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JOURNALISMRead some of Joyce's news stories and feature pieces.
Jobs Aplenty, but Disabled Find No Welcome
Appeared in Long Island Weekly of The New York Times
By JOYCE LITWIN ZIMMERMAN
I was an active kid," Suzanne Tarazi recalled. "I did ballet, ice skating, soccer. I loved to move around, to dance. But at about 12 I began dropping things. I had bladder infections. I lost body strength.""During adolescence I lived in limbo," she said. "The symptoms were like multiple sclerosis but it wasn't M.S." By age 19, Ms. Tarazi was using a wheelchair. "I was a theater major at C.W. Post," she said, "but I had to keep changing my career goal. I was in and of the hospital during college. It was easier once I knew what was wrong. It was spinal cord injury. But we didn't know why.
When she was 24, doctors diagnosed the cause of her spinal cord damage. Gasoline had leaked from an underground storage tank into her family home when she was 11, leaving her with a condition called myeloradiculopathy, with symptoms ranging from tingling to paralysis of the legs. But the knowledge couldn't cure her. Nor could it get her a job, despite the bachelor's degree she ultimately received from New York University and the credits toward a masters she also earned there. "I felt like I hit a brick wall getting my career going," said Ms. Tarazi, now 31 and living in Melville with her parents. On job interviews I heard, "I know you went to school for this, but are you sure you could do this job?"
To try to support herself and her parents, Ms. Tarazi edited a school calendar for a local publication and freelanced as a computer support technician. But she was unable to find work in nutrition, the field in which she was trained, despite sending out 375 resumes and having numerous interviews at hospitals, non-profit groups and vitamin manufacturers. She said she was often told that there were no jobs available due to budgetary limitations, or that the jobs paid little or were part-time. She got a job offer from a group home, but it paid too little to support her.
"Every day I consider bankruptcy because we are so behind in our bills from all the months I couldn't find work," she said. "I have a strong spiritual belief, but I didn't at first. I was angry with God." Non-profit groups, businesses and government agencies are working to train disabled Long Islanders and find them jobs. But even in a red-hot market in which thousands of jobs are going unfilled on the Island, Ms. Tarazi and other disabled Long Islanders continue to face major obstacles to employment.
Don Dreyer, now the director of the Nassau County Office of the Physically Challenged, has osteogenesis imperfecta, or brittle bone disease. He, like Ms. Tarazi, uses a wheelchair to get around. "I was forced to decline my first corporate job offer upon college graduation in 1971," said Mr. Dreyer, a Hofstra alumnus, now 49. "There was no way for me to travel there, and I couldn't get into the building." Back then, public buses did not have wheelchair lifts. Many building doors weren't wide enough to accommodate wheelchairs. That was before the Americans With Disabilities Act, which went into effect in 1992 and mandated that places of business provide access to the disabled.
But despite the law, employment and career development are still intimidating challenges for many people with disabilities. "Employers assume individuals in wheelchairs have cognitive disabilities, even though many have college and advanced degrees," said Patricia Caso, director of adult day services at United Cerebral Palsy of Greater Suffolk. Despite technological advances such as voice-recognition systems and specialized mouse devices, many employers can't imagine how those with more severe disabilities can operate personal computers and other office machines.
Laura Koster of Dix Hills received an M.A. in counseling and development from Long Island University in 1998. A mild case of cerebral palsy slurs her speech and affects her control of the left side of her body. But she can walk unassisted and drives a specially equipped Toyota. "I went on between 40 and 50 job interviews throughout Nassau, Suffolk, Queens," she said. "I know I was qualified to work at some of the these competitive jobs despite having cerebral palsy. I felt just as qualified as the other candidates. I felt if I were given a chance I would have been able to do a great job in some of the positions I didn't receive." Ms. Koster, 33, turned down five offers for jobs that she said "were not up to my qualifications or my degree of education" before landing a job as special projects coordinator at the Independent Living Center in Jamaica, Queens. She started in July, just before her wedding.
Matthew Crosson, president of the Long Island Association, the Island's biggest business organization, acknowledged that one way to sustain the region's economic growth, help solve its work force shortage and improve the lives of a significant segment of the population is for businesses to hire more workers with disabilities. Yet the current unemployment rate for those with disabilities on Long Island - even in a strong economy - remains high, said Edmund Cortez, chief operating officer at the National Center for Disability Services headquarters in Albertson.
Just how high is an open question. There are no up-to-date figures on the number of disabled Long Islanders, or on how many of them are unemployed. Data from the 1990 census found 136,095 who reported themselves disabled and of working age on Long Island. But Mr. Dreyer in Nassau and Bruce Blower, director of the Suffolk County Office of the Handicapped, estimated the total number of disabled Long Islanders at 461,000, of whom about 55 percent, or 253,550, would be of working age. (The Federal Government counts as disabled anyone with a condition that interferes with a major life function, such as walking, talking, breathing, or one of the senses, or who has a history of such a condition, such as AIDS or disfiguring accident or illness, in which the individual may recover and seek work but is shunned.)
Nationally, the jobless rate among the disabled was estimated in 1994, the last time the Census Bureau checked, at 48 percent. Even if the Long Island rate is far lower, it still far exceeds the current 3 percent rate for the general population. And those disabled who do have jobs often earn far less. Ms. Caso said that the average salary for 126 disabled workers placed last year by her agency was $7.46 an hour. Pearl Kamer, chief economist for the Long Island Association, said that the Islandwide average hourly wage last year was $16.39.
Faced with these obstacles, many of the unemployed disabled choose not to work. Mr. Dreyer also blamed "severe work disincentives" built into Federal Social Security entitlement programs. Once employed, the disabled often lose Federal benefits that help pay for health care, medication, and essential items such as wheelchairs-- although pending Federal legislation would change that.
Last year the Long Island Partnership, a coalition of community groups, non-profit agencies and business advisory councils and the Vocational and Educational Services for Individuals with Disabilities (a state agency) found employment for 2,138 Long Islanders with disabilities. Many have been helped by programs administered by nonprofit groups that help determine interests and abilities, teach job-readiness skills such as resume writing and basic office skills such as telephone etiquette. The National Center for Disability Services offers hands-on job training programs in computers, laboratory technology and other fields. "Job coaches" often teach specific job duties and provide additional support at the workplace if necessary.
Ms. Tarazi credits Eileen Chalmin at United Cerebral Palsy of Greater Suffolk with helping her to finally land a job with Interim Services, which employs contract workers on behalf of I.B.M. Global Services and other companies. Now Ms. Tarazi is working at I.B.M.'s Melville location on the help desk, relaying clients' computer networking problems to higher-level computer experts. . "Ninety-one thousand dollars in student loans went to pay my medical bills," she said. "I could have wiped out my debt if I signed a paper saying I was permanently disabled. But I wanted to be productive. Now I am contributing, not living off the government."
"State of Alternative Health Care"
Appeared in Long Island Business News
by Joyce Litwin Zimmerman
Appeared in Long Island Business News Health Supplement, August 17 - 21, 2001On November 28, 1998, Newsday reported that 58% of Long Islanders were using complementary methods, based on a Harvard University study. And the numbers are inching up. A recent, independently conducted consumer poll revealed that 66% of Long Islanders currently use alternative treatments, reported John Kaegi, Senior VP of Melville-based Vytra Health Plans, who keeps close tabs on alternative health care issues.
This reflects the national trend. According to a National Institute of Health study in 1990, more patients sought medical counsel from alternative practitioners than primary care physicians, with 388 million visits to the latter nationwide. At the same time, 425 million alternative health care visits across the country were estimated to cost about 13.7 billion dollars — mostly paid out of pocket.
So local residents, like other Americans, are choosing new ways to get and stay well. Most often Long Islanders use chiropractic, an almost-mainstream Western practice, as well as the Oriental-based modalities of acupuncture and massage therapy, all of which are most likely to be covered by health insurance. Not all insurance companies or employers who make up benefit packages cover these treatments. Those that do, though, further ponder whether to include additional treatments, such as nutritional counseling, vitamin and herbal medicine and the mind/body disciplines of Reike and yoga into the managed care plans introduced in the 1990's. The question of integrating their use with conventional Western medicine is further complicated by how these treatments should be paid.
One way is through a tier of services. Oxford Health, the first carrier to offer comprehensive alternative coverage, and other health insurers offer tiers of service: a standard benefit plan (which includes chiropractic care mandated by the state in 1998); medical riders that provide direct access to a variety of practitioners (usually the accredited ones, like acupuncturists and massage therapists); and access to discounted services by networks of participating medical professionals. For example, Access Managed Care of Floral Park, is such an organization. It serves its clients' employees by maintaining networks of chiropractors, physical therapists, acupuncturists, massage therapists, and diet and nutrition therapists who offer reduced fees.
An additional safety net for payment exists. "Workers' compensation, motor vehicle no- fault insurance and Social Security Disability Insurance offer reimbursement for acupuncture.....," reports Dr. Andrea Coladner, M.D. , an osteopath and state certified medical acupuncturist specializing in pain management.
In Dr. Coladner's experience, though, only 20% of private insurance companies offer specific riders to help cover the cost of acupuncture. And most ---if not all ---stipulate that acupuncture be used for acute care, and performed by a medical doctor. That may explains why 90% of the patients at the Wholistic Health Center (WHC) at New York College in Syosset pay out of pocket. The center utilizes the experience of state licensed and alternative practitioners trained in Chinese medicine.
Dr. Coladner feels that lack of coverage "absolutely discourages the use of health care for many, especially for seniors." Because Medicare doesn't cover it older adults cannot avail themselves of these methods that are so effective in their pain management issues," agreed Ken Moss, L.Ac., Dipl.Ac. ( a licensed "diplomat" in acupuncture), L.M.T. (a licensed massage therapist.)
But do these modalities work? Some conventional doctors would like to see scientific evidence, but no such studies exists, according to Vytra's John Kaegi, whose staff has searched world-wide for such quantitative verification. Statistics aren't needed, according to Faye Schenkman, L.M.T. Dipl. Chinese Herbal Medicine & Oriental Body Works. The Director of the WHC (and Dean of Ammatherapeutic Massage, New York College) emphasizes that Chinese medicine and wholistic concepts have prevented and healed a variety of medical conditions for over 5,000 years. Why else would so many patients be willing to pay without medical insurance, she asks?
Medical practitioners of traditional medicine and alternative varieties provide further favorable clinical observations and anecdotal evidence. Acupuncture "is more cost effective than other insurance-sanctioned treatments , like expensive ‘mri's' and prescription drugs,." states Dr. Jennifer Choi, MD, a specialist in Physical Medicine and Rehabilitation. She has practiced acupuncture for twenty years and is a New York State licensed acupuncturist.
Not only do patients benefit. Insurance companies could save money over the long run, says Dr. Mark Kavett, a Merrick chiropractor with 23 years of experience. "Conditions cost less to treat with chiropractic than the typical allopathic remedies, which can include surgery and a hospital stay."
Dr. Alan Sokolow, Chief Medical Officer, Empire Blue Cross and Blue Shield, states that Empire provides for these services, not because the company is sure they work, but in response to state mandates and consumer demand . Vytra's V. P. John Kaegi agrees. "In the past we responded to physicians in creating our products. But since physicians have not been open minded toward alternative health it has been the patients requesting the required referrals from the doctors."
In further reaction to user-demand, non-profit health insurers have developed new products. Vytra has prepared a new plan to be submitted for approval by the New York State Department of Insurance. Accredited complementary providers will be available in "certain premium insurance products" as well as in discount networks of alternative providers. Likewise, non-profit Empire Blue Cross and Blue Shield, the largest health insurer in New York State, offers a variety of commercial insurance products to the employees of 80,000 companies on Long Island. Dr. Alan Sokolow, Chief Medical Officer, explains that a new discounted network is being developed for massage therapy. The company serves a total number of 760,000 individual subscribers on Long Island.
Insurance companies cover standard Western and alternative treatments, which reflects the movement toward "integrative medicine." For example, medical doctors use acupuncture in conjunction with conventional methods. "Acupuncture is just one of the tools in my tool box," Dr, Coladner tells her patients. Different patients react differently to varying treatments. Acupuncture is a safe and effective option in reducing pain.
Dr. Choi, who serves as President of the New York Acupuncture Society for Physicians and Dentists, reports that current membership of this group is at four hundred, but states that more are needed. "Medical doctors need to obtain state licensing in acupuncture to help patients.... it should be a first line treatment to help patients with pain... I am using less cortisone, lidocain and narcotics" as a result, she reports.
Acupuncture has been used in limited circumstances at Southside Hospital, a public non-profit and autonomous"sponsored institution" of North Shore University/Long Island Jewish Health Care System. Dr. Choi hopes to develop a more structured acupuncture care program working in collaboration with Dr. Michael Delman, Southside's VP for Quality Control and Medical Affairs. Dr. Delman reports that the hospital already offers a "cleric program, which entails spirituality and meditation for emotional stress and pain"
In an attempt to further bridge the gap between "East" and "West" Dr. Ellen Kamhi, Ph.D, R.N. presents new concepts of healing and treating disease to graduating doctors at S.U.N.Y. Medical School. The "natural care" practitioner/author/Channel 12 "natural nurse" guest has presented elective courses on the benefits of natural remedies, nutrition and the use of toxic screening in diagnosing illnesses as a clinical instructor at the school's Department of Family Medicine.
Despite some progress, the polemics are difficult. Trying to attempt an alliance between conventional and non-Western methods, as well as the use of herbs/vitamins, and mind-body systems, such as yoga and reike, are only complicated by cost and insurance issues. For example, networks of providers may be favored by insurance carriers, but some complementary practitioners can't afford to discount their services, any more than a medical surgeon. Employers may want to offer alternative benefits to attract and retain employees, but they may not be able to pay for these services which are "add-ons" that cost more than the least expensive, most restrictive "HMO" plans.
Will the situation get less complicated? Maybe. Maybe not. As certain accredited complementary methods become mainstreamed — with others to follow - consumers, doctors, employers and insurance carriers all grapple with ways to pay for not only these methods, but medical care in general. That is part of a larger story — one of universal health care coverage — that affects not only Long Island, but the nation as a whole.
Joyce wrote a column, R.S.V.P., covering not-for-profit fund-raising events, for Distinction magazine.
COMEDIA DELL' ARTE BENEFITS LONG ISLAND PHILHARMONIC
By Joyce Litwin ZimmermanOn Thursday September 5.Simon DeBartolo Group , the largest shopping center developer in the country and Fortunoff's, previewed the grand opening of the Source, a new unique shopping mall in Westbury. The theme of the festive preview , which benefited the Long Island Philharmonic and North Shore University Health Systems, was "Comedia dell' Arte." 1500 Long Islanders enjoyed entertainment by acrobats, mimes, magicians, stiltwalkers and Tarantala dancers.
A musical highlight of the evening was a trio from the Philharmonic that featured maestro David Lockington playing the cello. The Long Island Philharmonic has provided cultural enhancement to our environs since 1979 by providing subscription concerts, free summer concerts in Hecksher and Eisenhower Parks and New Year's Eve concerts at Tilles Center. According to Executive Director Karen Barnes, its " Arts in Education" programs introduces the enjoyment an appreciation of music into the lives of 15,000 Nassau and Suffolk school children, and it helps to develop the careers of young Long Island artists with its yearly Young Artists Competition.
North Shore Health System offers a full-range of medical services with ninety outpatient facilities and six hospital campuses in Long Island and Queens. In addition, Manhasset's North Shore University Hospital offers highly specialized state-of-the-art care. Proceeds from this Gala will benefit the health system's community-based wellness programs, which educates the general public Chairman of the Board Saul Katz thanked the Fortunoff family and the Source for their generosity which enables the system to "continue to provide our surrounding communities with outreach programs....medical education and care for all...regardless of their ability to pay.
copyright, Joyce Litwin Zimmerman, 2005