THE 1014 HEALTH LINE ISSUE 14 Summer 2021 Protecting Firefighters & Their Families...FOR LIFE INSIDETrustee Message The Delta Variant- What You Need to Know Your Patient is A Fireighter Mental Health- Breaking the Stigma Newly Expanded Benefits in 2022 Photo by South Bay Fire
NEWLY BENEFITSEXPANDED
The Local 1014 Health Plan Board of Trustees is proud to present our Summer 2021 Edition of our quarterly newsletter, The Health Line. As we wrap up the summer of 2021, we are seeing a rise in cases of the Delta variant across the nation. While we are all looking to get back into a normal routine with children returning to school and adults to work, we must take precautions to ensure that we do not slide back on the progress we have made.
While we are all looking to get back into a normal routine with children returning to school and adults to work, we must take precautions to ensure that we do not slide back on the progress we have made.”
NEWLY BENEFITSEXPANDEDIN2022
The Local 1014 Health Plan now provides a $10,000 lifetime benefit for diagnosis, a $25,000 lifetime benefit for treatment and a $25,000 lifetime benefit for drug therapy for fertility treatments. These new lifetime maxes are in addition to a $3,000 lifetime allowance for testing.
BOARD OF TRUSTEES MESSAGE MESSAGETRUSTEESOFBOARD
The Local 1014 Healt h Trust is committed to ensuring that you have all the information necessary to make informed decision about your health care and vaccinations. We encourage all members and their families to speak to your doctor about the benefits of getting vaccinated. In this issue we have provided you with critical information that you need to know in order to take precautions against the Delta variant. We have also provided some helpful tips on keeping your vaccine card safe and accessible as we see more and more locations and destinations requiring proof of vaccination. Additionally, we have also provided information on some of our new upcoming benefits for 2022. We have also provided a perforated form for members to bring to your annual physical exam. The form is meant to assist healthcare providers in the evaluation, treatment, and ongoing observation of the health and wellness of TheFirefighters.ONLYhealth plan that is FOR FIREFIGHTERS BY FIREFIGHTERS, The Local 1014 Health Plan is tailored to meet the unique needs of our members and their families. We know that our members are at higher risk for disease like cancer than the general population. They also face daily exposure to COVID-19. That is why prevention and monitoring is key to keeping our members healthy. Thank you for continuing to place your trust in us as we strive to provide the best healthcare for our first responders who selflessly serve our communities each day.
The Local 1014 Health Plan has expanded its fertility benefits this year. We are committed to ensuring our members and their families have the resources they need to grow their families and enjoy the best life possible.
The Local 1014 Health Plan now covers both Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) for all member couples.
Unvaccinated people remain the greatest concern: Although breakthrough infections happen much less often than infections in unvaccinated people, individuals infected with the Delta variant, including fully vaccinated people with symptomatic breakthrough infections, can transmit it to others. CDC is continuing to assess data on whether fully vaccinated people with asymptomatic breakthrough infections can transmit. However, the greatest risk of transmission is among unvaccinated people who are much more likely to contract, and therefore transmit the virus. Fully vaccinated people with Delta variant breakthrough infections can spread the virus to others. However, vaccinated people appear to be infectious for a shorter period: Previous variants typically produced less virus in the body of infected fully vaccinated people (breakthrough infections) than in unvaccinated people. In contrast, the Delta variant seems to produce the same high amount of virus in both unvaccinated and fully vaccinated people. However, like other variants, the amount of virus produced by Delta breakthrough infections in fully vaccinated people also goes down faster than infections in unvaccinated people. This means fully vaccinated people are likely infectious for less time than unvaccinated people. We have expanded our out-of-network cap for COVID-19 testing from $200 to $2,000 so our members have increased access to the quickest most convenient testing for them and their families. Additionally, we have waived the members’ cost share, including copays, coinsurance, and deductibles, for diagnostic testing related to COVID-19, as well as for the in-network visit associated with COVID-19 testing whether it takes place at a doctor’s office or emergency department.
Continued Below is the most current information on the Delta variant from the Center for Disease Control (CDC).
ENHANCED COVID-19 TESTING BENEFITS BENEFITSTESTING
The Delta variant is more contagious: The Delta variant is highly contagious, more than 2x as contagious as previous variants.
GET YOUR VACCINATIONS, WEAR A MASK, WASH YOUR HANDS, AND PRACTICE SOCIAL DISTANCING. THE DELTA VARIANT –WHAT YOU NEED TO KNOW VARIANTDELTA
Some data suggest the Delta variant might cause more severe illness than previous strains in unvaccinated persons. In two different studies from Canada and Scotland, patients infected with the Delta variant were more likely to be hospitalized than patients infected with Alpha or the original virus strains.
In addition to our healthcare resources, we also encourage members to speak with our Labor/Management Peer Support Team. Use the QR code to contact the Peer Support Team today. We have resources for members, family members, kids and spouses.
•Don’t post your vaccination record on social media! Protect your personal information!
•Takerecord:aphoto of your card and save it on your mobile phone or email it to yourself.
•Keep your physical vaccination card somewhere safe at home.
In order to help you protect your records, we have provided some vaccination cardholders for you and your family. You should have received these cardholders in the mail last month. If you did not receive your cardholders or need extras please call 800-660-1014.
VACCINE CARD DID YOU GET YOUR VACCINE CARD HOLDERS?
HEALTHMENTAL
MENTAL BREAKINGHEALTH:THESTIGMA
•Don’t laminate the card until after your final dose! Remember booster shots may be needed in the future so laminating may not allow for future vaccine updates and is not
The Local 1014 Health Tr ust would like to remind you to take precautions and protect your COVID-19 vaccination card. Some destinations, cruise lines, and venues may require proof of vaccination so keeping your vaccination record accessible and protected is important.
The Local 1014 Health Plan is committed to ensuring that our members are healthy both physically and mentally as you and your families sacrifice to serve the residents of Los Angeles County. That is why we are committed to providing coverage up to 90% for in-network providers for out-patient and in-patient care for mental health and substance abuse
•Manyrecommended.companies are offering digital records of your vaccine. If you choose this option be sure the agency is reputable and will protect your personal information.
In addition to using the cardholder, please follow the guidelines below to protect your vaccination
•Finally, if you lose your card, you can obtain a new one from the clinic or agency that administered the vaccine. Your state health agency also has a record of your vaccination so you might be able to obtain a copy there as well.
Mentalprograms.health is the cornerstone for our overall health and wellness. Be sure to follow some simple tips to check-in with yourself and your family and ensure you are practicing self-care.
Photo by Bernie Deyo THIS HEALTH WITH YOU TO YOUR NEXT PHYSICAL EXAM
TAKE
GUIDE
A HEALTHCARE PROVIDER’S GUIDE TO FIREFIGHTER PHYSICALS
Firefighters routinely operate in harsh work Firefightersenvironmentswearmore than 70 pounds of Firefightersequipmentbreath compressed air Firefighters represent a distinct subset of the general population
It is meant to assist healthcare providers in the evaluation, treatment, and on going observation of the health and wellness of Firefighters. The recommendations in this document are supported by ongoing clinical research of Firefighters’ health and by the expertise of the providers caring for them. These recommenda tions are offered as assistance for healthcare providers making clinical decision regarding the medical fitness and/or treatment of Firefighters. They are not to take the place of your medically reasonable, appropriate and necessary medical evaluation of the Firefighter.
SELF CARE PRACTICE SELF CARE DAILY Feeling overwhelmed? Try some of these simple self-care practices to give yourself a break. HEALTH GUIDE YOUR PATIENT IS A FIREFIGHTERFIREFIGHTERSFACEUNIQUEOCCUPATIONALHEALTHRISKSDUETOTHEDEMANDSOFTHEIRJOB
Behavior health screening Colonoscopy or other appropriate colon cancer screening beginning at age 40. Annual PSA with digital rectal exam between 40-45. Sufficient information regarding the risk and benefits of screening and treatment should be discussed. Annual pap smear. Annual mammograms beginning at age 40. Discuss screening at an earlier age if there is a family history or any patient concern. Annual testicular exam and instruction about self-examination. Annual head to toe skin examination and appropriate dermatology follow-up. Urinalysis annually for microscopic hematuria. Screen for sleep apnea and consider sleep study as indicated.
PHYSICAL EXAM CHECKLIST RECOMMENDED YEARLY SCREENING BEHAVIORAL CARDIOVASCULARHEALTHHEALTH AND FITNESS LUNG SLEEPCANCERDISEASEDISORDERSMUSCULOSKELETAL
Firefighters are often first on the scene of an emergency and may be exposed to HIV, hepatitis (A, B and C), TB and other infectious Source:diseases.Firefighter Safety Through Advanced Research May 2017 Address underlying musculoskeletal issues. Assess for full range of motion, low back strength and flexibility as well as core muscle strength Refer as necessary for treatment Encourage flexibility and core strengthening exercises
Spirometry: Baseline and annual pulmonary function testing in those with a history of respiratory health problems and in healthy individuals; to include FEV1, FVC, and the absolute FEV1/FVC ratio. Chest x-ray: Baseline chest x-ray in those with any respiratory symptoms or disease and in healthy individuals. Repeat chest x-rays every 5 years or sooner if medically indicated. Assess sleep and use of sleep medications.
The high intensity and dynamic work environment of firefighting leads to a high incidence of musculoskeletal injuries. Low back injuries represent approximately 50% of all job-related musculoskeletal injuries among Firefighters. These include strains, sprains, and intervertebral disc injuries, often leading to significant morbidity with the possibility of permanent disability. Obesity and deconditioning are strong predictors of musculoskeletal injuries.
Chronic exposures to heat, smoke, and toxic flame retardants through inhalation, ingestion, and skin absorption put firefighters at risk for many cancers. The National Institute for Occupational Safety and Health (NIOSH) performed a multi-year study of nearly 30,000 Firefighters to better understand the potential link between firefighting and cancer.
In the line of duty, Firefighters are often exposed to carbon monoxide and other inhaled toxins, or irritants that may lead to acute respiratory issues such as hypoxemia or bronchoconstriction. Repeated exposure may cause chronic pulmonary disease and abnormal lung function. Changes in lung function and the development of lung disease may be detected with baseline and periodic assessment and should include the following tests.
The mental and physical stress of firefighting and repeated exposure to trauma can lead to depression, anxiety, acute stress reactions, post-traumatic stress, and suicidal ideation. Self-medication with alcohol and drugs can result in substance abuse disorders
QUALIFYING LIFE EVENTS INCLUDE:
INJURIES INFECTIOUS DISEASES
Sleep disorders are highly prevalent in Firefighters and include sleep apnea, insomnia, shift-work disorder, and restless leg syndromes. It is imperative to screen Firefighters for these disorders since they substantially increase the risks for motor vehicle accidents, cardiovascular disease, diabetes, depression, dementia, and anxiety in Firefighters.
Significant cardiovascular demands of firefighting lead to acute coronary events that account for 45% of deaths among on-duty firefighters, in contrast to 15% of all deaths occurring on conventional jobs. Myocardial infarction is the leading cause of death of Firefighters, and these events occur almost exclusively in susceptible Firefighters with underlying cardiovascular disease (CVD). It is therefore prudent to thoroughly screen for, and aggressively treat, all CVD risk factors, including diabetes, in this very high-risk group of patients.
Vitals: BP, HR, RR, Wt, Body Fat Percentage Multi-System PE: skin, mouth, thyroid, vascular, neurologic and musculoskeletal Labs: CMP, CBC, Lipid Panel, TSH, Urinalysis, HbA1c Testing: 12-lead EKG, eye exam, hearing test, oxygen saturation Family History: CVD, sudden cardiac death, diabetes and cancer Personal Health Behaviors: tobacco use, alcohol, exercise, dietary Ischemia is best evaluated by an imaging exercise stress test (nuclear or echocardiography) beginning at age 40 or earlier for clinical suspicion. Exercise stress testing without imaging is not recommended as it may fail to identify one-third of those who may need cardiac intervention (angioplasty or bypass surgery). Echocardiography is recommended once as a baseline to evaluate significant cardiac structural abnormalities, including LVH and HCM.
The Firefighters studied showed higher rates of certain types of cancer than the general U.S. population in digestive, oral, respiratory, and urinary cancers. Providers should be especially vigilant to conduct cancer screening efforts in these particular areas. The following cancer screening recommendations for Firefighters do exceed those of the USPSTF guidelines for the general population. It is because of our extensive clinical experiences dealing with Firefighter health issues that we are strongly advocating for these screening tests in this high-risk group. We rely on your medical judgment to prescribe the most appropriate screenings in this unique patient population.
Establish immunity by vaccination record review and/or titers and update vaccines including Tdap, MMR, HBV, and Varicella. Consider hepatitis A vaccine. Baseline and periodic screening for HIV, HBV, HCV and other communicable diseases. Provide annual influenza vaccine.
CONTACT INFORMATION: The Local 1014 Health Plan 3460 Fletcher Avenue El Monte, CA 91731 local1014medical.orgmedicalplan@local1014.org800-660-1014 Photo by Ken Morris LACoFD
