Thursday, February 16, 2006
Old advice still good: Put infants on backs to sleep

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Several years ago, the American Academy of Pediatrics (AAP) began the "Back to Sleep" campaign. The goal of this campaign was to reduce crib deaths. Crib deaths are also known as sudden infant death syndrome (SIDS). The campaign was successful in getting parents to keep their children on their back when they are put to sleep. This is now the preferred position. The AAP has put out some new information on SIDS. That information confirms the need for putting infants on their back for sleep. There are some other recommendations relating to safe infant sleeping. One of these is a new one. It is a recommendation that infants always lie on their backs and not on their sides. Side sleeping is not as safe. It is good for an infant to sleep in your room. It is not good for an infant to sleep in your bed. It is too easy to roll over during your sleep and suffocate the baby. For the same reason, infants should not be put to sleep on soft items. They should not sleep on an easy chair. They should not sleep on a sofa. They should not sleep on a waterbed. They should not sleep on a large cushion. They should sleep in a safety-approved crib. There should be a firm mattress in it. There should be no space between the mattress and the bed frame. There should be a fitted sheet in the crib. Do no use soft, pillow-like bumper pads. It is better to use warm sleepers than blankets. That way the infant cannot wiggle under the blanket. Keep the room temperature at a comfortable level. It should not be too hot Do not put pillows in the crib. Do not put comforters in the crib. Do not put stuffed toys in the crib. Cats have been known to sleep on baby's faces. Keep them out of the room. Ferrets have been known to chew on infants. Do not own one with a baby around. Second-hand smoke increases the risk of SIDS. It increases a lot of other risks for the infant as well. Infants can be kept on their stomach while they are awake so they can explore things around them. However, they need to be turned over when they are put in for sleep. These are the current recommendations from the AAP. They add some useful information to what we had before. However, the number one rule remains: Infants should be put to sleep on their backs.

Library to host breast health program
The Delaware Breast Cancer Coalition will hold a breast health program Monday, Feb. 27, 7 p.m. at the Greenwood Public Library. This program will use a multi-media approach to educate women about the risk factors of breast cancer, early detection, how to survive breast cancer and where to seek more information. The library is on the corner of Market and Mill streets. Registration is required by calling the Greenwood Public Library at 349-5309. The program is open to the public at no charge.

Health fair set for March at CHEER
The CHEER Community Center, 20520 Sand Hill Road, Georgetown, is hosting a health fair on March 31, from 10 a.m. until 2 p.m. The health fair will focus on health screenings and senior issues. Any service-oriented businesses that cater to the senior community are invited to set up displays. Some of the venders participating are Apple Discount Drugs, Diabetes Supply Service Inc., CHEER Home Services (diabetes screening), Harbor Health Care & Rehab Center, Office of the state bank commissioner, Rockford Center, Beebe Medical Center (osteoporosis screening), Berlin Nursing & Rehabilitation Center, Mercantile Mortgage, Peninsula Home Care (blood pressure), Delaware Hospice, Sussex Eye Care (visual acuity and intraocular pressure checks), CHEER caregiver resources, CHEER Nutrition (nutrition screenings) and CHEER marketing.

Admission to the health fair is free.
Any organization or businesses interested in exhibiting may call Nicole McCready at 854-9500.

State extends coverage under its drug program
In order to ease the burden on citizens who are receiving a pharmacy benefit through a state program, Delaware Health and Social Services announced last week that it is taking the following actions:

  • Delaware Prescription Assistance Clients (DPAP) - State law now requires citizens to utilize the Medicare Part D drug benefit before accessing DPAP. Originally this change was scheduled to go into effect on Jan. 1. Instead, all clients who are currently enrolled in the DPAP program will continue to be covered in DPAP through March 31, 2006.
This extension will include both clients who have submitted reenrollment applications as well as those who have not. All new applicants who have submitted proof of income will also be covered. Pharmacists have been instructed to attempt to bill the Federal Part D program first. If that is not successful, pharmacists will contact the DPAP program staff for a prior authorization so that the pharmacy bill will go through and be paid by the DPAP program. The pharmacists are also being encouraged to counsel the DPAP clients to enroll in a Part D plan if they have not already done so. It had been expected that some of each client's $2,500 DPAP benefit would be used to cover the premiums for the various Part D plans. Although this will eventually be possible, most of the plans have not responded to requests to link to our computer system and process premium payments. This will likely be a problem area for clients during the initial months. However, if any Part D drug plan refuses to pay a claim for DPAP clients, the state program will pay for the prescription during the three-month extension period.
  • Chronic Renal Disease Program (CRDP) – These clients do not have a re-enrollment process. Their drugs will continue to be covered by the state program. However, pharmacists will be asked to bill the new Federal Part D program first. If that fails, pharmacists will follow the same process as for DPAP. In addition, the problem with paying Part D premiums will also affect this group, but CRDP will pay the claim if the Part D plan refuses payment.
  • Medicaid clients – About 9,500 clients on Medicaid are also eligible for the new Part D drug program. This group is known as the "dual eligibles." By federal law, effective Jan. 1, Medicaid can no longer pay for drugs for this group. DMMA staff has worked closely with the federal government to identify all the clients in this group. The federal program has already automatically assigned everyone in this group to a new Part D drug plan and the clients have been notified of their assigned drug plan. The pharmacies have been given instructions by the federal government on how to bill for this group. It is expected that the federal government will take any steps necessary to ensure that none of these clients will have problems filling prescriptions during the initial months of the new federal program.
  • Other Medicare clients in Delaware – It is important to be aware that there are thousands of Delawareans covered by Medicare insurance who are not and never have been covered by Medicaid, DPAP or the CRDP programs. State government has not played any role in their past drug coverage and will not have any role as they now become eligible for the new federal program. Any problems encountered by this group will have to be addressed by the federal government.
The entire transition process is complex and state officials do not have control over the federal program. During the three-month extension, DMMA will work closely with DPAP and CRDP clients to help them succeed in enrolling in a Part D drug plan. In addition, many should apply for and be eligible for reduced co-pays and deductibles. Enroll with a Medicare Prescription Drug Plan by:
  • Using the Internet at
  • Calling 1-800-Medicare.
  • Calling a Prescription Drug Plan.
In addition, people can apply for "extra help" with the Social Security Administration if their yearly income is under $14,355 for a single person or under $19,245 for a couple by:
  • Using the Internet at
  • Calling 1-800-772-1213.
  • Calling a local Social Security office.
For more information, call the Delaware Prescription Assistance Program - (DPAP) at 800-996-9969.