InSight December 2011

INSIGHT Home Care

FALL 2011

The Magazine for Northwest Home Care Aides

INSIDE

BUILDING CAREERS tHROUGH HOME CARE PLUS: People-first language

A day in the life Benefits updates and more www.myseiubenefits.org InSight Magazine

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INSIGHT Home Care

EXECUTIVE DIRECTOr’S NOTE

STAFF

Welcome to the first issue of Home Care InSight, the magazine for Northwest Home

Editor Naomi Ishisaka

Care Aides.

Publisher SEIU Healthcare NW Training Partnership

& SEIU Healthcare NW Health Benefits Trust

The SEIU Healthcare NW Training Partner-

Graphic Design Naomi Ishisaka

ship and the Health Benefits Trust care about

CONTRIBUTORS

your work and your health. As Home Care

Photographer Inye Wokoma Writers Lora Shinn, Dori Cahn, Manny Frishberg,

Aides, your work makes a critical impact in the

Alison Sargent, Gayle Roberts, Dr. Rick Shepard

lives of others every day. And while you work to

PROOFREADER Regan Conley

care for others, you must also care for yourself,

BOARD OF DIRECTORS Training Partnership David Rolf, Board Chair SEIU Healthcare 775NW President

keeping you and your family healthy.

Through Home Care InSight, we want to

Marty Levine, MD, Board Secretary

share with you skills to improve your health; share best practices from others in the profession; and provide you with the

Group Health Cooperative, Assistant Medical Director, Primary Care

most updated information about your training and benefits.

Nora Gibson

To this end, in this issue we explore the importance of people-first language, offer health and wellness tips and provide the latest updates to training and benefits information – and much more.

Full Life Care, Executive Director

Adam Glickman SEIU Healthcare 775NW, Vice President

Sterling Harders

We hope you will find this magazine useful in your work as a Home Care Aide. Please let us know what you think – to share feedback and ideas, please contact insight@myseiubenefits.org.

SEIU Healthcare 775NW, Vice President

Seth Hemond SEIU Healthcare 775NW, Director Member Programs and Participation

Linda Lee

Charissa Raynor Executive Director SEIU Healthcare NW Training Partnership SEIU Healthcare NW Health Benefits Trust

Home Care Aide

Jesse Magana Consumer Advocate

Dan Murphy DSHS Aging and Disability Services Administration, Director of Legislative & Policy Analysis

Karen Washington Home Care Aide

Jan Yoshiwara State Board for Community & Technical Colleges, Deputy Executive Director for Education Services Health Benefits Trust David Rolf, Board Chair SEIU Healthcare 775NW President

Ryan Jacobsen, Board Secretary Addus Healthcare Regional Director

Home Care InSight Magazine is a publication of the SEIU Healthcare NW Training Partnership and Health Benefits Trust to serve Home Care Aides in the Northwest.

Tess Cannon Addus Healthcare, Agency Director

Sterling Harders SEIU Healthcare 775NW, Vice President

Have a Story You Would Like to Share?

Seth Hemond

Do you have a story about yourself or someone you know that would make a good topic for the next issue of Home Care InSight Magazine? We want to hear from you!

Do you have a letter to the editor, a healthy recipe or question you want answered? Let us know!

Dan Murphy

Pass on your story ideas to InSight Magazine Editor Naomi Ishisaka at insight@myseiubenefits.org.

SEIU Healthcare 775NW, Director Member Programs and Participation DSHS Aging and Disability Services Administration, Director of Legislative & Policy Analysis

Misha Werschkul SEIU Healthcare 775NW, Legislative and Policy Director

© Copyright Home Care InSight Magazine. All rights reserved.

COVER PHOTO OF ILENE, LEFT, AND MICHELLE HANNUM BY INYE WOKOMA. PHOTO OF CHARISSA RAYNOR ON THIS PAGE BY NAOMI ISHISAKA

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Contact Home Care InSight at insight@myseiubenefits.org for permission to reprint or republish content from Home Care InSight.

Contact Home Care InSight: insight@myseiubenefits.org, 635 Andover Park West, Suite 200, Tukwila, WA 98188

Contents Emily Rogers, Self Advocacy Coordinator for The Arc of Washington State, speaks about the importance of “people-first” language.

Page 18

FIRST PERSON

2 EXECUTIVE DIRECTOR’s NOTE 4 departmenTS understanding diabetes Country Spotlight Nutrition Quiz

Word Spotlight

PHOTO BY INYE WOKOMA

Coping with grief

8 The Climb

FAMILY ESSAY

3 OF CARE AND KINGS FEATURES

12 URGENT CARE OR ER? 14 BUILDING SKILLS, CREATING CAREERS 18 PUTTING PEOPLE FIRST 22 A DAY IN THE LIFE BENEFITS

27 Training INFORMATION 30 Health BENEFITS INFORMATION InSight Magazine

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Departments WORD SPOTLIGHT

Con•su•mer

1. A term used by people with disabilities or older adults instead of patient or client to show the right to an active role in the quality of care and services they receive.

Why use the term consumer?

Academics and advocates of people receiving care prefer the term consumer, rather than patient, client, customer, employer, or service-user, since it emphasizes the consumer’s self-determination: their conscious choice to receive services as well as their control over them. Some struggle to accept the term consumer, wary of confusion with images of department store checkout lines. The Training Partnership and Health Benefits Trust use the term to describe individuals needing services.

The best course of action is always to ask those around you what they would like to be called – but consider consumer a safe default.

For more on the importance of people-first language, see story on page 18.

– Alison Sargent

UNDERSTANDING DIABETES Knowing the Facts to Stay Healthy

By LORA SHINN

What is diabetes?

Diabetes means you have a high amount of sugar in your blood. Over 25 million children and adults in the United States have diabetes, according to the American Diabetes Association.

That’s a big number – but what may be worse is that 79 million people have pre-diabetes, which means they will develop diabetes if they don’t correct bad habits.

Are there different types of diabetes?

Yes. Type 1 diabetes is often diagnosed in children, teens and young adults. There’s often a genetic link – for example, perhaps a grandmother or father has Type 1 diabetes.

Type 2 diabetes is often diagnosed in adults.

Many (but not all) adults who are diagnosed with Type 2 diabetes are obese and not physically active. Like Type 1 diabetes, this form of diabetes is often genetic – perhaps your mother or father had diabetes. People who are growing older (over 45 or so) are also at risk of diabetes

What are the warning signs of diabetes?

The symptoms for diabetes vary, but slowly increase over time, particularly in the case of Type 2 diabetes. Symptoms can include: • Feeling very thirsty or hungry • Infections or cuts that heal slowly • Urinating more often • Fatigue

How is diabetes diagnosed?

A doctor will order a blood test to check glucose (or sugar) levels; it may be a fasting or nonfasting test. If your blood sugar levels are higher than normal, then you may have diabetes.

How is diabetes treated?

People diagnosed with diabetes inject insulin under the skin, which lowers blood sugar. People with Type 1 diabetes take insulin daily, while some people with Type 2 diabetes can manage with diet and exercise alone.

Eating stable, consistent meals that are low in sugar can help manage your levels. Your doctor and a dietician will help you plan your meals.

You will check your levels with a glucometer, a device that takes a tiny drop of blood to test your sugar levels.

What are some possible problems associated with diabetes?

•

• •

• •

A higher risk of heart attack due to difficulty controlling your blood pressure and cholesterol Eye problems and sensitivity to light Foot problems, including sores and infections that could lead to amputation (removal of the foot) Skin complications and infections Hearing loss

What’s next, after diagnosis?

The doctor will want to meet frequently to review how you are controlling your blood sugar.

You will learn how to recognize signs of low blood sugar and high blood sugar, how to check your blood glucose levels, learn to plan meals to reduce diabetes symptoms and learn how to give insulin.

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Read more about diabetes At the American Diabetes Association website: www.diabetes.org

DEPARTMENTS

Are you a Nutrition Know-It-All? Find out with a quiz about fats, fruits and food

By LORA SHINN

4. “Healthy fats” are found in nuts, fatty fish (like salmon) avocados and

1. All fats in food are bad.

HOW DID YOU DO?

olive oil. True or False?

Add one point for each correct answer.

True or False?

True. Unsaturated or “healthy fats” do

Count up your points and find your place

False. Fats are an important part of our

not raise cholesterol in the blood. While

on the scale below:

diet and they make food taste good. They

it’s not good to eat too much fat, a mod-

supply important nutrients and help the

erate amount of unsaturated fat is fine.

body absorb vitamins. But some fats are not as good as others.

5. A low-salt, low-saturated fat diet can cause high blood pressure.

2. Items that have a high percentage

True or False?

of saturated fat include butter, cream,

False. A high-salt, high-saturated fat

cheese and ghee. True or False?

diet is often associated with high blood

True. Dairy products often have a high

pressure. A low-salt, low-saturated fat

percentage of saturated fats. Because

diet is healthier for most people.

they raise cholesterol, a diet especially high in saturated fats can lead to heart

6. Sugar is mostly found in desserts.

problems and high blood pressure.

True or False?

False. Sugar is often found in soft

3. Saturated fats are associated with

drinks (pop), breakfast cereals and even

cancer and heart disease. True or False?

crackers. It can be called things like

True. Eating too much saturated fat is a

“corn syrup,” “lactose” or “glucose.”

risk factor for heart disease and cancer.

Daily sugary treats can promote tooth

Foods high in saturated fat (cookies,

decay and make you gain weight, which

cheese pizza, hot dogs) can be good

can lead to more health problems.

choices every once-in-a-while – just not a good idea three times a day, every day.

0-3 points: Need More Nutrition.

You’re on the right path by reading this article. But it looks like you need to read up on your nutrition.

3-6 points: Nutrition Know-How. You are fairly informed about healthy eating options and you’re interested in learning more. Keep up the good work!

7-8 points: Nutrition Superstar. You know what’s healthy and what’s not, and you can help friends and consumers learn how to take care of their health.

Read more about putting together a healthy meal with the fun “Choose My Plate” site from the U.S. government: www.choosemyplate.gov

7. Vegetables and fruits are part of a healthy diet. True or False?

True. You can fill half your plate with fruits and vegetables, both of which supply great nutrients without many calories. But try not to top them with too much saturated fat (butter, high-fat salad dressing).

8. Eating meat is bad for you.

True or False?

False. Meat is a fine way to meet your protein needs. Choose lean or low-fat cuts of meat for meals, and fish at least twice a week. To avoid adding extra fat, grill, broil, roast or bake meat, and remove skin from poultry.

ABOUT LORA SHINN Lora Shinn is a Seattle-based freelance journalist. She writes about career, business, food, health, travel and parenting for business, consumer, trade and custom publications. Her work has appeared in The Seattle Times, Wired, Parenting, Pregnancy, Inc., and many other publications.

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DEPARTMENTS

Good Grief

By LORA SHINN

Dealing with the Types and Stages of Loss Stages of Grief Why do you feel so sad when waking up, a little better by noon, and then angry by dinnertime? To help us understand, in 1969 Elizabeth Kübler-Ross outlined a model of grief’s stages, in her book “On Death and Dying.” This model applies to losses of every type, including death of a loved one, the end of a serious relationship or a divorce, or the onset of a disease or terminal illness.

People suffering loss may experience these stages in the order below, but many people move back and forth between the stages. You may first feel depression, then anger, acceptance, and then move back to bargaining. You may even experience different stages in just one day. You may not even feel all of these emotions, but most people go through at least two.

Denial What you might say: “It’s fine, I feel fine, there isn’t a problem.”

What you might feel: You feel numb, in shock and unable to cope with daily life. You don’t feel any emotions, but you also have a hard time getting through the day.

Anger What you might say: “I can’t believe this happened to me.”

“Why me? It’s not fair!” “It’s all your fault that she died!”

What you might feel: You feel angry and rageful at the situation, at God or at a person you feel could be blamed (say, a person who didn’t attend the funeral or someone who offered

Acceptance What you might say: “It’s going to be OK.” “We had many wonderful times together.”

What you might feel: You are in the process of acknowledging what happened – the good and the bad. You are coming to terms with the fact that the loss is final, and you are beginning to move on.

insensitive advice).

Bargaining What you might say: “If only I could change what happened.”

“I will give up all my bad habits if only it would fix everything.”

What you might feel: You wish you could change what is happening or what has already happened. You may feel overwhelmed with “what if” and “if only” thoughts.

Depression What you might say: “I hate life.” “I don’t feel like getting out of bed.” “There’s nothing good about today.”

Common losses •

Death of close family member (husband, wife, partner, parent, child)

•

Diagnosis of serious illness

•

Diagnosis of Alzheimer’s disease or dementia in a parent

•

Divorce or the ending of a relationship

•

Job loss

•

Loss of a consumer or coworker you cared about

What you might feel: You may cry and grieve for your loss, either for a few moments or for hours. You recognize that what has happened is final and you feel overpowered by heartbreaking emotion.

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GRIEF continues on page 17

WHERE IN THE WORLD?

SPOTLIGHT on ETHIOPIA

DEPARTMENTS

PHOTOS BY INYE WOKOMA

By ALISON SARGENT & Elan ebaling Ed. Note: Home Care Aides in the Northwest come from all over the world - East Africa, Asia, Eastern and Western Europe, Latin America. To help understand the people and cultures of the Home Care Aide population, we will present a spotlight on a country that many Home Care Aides come from.

When the owner’s of Seattle’s renowned Kokéb restaurant, Yeshi and Belete Shiferaw, arrived in Seattle 30 years ago, they were one of around 35 Ethiopian families living in the city.

Since then, Seattle’s Ethiopian population has grown to over 25,000, making it one of the largest in the United States.

With its grey skies and rainy climate, Seattle is 8,300 miles and worlds away from Addis Ababa, Ethiopia’s capital city and the Shiferaws’ hometown. In 1974, Ethiopia’s emperor Haile Selassie was overthrown, causing many to flee the country. Belete Shiferaw’s father, a member of Selassie’s parliament, was imprisoned during the takeover.

“It was a very difficult time. A lot of people died,” says Belete Shiferaw over lentil sambusas at the Capitol Hill restaurant, named for “star” in Amharic. Belete fled to Sudan where he met and married Yeshi, also a refugee, and the couple immigrated to Seattle in 1980.

The regime fell in 1991 and the Federal Democratic Republic of Ethiopia (FDRE) was founded in 1995. The present government, led

by Prime Minister Meles Zenawi, has been accused of rigged elections, as well as the suppression of widespread government opposition.

In 2010, the Economist’s Democracy Index identified Ethiopia’s current leadership as an authoritarian regime.

Doro Wat (serves 4)

From left, Belete and Yeshi Shiferaw.

The Shiferaws still hope to someday return to Ethiopia, but their children’s strong American roots keep them anchored to their family restaurant, which has served Seattle delicious Ethiopian cuisine and culture for three decades.

Ethiopian staples include injera, a pancakelike sourdough bread made with teff flour which doubles as an eating utensil. Diners gather around a communal platter, ripping off spongy pieces of injera and using it to scoop up mouthfuls of wat and alecha – traditional stews made with various meats, lentils, and vegetables.

Berbere, a seasoning derived from red peppers, gives Ethiopian food its distinctive spicy flavor.

Yeshi and Belete Shiferaw share their family recipe for doro wat, or chicken stew. Wat dishes can also be made with vegetables, lamb, beef, or seafood. “The chicken, it takes a long time to cook and you only make it with chicken for a very respected guest,” Belete said. “Traditionally it’s a very, very special dish.”

Fun facts Seattle may be the birthplace of Starbucks, but Ethiopia is the birthplace of coffee, the main export from the region of Kaffa. Ethiopia is the only country in Africa that was never colonized and one of the only with its own alphabet. Ethiopia has been home to Christians, Muslims and Jews, although the current population is predominantly Christian and many of the words in its official language, Amharic, bear religious significance.

Some basic Amharic words

Ingredients: 1 whole chicken, cut into 8 pieces 2 tbsp. strained fresh lemon juice 2 tsp. salt 2 cups finely chopped onions ¼ cup niter kebbeh (herb butter) 1 tbsp. chopped, scraped fresh ginger root ¼ tsp. pulverized fenugreek seeds ¼ tsp. ground cardamom 1/8 tsp. ground nutmeg (preferably freshly grated) ¼ cup berbere (hot pepper spice mix available at East African grocers) 2 tbs. paprika ¼ cup red wine 1 cup of water 4 hard-cooked eggs ½ tsp. ground black pepper 1 clove garlic Pat the chicken dry and rub the pieces with lemon juice and salt. Put the chicken aside.

In a heavy 3 to 4 quart enameled casserole, cook the onions over moderate heat for 5 or 6 minutes or until they are soft and dry. Stir the onions constantly.

Stir in the niter kebbeh and when it begins to splutter, add the garlic, ginger, fenugreek, cardamom, and nutmeg, stirring well after each addition.

Add the berbere and paprika and stir over low heat for 3 to 5 minutes.

Pour in the water and wine, still stirring, and cook over high heat until the liquid in the pan has thickened to the consistency of heavy cream.

Drop the chicken into the simmering sauce, turning the pieces about until they are coated on all sides. Reduce the heat to the lowest point and simmer for 15 minutes.

With the tines of a fork, pierce ¼ inch deep holes over the entire surface of each hard-cooked egg.

Then add the eggs and turn them gently about in the sauce. Cover and cook for 15 minutes more, or until the chicken is tender.

Hello: tena yestilign (“ten-ah yes-tee-ling”) Thank You: Igziabher yestilign (“ig-zi-ah-bear yes-tee-ling”) InSight Magazine

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Photos from Gayle Roberts’ hike up Mount Peak in the foothills of Mount Rainier.

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FIRST PERSON

The Climb One health care worker discovers that physical and emotional challenges require similar skills – perseverance, courage, and, most of all, support

By GAYLE ROBERTS

“When we look at the potential for living more fully through facing our fears, we discover that what we as caregivers do matters deeply. It matters because we learn to honor life by allowing it to unfold on its own. It matters because we learn to be more appreciative of every moment. It matters because caregiving demands from us the best we have - body, mind, and soul.”

- Beth McLeod

Gayle Roberts

T

he little town I live in is nestled in the foothills of Mount Rainier on a plateau. Hiking Mount Peak is a climb many locals frequently do when they want to get in shape. I had heard it was a beautiful but challenging hike, so one morning my son and I decided to climb Mt. Peak.

It is not like I never exercise. I garden, I go for walks, I work around the house. But just a few feet up the trail I realized I was not in the best of shape. I was out of breath from hiking straight up a hill instead of on level ground. It was painful and hard. I absolutely hated it! I complained to my son that I was in my 50s not 20s, and it may be too intense of a hike for me. About that time a woman in her 60s passed us going up.

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alone. Family can walk with me, friends, even professionals walk along at times.

I need to remember that I can stop and rest when I need to. After all, this isn’t a race. I rest when I need to. When I am ready, I stand back up, and start climbing again. I know one day we will turn a corner, and realize we have made it to the top. That will be the day when I can go no further with Mom; she will have to climb to the higher elevation without me. I take comfort in my belief that she will be met by loved ones who have gone on ahead of her.

Caregiving has demanded of me the best that I have - body, mind, and soul. And to be honest, at times I have whined, complained, and said: “I can’t do this.” The mild problems I have in the lower lands – anxiety, fear, melancholy – have become much worse when I am pushed to my limits. But I am doing this. One day, one step at a time, I am doing this. When I get to the top I know I will be pleased that I did my very best for Mom. That I didn’t turn away and let someone else do what I could not. I think when I get to the top of this climb, I will realize I am stronger than I ever thought I was.

ABOUT GAYLE ROBERTS Gayle Roberts is a longtime caregiver, homemaker and mother. She is a contract instructor for the SEIU Healthcare NW Training Partnership.

She started a site called the Beyond the Gate blog to share the “sweet, simple things in life.” www.behindthegateblog.com

PHOTOS COURTESY OF GAYLE ROBERTS

I almost quit just before the last hill. I just could not catch my breath and realized the mild asthma I have was more severe from the exertion of this climb.

My son offered to let me quit, but said, “You know, I think we have only one more hill left, and the view will be worth it.” So on we climbed.

When we got to the top, the view was amazing! Looking at how far I had climbed, I realized I couldn’t have made that climb alone. I needed someone to hike it with me, encourage me when I felt I couldn’t go on, and stop with me when I needed to.

On the hike down, I began to think about my life and the difficult climb I am in right now; caring for my mother who has dementia. It is overwhelmingly painful to be a family caregiver and watch someone you love slowly get worse. After three hospitalizations in just two weeks, we made the difficult decision to place Mom in hospice. I am determined to be there for my mother. Being with her at this time matters greatly, to her and to me. This is one of the most difficult climbs I have ever made. And just like my hike up Mount Peak, I think it is important that I not try to do this climb

FAMILY ESSAY

By GINNY STANSFELD*

Of Care and Kings

PHOTO ILLUSTRATION BY INYE WOKOMA

We found out my dad had brain cancer on November 1 my junior year of high school.

It was a Monday, Dia de los Muertos, the day after Halloween, the eve of George Bush’s reelection; mornings were foggy and the days had just turned much, much longer.

When Afi* entered our lives roughly six months later, he became the newest member of a family we had all ceased to be a part of. Grief had entered our house in the pre-cooked meals dropped off by friends, in home hospital equipment and dropping grades, averted eyes and closed doors. It entered us like radiation as our tight family nucleus rapidly divided, all five of us suddenly in more pieces than anyone could keep track of.

How was Afi to navigate between my sister’s anorexia, my mother’s mindlessness, my brother’s silent stoicism, my absence?

We had been living with illness for months, but Afi was the hardest symptom to ignore. A large, middleaged Samoan man, he was as thick and out of place in our house as the wavy black toupée he wore perched atop his balding head, the occasional displacement of which becoming a sole source of humor.

Afi smiled too much, he smelled too sweet and he made my father’s transformation into an impaired and dying man complete.

I still needed my dad, but my dad needed Afi and I hated Afi for that. A hate that grew each time he readjusted my dad’s hearing aids, poured him water, helped him up the stairs, buttoned his shirt.

I hated that this was the man Afi knew.

He didn’t know my dad the nature guy, who threw science experiment birthday parties, surprised me with cinnamon toast before early morning soccer games, brought home our family’s first guinea pig and helped us bury her in the yard six years later. My dad who played stand-up bass and mandolin, who dragged my family to bluegrass festivals and on camping

trips, who told bedtime stories about ghost cowboys and talking spiders and his delinquent teenage years growing up in Arizona. My dad who was so handsome his chemo and radiation nurses continued to make comments long after he lost his hair and his face swelled up from steroids.

Afi knew the dad who refused to speak to old friends, who cried with frustration when someone said something he couldn’t hear or understand, who inexplicably asked my mother again and again for a bulldog, who couldn’t get out of bed for my high school graduation. My dad who now sat and stared at hours and hours of late-night television, eyes glazed over, his bruised peach of a head rotting into the pillow.

I hated that Afi wasn’t experiencing our loss as profoundly and miserably as we were. My mother, brother, sister and I were sharing the same nightmare, and here was this person, wide-awake, watching us toss and turn in our sleep. I kept

waiting to wake up, sure that any minute Afi would exit, the curtain would fall and he and my father would both re-enter, everyone joining hands for a communal bow.

I hated Afi but I also hated myself for hating him; an excess of hate that was compounded by discomfort and confusion. Our relationship had no prototype – he was an invited but unwanted guest, an unwilling intruder seemingly able to make himself at home in a house where we no longer felt it ourselves. I didn’t know how to know Afi and I didn’t want to know him. How to be polite to someone whose proximity makes your stomach churn? I wondered whether it would have been different for my adolescent psyche had he been younger, older, a woman, a second generation American, thinner, whiter. But the real issue wasn’t who Afi was it was what his presence meant – his entrance into our lives marked my father’s exit.

Even now I try my best to erase him – to erase that entire year and a half. And still the only memory I have from my father’s funeral is of an impossibly solemn Afi draping a Samoan royalty mat across the wooden boards of my dad’s coffin. “Because Daniel was a king.” I realized then that Afi knew our loss even if he couldn’t feel it; he’d probably known many before.

It was the first time I truly appreciated Afi and the last time I saw him. There were no re-entrances, no joined hands, no final bows, nothing to do but draw the curtain and begin again without him. * Names changed to protect confidentiality

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YOUR HEALTH

By RICK SHEPARD, MD

Getting Care in a Hurry: Urgent Care or ER? When sudden illness or a serious injury strikes you or your family, is your first thought: “Maybe we’d better go to the emergency room?� While this may be your best choice for a life-threatening condition, it’s probably not your best option for urgent but less threatening needs.

Between August 2010 and July 2011, Group Health mem-

you’re not sure where to go, what to do, or whether the situa-

bers from the SEIU Healthcare NW Health Benefits Trust (HBT)

tion you’re experiencing is life-threatening, don’t hesitate to call

made about five avoidable emergency room (ER) visits every

Group Health’s Consulting Nurse Service, available 24 hours a

day, a total of about 1,700 avoidable ER visits during the year,

day, seven days a week. The Consulting Nurse Service phone

costing about $2 million. Most of this care should have been

number is on the back of your Group Health insurance card.

provided in a different location at half the cost, and HBT ben-

Group Health emergency and urgent care physicians provide

eficiaries could have saved significant out-of-pocket expense.

on-location backup at the Consulting Nurse helpline for difficult

The personal cost to each beneficiary for an avoidable emergency room visit is a $200 co-pay. As an alternative, doctor’s offices and urgent care centers are capable and willing to treat these same conditions, and your co-pay is just $10 for Group

or unusual problems. This greatly increases the health care

Need care now? Not s advice and treatment that can be offered over the phone. In some cases it’s obvious that 911 should be called.

What if you receive care from a Group Health community

Health and $30 for Kaiser.

What can you do to get the care you need in the best location? You need care right away but may not be familiar with your options. Here’s a brief guide to help you get care right away when you need it.

When it’s urgent but not life-threatening - same day appointments If you need help right away during regular office hours, Group Health’s Medical Centers and most Group Health primary care network physician’s offices offer same-day appointments. Call your doctor’s office and explain why you need an urgent appointment. You may be surprised how quickly you can be seen. It’s best if people see their personal physician for most things because that consistency leads to quality care.

Urgent Care Centers If you can’t wait for regular office hours or for an appointment, what then? Group Health operates walk-in urgent care centers in Western Washington and in Spokane. Also, Group Health contracts with many walk-in community urgent care centers.

The capabilities and hours of urgent care facilities vary from location to location. The Consulting Nurse Service or your community physician can best direct you to the closest urgent care center.

How serious is it? What should I do? Just call and ask Call 911 if you think you have a life-threatening problem. If

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Is this a life-threatening emergency?

No

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >Examples: > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >Call > > > >your >>>>>>>>>>>>>>>> > > > > > > > >■>Crushing > > > > > >or> ongoing > > > > > > chest > > > >pain >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >doctor’s >>>>>>>>>>>>>>>>>>>> > > > > > > > >■>Profuse > > > > >bleeding > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >offi > > >ce > > or > > >the >>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■>Loss > > >of> consciousness > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >Consulting >>>>>>>>>>>>>>>>>>>> > > > > > > > >■> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > (start CPR) > > > > > > > > >No > >pulse >>>> >>>> > > > > > > > > > > > > > > > > > > > > > > > > >Nurse > > > > > Service >>>>>>>>>>>>>>> > > > > > > > >■>Choking, > > > > > >diffi >>> > > >breathing >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> culty >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■>Limbs > > > >deformed > > > > > > or > >severed >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■>First-time > > > > > >seizure >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >Signs > > > of > >stroke: > > > > >sudden > > > > >numbness, > > > > > > >weak>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > >ness, > > > disorientation, > > > > > > > > > >diffi > > >culty > > > speaking >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■>Major > > > >burn > > >or > >electric > > > > >shock >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >■>Sudden > > > > >inability > > > > > to > >walk >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > >Call > > > >911 >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> CHECK > > > > > > > > > > > >

>>>>>>>>>>>>>>>>>>>>>>>> > > > > >YOUR > > > > >ID > >CARD >>>>>>>>>>>>>>>>

YES

Not sure

physician who is part the provider network?

list on your refrigerator and in your wallet that

Many doctors provide after-hours care by be-

includes:

longing to “call groups” where several doctors

•

Your doctor’s name and phone number.

share responsibility for calls. Some doctors

•

Your family’s Group Health consumer

take their own calls. Just check with your doctor before an emergency arises.

numbers.

•

The phone number for the Consulting Nurse Service.

In summary …

•

Everyone knows that if you’re severely

Addresses and phone numbers of the nearest urgent care and emergency facili-

injured, you go to the emergency room. But what if you are getting miserable with a cold,

ties.

•

cut your finger, have sudden back pain, or

Any ongoing health conditions family members are being treated for.

your child is screaming in pain? Your doctor’s

•

office or the Group Health Consulting Nurse Service can direct you to the best care.

•

Medications (and dosages) you’re cur-

ABOUT RICK SHEPARD, MD

rently taking.

Dr. Rick Shepard is Group Health’s Medical Director of Network Utilization.

If you have advance directives (such as durable power of attorney, living will, organ

Are you prepared?

donation card).

The very nature of emergencies is that they happen fast and require quick action. Prepar-

sure what to do? ing ahead can save precious moments. Make

sure you select a personal physical and keep a

Is this urgent?

No

When illness or a card, serious To get a freesudden Medication Record callinjury the strikes you or your family, is your first thought to go to the Emergency Department?

For a life-threatening problem, tha Group Health Resource Line at 206-326-2800

is your best option. But if the problem is less urgent, other steps might get you or 1-800-992-2279. appropriate care even faster—and with a smaller co-pay. Here are some guideline

Is this non-urgent?

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> your > > > > > > >that > > >usually > > > > >DON’T > > > > >require >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >Examples: > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Call >>>>> > > > > > > > > > > > > > > > > > > > > > > >Symptoms > > > > > > > or > >urgent > > > > >care: >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>High >>>> > > >that’s > > > >not > > >coming > > > > >down > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >emergency fever > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >doctor’s >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > fl > u, > >and > > >cold > > >symptoms >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Severe > > > > >asthma > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >offi > > > ce > > >or > >the > > > > > > > > > > > > > > > > > > > >■ > Fevers, >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Nausea, broken bone > > > > >vomiting, > > > > > > >diarrhea >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Possible >>>>>> >>>>> > > > > > > > > > > > > > > > > > > > > > > > >Consulting > > > > > > > > > > > > > > > > > > > > > > > > > > > >■ > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >■ > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Rashes, severe > > > > >skin > > >infections, > > > > > > >insect > > > >bites >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Lacerations > > > > > > > >or >> > > > >cuts > > > > > > > > > > > > > > > > > > > > >Nurse > > > > > >Service >>>>>>>>>>>>>>>>>>>>>>> > > > >burns > > > >and > > >cuts >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Puncture > > > > > > wounds > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >■ > Minor >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Acute > > > >low > > >back > > > pain > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >■ > Headaches >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Second-degree > > > > > > > > > >burns >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Severe > > > > >headache > > > > > > not > > >helped > > > > >by >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >home > > > >treatment >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > >■>Sharp > > > >abdominal > > > > > > > pain > > > >lasting > > > > more >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >than > > > an > > hour >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> ce> > > > > > > > >After > > > > > > offi >>>> > > > > >hours >>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >During > > > > > > > > > > > > > > > > > > >Call > > >your > > > doctor’s >>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >hours > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > >your > > >doctor’s > > > > > > > > > > > > >offi > > ce > >or > >the >>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >Call >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > >ce > >for > >advice > > > > > > > > > > > > >Consulting > > > > > > > Nurse >>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >offi >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> a >regular >> > > > > >offi > >ce > > > > > > > > >Service > > > > >for > >advice. >>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > >During > > > > > >offi > > > ce > > > > > > > > > >After > > > > >hours > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >or >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >appointment.

Call your doctor’s hours >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Call >>>>>>>> > > your > > > >doctor’s > > > > > > > > > > > > >offi > > ce > >or > >the >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>> > >ce > >for > >advice > > > > or > > > > > > > > >Consulting > > > > > > > Nurse >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> offi >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Service a same-day >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> appointment. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> GROUP HEALTH > > >A > >CALL > > OF > >MAY > > > > HELP >> > > YOU > > > >GET > > > >HELP > > > >MORE > > > > >QUICKLY >>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > COURTESY >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> offi > > > >doctor’s >>>>>>> > >ce >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Your >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> your > > > > >you > > >and >>> > > >medical > > > > >history, > > > > > and > > >has > > >access > > > >to > >your > > >medical > > > > > record. > > > > > Group >>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Knows > > > > >medical > > > > > centers > > > > > and > > >other > > > >personal > > > > > >physicians > > > > > > >often > > > >have > > > same-day > > > > > > >appoint >>>>> > > > > > > > Go > > > to > > >an >>> > > > > > >Care > > > > >Center > > > > > > if > >directed. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Health Urgent >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Magazine > > > > >available, > > > > > >especially > > > > > > >if>you’re > > > > fl > exible > > > > InSight > > > > >which > > > >clinician > > > >FALL >> >2011 > see. > > > 13 >>>>>> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ments about you >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

YES

Not sure

YES

Michelle Hannum brushes her motherin-law Ilene Hannum’s hair as part of her daily Home Care Aide responsibililtes.

14

FALL 2011

InSight Magazine

CAREER PATHWAYS

By MANNY FRISHBERG

Building Skills creating CAREERS Spokane Home Care Aide Michelle Hannum goes back to school with a Medical Assisting scholarship to build on her skills, improve her life

W

hen longtime health care

his mother should move in with them so

years. I’ve worked in group homes and

worker Michelle Hannum’s

Hannum could assume responsibility for

in adult family homes. I’ve worked with

mother-in-law needed

her care.

the developmentally disabled.” She says

around-the-clock care, she knew she was the best person for the job “(She has) severe dementia, 100

“I got into this because I am a natural

individual consumers, rather than in

you just develop that nurturing state,”

group settings.

percent incontinent

“The group homes that

and immobile. She’s

I worked in were not as re-

100 percent depen-

warding because it wasn’t

dant, so it’s 24/7 care,”

so much one-on-one. I

Hannum explains.

really decided that I like

“Someone in our family

the time that I can spend

is always here, but I am

one-on-one with a client,

the primary caregiver.

whether it’s family or just

I do have a couple of

someone I’m taking care

daughters here that

of. Just caring for their soul

step in as well. So I do

makes a tremendous dif-

have a good support

ference in their lives.” Two-

system here at home

and-a-half years ago, Han-

so I am able to step out PHOTO BY INYE WOKOMA

she really prefers to work on-on-one with

nurturer. Just having kids of my own …

when I need to.”

Hannum, from Spokane, worked

num, a member of SEIU she says. “I figured I would be best at

775NW, made another change, taking on

making money doing that. I find it very

the job of caring for her mother-in-law,

as a health care aide for a decade, in

rewarding to bring joy to another person

Ilene Hannum, as a Home Care Aide,

skilled nursing facilities, adult family

in a less fortunate situation, whether it’s

through Washington state.

care homes and as a Home Care Aide

medically, emotionally, financially. I’ve

before she and her husband decided

been in the caregiving field for about 12

“The only way we can have her in her home is because I am a paid caregiver

InSight Magazine

FALL 2011 15

can juggle all those responsibilities since the school is offering most of the program online. She will be on campus for a threehour lab session one day a week, when her daughters will be available to take care of their grandmother, both of whom are fully trained in her care.

“While I’m working I get to do school as well as be home, so I just can’t even think of a better scenario to construct this,” Hannum says. After finishing her schooling she expects to gain experience in the job working in a doctor’s office or clinic, though her long term goal is to find a place in a hospital setting where she can work nontraditional hours.

“I’m not necessarily looking for the and can stay home,” she says. “If I had

way, and possibly see where that takes me.

perfect 8-to-5 job, just because my kids

to go generate that income outside of the

I am good at what I do but because I never

are older now and I’m more flexible,”

home, it wouldn’t work to have her here.”

pursued higher education, I have reached

she allows. “I just see myself more in a

my max in responsibility and pay.”

nontraditional setting. I’m not sure where

Providing 24/7 care for her motherin-law is not Hannum’s only full-time re-

this will lead to at this point.”

sponsibility. Now in her mid-40s, she has

in medical offices and clinics, doing a

been married for the past 25 years and is

range of duties including greeting pa-

her is the threat of further cuts to the

raising two girls and two boys of her own,

tients, updating patient medical records

state budget in the coming year and

ranging in age from 14 to 22 years old.

and scheduling appointments as well

what that will do to funding for home

She is also a full-time student at Spokane

as performing basic lab tests draw-

care. She feels that cuts to the program

Community College, working to earn

ing blood, and preparing patients for

that pays Home Care Aides like herself

an AA degree. Thanks to a scholarship

examination. The scholarships (10 were

would be penny-wise but pound-foolish.

from the SEIU Healthcare NW Training

offered to members of SEIU 775NW who

Partnership she will be starting a Medical

are employed as Home Care Aides) are

mind, thinking, where does that send

Assistant program at the community col-

funded by a grant to the Washington

these people that are getting in-home

lege beginning of 2012.

Health Care Worker Training Coalition

caregiving? My mother-in-law, for

from the U.S. Department of Labor, paid

instance.” She says if the state cut the

giver in the union, stating they were

for the through American Recovery and

funding that pays for her to work at home

going to award 10 scholarships. Really, it

Reinvestment Act and administered by

and she had to go elsewhere to earn a

was an answer to my prayers because I’d

the Training Partnership.

living, her mother-in-law would have to

“I got an email, because I’m a care-

already enrolled in school. The amazing

One thing Hannum says really worries

“I just keep playing that out in my

be moved to an adult family home or a

thing is I get to start in January. I don’t

school expenses for five quarters, time

nursing home. As a Medicare-Medicaid

have to wait – it just gets the ball rolling

enough to complete the Medical Assis-

recipient she qualifies for either.

immediately for me.”

tant certificate program. Although most

“Both of those are higher cost to

students can finish in one year, she says

the state than the in-home caregiving.

in becoming a Medical Assistant after

recipients are given the extra time “to

I’m the least expensive option of those

spending time with consumers (clients)

lighten the load a little bit because we’re

three,” Hannum says. “If these programs

approaching the end of their lives.

all working.” Because she had already

are cut, we’re going to be faced with no

“Seeing hospice come in, in several

completed the program’s prerequisites

choice except to place her into a nursing

different instances, I realized there’s so

and taken other classes before getting

home, which will increase the state’s cost

much more to know out there, just about

the scholarship, Hannum will be just five

for her care. So it’s mind boggling to me

the physical part of the body,” she says.

credits short of completing her Associate’s

that they’re cutting what is essentially

“So I’ve recently taken an interest in that

degree, so she plans to take those after-

the least expensive option of the care of

and wanting to further my education that

ward. She says she is confident that she

these clients.”

FALL 2011

InSight Magazine

PHOTO BY INYE WOKOMA

The scholarship will pay Hannum’s

Hannum says she became interested

16

Medical Assistants work with doctors

GRIEF continued from page 6

Get help The Healing Center: Offers grief support groups and individual counseling for adults, children and families who have experience the death of a loved one.

Some services are offered for free, while others are on a sliding scale (based upon your income). www.healingcenterseattle.org Group Health Bereavement Support. Offers support groups for individuals dealing with the death of a loved one. Free. www.ghc.org/classesAndEvents/

Loss Q&A with Shannon Armitage a Seattle-area licensed therapist Q: Does time really heal all wounds?

Q: Is there a sign that you should

A: Time can help. The more recent

seek help?

the event, much more strongly you

A: If your feelings about this loss

might be feeling your emotions. Or

start to limit or affect your daily

you might feel numb until the emo-

activities, that’s a warning sign. For

tions set in, later. But in the immedi-

example, if you’re not enjoying the

ate aftermath, it’s hard not to think

things you used to enjoy or going

about anything else. Time does ease

places you used to go, it’s gone

this a little bit.

beyond what you can handle on your own. You need to reach out to a sup-

bereavementgroups.jhtml

port network or find a professional

Psychology Today Therapy Directory.

person to talk to.

Use this website to find an independent counselor or therapist to help you with your loss. http://therapists.psychologytoday.com Ask your church, mosque or temple whether support groups are offered.

In the Workplace: Many of us have to go back to work,

If someone you know is experiencing loss: Dos and Don’ts Don’t: Try to make them feel better by saying things like “He’s in a better place,” or “Your divorce is for the better” or “You’ll get over it soon.”

Do: Ask how he or she is feeling. Say you’re sorry for the loss and let her know you are available to talk. Offer a hug or your phone number for support.

Don’t: Ignore a person going through loss. Be aware that at one moment, they may feel happy, then they may feel sad or angry.

Do: Ask how they’re doing and watch for signs of depression (never laughing, never smiling). If you’re worried about them, let them know of your concern and point out support groups.

your customers? Visualize a calm, positive day.

4. Take breaks. Make sure you take breaks throughout the day. During that

even when dealing with a loss or grief.

time, focus on your feelings. “Allow your-

Here are ways to make it through the day,

self to feel sad or angry, but be gentle

with suggestions from Shannon Armitage,

with yourself,” Armitage says. Go for a

a Seattle-based therapist:

walk in the sunlight to “reboot” your emo-

1. Summon a saying. Come up with a

tions, because emotional stress can also

reassuring phrase you can repeat when

drain the body. Or find a peaceful spot

you feel stressed or sad. Something like,

on-site or in a park, where you can gather

“Go easy on myself,” or “I promise to

your emotions.

take as good care of myself as I can.” It

5. Find an ally. Share your story with a

can also be a prayer or religious verse

friend; you may find others who have

that has meaning for you, as long as it

experienced a similar loss. A supportive

brings comfort and peace.

ear can help you cope emotionally.

2. Hold on. Find a tactile object (a special pebble, a piece of paper you’ve written a saying onto, a piece of special cloth) that you can keep in your pocket for reassurance, or wear a favorite sweater that comforts. “Children are comforted by blankie,” Armitage says. “We’re not that different from children, although we like to think we’re different.”

3. Visualize the day. Imagine the kind of day you’d like to have, before getting out of bed in the morning or while on your way to work. How will you respond to your supervisor, your coworkers and InSight Magazine

FALL 2011 17

By MANNY FRISHBERG

Putting

People Movement toward “people-first” language puts respect, independence front and center

S

ticks and stones can break my bones

a euphemism). Still, one group that continues to

but words will never hurt me,” the old

routinely face insensitive language is people with

schoolyard chant goes. Yet, while the les-

disabilities. Most people still see nothing wrong

son it was meant to instill about not taking

with saying: “Joe is wheelchair-bound” or “Sarah

taunts and teases to heart was a positive one, our

is retarded.” But those are terms that make it

society has come to another conclusion: words

harder for others to see Joe and Sarah, first and

can hurt.

foremost, as just people.

Emily Rogers is the Self Advocacy Coordinator

“If you’re going to hear a couple of phrases

for The Arc of Washington State, which advocates

that people are most upset about, they would be

for people with developmental disabilities. As a

‘retarded,’ ‘handicapped.’ I guess the third thing

child growing up with cerebral palsy, she recalls

I would say is ‘wheelchair bound,’ ” says David

being teased by schoolmates.

Lord, Director of Public Policy for Disability Rights

“Kids get teased a lot, any kid will get teased,

not bound to it, like basically somebody ties you

I got teased more and with more bite to it,” she

into it. You can get in and out. It’s actually a tool,

says.

something that liberates you, as opposed to being

It is no longer acceptable, as it was half a cen-

FALL 2011

Washington. “You’re a wheelchair user but you’re

but on occasion it seemed that in some regards

tury ago in at least some places, to unthinkingly

18

First

bound to it.”

The movement to change the way people talk

toss off a racial epithet like the notorious “N-

about disabilities and the people who live with

word” (now so taboo even discussing it requires

them has been around for decades. Groups like

InSight Magazine

BEST PRACTICES

sdfsdfsadfsdfsd

Emily Rogers, Self Advocacy Coordinator for The Arc of Washington State, at work at the Capitol in Olympia during the special legislative session in December.

PHOTO BY INYE WOKOMA

InSight Magazine

FALL 2011 19

People-First Language to Use

Terms that Stereotype and Devalue

people/individuals with disabilities an adult who has a disability a child with a disability a person

the handicapped the disabled

people/individuals without disabilities typical kids

normal people/healthy individuals atypical kids

people with intellectual and developmental disabilities he/she has a cognitive impairment a person who has Down syndrome

the mentally retarded; retarded people he/she is retarded; the retarded he/she’s a Downs kid; a Mongoloid

a person who has autism

the autistic

people with a mental illness a person who has an emotional disability with a psychiatric illness/disability

the mentally ill; the emotionally disturbed is insane; crazy; demented; psycho a maniac; lunatic

a person who has a learning disability

he/she is learning disabled

a person who is deaf he/she has a hearing impairment/loss

the deaf

a man/woman who is hard of hearing person who is deaf and cannot speak who has a speech disorder uses a communication device uses synthetic speech

is deaf and dumb mute

a person who is blind a person who has a visual impairment man/woman who has low vision

the blind

a person who has epilepsy people with a seizure disorder

an epileptic a victim of epilepsy

a person who uses a wheelchair people who have a mobility impairment a person who walks with crutches

a person who is wheelchair bound a person who is confined to a wheelchair a cripple

a particular dislike for the word “re-

a person who has quadriplegia people with paraplegia

a quadriplegic the paraplegic

continued to be used in federal laws

he/she is of small or short stature

a dwarf or midget

he/she has a congenital disability

he/she has a birth defect

accessible buses, bathrooms, etc. reserved parking for people with disabilities

handicapped buses, bathrooms, hotel rooms, etc. handicapped parking

older adult

elderly

consumer

client, patient

the National Easter Seal Society and the National Rehabilitation Association have been writing about respectful terminology for talking about disabilities since at least the mid-1980s. In 1992, John Folkins of the American Speech-LanguageHearing Association’s publications board put out extensive guidance on the subject as a resource for editors and authors. Still, the movement really gained traction when, in 2005, Washington state led the way in adopting what has come to be known as “People-First Language” in the state’s laws and regulations. Rogers was one of the principal advocates for the bill, which replaces older terms in laws when they come up for renewal or revision.

Lord explains, “Over the last few years we’ve been going through a process of changing all of our statutes and all of our regulations to language that’s respectful to people with disabilities.” He says some examples are using the term “people with disabilities” and not “disabled people” or “handicapped.” Lord says the coalition to lobby for that change was spearheaded by people with developmental disabilities who had tarded.” Ironically that bill didn’t get rid of that particular word because it and they wanted to make sure that the change did not cause any confu-

Adapted from the Texas Council of Developmental Disabilities

20

FALL 2011

InSight Magazine

sion. That was remedied a few years ago when a national bill to discard the term was passed.

Rogers adds that while the real process of change comes through educating people, one by one, she is hopeful that the statute can help affect people’s perception of what is respectful and appropriate.

“It’s not going to come from top-down,” she says, “but rather (through) personal conversations with

one another.”

While the movement to change the ways we talk about someone who uses a wheelchair to get around or a person with a developmental disability is making headway, advocates for people-first language face ridicule for promoting “political correctness.” But Rogers says the real issue is respect.

“So many people that I worked with in the past … have felt really disrespected and really put down and really upset by the use of some of the old terms referring to folks with disabilities,” she says. “It’s a

Then-Gov. Gary Locke at the 2004 bill signing to create a “people-first” language standard for Washington state. Emily Rogers is next to him on the left.

visible reaction that people have to terms like ‘retarded’ and that sort of thing. So, for them it’s very personal and it’s very

I’m a person, then I have a disability, and

From the perspective of Home Care

emotional. Really, the respect issue is

then I’m a mom or a dad, or a husband,

Aides and others who work with people

huge. Lots of folks with disabilities feel

or whatever it is. As a person with a dis-

with disabilities, it can be a matter of pro-

hugely disrespected and almost as if

ability, my value doesn’t come from my

fessionalism, one of those things people

(they’re) second-class citizens because

disability. It’s part of my life and it’s part

learn when they’re in a profession. How

of their life experience.”

of how I experience life, but it’s not me.”

much it matters to a client may be an

The concept of “people-first language”

individual preference.

not everyone with a disability feels

and they do not define who a person

equally strongly about the issue. He says

a transfer – you can do a transfer right

is, so the general rule is to not replace

there is no unanimity on which words or

or you can do it wrong,” Lord says. “But

personal nouns with disability nouns, like

phrases are to be avoided

there’s also variations – different people

“the schizophrenic,” “stutterers” or “the

“I hear a lot of people refer to them-

“There’s some things, like how you do

have different kinds of views on how they

hearing impaired.” Instead, advocates

selves as handicapped. People have

want the transfers done. I think it’s that

say, use terms that emphasize the per-

different perspectives,” he says. “A lot

way with language. It’s good to know and

son rather than the disability by putting

of people don’t care, and other people

to be sensitive.” At its core it is a ques-

the person-noun first, using phrases

think that it’s really important. There’s an

tion of respect, on both the individual

such as “the lawyer who has dyslexia,”

approaching consensus on some things.

and societal levels.

or “people with cleft palate.”

I think there’s probably consensus on the

“I think that words have huge power

“In terms of people-first language and

PHOTO COURTESY OF EMILY ROGERS

At the same time, Lord acknowledges,

is the idea that disabilities are not people

word ‘retarded.’ Fairly recently the medi-

and that we need to be conscious about

respectful language, the idea is that the

cal community figured out that was in

how we speak about one another, includ-

person is going to come first in the way

the same category as ‘idiot’ or ‘imbecile’

ing people with disabilities,” Rogers

that you speak, and the way that you

– words that used to be legitimate medi-

adds. “I’m hopeful that in changing the

describe it,” Rogers says. “It’s really

cal terms that are now obsolete and of-

way that we speak that we take on a

about having the disability be the thing

fensive and slurs. That’s where ‘retarded’

different angle. For me the difference in

that comes after the descriptor of the

is right now. There’ll be another word

language means that everybody has the

person. So there’s sort of a separation –

some other day.”

same opportunities.”

I’m a person, then I have a disability, and then I’m a mom or a dad, or a husband, or whatever it is. As a person with a disability, my value doesn’t come from my disability. It’s part of my life and it’s part of how I experience life, but it’s not me. - EmILY ROGERS InSight Magazine

FALL 2011 21

SPOTLIGHT

STORY By DORI CAHN PHOTOS By INYE WOKOMA

a day in the life From exercise, medication, cleaning, transfers, grooming – a day with Home Care Aide Rae Kirumbi is anything but dull

W

hen you ask Rae Kirumbi about his job as a Home

and give (it to) them, and just spend time with them and show

Care Aide, his face breaks into a wide smile. A soft

them how much you care. You don’t have to know the person but

spoken man with kind eyes and a gentle manner,

the way they appreciate, you go home with that satisfaction. It’s

Rae positively beams when he talks about his work. “It’s very,

something you cannot buy.”

very rewarding,” he says. “You feel your life is richer.”

Before he was a trained Home Care Aide (HCA), Kirumbi

His first consumer (or client) suggested he go to an agency to get paid for the work he was already doing. Employed by Full Life

volunteered with people in hospitals. “On my days off I would just

Care for almost five years now, he also works in the memory care

go to hospitals and visit people and spend some time with them,”

unit at Emeritus assisted living facility in Bellevue, where he has

he says. “If I have something to buy, just one orange, I go there

become an assistant director.

Above left: Rae Kirumbi and Loren Mott study the exhibition guide for the Frye Art Museum’s resident collection.

Above: As a part of their weekly routine Kirumbi helps Mott do exercises.

Right: Kirumbi gives Mott a haircut.

22

FALL 2011

InSight Magazine

Kirumbi and Mott frequently go on walks and outings after they finish their weekly household duties. One of Mott’s favorite places to visit is the Frye Art Museum.

InSight Magazine

FALL 2011 23

Kirumbi meets with Luster Mitchell Sr. on a weekly basis.

Mitchell uses a wheelchair to get around most of the time, however with a leg brace he is able to go short distances using a walker.

Navigating cultural differences can take more than acceptance and adaptation. Kirumbi tells of a co-worker whose consumer asked her to cook pork, something that the HCA could not do. But the consumer did not want to lose the Home Care Aide, and so they had to brainstorm ways for the consumer to get the food he wanted without asking the HCA to do something against her wishes.

Going to work in someone else’s

24

kinds of relationships and people, but

ly, Kirumbi has never found that these

home requires trust and mutual respect.

the cultural differences he finds here

differences inhibit building relationships

Knowing how to achieve this comes

have sometimes surprised him. When

with a consumer.

from experience and guidance, which

the mother of a 45-year-old male con-

Kirumbi offers to new workers through

sumer showed Kirumbi how to give her

favorite job. While it can be extremely

the Training Partnership’s peer mentor-

son a bath, he was shocked to see a

challenging to care for people with

ing program. “That’s a training I wish I

woman bathing an adult male, some-

Alzheimer’s and dementia, he finds it

had when I started,” he says. “Because

thing that would never happen in his

exciting. Those consumers are also some

having this person who is not your

home culture.

of the most grateful and rewarding, often

Working in memory care is Kirumbi’s

supervisor … you create that friendship,

Navigating cultural differences can

and they are free to ask any questions.”

take more than acceptance and adapta-

Kirumbi helps mentees learn how to

tion. He tells of a co-worker whose

develop relationships while maintaining

consumer asked her to cook pork, some-

shift and I went to change him. This per-

professionalism.

thing that the HCA could not do. But the

son, he used to be a doctor, and he lost

because they have the hardest time showing it.

“I have one person, I was working my

Kirumbi came to the United States

consumer did not want to lose the Home

his ability to speak. So after… making

from Tanzania in East Africa nearly 10

Care Aide, and so they had to brainstorm

sure he was comfortable, on my way out,

years ago. Growing up in a home with

ways for the consumer to get the food

I was at the door, holding the door, and

seven children and a large extended

he wanted without asking the HCA to do

at the back I heard him say ‘thank you.’

family prepared him to deal with many

something against her wishes. Fortunate-

That meant a LOT to me. Just thinking

FALL 2011

InSight Magazine

about how hard he tried to have that word. I can never forget that.”

Working in memory care also means seeing consumers pass away, some of whom may have been in care a long time. “We have some people who have lived there for five years. You used to play puzzles with this person, they used to be able to do everything by themselves.

“They really encourage us not (to get) attached. I don’t know how you can work without being attached. Because this type of work needs people who are caring. And you are caring for them every day. I don’t know how you can do that, but most training they say, ‘OK, you be a professional, just go there to work, and Kirumbi and Luster Mitchell Jr. help the senior Mitchell transfer from his wheelchair to another seat.

don’t be attached to them.’ But these are people, they affect our lives.

Kirumbi also continues to work with in-home consumers. When there is a family in the home, relationships and respect need to be built with every member of the household. One of his current consumers is person who is recovering from a stroke who lives with his family, including a wife and grandchildren.

Noise and activity fill the house, and Kirumbi tackles the task of becoming an integral part of the household while maintaining his professional role. The consumer had already kicked out several Home Care Aides by the time Kirumbi met him. “The first time we are trying to read each other, and I’m trying to make him comfortable. Everyone called him grandpa, so I asked him, ‘Is it OK if I call you grandpa?’ He said OK. I just wanted to blend in. And slowly he started to treat me like he treats his grandchildren.”

Once the family could see the relationship Kirumbi had with the grandfather, they came to appreciate him and respect the systems he created that ensure complete and methodical care for his consumer.

A Home Care Aide may sometimes want to change the consumer’s routine, but if the consumer is free to make choices and be themselves, “they are

able to trust you. They know you don’t

try to put myself in their shoes, and say

judge them, you are their friend, you

‘maybe I’ll be like them.’ And that helps

have that unconditional friendship,” he

me not to criticize or be mad, helps me

says. “You help them to feel good and

to be more professional, to know I will be

… not to become totally dependent

like them too.”

on other people.” Sometimes it means

The intangible rewards of the work

letting the consumer make choices that,

have kept Kirumbi working in home

while safe, may be unconventional, like

care for more than seven years. “If

wearing two different socks or sleeping

you want to work as a Home Care Aide

until two in the afternoon. Sometimes it

just for money, it won’t work,” he says.

means having to confront a family mem-

“What we do is way more than what

ber’s expectations or desires; they may

we get paid for. I can say this – you get

want their loved one dressed a certain

two paychecks. There’s one paycheck

way or be awake when they come to

you get after every week or at the end

visit.

of the month, and there’s one you get

It often will fall to Home Care Aides

every day, that you got the chance to

to help families come to grips with the

help someone. You can go home and

changes that aging or illness has brought

lay down on your pillow and say, ‘ah, I

to their loved one.

helped this person.’ ”

“It’s hard. I don’t think I’ll be able to do this to my mom or my dad,” Kirumbi admits. “When I have a difficult situation and I’m trying to explain something (to a family) and they don’t understand, I just InSight Magazine

FALL 2011 25

GENERAL

BENEFITS INFORMATION

Training Quick Start

UPDATED DECEMBER 2011

In this Section

Individual Providers 1. Find Your Training Standards • There are different Home Care Aide standards depending on what category of care you provide.

• Use the online Training Wizard – a tool to help you know which category applies to you – to find your individual training standards.

Go to: www.myseiubenefits.org/wizard to complete the Wizard.

2. Schedule Training Early • Locate or create your Username and Password (see page 8 of your Benefits Book).

• Go online to www.myseiubenefits.org to log in to register for training or call the Member Resource Center at 1-866-371-3200.

This section of the magazine will update you on changes to your Training and Health benefits since the Benefits Book was published in July 2011. In addition, this section will highlight important information and resources that may be helpful to you. If you do not have a Benefits Book and would like one, please contact the Member Resource Center.

3. Get Student ID Card in the Mail • Your Student ID card will be mailed to the mailing address you provided to your primary DSHS contact. If you don’t receive your ID card within 7-14 days of your hire date, fill out a Contact form at www.myseiubenefits.org/contact or call the Member Resource Center at 1-866-371-3200.

Agency Providers 1. Review chart on Page 26 of your Benefits Book to see who can support you.

Health Benefits Quick Start 1. Check your eligibility for health insurance benefits and enroll Individual Providers: Go online to www.myseiubenefits.org to log in to see your eligibility and enroll online, or call the Member Resource Center at 1-866-371-3200. Your eligibility for health insurance depends on the number of hours you work.

Agency Providers: Contact your employer to see if you are eligible for health benefits through your employer.

2. Make an appointment with your primary care doctor Go to your health insurance provider’s website or contact them by phone (see contact info on Page 5) to find available doctors and other providers. See the Health Benefits section for more details.

For Assistance

việc lên lịch đào tạo hoặc tìm hiểu về điều kiện để nhận phúc lợi y tế.

Comuníquese con el Centro de Recursos para Miembros al 1-866-371-3200 si necesita asistencia para registrarse en su entrenameinto o para saber cuál es su elegibilidad para los beneficios de salud.

훈련일정을 잡거나 건강혜택 자격 확인을 위해 도움 이 필요하시면 회원지원센터 1-866-371-3200로 전 화주세요.

如需在安排培训日程或了解您是否有资格获取保健福 利方面获取协助，请致电 1-866-371-3200 联系会员 资源中心。 Hãy gọi Trung Tâm Nguồn Lực Thành Viên theo số 1-866-371-3200 nếu quý vị cần được trợ giúp trong

26

FALL 2011

InSight Magazine

Если у Вас есть вопросы, связанные с определением расписания занятий, или относительно получения Вами пособия по нетрудоспособности, обращайтесь в Учебнометодический центр по телефону 1-866-371-3200.

TRAINING

BENEFITS INFORMATION I-1163 PASSES, NEW TRAINING STANDARDS BEGIN JAN. 7, 2012 With the November 2011 passage of Initiative 1163, new training

with the MRC or your employer to determine your training require-

standards for Home Care Aides go into effect on Jan. 7, 2012. These

ments. To understand these changes, please see the revised training

revised training standards apply only to those Home Care Aides hired

grid below.

on or after Jan. 7, 2012. If you were hired before Jan. 7, 2012, check

For Existing Workers For providers whose categories are eliminated when 1163 goes into effect: •

Basic Training Exemptions

Certification Exemptions

•

•

If you worked as either a standard or

If you were a Childcare IP or Respite

Parent Provider, you are not required

credentialed IP or AP in 2011 and

worker, you will be re-categorized

to take any additional basic training,

have completed all your training, you

as you are grandfathered in.

are not required to take and pass the

If you were hired prior to Jan. 7,

certification exam, although you may

worked per month.

2012, you are only required to com-

elect to become certified.

Re-categorization will occur on January

plete the training standards in effect

7, 2012, at which time you will have

at the time of your hire. Your deadline

120 days to complete the appropriate

for training does not change.

as an IP or Limited Service Provider, depending on the number of hours •

If you worked in 2011 as an IP, AP or

•

basic training (either 70 or 30 hours).

Certification requirements may apply.

TRAINING STANDARDS - APPLIEs TO those hired on or after Jan. 7, 2012 ORIENTATION AND SAFETY

CONTINUING EDUCATION

BASIC TRAINING

Continuing Education 12 Hours

Orientation 2 Hours

Safety Training 3 Hours

Accelerated Basic Training 30 Hours

Basic Training 70 Hours

Parent Provider Class 7 Hours

Agency Provider (AP)

Completed prior to providing care

Completed prior to providing care

Not required

Within 120 days of employment

Not required

12 hours/year for the renewal of certification

Yes

Individual Provider (IP)

Completed prior to providing care

Completed prior to providing care

Not required

Within 120 days of employment

Not required

12 hours/year for the renewal of certification

Yes

Credentialed AP

Not required

Not required

Not required

Not required

Not required

12 hours/year for the renewal of certification

Yes

Credentialed IP

Not required

Not required

Not required

Not required

Not required

12 hours/year for the renewal of certification

Yes

Parent Individual Provider (HCS/AAA)

Completed prior to providing care

Completed prior to providing care

Within 120 days of employment

Not required

Not required

Not required, unless voluntarily certified

No

Parent DD IP (DDD)

Completed prior to providing care

Completed prior to providing care

Not required

Not required

Within 120 days of employment

Not required, unless voluntarily certified

No

Childcare IP (DDD)

This training category no longer exists under 1163. If you were previously this type of worker, you will be recategorized as either an Individual Provider or a Limited Service Provider.

Respite Worker (DDD)

This training category no longer exists under 1163. If you were previously this type of worker, you will be recategorized as either an Individual Provider or a Limited Service Provider.

Limited Service Provider (see note)

Completed prior to providing care

Completed prior to providing care

Within 120 days of employment

Not required

Not required

Not required, unless voluntarily certificed as a HCA.

No

Adult Child Individual Provider (HCS/AAA/DDD)

Completed prior to providing care

Completed prior to providing care

Within 120 days of employment

Not required

Not required

12 hours/year on date of birth

No

InSight Magazine

Certification Required?

FALL 2011 27

TRAINING

BENEFITS INFORMATION

HOME CARE AIDE WORKER CATEGORIES - EFFECTIVE JAN. 7, 2012 Home Care Aide (HCA)

Provide care to a consumer living in his or her home. Employed by a private homecare agency or DSHS.

Certified Home Care Aide

Provide care to a consumer living in his or her home having succesfully passed the DOH certification exam. Employed by a private homecare agency or DSHS.

Agency Provider (AP)

Provide care to a consumer living in his or her home. Employed by a private homecare agency.

Individual Provider (IP)

Provide care to consumer living in his or her home. Employer of record is DSHS

Credentialed Agency Provider

This is an AP with a current healthcare credential as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Nursing Assistant Certified (NAC), Physical Therapist, Occupational Therapist or Medicare-Certified Home Health Aide.

Credentialed Individual Provider

This is an IP with a current healthcare credential as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Nursing Assistant Certified (NAC), Physical Therapist, Occupational Therapist or Medicare-Certified Home Health Aide.

Parent Individual Provider (HCS/AAA)

This is an IP who provides care to his/her own adult child and contracted through Home and Community Services (HCS) and/or an Area Agency on Aging (AAA).

Parent DD Individual Provider (DDD)

This is an IP who provides care to his/her own adult child with a developmental disability and is contracted though the Department of Developmental Disabilities.

Limited Service Provider (HCS/AAA/DDD)

This is any IP who provides care 20 hours a month or less for one consumer.

Adult Child Individual Provider

An adult child providing care for his/her biological, step or adoptive parent.

HOW TO GET THE MOST OUT OF YOUR TRAINING Use the Training Wizard Start with the easy online Training Wizard to find the training you need. Go to: www.myseiubenefits.org/wizard to complete the Wizard.

Register Early for Training If you need Basic Training, we encourage you to register for your classes within the first 30 days of hire to get the best choice of class options. If you need Continuing Education (CE) classes, register as early as possible to get the best choice of class options before your deadline. If your birthday falls before or on June 30, 2012 your deadline is June 30th, 2012 and you are required to complete 10 hours of CE. If your birthday is after June 30, 2012, your CE deadline is your birthday and you are required to complete 12 hours of CE. NOTE: If you are an AP, please refer to page 26 of your Benefit

The www.myseiubenefits.org web portal is your comprehensive resource for available classes, your current training status,

Book for who to contact to get registration support.

benefits eligibility and much more. Log in to the portal first to

Take Online Learning for Continuing Education Credits

and password are in your Benefits Book on Page 8.

Online Continuing Education courses are an easy and convenient way to get the CE hours you need as a Home Care Aide.

You can view available courses, take classes and view your credits all from your computer – 24/7. NOTE: If you are an AP, please check with your employer before registering for online CE.

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Go Online for Fastest Service and Support

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InSight Magazine

get the answers you need. Instructions to getting a username

Update Your Contact Info Ensure you are receiving the most current information about your training by updating your contact information with your employer. If are you an Individual Provider, update your information with your primary DSHS contact. If you are an Agency Provider, update your information with your employer.

TRAINING

BENEFITS INFORMATION

NEW ONLINE CONTINUING EDUCATION CLASSES, BOOKMARKING AVAILABLE New Online Continuing Education Lineup Best Practices for the Professional HCA Now available in English AND Spanish Multiple Sclerosis Now available in English AND Spanish Traumatic Brain Injury Now available in English AND Spanish Body Mechanics Now available in English AND Spanish Infection Control and Workplace Safety In an ongoing effort to provide multiple platforms for taking Continuing Education, the Training Partnership released a number of new additions to the Online Continuing Education portion of the web portal.

In early December, six new English-language classes were

Updated for Error Now available in English AND Spanish Better Health through Nutritious Cooking Now available in English AND Spanish An Introduction to Developmental Disabilities Now available in English AND Spanish

added: •

Relationships between Consumers

An Introduction to Physical Disabilities

•

Home Care Aides Make a Difference

Now available in English AND Spanish

•

Supporting Consumer Independence

An Introduction to Mental Illness

•

The Faces of Down Syndrome

Now available in English AND Spanish

•

Dispelling Disability Myths

•

Promoting Creativity

Important Note: These courses were available in early 2011 for a short time so if you took them at that time, you cannot take them again. If you did not take them then, they are available to take online.

In addition to the new English courses, there are 10 additional Spanish-language versions of existing Online CE courses.

In addition, the system will now allow bookmarking, which will make it more convenient for students to take classes online.

Prior to Dec. 2, if a student stopped an eLearning course before completing it, they had to restart it from the beginning.

As of December 2nd, they will no longer have to do that. The

An Introduction to Dementia Now available in English AND Spanish NEW: Relationships between Consumers NEW: Home Care Aides Make a Difference NEW: Supporting Consumer Independence NEW: The Faces of Down Syndrome NEW: Dispelling Disability Myths NEW: Promoting Creativity Each online course takes about one hour to complete, which may vary depending on learning style, material covered and Internet connection speed.

next time they take an incomplete course, they will be taken to the screen previous to the last screen they were on when they stopped the course.

With online classes you pick the time and topics that work for you. You can see the available courses, register and access courses, receive credit, and navigate help information – all online and all 24 hours a day!

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FALL 2011 29

HEALTH

BENEFITS INFORMATION

POLICY UPDATES Please substitute the following update

initial eligibility.

for Frequently Asked Question #12 on page 54 of your Benefit Book.

Example: If an Agency Provider is enrolled on Sept. 30, 2011 but does not

(86) hours in January, her health coverage

meet the work requirements for ongo-

will terminate on March I (unless she ar-

What happens if I work fewer than 86 hours

ing eligibility in October 2011, her health

ranges to self-pay through COBRA).

in a month after I am enrolled in the plan?

benefit will terminate on November 1.

You must first determine if you are considered a “Grandfathered Agency Provid-

Why there is a difference? In the past,

2011 (unless she arranges to pay through

agency providers did not have a lag month,

COBRA).

while Individual Providers did. The Trust

er.” “Grandfathered Agency Providers”are

If you are not a Grandfathered Agency

was asked to adopt a policy that establish a

those agency providers who have coverage

Provider, there is a lag month between

lag month for Agency Providers. As a result,

as of September 30, 2011. Grandfathered

when you do not meet ongoing eligibility

all new Agency Providers wait an extra

Agency Providers who do not meet the

and when your health coverage ends.

month for health benefits, and have their

ongoing eligibility requirements will have

As a result, all other eligible Participating

health benefits continue an extra month,

their health coverage terminate the first

Employees (Agency Providers, who enroll in

once they no longer meet the ongoing eligi-

day of the first month following the month

coverage on or after October 1, 2011 and

bility requirements. Existing Grandfathered

that they no longer meet the ongoing eligi-

all Individual Providers), who do not meet

Agency Providers, however, started their

bility requirements. Grandfathered Agency

the ongoing eligibility in a given month will

health benefits without the lag month (one

Providers shall continue to be considered

not be eligible for coverage the first day of

month earlier than everyone else). As a re-

“grandfathered” unless and until the

the second month following the month they

sult, they do not have a “lag month” when

Agency Provider is required to re-establish

did not meet the eligibility requirements.

they no longer meet ongoing eligibility.

Participating Employers UPDATE Washington employers whose employees are eligible for benefits through the Health Benefits Trust. NOTE: This list may change, check with your employer to verify participation.

AAA Residential Services Addus Healthcare Amicable Healthcare Catholic Community Services CDM Chesterfield Healthcare Coastal CAP Full Life Home Care Services of Montana KWA Lower Columbia Community Action Council Oly CAP ResCare Senior Life Resources Northwest State of Washington (employer of record) Visiting Nurse Home Care

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Example: If a non-grandfathered Participating Employee fails to work eighty-six

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InSight Magazine

BENEFITS INFORMATION

HEALTH

HEALTH BENEFITS QUICK START

DID YOU KNOW? Urgent Care is a much more affordable option for Home Care Aides through the Health Benefits Trust. The out-of-pocket cost for a trip to the emergency room is $200 (waived if you are admitted to the hospital) vs. just $10 for a trip to Urgent Care with Group Health Options and $30 with Kaiser.

Check Your Eligibility for Health Benefits •

You must work at least 86 hours per month for three consecutive months to be eligible for these benefits. You do not need to wait until you are eligible to enroll, you can complete the form after you’re hired.

Apply Individual Providers: In order apply for enrollment an enrollment form must be complete and received by the Trust. Forms can be found by logging into www.myseiubenefits.org Agency Providers: Talk with your employer about applying for enrollment.

URGENT CARE

Where to Find Urgent Care

Look for Your ID Card

GROUP HEALTH OPTIONS: Seven Group Health medical clinics have Urgent Care Centers, most with evening, weekend, and holiday hours. Use the Provider Directory online to find urgent care providers in other areas.

After you apply for enrollment and eligibility is confirmed, you should receive an ID Card in the mail. You will need the ID card number to access your benefits. If you do not receive the card by the 10th of the month that your coverage starts, call the MRC at 1-866-371-3200 if you are an Individual Provider or if you are an Agency Provider, talk with your employer. Look for and write down your nearest Urgent Care Center and keep it with your card for reference.

KAISER: Find an Urgent Care Center at www.kp.org

Fill Out Your Health Profile or Health Assessment The Health Profile or Assessment is an online quiz and report to help you manage your health. To help encourage participation, you will receive a check for $25 for filling it out.

Make a Primary Care Appointment

URGENT CARE

Use the online provider directory at www.ghc.org or www.kp.org to find a primary care doctor who’s a good match for you. You will receive $10 for attending a preventative care/wellness appointment within the first three months of your coverage.

URGENT CARE

Locate Your Nearest Urgent Care Center URGENT CARE

As soon as possible, you should identify the closest urgent care center to you in case of an emergency. You can find urgent care centers online at www.ghc.org or www.kp.org.

Manage Your Prescriptions If you have existing prescriptions, have them transferred to Group Health Options or Kaiser Permanente. Next, set up mail order prescription refills online to save money and save time.

URGENT CARE

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FALL 2011 31

635 Andover Park W. Suite 200, Tukwila, WA 98188

www.myseiubenefits.org

ADVERTISE WITH HOME CARE INSIGHT WHAT IS HOME CARE INSIGHT? Home Care Insight is the go-to magazine for over 50,000 Home Care Aides in Washington and Montana. Its relevant writing engages readers with columns and articles that highlight the interests, needs and experiences of the Home Care Aide, as well as detailed information they need to access the best of their benefits. Other articles encourage readers towards healthier living, through nutrition, good use of health care and exercise. Home Care Insight is an indispensable resource for Home Care Aide and their families, consumers and employers.

CIRCULATION Home Care Insight is mailed directly to more than 40,000 actively employed Home Care Aide living in Washington, Idaho, Oregon and Montana. It is available at more than 100 agency and state offices, reaching thousands more direct care workers in healthcare. Total Circulation: 50,000; Readership: 150,000+ 32

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InSight Magazine

Editorial Calendar, Ad Rates and Production Specifications For details on our editorial calendar, ad rates and production specifications contact Christine Jimenez at 206-254-7125 or Christine.Jimenez@myseiubenefits.org.