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THE NEWSLETTER OF THE BUREAU OF HEALTH SERVICES • COUNSELING SERVICES UNIT • FDNY
Vol. 2 • No. 9 • July/August 2004

What's new for August 2004

WTC Medical Monitoring: Cancer Update

Health concerns after the exposures at Ground Zero were raised soon after September 11, 2001. In the immediate aftermath, full attention was focused on caring for those hospitalized with injuries and finding the perished. Our entire workforce worked at the site in the days, weeks and months after this tragic day. Initial eye irritation and pulmonary complaints began within the first few days. Cough and respiratory complaints have continued in many of our members since then.

Medical monitoring began in October 2001 and continued through February 2002 with 10,166 WTC medicals done at BHS. Additional WTC medicals were performed since for a total of 12,000. FDNY-BHS with cooperation from FDNY, the UFA, UFOA and our EMS unions has received federal funding to continue WTC Medical Monitoring evaluations for both incumbents as well as retirees. These medical evaluations will continue to track patterns of illness and evaluate emerging medical problems. This tracking is critical to follow both our active members and our retirees who worked at the site for so many months.

BHS has been tracking cancer cases for several years. The computerized medical record captures the primary diagnosis of members. The Cancer Bill is a presumptive bill that was passed with the efforts of the UFA and UFOA in recognition of the exposures of FDNY UNIFORMED members in the daily activities of firefighting. The cancer bill provides for an accidental disability pension for members retiring with a disability caused by cancer. The bill was expanded in the last year and now covers most kinds of cancer. Some members with the diagnosis of cancer have also returned to full duty.

The numbers of active members with cancers are tracked by type. This tracking will continue as active members come forward with medical problems. Here is the latest update for our active members (for both EMS AND FIRE), looking at patterns from 9/1999 through 9/2003.

Continued gathering of information will help determine patterns of illness. The WTC Medical Monitoring will help us track both active and retired members. At this point, the overall numbers for cancer have not increased. The numbers for specific types of cancer have varied and for nearly all types have also not increased. However, lessons learned from prior environmental and occupational exposures (both in the fire service and throughout the world) have clearly shown us that the time lag between exposure (acute or chronic) and the diagnosis of cancer is typically 15 to 30 years. This is why continued medical monitoring is critical if we are to provide effective early warning signs and treatment.

Our joint labor management WTC Medical Monitoring program undergoes frequent revisions to reflect the needs of our members. Whole body scans are not effective in early cancer screening but scans focused on specific symptoms or diseases of interest are effective. Chest X-ray imaging was offered to every member appearing for a WTC medical. Chest CT imaging cannot be offered to every member due to the risk of radiation exposure but was done for over 600 members with increased risk for disease. The results of these tests are included in the above table. Your participation in the WTC medical monitoring program is our best chance to provide early detection and warning for each individual and for FDNY (Fire and EMS).

NUMBERS OF CANCERS DIAGNOSED:

TWO YEARS PRE- & POST-WTC

Time Frame

9/11/99
to
9/10/01

9/11/01
to
9/10/03

 

Two year period

Two year period

Cancer Type

 

 

Kidney

1

1

Colon

4

8

Esophagus

1

0

Leukemia

3

2

Lung

4

3

Lymphoma

 

 

(Non Hodgkins)

4

0

Lymphoma

 

 

(Hodgkins)

6

5

Breast Cancer

4

2

Prostate

17

6

Skin

35

28

Testicular

6

4

Pancreatic

2

1

Cervical

1

1

Thyroid

1

3

Throat

2

2

Multiple

 

 

Myeloma

0

0

Brain

1

0

Stomach

1

0

Mouth

1

0

Parotid

2

0

Bladder

3

0

Totals

99

66

 

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Authorizations

We, at the Bureau of Health Services, remain steadfastly committed to the health and safety of our members. Part of that commitment toward wellness includes the authorization for treatment to qualified professional outside medical providers. Providers who not only give our members the utmost professional care but also understand the rigors of firefighting and emergency medicine. We expect nothing less of the care given to our members, care that will facilitate healing and return them to the profession they hold so dear.

Our current policy of authorization for treatment is antiquated at best; we understand how labor intensive the current process is and the challenges it presents. That is why we have entered a contract with "Imagework", a business processing company, who has worked with us to develop a state of the art Workers Compensation application.

A brief description of how this works:
Upon interaction with the Medical Officer in either Clinic or the Annual Medical Area, a member (patient) will be authorized for treatment. The Medical Officer then chooses the treatment required via the computer which will be electronically sent to the Nursing Station. As the member reports to the Nursing Station, all demographics on the member will be automatically completed on the electronic authorization. The Nurse will assist the member on what provider he/she would prefer. The medical provider and all related demographics (address, telephone #) will also be electronically loaded. The Nurse shall then print out a copy and give to the member to present to the provider at their appearance. Authorizations to members of the EMS Command will be held in abeyance and reviewed for eligibility by Captain Jay Swithers. His office will notify the member by mail with either an endorsement to appear for treatment (authorization will be enclosed) or denial of treatment based on their workers compensation claim eligibility.

This automated authorization now has an electronic 'barcode' which assists the Workers' Compensation Unit in matching the authorization to the bill thereby expediting claims processing.

Members will have the opportunity to voice their feedback to the Nursing staff on the treatment they receive (positive or negative) and it shall be duly noted; in the event our members have a less than favorable interaction with a provider, we will have a system in place to address the issue with the provider and work toward a viable and accepted resolution. Providers will be reviewed periodically for quality assurance and participation in our medical provider network.

This automation will assist the Workers' Compensation Unit to process claims more efficiently and expeditiously. As most of our members already know, providers have been calling and billing them for outstanding claims. On the fire side, Workers Compensation are self-insured, for EMS, they are processed through the NYC Law Department. The benefits of an automated system will satisfy all the needs and requirements of all involved.

We ask, however, your patience as we work on the transition from our existing procedure to our new one. We anticipate some 'bumps' in the road until all parties at BHS become familiar with the new process. We thank you for your continued support as we move ahead with this initiative.

 

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Kids Connections Program

In September 2003, the Kids Connections program of the Counseling Service Unit of the FDNY launched a partnership with Big Brothers Big Sisters of NYC to serve children who lost their FDNY fathers in the line of duty. The majority of children who are participating in the program lost their fathers on September 11th, but any child, age 6-17, who experienced the line-of-duty death of a parent is eligible to participate. Through this partnership the CSU and BB BS are recruiting current and retired FDNY members to be Big Brothers to boys, and women affiliated with the fire department (firefighters, EMS workers, civilian employees, wives or sisters of FDNY members) to be Big Sisters. There are currently 29 Big/Little matches in the program. Mentors are required to spend 8 hours per month with the child that they are matched with, doing one-on-one activities, for a minimum of one year. The 8 hours can be spent in whatever way works with the schedule of the mentor and the schedule of the family. This commitment is crucial due to the loss these children have sustained. It is important to provide them with a stable experience with a mentor. The emphasis is placed on building a relationship over time, doing simple things like playing ball, going to the movies, and whatever else the child enjoys. Mentors are discouraged from going on extravagant outings and spending a lot of money early in the relationship. Many mothers have said that they are just looking for someone to throw a ball around in the backyard with their son, something many boys have not done since the deaths of their fathers. Kids Connections provides outings in the communities where FDNY families reside to allow these children who lost their fathers to meet other children and have some fun, and "Bigs" and "Littles" are encouraged to come to these events as well.

Matches are based primarily on personality and geography. FDNY members who are interested in volunteering fill out an application over the phone with the CSU. They then meet with Big Brothers Big Sisters for an interview. The interview process allows BB BS to get to know the perspective mentor in some detail and to guide them in making the best match. The same staff members who interview the volunteers also interview the children who are applying for the program, so they thoroughly get to know the people enrolling, which in turn help them make the most appropriate matches. Once a volunteer is accepted into the program, he or she attends a one-day training with other FDNY volunteers at Big Brothers Big Sisters' office in Manhattan. The training covers topics such as defining what a mentor relationship is in comparison to other relationships, dos and don'ts, roll plays that are specific to FDNY, childhood development, and issues around grief and bereavement.

Once training is completed a "match meeting" is set up. This is the meeting where the Big Brother or Sister is introduced to the Little Brother or Sister and his or her mom. Time is spent with the mom, and then Big and Little are encouraged to take a walk together to start the process of getting to know each other. From that point on, it is the Big's responsibility to call the Little and his or her mom and set dates for outings. Bigs are required to check in with a caseworker at BB BS once a month, either by phone or email, to let them know how things are going with the match and to alert them if any problems surface. Bigs are also encouraged to stay in touch with the caseworker or CSU staff if any questions or issues arise at any time.

Anyone who is interested in volunteering for the FDNY Big Brothers Big Sisters program should call Kim Ahearn in the CSU at (212) 570-1693 x 323.

 

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Dr. Kerry Kelly
Chief Medical Officer

Dr. David Prezant
Deputy Chief Medical Officer

Malachy Corrigan
Director, FDNY CSU

Mary T. McLaughlin
Director, FDNY BHS


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