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Co-Presidents’ Message
CALIFORNIA MEDICAL ASSISTANTPublished Bi-Monthly by the California Medical Assistants Association, Inc. for Medical Office Professionals
CM
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UNITY IS STRENG
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CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016 1
JULY/AUGUST2016
________________________CALIFORNIA
MEDICAL ASSISTANTS ASSOCIATION, INC.
P.O. Box 5694Petaluma, CA 94954-5694Toll Free 1.888.464.2622
Fax 208.730.3763
www.cmaa-ca.orgEmail address: [email protected]
Well here we are into our 2nd newsletter already and into the heat of summer, although it hasn’t been too hot yet here in San Diego. I know you all are looking forward to the Fall Conference in San Carlos this September.
Also please mark your calendars for Saturday, November 5th, we will have our first ever Education Day in San Diego. It will be at Alvarado Rehab Institute located at 6645 Alvarado Road, San Diego, 92120. There will be more details to follow, plan on being there for some great speakers, CEU’s and most of all good company. Plan to get involved this year!
“Coming together is a beginning, keeping together is progress, and working together is success.” Henry Ford
I hope you all have a wonderful healthy summer and are able to enjoy some fun, family time.
Co-President Margie Hattox, CCMA-C
As we move into Summer I do hope everyone is enjoying vacations, or being outdoors, or just enjoying the longer days. I had the opportunity to attend the education day, “Plant the Seeds of Knowledge”, in Modesto. A Big THANK YOU goes out to Rebecca Baker and Theresa Henderson for all their work for putting on this great day. Besides the great education and receiving our CEU’s, and having a wonderful catered lunch, the best part of being in CMAA was seeing the old friends and so many new faces. People are so busy these days and always in a hurry. If you just take a moment to say hello to your neighbor or the person sitting next to you, you will realize what each person has to offer. There were lots of new faces to me in Modesto and I just loved the enthusiasm they all showed. We have so much to give to each other and CMAA is a great place to share with each other.
We will be having more education days this year, so please read your newsletters and spread the news. Bring along a friend and make some new friends at our meetings... it is well worth it. Our Executive Board is working hard on our Fall Conference, September 16-18, 2016 in San Carlos. It is sure to be a fun and educational weekend. So, circle your calendar and start making plans to join us and let us get to know you better.
Co-President Susan Gouig, CCMA-AC
WHAT’SINSIDE n CO-PRESIDENTS’ MESSAGE ............. 1
n CMAA HEADQUARTERS: CMAA Wants to Come to You ........... 2
n PRESIDENT-ELECT’S MESSAGE: Hello, California Certified Medical Assistants ............................. 3
n FALL CONFERENCE: Speaker Susan Fisher-Owens .......... 3 Fall Conference Update .................. 4-5 Tentative Agenda ................................ 6 Official Registration Form ................. 7
n CERTIFYING BOARD UPDATE: Newly Certified CMAs .................. 8-10
n CONTINUING MEDICAL EDUCATION: CHILDREN AND LEAD – A Dangerous Combination ............... 11-14 Self-Assessment Test....................... 15
n Personal Certificate of Participation Form ............................ 16
Looking forward to seeing you at CMAA FALL CONFERENCE!
Co-Presidents’ Message
Palo Alto Medical FoundationSAN CARLOS, CA
CMAA Co-Presidents Susan Gouig and Margie Hattox
Alvarado Rehab InstituteSAN DIEGO, CA
California Medical Assistant
E D I T O R
KIM JONES, CCMA-CEast Bay Region
Email: [email protected]
P U B L I C A T I O N C O M M I T T E EC H A I R M A N
THERESA HENDERSON, CCMA-ACRiverside Region
Certifying Board Executive Director
C M A A C O - P R E S I D E N T S
SUSAN GOUIG, CCMA-ACSonoma Region
MARGIE HATTOX, CCMA-CSan Diego Region
For Advertising contact:
CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC.
at
CMAA, INC.P.O. Box 5694
Petaluma, CA 94954-5694
Toll Free: 1.888.464.2622
Fax: 208.730.3763
Email: [email protected]
Material contained herein may NOT be used without the permission of the
California Medical Assistants Association, Inc.
ALL ITEMS FOR PUBLICATIONSHOULD BE SENT
DIRECTLY TO THE EDITOR.
2 CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016
MISSION STATEMENT
CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC.
The purpose of the California Medical Assistants Association, Incorporated, is to promote the professional and educational growth of medical assistants.
CM
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California Medical Assistant
— NEXT ISSUE —
September/October 2016
To submit items to be published in this newsletter, please mail or email:
KIM JONES, CCMA-C
Email: [email protected]
DEADLINE: August 1, 2016All materials must be submitted by the
deadline date to be included in the next issue!
CMAA WANTS TO COME TO
YOUWe need your meeting
space!
Does your company have a meeting room that could be used by CMAA to host an Education Day?
Would you be willing to assist our Education Chairman with planning a seminar in your town?
Please email Carol at CMAA Headquarters so we can schedule a date for this year.
CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016 3
I am hoping everyone is doing well. I have received emails from some CCMA volunteers preparing for the
upcoming fall meeting; many of these individuals have spent countless hours keeping the Association alive. These are great opportunities for us to enjoy these meetings, while earning con-tinuing education credits (CME’s) that are offered every year, as well as this newsletter. Also, I am getting excited to see everyone and ready to meet newly California Certified Medical Assistants.
We, California Certified Medical Assistants, deal with a lot of stress at our work, and often times, we feel overwhelmed. I would like to share a moment with you about the clinic where I am employed which is called K’ima:w Medical Center in Hoopa, California. It is approximately 60 miles inland from Eureka, California. We have a “Star Program” where a patient, clinician, co-worker, supervisor or a person facilitat-ing use of K’ima:w Services, may fill-out a nomination form. The nominee checks
appropriate value that the employee demonstrated; categories such as; caring, community, quality, excellence; respect, teamwork and integrity. The purpose of the K’ima:w “star program” is to honor and acknowledge those individuals and departments, who exemplify the values of K’ima:w Medical Center. The nominations are announced at our monthly staff wide meetings by the human resource depart-ment. When I received my first “Star” I was grateful to receive such recognition by individuals who I helped and that it was special to someone.
In my previous administrative employment, I was in many positions such as; clerk typist, office manager, recording secretary, administrative assistant and lastly, executive secretary. I, then realized that I was missing a great opportunity to help others. I decided to go into the medical field and become a Certified Medical Assistant. I joined the California Medical Assistants Association and became involved with not only attending the conferences
President-eleCt’s MessageHello, California Certified Medical Assistants!
and annual meetings; I also, attended the business meetings that took place during these meetings. Also, I recently became a Certified Phlebotomist NPT 1, which will help me continue with my professional goals, as a California Certified Medical Assistants.
Finally, I will continue to do much as I can, to go above and beyond, to reach our goals and succeed.
As your President Elect...
Debra A. Carpenter, CCMA-AC, NPT, 1
Susan Fisher-Owens is Associate Professor of Pediatrics at the School of Medicine, and of
Preventive and Restorative Dental Sciences at the School of Dentistry, at the University
of California San Francisco. She has run the award-winning “primary tooth” clinic at
the Children’s Health Center at San Francisco General, an FQHC, and has trained
thousands of pediatric providers to apply fluoride varnish and integrate oral health work
into their primary care. She serves on the American Academy of Pediatrics Section
on Oral Health nationally, the California Oral Health Plan Advisory Committee, the
California Perinatal Oral Health Quality Improvement Advisory Board, and chairs the
integration group for the San Francisco Children’s Oral Health Improvement Plan, but
is perhaps best known for her conceptual model of children’s oral health. ❧
introduCing Fall ConFerenCe sPeaker
SuSan FiSher-OwenS
Debra A. Carpenter, CCMA-AC, NPT, 1PRESIDENT-ELECT, CMAA, INC.
4 CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016
Upcoming Event . . .
301 Industrial Road • San Carlos, CA 94070www.pamf.org
Early in its history, the City of San Carlos adopted the motto “City of Good Living”. That phrase stuck
and is still used daily. With an ideal climate, charming neighborhoods, a thriving business/industrial district and a small airport with an adjoining com-mercial area, San Carlos continually attracts new residents and businesses.
CMAAFALLConference September 16-18, 2016
For more information, visit The City of San Carlos website at http://www.cityofsancarlos.org/residents/about/history_of_san_carlos/san_carlos_today.asp
Upcoming Event . . .
The “City of Good Living” stikes a fine balance between the picturesque neigh-borhood of its residential areas and the industrial area east of the railroad tracks.
The quality of life here is top-rated, with outstanding schools, excellent services for youth and seniors and wonderful recreational and educational
activities for all ages. The City also boasts of an unusually low crime rate. In recent years, citizens overwhelmingly endorsed bond issues to build a beau-tiful library and to upgrade local parks. A volunteer effort, spearheaded by San Carlos Rotary Club, was responsible for the conceptualization and building of an extensively used Youth Center.
There’s plenty of change elsewhere in the city too. Holly Street, the city’s main artery from Highway 101, was elevated at the Caltrain tracks to end the persistent bottleneck there. The construction was a joint project with the neighboring city of Belmont.
Quaint Downtown
A delightful down-town that includes a mix of excellent restaurants and unique shops. Laurel Street has evolved into one of the more popular areas in the County, with merchants clamoring for space amongst busy boutiques. ❧
CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016 5
Upcoming Event . . .Upcoming Event . . . NEARBY HOTELS
n Holiday Inn Express & Suites Belmont 1650 El Camino Real, Belmont, CA 94002 (650) 654-4000 • website: ihg.com
n Country Inn & Suites By Carlson, San Carlos, CA 251 El Camino Real, San Carlos, CA 94070 (650) 508-1800 • website: countryinns.com
n Fairfield Inn & Suites San Francisco San Carlos 555 Skyway Rd., San Carlos, CA 94070 (650) 631-0777 • website: marriott.com
n Sofitel San Francisco Bay 223 Twin Dolphin Dr., Redwood City, CA 94065 (650) 598-9000 • website: accorhotels.com
n Hotel San Carlos 26 El Camino Real, San Carlos, CA 94070 (650) 591-5771 • website: thehotelsancarlos.com
n Hillside Lodge 630 El Camino Real, Belmont, CA 94002 (650) 593-5883 • website: hillsidelodgeca.com
n Motel 6 1101 Shoreway Rd., Belmont, CA 94002 (650) 591-1471 • website: motel6.com
n Extended Stay America San Francisco - Belmont 120 Sem Ln., Belmont, CA 94002 (650) 654-0344 • website: extendedstayamerica.com
n TownePlace Suites Redwood City Redwood Shores 1000 Twin Dolphin Dr., Redwood City, CA 94065 (650) 593-4100 • website: marriott.com
Please note: Hotels are not listed above in any specific order or preference.
= Palo Alto Medical Foundation
6 CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016
SAN CARLOS, CALIFORNIASeptember 16-18, 2016
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
TENTATIVE AGENDA
CM
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THURSDAY, September 15, 20162:00 pm Tour7:00 pm Executive Committee Meeting
FRIDAY, September 16, 20168:30 am Registration 8:30 – 9:00 am Opening of Fall Conference 9:00 – 11:00 am Education11:15 – 12:15 pm Education12:30 pm Lunch1:30 – 2:30 pm Education2:30 pm Budget & Finance Reference Committee3:15 – 5:00 Education5:30 pm Dinner & Movie Night
SATURDAY, September 17, 20168:00 am Registration Opens8:30 – 9:30 am Education Session10:00 – 11:30 am “Fluoride Varnish in the Medical Office” CLINICAL CME
Susan Fisher-Owens, MD, MPH UC San Francisco11:30 – 12:30 pm Education12:30 pm Lunch1:45 – 2:45 pm Education3:00 pm Business Session3:30 – 5:00 Education5:30 pm Dinner & Education Session
SUNDAY, September 18, 20169:00 – 10:30 am Breakfast with Education Session10:45 – 11:30 am Close of Business Session
301 INDUSTRIAL ROADSAN CARLOS, CA 94070
FALL CONFERENCE 2016
CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016 7
PLEASE TYPE OR PRINT
Name: ___________________________________________
Credentials: ______________________________________
Address: _________________________________________
Region: _____________________________________
Telephone: __________________________________
Email: ______________________________________
**Check if first timer________
CHECK ONE:
________ Member
________ Student
________ Guest
REGISTRATION DEADLINE: 09/01/16
No refunds after September 8, 2016
Mail to: CMAA Inc. P.O. BOX 5694 PETALUMA, CA 94954-5694
Please make checks payable to: CMAA
Additional inquiries or registration by credit card:
Call Headquarters at 1-888-464-2622.
CHECK MEAL CHOICESFriday
_____ Lunch ....................................................$15.00
_____ Dinner ...................................................$25.00
Saturday
_____ Lunch ....................................................$15.00
_____ Dinner ...................................................$25.00
Sunday
_____ Breakfast...............................................$10.00
____________________________________________________________________________________________________
Dietary Restrictions:________________________________
__________________________________________________
__________________________________________________
MEETING REGISTRATION FEES:
_____ Members & Students ........................... $50.00
_____ Non-member ........................................ $75.00
_____ Late fee (after 9/01/16) ........................ $5.00
_____ Single Day Registration .........................$25.00
This option is available for Members and Students only able to attend for one day.
** If single day registration is selected, please indicate which day you will be attending here:_______________________
__________________________________________________
TOTAL AMOUNT ENCLOSED $____________
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
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FALL CONFERENCE 2016
OFFICIAL REGISTRATION FORMPalo Alto Medical Foundation
301 Industrial Road, San Carlos, CA 94070
September 16-18, 2016
Important information on reverse side - please copy this form, complete and mail.
8 CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T ECongratulations to the newly California Certified Medical Assistants
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
NAME SPECIALTY HOMETOWN
ABDESHAH, ELHAM C SANTA ROSA
ACUNA, KIANA C HAYWARD
AGUILAR, CAROLINA C. C SAN JOSE
ALAMILLO, PATRISIA C SANTA MARIA
ALEMAN, CEYLI C RESEDA
AMBRIZ, RUBY C STOCKTON
ANDERSON, MARIE A VENTURA
ANDRADE JR, MARIO C SAN JOSE
ARAGON, BLANCA A MISSION HILLS
ARMAS CORTES, RUBEN • A SAN JOSE
ATILANO, MARIA-SIMONA • C VALLEJO
AVILEZ, ADRIANE AC HESPERIA
BAILON, ANNALIZA C STOCKTON
BANEGAS, WENDY C RESEDA
BARAJAS, MORGAN • AC SANTA ROSA
BARANDA, MARLENI AC POWAY
BARKER, DEJANNE COURTNEY C PITTSBURG
BARRAGAN, ADRIANA AC RED BLUFF
BAUTISTA, ROSEMARY T. C MILPITAS
BAUTISTA, LAYLA C FELTON
BECERRIL, JEREMY A. AC SANTA ROSA
BENITES, MELANIE • AC WATSONVILLE
BERMUDEZ, ALEJANDRA • C WATSONVILLE
BETHANY, DENISE ANN A ANDERSON
BIEDERMANN, RYAN JOHN • C BAKERSFIELD
BISNETT, JENNIFER C GALT
BOYSO, KYRIA C MODESTO
BRAGADO-CELESTINO, LEAH • C WATSONVILLE
BROWN, YVONNE • C SAN JOSE
BROWN, La SHONDA R. C SAN LEANDRO
BUCKLAND, BRITTANY • C SAN JOSE
BUENROSTRO, OSCAR IVAN AC PALMDALE
BURKE, BRYDIE • C SANTA ROSA
BUSTAMANTE, WENDY • C SAN JOSE
CADOGAN, LAURA LEE AC TEMECULA
CALVA, VERONICA C OAKLAND
CAMACHO, MELISSA FABIOLA AC BAKERSFIELD
CANTON, FERN D. • C SAN JOSE
CARBALLO, VALERIA • C SOUTH SAN FRANCISCO
CARDIEL, JESSICA • C SOQUEL
CASCO MARIN, JOHANNA C SAN LORENZO
CASTLEBERRY, CHRISTINA M. C VISTA
CHAPMAN, JEANETTE MARIE C SAN DIEGO
CHARTER, NORMA JEAN AC SHINGLE SPRINGS
CHOW, IZAK TRYSTAN PACA C BAKERSFIELD
COCHRAN, CHEYNA HOPE AC REDDING
CORONA, JASMINE A BAKERSFIELD
CORTEZ, JESSICA C LA PUENTE
COYNE, MELINDA G. • C FOLSOM
CRUZ-RENTERIA, FABIOLA C WATSONVILLE
CUADRAZ, BETTY • C BRAWLEY
CUEVAS, JESSICA • C SAN JOSE
CUNNINGHAM, MARY K. • C ROCKLIN
DAOUAOU, NADIA A MANTECA
DAVIS, MANDY CAROLYN AC APPLE VALLEY
DE BLASIO, BRIANNA C FREMONT
DEAN, KELLY ++ AC PLACERVILLE
DELGADILLO, CONSUELO C BRENTWOOD
DELOSSANTOS-ALMIROL, SHEILA C CHULA VISTA
DeVOL, COURTNEY M. A SANTA ROSA
DIAZ, ISABEL C FAIRFIELD
DIXON, ANGELA • C RIVERBANK
DOBBINS, REBECCA ANN C CAPITOLA
DRIVER, ALORA GRACE FAUNTAINE AC CAMARILLO
DUARTE, KELLY A LANCASTER
DUMAOP, MAYDELLYN ODVINA C SAN YSIDRO
EAGLES, DANIELLE SAMANTHA C FAIRFIELD
EDWARDS, MONICA LYNN C MODESTO
ELIZONDO, NICOLE AC SACRAMENOT
ESPOSTI, DEBRA A. AC FULTON
ESTRADA, AMY KAREN • A FALLBROOK
EVANGELHO, KYLIE C OAKLEY
FERNANDEZ, ADRIAN C SAN JOSE
FINK, DANIEL LINDSAY • C SAN JOSE
FLORES, LINDSEY C MODESTO
FOSS, JENNIFER A. • AC MODESTO
GAMEZ, SUSANA AC STOCKTON
GARCIA, GLORIA G. • AC FRENCH CAMP
GARCIA, MARIA T. • C DALY CITY
GARCIA, CATHY MARIE AC YUBA CITY
GARCIA, MARIBEL C BAKERSFIELD
GEBREMESKEL, ABEBA C ALAMEDA
GEDJALI, JENNIFFER G. C LOMA LINDA
GIOVACCHINI, JENNIFER NICHOLE • AC BRENTWOOD
GOMEZ, MARISA GENINA C SAN BERNARDINO
GONZALES, JESSICA AC TURLOCK
GONZALEZ, PAULA J. C FARMERSVILLE
GONZALEZ, VANESSA SAMANIEGO C ANTIOCH
GRANADOS, SUSANA • C LIVINGSTON
GREEN, JEWELLIUS O. A PALMDALE
• RECERT ++ ADDING 2ND SPECIALTY
CALIFORNIA MEDICAL ASSISTANT — JULY/AUGUST 2016 9
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY
NAME SPECIALTY HOMETOWN
– continued from page 8 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
GREWELL, BARBARA • C SALINAS
GRIFFIN, O. CRISTINA • A PICO RIVERA
GUERRA, BRIANNA I. C BAY POINT
GUERRERO, AGUSTIN C UNION CITY
GUERRERO, ESTHER PEREZ C BAKERSFIELD
GUERRERO, LOURDES JANNETT C EL CENTRO
GUILIANO, TERIL LYNN C PARADISE
GUTIERREZ, DANIELLE MONIQUE C SAN BERNARDINO
GUTIERREZ, DENICE C TULARE
GUZMAN, DENISE AC SAN LEANDRO
HARDY, YVONNE M. • C STOCKTON
HARKER, AVERY MARJIE A LIVERMORE
HEPNER, JESSICA E. AC EL CAJON
HERMANO, TIFFANY AMIE C SAN JOSE
HERNANDEZ, STACY MARIE ++ AC VISALIA
HERNANDEZ, BRENDA • C OCEANSIDE
HERNANDEZ, MARTA MERCEDES AC BAKERSFIELD
HERNANDEZ, MAYRA ALEJANDRA A CANOGA PARK
HERNANDEZ, PERLA C SAN MARCOS
HERNANDEZ, ELIANA C PITTSBURG
HOTCHKISS, PAIGE C KELSEYVILLE
JEFFREY, STEPHANIE AC PARADISE
JIMENEZ, JUANITA P. • C STOCKTON
JORDAN, JOELL CHRISTINE AC YUBA CITY
JUAREZ, BRIANA C SAN DIEGO
KAUR, RUPINDER C STOCKTON
KENTON, DENISE MARIE • AC MISSION VIEJO
KINARD, TERRI R. • AC GOODYEAR AZ
KOEHLER, RENEE DIANE C CHICO
KOPP, TATJANA MARIA AC OAKLAND
KRINGLER, JACKIE C SUSANVILLE
LAYAOEN, MICHELLE M. • C MILPITAS
LEAL, SHAWNA K. • C PORTOLA
LEMKE, ANGELICA C PROBERTA
LEMUS MORALES, GABRIELA C COACHELLA
LIANG, YONG YAO AC SAN JOSE
LINARES, YESENIA J. C SAN JOSE
LINCOLN, LOREEN • C FORT JONES
LINDSLEY, MARGARET • AC GALT
LIRA, DIANA S. • C STOCKTON
LOPEZ, BRENDA C PALM SPRINGS
LOPEZ, CORAIMA A EAST PALO ALTO
LOPEZ MAYA, ANAI A STOCKTON
LU, MICHELLE • AC MILPITAS
LU, KIMBERLY AC VICTORVILLE
MAGAÑA OLIVERA, ANNA AC SANTA CRUZ
MAGANA-BECHTEL, GLORIA C HESPERIA
MAHAN, ANGELICA MONIQUE AC RIALTO
MALDONADO, LETICIA C MENLO PARK
MARSHALL, JACKIE SUE C ONTARIO
MARTINEZ, ORALIA P. C GREENFIELD
MASSE, LENNIE ++ AC YUBA CITY
MATANOVICH, MASSIEL VALESKA AC DOWNEY
MAYTA, LEE ANNE AC CHICO
MAZA, KAITLIN D. • C SANTA ROSA
McELROY, HEATHER MARIE C PASO ROBLES
McGRUDER-JOHNSON, CATHRINE A. AC NORTH HIGHLANDS
MEIDINGER, SHERI • AC LINCOLN
MEIER, ADRIENNE C. A ANDERSON
MEIXNER, JULIE C. • AC HEMET
MENDOZA, YAZMIN P. C POWAY
MILES, SARAH LYNN C LODI
MILES, MONICA E. AC MAGALIA
MIRELES, ANGELA C DELHI
MITCHELL, KATLYN AC CORNING
MOORE, JOHNNA AC ANDERSON
MORALES, LUIS A. • C CAPITOLA
MORALES, ANALILIA AC ARVIN
MOSCOSO, ROXANA E. • AC CUDAHY
NARVAEZ, CELESTE GABRIELLE ++ AC DOWNEY
NAVARRO, KRISTAL C ESCONDIDO
NUNES, TIFFANY ANNE A SAN LEANDRO
ORTEGA, AUGUSTINA JULIE C SANTA CLARA
ORTEGA-MAYORGA, ASHLEY YISEL C DESERT HJOT SPRINGS
OTTO, ROBIN E. • C UKIAH
PAGET, CANDACE M. • AC MOORPARK
PAGNIELLO, TORI A. C CITRUS HEIGHTS
PARKERSON, HILARY C LOS OSOS
PARRA, AMANDA C CHICO
PEDRAZA ARCILA, AIRAM C. • C WATSONVILLE
PEERAN, JABEEN C MOORPARK
PERALTA, ROCHELE M. C POWAY
PEREZ, JACQUELINE NICOLE A PALMDALE
PEREZ-SALAZAR, SILVERIO J. C SAN JOSE
PERRY, SAMANTHA ELECTA AC SHINGLETOWN
PETRIC, DEBBIE C WINCHESTER
PIMIENTA, ISABEL • C BAKERSFIELD
PURYEAR, SUSAN • AC RED BLUFF
QUEZADA, GABRIELLA • C LODI
QUIÑONEZ-OLUFSEN, ESPERANZA C EUREKA
continued on page 10
10 CALIFORNIA MEDICAL ASSISTANT — MAY/JUNE 2016
Congratulations to each of these medical assistants.
From the California Certifying Board for Medical Assistants
• RECERT ++ ADDING 2ND SPECIALTY
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
– continued from page 9 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
QUINTERO, BERNICE • C WATSONVILLE
RACZ, KATRINA C VALLEY SPRINGS
RADHAKRISHNAN, YASODHA • A LOS GATOS
RAMIREZ, SABRINA A BAKERSFIELD
RAMIREZ, VERONICA LAURA C WATSONVILLE
RAMIREZ, MELISSA C HAYWARD
RANGEL, KARINA C STOCKTON
RAPISURA, JULIE A. • C VALLEJO
RENNINGER, JULIA ABIGAIL AC GEYSERVILLE
RENTERIA, EILEEN M. C FRESNO
ROBERTSON, CHRISTINE JEAN MARIE AC YUBA CITY
ROBINSON, ADRIENNE D. C TEMECULA
RODE, MOLLY M. AC CITRUS HEIGHTS
RODRIGUEZ, VANESSA O. • C GARDEN GROVE
ROGERS, CHRISTINE C RAMONA
ROSAS, JESINYA P. C HARBOR CITY
ROSAS, CRYSTAL C KING CITY
RUBY, CINDY TRINIDY C MANTECA
RYAN, JACQUELINE C FRAZIER PARK
RYKER, KIMBERLY RAE • AC BOULDER CREEK
SAEFONG, KELLI • C OAKLAND
SALDANA, LAURA B. AC LONE PINE
SALGADO, GEMA GUADALUPE C ATASCADERO
SALIBA, LEA SIMON AC SAN LUIS OBISPO
SANBECK, JOHNATHAN C ROSEVILLE
SANCHEZ, NICKOLAS ROBERTO C INDIO
SANDOVAL, PATRICIA C PERRIS
SANTOS, ELIZABETH C GRANADA HILLS
SCHMIDT, ALLISON M. C LOS ALTOS
SCHULTZ, JOAN A. • AC GRASS VALLEY
SCOVILLE, JESSICA ++ AC EXETER
SEEGER, KENDAL AC CAPITOLA
SHAFER, LAUREN ELIZABETH AC SCOTTS VALLEY
SILVESTRE, JOSHUA F. AC GALT
SMITH, NICOLE AIMEE C VISTA
SMITH, SOCORRO T. C SAN JOSE
SOLORZANO, AMAIRANY C STOCKTON
SOPHABMIXAY, VIENGKHAMSOUK C SAN DIEGO
SOSA, GUSTAVO A. C LANCASTER
SOTO, DENISSE C CATHEDRAL CITY
STOGNER, TAYLOR C CORNING
STOLLER, GEOFFREY AC WALNUT CREEK
STONE, TAMELIN L. C SAN LEANDRO
STORAASLI, DANIEL R. C SHINGLE SPRINGS
SULLIVAN, LINDSEY A. C OAKLEY
SUMTER, PEGGIE • A TEHACHAPI
SUN, ZENG YUAN C MILLBRAE
THOMPSON, PERISHA A. C NATIONAL CITY
TODD, DEVIN A. • C SANTA ROSA
TONEY, RAMANEQUE DEHAVEN AC RANCHO CORDOVA
TOPETE, MARGARITA C OAKLAND
TORRES, PERLA GUADALUPE C REDWOOD VALLEY
TORREZ, MARIA A BAKERSFIELD
VADON, TIFFANEY A.B. AC CLOVERDALE
VALADAS, GABRIELA C SAN LORENZO
VALDOVINOS, CARLA AC SPRING VALLEY
VALENCIA, LEONEL C MOSS LANDING
VARGAS, CHRISTINA ANDREA C FREMONT
VILLALOBOS, CYNTHIA C RAMONA
VILLAREAL, HAZEL ANNE E. C SAN DIEGO
VOX, DORENE ANN C SHASTA LAKE
WALKER, HELEN AC SAN LORENZO
WALLACE, FREDERICK • C SANTA ROSA
WALLACE, MEGAN LUO C SAN DIEGO
WARREN, KRISTEN TAYLOR A DUBLIN
WASURICK, GERALYNE • C TRACY
WATERMAN, DARIAN ROSE C GUALALA
WERLEY, KAYLAN RENEE’ C ANTELOPE
WHISLER, SHARI B. • AC PLACERVILLE
WILLIAMS, CHERYL AC UKIAH
WONG, EMILY C VISTA
WOOD, MADELEINE AC YUBA CITY
WOODBERRY, BIANCA • C LOWER LAKE
YANCEY, LINDA DIANE AC SANTA CRUZ
ZAVALA VILLA, REYNA C MODESTO
C E R T I F Y I N G B O A R D U P D A T E
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The durability of lead made it an excellent paint additive, but the sweetness made it tempting to young children. Childhood lead poisoning was linked to lead-based paints in 1904. Several European countries banned the use of interior lead-based paints in 1909. At one time baby cribs were painted with lead-based paint, which resulted in infant illness and death. The League of Nations banned lead-based paint in 1922, but the United States declined to adopt this rule. In 1943, a report concluded that children eating lead paint chips and exposed to paint dust could suffer from neurological disorders including behavior, learning, and intel-ligence problems. Finally, in 1971, lead-based house paint was phased out in the United States with the passage of the Lead-Based Paint Poisoning Prevention Act and effectively banned by 1978.
The relationship between leaded gasoline, touted to prevent engine knocks, and blood lead levels was demonstrated when the EPA reported that blood lead levels declined by 37% in association with a 50% drop in the use of leaded gasoline between 1976 and 1980. In 1980 the National Academy of Sciences reported that leaded gasoline was the greatest source of environmental lead contamination. It is estimated that seven million tons of lead were released into the atmo-sphere from gasoline in the United States alone. The Clean Air Act, implemented on January 1, 1996, banned the sale of leaded gasoline for on-the-road vehicles in the U.S.
Lead is a soft, malleable, bluish-white metallic element found in ore with zinc, silver and copper. The oldest known lead article is a figurine found in Egypt that dates back to 4000 BCE.
Significant production of lead began about 3000 BCE. Because of its malleability and resistance to corrosion, lead was used extensively by the Romans for water pipes, aqueducts, tank linings and cooking pots; in fact, the word plumbing is derived from plumbum, Latin for lead, which also gave rise to the chemical symbol for lead, Pb. Lead has a slightly sweet taste, making it a good additive for the fine Roman wines that were shipped all over Europe. Even in those times there were reports that lead caused severe colic, anemia, and gout.
In medieval times, lead came to be used for roofing, coffins, cisterns, tanks, and gutters, and for statues, ornaments and coins. Another early use of lead was for the strips joining stained glass windows in cathedrals and churches. Household uses included dishes, utensils, cosmetics and paints.
By the 1920’s, lead was an essential part of the American home and could be found in telephones, ice boxes, vacuums, irons and washing machines. Lead could also be found in common children’s toys like dolls, painted toys, bean bags and baseballs. It was also found in fishing lures. Lead was in gasoline, pipes, paint and glazes. Despite the fact that lead was known to be toxic as early as the late 19th century, manufacturers and trade groups marketed it as essential to America’s economic growth and consumer lifestyle.
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Risk Factors
The highest risk of lead exposure is for children under age six with a peak risk at one to two years old. The California Department of Public Health website lists the following as common sources of lead exposure and risks to children:
• More time spent on floor
• Increased hand to mouth behavior
• High absorption of lead
• Rapid central nervous system development
• Lives or spends significant amounts of time in pre-1978 housing/buildings with paint in poor condition or undergoing renovation
• Exposure to lead contaminated dust or soil
• Low income
• Family member who works with lead
• Sibling with elevated blood lead level
• Mother with history of lead exposure/lead poisoning
• Recent immigration/foreign adoptee, or spends time outside of the U.S.
• Pica (ingestion of non-food items such as pottery, clay, dirt, plaster and paint chips)
• Family member with hobby exposure (e.g., stained glass, ceramics, firearms, fishing)
• Use of certain imported remedies/supplements/cosmetics
• Use of some types of traditional/imported/handmade dishware
• Consumption of lead contaminated foods (e.g., Chapulines, some Mexican candy, some imported spices)
• Exposure to lead contaminated consumer products
• Lives near source of lead air emissions
• Exposure to lead contaminated water source
Effects of Lead Exposure
Lead poisoning occurs when lead builds up in the body, often from exposure over a period of months or years. Lead accu-mulates in tissues like nerve cells and bone. It interferes with the metabolic pathways of the body in a gradual and progres-sive way, ultimately damaging brain, kidneys and production of red blood cells. Even small amounts of lead can cause serious health problems and can be fatal at very high levels. The Mayo Clinic website lists the following signs and symptoms of lead poisoning in children:
• Developmental delay
• Learning difficulties
• Irritability
• Loss of appetite
• Weight loss
• Sluggishness and fatigue
• Abdominal pain
• Vomiting
• Hearing Loss
• Constipation
Blood Lead Levels and Treatment
No level of lead in the body is known to be safe and effects of lead exposure cannot be corrected. The only way to diagnose lead poisoning is to obtain a blood lead level (BLL). The Centers for Disease Control and Prevention (CDC) reports that until 2012 children were identified as having a blood lead “level of concern” if the test result was 10 or more micrograms per deciliter (mcg/dL) of lead in blood. CDC is no longer using the term “level of concern” and is instead using that reference value to identify children who have been exposed to lead and who require case management.
After 2012, the current reference level was lowered to 5 mcg/dL which identifies children with blood lead levels much higher than most children’s levels. The focus has shifted to
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prevention of lead exposure in order to reduce or eliminate dangerous lead sources in children’s environments before they are exposed. For those children with relatively low lead levels, simply avoiding exposure to lead may be enough to reduce blood lead levels.
Unfortunately, once a child has absorbed a dangerous amount of lead, there’s no quick way to make the lead go away.
The CDC recommends children be medically treated with chelation (pronounced key-LAY-shun) therapy if they have a BLL result equal to or greater than 45 mcg/dL. Chelation means “to grab” or “to bind” and is a chemical process in which the chelating agent binds with lead in the body and is excreted in urine.
The following table from the California Department of Public Health (CDPH) website illustrates possible health effects of increasing blood levels:
Blood Lead Level Possible Health Effects
less than 10 mcg/dLDecreased IQ, developmental toxicity (No known lower level for effects)
10 - 44 mcg/dLBehavior problems (hyperactivity, irrita-bility), overt physical symptoms rare
45 - 69 mcg/dLApathy/fatigue, anemia, abdominal symptoms (pain, constipation, nausea/vomiting)
70 - 100 mcg/dL Nephropathy, colic, encephalopathy
> 100 mcg/dLCNS crisis (cerebral edema, ischemia, seizure, coma, possible death)
Standard of Care for California Health Care Providers
CDPH has developed care and management guidelines for health care providers. These state regulations impose specific responsibilities that apply to all physicians, nurse practitioners and physician’s assistants.
All children from six months to six years must be screened for lead exposure at each periodic assessment. Children in pub-licly supported programs (examples include Medi-Cal, CHDP, WIC) must be screened with a BLL at both twelve months and twenty-four months. Children age twenty-four months to six years in publicly supported programs must be screened with a BLL if they were not tested previously.
If a child is not in a publicly supported program, an assess-ment must include asking the question, “Does your child live in, or spend a lot of time in, a place build before 1978 that has peeling or chipped paint or that has been recently remodeled?” A BLL must be performed if the answer to the question is “yes” or “don’t know.” Other considerations include a change in circumstances that has put a child at risk of exposure, a history of living or visiting a country with high levels of environmental lead, or simply parental request.
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Read the Continuing
Medical Education Article
CHILDREN AND LEADA Dangerous Combination
located on pages 11 - 14,
then complete the Self-Assessment Test
on page 15 for CME credit.
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As well as evaluating children for lead exposure, CDPH requires health care providers to discuss test results with family, discuss hand-to-mouth activity, hand washing, sources of lead exposure, and counsel on any risk factors that have been identified.
All BLL results must be reported to CDPH’s Childhood Lead Poisoning Prevention Branch (CLPP) who is mandated to identify lead burdened children and see that they receive appropriate services to prevent environmental exposures to lead. This is done in conjunction with county health depart-ments who conduct surveillance activities, case management, and other necessary follow-up with children who have blood lead levels of concern.
Conclusion
Despite national headlines regarding lead levels in drinking water, the highest risk of lead exposure today remains lead-based paint and paint dust. Identification of children with elevated BLLs, and parental and community education is the best way to lower, and eventually eradicate, the risk of lead exposure and poisoning. CDPH and CDC have printable educational materials available on-line. A data map published by Vox has ranked more than 66,000 census tracts across the U.S. for their risk at childhood lead exposure based off housing age and poverty data. See it at http://www.vox.com/a/lead-exposure-risk-map. Another resource is the United States Consumer Product Safety Commission website which lists recalled goods that contain lead in excess of federal regulations. ❧
REFERENCES
Markowitz, Gerald and Rosner, David. Lead Wars and the Fate of America’s Children. Berkeley, University of California Press, 2013.
Houston, Will. “Data: Lead Exposure High.” Times-Standard 17 April 2016: 1+
Centers for Disease Control and Prevention, Lead. http://www.cdc.gov/nceh/lead
California Department of Public Health, Childhood Lead Poisoning Prevention Branch. https://www.cdph.ca.gov/programs/CLPPB/Pages/default.aspx
Mayo Clinic, Lead Poisoning. http://www.mayoclinic.org/diseases-conditions/lead-poisoning/basics/definition/con-20035487.
US Environmental Protection Agency, Lead. https://www.epa.gov/lead
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