Spring 2000

From playpen

to prom

* Keeping your child healthy *

From playpen

to prom

* Keeping your child healthy *

~CHILDREN’S Health Information Inside~~CHILDREN’S Health Information Inside~

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is published four times a year by theArkansas Blue Cross and Blue ShieldAdvertising and CommunicationsDivision for the company’s mem-bers, health care professionals andother persons interested in health

care and wellness. Opinions expressed herein do not necessar-ily reflect the views of Arkansas Blue Cross and Blue Shield orany of its publics.

Vice President of Advertising and CommunicationsPatrick O’Sullivan

EditorKelly Whitehorn

DesignerGio Bruno

ContributorsMark Carter, Janice Drennan, Damona Fisher and Kathy Luzietti

Customer Service Numbers

Little Rock Toll-freeCategory Number (501) Number

State/Public School Employees 378-2437 1-800-482-8416

e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com

Medi-Pak (Medicare supplement) 378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) 378-2173 1-800-482-5525 Part B (physician benefits) 378-2320 1-800-482-5525

UniqueCare, UniqueCare Blue, Blue Select® (individual products) 378-2010 1-800-238-8379

Group Services 378-5579 1-800-421-1112

BlueCard® 378-2127 1-800-880-0918

Federal Employee Program (FEP) 378-2531 1-800-482-6655

Health Advantage 221-3733 1-800-843-1329

Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904

USAble Administrators 378-3600 1-800-522-9878

Numbers to call for information about obtainingcoverage:

Little Rock Toll-freeCategory Number (501) Number

Medi-Pak (Medicare supplement) 378-2937 1-800-392-2583

UniqueCare Blue, Blue Select® (individual products) 378-2937 1-800-392-2583

Medi-Pak HMO (Health Advantage) 378-6987 1-800-588-5706

Regional Office locations:Central Little RockNortheast JonesboroNorthwest FayettevilleSouth Central Hot SpringsSoutheast Pine BluffSouthwest TexarkanaWest Central Fort Smith

Customers who live in these regions may contact theregional offices or call the appropriate toll-free telephonenumber listed above.

INSIDETHIS ISSUE

~SPRING 2000~

Prenatal information................................. 4-5Special Delivery program ............................. 5Immunize your child ..................................... 6Signs of sinus & ear infections .................... 7Measuring up, Sibling rivalry ....................... 8Is your child getting enough sleep? ............. 9Raising healthy kids ............................. 10-11Help! My child has ADD! ............................ 12Rules are good for children ....................... 13Teen turmoil: Acne & Depression ............... 14Talking to your teen ................................... 15Focus on Children’s Health (ways to praise, thegeneral’s plan and word scramble contest winner) .... 16Club Update, Ageless Heroes, Olympics .... 17Leading the Way(get to know some of Arkansas’ legislators) ....... 18-19Who owns Arkansas Blue Cross? .......... 20-21Survey results in a letter from the editor ... 21Health Advantage news for members ......... 22Blue & Your Community ............................. 23Clearly Blue (a terminology guide) .................... 24

4 Pregnant Women Guidelines*

1. Genetic andobstetric history,dietary intake,tobacco/alcohol/drug use, riskfactors for intrau-terine growthretardation andlow birthweight,prior genitalherpetic lesions.

2. Fundal height andfetal heart tones.

3. Urine culture.4. Blood pressure.5. Hemoglobin and

Hematocrit.6. ABO/Rh typing.7. Rh(D) and other

antibody screen.8. Pap smear.9. VDRL/RR.10. Hepatitis B

surface antigen(HBsAg).

11. Urinalysis forglucose andprotein.

12. Gonorrheaculture andChlamydialtesting.

13. Ultrasoundcephalometry.

14. HIV counselingand testing.

Improving the health of mothersand infants is a national challenge.Talk to your physician today aboutsteps you can take toward ensuring ahealthy pregnancy. Adopted fromnational guidelines, the services listedhere were reviewed by local physiciansprior to release. Health Advantage hasdistributed this information to primarycare physicians and those physiciansspecializing in obstetrics and gynecol-ogy (OB/GYN) within the HealthAdvantage network. This informationis intended only as a guide. Individualtreatment is a coordinated effortbetween you and your physician.

Each Visit:1. Fundal height and

fetal heart tones.2. Blood pressure.3. Urinalysis for

glucose andprotein.

Each Visit:1. Fundal height and

fetal heart tones.2. Blood pressure.3. Urinalysis for

glucose andprotein.

(Clinical discretionduring 24 to 28week period):

4. Maternal serumalpha-fetoprotein(MSAFP)(2).

5. 50g oral glucosetolerance test.

*NOTE:These guidelinesrepresent minimumlevels ofrecommended care.Individual riskfactors may requireadditionalscreenings andservices.

Notice to allmothers-to-be

11111ststststst Prenatal Visit Prenatal Visit Prenatal Visit Prenatal Visit Prenatal Visit 14-16 Weeks14-16 Weeks14-16 Weeks14-16 Weeks14-16 Weeks 24-28 Weeks24-28 Weeks24-28 Weeks24-28 Weeks24-28 Weeks 36 Weeks36 Weeks36 Weeks36 Weeks36 Weeks

Each Visit:1. Fundal height and

fetal heart tones.2. Blood pressure.3. Urinalysis for

glucose andprotein.

(Clinical discretionduring 36-weekperiod):

4. Beta strep.

1. Take a vitamin pill that has afolic acid in it every day. Folicacid is a special vitamin thatcan help prevent birth defects ofthe brain and spine. Foods thathave folic acid include orangejuice, green vegetables, fortifiedbreakfast cereals and enrichedrice and whole wheat bread.

2. Have a medical checkup beforegetting pregnant.

Planning to have a baby?

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3. Adopt a healthy lifestyle — eata balanced diet, get plenty ofexercise and reduce stress.

4. If you are not immune tochicken pox and rubella, checkwith your health care providerabout getting vaccinated beforeyou conceive.

5. Have medical problems likediabetes, epilepsy and highblood pressured treated.

6. Try to achieve your idealweight. If you are overweightwhen you become pregnant,you’re more likely to develophigh blood pressure and diabe-tes during pregnancy. If you’reunderweight, you’re more likelyto have a low-birthweight baby.

7. If you have had problempregnancies or birth defects inyour family, you should talkabout it with your health careprovider.

8. Avoid exposure to toxic sub-stances and chemicals.

9. Don’t eat undercooked meat orhandle cat litter.

~ Here are some helpful hints for having a healthy baby

All about theSpecial Delivery program All about theSpecial Delivery program

Call toll-free

1-800-742-6457

or 501-954-5468.

The Special Delivery program is a pregnancy program offered as an additional benefit to Arkan-sas Blue Cross and Blue Shield, Health Advantage and USAble Administrators members. It was createdwith three strategies in mind to make sure our members have healthier pregnancies — education,assessment and intervention.

The Special Delivery program seeks to assist the expectant mother and her physician in theprevention of preterm births secondary to high-risk perinatal conditions. All program participantsreceive educational materials and coupons by mail. Services not normally offered such as skillednursing assessments or nursing assistant care in the home for conditions including pregnancy-inducedhypertension, diabetes mellitus and preterm labor are covered through the Special Delivery program.

How the program works:• Expectant mothers should enroll in the program by the 14th week of pregnancy.• The expectant mother will complete a risk assessment brochure where she

answers a series of basic questions. The questions are designed to identify factorsthat may put the mother and/or baby at risk.

• If risk exists, the expectant mother is followed throughout her pregnancy todetermine if home health care is appropriate.

If high risk exists, the mother and baby are monitored at regular intervals throughout the preg-nancy to identify needs she might have (for example, home health), provide further education and toencourage the mother-to-be to keep her appointments with her doctor.

If low risk exists, the patient will be rescreened at 24 to 28 weeks via telephone contact by theSpecial Delivery nurse or by completing a risk assessment brochure that will be mailed to her andreturned to Medical Management.

If the Special Delivery program is a benefit of your health insurance and you would like moreinformation, please call toll-free 1-800-742-6457 or 501-954-5468.

6 I f you have a newborn baby or are thinkingabout starting a family, you have plenty to worry

about. One thing you shouldn’t worry about is whetheryou should get your child immunized.

The American Academy of Pediatricsrecommends that parents protect theirchildren from serious childhood illnessesthrough immunizations. Withoutimmunizations, your child is atrisk for illnesses such as measles,whooping cough, hepatitis, polioand much more.

Immunizations begin at birth, and children shouldreceive most of their immunizations during their first twoyears of life.

Some immunizations are combined and protectagainst numerous diseases. The current immunizationschedule is available from your pediatrician and wasfeatured in the Winter 1999 issue of Blue & You. Yourchild needs the following immunizations to stay healthy:

• MMR vaccine to protect against measles, mumpsand rubella.

• Polio vaccine to protect against polio.• DTaP or DTP vaccines to protect against diptheria,

tetanus and whooping cough.

• Hib vaccines to protect infants and children againstHaemophilus influenzae type B infection (this canbe a cause of meningitis or blood strain infections).

• HBV vaccine to protect against hepatitis B, whichcauses liver disease.

• Varicella vaccine to protect against chicken pox.

Reactions toimmunizations mayoccur, but they areusually mild. Seriousreactions are very rarebut may occur. Therisks from thesepotentially seriousdiseases are greaterthan the risk of aserious reaction froman immunization.

Immunizations are an important part of keeping yourchild healthy. Immunize your child on time and keepyour child’s records up-to-date. Also, make sure yourchild has regular checkups with his or her pediatrician orhealth clinic.

Remember, the best way to make sure your child getsthe immunizations he or she needs is to check with yourchild’s pediatrician or your local health clinic.

Information for this article was obtained from theAmerican Academy of Pediatrics.

Be an overprotective parent — immunizeBe an overprotective parent — immunize

Special thanks Special thanksA special thanks to Tony Johnson, M.D., and Charles Gist, M.D.,

for their time and commitment to this issue of Blue & You focusingon their area of specialty — children. Dr. Johnson is a pediatricianwith the Arkansas Pediatric Clinic and Dr. Gist specializes in child,adolescent and adult psychiatry with Psychiatric Associates ofArkansas, PLLC. Both practice in Little Rock, Ark.

7How can you tell ifyour child has an acutesinus infection rather than

a case of the common cold?• Symptoms of a cold that linger more

than 10 days without any improvement.• High fever.• Large amount of yellow-green discharge

from the nose.• Eye swelling and eye pain or headache.• Coughing (worse at night).• Bad breath.If your child exhibits these symptoms,

chances are you’ve got an acute sinus infec-tion on your hands.

Colds (viral upper respiratory infections)can last a week to 10 days and include somefever at the onset. But colds require nospecific treatment from a doctor. Nasaldischarge resulting from a cold will look clear

Ear infections can be serious, especiallyin children.

Acute ear infection, or infection of theinner ear, can affect anyone but ismore common in children. Itresults from bacterial or viralinfection of the fluid in the middleear, which causes production offluid or pus.

Chronic ear infection is the result ofprolonged or repeated acute ear infection andcan cause permanent damage to the ear.Chronic infections may go unnoticed andshow less severe symptoms, leading todelayed treatment.

Parents should always hold their babies ina sitting position when feeding to help reducethe risk of acute ear infection in infants.

Symptoms parents can look out forinclude:

• Ear pain or discomfort

SOMETIMES A SINUS INFECTION CAN MASQUERADE AS A COLD

at first, turn yellow-green and then clearagain before disappearing. It’s important toremember that antibiotics do not treat viralinfections.

Children get sinus infections for much thesame reason they get colds. The sinuses arelined with the same layer of mucous-produc-ing tissue found in the nose and upper-respiratory tract. When inflamed and swollen,the sinus’ exit passages can’t drain properlyand bacteria creates an infection for whichantibiotic treatment is necessary.

Some children who have allergies andthus swollen and inflamed upper respiratorytracts are prone to sinus infections. Allergicchildren with sinus infections should betreated for the allergy as well as for the sinusinfection.Information for this article was obtained from“Ask Mom M.D.,” Dr. Karen Kaplan, Pediatrician

(severe earache, pressure in the ear).• Pulling at the ear.• Drainage from the ear.

• Hearing loss in theaffected ear.

• Fever.• Chills.• Irritability.• Feeling of general illness.

• Nausea or vomiting.• Diarrhea.Ear drops, nasal sprays, nose drops, oral

decongestants, and sometimes oral antihista-mines, can be used to helppromote drainage orrelieve pain.

But most impor-tantly, if symptomspersist, see yourdoctor or health careprovider.

EAR INFECTION OR NOT? KNOW THE SIGNS

8 I f your baby or child seems small for his or her age, the best advice for you is — don’t panic.

Everyone is different, so what is normal for the childnext door may not be what is normal for your child.

The mostimportant thing towatch for is a patternof steady growth anddevelopment. Eachtime you visit yourpediatrician’s officefor your baby or child’s checkup, the nurse will weighyour child and take a height measurement. Thosemeasurements are usually graphed on a chart so thepediatrician can watch your child’s growth.

Other factors to consider:• Size at birth is a poor predictor of your child’s final

adult height or weight.• Reaching developmental milestones (talking,

walking, fine motor skills, etc.) does not necessar-ily indicate greater intelligence.

I t’s a scene that’s played out every day in homesthroughout the country. Your children are arguingover which show to watch on television or maybearguing over whose turn it is to set the table.

If you have more than one child, you likelyrecognize these scenarios immediately as something yousee in your own home — sibling rivalry.

No matter how much it seems to distract you andtake away from the harmony in your family, siblingrivalry is a natural part of growing up. Sometimes thearguments can work themselves out, but when they

seem out of hand, Mom or Dadshould step in and control thesituation.

Here are some tips forhandling sibling rivalry:• When children are bickering, pointedly praise the child who

• Abnormalities in hearing or sight require earlycorrective action, so be especially watchful of anyapparent problems.

Babies normally lose weight in the first few daysafter birth. Breast-fed babies lose no more weight thanbottle-fed babies. Within the first few months after birth,babies usually establish a growth rate that is consistentfor many years.

By the time your child is 2 or 3 years of age, he orshe should have established a consistent growth patternthat is a fairly good indicator of final height.

The measurements that your pediatrician will betaking — andwatching — fora consistentpattern areweight, height,head circumfer-ence anddevelopmentalmilestones.

is behaving more appropriately.• Put a behavior plan into place, with a written contract that rewards certain behavior (for example, give your brother a sincere compliment each day).

• Many times, children are arguing for their parent’sattention. Try to spend regular uninterrupted timewith each of your children.

• Parents should not quarrel or bicker with each otherin front of the children. Parents also should maintaina calm demeanor with the kids.

• Family rules should be clearly explained and bound-aries defined. The consequences of actions should beappropriate. For example, if one child hits a sibling,denial of a favorite treat or television program wouldbe appropriate.

• If your children cannot control their bickering,separate them from each other for a period of time

Measuring up What is normal for your child?

Sibling rivalry: A normal part of the sibling relationship

(separate parts of the house where they cannot seeor speak to each other).

• Don’t take sides in a sibling argument. Encourageyour children to work out their differences.

• Do not compare your children to each other, or totheir friends.

• Do not reward tattling. It will only encourage yourchildren to tell on each other and create morefriction between them.And most of all, don’t give up. Time and persistence

will help you learn new ways of dealing with siblingrivalry. Some bickering or disputes are entirely normaland help the children to resolve conflict. In the long run,you are teaching your children how to get along better,and that will prepare them for important relationshipsin the future.

9W ith Mom and Dad both working and the kids

involved in numerous activities, today’s family is verybusy … and very tired. While adults can get by on eighthours of sleep per night, children often need moredepending on their age, activity level and health status.

When school is out, kids are doing their homework,going to soccer practice, taking piano lessons, workingon their school science project and much more. Whilekeeping your children involved in activities is an admi-rable goal, keep in mind that making sure your childrenget enough sleep will help them in school and with theirextracurricular activities.

A 1999 survey commissioned by the National SleepFoundation found that a majority of kids say they aresleepy during the day and 15 percent admit to fallingasleep in school. Teen-agers, more than any other agegroup, are not getting enough sleep.

Researchers believe that access to the Internet,television, academic pressures, social obligations andafter-school jobs all contribute to the sleep shortageamong children and teen-agers.

Lack of sleep contributes toproblems comprehending andretaining educational informa-tion during school hours. It alsocontributes to behavioralproblems in children.

So how much sleep doesyour child need? Here are a fewsimple guidelines:• Newborn babies — Anywhere

from 12 to 20 hours per day.• Toddlers and preschoolers —Approximately 12 hours

per day and one afternoon nap.• School-aged children (grades K-6) — Approximately

10 hours per day.• Teen-agers — At least nine hours of sleep per day.

“Sleep hygiene” is another way to view sleep pat-terns for your children. Try to remember:

• Keep regular sleep patterns and wake-up times sevendays per week.

• Use the bedroom for sleeping only (keep computer,television, etc., in a separate room).

• Teen-agers that have trouble sleeping may need toget up, read a boring book until they feel sleepy, thenreturn to bed.

• Significant sleep problems can be a symptom ofclinical depression.Remember that good sleep habits begin early —

between 2 and 4 months of age. Even at that young age,babies are learning where to sleep, how to sleep andwhen to sleep. By the time yourbaby is 4 to 6 months of age,he or she should be able tosleep eight to 12 hours pernight. Establish a routinethat helps you — andyour baby — get a goodnight’s sleep.

Is your child getting enough sleep?

10Two of the most important things that parents

can do for their children are making sure they getproper nutrition and regular exercise. Teaching childrenhealthy habits early in life can help them develophealthy attitudes and behaviors that can benefit themthroughout their lives. Unfortunately, in today’s world,not only are getting proper nutrition and exercisevery important to children — they can also be verychallenging achievements for parents — at least withoutappropriate planning.

Some Surprising Facts

Did you know that …• Take-out foods make up 35 percent of the average

family’s meals.• Three or more cans of soda are consumed daily by

two-thirds of teenage boys.• Less than 35 percent of children participate in

physical education classes at school and themajority do not get recess.

• By the time children reach ninth grade, 70 percentof girls and 50 percent of boys do not take part inany vigorous activity.

• Obesity in children has more than doubled sincethe 1970s.

Nutrition

Good eating habits and table manners should beginat a young age. By the time a child is eating in his highchair, parents should establish regular meal

schedules and good tablemanners. It is importantthat children have theirmeals at the same time andavoid excessive snacking ordrinking juice, which interferes

with mealtime. Children also should

eat at the table — not infront of the television oranywhere else.

In today’s fast-pacedworld, with families often goingin many different directions, weoften find ourselves grabbingmeals on the run. Most often,microwave meals, snack foods and fast-food restaurantswin out over home-cooked meals. In fact, in the averagefamily, home-cooked meals are usually the exceptionrather than the rule. So the best way to ensure thatyour children get the nutrition they need is withcareful planning.

Some things you can do to help

your children be healthier eaters:

• Resist the tendency to let your kids “be in charge”of what they eat.

• Become familiar with the Food Guide Pyramid forYoung Children and keep the shelves and refrigera-tor stocked with items from each food group.

• Spread out some of the recommended servingsfrom the Food Guide Pyramid so you can includethem, not only at mealtime, but in snacks as well.

• Pack healthy lunches for school.• Offer a variety of foods and serve reasonable child-

sized portions that won’t overwhelm your child —he or she might even go back for

seconds.• Don’t make your kids “clean

their plate.” That’s asking them toignore their body’s own natural

signals that tell them whenthey are full and might

possibly even lead to eating disorders.• Limit the amount of beverages your child may

Healthy Habits That Last a Lifetime

RaisingHealthyKids

11drink between meals. Beverages may spoiltheir appetite for meals and snacks.

• Dessert should be just another part of ahealthful meal and not set up as a “reward.”

Got a picky eater in the family? What familydoesn’t? The first rule to remember when dealingwith a picky eater is — forget the hard sell! Try tointroduce new foods gradually by using a low-keyapproach. Most children usually resist trying newfoods, but if given enough good-tasting variety to choosefrom, almost all children will eventually give in. Let thembecome familiar with the food by touching it, picking itup and slowly tasting it. They may not try it until the10th time it’s served, but the important thing is — theywill try it. If you’re concerned about your child noteating enough, put at least one food on the table thatthey like.

Overall, most children, if given an opportunity toselect from a variety of foods from all of the food groups,will select sufficient amounts of nutrients, and eatingpatterns will usually improve over time. If you’re seri-ously concerned about your child not getting the propernutrition, check with your pediatrician.

Exercise

Another important part of a child’s growth anddevelopment is regular exercise. In recent years, studieshave shown that childhood obesity has increased at analarming rate. According to a recent survey, kids blamehomeworkfor their lackof time forphysicalactivity. But twoout of threeparents surveyedsay lack of interestor competition fromtelevision is the reasontheir youngsters aren’t getting enough exercise.

Considering the decrease in physical activity inschools in recent years and the fact that many childrenchoose television and video games as primary sources ofentertainment, it’s no wonder that there is a lack ofphysical activity in our children’s lives. Once again,involvement by adults or parents is critical if children are

to receive adequate exercise in their dailyroutine.

Some things you can do to help

your children get more exercise:

• Limit your child’s time in front of the television orcomputer.

• Encourage his or her participation in outdoorsports — soccer, baseball, swimming, etc.

• Encourage funactivities thatinvolve physicalmovement suchas riding a bike,jumping rope, agame of chase,playing hopscotch, etc.

• Ask older children to do chores that involvephysical activity, like walking the dog or helpingwith yardwork.

• If your child’s school doesn’t have a recreationprogram for children, encourage school officials toadd it to the curriculum.

• Volunteer your time at your child’s school to helpwith recreational activities after school or onweekends.

If you want your children to live a healthy lifestyle —get involved in their lives and start the process now. It’sup to you to teach them healthy habits and behaviorsthat will benefit them the rest of their lives.

Resources for this article include: Stephen Tucker, M.D.,Little Rock; International Life SciencesInstitute; NetBiochem: Nutrition;and “Arkansas Times: 2000How-to Guide.”

The bell rings. The children sit down in theirseats and the teacher gives instructions for the firstassignment of the school day. However, there is onechild who is looking out the window and thinkingabout the airplane that just flew by, or wonderingwhat kind of bird she hears chirping. The teachernotices and redirects that child to the assignmentat hand.

The child pays attention for a moment, but then herpencil falls to the floor. She then is distracted by all thedifferent tennis shoes the other children are wearing andbegins thinking about when and where she might get hernext pair.

These are a few moments in the life of a child withAttention Deficit Disorder (ADD) or Attention DeficitHyperactivity Disorder (ADHD). It is estimated that 3 to10 percent of children have this disorder, which ischaracterized by the inability to pay attention in class ordifficulty completing academic assignments.

However, not every student who can’t sit still inclass or can’t complete an assignment has ADD orADHD. This is particularly true in the lower elementarygrades when children naturally have more energy andhave not reached a level of maturity to meet thedemands of the classroom.

If your child has had the symptoms of poor atten-tion, concentration and/or poor impulse control for sometime, you should have your child examined by a physi-cian. In addition to a physical exam, the physician mayhave the parents and teachers complete questionnaires

about the child’s behavior. A child with ADD or ADHD

may have some of thefollowing symptoms:• Doesn’t seem to listen.• Doesn’t complete assignments.• Easily distracted.• Difficulty in concentrat-

ing or paying attention.

• Often acts without thinking.• Shifts excessively from one activity to another.• Needs a lot of supervision.• Speaks out of turn in class.• Doesn’t wait for his or her turn in games or group activities.• Runs or climbs excessively.

• Can’t sit still.• Excessive activity during sleep.• Always on the go, acts as if “driven.”• Experiences angry outbursts.• May be a social loner.• Blames others for problems.• Fights with others quickly.• Very sensitive to criticism.

ADD or ADHD symptoms are caused by a neurologi-cal dysfunction within thebrain. Studies have con-firmed that there is a

definite difference inbrain functioning betweenthose with ADD/ADHD and those without it. ADD orADHD may be acquired or inherited.

Treatment of ADD or ADHD includes medicationssuch as Ritalin®. Ritalin is used to improve the chemicalimbalance in the brain that is causing the symptoms. Itis considered a very effective and relatively safe formof treatment.

When properly treated through medication and apsychological treatment program under the direction of aphysician, children and adolescents with ADD or ADHDcan lead very normal and productive lives. In fact, manytraits in ADD or ADHD children lead them to verysuccessful adult lives. Children with ADD or ADHDusually have average or above-average intelligence. Theyare often creative and usually have a high energy level.

Remember that a loving, supportive and consistentenvironment is essential for positive growth and develop-ment of children, especially those with ADD or ADHD.

My childhas ADD!My childhas ADD!

13What is your wish for your children?Like most parents, you probably hope your

children grow up happy, healthy and well-adjusted— all admirable (and achievable) aspirations, butthey may take a lot of dedication and work on yourpart. Just remember that rules are tools … whenyou are constructing a well-balanced child.

Children are not little adults. They do not havethe depth of experience, the knowledge or thereasoning capacity to think as adults; therefore, itis up to you to guide them, help them in decision-making, and most importantly, teach them thedifference between right and wrong.

As a parent, the best thing you can do to helpyour children achieve those goals is to encouragehealthy habits, maintain rules and boundaries, andbe a role model for your children as to what isappropriate and inappropriate behavior.

Tony Johnson, M.D., a pediatrician with theArkansas Pediatric Clinic in Little Rock, stresses thatparents should begin setting rules and limits whentheir children are at a young age. Children alsoshould understand the disciplinary consequencesof their actions.

According to Dr. Johnson, setting formal bedtimes, encouraging healthy eating habits andestablishing household rules is not only good for theparents, it’s even better for the children. Dr. Johnsonmaintains that consistent, effective parenting isbetter for everyone in the long run.

“You have to maintain your role as a parent,”said Dr. Johnson.

“It is important for the parents to be the parentin the relationship with their children. In manycases, with both parents working these days and

children busy withextracurricular activi-ties, sometimes it iseasier to let thechildren stay up lateror ignore the house-hold rules.

“Letting yourchild establish un-healthy eating orsleep habits or nothaving establishedrules or guidelinesmay lead to anunhealthy lifestyle orinappropriate behavior later,” said Dr. Johnson.

“Children need rules,” said Charles Gist, M.D., apsychiatrist with Psychiatric Associates of Arkansas,PLLC, in Little Rock. “Think about those fourth-gradeboys on the playground. They may have 20 minutes forrecess, but they will spend 15 of those minutes makingup the rules for the game. It’s normal, and it is how theyunderstand the world.”

A common diagnosis today, and one that bothDr. Johnson and Dr. Gist see among 7- to 13-year-olds,is “episodic outburst disorder” or “intermittent explosivedisorder.” With this diagnosis, children under stressfulsituations simply fall apart, throw tantrums or “just loseit.” According to Dr. Gist, studies have been ineffectiveand have not ruled conclusively the cause of this disor-der, but theories include depression, manic-depressivedisorder or a chemical imbalance. Also, there is a possi-bility that the disorder could be the result of many yearsof parents having failed to set limits. As a result,children do not know how to react in stressful situations.A 2-year-old has a tantrum because he or she hasn’tlearned appropriate behavior, but now physicians areseeing this behavior with children who are much older.

Along with discipline and guidance, Dr. Johnson andDr. Gist agree that positive reinforcement goes a longway in creating an emotionally healthy child.

“It’s self-fulfillment. If you expect joyand success for your child, that iswhat you will get. Parents shouldexhibit a demeanor that concen-trates on the positive and isrespectful to the child. Then, thechild will flourish,” said Dr. Gist.

Rules are good for your children Rules are good for your children

14If your teen-ager has acne, he or she is not alone.

Close to 100 percent of young people between the ages of12 and 17 have at least an occasional bout with acne.

Many teen-agers are able to manage their acne withover-the-counter treatments; however, approximately 40percent of teen-agers have acne severe enough for themto seek treatment from a physician.

The two things that teen-agers should rememberabout taking care of their skin are: 1) He or she shouldwash his or her face twice a day with a mild cleanserand 2) Keep their hands off of their faces as the handscan spread bacteria, which may increase the acne.

So what causes acne? Acne is a disease of thesebaceous glands. There are some basic factors that worktogether to cause acne including hormones, the factorthat usually causes acne in teen-agers. Acne usuallybegins when the body starts to produce hormones —usually between 11 and 14 years of age.

There are many myths associated with acne and its

causes. Things that do not causeacne are poor hygiene, food(including pizza or chocolate)and stress.

Besides physical symptoms, teen-agers usuallyexperience some psychosocial effects of acne. Recentstudies indicate that some teen-agers with acne experi-ence social withdrawal, decreased self-esteem, reducedself-confidence, poor body image, embarrassment,depression, anger, preoccupation and frustration.

If your teen-ager has acne, don’t let it get himor her down. If over-the-counter products have notproduced the desired results, contact your pediatri-cian or family physician. With all the outlets availabletoday for treating and preventing acne, teen-agers canhopefully avoid the scars of acne — both physicaland emotional.

Information for this article was obtained fromthe American Academy of Dermatology.

Approximately 7 to 10 percent of children or adoles-cents will experience an episode of major depressionbefore the age of 15.Recent studies show thatthere is a significantclinical occurrence ofdepression amongadolescents.

Depression is noteveryday ups and downs.It is when a “down” moodlasts for weeks. Thecondition may stem from abiological illness, a chemical imbalance or certain

personality traits (low self-esteem,extreme pessimism). There may be

a history of depression in thefamily. Clinical depression is aserious health problem thataffects the whole person. It canchange behavior, physical healthand appearance, academic

Troubled teens may be dealing with depressionperformance, social activity and the ability to handleeveryday decisions and pressures.

Signs include disruptive behavior, possibleacademic difficulties, peer problems, irritabilityand aggression or suicidal threats.

Approximately 3 to 5 percent of the teenpopulation experiences clinical depression eachyear. With teen-agers, depression has been linkedto poor school performance, truancy, alcohol anddrug abuse, running away and feelings of worth-lessness. Suicide is often linked to depression.

There is hope.Depression is treatable.

Between 80 and 90 percent ofpeople with depression can behelped. Symptoms may berelieved with psychologicaltherapies, medications or acombination. See your pediatri-cian or family physician if yoususpect your adolescent issuffering from depression.

Acne: Good news,

it’s treatable

15The teen-ager behind the closed doors in his upstairsbedroom used to be your clingy, cuddly toddler whoscreamed when you left the room. Now it seems like hewants to scream when you walk into the room.

The teen-age years can be difficult — for both theteen and the parent. Despite their outward bravado, teen-agers are unsure of who they are, what they want to beor whether the choices they make are the best choices.

As a parent, what can you do to guide your teen-ager, yet give them room to help develop their own

decision-making skills?

1. Keep communications open. Try to listen calmly even if you have a different opinion. Develop a courteous, respectful tone. Avoid

making judgments. Keep the door open onany subject. Many times, teens avoiddiscussing things that make their parentsfeel uncomfortable.

2. Encourage positive self-worth. Encour- age (but don’t force) participation in sports, music, art, dance or other hobbies or interests.

3. Supervise and guide. Set limits on their freedom andbehavior. Teen-agers may want some “say” in the

decision-making, however, they donot want parents to give upauthority or be wishy-washy.Parents who appear confusedabout discipline or who are

inconsistent may be perceived as weak.

4. Respect their need for independence. Parents canaccept and respect teen-agers as individuals withoutalways agreeing with their opinions and vice-versa.

5. Try not to overreact. Many parents brace themselvesfor adolescence like they are preparing for battle. Asa result, they may be quick to overreact the first timetheir teen-ager steps out of line. They punish se-verely, withdraw trust and lose confidence in theirteen-ager. Parents must prepare to let their childrenmake mistakes but step in when help is needed.

Being a parent is never easy. With each year comes adifferent challenge. However, efforts to communicate andunderstand your teen-ager will pay off in the long run.And maybe you and your teen will look back at the teenyears as a positive experience in your relationship.

Take time for teen talk

It is never too early to talk to your child about thedangers of substance abuse. You are the parent, and it isyour responsibility to make sure your child understandsthe dangerous consequences of substance abuse.

What can you do?1. Talk with your child honestly and really listen when

your child is talking to you.2. Help your child develop self-confidence. Praise his

or her successes.3. Help your child develop strong values. Teach

your child how to make decisions based on rightand wrong.

4. Be a good example. If you smoke or drink exces-sively, your child is aware of your actions.

5. Help your child deal with peer pressure and accep-tance. Discuss the importance of being an indi-vidual and the meaning of real friendships.

6. Provide guidance and clear rules about notusing drugs.

7. Encourage healthy, creative activities.8. Spend time with your child, sharing the good and

bad times.9. Facilitate early intervention with the help of a

physician when your child is having problems inschool, dealing with learning disabilities, orexperiencing trauma, stress or depression.

Remember, prevention starts with you as the parent.There are no guarantees that yourchild will not choose to use drugs,but you can influence their deci-sion by setting a good example.

Information for this articlewas obtained from the AmericanAcademy of Pediatrics.

Communicating about substance abuse — what all parents should know

16 C H I L D R E N ’S

The kid with the codeCorey Felts, 9, of Jonesboro, out-scrambled more than 530 other entrants from

throughout the state to win the Healthy Habits Word Scramble contest that appeared inthe Summer 1999 issue of Blue & You.

Kids of all ages decoded nine hidden health messages, and Corey’s correctlycompleted entry was pulled from among them in a drawing for a $25 Wal-Mart giftcertificate and a fun assortment of Arkansas Blue Cross and Blue Shield novelty items

(many of which feature health-and-wellness ambassador BlueAnn Ewe).

The surgeon general has unveiled a 10-year healthplan for the United States that focuses on getting ournation’s children into better shape, helping people quitsmoking, eliminating drug abuse and encouraging teensto either abstain from sex or use condoms.

Surgeon General David Satcher’s plan aims for 30percent of Americans to exercise 30 minutes each dayand reduce by half the number of overweight or obesechildren, which currently stands at about 11 percent ofour children.

To reach his goal, the surgeon general will beginmeasuring 10 areas called the “leading health indicators”which address a broad range of health and social con-cerns. Health goals include an increase in the number ofchildren getting vaccinated, encouraging people toexercise more, combating depression, increasing accessto health insurance, and discouraging substance abuse.

The new program is the first to establish a set ofmeasurements. The surgeon general’s office will collectdata from state and local agencies and from federalagencies that compile health statistics that track whetherAmericans are annually reaching goals set by the pro-gram in the 10 areas.

I f you want to tell yourchild that he or she is doing agood job but can’t quite thinkof the right words, here are 15

The kid with the code

15 Ways to Praise Your Child

ways to tell your child he or she is great!

1. You’re on the right track!2. That’s a lot better!3. I knew you could do it!4. You’re getting better every day!5. Terrific!6. Fantastic!7. Good thinking!8. I’m very proud of you!9. You’re learning very fast!10. You’re very good at that!11. Outstanding!12. Wonderful!13. You certainly did well today!14. You are doing a good job!15. You’re the best!

The general’s plan for the future

Ageless Heroes 2000For the third year, Arkansas Blue Cross and Blue

Shield will be searching for seniors whose achievementsprove that the golden years can be a time of health,vitality and accomplishments.

Ageless Heroes TM, a national and state awardsprogram, was created as a cornerstone of the Blue Crossand Blue Shield Association’s commitment to healthyaging and is designed to honor inspirational matureindividuals who set examples of how to live life fully,with vigor and health.

The Ageless Heroes Awards Program encouragespeople in communities throughout the state to nominatesenior heroes — colleagues, family, friends and

neighbors — who are age 65 and older and who continueto achieve and inspire.

Nominations will be accepted beginning in May.Watch for more information in the next issue of Blue &You as well as your local newspapers.

Blue sheep could be parents’ best friendParents and teachers in Arkansas have tapped into a

new resource which is encouraging kids to eat theirveggies, brush their teeth, exercise and be safe ... andhave fun in the process.

Since September 1999, more than 5,000 elementaryschool-aged children have joined the BlueAnn HealthClub or BlueAnn Class Club through their homes orclassrooms. The central figure of the clubs is BlueAnnEwe — Arkansas Blue Cross and Blue Shield’s ambassa-dor of health and wellness — a blue sheep. The clubsgive parents and teachers a new set of fun tools to helpteach children about healthy habits and encouragethem to participate in positive behaviors that could lasta lifetime.

BlueAnn Club members receive packets of fun,educational health information and activities in the mail.Plus, they may have a chance to win some really coolprizes when they practice doing healthy things.

So, if you need a little assistance motivating yourlittle ones to practice healthy habits, join lots of otherparents and teachers and let a big, blue sheep help out.Sign up today! BlueAnn wants ewe!

Just call 1-800-515-BLUE, toll-free, and ask for theBlueAnn Club.

The BlueAnn Health Club is recommended forelementary school-aged children (5 to 10 years old). TheBlueAnn Class Club is recommended for kindergarten andfirst-grade classrooms.

To help bring the spirit of the Olympics to theNatural State, Arkansas Blue Cross and Blue Shield isbringing the “Caring for the Human Spirit” tour toArkansas during Riverfest 2000 May 27-28 in Little Rock.The tour is part of the Blue Cross and Blue ShieldAssociation’s sponsorship of the United States Olympicteam in the 2000 Summer Games in Sydney, Australia,and the 2002 Olympic Winter Games in Salt Lake City,Utah. Arkansans will have an opportunity to visit a mini-Olympic Village at our own River Market during theweekend festival. There will be Olympic memorabilia

Olympic village by the river sideOlympic village by the river sideOlympic village by the river sideOlympic village by the river sideOlympic village by the river sidedisplays and three exhibits for visitors to enjoy, includingan Olympic mini-decathlon, health fair and nutritioncenter. Visitors can get a body fat evaluation and bloodpressure, heart rate and vision screenings. Plus, sportsfans can shoot hoops, have the speed of their baseballpitch checked by radar, shoot a fast and accurate hockeypuck, put on a bungee vest and sprint against resistance,or ride a virtual cycle against a computer program andclock. Look for the Olympic Village at the corner ofMarkham and Rock Street, just north of the main library.It’s fun. It’s free. And it’s only here this year!

Leading18 This issue of Blue & You continues our mission to introduce ourstate senators and representatives of the Arkansas General Assembly toour customers.

Rep. Sarah Agee (R)(Dist.9) Prairie GroveCity, County & Local Affairs;Joint Performance Review;Public Transportation(O) 501-846-4606(H) 501-846-4177

Rep. Jerry Allison (D)(Dist. 86) JonesboroVice-Chairman; Agriculture& Economic Development;Education; Joint PerformanceReview(0) 870-932-7765(H) 870-932-7960

Rep. Denny Altes (R)(Dist. 14) Fort SmithPublic Health, Welfare andLabor; State Agencies &Governmental Affairs(O) 501-646-8922(H) 501-484-5494

Rep. Russ Bennett (R)(Dist. 22) LewisvillePublic Transportation; StateAgencies & GovernmentalAffairsO/H 870-921-4866

Rep. Bill Bevis (D)(Dist. 70) ScottAgriculture & EconomicDevelopment; Energy; PublicTransportation(O) 501-945-5630(H) 501-676-5630

Rep. Pat Bond (D)(Dist. 64) JacksonvilleVice-Chairman, City, County &Local Affairs; Education; JointRetirement & Social Security(O) 501-982-1538(H) 501-982-8872

Rep. Mike Hathorn (D)(Dist. 24) HuntsvilleAgriculture & EconomicDevelopment; Judiciary; Rules(O/H) 501-665-2448

Rep. Russ Hunt (R)(Dist. 68) SearcyCity, County & Local Affairs;Revenue & Taxation(O) 501-268-3055(H) 501-279-2928

Rep. Jimmy Jeffress (D)(Dist. 83) CrossettCity, County & Local Affairs;Education; Energy; Joint Budget(H/O) 870-364-8291

Rep. Jim Milum (R)(Dist. 29) HarrisonAgriculture & EconomicDevelopment; Joint Retirement &Social Security; Revenue &Taxation(O) 870-365-0042(H) 870-741-7532

the Way 19These elected officials spend numerous hours working on health careissues that affect you. (Upcoming issues of Blue & You will featureadditional profiles of our legislators.)

Rep. Mark Smith (R)(Dist. 49) El DoradoCity, County & Local Affairs;Judiciary(O) 870-862-7965(H) 870-862-7929

Rep. Larry Teague (D)(Dist. 19) NashvilleVice-Chairman; Revenue &Taxation; Insurance &Commerce; Rules(O) 870-845-5303(H) 870-845-3708

Rep. Lindbergh Thomas (D)(Dist. 74) GradyAging, Children & Youth;Legislative & Military Affairs;Judiciary(H/O) 870-479-3969

Rep. Jim Wood (D)(Dist. 80) TupeloVice-Chairman, PublicTransportation; Agriculture &Economic Development;Rules(O/H) 870-744-2266

Senator John Brown (R)(Dist. 34) Siloam SpringsChildren & Youth; Education;Rules, Resolutions &Memorials; State Agencies &Governmental Affairs(O) 501-549-3290(H) 501-524-4667

Senator Bill Gwatney (D)(Dist. 19) JacksonvilleVice-Chairman, State Agencies &Governmental Affairs; Children &Youth; Joint Budget; JointRetirement & Social Security;Revenue & Taxation; Rules,Resolutions & Memorials(O) 501-982- 2102(H) 501-982-4817

Senator Jodie Mahony ( D)(Dist. 2) El DoradoVice-Chairman, Education; City,County & Local Affairs; JointAdvanced Communications &Information Technology; JointRetirement & Social Security;Rules, Resolutions & Memorials(O) 870-862-6464(H) 870-862-5950

Senator Doyle Webb (R)(Dist. 14) BentonChildren & Youth; City, County &Local Affairs; Judiciary; Rules,Resolutions & Memorials(O) 501-315-9322(H) 501- 315-4266

20For more than 50 years, Arkansas Blue Cross and Blue Shield has been covering the lives of Arkansas residents,

growing and changing to meet your health care needs. Sometimes we are considered a big business or corporate entity inour state, but Arkansas Blue Cross differs from commercial insurers in several ways.

Arkansas Blue Cross is a not-for-profit organization.That means that nearly all the money collected as premium is paid out in benefits for customers — on the average

about 85 cents of every dollar. The remainder — about 15 cents of every dollar — is used for operating expenses andreserve funds, which we are required by law to maintain. However, as a mutual not-for-profit company, Arkansas BlueCross does pay state premium taxes and federal corporate income taxes.

As a non-profit, mutual insurance company, Arkansas Blue Cross is owned by its policyholders, not by stockholders.This means that premium dollars are used solely to pay claims and administrative costs, not to pay stock dividends.

Any excess funds are held in reserve for payment of future claims and expenses. Arkansas Blue Cross must maintain afiscal balance between premium income and benefits paid to ensure that we have the ability to continue to offer insur-ance products and to pay policyholder claims in the future.

Blue Cross and Blue Shield Association AffiliationArkansas Blue Cross is a member of the Blue Cross and Blue Shield Association. This means Arkansas Blue Cross

has licenses from the Blue Cross and Blue Shield Association to offer health insurance benefits and related servicesunder the Blue Cross and Blue Shield names and service marks in the state of Arkansas.

The Blue Cross and Blue Shield system is not a single company. Rather, it is a coordinated group of 49 individual andautonomous Blue Cross and Blue Shield Association Plans located throughout the United States and Puerto Rico. EachPlan is an independent corporation committed to providing affordable health care financing.

One of the unique aspects of the Blue Cross and Blue Shield Association is that each member Plan is managed andcontrolled by its own community-based board of directors, which must contain a majority of “public members.” Publicmembers are people from the community who are not employed in the health care industry. As a result, the Blue Crossand Blue Shield Plans have a strong commitment to their local communities and customers, which is not necessarilyshared by commercial insurance companies.

Neither the Blue Cross and Blue Shield Association nor the other member Plans of the Blue Cross and Blue ShieldAssociation act as guarantors of the financial obligations of Arkansas Blue Cross and Blue Shield. However, ArkansasBlue Cross and Blue Shield and the other member Plans in the Blue Cross and Blue Shield Association are subject touniform financial standards established by the Blue Cross and Blue Shield Association which are intended to foster asystem in which each member Plan maintains adequate financial resources to meet its obligations to its customers.

National Institute for Health Care Management (NIHCM) AffiliationIn 1993, Arkansas Blue Cross joined with 11 of the nation’s leading health care companies to form the NIHCM. The

NIHCM is a non-profit organization based in Washington, D.C., that was established to: 1) sponsor high-quality, non-

Guess who owns Arkansas Blue Cross andBlue Shield?

You do.

21From the editor

More than 91 percent of those who responded to the readership survey from the Winter

1999 issue of Blue & You gave high ratings to Arkansas Blue Cross and Blue Shield’s health-

and-wellness magazine.

Comments such as “Enjoyed the article on heart disease and how to prevent related

disorders” and “Thanks so much. Keep them coming!” were common.

Blue & You is designed with our members in mind. Each issue offers a different focus —

so no matter what stage you are in your life — there will be something for you. By helping

you and other Arkansans understand how to live healthier lifestyles, we will all benefit in the

long run.

This issue focuses on how to keep our children healthier from birth through the teen

years. The past few issues have focused on women’s health and heart health. The summer

issue of Blue & You will be mailed to your household in June 2000 and will focus on healthy

living for seniors — a recurring request from our survey respondents. Look for additional

information on topics you have requested in future issues of Blue & You.

A small number of our members have asked about the cost to produce this health-and-

wellness magazine. The cost of producing Blue & You per year (including printing and mail-

ing costs) is approximately 60 cents per member per year which is equal to 15 cents per

issue per member. For 60 cents per year, you receive valuable health-and-wellness informa-

tion for considerably less than the cost of a health magazine subscription, Internet service or

cable television. You might think of it as being less than the cost of one soft drink or one

order of French fries — and it is better for you. We believe the benefits far outweigh the

modest cost.

We read and appreciated your survey responses. Questions will be answered personally if

you included a name and address. Arkansas Blue Cross is your health insurance company;

and everything we do, we do with the health and future of our members in mind.

Sincerely,

Kelly Whitehorn

Editor

partisan research of health care issues; 2) act as a clearinghouse for research on health caremanagement and state managed care data; and 3) promote innovation to continuouslyimprove the health care system.

Here to serve youA staff of almost 2,000 Arkansas Blue Cross employees continues to meet the health insur-ance needs of you, our policyholder. Our employees are your neighbors, your family andyour friends.

Health Advantage

members —

take note!22MEMBER RIGHTS AND

RESPONSIBILITIES

A member should:

1. Become familiar with therequirements and proce-dures of Health Advantage.

2. Present Member ID Card tothe health care providerwhen seeking care.

3. Select a primary carephysician.

4. Maintain health levels byliving a healthy lifestyle.

5. Coordinate all health carethrough the primary carephysician.

6. Provide information tohealth care providers toassist them in the careneeded to achieve healthoutcomes.

7. Follow all instructionsgiven by health careproviders to achievemaximum benefits ofthe care.

8. Meet all co-payment andco-insurance obligationsand any billed charges inexcess of allowable charges.

9. Notify Health Advantage ofany status change.

10. Obtain all care throughPlan providers.

11. Communicate any com-plaint or grievance immedi-ately to Health Advantage.

12. Ensure all claims forservices provided by non-Plan providers are filedwithin 60 days.

A member has a right to:

1. Information about HealthAdvantage, its services and

providers, and membersrights and responsibilities.

2. Access to a Plan physician.3. An explanation of benefits.4. Be treated with respect

with recognition of theirdignity and right to privacy.

5. Confidential treatment ofmedical information.

6. Participate with practitio-ners in decision-makingregarding their health care.

7. A candid discussion ofappropriate or medicallynecessary treatment optionsfor their conditions,regardless of cost or benefitcoverage.

8. Change primary carephysicians.

9. Voice complaints or appealsabout Health Advantage orthe care provided.

10. Provide, to the extentpossible, information thatHealth Advantage and itspractitioners and providersneed in order to carefor them.

CHANGE TO HEALTH ADVANTAGE

MEDICAL BENEFITS

Health Advantage has amendedthe Evidence of Coverage andSchedule of Benefits for all lines ofbusiness. Coverage for the addedbenefit was effective Feb. 1, 2000,for all Health Advantage members.

The change shown in boldprint to the right will be added tothe Evidence of Coverage, Attach-ment B, Schedule of Benefits,Section P. with the next revision. If

you have questions, please contactyour group marketing representa-tive or Customer Service at 501-221-3733 or toll-free 1-800-843-1329.

P. Dental Care Services

General dental services are notcovered under this evidence ofcoverage; however, the followingservices may be provided in aninpatient or outpatient setting andcovered when authorized by theprimary care physician subject tothe co-insurance specified inAttachment C, Benefit Summary.

1. Services for treatment andX-rays necessary to correctdamage to non-diseased teethor surrounding tissue causedby an accident occurring on orafter effective date of coverageare covered subject to a$2,000 maximum per memberper accident. Member mustseek treatment within 72hours of injury for services tobe covered.

2. Treatment or correction of anon-dental physiologicalcondition which has resulted insevere functional impairment.

3. Treatment for tumors andcysts requiring pathologicalexamination of the jaw, cheeks,lips, tongue, roof and floor ofthe mouth.

4. Pre-treatment dental servicesin connection with the treat-ment of cancer of the heador neck.

Injury to teeth while eating is notconsidered an accidental injury.

BlueAnn Ewe and cast members ofthe “Hansel and Gretel” productionpose with young fans.

BlueAnn Ewe and High SchoolHeroes teach fifth-graders aboutthe dangers of smoking.

23Arkansas Blue Cross and Blue Shield strives to be a

good corporate citizen. Our employees raise money andspend many hours helping those causes near and dear tothe hearts of Arkansans.

Hansel and GretelMore than 100 performances of the fairy tale classic

“Hansel and Gretel” have been scheduled for the Wild-wood Park for the Performing Arts Spring Tour 2000,sponsored by Arkansas Blue Cross and Blue Shield. Thisis the fourth year Arkansas Blue Cross has teamed upwith Wildwood in an effort to entertain and teachelementary school-aged children througha live theater experi-ence. Through thecenturies, fairy taleshave taught childrenand adults importantlessons in character,conquering fears andovercoming problems.Students today stillcan learn these lifelessons as they experience this enchanting story, basedon the Grimm Brothers fairy tale, in a musical theatersetting — complete with a tasty gingerbread house andthe delightful tunes of composer Engelbert Humperdinck.A question-and-answer session with the cast and stu-dents immediately following the performance focuses ondealing with emotions and fears. The tour will continuestatewide through April.

High School HeroesHigh School Heroes, a unique student-to-student

teaching program with a strong anti-smoking messagetargeting fifth-graders, finished a successful year in 1999.Developed by the American Lung Association andsponsored statewide by Arkansas Blue Cross and BlueShield, more than 990high school studentsacross the state weretrained by the ALA toteach the program inelementary and middle

schools. These specially trained high school students —High School Heroes — presented a message on theimportance of never starting to smoke to 12,081 fifth-graders in Arkansaslast year. Usingbrainstorming, role-play, discussion andquestion-and-answersessions, Heroesteach and serve asrole models for thekids. The goal is toreach kids at an agewhen peer pressureand advertisingmight entice them tostart smoking. Themessage includesinformation abouteffects of smoking tothe body as well asthe deceptiveappeals of tobaccoadvertising. High School Heroes now is active in 28counties in Arkansas. With more than 3,000 youthsstarting to smoke each day, it is more important thanever to reach them early in an effort to avert this danger-ous and damaging habit. If you are interested in bringingthe program to your school, please contact the AmericanLung Association/Arkansas Chapter at 1-800-880-5864.

Healthy Me & EweAs part of St. Bernards Regional Medical Center’s

annual kindergarten education program in Jonesboro,BlueAnn Ewe and Dwayne Pierce of the Arkansas BlueCross Northeast Regional Office brought “Wild andWoolly Health Tips for Kids” to more than 800 studentsin local schools. BlueAnn and Pierce presented a20-minute wellness lesson to students, teaching themabout such things as healthy eating, exercise, bike safety,good sleep and dental health. All students were pre-sented with a coloring book and an opportunity to meetBlueAnn following the program.

I

Arkansas Blue Cross and Blue ShieldP.O. Box 2181Little Rock, AR 72203-2181

BULK RATEU.S. POSTAGE

PAIDArkansas Blue Cross

and Blue Shield

— a guide to health insurance terminology

If health care terminology (including abbreviationsand acronyms) leaves your head spinning … ArkansasBlue Cross and Blue Shield would like to help you makesense out of all the jargon. We want you to be an in-formed customer, so in each issue of Blue & You we willexplain the meaning behind those health insurancewords, acronyms and abbreviations that you may en-counter when reading health care-related materials.

Case Management — A process where covered personswith specific health care needs are identified. It typicallycombines the care from all involved including thephysician, the hospital, the patient and the family — allin an effort to find the most appropriate treatment forthat patient.

Disease Management — A coordinated system ofpreventive, diagnostic and therapeutic measures for aspecific chronic illness or medical condition.

Exclusions — Specifically listed conditions or situationswhich, under an insurance policy (or health insurancecontract), are not considered covered expenses. Commonexclusions include cosmetic surgery, custodial care,services covered by Workers’ Compensation, treatmentwhich is experimental or investigational, etc.

Gatekeeper — A primary care physician (PCP) whoserves as the patient’s initial contact for medical care,and who makes referrals to specialists.

Group Insurance — Any insurance policy or healthservices contract by which groups of employees (andoften their dependents) are covered under a single policyor contract issued to their employer or other group entity.

Inpatient — A patient who has been admitted, at leastovernight, to a hospital or other health facility andoccupies a hospital bed, crib or bassinet while underobservation, care and diagnosis.

Member — The individual actually eligible for healthcare services due to employment or purchase of non-group coverage. While the coverage also may pay ben-efits to a dependent, the dependent is not the member.

Outpatient — A person who is receiving ambulatory careat a hospital or other health care facility for diagnostic orother treatment services without being admitted as aninpatient.

Provider — Either an individual or an institution li-censed by the state to provide health care services orsupplies to those in need of such, including but notlimited to a physician, osteopathic physician, dentist,optometrist, podiatrist, psychologist or pharmacist, aswell as facilities such as a hospital, clinic, ambulatorysurgery center or skilled nursing facility.

Utilization — The use of health care services andsupplies. Usually measured in terms of average length ofstay, admissions and days of care per 100 or 1,000population or enrollees of designated group. Utilizationrates are often compared by geographic location, peergroup, facility or by physician and are used in compre-hensive health planning.

Wellness — A type of preventive medicine associatedwith an individual’s lifestyle which, through a combina-tion of exercise and diet, may have the effect of a reduc-tion in health care utilization and costs.