries, raspberries, and strawberries may help prevent the release of cortisol, a hormone produced by the adrenal gland. During stressful situations, cortisol heads toward your hippocampus, a major portion of the brain that provides emotional responses.

1. Lean proteins Besides being high in omega-3s, salmon is a great source of lean proteins. Lean proteins carry plenty of amino acids, which may positively affect your mood. Lean proteins are also a great source of energy, which is something you’ll need to help beat fatigue.

7. Vitamin D Vitamin D is known as the “sunshine vitamin” because your body can make it by using cholesterol and absorbing natural sunshine. Your mood may improve with as little as 10 minutes of sun exposure. This is why light therapy is an important treatment for SAD. You can also get vitamin D in supplement form.

2. Omega-3 fatty acids Omega-3 fatty acids have been praised for their health benefits, including possibly influencing your mood. Sources that contain the highest levels of omega-3 fatty acids include flax seeds, walnuts, and salmon.

4. Limit sugar intake If you start looking at the ingredients of food labels, you’ll notice various forms of sugar. They’ll appear as syrups or words that end in “-ose.” Sugar may give you a little happy boost at first, but the crash after a sugar high can easily make you feel worse than before.

9. Turkey Turkey contains the amino acid tryptophan and melatonin, which are the calming and relaxing chemicals that make you tired after Thanksgiving dinner. Tapping into turkey’s calming powers is a great, natural way to help your body cut through stressful situations.

Source:www.healthline.com

8. Dark chocolate Chocolate has always been a tasty and good way to self-medicate through down times. Dark chocolate has high levels of polyphenols --- a type of antioxidant. When you’re feeling down, pick up a bar with the highest cocoa content you can find.

6. Vitamin B-12 Like folic acid, low levels of vitamin B-12 in the blood are associated with depression. There are lots of tasty ways to fit it into your diet. Food sources of vitamin B12 include lean beef, clams, oysters, crab, wild salmon, eggs, cottage cheese, yogurt, milk, and fortified cereals.

5. Folic acid Some research on folic acid’s effect on the brain has given insight into how it can boost your mood. You can get high amounts of folic acid in leafy greens, oatmeal, sunflower seeds, oranges, fortified cereals, lentils, black-eyed peas, and soybeans.

10. Bananas Like turkey, bananas contain tryptophan.

Besides that, the carbohydrates from natural sugars and potassium in bananas help fuel your brain. Magnesium, also found in bananas, may improve sleep and reduce anxiety — two symptoms of seasonal depression.

PAGE 17

Healthcare News - Westchester January, 2018

Healthy Recipe

Honey Garlic Salmon

Honey Garlic Salmon Serves 6

Ingredients

2 tbsp honey 1 tbsp lemon (lime) juice 2 - 3 large garlic cloves, grated 1/2 tsp salt 1/2 tsp ground black pepper 6 x 3 oz each salmon fillets, skin on/off 1 - 2 tsp avocado oil 2 green onions, finely chopped

Directions

1. In a small bowl, whisk together honey, lemon/lime juice, garlic, salt and pepper. Place salmon fillets in a large resealable Ziploc bag and pour marinade over.

Squeeze as much air out as possible and seal the bag.

Gently move fillets around inside the bag to make sure they are all evenly coated. Place flesh side down and let marinate 15 minutes.

2. Preheat large non-stick skillet on low - medium heat and add oil, making sure it coats the bottom of the skillet evenly. Place salmon fillets flesh side down leaving enough space in between them. Cover with a lid and cook for 3 minutes. Remove the lid, cook another minute and flip over. Repeat: cover, cook for 3 minutes, remove the lid and cook for another minute. Sprinkle with green onions.

Source:ifoodreal.com/

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PAGE 18

January, 2018

Healthcare News - Westchester

Reading is exercise for your brain: Our January Book List for Healthcare News Sisters First: Stories from our wild and wonderful life Jenna Bush Hager & Barbara Pierce Bush A charming personal tour of the behind-the-scenes life of former first daughters

A Connecticut Christmas: Celebrating the Holiday in Classic New England Style Caryn B. Davis & Eric D. Lehman Beautiful visual and narrative documentation of classic Christmas in this Yankee state.

Fifty Years of 60 Minutes Jeff Fager An inside look at the venerable, ground-breaking TV program that has shaped and chronicled the most memorable moments of the past 50 years

Hidden History of Connecticut Wilson H. Faude A must-have for any Connecticut resident; full of interesting history of people and places in the Nutmeg State.

Promise Me, Dad Joe Biden A moving memoir that inspires hope, confronts hardship, and affirms purpose for the Biden family and all of us.

all in good taste Kate Spade All you need to do to be a modern American tastemaker, a new classic.

America: The Cookbook Gabrielle Langholtz A guide to the diverse and creative food and culture in the 50 states of America.

Celebrate Everything: Fun ideas to bring your parties to life Darcy Miller Casual, chic, fun, easy, DIY tips for making every party fun for all ages. photos provided

Healthcare News - Westchester January, 2018

PAGE 19

Doctors of Distinction Awards recognize WMCHealth Director of Surgery Rifat Latifi, MD, FACS for Global Health Efforts

While many physicians travel around the globe to treat patients in underdeveloped nations, few like Rifat Latifi, MD, FACS, Director of the Department Surgery and Chief of Trauma and General Surgery at Westchester Medical Center Health Network (WMCHealth), can say they are responsible for bringing advanced medicine to those countries in a more permanent form.

Dr. Latifi was recently honored by the Westchester County Business Journal with a Doctors of Distinction award in the No Land Too Far category, recognizing his efforts to bring advanced medicine to people around the world.

Dr. Latifi has spent the past 17 years building a telemedicine network in developing nations. Telemedicine allows physicians to examine patients and consult with other healthcare providers virtually, making long distance treatment possible. In addition, the telemedicine network is used for healthcare system development and education of healthcare providers in some of the most remote sites of developing countries, by making expertise from around the world available through a virtual presence.

Since 2002, through his work with The International Virtual e-Hospital, an organization he helped found, Dr. Latifi has helped to create virtual telemedicine programs at 45 hospitals in three countries and is working to add more. Countries like Kosovo, Albania and Cabo Verde (West Africa) are already connected, and Dr. Latifi is currently working to establish a program in northern Vietnam. He has also done telemedicine projects in other parts of the world, including in the remote Amazon River region of Peru and Brazil, and in the Philippines.

Dr. Latifi, who resides in Katonah, joined Westchester Medical Center in January 2016.

Westchester Medical Center is the premier provider of advanced medical care in New York’s Hudson Valley region.

The flagship of the Westchester Medical Center Health Network, this 895-bed academic hospital located in Valhalla, New York, provides local residents with acute care services - Level I trauma and burn care, organ transplants and advanced neurovascular procedures and more found nowhere else in the region.

WestchesterMedicalCenter.org.

Rifat Latifi, MD, FACS

provided

ST TART YOUR N NEW CAREER IN HEALTHCA ARE NOW! PHARMACY TECHNICIAN N Students will learn medical terminollogy y, the role and responsibilities of a pharmacy technician, and interpreting prescriptions, and develop the skills needed to work under the supervision of a registered pharmacist.

January 27-April 15, Saturday & Su unday, 9:00 am-3:00 pm

Arcadian Shopping Center

Westchester Community Colleg ge OSSINING EXTENSION CENTE ER

Route 9, Ossining, NY 914-606-7400 sunywcc.edu/ossining

PAGE 20

January, 2018

Healthcare News - Westchester

Healthcare News - Westchester January, 2018

PAGE 21

PAGE 22

January, 2018

Healthcare News - Westchester

Tax Season and your Business

Be STRESS-FREE When Your Business Needs Are Met and Completed Renee DeVincenzo Outsourced Administrator/Owner www.mdracs.com

Have a System in Place For Your Office There will always come a time when you may ask yourself ” why wasn’t I more organized!”

When you’re running a business, it’s tempting to overlook the importance of keeping receipts and financial documents.

Staying on top of your record keeping is vital for filing tax returns and being able to prove they are correct in the event of a tax audit.

Well-organized records can help you track the progress of your business and prepare accurate financial statements.

Having the right system designed for your business will help element tension, stress and frustration. When your office is running smoothly you will be more efficient, productive and less time sitting behind a desk.

“Tips to Help Your Business Records Stay Organized” Arrange your receipts accordingly is the first step in organizing what will probably amount to a small pile of records.

It is important not discard your records after a year or two. The IRS advises businesses to keep records for up to seven years, or more in some cases.

Gross Receipts: These reflect your business’ income, on which its taxes are based. Save documents that show the amounts and the sources of the income.

Purchases: Items you buy and resell to customers; can include raw materials or components that are included in finished products.

Such purchases may be considered part of the cost of goods sold, and be eligible for a tax deduction.

Expenses: Expenses are the costs of running a business, from salaries to rent to travel, and most are tax deductible. In addition to records such as canceled checks and account statements, use petty cash slips or a petty cash log to record your small purchases.

Employment Records: It’s important to keep complete records of the wages, benefits and tips that have been paid to your employees with amounts and dates. Keep the names, addresses and Social Security numbers of your employees, and their dates of employment. Hold on to employee copies of W-2 Forms that have been undeliverable and keep copies of employees’ income tax withholding allowance certificates.

Business Assets: Be sure to keep records of the cost of the asset and the sales tax, as well as costs for delivery, setup, training. When assets are sold, keep a description of the item, the price and date of sale, and any expenses pertaining to the sale-such as brokerage fees or advertising costs.

Travel: Keep records each time you make a payment-large or small-that involves a trip. Receipts for transportation, meals and lodging are a must. Keep a journal listing travel dates and destination and the reasons for the travel with a list of expenditures.

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PAGE 23

Healthcare News - Westchester January, 2018

Business Card Directory Angela DeAngellis President—Founder Info@Angelfacespa.com A mind-body-spirit approach to health and healing.

Somesh N. Kaushik, ND, BAMS, MPH, E-RYT 500

angelfacespa.com 322 Underhill Avenue Yorktown Heights, NY 10598

914-245-1084

Ayurvedic and Naturopathic Physician

Angelface Day Spa Excellence in Esthetics

Yellow Monkey Village 792 Route 35 Cross River, NY 10518

914-875-9088 clinic (M. T, W) 646-670-6725 cell DrKaushik@DrKaushik.com www.DrKaushik.com

We offer a wide range of services for small businesses including: angelfacespa.com Database/Record Management

• Email Marketing/Management • Internet Research • Organizational & Marketing Support • Word Processing

browerandrussointeriordesign.com 914.946.5818

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Outsourced Administrator

Reiki Master Teacher-RMA Recreational Therapist Intuitive Reader Crystal Worker

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Professional Head Lice Removal Service Good Riddance!

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WANTED: Your Business Card Please call Nancy Sorbella at 845-534-7500 Ext. 219 for more information.

PAGE 24

January, 2018

Healthcare News - Westchester

Hey there,

Saunders gives back to some very special children

provided

The Saunders Trades and Technical High School Cosmetology Program went above and beyond to utilize their skills. These students brought a day full of joy to the students from Cerebral Palsy of Westchester. On Wednesday December 6th, 2017 Cerebral Palsy of Westchester brought young adults from the BRIDGE School Program to enjoy a day of haircuts, manicures and makeup.

The students had their hair blown out, nails done and some even got a wonderful hair cut from the students of Saunders High School. The students look forward to returning for another day of pampering.

The Saunders Trades and Technical High School Cosmetology Program is a three year program designed to teach the student all the requirements necessary to take both the written and practical exam at the end of the third year. In addition, a Co-Op program has been added to

the 12th grade curriculum to give students a hands-on experience.

Cerebral Palsy of Westchester was grateful to experience the skills that the students from Saunders High School had to offer as well as their genuine care they had for our participants. We look forward to a continued and expansive relationship!

For over 65 years, Cerebral Palsy of Westchester has been the leading non-profit organization in Westchester County, providing essential services to children and adults with all developmental disabilities including autism, neurological impairments, intellectual disabilities, epilepsy and cerebral palsy. It has always been our purpose to help people realize their goals, build brighter futures, and lead more independent lives as members of their community.

For more information about Cerebral Palsy of Westchester’s programs visit www.cpwestchester.org.

We hope you are enjoying this edition of

Healthcare News!

In 2018, we will be sending out

Healthy Tips & Topics, our digital newsletter.

Please send us your email address so that you won’t miss a thing and will be entered into our monthly drawing of healthy prizes!

We promise to not sell or share your email address and you may opt-out at any time.

Contact us at info@healthcarenewspaper.com.

PAGE 25

Healthcare News - Westchester January, 2018

2018 Limits for HSA Contributions, HDHP Minimum Deductibles, and HDHP Out-of-Pocket Maximums

By Andrew J. Cavaliere, CLTC

The 2018 limits on contribution and out-of-pocket spending amounts for Health Savings Accounts (HSAs) as well as for High-Deductible Health Plans (HDHPs) were set again to reflect the cost-of-living adjustment and rounding rules of Internal Revenue Code Section 223. A comparison chart of the 2017 and 2018 limits is shown below:

Contribution and Out-of-Pocket Limits for Health Savings Accounts and High-Deductible Health Plans 2018

2017

Change

HSA contribution limit (employer + employee)

Self-only: $3,450 Family: $6,900

Self-only: $3,400 Family: $6,750

Self-only: +$50 Family: +$150

HDHP minimum deductibles

Self-only: $1,350 Family: $2,700

Self-only: $1,300 Family: $2,600

Self-only: +$50 Family: +$100

HSA catch-up contributions (age 55 or older)*

HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums)

$1,000

Self-only: $6,650 Family: $13,300

$1,000

Self-only: $6,550 Family: $13,100

No change**

Self-only: +$100 Family: +$200

A s k A n

* Catch-up contributions can be made during the year by HSA-eligible participants who will turn 55 by year-end.

** Unlike other limits, the HSA catch-up contribution amount is not indexed; any increase would require statutory change.

Contributions for a given year may be made until the individual's federal tax return due date for that year, without extensions, in which case the HSA administrator must indicate that post-yearend contributions are attributed to the prior calendar year.

The 2018 annual HSA contribution limit for individuals with self-only HDHP coverage will be $3,450 (a $50 increase from 2017), and the 2018 limit for individuals with family HDHP coverage will be $6,900 (a $150 increase from 2017).

The 2018 minimum annual deductible for self-only HDHP coverage will be $1,350 (a $50 increase from 2017), and the 2018 minimum annual deductible for family HDHP coverage will be $2,700 (a $100 increase from 2017).

The 2018 limit on out-of-pocket expenses (including items such as deductibles, copayments, and coinsurance, but not premiums) for self-only HDHP coverage will be $6,650 (a $100 increase from 2017), and the 2018 out-of-pocket limit for family HDHP coverage will be $13,300 (a $200 increase from 2017).

An HSA is always in an individual’s name. There are no joint HSAs, even when the HSA is linked to a family coverage HDHP and subject to the higher family coverage contribution limit. Some employer plans include an “employee plus one” tier in addition to self-only and family coverage. An “employee plus one” such as an eligible employee and her dependent child, would fall under the HSA family coverage limits.

HSAs and coverage of adult children under age 26

While the Patient Protection and Affordable Care Act (PPACA) allows parents to add their adult children (up to age 26) to their health plans, the IRS has not changed its definition of a dependent for health savings accounts. This means that an employee whose 24-year-old child is covered on their HSA qualified high-deductible health plan is not eligible to use HSA funds to pay for medical bills for that 24-year-old. If account holders can't claim a child as a dependent on their tax returns, then they can't spend HSA dollars on services provided to that child.

According to the IRS definition, a dependent is a qualifying child (son, daughter, stepchild, sibling or stepsibling, or any descendant of these) who: • • • •

Has same principal place of abode as the employee for more than one-half of the taxable year.

Has not provided over one-half of their own support during the taxable year.

Is not yet age 19 (or not yet age 24 if a student) at the end of the tax year.

Is permanently and totally disabled.

For more information about High-Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs) please call Andrew J. Cavaliere, CLTC at 914-682-2190 or toll free at 877-676-9900. Andrew is certified in Long-Term Care (CLTC) from the Corporation for Long-Term Care Certification, Inc. Andrew is a member in good standing of the Million Dollar Round Table (MDRT), which is the premier Association of financial professionals nationally. Andrew’s offices are located at 50 Main Street, Suite 1000, White Plains, NY 10606 and at 263 Tresser Blvd, 9th Floor, Stamford, CT 06901.

E x p e r t

PAGE 26

January, 2018

Healthcare News - Westchester

Resource Directory

Chiropractors

Westchester Spinal Decompression Center Dr. Jonathan Donath, DC, MS 222 Westchester Ave. Suite 405 White Plains, NY 10604

914-421-1502

www.westchesterpainrelief.com

Nursing & Rehabilitation

VICTORIA HOME Skilled Nursing and Rehabilitation Person- Centered Care on a Riverview Estate Since 1916.

Entertainment

Victoria Home is a New York State Licensed Nursing Facility.

Please contact us for more information or to schedule a tour.

25 North Malcolm Street Ossining, New York 10562 (914) 941-2450 Fax: (914) 941-2962 www.victoriahome.org

A unique movie-going experience is coming this May. RIVERTOWNS SQUARE SAW MILL RIVER PKWY & LAWRENCE ST. 1 Livingstone Ave., Dobbs Ferry, NY 10522 914.348.7002 ipic.com

Hospitals

Burke Rehabilitation Hospital 785 Mamaroneck Ave. White Plains, NY 10605 914-597-2268

Life & Health Insurance

KEYSTONE FINANCIAL ADVISORS

Keystone Financial Advisors 50 Main Street, Suite 1000, White Plains, NY 10606 Tel: 914-682-2190 • Fax: 914-931-8400 Toll: 877-676-9900 www.Keystonefa.com • acavaliere@Keystonefa.com ANDREW J. CAVALIERE, CLTC Life Insurance Health Insurance Long-Term Care Insurance Long-Term Disability Insurance Guaranteed Fixed Annuities Medicare Supplements Life Settlements

Residential & Health Care Services • 24- Hour On-Site Nursing Services • Attending Physicians/ Medical Director • IV Therapy/ Wound care • Dental/ Podiatry • Mental Health/ Social Services • Registered Dietitian & Specialized Diets • Full Service Dining-Room • Housekeeping & Laundry Services • In-House Beauty Parlor • Therapeutic Recreation • Exercise Program/ Nursing Rehabilitation • Palliative & Comfort Care • Specialized Residence For Alzheimer’s & Dementia Care Rehabilitation Services • Physical/ Occupational & Speech Therapy • Short Term Stay Available • Surgical Recovery • Cardiac Recovery • Pulmonary Care • Orthopedic Recovery & Care • Neurological Recovery & Care • Medically Complex Care • Disease Management Education

All Listings are also available online at www.healthcarenewspaper.com.

Click on Resource Directory on the top right side. To include your business in our next edition call Nancy at 845-534-7500 ext. 219 or email Nancy@healthcarenewsmagazine.com

Westchester County Health Services

Health Insurance Access Program (NY State of Health) Free or low-cost health insurance for all children and teens under 19 years of age. he Westchester County Department of Health has 8 IPAs/Navigators available in 25 ocations throughout Westchester County and the Bronx. To schedule an appointment to meet with a Navigator or for more information about Program services, contact the Health Department at hnav@westchestergov.com or call (914) 995-6350, 9:00am - 5:00pm, Monday through Friday.

Healthy Mom, Healthy Baby By calling 2-1-1, pregnant women can get help to connect to prenatal care, apply for insurance coverage for prenatal care and receive care for themselves and their baby.

WIC Program Supplemental food, nutrition education and referrals for health care for eligible pregnant and breastfeeding women and for nfants and children to age five.

How to Apply Westchester County WIC Offices are located at the Health Department District Offices in Yonkers, and Port Chester. To find out more about the WIC Program or to schedule an appointment, contact one of the offices below.

Yonkers WIC Office 20 South Broadway, 2nd floor Yonkers, New York 10701 Phone: (914) 231-2510 Port Chester WIC Office 1 Gateway Plaza, 1st floor South Main Street Port Chester, NY 10573 Phone: (914) 813-7244

Complaint Bureau Call (914) 813-5000 for public health emergencies 24 hours a day; call for referrals and public health information weekdays between 9 a.m. and 4:30 p.m.