New pediatric vaccines add up to costly burden.(Practice Trends) - Family Practice News

HONOLULU -- A complex regimen of 21 vaccines added to the routine child immunization schedule since 2000 has left many health care providers shaking their heads.

Dr. Andrew D. Racine took his frustration one step further, and took out his calculator.

By his calculations, administration of the new vaccines recommended for pediatric patients from infancy through adolescence by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians has added up to 17.8 weeks of salary for a full-time nurse in a busy practice, as well an upfront inventory cost of $100,000-$200,000.

'The instigation for this [study] was just looking at our nursing staff,' said Dr. Racine following the oral presentation of his results at the annual meeting of the Pediatric Academic Societies.

'They were going crazy.'

Dr. Racine, chief of clinical pediatrics at Albert Einstein College of Medicine, New York, noted that 10 childhood vaccines were recommended in 1983. That number now stands at a mean 27 vaccines per healthy child, depending on their gender and risk profiles.

Added to the schedule since 2000 are pneumococcal 7-valent conjugate vaccine (PCV7) at 2, 4, 6, and 12 months; influenza vaccine at 6 and 7 months, then annually to all patients up to 5 years and to 50% of 6- to 21-year-olds; meningococcal polysaccharide conjugate (MCV4) vaccine and tetanus/diphtheria toxoid/acellular pertussis (Tdap) vaccine at 11 years; hepatitis A vaccine at 18 and 24 months; rotavirus vaccine at 2, 4, and 6 months; 3 human papillomavirus (HPV) vaccines to girls at 11 years; and a second varicella vaccine at 5 years.

To find out how much staff time was needed to administer these added inoculations, Dr. Racine conducted an observational time-flow analysis of nurses in a busy urban academic practice as they simulated the tasks required to deliver one childhood inoculation.

He then multiplied the mean time to deliver a shot by the number of vaccines required per one pediatric patient over the course of childhood and calculated the total time cost to practices of various sizes.

The study was designed to be widely applicable to many types of practices: large or small, private or academic, staffed by experienced or relatively inexperienced nurses.

Tasks in the simulation included checking the chart for a vaccine order, obtaining the vaccine from storage and drawing up the medication, accessing the examination room, counseling parents, administering the shot and, finally, recording the immunization on the child's personal immunization card and on the chart.

The analysis used conservative assumptions, Dr. Racine noted.

Even so, the time added up to a substantial burden, even for a small panel of 1,000 patients, he reported.

'We've got anywhere from about 4.5 weeks of nursing time for a small panel that gave shots quickly to almost 18 weeks for a full-time equivalent nurse just to give these vaccines to a large panel of patients,' said Dr. Racine. (See box.)

[ILLUSTRATION OMITTED]

The potential implications of the study are profound, he added.

'We think this incremental cost [in terms of nursing time and up-front outlays for vaccine stock] presents significant challenges for the pediatric community and to the public policy goal articulated in Healthy People 2010 of increasing the proportion of all children and adolescents who receive all of their recommended vaccines,' he said.

BY BETSY BATES

AMERICORPS*VISTA ANNOUNCES SIX UNIVERSITY OF WISCONSIN-PARKSIDE APPOINTMENTS - US Fed News Service, Including US State News

The University of Wisconsin-Parkside issued the following news release:

Wisconsin Campus Compact (WiCC), headquartered at the University of Wisconsin-Parkside, has named six people to lead AmeriCorps*VISTA programs. Working with the Center for Community Partnerships, Ben Lehner, Caitlin DeLap, Erin Morey, Christopher Kugel, Ann Pratt, and Evan Witalison promote service and civic engagement by students, faculty, and community partners. UW-Parkside has been involved in WiCC's AmeriCorps*VISTA program since 2003 when WiCC received the largest VISTA grant in the country.

Ben Lehner has served as AmeriCorps*VISTA's environment coordinator for the past year. He was instrumental in developing Racine's Root River Environmental Education Community Center (REC) and Kenosha's Center for Environmental Education, Demonstration, and Applied Research (CEDAR). He also organized a highly successful coat drive and helped 1300 4th graders learn conservation through the River Bend SWIMR program.

Lehner continues to work on the environmental centers while supervising new environment coordinators Caitlin DeLap and Erin Morey. In September, DeLap and Morey spearheaded the collection of bicycles for Racine's 'Earn a Bike' program. They are now leading a coat drive to benefit local charities and Racine's homeless shelters, and in spring 2009 both will play major roles in the opening of CEDAR.

Chris Kugel is the education and development coordinator for Peace Learning Circles (PLC). PLC promotes a culture of peace through the education of youth and communities. The program, now in its third year, has improved communication, conflict resolution, and peaceful living skills among the 4th grade students it targets. Kugel is working to increase PLC's capacity and sustainability by building awareness of its programming and making connections with like-minded individuals and groups interested in becoming involved with PLC on various levels.

In the past year, Ann Pratt helped launch Mentor Kenosha & Racine and the HOPES Center. A collaboration between UW-Parkside, Racine Dominicans, and other service providers, the HOPES Center builds awareness of poverty and finds solutions to alleviate it. The HOPES Center opened in October 2008 and is anchored by the Just Trade retail shop and Cup of Hope coffee shop. The HOPES Center also provides mental health and substance abuse services to the uninsured and underinsured.

Evan Witalison recently assumed leadership of Mentor Kenosha & Racine (MK&R). MK&R helps mentoring programs increase their capacity to meet participants' needs and provides them with a certification process. Big Brothers/Big Sisters and Racine's San Juan Diego Middle School have received certification. Professional development and volunteer training are available to all area mentoring programs.

'The teen-age problem:' it's us.(includes related article on the 1996 Stand for Children Day) - Nation's Cities Weekly

Today's teen-agers, writes high school freshman Jeannette Fornadel in the Reading Eagle/Times, 'are assumed to be juvenile delinquents, shoplifters or worse.' And the media only makes things worse, she charges, portraying teen-agers 'as brainless, bubble-gum chewing, hormoneladen slobs whose concerns center only around the opposite sex.'

But recently the National League of Cities pegged growing youth crime as the top concern of 406 municipal officials polled in the organization's yearly 'State of American Cities' survey.

Indeed, city officials pinpointed youth crime as their most disturbing trend--even while they believe overall crime is abating, police/community relations are on the upswing, and that neighborhoods are becoming more vital.

A big majority (62 percent) of the city officials said youth crime was worsening. Fifty percent found gangs increasing, 45 percent pointed to mounting drug use, teen-age pregnancy and school violence, and 38 percent said family stability was deteriorating.

The mounting youth problems, said Columbus (Ohio) Mayor Greg Lashutka, president of the league, 'tell us that an indispensable future asset of our communities is at risk.'

So what to do about it? Focus on trying teen-age offenders in adult courts? Install metal detectors at school doors? Invent programs for social workers to deliver to kids who have too much time on their hands?

A mounting number of critics say such fixes won't work, in fact would make things worse. The basic problem, says Charles Bray, president of the Johnson Foundation in Racine, Wis., is Americans' 'progressive disengagement from the lives of kids.'

We live, says Bray 'in the most age-segregated society in human history.' Indeed, only one home in four has a school-age child; the vast majority of adults don't speak with a kid once in a day.

When several Wisconsin foundations surveyed both adults and teen-agers on what it's like for young people in their communities, the adults said 'dull' and suggested programs like midnight baseball. The kids said 'crashingly boring,' rejected the midnight games but said they wanted ways to get involved, in some significant way, in their communities.

When asked who are kids' role models, the adults named Michael Jordan; the teenagers tended to say 'an adult who cares about me.'

Racine, as a result, has set out to become, within five years, 'America's most youth-friendly community.' Among the leaders are the head of the United Way, the police chief and human services director. They've joined to create a pilot family and children resource center that combines a recreation center, family support services and community policing.

Ideally, high schools would long since have opened their doors to such inventive, shared activities--including health services for teens and families. But as Bray comments:

'The single most youth unfriendly institution in American society is schools. It's not very good at educating; it's a warehouse where kids are parked until they are 16, told to shut up and takes notes. It's cut off from any consequential involvement in the community.'

But what do kids want? The new Racine Community Coalition for Youth scraped up funding to engage a diverse group of young people to design and implement a community-wide survey of high school students. Among the 2,246 questionnaires returned the biggest votes were for 'more things to do,' sports, cleanup campaigns, a dance club, youth clubs, hangouts, prevention activities, curfew extensions. What the young people said they didn't want was more violence, cops, racism, pollution, bars, guns and alcohol.

Three Racine insurance agents--calling themselves 'Agents Who Care'--funded a dance that was planned and implemented by teens. Now the admission profits are going to set up a model teen court in a middle school, hearing cases that would otherwise move through the school disciplinary system.

In another outreach, the Racine Community Foundation and United Way are funding a 'Youth as Resources' program that empowers a panel of teen-agers to make small awards ($200 to $2,000) for projects they believe will make Racine a more youth-friendly community.

Major youth outreach programs have begun in recent years in communities stretching from Westchester County, N.Y., to Oakland, Calif, Columbus, Ind., Kansas City, Peoria, St. Louis to San Diego. It will be years until we know whether they impact youth crime--or strengthen youth citizenship and engagement in American life.

More vital than simply launching programs, says Bray, is 'a culture shift--providing opportunities for young people's consequential involvement in their communities.'

In some cities, the public is even getting to read about teen-agers' interests and volunteering efforts, not just the dreary litany of school disorders, drug and booze parties and teen-age crime.

One example: the Racine Journal-Times special youth page, with reporters assigned to the youth beat. Another: the Reading Eagle/Times weekly 'Voices' section, written by and for teen-agers.

If American newspapers did more of this, perhaps more of us would start shifting our attitudes, and engage teenagers in our lives and communities.

RELATED ARTICLE: Join Stand for Children on June 1

The National League of Cities is one of hundreds of national and local organizations that has endorsed Stand for Children Day on Saturday, June 1.

Convened by the Children's Defense Fund, Stand for Children will be a national day of commitment to children, a celebration, and a day of community renewal. Thousands of adults, children, and families will come to the Lincoln Memorial in Washington, D.C. to commit themselves to improve the quality of children's lives: their health, safety, school readiness, education, and future.

The focus on June 1 will be on concrete steps that every American can take to ensure that no child is left behind. Stand for Children encourages everyone 'to commit herself or himself to taking specific positive, personal steps.... This may mean walking a child in the neighborhood to school, reading more to your child, mentoring a child, or it may mean getting your religious congregation, community group, or organization to do more for children.'

To receive an Action Packet of information about the Stand, about organizing people to attend, and about observing the Stand in your own community, contact Stand for Children, 1832 Connecticut Avenue, N.W., Washington, D.C. 20009. The phone number is 800/233-1200; the fax number is 202/234-0217.

Mother's needs often are neglected in life after baby - Chicago Sun-Times

For nine months, you have housed and fed that beautiful littlebundle.

For nine months, that beautiful bundle has been readjusting,realigning and redesigning your body.

'And then somehow, magically, in six weeks (after the baby'sbirth), you're suppose to be back to normal,' said Beth Racine, 27, amother in Mundelein.

'And after you have the baby, somehow everybody makes you feellike you don't have the right to complain. It is a woman's role tosuffer and suffer in silence. It's just not reasonable.'

Racine had more problems than most. After the third child, herrecovery was just not progressing. She was dragging, she wasconstantly befuddled and she could not lose weight.

'I called the doctor, and she made me feel like ahypochondriac,' she said.

But Racine knew something wasn't right and insisted on a thyroidtest. The test showed her problems were not in her head - they werein her thyroid - and easily taken care of with medication.

Physiologcal complications in women after childbirth are theexception rather than the rule. Rough estimates show that Racine'sthyroid condition occurs about one or two in a hundred.

But there isn't enough research to give exact estimates.

'We do know there is a direct association between some problemsand pregnancy post-partum,' said Dr. Linda Hughey Holt, head ofobstetrics and gynecology at Rush North Shore Hospital and a motherof three. 'There is a percentage or two getting thyroid problems,the same with autoimmune system problems, probably about 2 or 3percent that get gallbladder problems, and muscular skeletal problemsmay be aggravated.'

'And it also looks like from 10 to 15 percent of women getsomething more serious than `baby blues' and fall into post-partumdepression,' according to Dr. Camilla Ashley, a psychiatrist atIllinois Masonic Hospital's Women's Health Resources center.

And while Holt agrees that most of the problems are'self-limiting,' she adds: 'The real problem is the focus (of thehealth community). Once the baby is out, obstetricians have atendency to discard their involvement with the mother, and complaintsand problems get discarded.'

Racine's story is an example of how women's post-partum healthhas been ignored. Most people - even those who were well-read onpregnancy - do not even know there is a chance of these otherproblems occurring.

Just about everything you have always wanted to know about awoman's body during pregnancy and childbirth can be found in a book, a magazineor a video these days. The store shelves are packed.

But once that baby is born, everybody is looking at baby, andnobody is looking out for mom.

'And in obstetrics there is this external structure that inessence tells women they are going to be back to normal in sixweeks,' Holt said.

In a normal delivery, which is a misleading reference itselfbecause births are as individual as the mothers, doctors usuallyschedule a followup visit for a new mother at about six weeks.

At this time, a woman's organs are mostly back in place, theepisiotomy well on its way to being completely healed and the uterusalmost back to normal size, according to Dr. Laurie Sherwen, anassociate professor in nursing at Thomas Jefferson University inPhiladelphia.

But combine the physiological recovery with emotional stress andfatigue, along with the hormonal changes that occur during nursing,and total recovery is highly unlikely in this short a time.

Still, six weeks has come to signal the end of recovery - andmany women are expected back on the job.

'Everybody wants to believe this,' said Nina Barrett, a motherand author who tried to offer a clearer picture of pregnancy,childbirth and recovery in her book I Wish Someone Had Told Me.

'And a lot of the books and articles just help perpetuate thismyth of this magical six-week period.'

The result of these unrealistic expectations is more stress andmore problems for the new mother. It is a vulnerable time for mostwomen, and even the strong at heart find themselves not questioningauthority.

'So many see their lives are not running as the experts say, andthey feel that they are the problem, they are not in control,'Barrett said.

'We are just now coming to understand making those transitions -nonpregnant to pregnant state and then to post-partum - is just a lotmore complex physiologically and psychologically than we thoughtbefore,' Sherwen said.

So, what does all this mean to the 'normal' woman?

'First, there is no back-to-normal after having a child becauseyour life has changed so totally,' Holt said, adding that it takesabout a year to adjust to the emotional and physical changes.

And even if you eliminate the emotional component, Holt said,'The physical adjustment is extended into at least the first sixmonths.'

Don't expect to bounce back in six weeks. Some women can get agood figure back quickly, but for many it will take time.

Ironically, at the same time the medical profession isdiscovering it is healthy to gain more than just the formerlyrecommended 25 pounds during pregnancy, society is still certain anyyoung woman should be taut and tight even if she's a brand newmother.

Just don't expect to return to the same state. Because youwon't.

It doesn't mean you can't diet and exercise yourself into goodshape. But things do change, such as vaginal and abdominal tone aswell as breast density. And those changes become more pronouncedwith each birth.

Most women will be tired, depressed, confused and achey for awhile, but if the pronounced symptoms continue past six weeks, callyour doctor.

And when you call, call your internist or family doctor ratherthan your obstetrician, who is a specialist and should not be reliedupon for general health.

Don't accept a categorical dismissal from a doctor - 'Oh, that'snormal, you just had a baby' - if you feel that there is more to it.

Plethora of shots burdens providers.(News) - Pediatric News

[ILLUSTRATION OMITTED]

HONOLULU -- A complex regimen of 21 vaccines added to the routine child immunization schedule since 2000 has left many health care providers shaking their heads.

Dr. Andrew D. Racine, chief of clinical pediatrics at Albert Einstein College of Medicine, New York, took his frustration one step further and took out his calculator.

By his calculations, administration of the new vaccines recommended for pediatric patients from infancy through adolescence by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians has added up to 17.8 weeks of salary for a full-time nurse in a busy practice, as well an up-front inventory cost of $100,000-$200,000.

'The instigation for this [study] was just looking at our nursing staff,' said Dr. Racine following the oral presentation of his results at the joint meeting of the Pediatric Academic Societies and the Asian Society for Pediatric Research.

'They were going crazy.''

Dr. Racine noted that 10 childhood vaccines were recommended in 1983. That number now stands at a mean 27 vaccines per healthy child, depending on their gender and risk profiles.

Added to the schedule since 2000 are pneumococcal 7-valent conjugate vaccine (PCVT) at 2, 4, 6, and 12 months; influenza vaccine at 6 and 7 months, then annually to all patients up to 5 years and to 50% of 6- to 21-year-olds; meningococcal polysaccharide conjugate (MCV4) vaccine and tetanus/diphtheria toxoid/acellular pertussis (Tdap) vaccine at 11 years; hepatitis A vaccine at 18 and 24 months; rotavirus vaccine at 2, 4, and 6 months; 3 human papillomavirus (HPV) vaccines to girls at 11 years; and a second varicella vaccine at 5 years.

To find out how much staff time was needed to administer these added inoculations, Dr. Racine conducted an observational time-flow analysis of nurses in a busy urban academic practice as they simulated the tasks required to deliver one childhood inoculation.

He then multiplied the mean time to deliver a shot by the number of vaccines required per one pediatric patient over the course of childhood and calculated the total time cost to practices of various sizes. The study was designed to be widely applicable to many types of practices: large or small, private or academic, staffed by experienced or relatively inexperienced nurses.

Tasks in the simulation included checking the chart for a vaccine order, obtaining the vaccine from storage and drawing up the medication, accessing the examination room, counseling parents, administering the shot and, Finally, recording the immunization on the child's personal immunization card and on the chart.

Because nurses varied in the time they required to prepare and administer a shot, Dr. Racine offered two calculations for each type of practice: one in which nurses took a mean 5 minutes to deliver an inoculation and one in which nurses took a mean 10 minutes to complete the tasks. (The total mean time per vaccine in 50 observed simulations was 8 minutes, plus or minus 1.8 minutes, depending on the nurse's experience level, the day, and the time of day in the clinic.)

The analysis used conservative assumptions, Dr. Racine noted.

For example, time spent ordering and stocking vaccines was not included.

The formula assumed that all patients received their immunizations on time, so no added time was allotted to investigate and administer catch-up vaccines.

Likewise, no allowance was made for discussions with parents who oppose vaccination.

Despite those exclusions, the time added up to a substantial burden, even for a small panel of 1,000 patients, he reported.

'We've got anywhere from about 4.5 weeks of nursing time for a small panel that gave shots quickly to almost 18 weeks for a full-time equivalent nurse just to give these vaccines to a large panel of patients,' said Dr. Racine. (See box.)

The potential implications of the study are profound, he added.

'We think this incremental cost [in terms of nursing time and up-front outlays for vaccine stock] presents significant challenges for the pediatric community and to the public policy goal articulated in Healthy People 2010 of increasing the proportion of all children and adolescents who receive all of their recommended vaccines,' he said.

In addition, Dr. Racine called for a revamping of payment schedules for pediatricians by both public and private payers to reflect the high costs of administering a vastly expanded vaccine schedule.

TALK BACK

What is your experience dealing with the cost and time factor of administering the new vaccines?

Weight in at pdnews@elsevier.com We look forward to hearing from you!

BY BETSY BATES

FORT ATKINSON SCHOOL TO REOPEN AFTER FLU SCARE.(NEWS) - The Capital Times

Byline: Bill Novak

A Fort Atkinson elementary school shut down Monday and Tuesday because of a probable case of swine flu will reopen Wednesday.

The Jefferson County Department of Health told the school district that Barrie Elementary School could reopen on Wednesday, after originally determining the school should stayed shuttered all week.

'Based on a more recent assessment of the Fort Atkinson community for any influenza-like illness, it was determined that it would be safe for students and staff to return to school much sooner than originally anticipated,' the school district said in an update letter posted on its website Monday night.

One area school, Milton High School, will remain closed on Tuesday by order of the Rock County Health Department, after one student was identified as a probable case of swine flu.

The high school could remain closed longer, but the sick student has stayed home since last week, reducing the chances for other students or staff to get the disease.

The school building was posted as closed on Monday, with no staff or students allowed inside.

The school district sent letters to parents on Monday, advising children and adults to stay away from other people and groups as much as possible, and not to gather in public places such as shopping malls, movie theaters or community centers.

The number of probable swine flu cases in Wisconsin increased to 105 on Monday, but only three of those cases have been confirmed by the Centers for Disease Control and Prevention, one in Adams County and two in Milwaukee County.

Milwaukee has 48 probable cases of swine flu pending testing results from the CDC, with five cases in Waukesha County, three in Racine County, two each in Rock and Sheboygan Counties and one each in Jefferson, Kenosha, Ozaukee and Polk Counties. Thirty-eight probable cases still have their county identifications pending.

Milwaukee city officials have closed 22 schools and one child care facility because of concerns about the spread of the flu.

Added to the list Monday was Alexander Hamilton High School, the largest high school in Milwaukee Public Schools with an enrollment of 1,995.

In Racine County, Kansasville Elementary School will be closed for at least a week after tests indicated a student there has a probable case of swine flu.

Jennifer Johnson of the Western Racine County Health Department said the school's staff and about 100 students are to stay on their own properties, although not necessarily in the house, until at least May 12 as a precaution.

She said health officials decided Monday on the closure after the state Laboratory of Hygiene classified it as a probable case of the swine flu, or H1N1. It is one of three probable cases in Racine County. The U.S. Centers for Disease Control and Prevention has not confirmed any of them.

Johnson said the Kansasville student had mild symptoms like high fever, cough, sore throat and body aches, and he was not hospitalized. He had missed classes part of last week.

In northern Wisconsin, officials said the Lac du Flambeau School, Headstart, and Pre-K programs are closing Tuesday as a precautionary measure.

The Vilas County Health Department said two individuals are suspected of having swine flu.

One previous probable case in Wisconsin attributed to Winnebago County was actually from Winnebago County, Illinois.

The CDC said swine flu is now being reported in 36 states, with a total of 286 laboratory-confirmed cases. Only one death has been attributed to swine flu in the U.S., that of a 22-month-old Mexican child in Texas.

The state Division of Public Health issues daily updates on the swine flu situation and has set up an emergency operations center.

The center has a 211 hotline people can call to find out more about swine flu, with staff taking calls from 8 a.m. to 5 p.m. every day.

So far, the call center received 105 calls on Friday, 160 calls on Saturday and 130 calls on Sunday.

More information is available online at http://pandemic.wisconsin.gov/.

The Associated Press contributed to this report.

Southeast Wisconsin - Corporate Report Wisconsin

CEDARBURG

The General Aluminum plant that makes castings for the automotive industry and employs about 140 production workers is set to close May 1. The factory was sold last summer to Cleveland-based Park-Ohio Holdings Corp. by Amcast Industrial Corp., Dayton, Ohio. A combination of factors including shipping costs, no room for expansion, and environmental concerns about alleged PCB contamination of Cedar Creek were cited by management as reasons for the closing.

METRO MILWAUKEE

A new health care plan is available to the more than 2,000 member businesses that are members of the Metropolitan Milwaukee Association of Commerce and employ approximately 200,000 people in the metro area. The Patient Choice plan was introduced to the area in April by WPS Health Insurance. Patient Choice is designed to create competition among health care providers using data that ranks their quality, efficiency, and total costs of Care Systems. Employees then compare Care Systems and choose the one they want as part of their health insurance plan.A similar network has been offered in Minneapolis since 1997 and has produced significant savings for participants.

Area political and business leaders meeting at the University Club agreed to work together on extending Chicago's Metra commuter trains from Kenosha to Milwaukee to help the region grow and compete with other metro areas that have commuter rail. The leaders included Bob Mariano, chief executive officer of Roundy's Inc. and chairman of the regional transportation committee of the Greater Milwaukee Committee, Milwaukee Mayor Tom Barrett and his Chief of Staff Patrick Curley, Milwaukee County Executive Scott Walker, Racine County Executive William McReynolds, Kenosha Mayor John Antaramian and state Rep. Jeff Stone (R-Greendale). Racine Mayor Gary Backer, Kenosha County Executive Allan Kehl and Sen. Jeff Plale (D-South Milwaukee) sent aides. Business leaders present included Dennis Kuester, chief executive officer of M&I Corp., Fred Luber, chief executive officer of Super Steel Inc., and Tim Sheehy, president of the Metropolitan Milwaukee Association of Commerce. The 33-mile route from Kenosha to Milwaukee could run on existing freight railroad tracks with stops in downtown Milwaukee, Cudahy, South Milwaukee, Oak Creek, the Town of Caledonia, Racine, and the Town of Somers. The next step is to start preliminary engineering and the final two-year phase of study on the line.

MILWAUKEE

The Main Street Milwaukee program was approved by the city's Common Council to help revitalize older traditional neighborhood commercial districts. The program would provide technical assistance for up to four commercial areas in its first year for fa�ade improvement design, business planning, marketing and other business issues. The Department of City Development will partner with the Local Initiatives Support Corp. to provide support services. Under the program, $350,000 in Community Development Block Grant funds will be matched with private resources raised by LISC.

A high-tech business incubator called IT Fusion Business Center 633 was created by Towne Investments, a major owner and manager of downtown office space. The facility on the seventh floor of the 633 W. Wisconsin Ave. building and has more than 6,000 square feet available for start-up and emerging tech businesses. In addition to the latest Internet and Wi-Fi connections, the facility has shared conference and meeting space and other office services. Kuhlfsion LLC is the on-site manager.

Smurfit-Stone Flexible Packaging is nearly doubling the size of its packaging factory on the northwest side with a 54,000-sq.-ft. $3 million addition. The Parkland Court plant now employs about 100 and the company expects to add at least 12 more jobs when the expansion is complete in July. Smurfit-Stone prints and fabricates flexible packaging materials for customers in the meat, cheese, candy and pharmaceutical industries. SmurfitStone Flexible Packaging is a division of Chicago-based publicly traded Smurfit-Stone Container Corp., which also has plants at 2800 W. Custer Ave. and in Germantown, and has 250 plants nationwide.

PEWAUKEE

Up to $13 million would be invested along Wisconsin Avenue's lakefront in a project proposed by Cameron Scott Development. The four-story building would have 12,000 square feet of retail space on the first floor and 32 condominiums on the upper three floors. It would go next to a two-story building called Old Main Street developed by Siepmann Realty Corp. in 2002 with retail space on the first floor and office space on the second floor. A riverwalk on the Pewaukee River is also being proposed.

RACINE

A contaminated 14-acre brownfield site downtown will be cleaned up and turned into an industrial park that could employ up to 200, thanks to a $550,000 Department of Commerce award to the city. The site had been used by the Jacobsen Textron Company for 35 years to manufacture lawn care equipment. The City of Racine purchased the land in 2002. The project includes demolition and infrastructure improvements with a total project investment of $4.6 million.

SUSSEX

TPS International Inc. has been awarded two contracts valued at $2.9 million to supply highly automated computer-controlled metal-cutting manufacturing equipment to an undisclosed maker of fluid power parts. TPS makes machine tools and equipment for the metal-cutting and turned-parts industries, and has plants in Chicago, Atlanta, New York City, Columbia, S.C., and Switzerland.

STATEWIDE DEVELOPMENTS

NORTHEAST

GREEN BAY: From last October to December, members of the local Young Professionals Network participated in a project called Downtown H.Y.P.E. (Harnessing Young Professionals Energy). The project was a joint venture between the YPN, UW-Green Bay and Downtown Green Bay Inc., in which young professionals provided weekly summaries of their impressions of the downtown area. Food, entertainment and shopping options were good or better than expected, but the group found too many empty buildings in central Green Bay. Two other groups are expected to conduct similar evaluations of the area this spring.

The official medal for the presidential inauguration of George W. Bush was produced by Medalcraft Mint Inc., the same as in 2001. Minted in gold, silver, bronze and brass, the commemorative medals cost between $12.50 and $1,200.

MANITOWOC: National home-improvement retailer Lowe's paid a little over $1 million for a 13-acre parcel at the Harbor Town Center. Construction on the new Lowe's store will begin this spring, with the store opening by the end of 2005. Lowe's just entered the Wisconsin market with a store in Milwaukee, and plans to open a second store in Plover this spring. With more than 1,000 stores in 46 states, Lowe's is now the second-largest home-improvement retailer in the country after Home Depot.

NEENAH: Aurora Health Care broke ground on a new 38,550-sq.-ft. clinic on five acres in the Westowne Village development. Aurora currently leases space for a primary care facility. The new building will provide additional primary care space, along with room for specialty care services, physical therapy, a laboratory and a pharmacy.

NEW LONDON: Wolf River Lumber Inc. received $250,000 in Technology Zone tax credits from the Department of Commerce toward the construction of a new 80,000sq.-ft. facility. The company is investing $4.5 million in the project and expects to create 60 new jobs. Wolf River Lumber manufactures and kiln-dries more than 36 million board feet of hardwood lumber annually.

OSHKOSH: The local FedEx Ground facility should create 130 jobs when it opens a new 51,000-sq.ft. distribution center here. Construction is scheduled for completion this spring.

SHEBOYGAN: Construction on a new $1.7 million aviation museum should be completed this month. The privately funded museum is located on the grounds of the Sheboygan County Memorial Airport and will celebrate its grand opening in June, after volunteers finish the building's interior work.

RIPON: Family-owned manufacturer Admanco Inc. announced in early January that it was closing its business, due to a lack of working capital. About 180 employees lost their jobs, although Admanco was reportedly still looking for an outside buyer that would be willing to keep the company in Ripon.

NORTHWEST

MARSHFIELD: Marshfield Clinic was named one of the nation's most technologically sophisticated medical providers by Health Imaging & IT magazine. The clinic was praised for its leadership role in health care information technology and listed as one of the 'top 15 connected health care facilities' in the U.S.

Macintosh computer users in the Marshfield area no longer have to travel to larger central-Wisconsin cities for Mac products. SimplyMac opened for business in December and sells computer systems, laptops, peripherals, software and iPods to individuals and companies.

MERRILL: Rondele Specialty Foods was sold to France's Groupe Lactalis, one of the world's largest dairy companies that sells in about 140 countries and is best known for cheese brands such as President and Sorrento. Rondele had been owned by Facilitator Capital Fund, a Wisconsin-based private equity fund, since 1998. There are no plans to move Rondele, which has about 75 employees and has been in town more than 30 years.

STEVENS POINT: JHL Mail Marketing is building a 10,000-sq.-i't. addition to its current facility in the Stevens Point Industrial Park. The expansion will create room for new mail-processing equipment and additional warehouse space for customer inventory. The 20-year-old company provides laser-printing, imagining and mail services.

SOUTHWEST

MIDDLETON: National Specialty Insurance is moving to the Greenway Center from Madison, occupying 47,000 square feet in the Wisconsin Trade Center building. NSI started in 1999 with two employees, has 75 now, and expects to add at least 20 this year.

MADISON: Expansion will continue at the former Tetrionics, a chemistry services company founded in 1989 in University Research Park that was acquired last year by St. Louis-based biotech Sigma-Aldrich Corp. and is now part of its SAFC division. The firm will add 38,000 square feet to its 23,500-sq.-ft. Research Park building.

American Family Insurance will add 100,000 square feet to its 225,000-sq.-ft. regional office in St. Joseph, Mo., where it has centralized its commercial lines of insurance and added 300 employees since 2000. In Madison, American Family has added more than 425 jobs since 2000, bringing the current total here to 3,710.

Madison Area Technical College announced that its Business Procurement Assistance Center has helped Wisconsin companies get a total of $1.2 billion in government contracts since its began in 1988. In 2004, BPAC guided state firms in winning a record $205.5 million in contracts, up from $193 million in 2003. BPAC is funded by an annual Department of Defense grant. Wisconsin is 48th among the states in winning federal dollars.

Waterpark developer Great Wolf Resorts Inc. completed its initial public offering of stock in December, raising $238 million on the Nasdaq exchange. The company has five resorts open and plans 10 more this year. In Wisconsin, it has Great Wolf Lodge in Wisconsin Dells and Blue Harbor Resort in Sheboygan. It also has resorts in Michigan, Ohio and Kansas.

[Sidebar]

In union strongholds, residents wrestle with cuts - Sunday Gazette-Mail

RACINE, Wis. - There once was a time when Harry and NancyHarrington - their teenage children in tow - walked the picket lineoutside the nursing home where she was a medical aide, protestingthe lack of a pension plan for the unionized work force.

But those days of family solidarity are gone.

Harry now blames years of union demands for an exodus ofmanufacturing jobs from this blue-collar city on the shore of LakeMichigan. He praises new Wisconsin Gov. Scott Walker for attemptingto strip public employee unions of nearly all of their collectivebargaining rights. Protesters opposed to Walker's plan have heldsteady at the Wisconsin Capitol for nearly three weeks, though theirovernight sit-ins ended Thursday with a judge's order.

'I'm sorry, but the unions want to yell, they want tointimidate,' said Harry Harrington, 69, as he sets a coffee cup downnext to another newspaper headline about the union demonstrations.

'They want to be heard,' retorts Nancy Harrington, 66, who fearsa weakened union would jeopardize the teaching career of their now38-year-old daughter.

The Harringtons typify the new national reality for labor unions.Support is no longer a sure thing from the middle class - not evenin a city long considered a union stronghold in a state that gavebirth to the nation's largest public employee union. National pollsshow that the portion of the public that views unions favorably hasdropped to near historic lows in recent years, dipping below 50percent by some accounts.

But surveys also show a public uneasy with attempts to weakenunion bargaining rights by emboldened Republican governors who sweptinto power in the 2010 elections amid concerns about state finances.A Pew Research Center poll released earlier this week found moreadults nationwide sided with unions than the governor in theWisconsin dispute.

For unions, the political standoffs occurring in states such asWisconsin, Indiana and Ohio are a make or break moment - a chance torepair tarnished luster or risk sinking toward irrelevancy among theAmerican public.

In Racine, a nearly two-hour drive southeast of the epicenter ofthe union controversy in Madison, the question of the union'sappropriate role has divided husband and wife, mother and child, co-workers and friends. It's the hot topic on editorial pages, atcoffee shops, even at the craft club that meets in the communitycenter at Roosevelt Park, where a dozen retired women recently weretalking over the top of each other about union powers while knittingsocks and hats.

Among these women, at least, the pro-union protesters are rightand Wisconsin's governor is wrong. Their group includes a retiredRacine public school teacher who in 1977 joined in a teacher walkoutthat lasted more than a month. Racine schools shut down again forone day this February when a quarter of their teachers were absentin a show of support for pro-union protesters.

Yet the teachers' union is not the power it once was in theRacine area. Despite a well-funded media campaign, the union'scandidate, Democratic state Sen. John Lehmen, of Racine - a formerhigh school teacher - was ousted by Republican challenger VanWanggaard in last fall's election. District voters also pickedWalker over Democratic gubernatorial candidate Tom Barrett.

When the teachers walked out last month in nearby Kenosha,substitutes such as Kevin Kreckling quickly stepped forward.

'I felt a little torn - I wanted to have solidarity with theteachers, but I have to make money, too,' said Kreckling, 30, theson of a union painter and who is studying to be a teacher atConcordia University in Mequon.

The decline in union power is perhaps best symbolized by the areanear Roosevelt Park, where a monument dedicated by the AFL-CIOhonors the Depression-era president who signed a 1935 federal lawguaranteeing collective bargaining rights. Not far away is a tallchain link fence protecting the vacant plot of the old Case Corp.farm equipment factory, which was razed a few years ago after thecompany merged with another corporation and then downsized.

CNH Global N.V., the successor company, still operates in thearea. And the city remains the home of S.C. Johnson & Son Inc.,which makes cleaning products and bug sprays, and vehicle radiatormaker Modine Manufacturing Co. Yet numerous other companies havescaled back or shut down, resulting in the loss of a third ofRacine's manufacturing jobs in the past 20 years, according tofederal Bureau of Labor Service statistics.

'It's been a real blood-letting of companies,' said Racine MayorJohn Dickert, adding optimistically: 'But we're turning thataround.'

Racine's unemployment rate remains the second highest in thestate, at 12.8 percent in December. As the jobs have diminished, soalso have the union ranks. But the problem isn't solely about fewermembers. It's also that more people have come to perceive unionemployees as the beneficiaries of cushy pension and health-careplans that others no longer enjoy, and even attribute union gains tobusiness losses.

'Way back when, they protected the workers when there was noprotection - when they were overworked and not paid enough. But intoday's society, they're too strong,' said Wendy Vesely, a Modineemployee who was celebrating her 44th birthday with her family atRacine diner that attracts a cross-section of pro- and anti-unionpatrons.

Vesely thinks the Wisconsin governor is on the right track, butmay be 'trying to get too much too quickly.'

Barbara Ford, one of the knitters at the community center, saidshe thought little about unions when she worked in the financedepartment at S.C. Johnson, a non-union company. Now, with Walker'spush to limit their bargaining rights, 'Every time I think about it,my blood boils,' said Ford, 65, who retired five years ago. 'It'sjust horrible what he's doing to the state.'

Public anxiety about the economy has created an opportunity forpro-business Republican officials to challenge unions in ways thatwould have been unthinkable even a few years ago.

In Missouri, where unions' share of the work force is half whatit was a generation ago, the leader of the state Senate is pushingfor 'right to work' legislation that would prohibit union shops inwhich all workers must pay union fees. In Ohio, Republican leadersare pushing a bill that would restrict collective bargaining rightsfor 350,000 public employees.

The national framework for collective bargaining was laid in 1934in Toledo, Ohio, after a violent labor dispute. But there's noquestion that support for unions has waned there in recent years,said Oscar Bunch, 81, who worked for 50 years at a General Motorsplant. He notices a mindset now that anyone with a well-paying jobis lucky. Auto workers have given 'concession after concession,' andthat hasn't helped the cause of public-sector employees, he said.

Dining at the same restaurant as Bunch, union electrician NormanCook, 57, of Elmore, Ohio, said the Republican officials sense anopportunity. 'Their entire motive is to bust unions,' he said.'They're taking advantage of the financial times.'

Just south of Racine, in what would have been the shadow of theformer Case foundry, Jim Geshay runs a one-man chemical repackagingbusiness in an aging cinder block building across the street fromthe bar that has been a union hang out. Yet Geshay says he soured onunions during the 1977 teachers strike when teachers he trustedtried to stop students from attending classes.

'I personally think it's time for them to pay their fair share,'Geshay said.

AP photo Nancy (left) and her husband Harry Harrington talk aboutthe Wisconsin budget crisis at Wilsons Coffee & Tea in Racine, Wis.Harry now blames years of union demands for an exodus ofmanufacturing jobs from this blue-collar city on the shore of LakeMichigan.

Easing pain of dental visit. - The Milwaukee Journal Sentinel (Milwaukee, WI)

Byline: Sheila B. Lalwani

Apr. 28--RACINE -- Without dental insurance or money to meet a dentist, Jarrod Alston and the cavity within his mouth were in trouble.

The cavity had rotted much of one of the 25-year-old's teeth, and his mouth was sore and inflamed. Parts of the tooth had chipped off.

All options had escaped him except one: the Health Care Network, 904 State St.

Wednesday was his first visit to a dentist.

'I've met some nice people who've never had dentistry and really needed it,' said James A. Levandoski, a practicing dentist in North Bay and a clinic volunteer.

That's the point behind the Health Care Network's newest effort: Offer free basic dental care to low-income, uninsured people living in Racine County.

The dental clinic, which opened earlier this month, is the only such center in Racine County. It opens in time for Cover the Uninsured Week, which begins Sunday.

'This is really a community effort,' clinic Executive Director Barb Tylenda said Wednesday. 'It's people helping people in Racine County.'

Thirteen area dentists and several hygienists are donating their time to the clinic. The dentists donate one day a month to meet with patients who need a cleaning or help with basic dental hygiene.

Medical professionals aren't the only ones willing to lend a hand for the clinic's success. Contractors helped remodel the inside of the building. Civic groups donated paintings and wall trim to make the office seem warmer.

Area dentists donated an X-ray machine and other dental tools.

Other organizations are helping out with supplies. The Prairie School last week donated tubes of toothpaste, cartons of dental floss and other dental hygiene material.

'There's a civic responsibility being installed in the kids,' Tylenda said.

The dental clinic adds another layer of service to the existing on-site medical clinic, which has been around since 1992.

The clinic schedules nearly 10,000 health care appointments a year.

About 90 percent of the people coming through the clinic's doors are from Racine. The remaining 10 percent are from other parts of the county.

The clinic also has referred patients to dentists around the community who can treat them for discounted fees.

With the state's highest unemployment rate and an increasing number of uninsured, dental coordinator Peg Pier said, the clinic needs the support.

'There is such a big demand out there,' she said. 'I didn't realize it until I started working here.'

BILINGUAL EFFORT

Levandoski had a little trouble his first day volunteering: All his patients spoke Spanish.

Lesson learned: Help dentists learn dental phrases in Spanish.

Alston finished his visit with one less tooth and a lot less pain.

Racine dentist and volunteer Jim Luetzow removed the tooth.

As Alston rose from the patient's chair, he held his hand to his mouth.

It was sore. This was a good sore, though.

'I would recommend this to any person,' Alston said.

Luetzow has practiced in Racine for years and plans to continue volunteering with the clinic.

'It's nice to help out people who need helping out,' he said.

To see more of the Milwaukee Journal Sentinel, or to subscribe to the newspaper, go to http://www.jsonline.com.

Copyright (c) 2005, Milwaukee Journal Sentinel

Distributed by Knight Ridder/Tribune Business News.

WISCONSIN HOSPITALS, NURSING HOMES ACHIEVE HIGH LEVELS OF EMPLOYEE INFLUENZA IMMUNIZATION - US Fed News Service, Including US State News

The Wisconsin Department of Health and Family Services issued the following news release:

Noting that September 21-27 is Adult Immunization Week, state health officials today praised the efforts of 107 health care facilities that immunized at least 80 percent of their employees against influenza last year and encouraged more to do so this year.

'Reaching an 80 percent immunization rate is a tremendous accomplishment, and we want to recognize such dedication to patient safety,' said Secretary Karen Timberlake. 'We also want to encourage more health care staff to get immunized. Sick health care workers can pose a serious threat to patients, and immunization of hospital and nursing home workers against influenza reduces the risk of illness, even death, for their patients.'

In 2005, the Division of Public Health began its effort to help hospitals and nursing homes in the state immunize more of their employees against influenza. That year, only 32 state facilities reached the 80 percent mark. In 2006, that number increased to 64. In 2007, a total of 107 hospitals and nursing homes reported that at least 80 percent of their employees were immunized against influenza.

Nationally, only about 40 percent of health care workers get the flu shot each year, despite strong evidence that residents in long term care facilities are less likely to become ill or die when their care providers are immunized against influenza.

Despite steady improvement, the challenge remains to persuade the 105 Wisconsin hospitals and 326 nursing homes that have not yet reached the 80 percent mark that immunization of their staff against influenza is an important step in maintaining a safe environment for their patients.

'Health care staff immunization is one of the most effective tools we have to reduce illness and mortality in Wisconsin,' Timberlake said. 'It's a message that we have to convey to all Wisconsin health care facilities.'

Please note: a list of the 80 Percent Club members from 2007 is attached.

2007 Hospitals

Hospitals - County

Cumberland Hospital - Barron

Lakeview Medical Center - Barron

Luther Midelfort Northland - Barron

Luther Midelfort Chippewa Valley Mayo Health System - Chippewa

St Joseph Hospital - Chippewa

Prairie du Chien Memorial - Crawford

Select Specialty Hospital - Dane

Stoughton Hospital - Dane

Red Cedar Medical Center - Dunn

Luther Midelfort Mayo Health System - Eau Claire

Sacred Heart - Eau Claire

Ripon Medical Center - Fond du Lac

Southwest Health Center - Grant

Upland Hills Health - Iowa

Black River Memorial Hospital - Jackson

Aurora Medical Center Manitowoc Co - Manitowoc

Wheaton Franciscan Healthcare St Joseph EL - Milwaukee

Tomah Memorial - Monroe

Appleton Medical Center - Outagamie

Osceola Medical Center - Polk

St Croix Regional MC - Polk

Flambeau Price

Aurora Memorial Hospital of Burlington - Racine

The Richland Hospital - Richland

Reedsburg Area Medical Center - Sauk

St Clare Hospital and Health Services - Sauk

Hayward Area Memorial Hospital - Sawyer

Shawano Medical Center - Shawano

Aurora Medical Center Sheboygan - Sheboygan

River Falls Area Hospital - St. Croix

Luther Midelfort Oakridge - Trempealeau

Oconomowoc Memorial Hospital - Waukesha

Aurora Medical Center Oshkosh - Winnebago

Childrens Hospital of Wisconsin - Fox Valley Winnebago

Riverview Hospital Association - Wood

2007 Nursing Homes

Nursing Homes - County

Ashland Health & Rehab Center - Ashland

Mellen Manor - Ashland

Heritage Manor - Barron

Luther Midelfort Northland - Barron

Santa Maria - Brown

St Michaels - Buffalo

Chippewa Manor - Chippewa

Cornell Area Care Center - Chippewa

Luther Midelfort Chippewa Valley - Chippewa

Belmont Nursing & Rehab - Dane

Karmenta Center - Dane

Nazareth Health and Rehab - Dane

Oak Park Place - Dane

Rest Haven HCC - Dane

St Marys Care Center - Dane

Waunakee Manor Health Care Center - Dane

Golden Living - Dodge

Marquardt Memorial Manor - Dodge

Door County Nursing Home - Door

Good Samaritan Scandia Village - Door

Villa Marina - Douglas

Grancare Inc - Fond du Lac

Southwest Health Center Grant

Markesan Resident Home - Green Lake

Bloomfield Manor - Iowa

Upland Hills Nursing & Rehab - Iowa

Countryside Home - Jefferson

Willowbrook - Jefferson

Fairview Home - Juneau

Heritage Manor - Juneau

Grande Prairie Health & Rehab - Kenosha

Onalaska Care Center - La Crosse

Pine Crest Nursing Home - Lincoln

Shady Lane Inc - Manitowoc

Kennedy Park Medical & Rehab Center - Marathon

Montello Care Center - Marquette

Alexian Village of Milwaukee - Milwaukee

Mary Jude - Milwaukee

Mercy Residential & Rehab Center - Milwaukee

Wisconsin Lutheran - Milwaukee

Morrow Memorial Home - Monroe

Woodland Village Nursing Home Oconto

Brewster Village Outagamie

Rennes Health & Rehab - Outagamie

Heritage of Elmwood - Pierce

Prescott Nursing and Rehab Community - Pierce

Spring Valley - Pierce

LO Simenstad NCU - Polk

Portage County Health Care Center - Portage

Becker Shoop Center - Racine

Mt Carmel Medical & Rehab Center - Racine

Oak Ridge Care Center - Racine

Pine Valley Healthcare & Rehab Center - Richland

Schmitt Woodland Hills - Richland

Mercy Manor Transition Center - Rock

Greenway Manor - Sauk

Ridgeview Terrace - Sauk

St Clare Meadows Care Center - Sauk

Hayward Area Nursing - Home Sawyer

Birch Hill Care Center - Shawano

Baldwin Care Center - St. Croix

Luther Midelfort Oakridge - Trempealeau

Norseland - Vernon

Aspirus Lillian Kerr Healthcare - Vilas

Geneva Lake Manor - Walworth

Holton Manor - Walworth

Cedar Lake Health & Rehab Center - Washington

Linden Grove Menomonee Falls - Waukesha

Muskego Health Care Center - Waukesha

Wild Rose Manor - Waushara

Oakridge Gardens - Winnebago

Vallhaven Care - WinnebagoContact: Stephanie Marquis, 608/266-1683.

New race generates plenty of interest: One of 13 will be eliminated in primary. - The Milwaukee Journal Sentinel (Milwaukee, WI)

Byline: Sheila B. Lalwani

Feb. 19--Caledonia -- The primary Tuesday in Caledonia appears to be the most competitive race the community has seen in years. Thirteen candidates are on the ballot in Tuesday's primary, and 12 will advance to the general election for the community's first Village Board on April 4. The top three vote-getters in April will serve two-year terms on the board; the next three finishers will serve one-year terms.

Village President Jonathan Delagrave is running unopposed, while incumbent members of the former Town Board -- Howard Stacey, Ron Coutts, David Prott and Kevin Wanggaard -- join nine newcomers competing for the six new Village Board seats. The town filed a petition with the Racine County Circuit Court in 2003 and again with the state Department of Administration in 2004 to become a village. Becoming a village allows Caledonia to freeze its boundaries and prevent annexations to neighboring communities. Incorporating also will allow Caledonia to establish economic development tools, most notably tax incremental financing districts, to spur development. 'The momentum of incorporation and people wanting to get involved,' Delagrave said when asked to explain the number of candidates interested in running for the board. Candidate turnout no surprise 'The other issue was that because of incorporation, a lot other issues (came) to the forefront,' Delagrave said. Delagrave wasn't surprised with the turnout because first-time elections tend to attract more candidates, he said. When Mount Pleasant incorporated into a village in 2003, a record number of candidates -- 12 -- turned out for the village election. Major issue: Development The major issues surrounding Caledonia concern the village's economic development plan. Delagrave said the village is putting together a community development authority that will balance the rural character of the village while trying to attract pockets of high-quality development. About 24,600 people live in Caledonia, and many residents have indicated their wish to keep the rural quality of the village intact. Village Clerk Wendy Christensen said residents who want to vote and have not registered should bring a photo ID and proof of residency to the polls. The candidates: Bob Bradley Age: 55 Address: time in district: 6022 Leeward Lane, Caledonia; 8 years Occupation: Will retire Feb. 24 from the Racine Wastewater Utility Elective offices; other government experience: First try for public office Education: Graduated from South Dale (Florida) High School, 1969; environmental health degree, Milwaukee Area Technical College, 1986; bachelor's degree, communications, Concordia University, 1996 Family: Married, three grown children Patrick Cherf Age: 61 Address; time in district: 6931 Revere Road, Caledonia; since 1973 Occupation: Master sharpener, tool repairman Elective offices; other government experience: Defeated for state Assembly, 1990s Education: Obtained GED; attended Gateway Technical College Family: Married, 2 children

Ronald Coutts Age: 60 Address; time in district: 609 Kentwood Drive, Caledonia; 28 years Occupation: Retired from Racine Fire Department Elective offices; other government experience: Town Supervisor since 1993. Ran unsuccessfully for town chairman, 1997

Education: Graduated from Racine Horlick High School, 1965

Family: Married William A. Infusino Age: 56 Address; time in district: 4836 Erie St., Caledonia; 50 years Occupation: Employed In-Sink-Erator Elective offices; other government experience: First try for public office Education: Graduated from Racine Horlick High School, 1967; marketing, sales and broadcasting, Racine Technical College; attended Penn State-Erie, UW-Madison Family: Married, 3 children Stephen Kalmar II Age: 46 Address; time in district: 4305 Erie St., Caledonia; nearly 2 years in Caledonia, more than 30 years in Racine area Occupation: State Department of Health and Family Services, Bureau of Regulation and Licensing, child care center regulation Elective offices; other government experience: First try for public office; founding board member, Racine Interfaith Coalition; administrator, Racine Area Soccer Association; board member, Bright Public Power; Racine Unified PTA; Racine Theatre Guild Education: Graduated from Racine Horlick High School, 1977; bachelor's degree, UW-Parkside, 2002 Family: Divorced, four children Wendy McCalvy Age: 62 Address; time in district: 5400 Six Mile Road, Caledonia; 22 years Occupation: Runs horse farm; substitute teacher, Racine Unified Elective offices; other government experience: Defeated for Town Board, 2003 Education: Graduated from Appleton High School; bachelor's degree, Lawrence University; master's degree, education, UW-Milwaukee Family: Married Brett McDonald

Age: 40 Address; time in district: 4847 Aberdeen Drive, Caledonia; 7 years Occupation: Maintenance coordinator, Racine County Buildings and Facilities Management Elective offices; other government experience: First try for public office Education: Graduated from Racine Horlick High School, 1983; U.S. Navy nuclear program, 1985 Family: Married, two children Jeff McKeown Age: 32 Address; time in district: 2731 Cardinal Drive, Caledonia; 10 months Occupation: Owner, Express Personnel Services Elective offices; other government experience: First try for public office Education: Graduated from Aledo (Illinois) High School, 1992; bachelor's degree, political science, University of Illinois, 1996 Family: Married, two children Paul Orlowski

Age: 31 Address; time in district: 1211 Hialeah Drive, Caledonia: 2 1/2 years Occupation: Kenosha County Division of Health Elective offices; other government experience: First try for public office Education: Graduated from Milwaukee Rufus King High School, 1992; bachelor's degree, UW-Platteville, 1997; master's degree, business environmental management, Illinois Institute of Technology, 1999

Family: Married, one child David Prott Age: 39 Address; time in district: 2442 Rebecca Drive, Caledonia; 4 years Occupation: Shop operational manager, Racine County Highway Department Elective offices; other government experience: Appointed to Caledonia Town Board, May 2005; Caledonia Storm Sewer Utility Commission, 2003-'05 Education: Graduated from Racine Case High School, 1985; combustion engine technology degree, Milwaukee Area Technical College, 1988; attending Concordia University Family: Married, one child Howard Stacey Age: 62 Address; time in district: 5750 Five Mile Road, Caledonia; 30 years Occupation: Retired from Golden Books Publishing Co.

Elective offices; other government experience: Elected town supervisor, 2001, re-elected since Education: Graduated from Racine Park High School, 1961; Carthage College, 1967 Family: Single Kevin Wanggaard Age: 44 Address; time in district: 4932 Aberdeen Drive, Caledonia; 4 years Occupation: Racine Water Utility

Elective offices; other government experience: Elected Caledonia town supervisor, 2003 Education: Graduated from Racine Lutheran High School, 1979; bachelor's degree, labor and industrial relations, UW-Parkside, 1985 Family: Engaged Lee Wishau Age: 48

Address; time in district: 8345 Foley Road, Caledonia; 42 years

Occupation: Manager, retail operation accounting and inventory control, Roundy's Supermarkets Elective offices; other government experience: First try for public office Education: Graduated from Racine Horlick High School, 1975; bachelor's degree, business management, UW-Parkside, 1980 Family: Married

Copyright (c) 2006, Milwaukee Journal Sentinel

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.),

Births Advocate Lutheran General Hospital Centegra Health System Northwest Community Hospital St. Alexius Medical Center.(Neighbor) - Daily Herald (Arlington Heights, IL)

* Dylan James Altmayer, March 29, to Bob and Audrey Altmayer, Prospect Heights. Brother of Jake and Luke. Grandparents: Richard and Sue Buerger, Mount Prospect; and Mariana Altmayer, Glenview.

* Anthony William Libonati and Andrew Theodore Libonati, Feb. 9, to Angela and William Libonati, Woodstock. Grandparents: Jerry and Mary Ann Suhi, West Dundee; Ted and Trish DeRose, Racine, Wis.; and George and Georgiana Libonati, Lodi, Wis. Great-grandparents: Pearl Medziak, Bensenville; and Dorothy Libonati, Schaumburg.

* Henry Matthew Pomis, Feb. 24, to Brian and Lisa Pomis, Arlington Heights. Brother of Charlie. Grandparents: Mr. and Mrs. Joseph Gardiner, Chicago; and Mr. and Mrs. Terrance Pomis, Norridge.

* Caleigh Elyse McNally, March 3, to Gregory and Emily McNally, Mount Prospect. Sister of Andrew and Thomas. Grandparents: George and Ilse Lannin, Elgin; and Thomas and Elderine McNally, Houlton, Maine.

* Maksym Boguslaw Smarzynski, March 13, to Marek and Amy Smarzynski, Mount Prospect. Sibling to Natalia. Grandparents: Roman and Christine Pietrucha, Mount Prospect; and Wojciech and Jadwiga Smarzynski, Mount Prospect.

The 29th International Reggae & World Music Awards (IRAWMA) Returns To NYC On May 2; Star-Studded Event Dedicated To 'Health Awareness' And 'People Of Haiti' - The Culvert Chronicles

New York - A number of music awards acknowledge Reggae and World music, with one or two categories thrown in to show some appreciation. The International Reggae and World Music Awards (IRAWMA), honors Reggae music equally alongside its World Music counterparts. The IRAWMA has traveled to numerous locations in it's 29-year history. So it's only fitting that music so rich in culture and history find a home in a place with an even more impressive story to tell, like New York City.

The prestigious red carpet 28th Annual International Reggae and World Music Awards (IRAWMA) produced by Martin's International & Associates, LLC returns to New York City, on Sunday May 2nd. The star-studded event is dedicated to 'health awareness' and the 'people of Haiti' will take place at York College Performing Arts Center located at 94-45 Guy R. Brewer Blvd in Jamaica, New York. The VIP reception begins at 6:00 pm and general admission is at 7:30 pm.

Jamaica's sing/jay Queen Ifrica captured nine nominations and set an IRAWMA record for most nominations in a single year for a female artist. Other leading contenders include: Tarrus Riley(six nominations); Machel Montano and Gramps Morgan (five nominations each); Julian Marley, Sean Paul and Macka Diamond (four nods each); followed by Barbee, Beenieman and Vybz Kartel with three nominations each.

Grammy award winning songstress India.Arie and fellow IRAWMA nominee Gramps Morgan share a Best Crossover Song nomination for their duet on the single 'Therapy'. In addition, India.Arie and lyricist Matisyahu are each slated to receive the Martins International Award of Honor.

Wyclef Jean and Rev Al Sharpton will receive the Marcus Garvey Humanitarian Award for their tireless efforts in the community. Veteran entertainer/songwriter will receive the Producer's 'Respect' Award. Music pioneers Maurice 'Jack Scorpio' Johnson, Noel 'King Sporty' Williams, Tony Ryan and Tony Greene will be inducted into the IRAWMA Hall of Fame. Radio personalities Trevor Forde, Ron Muchette, Donovan Longmore and Ricot Dupuy will be honored with a special award for their contribution to music, arts and culture.

Just in case you thought that this was just about Reggae music, the IRAWMAs recognize artists in Gospel, Salsa, Latin, Reggaeton, Calypso, Soca, African, Soukous, Compas, Racine and Hip Hop. 'We remain steadfast in our commitment to honor those who have made their mark globally in the Reggae and World Music industry,' says Ephraim Martin, president of Martin's International and Associates and IRAMWA producer.

American Airlines, which has served the Caribbean region for more than 30 years, is again the official airline sponsor of the IRAWMA, visit www.aa.com. The LaGuardia Airport Hotel will serve as the official 'IRAWMA' hotel, mention 'Reggae Awards' to get the special rate or visit www.hotellaguardiaairport.com. Advance tickets for the IRAWMA are $120 platinum(includes VIP reception), gold/main floor $75 and $49 general admission (ticket price more if purchased at the door). Tickets are available at all ticketmaster locations, www.ticketmaster.com, or 800/745-3000 or 877/9-REGGAE and selected from sponsors' locations.

Occupational Curricula and Areas of Instruction: Health Aide - College Blue Book

HEALTH AIDE

ALASKA

Anchorage
Community and Technical College, University of Alaska

ARIZONA

Mesa
Arizona Institute of Business and Technology

Thatcher
Eastern Arizona College

CALIFORNIA

Concord
Mount Diablo Adult Education

Cupertino
De Anza College

Fresno
Galen College of Medical and Dental Assistants

Imperial
Imperial Valley College

La Puente
Hacienda La Puenta Adult Education - Willow Campus

Los Angeles
American Red Cross of Greater Los Angeles

Lynwood
St. Francis Career College

Madera
Madera Adult School

Panorama City
Preferred Training Center

Sacramento
Cosumnes River College

San Diego
George G. Glenner Alzheimer's Family Center

San Luis Obispo
Cuesta College

Santee
Grossmont Union High School District-Adult Health Occupations Education Center

South Lake Tahoe
Lake Tahoe Community College

Victorville
Victor Valley College

COLORADO

Denver
Emily Griffith Opportunity School

FLORIDA

Bonita Springs
Florida Health Academy

Bradenton
American Red Cross Manatee Chapter

Chiefland
Health Education Center, Inc.

Chipley
Washington Holmes Technical Center

Clearwater
Pinellas Technical Education Centers, Clearwater Campus

Davie
William T. McFatter Technical Center

Fort Lauderdale
Coral Ridge Nurse's Assistant Training School, Inc.

Fort Myers
Lee County High Tech Center (Central)

Hollywood
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Jobs for Miami Training Academy Lindsey Hopkins Technical Education Center

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Port St. Lucie School of Practical Nursing

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Tucson, Ariz., health executive works to get a new hospital off the ground. - AZ Daily Star

Byline: Jane Erikson

Nov. 6--The son of a World War II fighter pilot, Norm Botsford learned to fly planes when he was 9 years old.It was improbable, risky, exhilarating -- much like the feats Botsford performs today as president and CEO of University Physicians Healthcare.

From his resurrection of Kino Hospital to his decision earlier this year to take University Physicians Healthcare into Maricopa County, Botsford, 55, has proved his skeptics wrong time and again. Like the boy flying his father's Cessna, he's doing things others doubted he could.

While many of the UA doctors opposed University Physicians' takeover of Kino last year, Kathy Reed, the University of Arizona's chief of maternal and fetal medicine, has been a strong supporter of Botsford's goals.

'Norm is a visionary who has the courage to guide an organization to the next level -- in fact several next levels,' Reed said in an e-mail. 'He has this amazing ability to see farther and persuade, negotiate, nudge, encourage, and inspire a naturally resistant group of well-intentioned physicians and staff into unfamiliar territory.' Another thing she likes about Botsford: He can conduct an e-mail exchange in the style of haiku, a Japanese poem written in 17 syllables.

And despite being diagnosed with a heart arrhythmia in May -- a problem that put him in University Medical Center for a night but is now controlled by medication -- Botsford is optimistic about the future.

'Life is rich and full of possibilities,' he said.

The possibility on Botsford's mind last week was a proposed $60 million expansion of psychiatric services at the former Kino Community Hospital, now known formally as University Physicians Healthcare Hospital at Kino Campus and informally as UPH.

To pay for $48 million of the construction, the county will need to sell bonds. Botsford's job on Thursday was to convince a three-member subcommittee of the Pima County Board of Supervisors it was a good idea.

On Wednesday Botsford was sweating the presentation.

He wants to add a separate 80-bed psychiatric hospital and a UA Institute for Psychiatry and Clinical Neurological Sciences on the hospital campus. The new psychiatric hospital would include its own emergency department to reduce the crowding and chaos in UPH's emergency room -- and in other ERs around the city.

When he appeared before the subcommittee, Botsford's tension eased. He came across as relaxed and upbeat.

He told the subcommittee treating the mentally ill in the UPH emergency room creates 'an incredibly difficult environment for us to try to calm someone who is in the middle of a psychiatric episode, and at the same time try to take care of grandma with a heart attack and junior with a broken leg.' He has a good effect on people in such situations, said attorney Larry Hecker, who chairs the bond advisory committee.

'The word I would use is calming,' Hecker said, 'like we're working together toward a common goal. He's very straightforward and factual, as opposed to trying to embellish or exaggerate. I trust what he says is accurate.' After a friendly exchange of questions, the three-member subcommittee voted 3-0 to recommend the expansion to the full committee. Eventually, if the bonds are to be issued, the supervisors and county voters will be asked to approve.

Botsford grew up in Racine, Wis., where he not only flew planes, but developed a passion for swimming, camping and fishing in northern waters. He spent a lot of time at the YMCA, became a lifeguard and was on his high school's swim team.

'It was a nice way to grow up,' he recalled.

It is perhaps no accident that Botsford ended up a health-care wonk. After World War II, his father took over his grandfather's accounting firm and was on a hospital board for his entire adult career. His mother was an orthopedic-surgery nurse at the same hospital.

Botsford earned a bachelor's degree in history and a master's degree in finance from the University of Wisconsin. Then he went on to work in hospital administration for 15 years, most of them at the University of Wisconsin Hospital and Clinics.

He arrived in Tucson in 1991, joining University Physicians Inc. as associate director of ambulatory care services. At the time the group had about 300 doctors. Botsford was promoted to chief executive the next year.

Tucson then was becoming a proving ground for managed care -- a health-care trend that slashed patients' costs but also their doctors' pay. Managed care would later bear the blame for the demise of some of the city's most revered health-care institutions: Tucson Clinic, Thomas-Davis Clinic, Group Health Medical Associates and Tucson General Hospital.

University Physicians survived, but with some speed bumps along the way -- notably, the group's temporary loss of its Arizona Health Care Cost Containment System contract in 1994.

Botsford's best-known maneuver emerged from a health-care crisis.

Kino Hospital was all but shut down in May 2003. Years of administrative and financial turmoil -- including four different hospital administrators over eight years -- led to an exodus of nurses and doctors. Kino was little more than an emergency room and some clinics, and it stopped admitting patients.

Botsford first suggested University Physicians take over management of the hospital in 2002. County Administrator Chuck Huckelberry supported his idea, but some supervisors and citizens were skeptical.

'I was not one of the skeptics,' said Sharon Bronson, who chairs the Board of Supervisors. 'I was thrilled because I thought we would be able to restore Kino to a full-service hospital that would attract more patients. It was certainly a risky proposition, but I was ready to take that risk. Today it certainly it seems to be working better than even I expected.' And it is working for University Physicians. Its roll of doctors has grown to 350 and revenues are growing. In 1995, University Physicians took in $55 million; in the 12 months ending June 30, it had revenues of $200 million, with about $90 million of that coming from UPH clinics and inpatient services.

The former Kino Hospital is operating at a loss, but less than before, Botsford said.

'We'll probably lose $20 million this year. Last year it was $25 million. The last year the county had it, the loss ran into the $30 million-plus range,' he said.

Attorney Hecker said after the subcommittee meeting that he's impressed with Botsford's work at Kino.

'He's been able to turn a very large ship around and it's heading in the right direction.' Asked to predict the future, Botsford replied by e-mail: 'Professionally, I have 10 years to make the vision of the Kino campus a reality. Having the opportunity to work with a great team of professionals makes me certain we will get it done.'

To see more of The Arizona Daily Star, or to subscribe to the newspaper, go to http://www.azstarnet.com.

Copyright (c) 2005, The Arizona Daily Star, Tucson

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

GOV. DOYLE ANNOUNCES TELECOMMUNICATIONS GRANTS TO NON-PROFIT HEALTH ORGANIZATIONS - US Fed News Service, Including US State News

MADISON, Wis., July 13 -- The Wisconsin Public Service Commission issued the following news release:

Governor Jim Doyle announced today that several non-profit health organizations around the state will receive grants totaling $1.0 million from Wisconsin's Universal Service Fund (USF) Telemedicine program.

'These funds will help deliver vital medical services to communities throughout Wisconsin,' Governor Doyle said. 'The advancements and improvements these grants provide are a great benefit to health care in this state.'

The Telemedicine Program is part of the Universal Service Fund created under Wisconsin law. The program awards grants annually to non-profit medical clinics and hospitals and public health agencies. The grants help clinics and hospitals purchase telecommunications equipment to promote advanced medical services and enhance access to medical care in underserved areas. This year, 37 organizations requested approximately $3.8 million from the fund for the 2010 and 2011 fiscal years with 27 being selected as grant recipients and grant awards totaling $1.0 million.

The telecommunications technology grant helps fund improvements in medical care through greater communication between patients and healthcare staff and communication between medical experts throughout the state. Since the program began in 2001, the Telemedicine Grant Program has awarded over $4.9 million to Wisconsin non-profit healthcare providers.

The following non-profit organizations received Wisconsin USF grants:

* Access Community Healthcare Centers, in Madison, received $36,000 to fund video conferencing for up to three of its clinic locations.

* Aspirus Wausau Hospital, in Wausau, received $51,222 to fund telemedicine carts to link critical access hospitals in Langlade and Medford with specialty services.

* Black River Memorial Hospital, in Black River Falls, received $31,500 to purchase home monitoring units to improve patient care and address health care professional shortages.

* Calumet County Dept. of Human Services, in Chilton, received $25,990 to provide videoconferencing for telepsychiatry to connect the Chilton and Appleton offices.

* Community Health Systems, in Beloit, received $37,873 to purchase four videoconferencing workstations to expand telepsychiatry, AODA treatment, and diabetes screening and monitoring to the Beloit, Darlington, Fennimore and Racine Clinics.

* Community Memorial Hospital, in Oconto Falls, received $33,000 to purchase computed radiography for one of its satellite clinics in Lena or Oconto to increase access to radiologists.

* FPHS, Inc./WIRHN Inc., in Wausau, received $28,200 for videoconferencing equipment for 25 sites in the state for doctor and nurse practitioner consults for primary, reproductive and mental health.

* Forest County Potawatomi Community, in Crandon, received $49,484 to purchase telemedicine exam equipment to be used by nurses or physicians in patient homes or at the Carter or Stone Lake Wellness Centers.

* Gunderson Lutheran Clinic, in La Crosse, received $31,789 to purchase telemedicine exam equipment to connect Independence Clinic with Gunderson Hospital in La Crosse.

* Home Health United, in Madison, received $48,858 to purchase an integrated wound management system to improve care for in-home patients.

* Langlade Hospital, in Antigo, received $43,767 to purchase computed radiography for a satellite clinic in either Elcho or Birnamwood to increase access to radiologists.

* Luther Midelfort Chippewa Valley, in Bloomer, received $39,456 to purchase a video exam system for the critical access hospital in Chippewa Valley to connect with Luther Hospital in Eau Claire to have access to specialty consults.

* Marshfield Clinic Telehealth received $59,279 to purchase telemedicine exam equipment for seven hospitals in north central Wisconsin to implement the Telestroke program.

* Memorial Hospital of Lafayette Co., in Darlington, received $105,000 to purchase telemedicine equipment for critical access hospitals in Darlington, Boscobel and Tomah.

* Milwaukee Health Services received $10,308 to purchase a videoconferencing site to be able to continue to expand its services at its two health centers.

* Moundview Memorial Hospital, in Friendship, received $11,554 to purchase electrocardiogram, radiology monitor and video conferencing for improved cardiac diagnosis, transmittal of data and improved educational opportunities.

* Northern Health Centers, in Lakewood, received $50,317 to purchase computed radiology equipment to improve access to radiologists.

Rest of the document can be viewed at (http://psc.wi.gov/pdffiles%5CNews%20Releases%5C2010%5C07%20July%5CGovernor%20Jim%20Doyle%20Announces%20$1.0%20Million%20in%20Telecommunications%20Grants%20to%20Non-profit%20Health%20Organizations%20.pdf)For more information please contact: Sarabjit Jagirdar, Email:- htsyndication@hindustantimes.com.

Susan G. Komen for the Cure, Ryan Community Health Centers, Breast Cancer Survivors Call on New York State to Expand Breast Cancer Screening, Treatment Programs. - Health & Medicine Week

On January 8, representatives from the Greater New York City Affiliate of Susan G. Komen for the Cure will join breast cancer survivors, health experts and advocates at the Ryan-NENA Community Health Center to release a revealing report describing gaps in New York's public health policies. These gaps make breast cancer deadlier for women of color, women who are uninsured and those from low-income households. Advocates will call for expanded screening and treatment programs on the eve of Governor Spitzer's State of the State address (see also Breast Cancer).

This event marks the seventeenth stop of the Komen Community Challenge, a 25-city campaign to elevate breast cancer on the national agenda and to draw attention to disparities in breast cancer mortality. Uninsured women are more likely to receive a late-stage breast cancer diagnosis and are 30 to 50 percent more likely to die from the disease than women with insurance. Nationwide, one in eight women will be diagnosed with breast cancer in her lifetime. In 2007, it is estimated that more than 12,000 women were diagnosed with breast cancer in New York State, and more than 2,500 died from the disease.

Before the press conference members of the media are invited to tour the host facility, the Ryan-NENA Community Health Center, which receives a Komen grant for coordinating breast cancer screening and treatment for uninsured and underinsured low-income women.

WHAT: Press Conference and Tour of Ryan-NENA Community Health Center

WHO: Theresa Racine, breast cancer survivor and Harlem resident

Keywords: Breast Cancer, Breast Carcinoma, Community Health, Oncology, Public Health, Women's Health, Susan G. Komen for the Cure.

New Mental Health Research Reported from University of Colorado. - Mental Health Weekly Digest

'Youth and young adults with mental health disorders and addictions are at a high risk of becoming nicotine dependent, and at least half will die of tobacco-related diseases. In comparison to the general population, this population also faces neurobiological and psychosocial vulnerabilities,' scientists in Aurora, Colorado report (see also Mental Health).

'There is a critical need for community services and research targeting tobacco interventions for these individuals. A concurrent mixed methods study was conducted by collecting data from in-depth key informant interviews, focus groups, and a survey. Qualitative key informant interviews with healthcare professionals (n = 11) and youth focus groups (n = 32) were conducted by using semi-structured questioning regarding barriers and facilitators to tobacco interventions. Content analysis was used to code transcripts and categorize themes. Survey data were also collected from 230 smokers ages 13 to 17 years (n = 62) and young adults ages 18 to 25 years (n = 40) at three community mental health centers. The survey inquired about tobacco use, motivation to quit, history of quit attempts, and treatment preferences. Five thematic categories were identified in both the adult key informant interviews and the focus groups with youth: (1) motivation to quit, (2) cessation treatment needs, (3) social influence, (4) barriers to treatment, and (5) tobacco-free policy. Among those surveyed, 44% currently smoked. Youth and young adult survey respondents who smoked were often motivated to quit, few had used proven tobacco cessation aids, but there was interest in access to nicotine replacement therapy. Merged qualitative and quantitative findings support past literature regarding youth in the general population but also expand upon our knowledge of issues specific to youth and young adults with mental health disorders and addictions,' wrote C.D. Morris and colleagues, University of Colorado.

The researchers concluded: 'Findings suggest interventions warranting further attention in community treatment settings. (Am J Health Promot.'

Morris and colleagues published their study in American Journal of Health Promotion (Multiple Perspectives on Tobacco Use Among Youth With Mental Health Disorders and Addictions. American Journal of Health Promotion, 2011;25(5 Suppl. S):S31-S37).

For additional information, contact C.D. Morris, University of Colorado, Dept. of Psychiatry, Anschutz Med Campus, Campus Box F478, 1784 Racine S, Aurora, CO 80045, United States.

The publisher's contact information for the American Journal of Health Promotion is: American Journal Health Promotion Inc., PO Box 1254, Troy, MI 48099-1254, USA.

Keywords: City:Aurora, State:Colorado, Country:United States, Region:North and Central America

State grants money to Milwaukee program to provide health care for indigent. - The Milwaukee Journal Sentinel (Milwaukee, WI)

Byline: Guy Boulton

Dec. 17--The Department of Health and Human Services announced on Friday a $100,000 grant to MilwaukeeCares to help the fledgling project set up its proposed network of volunteer doctors who would provide free care to low-income people without health insurance.

The state grants, which give the money over two years, marks the first significant funding of the project.

'They are the first to put their money on the table,' said James Ketterhagen , president of the Medical Society of Milwaukee County.

MilwaukeeCares is an initiative of the Medical Society of Milwaukee County and Partnerships for Healthy Milwaukee, an organization, funded by the College of Health Sciences at the University of Wisconsin-Milwaukee.

The goal is to set up a coordinated network of doctors who would agree to see a set number of uninsured patients. It also would put in place a system in which people without insurance would have a primary care doctor who would oversee and coordinate their health care.

The network also would include hospitals, imaging centers, lab and other businesses that would provide their services for free.

The project is modeled after a widely praised program started in Asheville, N.C., that has since spread to other communities. A similar program -- the Health Care Network in Racine -- was started in 1987.

MilwaukeeCares' network would replace the patchwork of services -- such as community health centers, free clinics and hospital emergency rooms -- that bear much of the burden of providing health care for the uninsured.

'This is a step toward more rational health care and more timely health care,' said Helene Nelson, Secretary of the Department of Health and Family Services.

Nelson announced the grant -- which came from a one-time federal grants -- at the Westside Health Care Association, a community health clinic at 3522 W. Libson Ave. Community health care clinics also see uninsured patients, charging them fees tied to their incomes.

The state grant money will go toward hiring an executive director. Ketterhagen estimates the project will need an additional $50,000 to hire someone to oversee the project. The work so far has been done by volunteers.

Ketterhagen, who is chief medical officer of Covenant Healthcare, estimated that MilwaukeeCares could have a network in place within a year of hiring a director and staff.

The program would require an annual budget of about $500,000, he said. That would cover the cost of a staff to handle such tasks as determining eligibility and assigning patients.

That would eliminate a frequent frustration for doctors who see uninsured patients -- finding specialists when the patient needs a referral.

Many doctors already see the uninsured, said Dr. David Olson, a family practice physician and past president of the medical society.

'The problem is it is not coordinated,' he said.

MilwaukeeCares, which hopes to recruit 80 percent to 90 percent of the doctors in Milwaukee County, would set up a network that would make the referrals effortless.

The project also could save the health care system money.

The uninsured often postpone seeking health care, which can lead to costly complications. The Institute of Medicine, part of the National Academy of Sciences estimates that at least 18,000 Americans die prematurely each year because they lack health coverage.

'People aren't getting the right care at the right time and place,' Nelson said.

In Wisconsin, an estimated 212,000 people in 2003 were without health coverage for a full year. They typically are people who work in low-paying jobs that don't offer affordable health insurance or are self-employed. An estimated eight out of 10 people without insurance are from working families.

Others have pre-existing medical conditions that make insurance unaffordable or impossible to get.

'What we know is there is a long way to go to provide health care for all,' Nelson said.

To see more of the Milwaukee Journal Sentinel, or to subscribe to the newspaper, go to http://www.jsonline.com.

Copyright (c) 2005, Milwaukee Journal Sentinel

Distributed by Knight Ridder/Tribune Business News.