Now that summer is here you are probably opening up your windows and enjoying the lovely warm air and sunshine.  But that usually isn’t the case the rest of the year.  Here are some tips to help you create and maintain a healthy home:

If you smoke, please smoke outside and wear a smoking jacket and hat.  All those toxins in cigarette or cigar smoke are very dangerous especially to children, the elderly and those with compromised immune systems.  There are 4,000 chemicals in one cigarette and 40 of them are carcinogenic.  Protecting your clothing with a jacket and hat will reduce your children’s exposure to those chemicals.

One of the best things that you can do for the health of your home is to remove your shoes at the door.  Outside we step in lead, arsenic, pesticides, insecticides and all sorts of other chemicals. Outside they can be broken down by the sun and the rain – inside they are not.  Make this easy for your friends and family – install shoe racks at the front door (or the door that is used the most), install a high quality commercial grade walk off mat at the exterior of the door, provide a basket with slippers and socks as well as a chair to sit on.  Removing one’s shoes at the door also keeps your house a lot cleaner!

In terms of cleaning, we really don’t need any commercial products – white vinegar and baking soda work great!  Mix white vinegar with water in a squirt bottle and use it to wash windows and hard surfaces such as your wood or vinyl flooring.  Your house may smell like a salad but you’re breathing better air for it!  Baking soda makes a great scouring powder as well.  These products are incredibly inexpensive and will help you save money, your health and the environment.

What to do with carpeting? The best surface in the house is a hard surface as they are much easier to clean and to keep clean.  Carpeting can harbor dust mites, chemicals, dust, pesticides etc. One must vacuum a lot longer than you think you have to, to remove the deep dust. We recommend vacuuming at least once weekly using a high quality vacuum that has a HEPA filter and a bag. Empty the bag when it is half full and consider upgrading to an ultra filtration bag.  If you have a bagless vacuum, empty the canister outside.  Before emptying, place a plastic bag on top of the canister and once you’ve turned the canister over, clamp down on the bag quickly – this will reduce your exposure to the dust.

Damp dust weekly using a lint free cloth and only water.  If you want to put some oil on the cloth, mineral oil works well.  Dust contains a multitude of chemicals that are not healthy to breathe.  The smaller the particle, the potentially more dangerous they are, as they can pass directly into the bloodstream.

Consider using environmentally friendly products whenever you clean, shower or bathe. Highly perfumed products may contain petrochemicals and other chemicals such as phthalates that may be harmful to you, your child and to the environment.  

Open your windows and ventilate daily.  According to the EPA our indoor air can be up to 5 times as polluted as our outdoor air!  All sorts of products in the home can be off gassing – furniture, bedding, carpeting, carpet padding, paint, furnishings, dry cleaned clothes, dryer sheets, candles, plug in air fresheners, curtains, etc.  Open your windows and doors frequently (weather and safety permitting) and read labels before purchasing any household products.

Community Blood Lead Screening; Navigating Barriers in your Blood Lead Testing Program For those of you who have tried to start a blood lead testing program, you have no doubt come up against some pretty solid barriers to getting your program going. However, the good news is that overcoming those barriers is not an impossible task and it helps to make the program stronger.

Some of the challenges that Community Lead Education and Reduction Corps (CLEARCorps) has faced are: financial sustainability, working with health plans, defining the role within the public health and medical communities, medical staffing, case management, elevated lead level follow-up, educational messages, outreach, collaboration with primary care, and collection methods.

In the next few blogs I will address a few of these issues at a time. I welcome your comments and emails. If you are interested in more information or chatting about specific barriers and challenges that you are facing in your program, please contact me and we can work together!! My contact phone number is 651-603-8000 and email megan [at] clearcorps [dot] org.

Today let’s take a look at how to achieve financial stability by working with health plans. So you have identified that there are children in your community who are not being tested for lead. You have identified your blood lead screening rate and you have made a commitment to increasing that rate. Awesome!! You have decided to head into the community to find and test those at-risk children and test them for lead. The problem is…money is tight and you are concerned about being able to pay for the tests, pay your staff and hired medical professionals. Let’s be real here and face the facts…as much as we want to save the world, much of the time it simply comes down to money.

When it comes to payment for services, health plans can be your best allies. An essential piece to the financial sustainability puzzle is contracts with health plans. Many health plans are willing to negotiate special rates for 36416 (the finger stick). CCUSA’s current rates of reimbursement for 36416 range from $3.50 to $25.00. Imagine 100 children at $25.00 each? In many states the possibility of billing 83655 (blood lead analysis) where the rate of reimbursement seems to range from $9.00 to $27.00 also exists.

Negotiating health plan contracts can be a tricky endeavor. There is a great tutorial written by Christine L. Jones, BS, and Terry L. Mills Jr., MD, FAAFP which can be found in PDF format at http://www.aafp.org/fpm/20061100/49nego.html. This tutorial lays out the basic pieces that need to be well thought out before approaching the plan.

The truth is, if your community organization is attempting to negotiate a contract with a local health plan, you will most likely be asking them to reimburse you for one or two CPT codes. In my experience these negotiations have not been difficult and the plans have been more than willing to accommodate our needs.

CLEARCorps has had successful relationships with the following health plans. Some of the relationships have been contractual and some have been more like working relationships.

Medica (www.medica.com)

HealthPartners (www.healthpartners.com)

UCare Minnesota (www.ucare.org)

Metropolitan Health Plan (www.mhp4life.org)

Blue Plus (www.bluecrossmn.org)

Prime West (www.primewest.org)

First Plan (www.firstplan.org)

South Country Health Alliance (www.mnscha.org)

Despite the challenges, this is a source of income that is worth pursuing. If you and your organization would like further guidance, CLEARCorps USA and I would be EXCITED to help you out!! Please feel free to contact me at anytime and we will get a dialog started.