Editor’s DeskChanges for 2012Medicaid Revises Home &Community-Based Care, AdultDay Health Care, ParatransitIn a move that offerssignificant benefits to theelderly in Nevada, theNevada Division of HealthCare Financing and Policy(DHCFP) adopted amendmentsto the MedicaidServices Manual (MSM) inDecember, that streamlineswaiver services provided inthe home to seniors andpeople with disabilities.DHCFP additionally adoptedamendments thatincreases reimbursementsfor Adult Day Health Care(ADHC), and non-emergencyparatransit transportation.Revising Chapter 2200,affective January 1, 2012,the new Home andCommunity Based Waiver(HCBW) for the FrailElderly will provide a widerarray of services formerlyoffered by the CHIP waiver.The HCBW waiver establishesefficiencies in servicesto eligible individualswho may require such servicesin order to remain intheir communities andavoid institutionalization ina hospital or nursing facility.The waiver streamlinesservices that in the pastwere fragmented. It allowselders to receive in-homecare, and when appropriatebe considered for a higherLevel of Care (LOC) if theymeet additional criteria,such as change in health,and mobility. Waiver servicesmay follow an elderinto a residential facility forgroups without disruption ifthere is no Wait List inservices.The HCBW has been widelyhailed as the SuperWaiver by the StrategicPlan AccountabilityCommittee for Seniors,who advocated for its creationto maximize servicesfor Medicaid applicants,and create efficiencies inDHCFP, Aging andDisability Services(ADSD), and the Divisionof Welfare and SupportiveServices (DWSS). Thethree state agencies collaborativelydetermine eligibilityfor people 65 years andolder. The HCBWapproved by the Centers forMedicare and Medicaid(CMS) in October, is sureto provide great changes forat risk elders living inNevada.In other action, DHCFPadopted amendments tomodify the reimbursementmethodology for Adult DayHealth Care Services forlocal government providers.The amendment affectsWashoe County SeniorServices, who initiated theamendment allowing ahigher reimbursement ratefrom the federal government.“We initiated theimproved rate that provides(Editor’s Desk page 4)January 2012This Issuepage 3 - Editor’s Deskpage 5 - Guest Editorial: Implementthe Food Safety Lawpage 6 - Guest Editorial:Prescription Drug Reimportationpage 8 - Silver State HealthInsurance Exchange Ex. Directorpage 18 - Social Security Can Helpthe Homeless with Benefitspage 19 - CMS: What MedicareCovers in the Hospitalpage 22 - NCOA: Congress FinalizesOlder American Act, FY12 Budgetpage 24 - Sanford Center for Aging’sNew Director of Volunteer Programspage 24 - UnitedHealthcare RenewsContract with Saint Mary’spage 28 - Renown Medical GroupOffers Concierge Medical Programpage 29 - Direct Deposit for SocialSecurity on the Upswing in the Westpage 30 - The Art of Living WellThrough Bookspage 33 - Eight-Annual NBADevelopment League ShowcaseEvery Issuepage 25 - 26 - Calenderpage 32 - Eclectic ObserverJanet Rosspage 34 - this ‘n that - Anne Vargaspage 36 - Eydie Scher - Excerptspage 40 - Seniors 4 TravelRobert Boyd & Carolyn Prusapage 41 - Santa Makes a VisitHealthpage 10 - Ask Dr. Marionpage 12 - Technology and theFuture of Health CareDr. Lawrence J. Weiss, Ph.D.Center for Healthy Agingpage 15 - Ophthalmology:Dr. Michael Fischer, M.D.page 16 - Ask Dr. DebDebra Fredericks, Ph.D.page 20 - Get Up & Go!Natalie HilbertFinancialpage 7 - What to Expect WhenYour InheritingBradley B. AndersonWealth AdvisorsSenior Spectrum NewspaperP.O. Box 7124 • Reno, NV 89510(775) 348-0717e-mail: Seniorspectrumnv@aol.comSeniorspectrumnewspaper.comPublishers: Chris & Connie McMullenSenior Spectrum is a monthly publication dedicated to inform, serve, and entertain.Publication of advertising contained does not constitute endorsement. Signed columnsare the opinion of the writers, and not necessarily the opinion of the publishers.Copyrighted publication. All rights reserved.January • 2012 • 3
Editor’s Desk / page 3a federal match of over $26per client per day,” saidWashoe County SeniorServices Director GradyTarbutton. “We’re also lookingforward to future projectswith the state involving theMoney Follows the Personprogram.”DHCFP also approvedamendments to the State Planproviding a higher reimbursementrate for non-emergencyparatransit transportationservices. The amendmentaffects the RegionalTransportation Commissionof Washoe County, theRegional TransportationCommission of SouthernNevada, and the Carson CityPublic Works Department.The amendment allows transportationentities to drawdown federal matching revenuesby as much as 56 percent.This is good news forRTC ACCESS as the actualcost of a trip one-way averagesaround $24, even thoughthe rider pays $3 in the ADAZone, and $6 in the Non-ADA Zone (rural areas).RTC ACCESS is the paratransitservice that providesdoor-to-door, prescheduledtransportation for people whomeet the eligibility criteria inWashoe County. More andmore seniors use paratransitand fixed route transportationservice than ever before. OnRTC RIDE, seniors and peoplewith disabilities make up32 percent of all passengertrips many citing the economy,high gas prices, and thecosts to drive a vehicle.Town Hall MeetingsThe Nevada Division ofAging and Disability Services(ADSD) is holding TownHall Meetings at the SparksSenior Center and the NeilRoad Recreation Center. Thepurpose of the meeting is togather input from area seniorson what they perceive is theirhighest need whether that behealth care, nutrition, or communitybased services. ADSDis required to write a StatePlan for the federal governmentevery four years. Inputgathered helps determineOlder American Act programfunding, and priorities for useof the Master TobaccoSettlement fund. Seniors areencouraged to attend theTown Meeting at the SparksSenior Center, January 9,from 10:30-11:30 a.m., locatedat 97 Richard Way, inSparks. The second meetingwill be held January 11,10:30-11:30 a.m. at the NeilRoad Recreation Center, 3925Neil Road, in Reno.4 • 2012 • JanuaryWashoe County BudgetThe Washoe County SeniorServices budget is scheduledto be discussed along withthe county budget in commissionchambers, January24. Seniors are urged towatch the budget discussionsclosely and provide input.Current talks have centeredaround cutting SeniorServices from the generalfund, leaving a $230,000budget shortfall. The deficitmay eliminate services thatinclude Adult Day HealthCare, nutrition programs, theSenior Law Project and otherservices.
Guest EditorialWe Can’t Afford Inaction in ImplementingU.S. Senator Harry Reid the Food Safety LawNevadansmay rememberhearingabout ayoungHendersongirl who sufferedmightilySen. Harry Reidfrom simply eating her vegetables.When she was nineyears-old,Rylee Gustafson ateraw spinach salad that madeher so sick that she spentmonths in the hospital, and theeffects of her E. coli food poisoninglinger.Rylee wasn’t the onlyNevadan to suffer from lifethreateningfood poison, buther story serves as a starkreminder of why food safetylaws should have been updateda long time ago. Because of herand others, I worked hard tomake that happen.As a result, I was pleasedwhen, about a year ago, onJanuary 4, 2011, PresidentObama signed the Food SafetyModernization Act into law,marking the first expansion offood safety and security lawssince the 1930s. This bi-partisanbill overwhelmingly passedthe Senate and allows the Foodand Drug Administration(FDA) to enact much-neededimprovements to the food productionand distribution system.We mark the one-yearanniversaryof that modernfood safety law this month and,as food outbreaks and recallshave continued, we mustremain steadfast in implementingthe new law. On thisfront, Nevadans scored a victorylast month when the FDAreceived the 2012 funding itneeds to improve how weinspect food before it reachesgrocery stores and dinnertables.Yet inaction on other vitalmeasures threatens the integrityof the law. The Food SafetyAccountability Act would holdaccountable those who knowinglyviolate food safety standardsand place tainted foodproducts on the market.While this bill passed unanimouslyin the Senate last April,Republicans in the House ofRepresentatives refuse to evenhold a vote on this importantprovision.After decades of inaction,we can’t wait for more childrento suffer like Rylee did. WhileAmerica has one of the safestand most abundant food suppliesin the world, too manyare sickened by food-borne illnesseach year. I will continueworking on this issue to ensurethat harmful foods stay out ofNevada stores and kitchens.January • 2012 • 5
Guest EditorialPrescription Drug Reimportation Would Help SeniorsU.S. Senator Dean HellerAs a memberof theSenateSpecialCommitteeon Aging, Iam workingSen. Dean Heller every day toensure seniors’ access to reliableand affordable healthcare.I am deeply concerned with6 • 2012 • Januarythe impact rising prescriptiondrug prices have on Nevada’sseniors, especially those onfixed incomes.According to a report referencedduring a recent hearing,Americans spent more than$300 billion on prescriptiondrugs in 2010. We continuepaying high prices for the samemedications that are lessexpensive in many other countries.Americans have resortedto purchasing drugs online inan effort to save money.Unfortunately, many of theseonline pharmacies are notlegitimate. Some jeopardizeseniors’ health by providingillegally manufactured medicationsthat in many cases do notcontain the correct dosage oreven the right active ingredient.As a result, those whochoose this route may seriouslyjeopardize their health.While seniors struggle withprescription drug costs, theU.S. Food and DrugAdministration (FDA) hastaken the position that thepurchase of drugs from outsidethe U.S. may be illegalunder federal law. I believeCongress should act to allowAmericans to import FDAapprovedprescription drugsfrom Canada into the U.S.In October, I supported anamendment that would haveallowed prescription drugreimportation for personal use.Despite the bipartisan supportof twenty-eight Democratsand seventeen Republicans,this effort failed. The measurewould keep large drug companiesfrom passing along inflatedprescription drug costsonto Nevadans already strugglingto pay their bills. Morecompetition in the pharmaceuticalindustry would helpbring down the costs of prescriptiondrugs and increasetheir availability.During the last Congress, Iintroduced the Steps TowardAccess and Reform (STAR)Act, part of which encouragedprescription drug reimportationon the federal level.Prescription drug reimportationis something I stronglysupport, and I will continuepursing federal policies thatwould allow this practice tohelp make prescription drugsmore affordable. Nevadansneed to find healthcare savingswherever they can. Providingreliable and affordable healthcarefor our nation’s seniorsshould be a high priority forCongress.
What to Expect When You’re InheritingThe American Academy of Estate Planning AttorneysBrought to you by www.probatebusters.com • blog.wealth-counselors.comBradley B. AndersonAnderson, Dorn, & Rader, Ltd.Who hasn’t daydreamedabout what they’d do with aninheritance? We imagine asudden windfall from a longlostrelative and think aboutthe new car we’d buy, thelong vacation we’d take, orthe beautiful new home we’dmove into. In reality, inheritingmoney can be a littlemore complicated, and it cangive rise to unanticipatedquestions and concerns. Hereare answers to four commonconcerns about inheritances.1. There May be EmotionalStrings. An inheritance oftenresults from the death of aclose friend or relative. Thismeans you may have griefand other emotions to workthrough before you can thinkclearly about how best to useyour inherited property orfunds. In most instances,you’ll have plenty of time tomake these important decisions,and it is best to waitrather than risk taking actionsyou’ll later regret.2. You Might Not Want theInheritance. It may soundstrange, but there are somesituations where you mightwant to refuse an inheritance.When you do this – it’s called“disclaiming” the money orproperty – the inheritancepasses to whoever wouldhave inherited in your place ifyou were dead. People sometimeschoose this optionwhen inherited funds wouldbe eaten up by creditors’claims. Rather than let thishappen, they disclaim theinheritance and instead keepthe inheritance in the decedent’sfamily or circle offriends.3. You Likely Won’t PayIncome Tax. In most cases,heirs do not have to payincome tax on inheritedfunds. For example, if yourUncle Joe leaves you $50,000in cash, the money does notcount as taxable income. IfUncle Joe leaves you hishouse, you don’t have toreport it as income in the yearof his death.What if you choose to sellthe house? Your tax liabilitywill depend on how much ofa profit you make on thehouse, but even then, therules are in your favor. Yourprofit is calculated using theamount for which you soldthe house minus the value ofthe house at the time of UncleJoe’s death, rather than usinga value for the house equal tothe price Uncle Joe originallypaid for it.There are some otherinheritances, such as IRAs,that might be subject toincome taxes. However, theseare the exception rather thanthe rule.4. Patience is Key. Settling(Inheriting page 8)January • 2012 • 7
Silver State Health Insurance ExchangeSelects Executive DirectorThe Executive Director for the newSilver State Health Insurance Exchange(SSHIX) has been selected by its Boardof Directors.Jon Hager was named following anopen interview process. Hager, currentlythe chief financial officer for thePublic Employee Benefits Program, wasunanimously voted to become theExecutive Director after competing forthe position with two other candidates.Hager was selected because of his leadershipskills, group-insurance planknowledge, and hands-on-experiencelaunching and operating a health insuranceexchange.The SSHIX was created by SenateBill 440 following passage of the federalhealth reform law. SSHIX is requiredto:• create and administer a state-basedhealth insurance exchange;• Facilitate the purchase and sale ofqualified health plans;• Provide for the establishment of aprogram to assist qualified smallemployers in Nevada in facilitatingthe enrollment of their employees inqualified health plans;• Make only qualified health plansavailable to qualified individuals andqualified small employers on or afterJanuary 1, 2014;• Unless the Federal Act is repealed oris held to be unconstitutional or otherwiseinvalid or unlawful.“The Board is pleased and excited tohave someone with Jon’s experienceand enthusiasm to implement andoperate a health insurance exchange,”said Barbara Smith Campbell, SSHIXChair. “Jon brings the understandingand skill sets we need to spearhead ourefforts to establish a health insuranceexchange for Nevada.”The role of Executive Director wasbeing performed in an “acting” capacityby Department of Health and HumanServices Director, Mike Willden, until aselection process was complete.8 • 2012 • JanuaryInheriting / page 7an estate is a multi-step process, andwhile some estates settle quickly, it isnot unusual for an heir to wait a yearto eighteen months before receivingan inheritance. Before inheritancescan be distributed, a decedent’s assetshave to be inventoried and valued,creditors must be identified, and debtsmust be paid. In many cases, theprocess is subject to court supervisionand approval, which means additionaltime and paperwork. If the estate islarge enough for estate taxes to be aconcern, the executor or trustee mustfile an estate taxreturn. The processof paying estate taxcan be time consuming,and it cantake fifteen monthsor more for a returnto be filed and forthe IRS to give itspermission for theestate to be closed.Executors orTrustees are oftenreluctant to distributeinheritanceswithout such permission.Distributing fundsbefore the IRS’s release leaves theExecutor or Trustee personally liable forany shortfall.An experienced estate planning attorneycan be a helpful advisor if you areanticipating an inheritance. He or shecan help you address any tax issues,determine whether it would be wise todisclaim your inheritance, and ensureyou get your full inheritance withoutundue delay. Once you have your inheritancein hand, the attorney can help youmake a new estate plan of your ownwith your current financial circumstancesand personal goals in mind.The Law Firm of Anderson, Dorn &Rader, Ltd. is devoted exclusively toestate planning. We are members of theAmerican Academy of Estate PlanningAttorneys, and offer guidance andadvice to our clients in every area ofestate planning. For more information orto attend an upcoming seminar, pleasecontact us at (775) 823-9455 or visit usonline at www.probatebusters.com.(This article was written by theAmerican Academy of Estate PlanningAttorneys. The Academy regularly publishesarticles on various estate planningtopics as a free resource to consumers.)
January • 2012 • 9
Ask Dr. MarionDr. Marion Somers, Ph.D.Caregiving Your Aging ParentQ: The new year always makes me think about starting fresh and makingplans for the future. What should my “caregiver resolutions” be? Jolene, 59I’m so glad youasked this question.Too often,we’re caughtDr. Marion Somersunprepared when itcomes to caring for others, let aloneourselves. Planning ahead can greatlyalleviate the financial, emotional, evenphysical toll of caregiving and aging.Here are my suggestions:• Prepare for a crisis. Don’t wait tillan emergency hits. Choose a hospitalin advance, create a emergency chainof communication, and put criticaldocuments together in a handy place,including insurance cards, allergyinformation, a list of current medications,and legal documents like DNRorders and living wills.• Talk about caregiving now. Talkingabout finances, legal issues, and othercaregiving topics can be tricky – butyou just can’t tiptoe around theseissues. Communicate in a direct, positivemanner, and always make sureyou’re taking your loved one’s feelingsand opinions into account.• Make your home safe. This is agood idea for all of us as we age.Create a safer living environment witha few easy steps, from adding grabbars in the shower to simply increasingthe wattage of light bulbs throughoutthe home. For room-by-room tips,download my free home safety guideat www.MedicalAlert.com.• Think long-term. About three outof four of every one of us will needexpensive long-term health care serviceslike assisted living, nursinghomes, and the like – and are not preparedto pay for it. Take time now toconsider you and your loved one’shealth risks, research the local cost ofcare, and educate yourself on optionslike long-term care insurance, reversemortgages, government programs, andmore.Good luck, and happy new year!10 • 2012 • January
Outreach ClinicIf you are uninsured andneed medical attention, theUniversity of Nevada Schoolof Medicine is continuing tohold its Student OutreachClinic on the UNR campus.The clinic treats only theuninsured and patients areseen on a first come, firstserve basis. Treatmentincludes lab services ($5)such as cholesterol checks,and blood glucose monitoring.Other services includegeneral physicals, EKGs,blood pressure monitoring,and referrals.A Geriatric Clinic will beheld September 10, 8-12 p.m.A Well Women’s Clinic isscheduled January 10, 6-9p.m.The Student OutreachClinic is located at 1664 N.Virginia St., BrighamBuilding/316, Reno. Formore information, call 775-682-8646 or email@example.com.HealthcareReform TrainingThe Nevada GeriatricEducation Center at theUniversity of Nevada Schoolof Medicine is holdingHealthcare Reform Trainingstatewide, January 12.The interactive videolocations are free, and offerContinuing Education Creditfor nurses, long-term careadministrators, and socialworkers. To register, contactDiann Jones at 775-682-8470or email to firstname.lastname@example.org.In Reno,training will be held 11-12:30p.m., at the Nevada GeriatricEducation Center, 411 W.2nd, Reno, NV 89503.Registration is 10:45-11 a.m.Training is also scheduled at14 other locations.January • 2012 • 11
Adding Life to YearsTechnology and the Future of Health CareDr. Larry WeissCenter for Healthy AgingOur country’s healthcare system is comingof age. Through theAffordable Care Act – thehealth reform law, our governmentis making a significantinvestment in bringinghealth care information, medicalrecords, and other medical/healthinformation intoelectronic medical records(EMR) and electronic healthrecords (EHR). Informationtechnology is booming in thehealth field and we all cansignificantly benefit from theresults.Some examples includethe tremendous ease ofaccessing medical recordsfrom one facility to another.Medical and health informationsharing between hospitals,rehabilitation centers,home health, and the primarycare or special physicians inthe community is greatlyenhanced. Even mismanagementof prescription medications,which is the leadingcause of being re-hospitalizedafter a discharge (20% of allhospital discharges end upback in the hospital within 30days), can be curtailedthrough increased communicationbetween providersthrough electronic recordsharing and technology. Thetechnology is there. We justneed to design it and use it.The information-technologywave is even hitting nursinghomes and long-term carefacilities, and residents arestarting to enjoy the ride. Infact, facilities are beginningto encourage residents’ personalinterest in technologyas part of the effort toimprove their health andlives.As health informationtechnology (HIT) has enteredlong-term care, a question hasbeen whether it means anythingto residents personally.Researchers who reportedtheir results online this summerin the Journal of Agingand Health assessed nearly800 nursing home residentsbefore and after their facilitiesimplemented HIT.Although 60 percent saidthey noticed no change and 7percent said care haddeclined, 30 percent said thatthey felt the use of HIT hadimproved care, and 71 percentsaid that they believedthat handheld devices thattrack and manage informationare positive innovations. Amajority said they were gladsuch devices were being usedin their facilities. Many of usin health care settings areunaware of HIT and it is notsurprising, since most of theaction is backstage. HIT hasand will dramaticallyimprove patient and resident(Life to Years page 14)12 • 2012 • January
MORE choice. MORE flexibility.That’s Sierra Nevada Spectrum. $0 monthly premium Medical and prescription coverage Urgent care anywhere in the U.S. See any doctor or specialist you want $0 copay for preventive servicesCall Sierra Nevada Spectrum to learn moreabout our Medicare Advantage plan.1-888-202-9076; TTY: 711Regional PPO Plana product of Sierra Health and Life Insurance Company, Inc.8 am to 8 pm, 7 days a weekRegional PPO Plana product of Sierra Health and Life Insurance Company, Inc.www.sierranevadaspectrum.comspectrum.comSierra Nevada Spectrum has free language translation services available for non-English speakers.Sierra Nevada SpectrumMedicare Advantage plan is insured through Sierra Health and Life Insurance Company, Inc.,a UnitedHealthcare Insurance Company and Medicare Advantage organizationn with a Medicare contract. Enrollment inthe plan is only during specific times of the year. You must continue to pay your Medicare Part B premiumm and use planproviders for routine care. Service area covers the state of Nevada. Prescription coverage subject to limitations. Thebenefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information,contact the plan. Benefits may change on January 1, 2013.41NVSNS11766R5674_110920_214624 File &Use 10032011January • 2012 • 13
Life to Years / page 12care. Astute patients, residents,or family may noticethat they don’t need to repeateverything that happened atthe hospital, or with the lastshift or provider. Evendetails of a surgery or procedureare communicatedeffortlessly, even to thepatient or family member thatis interested. I am! I want tosee my lab tests, x-rays, oreven my physician notes. Themore I am informed andaware of my conditions, themore I am empowered andable to self-manage. Don’tyou want to know and takecontrol of your own health?As we become more comfortablewith computers andtechnology in our own lives,we are more open to its usesto improved communication,documentation, and care. Ofcourse, the simpler and easierto use, the better. Take forexample the personal emergencyresponse or medicalalert system technology, suchas Lifeline. Lifeline providesfast access to help by a familymember or EmergencyMedical Technician if a personfalls. Lifeline’s AutoAlertcan automatically call forhelp if the person is unconscious,disoriented, or immobilized.This technology cantell the difference betweenfalling and normal activitiessuch as sitting or lying down.If you want more information,contact me at the Centerfor Health Aging. It providesa tremendous peace of mindfor the elder wearing it aswell as the family and caregivers.In addition, Lifeline has aMedication Dispensing servicethat is an automated systemin the home that dispensesmedications at pre-programmedtimes, helpingreduce the potential risk ofunplanned hospital and doctorvisits due to incorrectmedication use. The technologyholds 40 doses of medications,gives the person averbal and visual reminderand if not followed, contactsthe appropriate caregivers.The Center for Healthy Agingalso provides this service,contact me if you are interestedin learning more or knowsomeone that could benefit.Getting people to startusing technology is not easy,but once they do, the valuecan shine. With this in mind,a company has introduced“Connected Living”, a programthat enables elder residentsin long-term care settingsto access a customizedhome page that offers e-mail,photo sharing, music, audiobooks, video conferenceswith family members, andnotices about daily eventsand special activities. Theprogram has been wellreceived.Just placing computers incommunities and expectingresidents to use them isn’tenough. By motivating residentsto connect with theirkids and grandchildren, technologybecomes less intimidating.Social engagement is animportant element of health.Using technology and socialmedia not only facilitatesocial connectiveness, butexpose the users to healthinformation and communication.This use of technologyis a significant step that notonly builds on social platformsbut encourages peopleto be more proactive in theirown care. Making technology(Life to Years page 15)14 • 2012 • January
OphthalmologyAnewEating DisorderAffects EyesMichael J. Fischer, M.D.Eye Physician & Surgeonsmall study demonstratesthat those sufferingfrom the eating disorder“anorexia nervosa” may be atrisk for eye damage that canbe potentially quite serious.Specifically, researchersfound that women with anaverage age of 28 who hadanorexia nervosa for an averageof ten years displayedcentral portions of their retinas(known as the macula)and the nerve fibers leadingto it (retinal nerve fibers)were thinner than those ofcontrol subjects. The anorexiapatients also showed significantlyless working of theneurotransmitter dopamine,which figures prominently inthe brain’s ability to processvisual images. It is yet to bedetermined if these conditionswill return to normal if regulareating habits are resumed.It should be noted -- the studymentioned above also foundthat the fovea (the part of themacula that is rich in lightsensitivephotoreceptors) wasthinner in women who bingedand purged than in those whoonly severely restricted theircalorie consumption.If you would like furtherinformation or an appointment,please call (775) 882-2988. Dr. Fischer is locatedat 3839 N. Carson Street, inCarson City. Hours are 8-5p.m., Monday through Fridayby appointment.Life to Years / page 14and health information fun forelders is also essential. Themore we accept and use technology,the healthier we willbe as well as our community.Another innovative company,BlueLibris, is buildingthe underlying platform formobile health and safety monitoring.Their mobile solutionenables the real-time sensingof health information, theautomatic monitoring of userlocation and activity, andsimultaneous voice communicationwith users. The informationcollected through thissmall, wearable device istracked over time to allowcaregivers to make intelligent,timely and informed decisions.Stay tuned for anexplosion in technology thatin my eyes will add life toyears.Lawrence J. Weiss, Ph.D.is CEO of the Center forHealthy Aging. Dr. Weisswelcomes your comments onthis column. Write to him email@example.com c/o Center for HealthyAging, 11 Fillmore Way,Reno, NV 89519.January • 2012 • 15
ASK DR. DEBDebra Fredericks, Ph.D., APN, PMHCNS-BCIntegrated Behavioral HealthcareDear Dr. Deb;I am worried about my grandfather. I’ve been away at college so I do not see my family often.Every year we spend Christmas at “Nana’s and PopPop’s” house. This year he seemed sort ofdistracted and thought I was still in high school. My dad said that there is nothing wrong –that he has “good days and bad days” because of his age (PopPop is 84). I took a psychologyclass and learned about dementia. My grandfather acted like I learned about in my class.Could my grandfather be coming down with dementia? What should I do?Signed, A Loving GranddaughterDear “A LovingGranddaughter;”Every year I receive manyphone calls from familymembers after visiting withrelatives over the holidays. Itis often difficult to noticesymptoms of early dementiawhen you are with a personevery day. When you haven’tseen someone for a year,changes appear more obvious.There are so many differentcauses of cognitivedecline it is very importantto obtain a thoroughevaluation. Unfortunately,people often delay seekinghelp due to fear. Icannot overstate theimportance of obtainingexpert evaluation if cognitiveperformancedeclines. What if it is dueto a reversible cause suchas sleep apnea or vitamindeficiency? How terribleto continue to sufferwhen reversal orimprovement is available.Of course, in yourcase, it seems that yourfamily is not concerned.However, I think you arecorrect to be concerned.Your “PopPop” mighthave been experiencing amild delirium, earlysymptoms of dementia,cognitive symptoms ofphysical illness, or simplywas just overtired. It issignificant that he forgotyou are in college, even inpassing. He deserves anevaluation before somethingworse happens. Iwould encourage you toidentify local expertsbefore talking with yourfamily. This way, you willhave a number to call foran appointment immediatelyif they agree.In general, the advice Igive to family members asthey prepare to share theirconcerns, is to emphasize thepositive aspects of evaluation.Do not use the term“mental.” For the elderly, thisis a very frightening conceptand usually means that youthink they are “crazy.” Whenyou approach your grandfatherand grandmother, talkto them about how muchyou love them. Focus onwellness and preventioninstead of symptoms youhave observed. Ask them ifthey have noticed any memorychanges and talk to themabout how “normal” it is tohave changes as we age.Then emphasize that thereare things that can be doneto help maintain a goodmemory. If they are resistant,perhaps ask them tohumor you. If they say it isnothing, agree that it probablyis nothing but you worry.Again, emphasize preventionand wellness.If your grandfather refuses,call and make an appointmentfor yourself and yourgrandmother (plus otherconcerned family members).An expert can educate yourfamily and, perhaps, helpyour grandmother cope withher husband’s cognitive(Dr. Deb page 18)16 • 2012 • January
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SOCIAL SECURITYRita MeierNevada Public Affairs SpecialistSocial Security Helps The HomelessMore than half a millionAmericans experiencehomelessness on any givennight. Nearly 20 percent ofthem are “chronically homeless,”meaning they are onthe streets regularly.Social Security has severalprograms that pay benefitsto qualified individuals,including those who arehomeless. These programsinclude retirement, disability,and survivors benefits, aswell as SupplementalSecurity Income (SSI), whichis a needs-based programfor people who are blind,disabled, or age 65 or older.If you know someonewho is homeless, and youwant to learn more abouthow Social Security mighthelp, a good place to getinformation is atwww.socialsecurity.gov/homelessness.That page includes a linkto the Spotlight onHomelessness — a Websitedesigned to help the homelessapply for SSI. It’s availableat www.socialsecurity.gov/ssi/spotlights/spothomeless.htm.The homelessness pagealso includes links to informationon health care forthe homeless, institutionalization,advocacy groups,reports on homeless outreach,and even links toother Websites like the U.S.Interagency Council onHomelessness and HUD.You’ll find other informationhelpful to the homelessat the Benefit EligibilityScreening Tool or BEST.Based on answers to variousquestions, this tool helpsdetermine the benefitssomeone might be eligiblefor and gives informationabout how to qualify andapply. Go directly towww.socialsecurity.gov/best.Dr. Deb / page 16changes. I see many familymembers without thepatient in my office forongoing education, behavioralconsultation, andfuture planning. Best ofluck and I hope yourgrandfather is well. Youobviously love him verymuch.Signed,Dr. Deb(Debra Fredericks PhD,APN, PMHCNS-BC is abehavioral psychologistand advance practicenurse specializing indementia. For appointmentsin either Reno orCarson City, call 775-657-8499. Questions for thiscolumn can be sent to 890Mill, Ste. 305, Reno, NV89502 or firstname.lastname@example.org)18 • 2012 • January
Centers for Medicare and MedicaidWhat Medicare Covers in the HospitalDavid SayenMedicare Regional AdministratorDavid SayenOne of Medicare’smost important benefitsis helping tocover your expenses if youneed to be hospitalized. Butwhat exactly is covered, andhow much do you pay?Medicare helps cover certainmedical services and suppliesin hospitals. To get the fullrange of benefits, you musthave both Medicare Part A,which is hospital insurance,and Part B, which is medicalinsurance.What you pay depends onwhether you’re an inpatientor an outpatient. Stayingovernight in a hospital doesn’talways mean you’re aninpatient. You’re an inpatienton the day the doctor formallyadmits you, with adoctor’s order.tient, Part A will help coveryour stay. This would generallyinclude a semi-privateroom, meals, general nursingcare, drugs, and other hospitalservices and supplies.How much you’ll paydepends partly on howlong you stay.Medicare pays for inpatienthospital care and skillednursing care based on “benefitperiods.” A benefit periodbegins the day you’re admittedto a hospital or skillednursing facility – and endswhen you haven’t had anycare in either setting for 60days in a row.You can have more than onehospital stay within the samebenefit period. There’s a limiton how many days Medicarecovers during a benefit period,but there’s no limit onthe number of benefit periodsyou can have over yourlifetime.So much actually comesout of your pocket whenyou’re in the hospital?Part A has a deductible,which is $1,156 for 2012.reserve days.” These can beused after day 90 of eachbenefit period, and your copayis $578 per day in 2012.After you use up these “lifetimereserve days,” you mustpay all costs yourself.If that all seems a bit complicated,you can always call uswith your questions at 1-800-MEDICARE.You can also find a lot ofgood information in the“Medicare & You” handbook,which is mailed to allMedicare beneficiaries in thecountry each fall. The handbookis online atwww.Medicare.gov.Keep in mind that Part Adoesn’t cover doctor feesor other medical services.That’s where Part B comesin.tient. Part B also helps coveroutpatient costs, such asdoctors’ fees, emergency andobservation services, labtests, and X-rays.I should also point outsome of things Medicaredoesn’t cover in the hospital.It doesn’t pay for privatedutynursing, a telephone ortelevision, personal items(like toothpaste or razors), ora private room, unless it’smedically necessary.For hospital outpatientcare, you pay a copaymentfor each individual outpatientservice.The copayment can be differentfor each service, butnever more than the Part Adeductible. In some cases,your total copayment for allservices may be more thanthe inpatient hospitaldeductible.I’ve very much enjoyedbringing you Medicare informationover the past year.And I hope you and yourfamily have had a happy andhealthy holiday season!If you aren’t sure whetheryou’re an inpatient or an outpatient,ask your doctor orthe hospital staff. Or you cancall Medicare at 1-800-MEDICARE (1-800-633-4227).If you’re admitted as an inpa-After you’ve paid that, there’sno copayment for days 1through 60 of each benefitperiod. For days 61 through90 of each benefit period,there’s a copayment of $289per day next year.You also have 60 “lifetimeTo get Part B, you must pay amonthly premium, which formost people will be $99.90per month in 2012.Then you’ll pay 20 percent ofthe Medicare-approvedamount for most doctorservices while you’re an inpa-David Sayen is Medicare’sregional administrator forCalifornia, Arizona, Nevada,Hawaii, and the Pacific TrustTerritories. You can alwaysget answers to yourMedicare questions by calling1-800-MEDICARE (1-800-633-4227).January • 2012 • 19
Get up & Go!Natalie HilbertFitness DirectorCascades of the SierraPursue a Fit LifeFitness is not somethingthat only belongs to theyoung-it’s everybody’sright no matter what the age.The body is born to move,and all systems function moreefficiently when you canengage in at least 20-30 minutesof moderate activity severaltimes a week. It’s nevertoo late to start.Select an activity youenjoy and will participate inon a regular basis. Cardio respiratoryexercise, which iscontinuous, non-resistivemovement, should be done atleast three times a week for aminimum of 20-30 minutesper session. Some cardio respiratoryexercise, such aswalking, is fine to do everyday.Strengthening exercisesare also highly beneficial.Aim for two to three timesper week, for at least 15-30minutes per session.Here are some examplesof different types of exercise.• Cardio respiratory exercisescould be walking, swimming,cycling, rowing, stair climbing,jogging and dancing.• Recreational activities couldbe gardening, bowling, golfing,croquet, horseshoes,lawn bowling and horsebackriding.• Strengthening exercisescould be calisthenics, resistance/weighttraining andexercises utilizing elasticbands or tubing.Some of the benefits ofregular exercise are lowerblood pressure, lower cholesterol,maintain or increaselean muscle tissue, improvesglucose tolerance and metabolism,controls weight andreduces body fat, improvesendurance for daily activityand enhances quality of life.First consult your physicianbefore starting any exerciseprogram. Be familiarwith the exercise dangersigns such as unusual fatigue,any pain or tightness from thejaw to the waist, loss of musclecontrol, nausea, dizziness,lightheadedness, blurredvision or severe breathlessness.Notify your doctorimmediately if you experienceany of the above symptoms.To learn more about livinga healthy lifestyle contact,Natalie Hilbert, FitnessDirector at Cascades of theSierra. The EverFit Club isavailable for monthly gymmemberships and is a Silver& Fit® provider. For moreinformation call (775)-424-5400, ext. 155 or email email@example.com • 2012 • January
3 ERS, 1 JUST FOR KIDS.They treat the most serious emergencies in the ER with thetreat you without an appointment at eight Urgent CareLearn more at renown.org/seniors.To check ER wait times and find locations,scan this QR code with your smart phone.SKILL. EXPERTISE. TECHNOLOGY.January • 2012 • 21
NCOA Budget UpdateCongress Finalizes Older American Actand Other FY12 AppropriationsIn December, Congressapproved theConsolidatedAppropriations Act of 2012,which will fund governmentagencies through Sept. 30,2012.The legislation containsnine FY12 appropriationsbills that had not yet beenenacted, including theLabor-HHS-Educationappropriations bill thatfunds the Older AmericansAct (OAA) and severalaging services programs.What does the packagemean for older adults andthe aging services network?Here are highlights of what’sincluded:Administration on Aging(AoA) FundingAoA is essentially levelfundedfor FY12, with thefollowing notable exceptions:• All Program Innovations(Title IV) funding eliminated(from $13 million to zero)• $7.4 million (65%) cut inAlzheimer’s DiseaseDemonstrations• $3.2 million increase inAoA administrationAreas funded under TitleIV include:• Multigenerational CivicEngagement• National Resource Centers• Community Innovationsfor Aging in Place• National Alzheimer’s CallCenterThe legislation does notinclude the Administration’srequests for:• The Caregiver Initiative,which included increases of$40 million for the NationalFamily Caregiver SupportProgram.• $48 million for SupportiveServices and Senior Centers.• $7.5 million for LifespanRespite Care.• Transfer to AoA of theSenior Community ServiceEmployment Program(SCSEP), and the StateHealth Insurance Programs(SHIPs).• First-time funding for theElder Justice Act (EJA).Prevention and PublicHealth Fund InvestmentsSenate appropriators hadproposed that $10 millioneach in funding for theChronic Disease Self-Management Program(CDSMP), and falls preventionbe allocated from thePrevention and Public HealthFund.The ConsolidatedAppropriations Act does notcontain specific allocationinstructions, but the NCOAunderstands that appropriatorswill direct theDepartment of Health &Human Services (HHS) toprovide the $10 million inCDSMP funding. No fundingis budgeted for falls prevention,which will continue toreceive $1.96 million in fundingfrom the Centers forDisease Control andPrevention (CDC).Senior Community ServiceEmployment ProgramAlthough the legislationdoes not transfer the SeniorCommunity ServiceEmployment Program(SCSEP) from theDepartment of Labor toAoA, it does maintain levelfunding for the program at$449.1 million. With thisappropriation amount, workhours will continue toremain as low as 12 hoursper week, and waiting listswill continue to grow acrossthe country.Amidst the debate onreauthorization of theWorkforce Investment Act,legislation has been introducedin the House thatwould repeal SCSEP in thename of consolidation. Thishas been proposed despite aGeneral AccountabilityOffice report that specificallystates that SCSEP is one ofthree job training programsthat serves a unique population,and hence was notduplicative. The timing ofany action on this legislationis currently unclear.Low-Income Home EnergyAssistance ProgramThe legislation provides$3.5 billion for the Low-Income Home EnergyAssistance Program(LIHEAP), which providesutility assistance for familieswith low-incomes, seniors,and individuals with disabilities.This is significantly lessthan the $4.7 billion providedfor FY11, and contains noallocation for the EmergencyContingency Fund that providesadditional assistanceduring extreme weather orenergy price spikes. It ismore than the $2.57 billionrequested by theAdministration, which wouldhave been a 45 percent cut.Several stories submittedby seniors to the One Awaycampaign relate the strugglesthey are having paying theirenergy bills. They face difficultchoices between heatingtheir homes and paying formedication, or keeping thelights on or paying for food.Senior CorpsThe debate concerningvolunteerism and civicengagement continues to becomplicated. As noted above,OAA civic engagement hasbeen defunded for FY12. InFY11, the Retired and SeniorVolunteer Program (RSVP)was the only AmeriCorpsprogram that saw cuts. Yet,the House FY12 draft appropriationsbill proposed todefund the entireCorporation for National andCommunity Service exceptfor Senior Corps programs.The final word on FY12and Senior Corps is statusquo: The FosterGrandparents Program($111 million), the SeniorCompanion Program ($47million), and RSVP ($50 million)are all level funded.Source: http://www.ncoa.org22 • 2012 • January
when it comes toyour health plan,IS CLEAR.John TysonLocal Storyteller/Northern NevadanAttend a free informational meeting:Carson City, Fernley, Fallon, Gardnerville, Reno, Sparks, Minden and Virginia CityCall to reserve your spot: 775-982-3191 or 888-775-7003. A sales person will bepresent with information and applications.For accommodation of persons with special needs at sales meetings call (775) 982-3158 or (888) 775-7003, TTY Relay Service 711.Choose Senior Care Plus –The health plan that offers more value than just Medicare.• Low premium plans• Low prescription copays• Largest provider networkin northern Nevada**• Multiple plan options• Access to Renown hospitals• No referrals to see specialists• Only not-for-profit MedicareAdvantage plan in Nevada***• Rx “gap” coverage• Worldwide emergency care• Only locally owned and operatedMediare Advantage plan in Nevada***• Local personalized customer service• Fitness club memberships• Hearing aid coverage• Supplemental dental and vision benefits• Largest Medicare Advantage planenrollment in northern Nevada*****Based on 2011/2012 Centers for Medicare and Medicaid Services Health Plan ratings and Consumer Assessment of Health PlansStudy - Medicare & You Handbook. **Based on comparison of plans provider networks offered in northern Nevada counties. ***Basedon comparison of Medicare Advantage plans offered in northern Nevada counties. ****Based on CMS Medicare Advantage/Part DContract and Enrollment Data for October 2011.Senior Care Plus is a 4-Star Rated Plan. Plan performance summary star ratings areassessed each year and may change from one year to the next. Senior Care Plus is a health plan with a Medicare contract, available toanyone with both Medicare Parts A and B. A member must be a resident of Carson City County, Churchill County, Douglas County,Lyon County, Storey County or Washoe County and continue to pay his or her Medicare Part B premium. John Tyson is a paidspokesperson for Senior Care Plus. Material ID: Y0039_2012_SeniorSpectrumJan File & Use: 01032012HEALTH CAREPLAN IN NEVADA *Extended Call Center HoursMonday-Sunday 8am-8pm(Oct. 15-Feb. 14)www.SeniorCarePlus.com(775) 982-3158 or (888) 775-7003TTY Relay Service 711830 Harvard WayReno, NV 89502Office Hours: Mon. - Fri. 8 am - 5 pmA Medicare Advantage Plan from Hometown Health.January • 2012 • 23
Sanford Center for Aging’s NewDirector of Volunteer ProgramsRetirement Living 24 • 2012 • JanuaryJoin Us UnitedHealthcare hasannounced its continuedpartnership with SaintMary’s, with a renewed contracteffective Dec. 28, 2011.The contract includes allUnited Healthcare products:Commercial HMO, ChoicePlus PPO, Secure Horizonsand Options PPO.The renewed contractensures that UnitedHealthcaremembers can continueto access healthcare servicesthrough Saint Mary’s and itsaffiliates, with no gap in networkcoverage. This includeshospital care (i.e., emergencyScott Trevithick has beenhired as the new ProjectDirector for the SanfordCenter for Aging, VolunteerPrograms, at the Universityof Nevada, Reno.Trevithick previously wasthe Executive Director of theSpecial Advocates for Elders(SAFE), a program thatrecruited and trained volunteersto be advocates for elders facing guardianship.Trevithick’s experiencespans more than 20 years.As Project Director, he willoversee the Retired andSenior Volunteer Program(RSVP) of Washoe County,and Senior OutreachServices (SOS). RSVP is partof the Corporation forNational and CommunityService that encourages people55 years and older toshare their skills, talents andexperiences with communitynonprofit and public agencies.The SOS program pro-Scott Trevithickvides support to WashoeCounty’s most vulnerableelders through trained volunteersthat help them to stayin their homes as long aspossible."Scott's understanding ofsenior issues, coupled withhis diverse experiences workingwith volunteers, governingboards and the NevadaAging Services Network, willallow him to hit the groundrunning," said DeniseMontcalm, director of theSchool of Social Work, UNR.UnitedHealthcare RenewsContract with Saint Mary’sservices, inpatient/outpatientcare, lab and imaging), aswell as primary care, urgentcare and Walmart retail clinicsprovided via Saint Mary’sMedical Group.Catholic Healthcare West(CHW) also announced ithas ended exclusive negotiationswith CommunityHealth Systems ProfessionalServices Corporation for thesale of Saint Mary’s RegionalMedical Center in Reno. Thetwo organizations wereunable to reach mutuallyagreeable terms and havedecided to end negotiations.
CalendarJan. 7 - Four Seasons BookClub, Sparks Library, 1 p.m.,(775) 352-3200.Jan. 9 - AARP DriverSafety Program, 8:30 - 1:30p.m., Reno Senior Center,Reno, call (775) 786-3509.Jan. 9 - Town Hall Meeting,Nevada Aging and DisabilityServices, 10:30 - 11:30 a.m.,Sparks Senior Center, call(775) 687-4210.Jan. 10 - Cool Jazz, MileHigh Jazz Band, 8 - 10 p.m.,Sheryl Adams at CommaCoffee, call (775) 883-2662.Jan. 10 - Yoga Basics, Jan.10 - Feb. 14, 5:30 - 6:45 p.m.,Larry D. JohnsonCommunity Center, Sparks,(775) 353-7857.Jan. 10 - RadonPresentation, SpanishSprings Library, 6:30 p.m.,call (775) 424-1800.Jan. 10 - Drawing Class,Comma Coffee’s New ArtsClassroom, 5:30 - 7 p.m.,Jan. 10 - Feb. 28, Tuesdays,108 1/2 W. Fourth Street,Carson City, (775) 721-4453.Jan. 11 - Author HollyRiley, A Portrait ofForgiving and Letting LifeLove You, Sierra Place,Carson City, 2 p.m., call(775) 841-4111 orwww.kiscoseniorliving.com.Jan. 11 - Town HallMeeting, Nevada Aging andDisability Services, 10:30 -11:30 a.m., Neil Road Rec.Center, call (775) 687-4210.Jan. 12 - ConversationCafe, Current Events, 10 -11 a.m., $2, Aspen Grove,960 Lakeshore Blvd., InclineVillage, (775) 832-1310.Jan. 12 - Health CareReform, 10:45 - 12:30 a.m.,Geriatric Education Center,411 W. 2nd St., Reno. (775)682-8470.Jan. 13 - Art of HealthyBudgeting, 5:30 - 7:30 p.m.,Comma Coffee’s Classroom,108 1/2 West Fourth Street,Carson. For information, call(775) 884-0664.Jan. 13 - Registration forSierra Nevada College/LifeLong Learning Program,classes start Jan. 17, call(775) 831- 1314 orwww.sierranevada.edu.Jan. 14 - Mindful FlowYoga, through Feb. 18, 9:30 -11 a.m., Larry JohnsonCommunity Center, Sparks,(775) 353-7857.Jan. 14 - Pitcairn Island:Paradise Found and Lost,scholar Christine Johnsondiscusses history, 3 - 4 p.m.,Incline Village Library. Answers page 41January • 2012 • 25