Author Archives: katie.rojas-jahn

Children’s at the Capitol: A simple test can save a child’s life

Since the newborn-screening program began, more than 5,000 children have been saved. (iStock photo / Getty Images)

Every parent hopes and dreams for a happy, healthy child. Unfortunately, those dreams don’t always come true. Sometimes children are born with serious conditions that impact their health, but if caught early, many can be treated and the severity lessened. Since the newborn-screening program began, more than 5,000 children have been saved; children like Zak and Ella. Thanks to newborn screening, Ella was diagnosed early with Cystic Fibrosis (CF) and because the blood spots and test results were saved, doctors were also able to diagnose her older brother with CF when he became sick.

The Newborn Screening Program tests newborns between 24-48 hours after birth for more than 50 rare, life-threatening disorders; disorders that if left untreated, can result in illness, physical disabilities, learning and developmental disabilities, hearing loss or even death. Yet early treatment and diagnosis, medications, and/or changes in diet can prevent or lessen the impact of most of these health problems.

Two years ago, changes were made to the program that drastically altered the amount of time blood spots and test results could be retained. Now, after only 71 days parents and providers no longer have access to blood spots, despite the fact that testing can often take up to six months or longer to confirm a diagnosis. After two years, parents have no access to data (unless they make a special request) and therefore lose the ability to access that critical information for the purposes of retroactive investigation or sibling comparisons. And lastly, these changes mean that the department of health cannot use de-identified information for research to create new life-saving tests.

This year, legislation is being proposed to return Minnesota’s Newborn Screening program back to the nation-leading one it once was. House File 2526/Senate File 2047 would allow parents to store their children’s blood spots and test results indefinitely, preserving access to the life-saving information they need. We owe it to our kids, their parents and our communities to strengthen programs that can be used to not only save lives but to protect those in the generations to come.

Until further legislative changes take place, parents can request to have their blood spots and test results retained for a longer period of time on the Minnesota Department of Health website.

Take action!

You can help restore Minnesota’s Newborn Screening Program to its nation-leading status by calling members of the Senate Judiciary committee by Thursday, March 20th, 2014 at 5 p.m. and asking for their support of the Newborn Screening bill, H.F. 2526/S.F. 2047.

Calling is easy and it just takes a minute! (Phone numbers below). If you are a constituent of the person you call, make sure to let them know! Look up your legislators and compare them to the list below. Here is a sample of what you can say:

———

Hello,

My name is [your name] and I am calling to ask for Representative [last name]‘s/Senator [last name]‘s support of the Newborn screening bill, H.F. 2526/S.F. 2047.

This bill will allow parents and families to have access to the newborn screening spots and test results for a longer period of time, allowing for follow-up care re-analyses and sibling comparisons. I support this bill because it will help all children have the best chance for a healthy start in life. I hope [Legislator's name] will support it as well, by voting in favor when the bill is heard in committee.

Thank you!

Once you call committee members, send a note to Katie Rojas-Jahn at Katherine.Rojas-Jahn@childrensmn.org to let us know you took action. 

Here’s who to call:

Senate Judiciary committee members

Chair: Senator Ron Latz 651-297-8065

Vice Chair: Senator Barb Goodwin 651-296-4334

Senator Warren Limmer 651-296-2159

Senator Bobby Joe Champion 651-296-9246

Senator Dan D. Hall 651-296-5975

Senator Kathy Sheran 651-296-6153

Senator Kari Dziedzic 651-296-7809

Senator Scott J. Newman 651-296-4131

Children’s at the Capitol: Child health and wellbeing a big focus this year

(Kristin Marz, kristinized / Flckr)

Briefcases and business suits are lining the halls of the Capitol once again as the legislature reconvened for the 2014 session this week. The governor and legislative leaders have been promising a shorter, more focused session, but with all 134 house members and the governor up for re-election in November, legislators will be working on legislative successes they can take back to their districts.

This year, Children’s will be supporting several policies that impact the health of kids in our state.

School lunches
Recently, the internet exploded with stories about a school in Utah that was denying children lunches who couldn’t pay their lunch bill. Not only were they refusing to feed the children but they were throwing lunches away right in front of them. Unfortunately, amidst the uproar and outrage we learned that many schools in Minnesota do the same. A recent report from Legal Aid showed that 15 percent of Minnesota school districts report that their policies allow lunchroom staff to refuse hot meals to students who can’t pay.

As the state’s leading provider of health care for children, we know this is unacceptable. Children need food to grow and to learn. And they shouldn’t be punished or stigmatized because their family has limited resources or because someone forgot to pay a bill.

Children’s is part of a coalition working to put a stop to this practice and will advocate providing all students with access to a healthy school lunch. With an estimated cost to the state of $3.5 million, the costs of not providing children with adequate nutrition are far greater.

Newborn screening
Since its inception over 50 years ago, Minnesota’s newborn screening program has saved the lives of over 5,000 babies. But once a nation-leading program, recent legislative changes have begun to put Minnesota children at risk.

Between 24-48 hours after birth, blood is taken from a baby’s heel and tested for over 50 congenital conditions including cystic fibrosis and sickle cell disease; conditions that often are asymptomatic at birth but that once detected can be treated. Prior to 2013, the test results and data were stored so that at any time they could be accessed for additional testing. Unfortunately, in 2013, changes were made so that test results and blood spots would be destroyed after two years and 71 days, respectively. This means that millions of children’s results are now being destroyed.

We will be working to restore the newborn screening program to ensure that parents and children have the option and ability to save their test results for future use. You can read the stories of just a few of the children that have been saved by the program.

Mandatory flu vaccines for health care providers
This flu season, Children’s has seen over 520 confirmed cases of the flu. For some patients, it’s a quick diagnosis and visit. For others, it can mean an overnight stay, admission to our ICU, or even requiring ECMO (heart-lung bypass) treatment. Children and those with immune-suppressed systems are the most vulnerable, and for a very small few, they may never survive.

We know that a hospital should be the place where people and children go when they are sick, not to become sick. Being protected from the influenza virus is one small but important step in doing that, so Children’s is supporting a bill that would make flu vaccines mandatory for health care providers.

The good news is that Children’s is already a leader among hospitals. Ninety-three percent of our employees receive their vaccination. But we can do better and so can many other hospitals.

Early childhood education scholarships
Healthy children are learning children. Research shows that investment in high-quality early childhood education improves health outcomes, socio-economic status and school achievement. Every year, over 50 percent of new kindergartners are not prepared with the skills necessary to succeed in school.  As a result, many children lag behind their peers never able to catch up.

Our health care providers know how crucial education and developmental opportunities are for children ages 0-5. That is why we have joined MinneMinds, a coalition of non-profits, education organizations, health care providers, and businesses, that are devoted to assuring access to high-quality early education programs for our early learners most in need.

Photo by Kristin Marz (ristinized on Flckr)

Learning more about the health of our community

This fall, Children’s Hospitals and Clinics of Minnesota completed a valuable process to help us better understand pressing health needs in the communities we serve.

Under the Affordable Care Act, all non-profit hospitals are required to conduct a community health needs assessment every three years. The intention is to help hospitals understand the most pressing health needs in the communities they serve and to explore how the hospital can support efforts to address these needs.

The community we looked at

Map of the community boundaries as defined in the 2013 Children's CHNAChildren’s serves families from every county in Minnesota, and a majority of counties in the four surrounding states (Wisconsin, North Dakota, South Dakota and Iowa). However, for the purposes of this health needs assessment, we defined the seven-county metro area as our “broader community.” From there, we also took a closer look at the five school districts (Minneapolis, St. Paul, South St. Paul, Richfield and West St. Paul – Mendota Heights – Eagan) that surround our hospital campuses in Minneapolis and St. Paul. We called this group of five school districts our “immediate community.”

What we found

The health needs assessment findings largely reflect the experiences of our medical providers and patient families. The needs we identified are related to overarching community health problems that can’t be solved by one institution alone, but instead will require the commitment and collaboration of many organizations and individuals to solve. The identified areas of health need are the following:

  • Access to care
  • Maternal and child health
  • Mental health
  • Childhood obesity
  • Youth asthma
  • Support for families/caregivers for children with special needs

What we’re doing

At Children’s, we are working to address all of the health needs identified in our CHNA through many of our clinical services and community engagement work. Over the coming weeks, we’ll highlight some of our programs right here on the Mighty blog.

Today we’re looking at how Children’s is addressing health needs in the area of access to care.

Children’s has long been committed to ensuring that all children who come to us receive the care they need, regardless of ability to pay. Approximately 42 percent of the children we care for rely on Medicaid, for example. In addition to serving these children, we provide extensive interpreter services which include having interpreters on staff for the three most common non-English languages (Spanish, Somali and Hmong) our patients speak.

Families can also access our family resource centers, which houses financial counselors who assist families in applying for public health insurance programs and financial assistance. Our financial counselors are now also certified application counselors that can assist families in signing up for health insurance through Minnesota’s new insurance exchange, MNSure.

Over the next three years, we plan to take on several additional initiatives that deal directly with access to care, including: improving collection and analysis of data to better understand health disparities and investing in strengthening relationships with community stakeholders to better understand the health needs and assets in underserved communities.

Learn more

You can learn more about Children’s work in the local community at childrensMN.org/community. This page houses all information on our community needs assessment, implementation strategy and past community benefit reports.

To provide feedback on the health needs assessment or implementation strategy, please contact Katie Rojas-Jahn at Katherine.Rojas-Jahn@childrensmn.org.

When is it bullying?

Classroom bullyingIt’s bullying prevention month, so you may be hearing a lot about the problem of bullying and how to address it. But what exactly is bullying? It turns out that defining this problem is not as easy as it might seem.

Bullying, defined

Perhaps the most commonly used definition is one offered by Dan Olweus, a psychology professor from Norway and one of the world’s leading experts on the subject.

According to Olweus, “Bullying is when someone repeatedly and on purpose says or does mean or hurtful things to another person who has a hard time defending himself or herself.”1

The definition may not say it all

The Olweus definition is a sound starting point for discussions on bullying, but other experts have pointed out some grey areas that require attention when determining if a child is involved in bullying behavior:

  • On purpose or not? Some bullies may be too young to know exactly what they are doing and why. In such cases, the bullying may not be done “on purpose,” but it may be bullying nonetheless.
  • Was that a joke? A child may perceive a remark as “bullying” when it was intended to be a joke, especially in the case of cyberbullying, where there are no facial cues to help interpret the intention of the remark.
  • Who’s in charge? Sometimes bullying takes place between kids of equal standing, which may be especially common in cyberbullying.
  • Kids with mental health conditions. Children who suffer from pre-existing mental health issues, such as depression, or are used to being bullied, may be predisposed to assume a negative intent behind a comment or action that isn’t there.2

Normal conflict vs. bullying

Spectrum of conflict infrographic

Click image to view full-size version

Conflict is an inevitable part of human association and resolving conflict constructively, rather than destructively, is a critical skill set that children begin to develop even as infants. The infographic at right (click for a full size version) is a guide to help us consider whether a conflict has crossed into “bullying territory.”3

While parents and teachers can help children learn how to successfully resolve conflict, most children need to learn conflict resolution skills on their own through experience. Aside from problem-solving, one of the most critical conflict resolution skills is for children to know when they can resolve the conflict on their own and when they need help from others.4

Learning to use problem-solving skills to resolve conflict is associated with:

  • Increased achievement
  • Motivation to learn and improve
  • Higher-level reasoning
  • Healthy social and cognitive development
  • Enriched relationships
  • Clarified self-image
  • Increased self-confidence
  • Resilience in the face of adversity5

On the other hand, the inability to successfully resolve conflict often leads to aggression and violence.

How to tell the difference between bullying and healthy conflict

Drawing a distinction between bullying and day-to-day conflict isn’t always easy, said Emily P. Chapman, MD, medical director of Children’s Hospitals and Clinics of Minnesota hospitalist program.

“If a child teases a good buddy, it can be in fun,” Dr. Chapman said. “If trust isn’t there, it could be intimidating or alienating, and that is bullying. It’s also likely to be bullying if there is mismatched stature between the ‘teaser’ and the ‘teased’ — older versus younger, popular versus not so popular.”

“Learning how to handle and resolve conflict is important to a child’s psychosocial development,” Dr. Troy said. “If we as parents or other responsible adults constantly intervene to help resolve these conflicts, then we may hinder rather than help the children involved. Bullying is different — it is outside the normal range of conflict, and it can be very harmful if not stopped.”

For more tips on how to address bullying check out this blog entry, or visit our resources page at ChildrensMN.org/bullying.

Notes:

[1] The Olweus Bullying Prevention Program, U.S., 2011.

[2] Dempsey AG, Storch EA. Psychopathology and Health Problems Affecting Involvement in Bullying. Preventing and Treating Bullying and Victimization (2010), Oxford University Press: 107-131.

[3] Broadbear BC, Broadbear JT. Development of Conflict Resolution Skills in Infancy and Early Childhood. The International Electronic Journal of Health Education (2000);3(4):284-290.

[4] ibid.

[5] Johnson DW, Johnson R. Why violence prevention programs don’t work and what does. Educational Leadership (1995);52(5): 63-67.