Newsnight Maryland; 297

Are the special needs of Maryland's elderly citizens being met by health care organizations. Plus some of the best chocolate in the country can be found here in Maryland. Good evening everyone I'm Camilla Carr. I'm job a shot a state survey done less than a year ago indicated most Marylanders were satisfied with the health care they were receiving from their managed care organizations. The Maryland health care access and cost Commission found about half of the 27000 people they polled were satisfied with their HMO. But one complaint often heard around the country is about the impersonal relationship between doctors and patients and how little time is available for office visits. NEWSNIGHT Bob has a look now at one each of those efforts however to remedy that problem. In tonight's Maryland discoveries at least once a month. Jan and Syd Lewis come to their HMO in white march not for a formal

doctor's appointment but for a group meeting that combines medicine with socializing. The atmosphere at these gatherings is designed to be relaxed and informative. Kaiser Permanente began offering what it calls a co-operative health care clinics a few years ago. There are a lot of fun and I think really get a chance to meet other people in the same boat more or less. It's sort of a social thing too. And and also the Doctor is there and you have no particular question you can set of how to make an appointment and. Take up you know a 15 minute slot you can just say well look at that mall and so that's OK. And it saves you time saves some time and with time in the doctor's office getting more scarce these gatherings are a way of taking care of less urgent health matters. They know me as a human being and I know them as human beings. And if they ask me something I don't know for example I say well I don't know but I'll find out. Part of the monthly program usually includes a talk from a specialist on a specific aspect of

health care such as arthritis exercise or nutrition. Here the patients get to talk to the experts and among themselves. Also scribed a lot of these here health magazines and newsletters. And a lot of times I bring up questions and in the program if you know this is true or that's true and it generally stirs a lot of conversation about it it's really interesting the various You learn a lot from other people. The monthly meetings also allow members to keep track of their baseline health data through regular screenings. We do routine blood pressure will do if the patients have any routine needs that such as a patient receives allergy injections once a month will do that. We do flu clinic during the meeting sessions. Patients are scheduled routinely for visits after the meeting with their primary provider. They also give us printouts if we have a blood test or something. We have printouts that we can put in our folder and you can be fair back to

them and see if you're improving when certain things are not improving. Those who put on and participate in the cooperative health clinics believe they may help solve the problems associated with dwindling time and access to doctors. In an age of change in health care NEWSNIGHT Marilyn. And joining us now are Mary Turner a senior program specialist with AARP and Dr. Marlene Heyman from Kaiser Permanente. Dr. Heymann we have some idea of how the cooperative clinic works but could you give us a little bit more detail. Yes yes. I run a clinic to similar to the one that you just saw. It's a one month 90 minute session that a group of my patients comes to. It features a speaker on a topic of interest to them or something that we think is important to them. They also have time to ask me questions do some little housekeeping issues like prescription refills that may save them a

call or an office visit. We do blood pressure screening and then they socialize for a little bit. So the patients that we're seeing for example in that story they all have the same doctor. Yes. OK. OK. Now how did this program start. Well it started as a brainchild of a physician a Kaiser physician in Colorado I believe in 1991 and it became so successful that it is now being used in different regions of Kaiser and it has just started in our region in several of our medical centers this past year. And I run Miss Turner. What do you think of this idea. I think it's exciting I think any program that offers an opportunity for education access to screening and talking and ability opportunity to talk with their doctors at greater length an opportunity to engage in discussions with other individuals is very important to maintaining one's health based on what you say you've found out from your members of what are some of their needs and will something like

this fit or fit their needs. I think so. We know that 80 percent of individuals over the age of 65 have at least one chronic health problem. Many have multiple conditions. In fact chronic disease is the leading cause of illness disease and disability in the United States today. So we do know that dealing with these coping with these conditions is often one of the greatest challenges to an individual's ability to live independently. So again opportunities such as these really offer exciting opportunities for individuals to maintain their health. Dr. Heymann what makes the needs of the elderly more difficult to address let's say in an office visit or are they more difficult to address in that office visit. Yes yes they're much more difficult. The patients need more time. They may have trouble hearing what they may have trouble getting in out of the office they need more time to actually get into the appointment. They have more complicated medical problems and multiple medical problems. They may live alone they may

be lonely they may be depressed. You need to address all these issues and office visit and there's just not enough time in a routine office visit this. This gives me one and a half hours with the patient and hopefully I can give them a little more of my time and give them more of what they need. I notice that socializing is a part of this and that's very important for seniors isn't it. Yes yes. Several of the patients in my clinic live alone. Some are widowed. Some are single. I do have a lot of couples though that come together but they use it as a opportunity to socialize they've made friends within this clinic they've carpool together and they do get a lot of emotional and social support and that we'd like to remind our viewers that we are taking phone calls and the number is 1 800 9 2 6 0 6 2 9. That number again is 1 eight hundred nine 2 6 0 6

2 9. Mr. TURNER. What do you think is the single major issue though facing seniors right now in terms of health. Is it the fact that they do have multiple problems. I think that's a very key one of the exciting things that I'd like to talk about is the opportunity to prevent many conditions and to certainly manage and control them. We know a lot about the importance of healthy lifestyle eating right exercising on a regular basis not smoking getting appropriate screenings engaging in the community I mean these are all critical things that an individual can do to have an impact on their health and there are really key determinants to health and function in old age. In fact I saw you nodding several times to Dr. Heymann was describing her particular program so this is all based on what both of you were saying it would seem to me that these cooperative health clinics cover a lot of the bases. I would think so and I really would like to emphasize the importance of the social support aspect of it.

Social isolation has been shown to be a key determinant in actual death and the importance of being able to engage yourself in the community being able to share your your thoughts and ideas with others to gain a sense of control as a group is really important. What kinds of programs does the AARP offer. For seniors that are related to health. That would dovetail into something like this. Sure we do offer a variety of health information publications available to our members and to the general public. We're certainly involved in a variety of community activities promoting health promoting various aspects of health. So AARP is very committed to health and health care for seniors. I mean we look forward to working on these issues for many years to come. Dr. Heymann one question that probably needs to be asked is Does this cut down on Doctor doctor visits and doesn't deny the patient an ability to go

One on One with a doctor by going to these cooperative health clinics. Right. To answer the last question in no way does this take the place of an individual appointment with myself a physical appointment. It is in addition to their normal office visits. It does not deny access. In fact it improves access and it may cut down on some. Need to see specialists if we get speakers in that specialty the patient may not have to go and see that specialist individually. It has been shown in some of the studies done in Colorado that it does cut down on emergency room visits and hospitalization rates. And that way it may actually benefit the patient and be more cost effective. MR Do you find that your members are having problems though negotiating through the health care system health care delivery system the way it is it's set up now.

Certainly I mean the ownership is often on the individual patient to work themselves through the maze and we work hard to provide tools for individuals. Learning how to understand various health care systems learning how to communicate with their doctor stressing the importance of communication with your doctor. Certainly that is a key issue. Do you for example offer workshops or printed material or both. We do both as a matter of fact. We're currently involved in developing a variety of tools for older adults to use in managing for or understanding the maze of managed care. When you talk about tools What are you talking about are talking about publications we're talking about community workshops. Primarily. What do you get any complaints from seniors about most. One of the complaints that that has been publicized is the fact that the there is this lack of personal contact. I'm not really able to discuss that in too much detail as I am certain that

we do I know that in the general public it's an issue it's certainly a big issue and I would encourage people to be as informed as they can to seek out information to engage in dialogue with their physician to talk with their family and their friends and to really keep these issues at the front of their mind. Dr. Hyman do you find that there is confusion among your patients some of the seniors that come in and just how to negotiate the health care delivery system. Somewhat. And I feel as their personal physician I am helping them negotiate the health care the health care that they're getting. Skies are stresses the personal physician kind of concept and I have a very strong relationship with these patients that I've seen for many many years and the happier the patients are they happy happier patients seem to be the ones that have the personal care that we give. We have a caller Paul off from Baltimore County you're on the air.

Hired what or what their criteria the doctor used. I invite people to the group are they all or registration or are they all heart related or is it anyone that you record that you offer opportunity. Dr. Amen. Well we have started this program in this area as a pilot study. So not every one of my patients over 65 is is in this type of clinic. We have a selected a group of patients we think may benefit because of a variety of health problems. Patients who have needed to see the doctor many times over the previous few months and we're trying to now select the patients who might benefit more by that and it was by invitation to this to this program. Another problem that's facing many seniors is the issue of prescription plans and how to pay for medication now some HMO laws

do offer prescription plans and some require fees. MS. Turner is that an issue. Certainly I mean prescription drugs is a critical issue it's a it's an extremely significant health care cost to individuals. Again I you know I would encourage people to become informed as they're looking at their health care options and seeking out perhaps opportunities too. Get more information about prescription plans when they're considering joining a health plan Dr. Heymann. Kaiser offers many prescription plans for patients. There is a newer package that I am aware of called the Senior Advantage package which Kaiser is now offering which I believe cuts down significantly on the cost of their prescriptions. There are transportation vouchers that the patients can use so it offers a lot of advantages for these this age group that so that's an interesting issue very strange because it is very difficult for some seniors to get to the doctor

either even if they have a car maybe they're suffering from arthritis and if they have to take public transportation What is your group trying to do to address that Ms Turner. Again I'm not really prepared to answer that question other than to say that transportation is a key issue. There are certain community organizations that perhaps can help individuals get to the doctor. Some health plans perhaps may offer the same. It is a critical issue. Dr. Amen. I noticed that when you talked about the transportation vouchers was it determined based on this study in Colorado that that was an issue as well. No I don't think it was that study but just Kaiser sees a need for the elderly patient to have access to transportation and they have put this in in one of their senior packages for people out there who are watching this show what would you advise those people who are seniors.

I we're not asking you to give you know real medical advice here but for we have or will have elderly relatives what would you what's the key. The key is to establish a relationship with one doctor. You know that doctor have them know you consistently see that doctor ask a lot of questions have that doctor become your spokes person to help negotiate health care delivery. And those are the most satisfied patients that I have. Mr. Turner are we dealing with a cultural gap here though in the sense that many seniors were they come from a generation where you didn't question the doctor where the doctor what was it. Right. I think there is some of that although it's changing. I think people are becoming more informed. They're certainly learning more about their specific condition and opportunities to talk with other individuals helps to strengthen that. So my my main point here would be stressing the

importance of being informed know your condition you know seek out as much information as you can so you are an informed patient. Well I'd like to thank both of you for joining us. Thank you. Turning now to the Maryland because it seems that a panel of experts has found the best chocolate in the nation and guess where they found it in the basement of a house in East Baltimore where a family business produces Moore's chocolates. NEWSNIGHT introduces us to some remarkable people. The company's been around more than 75 years and for nearly 40 of those years Virginia little has been a part of it. She's 91 the only hand dippers still at work. I love the work force that goes all the time in. My state and. It's easy work but nobody wants to do it. Too. Messy for him you know they don't want to get. To truly and an art a crayon because real. Needs to be at 100 degrees when it

melts and then you have to cool it down to like 78 degrees. And from that point then you have to get it up to about 86 degrees and keep it at that temperature. And when Virginia dislike gets her hands like a thermometer. It's not so good wow man how would do you. It really doesn't. Something you don't learn overnight. The business itself didn't spring up overnight either. The Heil family has owned more since 1962. Jim Heil wife Lois and son Dana are on the job daily along with eight employees and along with experience the other factor here is a tradition of top quality ingredients that's made right here in the United States. We use the recipes like the the caramel like for two hours and we still use the water and the creams. Morris offers a full product line and though it's a small operation tours are conducted if you call ahead and the occasional sample is handed out. It's very tender it's going to surprise you. I caramels are designed. For

tender eaten. Low fat right. Definitely because you won't be as hungry at your dinner time when you give off 500 calories. I'm Jeff Salk and for Newsnight Maryland. Now I like that rationalization don't you. By the way we first broadcast this story a few years ago but Virginia little is still at work. And next on NEWSNIGHT Marilyn meet the young woman who founded the country's first grassroots anti substance abuse program. Her friends know her as Heather Davis but you may know her as Miss Maryland. We'll be right back. Beginning August 7. NEWSNIGHT not only will those discussions between county executive on fewer than 30 Friday. We give you a chance to get to know the client and understand the issues that affect you and the job would look. Old. On NEWSNIGHT No. Topic. Bottom line.

It was one of the greatest adventures of all time. But first they had to face their greatest fears. More than 500 years ago traders dreamed of gold spices and a route to the riches of India against all odds they pushed back the brown tears of the unknown to the point where reality began. This is the story of those who dared to sail into the rising sun beginning Wednesday August 26 on NPT. She was only 16 when she established a successful and still operating

life program. L I F E. And the substance abuse program at a school in Annapolis. Life later became her platform a shoot on the way to becoming Miss Marilyn. Heather R. Davis joins us now. Well Heather your resume frankly sounds like it might have taken three or four people to do everything you have a stellar scholastic career could allow Day honors in grad school or working four or five jobs from waitress to a long distance telephone customer service operators broadcasting internships from CNN to the Christian Broadcasting Network to local stations. Volunteer work and of course pageants. Are you a workaholic How do you go and hire a workaholic. Well yes and no but now I do have find time to play and I think it's important. The busier you are that you do find time for yourself. I think that's an important part of life for anyone who's busy. You stay focused though. Yes I do have I'm that invaded Yes. In competition Your talent is classical piano. Your platform issue as

we said is youth peer counseling an anti-drug effort that you founded. First what did you play to win the Miss Maryland competition. I played it a triad montage of three pieces flight of the Bumblebee and I'm going out to sea by Liszt and the piece and what's on your Atlantic City agenda of the same and I've composed them all together it's an original arrangement for the part of the talent is that I compose them as well. You were 16 when you founded the group called life. We're going to as we talk give both the phone number and alternate website the world wide web site address on the screen as we talk about that tell us about life. Well life is actually stands for loving instruction for elementary and it's a three tiered program. The first here is that the high school students sign a contract pledging their abstinence from drugs and alcohol and I feel that's a very important part of the group because it keeps the group cohesive and the students enforce that contract. And then the second tier is the high school students Caray and performs skits Anti-Drug Abuse skits for the elementary schools and then the third tier which is the most exciting tier is the one on one time where the high school students and elementary school

students come together in classrooms and discuss life issues. The skits that they just saw. And that's what behaviors and attitudes change. Why do kids respond better to other kids. Goodness Well it's proven that peer mentors. That is that that's the strategy we need to fight this drug war because I think that. We're saying increasingly that kids are not listening to parents police officers and teachers as much as they'll listen to their high school peers. What brought you to the playing field on this. Well and high school I went to a public school and I was in an anti-drug abuse group there as well. They didn't have the contract that I did in my group and I think that's important because it does keep the bad apples out and it really promotes the positive. And so I think that's an important also had personal experiences with friends who have died in drunk driving accidents or have been victims of ever dosing. So I know I know from personal experience when you know someone when a friend has a drug abuse problem it not only hurts that person but everyone around anyone around them. You're absolutely right. And it affects the school.

Yes it does. Yes it does that's why peer mentorship is so important it's why we need to get this program out and I'm actually the State Board of Education for Maryland has given the Miss World Pageant a grant for Miss Marilyn to go out into all of Maryland and I'll be implementing this program in every county in our state this year so look for me. And please support me. Well we'll look at we're you know and as we say the phone number is on the screen for information about the life program and the World Wide Web addresses is on the screen right. Right. You know I don't think many of us can imagine what it's like inside the world of beauty and talent competitions. But we saw a dark side of it in the story surrounding the tragic death of little Jon-Benet Ramsey. Stories about help parents push their children relentlessly and single mindedly. You know parents and young when you've been around the world of pageants now and are part of it you know parents and young women who fit that mold.

Right well I've actually been in pageants for three years so I haven't been in it on my life but. I'm sure I have not met parents who have done that. But I'm sure that there are parents like that but they are in the minority. I know you say to them what I say to that if I were to me. Well I think that it should be when I have children I think it should be my child's choice I think that the child should be old enough to make their own decision to know what they're getting themselves into. I did attend a pageant once where a 5 year old was in this pageant and she didn't win. She didn't understand it and it just broke my heart she just didn't understand what she was doing anyway and it's her and she was upset understandably because she knew she lost but she didn't really know what she lost and so I think it's important that parents explain to their telling what's going on and that they decide for themselves. Is 5 too young to compete. I believe so. You leave next week for Atlantic City to prepare for September's Miss America Pageant of course. Time for Third I believe that's right in September 19th is the big day. It's on it's 8:00 p.m. ABC Please watch.

How do you deal with when they're not watching. Oh how do you deal with nerves before a competition. Well I'll do two things First of all pray and second of all sing I'll sing before I go out I think that relaxes every my nerves at least in that I've heard it's a good stress relieving technique. Have you lost any along the way as we've been all winter for you. Oh sure I've lost plenty and in fact I've never walked away with a loss that I haven't gained something at that pageant So what has computing taught you. Oh goodness the right motivation for my cause I think is most important. I've done this community service for six years obviously before I was even in pageantry but I think it's just important to have your motivations in the right place. I guess the best thing I've gotten out of it. Heather R. Davis Miss America 1998 why don't you give us the Miss Maryland's 1998 and prospective Miss America. Why don't you give us the phone number for information and the World Wide Web address before we go. OK well the phone number is 4 1 0 3 1 5 8 1 0 1 and the address is w w w dot when Dash meaning hyphen SBIR dot

com. And that's for the wife program the peer counseling substance abuse program which you founded head of Davis thank you. Thank you very much. And that's it for this edition of NEWSNIGHT Marilyn. But be sure to join us tomorrow. Why is Fort Meade been on the EPA list of environmentally hazardous sites for six years and little or nothing has been done to reduce the pollution. The answer depends on who you ask. We'll hear from key players. For all of us here at NEWSNIGHT Maryland. Thanks for watching good night good night. We want to hear from you. If you have a comment on tonight's edition of NEWSNIGHT Mary. For a story idea for future progress please e-mail us at NEWSNIGHT at MPG dot org. Or call our TALKBACK LIVE. At 1 800 5 8 6 1 4 6 1. That's 1 800 5 8 6 1 4 6 1.