#1     Tues. 10:30 to 11:30 am           Medicaid Reimbursement for Local Health Departments

#2     Tues. 1:30 to 2:30 pm               Data Sharing  CANCELLED

#3     Tues. 2:40 to 3:40 pm               Pest Management & Indoor Air Quality

#4     Tues. 3:50 to 4:50 pm               Trash Burning and Heavy Metals

#5     Wed. 9:15 to 10:30 am             The Doctor Is In:  Asthma and Lead Poisoning

#6     Wed. 10:45 to 11:45 am           Indiana's Asthma Plan for Healthy Homes

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#1   Medicaid Reimbursement for Local Health Departments - Tuesday 10:30 to 11:30 am

Since 1999, state Medicaid programs have been required to reimburse Medicaid service providers for case management and environmental investigation services provided to lead poisoned children.  After five years of effort, ISDH and Indiana Medicaid have established a mechanism to provide that reimbursement to local health departments and contractors.  The system is scheduled to start up in January 2005. 

Under the system, local health departments and their contractors will not have to be Medicaid service providers.  ISDH will handle the claims and arrange for 50% to 75% reimbursement for the actual expenses incurred.   

This session will provide an opportunity to learn about the mechanism and how to take advantage of the system to fund case management and environmental investigation services.  OMPP and ISDH staff will be on-hand to explain the system, take your comments, and address your concerns before finalizing the system. 

This is great news for Indiana health departments and lead poisoned children! 

Moderator:    Karen Long - Public Health Nurse for Kokomo County Health Department

Speakers:  

• Maria Larson - Director, Childhood Lead Poisoning Prevention Program at the Indiana State Department of Health in Indianapolis

• Wendy Gettlefinger - Assistant Commissioner at the Indiana State Department of Health in Indianapolis

• Elizabeth San Miquel - Office of Medicaid Policy and Planning at the Indiana Family and Social Services Administration in Indianapolis

References:

• ISDH August 19, 2004 Report to the Indiana General Assembly on Blood Lead Poisoning for Indiana Counties
• ISDH-OMPP October 18, 2004 Report to the Joint Select Commission on Medicaid Oversight
• State Senator Simpson’s Draft Legislation Regarding Medicaid Reimbursement and Screening Endorsed by the Joint Select Commission on Medicaid Oversight
• IKE August 30, 2004 Report to the Joint Select Commission on Medicaid Oversight regarding Indiana Medicaid’s Unfulfilled Responsibilities to Identify and Protect Lead Poisoned Children
• IKE April 9, 2004 Summary of Blood Lead Testing on Medicaid-Eligible Children – 1999 to 2003 Progress Report

#2   Data Sharing – Tues. 1:30 to 2:30 pm  CANCELLED - UNABLE TO SECURE SPEAKERS

House Enrolled Act 1171 was enacted in 2002.  It required that the Indiana State Department of Health share data with local health departments on children who were lead poisoned after 1990.  It also requires that the information be shared with state and local housing agencies for cases identified after July 1, 2002.  

Implementation of HEA-1171's mandate to share data has been slowed various interpretations and perceived conflicts with state and federal medical confidentiality rules.  Some health departments have evaluated the laws and concluded that it can reconcile the differences and reveal address and other information to housing agencies because lead poisoning is a serious public health issue - an exemption under the federal Health Insurance Portability and Accountability Act (HIPAA).  Other agencies read the mandate to share the data as prohibiting the sharing of information not mandated to be shared.  And there are disagreements as to what must be shared and how much access can environmental agencies and housing agencies get.

The Indiana State Department of Health and the Centers for Disease Control and Prevention have been intensively working through these issues.  They were unable to resolve the issues in time for the conference.  Therefore, we regretfully had to cancel the conference,  ISDH is planning to propose legislation in the next session to resolve their concerns about the existing state law. 

Moderator:     Karen Long - Public Health Nurse for Howard County Health Department

Speakers:       CANCELLED - UNABLE TO SECURE SPEAKERS

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#3  Pest Management & Indoor Air Quality – Tues. 2:40 to 3:40 pm

From mold to cockroaches to dust mites to pet dander, the home abounds with materials that can trigger an asthma attack.  The science of asthma and the identification of environmental sources of asthma causes and triggers is quickly evolving as the issue has leaped into national focus.  

This session consists of two parts.  First, Al Fournier of Purdue University will explain how to identify and select the best methods to reduce exposure to both pests and pesticides.  This approach is called Integrated Pest Management.  He will also explain how to identify child-care facilities and schools that effectively use integrated pest management.  Pest management is always a challenge for housing agencies and health specialists.  This session is a good chance to learn from a pro.

The second part will focus on indoor air quality.  Lisa Cauldwell of Marion County Health Department will join us again this year to share her ideas and experiences with indoor air quality problems in Indianapolis.  She gets rave reviews each year, but each year she brings new stories and approaches.  

Moderator:     Jack Leonard - President of the Environmental Management Institute in Indianapolis

Speakers:         

• Al Fournier - IPM in Schools Coordinator at Purdue University's Department of Entomology in West Lafayette

• Lisa Cauldwell - Indoor Air Quality Specialist and Code Inspector at the Marion County Health Department

References:

• Cockroach Control Guide by the Environmental Health Watch
• IPM Overview by the Minnesota Department of Agriculture
• Back-to-School Organizing for Safer Pest Management by Beyond Pesticides/National Coalition Against the Misuse of Pesticides
• Advisory Pest Control Policy in Schools by the Indiana Pesticide Review Board on March 3, 2001
• Model Pest Control Policy for Indiana Child Care Facilities by the Indiana Pesticide Review Board on February 17, 2003
• IKE August 31, 2004 Letter to ISDH and Indiana School Air Quality Panel
• Indianapolis Star article Judge OKs Mold Settlement on October 21, 2004 - www.indystar.com/articles/6/188071-3556-102.html

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#4 Trash Burning and Heavy Metals – Tues. 3:50 to 4:50 pm

This is another two part session.  The first part will address illegal trash burning.  Trash burning is illegal unless in a permitted incinerator.  Despite the law it is common throughout rural areas of Indiana.  Jeff Meyers of the Indiana Illegal Burning Task Force will walk you though a new media campaign and interactive website to help explain the serious hazards posed by trash burning.  If your community has a problem with trash burning, plan to attend so you can be better prepared to educate the community about it.

Heavy metals such as lead, mercury, and arsenic have been on the public health agenda for years.  But it is confusing - not just for the public but for public health advocates.  For example, what is the scoop on arsenic treated lumber and what is ACQ?  Or is mercury in fish different than mercury in consumer products?  This session will wrestle with the issues surrounding heavy metals and help participants draw their own conclusions.  

Moderator:  Patty Muehlhausen - Healthy Families of Area Five in Logansport

Speakers:         

• Jeff Meyers - Executive Director of the Greene County Solid Waste District and Chair of the Indiana Illegal Trash Burning Task Force in Bloomfield

• Paula Smith - Director of the Office of Planning and Assessment at the Indiana Department of Environmental Management in Indianapolis

References:

• IDEM Illegal Trash Burning Brochures

• IDEM Mercury Brochures

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#5 The Doctor Is In: Asthma and Lead Poisoning – Wed. 9:15 to 10:30 am

Doctors are critical to preventing lead poisoning.  They can help ensure that the right kids are tested for lead poisoning.  They can also reach parents at that "teachable moment" with just a word.  

Yet, like most professions, not all doctors are the same.  Some have a great grasp on the issue and make a tremendous difference in the lives of their patients.  Other doctors still look for symptoms of lead poisoning in children before acting.  They do not all know what the latest research shows about the long-term effects of lead poisoning - even at low levels that do not have any symptoms.  How can you measure the lost learning potential of a child?

Asthma represents similar challenges.  While identifying the problem may be easier, identifying the sources of the problem are much more complex and varied.  The key is that the medical profession must look at the exposures to asthma triggers in the home, in school and at work in order to make a sustainable difference for the asthmatic.  

This session will explore the medical view of asthma and lead poisoning from the perspective of Hoosier doctors who care about the issue and have demonstrated leadership in their community.  Concerned parents, educators, risk assessors, and social service providers should attend this session.

Moderator:     Sandy Wampler - Director of Home School Relations at Marian College and Healthy Schools Director for Improving Kids' Environment

Speaker:         

• Dr. John Ellis - Associate Medical Director with The HealthCare Group / M-Plan in Indianapolis.

References:

• ISDH August 19, 2004 Report to the Indiana General Assembly on Blood Lead Poisoning for Indiana Counties.

• ISDH July 13, 2004 Indiana Childhood Lead Poisoning Elimination Plan
• Indiana Joint Asthma Council (InJAC) Draft October 20, 2004 Indiana Asthma Plan – Housing-Related Sections
• InJAC Environmental Committee Goals to Reduce Environmental Risk Factors that Contribute to Asthma in Indiana Homes and Commercial Buildings

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#6 Indiana's Asthma Plan for Healthy Homes – Wed. 10:45 to 11:45 am

Indiana Department of Environmental Management and Indiana State Department of Health formed the Indiana Joint Asthma Council in May 2003.  InJAC was directed to develop a State Asthma Plan for Indiana by September 2004.  Dr. Ingrid Ritchie of Indiana University's School of Public and Environmental Affairs chairs the Environmental Committee.  The committee developed specific recommendations for housing, child-care, schools and other buildings.  

Dr. Ritchie will explain the healthy homes aspects of the plan and share with you her ideas to implement the recommendations.   

Moderator:     Pat Daniel - Team Leader with the Office of Planning and Assessment at the Indiana Department of Environmental Management in Indianapolis

Speakers:         

• Paula Smith - Director of the Office of Planning and Assessment at the Indiana Department of Environmental Management in Indianapolis

• Dr. Ingrid Ritchie - Professor at the School of Public and Environmental Affairs at the Indiana University & Purdue University at Indianapolis

References:

• Indiana Joint Asthma Council (InJAC) Draft October 20, 2004 Indiana Asthma Plan – Housing-Related Sections
• InJAC Environmental Committee’s Goals to Reduce Environmental Risk Factors that Contribute to Asthma in Indiana Homes and Commercial Buildings

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