Health Care District looks to take on heroin epidemic

As opioid drug overdose deaths increase exponentially, the Health Care District of Palm Beach County — the taxpayer-supported safety net for medical services here — plans to partner up with first responders to help drug abusers in crisis.

Hypodermic needles mixed with cigarette butts and empty prescription bottles found in the trash at a cottage apartment rented by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

It’s a big first step for the district that already runs the Trauma Hawk air ambulance, Lakeside Medical Center in Belle Glade and primary care clinics and school nurses, among other services.

The opioid epidemic has been fueled by prescription pill abuse and the mixing of powerful synthetic opioids like fentanyl with heroin by traffickers and dealers to increase potency and profit.

The district this week applied for a $10 million state grant over five years from the Department of Children & Families that would allow it initially to provide services to addicts at their most vulnerable: right when they overdose and are taken to hospital emergency rooms.

The district will partner up with Southeast Florida Behavioral Health Network, the Palm Beach Sheriff’s Office, Palm Beach Fire-Rescue, as well as hospital emergency rooms.

The first stage of the plan is to get addicts in crisis who have been stabilized to an open bed at a local detox or drug recovery center.

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Darcy Davis, CEO of the Health Care District of Palm Beach County, says it is time to tackle the heroin epidemic.

The Health Care District is also not just focusing on poor and homeless drug abusers, aiming to help any community drug users who needs to navigate the drug rehabilitation and insurance industries to get treatment, as well as providing those without means an avenue for recovery.

But the district’s CEO Darcy Davis says the second phase of the plan will establish a “centralized receiving facility” that would not only provide treatment for addicts but also mental health services.

“We recognize the opioid crisis is significant and we need to act as quickly as possible to respond,” she said. “And you have to start somewhere. It’s a huge problem. We feel like we need to get involved.”

Read more about the Health Care District’s plans to expand into addiction services this weekend in the Palm Beach Post.

And read our coverage of the heroin epidemic by clicking here.

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Marketing over common sense? May be better to wait on flu shot

The marketing of the flu vaccine has become an almost year-round effort as drug store chains urge their customers to get a shot earlier and earlier.

But a story by CNN says that may not be the wisest thing to do to combat the flu.

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When should you get a flu shot? It may be better to wait despite retailers’ claims.

Some experts say marketing may be overtaking medical wisdom since it’s unclear how long the immunity imparted by the vaccine lasts, particularly in seniors.

An early flu shot is better than no flu shot at all, but the science is uncertain how long your immunity will last if you get the shot in late summer as opposed to early fall. Flu season generally peaks in mid-winter or beyond.

“If you’re over 65, don’t get the flu vaccine in September. Or August. It’s a marketing scheme,” said Laura Haynes, an immunologist at the University of Connecticut Center on Aging.

Tom Charland, founder and CEO of Merchant Medicine, said medical services on demand appeals to millennials but when it comes to late summer flu shots, “It’s a way to get people into the store to buy other things.”

Read the whole debate on the issue at CNN by clicking here.

Lawsuit contains new allegations of sexual assault by doctor

Another patient has come forward and accused an Orlando doctor forced to give up his license of sexual assault.

Dr. Gopal Basisht was profiled in The Palm Beach Post’s investigation on physicians accused of molesting their patients.

The Florida Department of Health in June accepted Basisht’s ermanent relinquishment of his license to practice medicine. The Post discovered, though, that it took nearly four years for the state to act after the initial complaint.

A new lawsuit filed by patient Lauren Kusner says Basisht committed sexual battery during an appointment in February. She says Basisht, a rheumatologist, told her to lay down and massaged her breasts and her genitals.

When a sobbing Kusner tried to leave the office,  Basisht put his arms around her and said, “I love you,” the lawsuit alleges.

Kusner’s attorney Adam Horowitz provided evidence that there have been more than a half dozen sexual assault complaints lodged by patients with law enforcement against Dr. Basisht

 

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It took four years from the time a patient said she was molested by Dr. Gopal Basisht to when he officially gave up his medical license in June.

The Health Department’s administrative accused Basisht of sexually assaulting two adult female patients at his rheumatology practice. Basisht denied any wrongdoing to an Orlando television station.

One of his alleged victims, Astrid Ebner, testified to the Board of Medicine that Basisht groped her genitals during an exam on June 5, 2012.

“What happened to me was absolutely atrocious,” she testified. “He was harming me physically and he was getting a kick out of it. … I know he would continue to do this if he has a chance.”

To read The Palm Beach Post’s full investigation on doctors accused of molesting their patients click here.

Jupiter mother fought rare leukemia in public eye

Nicole Rivera, a young Jupiter mother, made the struggle with a rare form a leukemia a platform to help others battling the deadly blood cancer.

By going public, Rivera gave a face to the financial hardship the disease causes families and the struggle minorities face to find suitable donors for a bone marrow transplants.

Rivera lost her own battle Saturday with the disease after a bone marrow transplant on Aug. 23 from her mother failed because it wasn’t a perfect match.

She was 28 and leaves behind her two sons, Liam, 4, and Logan, 2.

“She fought a hard battle for 10 years ,” her mother, Wanda Laracuente, said on Monday. “Ten years is long time to fight this disease, but she left me a piece of her. I have her boys, her two precious miracles.”

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Nicole Rivera, kisses her son Logan Nguyen, at their home in Jupiter. Rivera died on Saturday after a very public fight with leukemia. (Madeline Gray / The Palm Beach Post)

Barbara Abernathy, the CEO of Pediatric Oncology Support Team (POST) on the campus of St. Mary’s Medical Center, called Rivera a “brave ambassador” who showed keen interest in others battling with leukemia.

“By telling Nicole’s story, we were able to get that message out there about the impact this disease has on the family, both financially and emotionally,” she said.

In April 2015, as Rivera struggled to find a donor, she urged Hispanics to get tested.  Hispanics make up just 10 percent of the U.S. bone marrow donor list, compared to 61 percent of caucasian donors.

“They are afraid to get tested or they don’t have the knowledge that Hispanics donors are rare or that Hispanics do get sick like this,” she said.

Laracuente said that increasing bone marrow donors among Hispanics is difficult because of socioeconomic reasons. “A lot of them are misinformed, thinking if they are here illegally and joining the donor registry that is going to put them at risk at being deported,” she said.

POST will hold a bone marrow donor drive in Rivera’s name on Oct. 1 at Roger Dean Stadium in Jupiter. All is needed is a cheek swab to join the donor list. A blood test is not necessary.

Rivera came to the public eye in 2007 when The Palm Beach Post featured her in its “Season to Share” annual holiday campaign, which rallies assistance for struggling individuals and families.

When she was a teenager, Rivera was diagnosed with the Philadelphia chromosone associated with chronic myelogenous leukemia, a difficult  form of the disease to disease

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Nicole Rivera fought back leukemia when she was a teenager, but the lack of a suitable donor ended up costing her life.

Still, she beat back the cancer through chemotherapy and proved predictions wrong by giving birth to her two boys.

Her family, though, knew even after she was cancer free for five years, that without a full bone marrow transplant, the disease could always return for Rivera.

And it did in early 2015. At first her mother didn’t believe her daughter’s complaints of lethargy until blood tests confirmed that indeed the leukemia was back.

“I don’t know how many times a person has to be tested to prove that they should be here,” Laracuente said at the time.

“I don’t know how I’m going to help her fight. I told her, ‘You have two boys you have to fight for. You have to come back to them.’

Her mother did help her fight in the most personal way possible. After a public outreach to find a suitable donor for Rivera failed, it was Laracuente in August who became a donor but she was only a half-match.

“Because she was Hispanic she was not able to find a perfect match,” Abernathy said.

And the toll of the disease continues. Rivera’s family is struggling to bury her. “Her family is financially depleted from caring for her,” Abernathy said. “They don’t have the money for a proper service.”

She said people who want to donate to offset funeral costs can contact POST,  at 561-882-6336.

Services are set at 6 p.m. on Saturday Aycock-Riverside Funeral and Cremation Center in Jupiter.

Besides her children and mother, Rivera is survived by her grandmother Carmen Laracuente, five brothers and her longtime boyfriend and father of  her children, Ha Nguyen.

To join the national bone marrow donor register contact bethematch.org.

 

 

Bock receives international acclaim on guardianship front

As problems with guardianship of seniors citizens and incapacitated adults  make headlines, Palm Beach County’s Clerk & Comptroller Sharon R. Bock has been held out as an innovator in combating fraud in the arena.

Now Bock has gone international.

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Sharon R. Bock, Clerk & Comptroller for Palm Beach County, will receive an award in Germany for innovation in combating guardianship fraud.

The 4th World Congress on Adult Guardianship in Berlin, Germany to be held this weekend will recognize Bock for her Guardianship Fraud Program & Hotline.

“The three-day conference provides guardianship advocates from countries around the world a rare opportunity to share problems and solutions,” Bock’s office said in a news release.

“Organizers of this bi-annual, worldwide symposium encourage international exchange on the ideas, concepts and practices of the protection of vulnerable adults.”

Bock said the exploitation of our most vulnerable citizens is not only an issue in the United States.

“I have made it my mission to team up with leaders on a national and international level to strengthen guardianship laws,” she said.

Bock’s Division of Inspector General has audited and investigated more than 900 guardianship cases since the inception of the hotline in 2009, leading to the identification of more than $5.1 million in unsubstantiated disbursements, missing assets and fraud.

For more information about the Clerk’s Guardianship Fraud Program & Hotline, visit www.mypalmbeachclerk.com/fraud or call 561-355-FRAUD (561-355-3728).

 

Researchers: Five-second rule is a myth – or is it?

The “five-second rule” that states you can eat food after it fell briefly on the floor is a myth, researchers at Rutgers University say.

This study contradicts research done at Aston University in England two years ago that found the less time food spends on the floor, the less germs it gets.food-dropped

CBS New York reports that the Rutgers brainiacs  say they’ve “disproven” the notion that it’s OK to eat food that’s fallen on the floor, as long as you do it within five seconds.

Time is relative when it comes to eating that donut you just dropped in the parking lot.

What matters, Donald Schaffner, a food science professor at Rutgers, is the amount of moisture present, as well as the type of surface. Time does play a factor, but is just a part of the “can I still eat it” question.

He said the study may seem light-hearted but is worthwhile because the practice is so widespread.

According to Rutgers Today, the test objects were  watermelon, bread, bread and butter and gummy candy. They were dropped on four surfaces:  stainless steel, ceramic tile, wood and carpet – and four different foods.

Watermelon garnered the most contamination, while gummy candy had the least. Carpet also had the lowest bacteria transfer rate.

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Are you going to eat that? Is the five-second food on the floor rule a myth? Rutgers researchers say yes. (Photo courtesy of Creative Commons)

“Transfer of bacteria from surfaces to food appears to be affected most by moisture,” Schaffner said. “Bacteria don’t have legs, they move with the moisture, and the wetter the food, the higher the risk of transfer.”

Though, he did say food contact times usually result in the transfer of more bacteria from each surface to food.”

So the debate continues, but we all know you are going to eat that Oreo you just dropped on the office break room floor.

 

FAU spearheads effort to help intubated patients communicate

Every year, almost 800,000 patients in the United States are intubated with a tube inserted in their body to help them to breathe during hospitalization.

More than 50 percent of these patients are awake and alert, but they are unable to communicate with nurses, physicians and their loved ones save for scribbling on a piece of paper — not exactly conducive to a patient in an emergency medical situation.

Enter the tablet-based communication application called “Speak for Myself,” developed at Florida Atlantic University’s Christine E. Lynn College of Nursing in Boca Raton.

 

 

“Speak for Myself” was developed by Rebecca Koszalinski  during her doctoral studies under the guidance of Ruth Tappen, an eminent scholar and professor at the Christine E. Lynn College of Nursing.

Results of a pilot study of Speak for Myself, conducted at three hospitals in South Florida, was recently published in the journal Computers, Informatics, Nursing. It found there is a  disconnect between what health care providers think patients want to communicate and what patients actually want to say.

“When patients are not able to clearly verbalize their needs, there is an elevated risk of misinterpretation and misunderstanding, which could lead to errors and unintentional poorer quality of care,” Tappen said.

“While writing boards and other traditional methods may be helpful, important information is often lost. Furthermore, allowing others to speak for the patient has its limitations.”

The app lets a patient communicate his or her level of pain using a scale from 1 to 10. It also helps them convey their physical needs such as suctioning, repositioning and requests to use the bathroom.

During the study, one patient using the device was able to help doctors learn that the nasogastric tube had become twisted and was causing severe pain. Another patient communicated her end-of-life decisions to stop treatment and disconnect the mechanical ventilation that was keeping her alive.

“It is accurate to assert that with enhanced communication, patients will have less frustration, their pain will be better controlled, and they will have a greater opportunity to participate in their own care, and this is all supported in our study,” Tappen said.

approximately 1,600 nursing students enrolled in programs at FAU’s College of Nursing.

 

Florida Supreme Court accepts guardianship case on marriage annulment

The Florida Supreme Court has officially accepted jurisdiction of Palm Beach County case on whether a court-appointed guardian can seek to annul a marriage of a senior citizen found to be incapacitated.

The annulment issue has surfaced recently in at least two guardianship cases in Palm Beach County – both involving elder law and special needs attorney Ellen Morris of Boca Raton.

 

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J. Alan Smith and Glenda Martinez Smith have fought to reverse the annulment of their 2011 marriage at the behest of a professional guardian. The case will be heard by the Florida Supreme Court.

Morris represented guardian John Cramer in the case in question involving 85-year-old J. Alan Smith. She also represented Elizabeth Savitt in the case involving senior Robert Paul Wein where she sought authority from the court to annul a 1959 marriage. Wein died before the issue was settled.

Concerns about Florida professional guardians in recent yearshave result in the state Legislature passing the state’s first regulatory authority over the industry that cares for adults and seniors found to be incapacitated by illness, such as Alzheimer’s disease.

 

Robert and Vita Wein. Vita Wein says professional guardian Elizabeth Savitt has worked to break up the couple, who were married in 1958..
The late Robert  Wein with his and wife Vita last year. The couple fought to keep their 1958 marriage from being annulled by professional guardian Elizabeth Savitt.

The Smith case has already set precedent when the 4th District Court of Appeal ruled that a senior’s advance directive naming a health care surrogate  must be followed by the court and not usurped by the appointed professional guardian.

Currently, Smith is being cared for by the woman he married, Glenda Martinez Smith. She is now fighting to reverse the decision by Circuit Judge David French to annul the marriage at behest of the guardian.

The 4th DCA in July certified a question of great public importance on whether incapacitated individuals can retain the rights to marry. The Supreme Court on Aug. 25 accepted the case and ordered attorneys to submit briefs by next week.

An annulment can be a fee generator for  guardians and the attorneys who represents them. The Post reported in its series Guardianship: A Broken Trust how annulment proceedings initiated by a guardian can drain the estate of the senior and cost loved ones tens of thousands of dollars in court fees fighting it.

Vita Wein told The Palm Beach Post that Savitt – who is married to Circuit Judge Martin Colin – aimed not only to generate fees but to cut her out of any of her husband’s inheritance and social security money in order to benefit relatives of her husband.

Elizabeth Savitt appears at a hearing with Attorney Sheri Hazeltine to discuss attorney fees for Albert Bach on Thursday, August 20, 2015 at the South County Courthouse in Delray Beach. Elizabeth Savitt is the wife of Judge Martin Colin and also a professional guardian. (Madeline Gray / The Palm Beach Post)
Professional guardian Elizabeth Savitt  (Madeline Gray / The Palm Beach Post)

America is fat – and Florida is no exception, report says

So does all this beach living and sunshine keep Florida skinny?

Nah, not even close.

But Florida does fall in the third-tier of states where more than 26 percent of its citizens are considered obese, according to new data ranking state-by-state obesity rates.

The Trust for America’s Health and the Robert Wood Johnson Foundation compiled the report. The fattest states were Louisiana at 36.2 percent. Mississippi, Alabama and West Virginia weren’t far behind, all with obesity rates above 35 percent.obesity-state-map-trust-for-americas-health

Colorado had the lowest obesity rate in 2015 at 20.2 percent.

Florida was the 35th.

But how bad has it gotten in the USA for our waist lines?

Adult obesity rates now exceed 35 percent in four states and 30 percent in 25 states. What’s more, obesity rates are above 20 percent in every single state across the country.

In 1991, no state had a rate above 20 percent.

It’s like America is becoming the citizenry of the animated movie Wall-E.

“The stakes could not be higher,” said Dr. Donald F. Schwarz of the Robert Wood Johnson Foundation. He called the report an “urgent call to action.”

A huge swath of the Midwest from Texas to Michigan, sport obesity rates 30 percent or higher.

“Obesity remains one of the biggest and costliest health threats in the country,” said Richard Hamburg, interim president and CEO, Trust for America’s Health.Wall-E

Being overweight increases the risk for a range of chronic diseases, such as diabetes and heart disease, and costs the country between $147 billion and $210 billion each year.

Other findings in the report were of little solace on the health front:

  • Adult obesity rates are at or above 40 percent for blacks in 14 states.
  • Adult obesity rates are at or above 30 percent for blacks in 40 states and Washington, D.C.
  • Adult obesity rates are at or above 30 percent for Latinos in 29 states and Washington, D.C.
  • Adult obesity rates are at or above 30 percent for whites in 16 states and Washington, D.C.
  • American Indian/Alaska Natives have an adult obesity rate of 42.3 percent.