Senior Spectrum Newspaper October 2012

36

Editor’s Desk:

Vote YES on WC-2

N

evada seniors will be asked to vote for a non-binding Advisory Question this November 6th, asking if Washoe County should increase the Government Service Tax (GST) one percent to support seniors, public safety, and infrastructure.

Little is known about the Advisory Question as it has not been given much publicity, but when you go to vote this fall, the question will be on the ballot. Washoe County seniors should vote YES on this question because it will give the existing and new Washoe County Commissioners direction on funding for senior service programs for residents who need it.

Why should you vote for WC-2? Because the funding is desperately needed. Many of you may not be aware but because of declining property taxes and budget cuts, Washoe County Senior Services is close to cutting, eliminating or contracting out much of its services that provide the disadvantaged with nutrition programs, legal services, adult day care, representative payee, case management, and home care.

These programs are a good thing for low-income elders who do not have the resources to live without help during their retirement years.

Additionally, the popular Meals on Wheels program that delivers meals to isolated homebound elders, and the congregate meals provided at the senior center may be scaled back even though the population is growing. This means there is less money, less staff, less resources to provide nutrition services.

Older people will go hungry.

Vote YES on WC-2! If

enacted, the GST will appear on vehicle registration bills from the Department of Motor Vehicles. The average, which means not every registration bill, may increase $43! However it could generate over $9 million for vital services.

While it will not benefit Incline Village seniors who provided the argument against WC-2, it will support those who for whatever reason need assistance. Those of us who do not need this help are indeed fortunate in these difficult times.

Senior Law Project In October, the Washoe County Senior Services Advisory Board will hold a series of meetings to discuss whether the Senior Law Project should be discontinued, remain intact, or be contracted out to another law firm.

A few years ago a similar process occurred that included public meetings and a town hall type of gathering for input about the program.

Testimony came from staff, clients and previous users of the legal firm, that offers service to low-income seniors. Reductions in program funds and budget cuts have resulted in the elimination of staff and resources. More recently, the courts have questioned if the Senior Law Project can continue to perform its duties regarding cases brought before it.

Hopefully these series of meetings, facilitated by Social Entrepreneurs, will provide a thoughtful recommendation to be forwarded to Senior Services Director Grady Tarbutton and eventually the County Commission.

Comments should be mailed to www.co.washoe.nv.

October 2012 This Issue

page 3 - Editor’s Desk: Vote YES on WC-2 for Seniors page 4 - Nevada Silver State Health Insurance Exchange page 5 - Roadmaps From Democrats and Republicans: Two Very Different Paths page 6 - Opinion: The Truth About the Medicare Debate page 12 - Tools for Your Toolbox page 17 - Silver Haired Legislative Forum Votes on Priorities page 21 - HCQC: Quality Improvement in Nursing Homes page 26 - Medicare is Targeting Quality and Hospital Readmissions page 27 - Lend-A-Hand Senior Services Celebrates 20-Years! page 30 - Sparks Senior Center Gets New Improvements page 32 - SSA: Supplemental Security Income Helps the Needy

Every Issue

page 29 & 31 - Calender page 31 - Crossword page 33 - Biggest Little City Harry Spencer page 36 - this ‘n that - Anne Vargas page 38 - Eclectic Observer Janet Ross page 39 - Eydie Scher - Excerpts page 41 - Seniors 4 Travel Robert Boyd & Carolyn Prusa

Health

page 14 - Health Prevention Dr. Lawrence J. Weiss, Ph.D. Center for Healthy Aging page 18 - CMS: David Sayen Medicare Questions page 19 - Caregiving: Dr. Marion Benefits in Volunteering page 19 - Ophthalmology: Dr. Michael Fischer, M.D.

Financial

page 7 - Why Everyone Needs an Estate Plan Bradley B. Anderson

Senior Spectrum Newspaper P.O. Box 7124 • Reno, NV 89510 (775) 348-0717 e-mai l : S eni orspectrumnv@aol . com S eni orspectrumnewspaper. com Publishers: Chris & Connie McMullen

Senior Spectrum is a monthly publication dedicated to inform, serve, and entertain.

Publication of advertising contained does not constitute endorsement. Signed columns are the opinion of the writers, and not necessarily the opinion of the publishers.

Copyrighted publication. All rights reserved.

October • 2012 • 3

Update:

Silver State Health Insurance Exchange The Nevada Insurance Commissioner is expected to select and submit to the federal government for approval health insurance plans that will be part of the Silver State Health Insurance Exchange to provide coverage for the states uninsured.

Nevada has received five grant awards to build its Affordable Insurance Exchange totaling over $76 million as of August 2012.

Nevada’s exchange received a Level Two Establishment grant to meet certification requirements in January 2013, provide coverage to enrollees by January 1, 2014, and to achieve self-sustain-

4 • 2012 • October

ability by January 2015 as required under the federal Affordable Care Act. In August, the Board of Examiners approved a contract with Xerox State Healthcare to set up the computer system and operations needed to begin enrolling people by October 2013.

Nevada Governor Brian Sandoval is expected to include the exchange in his 2013-2015 budget now being drafted for the 2013 legislative session. Nevada opted to develop its own exchange rather than letting the federal government operate it.

(Exchange page 10)

OWL- Voice of Midlife and Older Women

Roadmaps From Democrats and Republicans:

Two Very Different Paths

On November 6, we will choose between competing and very different visions of our nation's future. Please take time to study how the major parties plan to tackle some of the most important policy issues of our time: Social Security, Medicare/Medicaid and the Affordable Care Act. We urge you to read the full Republican and Democratic platforms found at: http://www.owlnational.org/ OWL has prepared a few highlights that illustrate the contrast between the two parties when it comes to major issues affecting women over 40 and their families.

Social Security Republican • No changes to current or near-retiree benefits.

• Social Security is long overdue for major change.

• Reform should address medical advances in longevity.

• Allow younger workers the option of creating personal investment accounts as supplements to the system.

Democrat • Seniors earned Social Security.

• A commitment to keeping current system.

• Opposed to any attempts to privatize.

• Supports making it easier for people to save on their own for retirement.

Medicare/Medicaid Republican (Note: Medicare and

Medicaid are addressed together in the RNC platform) • Current course cannot be sustained for either program.

• More emphasis on personal responsibility for health maintenance.

• Call for transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee's choice.

• Move two programs away from a defined-benefit entitlement to defined-contribution model.

• Reexamine age eligibility for Medicare.

• Block Grant Medicaid Limit federal requirements on private insurance and Medicaid; remove existing federal requirements on how money is spent.

Democrat (Note: Medicaid references are part of the healthcare section in the DNC platform) • Oppose efforts to privatize Medicare or make it a voucher system.

• Oppose efforts to Block Grant or cut Medicaid funding.

• Affordable Care Act (Roadmaps page 10)

October • 2012 • 5

Opinion

The Truth About the Medicare Debate Scott Watts Nevada Alliance for Retired Americans For close to fifty years, Medicare has successfully and efficiently provided millions of seniors in Nevada and across the country with quality and affordable health care that they have paid into all their working lives.

Medicare helps save lives and helps older Americans stay healthy during their golden years. Along with Social Security, Medicare is the most important promise we've made to our seniors.

However, forty-seven years after its creation, Medicare is facing the greatest threat to its existence and

6 • 2012 • October

is under attack by Washington politicians who are all-too-ready to turn Medicare and seniors’ guaranteed benefits over to private profit-hungry insurance companies.

Senator Dean Heller, one of our state’s highest officials, is one of those Washington politicians who don’t understand how important Medicare is to our state’s seniors. In fact, Senator Heller has the distinction of being the only member of Congress to vote twice for the plan to end Medicare authored by Vice Presidential

nominee Paul Ryan, and supported by Presidential nominee Mitt Romney, and even said he was “proud” to have this distinction.

What does the HellerRyan-Romney plan, which Heller “proudly” voted for twice, seek to do? According to the conservative Wall Street Journal, the plan would “essentially end Medicare” and turn the program over to the profit-hungry private insurance industry.

Dean Heller's proposal would end the promise of guaranteed benefits for seniors by providing a voucher to buy insurance on the private market. According to the non-partisan Congressional Budget Office, turning Medicare over to a private voucher system would raise seniors’ average

health care premiums by over $6,000. In addition to paying more for premiums, Nevada seniors would have had to pay $15 million more for prescription drugs in 2012 alone under Heller’s plan.

Instead of relying on guaranteed benefits to take care of their health care needs as they have for more than four decades, seniors would be placed at the mercy of private insurance company bureaucrats who would be allowed to come between patients and their doctors.

The reality is that Senator Heller’s plan terminates the Medicare program and creates a system where private insurance companies are in charge.

Now, after “proudly” voting twice to dismantle (Medicare page 13)

Why Everyone Needs an Estate Plan

E

Brought to you by Bradley B. Anderson Anderson, Dorn, & Rader, Ltd.

state Planning. To many people, it sounds complicated and foreign, something only the wealthy or the elderly need to worry about. It is often not at the top of the priority list for single people or for young couples. Even parents with young children, who know they should at least have a Will, tend to think of estate planning as somehow beyond their reach.

Planning for Illness What would happen to you or your family if you became very ill – or even if you suffered a debilitating injury –

The American Academy of Estate Planning Attorneys www.probatebusters.com • blog.wealth-counselors.com

and you couldn’t make your own financial or medical decisions? If you are married, you might assume that your spouse would automatically have the right to step into your shoes and make these decisions for you. However, this is not necessarily the case. If you have accounts on which your spouse is not a joint or authorized user, he or she would likely hit a brick wall when trying to communicate with your financial institutions. The same problems can arise when it comes to talking to doctors or accessing your medical records. If you are not mar-

ried, your friends or family members would face similar difficulties. In truth, regardless of your age, your situation in life, or your level of wealth, estate planning accomplishes certain universal goals.

Without the right plan in place, financial and medical institutions require a court order before they will communicate with anyone attempting to make decisions on your behalf. This puts your loved ones in the position of hiring a lawyer and spending time and money in court during an already

stressful time in their lives and yours, simply so that they can handle your daily affairs.

Add in relatives who disagree over how your affairs should be managed and the trouble compounds.

Whether you are married or single, regardless of your age, you should have at minimum, a General Durable Power of Attorney, a Health Care Power of Attorney, and a HIPAA authorization. In most cases, a Revocable Living Trust will also be important.

A General Durable Power of (Estate Planning page 8)

October • 2012 • 7

Estate Planning / page 7 Attorney allows you to name someone to manage your financial affairs in case of your disability.

Banks and other financial institutions are often reluctant to accept a Power of Attorney, however that reluctance is eliminated with a RLT (Revocable Living Trust) because the Trust owns the account. A Health Care Power of Attorney lets you name someone to make medical decisions on your behalf, and a HIPAA authorization lets you direct your physicians and medical facilities to release medical information to certain, specified individuals. These documents work together to keep the details of life running as smoothly as possible for you and your family, without the need for a court order.

Planning for Death Nobody likes to think about death, but it can happen at any time. If you have not created a plan, the family you leave behind will have to pick up the pieces. The most basic way to plan for death is to create a Will. You use your Will to leave instructions for who gets which of your assets and when, as well as to name a guardian for your minor children.

A Revocable Trust goes a step further, allowing you to distribute your assets while avoiding the time and expense of the probate process. An additional advan8 • 2012 • October

tage of a Revocable Trust is that, since it is not subject to probate, the terms of your Trust remain private. This is not true of a Will, which is filed in court during probate and becomes a matter of public record.

Estate planning does not have to be complicated, and it is certainly not only for the wealthy or the elderly.

Planning your estate is a matter of putting together a few elements that will protect you and your family in case the unexpected happens.

An experienced estate planning attorney can help you put a plan in place that is tailored to your family’s needs.

About the Law Firm The Law Firm of Anderson, Dorn & Rader is devoted exclusively to estate planning. We are members of the American Academy of Estate Planning Attorneys and offer guidance and advice to our clients in every area of estate planning. We offer comprehensive and personalized estate planning consultations.

For more information or attend an upcoming seminar, please contact us at (775) 823-9455 or visit us online at www.probatebusters.com.

October • 2012 • 9

Roadmaps / page 5

helps state Medicaid programs fund home and community-based services.

• ACA provisions strengthening Medicare.

• Under ACA, Medicaid will cover more working families.

Affordable Care Act Republican • Repeal ACA • Use price transparency to stop over-utilizing expensive services.

• Cap non-economic damages in medical malpractice lawsuits.

• End tax discrimination against the individual purchase of insurance.

• People with pre-existing conditions who maintain continuous insurance coverage should not be discriminated against.

10 • 2012 • October

Democrat • Preserve ACA • Improve the healthcare workforce with emphasis on primary care.

• Eliminate disparities in healthcare.

• Continue access for families to mental health and substance abuse services.

Jobs

Republican • Simplify the tax system.

• Cut government spending and regulation.

• Promote U.S. products abroad and secure open markets for them.

• Build Federal-State-private partnership to invest in national infrastructure.

• Overhaul federal training programs for the workplace of the twenty-first century.

Democrat • Keep provisions of the American Jobs Act already enacted, including payroll tax relief, tax credits for businesses that hire veterans, and an extension of unemployment insurance.

• Retain executive orders such as expanding access to refinancing for families who have stayed current on their mortgages, challenging Community Health Centers to hire veterans, accelerating permitting for transportation projects and enabling student loan borrowers to cap their payments at a percentage of income.

• Invest in national infrastructure.

• Supports relief for longterm unemployed.

• Supports ban on discrimination against unemployed.

Exchange / page 4

Medicaid Expansion

The Nevada State Medical Association Council has voted to support Medicaid expansion provided for in the Affordable Care Act (ACA). In making the announcement, the NSMA said, “We believe that this is necessary to assure that there is not a new class of uninsured Nevadans crated by a gap in the ACA coverage plan.”

Gov. Sandoval and the Legislature will be considering the impacts of Medicaid expansion on the state budget in making a decision to opt into expansion for the uninsured.

October • 2012 • 11

Tools for Your Toolbox

What Inquiring Professionals Need to Know Over 100 health care organizations, providers and educators attended a resource forum September 25 in Reno titled “Tools for Your Toolbox,” offering opportunities for professionals to share skills, services and network.

The forum, sponsored by the Nevada Geriatric Education Center at the University of Nevada School of Medicine, was said to be a first in bringing community providers together for the purpose of sharing information and educating. Among the various agencies present at the forum were representatives of the state Medicaid program, the Aging and

12 • 2012 • October

Disability Services Division, Washoe County Adult Social Services, Northern Nevada Adult Mental Health Services, and Welfare and Supportive Services.

Veterans eligibility, service connection and the Aid and Attendance program, as well as respite and hospice services were explained. The forum was followed by breakout sessions providing further opportunities to share information and network.

Keynote speaker, David A. Ishida, MA, Regional Administrator of the U.S. Department of Health and Human Services, spoke of the new Administration for

Community Living, a federal initiative to help people live independently to avoid institutionalization.

Ishida said the division brings together the Administration on Aging (AoA), the Office on Disability (OD), and the Administration on Developmental Disabilities (ADD) to develop policies and improve supports for seniors and people with disabilities.

The federal division has been working to implement initiatives nationally focused on nursing home diversion.

Programs rolled out over the past few years include the

David A. Ishida

Community-based Care Transitions Program to prevent hospital readmissions, Consumer Direction and Home and Communitybased Services for Veterans.

(Toolbox page 16)

Medicare / page 6

Medicare, Senator Heller is attacking Shelley Berkley on Medicare. Senator Heller must think he can fool Nevadans, because his attacks don’t pass the smell test and should be dismissed by seniors across Nevada.

The claim that the Affordable Care Act cut $700 billion from Medicare has been widely debunked as “untrue,” “misleading” and a “distortion.” The AARP says what Shelley Berkley voted for is legislation that “cracked down on Medicare fraud, waste and abuse” and “strengthened guaranteed benefits.”

Factcheck.org has called the claim that the Affordable Care Act “cuts” billions from Medicare “misleading.” They accused groups who use this line of attack of misleading “seniors by making false claims about the law’s effect on Medicare.”

Politifact said, “Neither Obama nor his health care law literally ‘cut’ a dollar from the Medicare program’s budget.” TIME wrote that the idea that “the Affordable Care Act struck a dangerous blow to Medicare that will change the program in fundamental ways is untrue.”

While we must make common sense improvements to strengthen Medicare for future generations, we must not take the Heller-Ryan-Romney approach and dismantle Medicare all together by turning it over to profithungry private insurance companies. While this plan might be a boon to these profit-hungry private insurance companies, it is

surely not in the best interests of Nevada seniors, like me, and middle-class families, who rely on the guaranteed benefits of Medicare to meet their health care needs.

Please join me in supporting Shelley Berkley this November because she will fight to protect and preserve Medicare, not destroy it like her opponent would do.

Scott Watts, a resident of Minden, is the President of the Nevada Alliance for Retired Americans.

Brekhus Jenny

FOR RENO CITY COUNCIL jennybrekhus@gmail.com www.jennybrekhus.com

775.544.1694

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October • 2012 • 13

Adding Life to Years

Health Prevention: Its time has come!

Dr. Larry Weiss Center for Healthy Aging

I

believe that food and lack of exercise is slowly killing our community.

Local governments across the country are creating dozens of program experiments with money from the Obama administration’s Affordable Care Act that focus on prevention. It is part of a broad national effort set in motion by the health care law. It encourages the health care system, that is geared toward responding to illness, to move toward, one that helps people keep from getting sick in the first place. To that end, the law created the

14 • 2012 • October

$10 billion Prevention and Public Health Fund, the largest-ever federal investment in community prevention.

The effort is long overdue in an age where preventable disease is the single largest cause of death. Indeed, unhealthy behaviors, like smoking and poor diet, account for 40 percent of premature deaths in the United States, while poor health care and limited access to the health care system accounted for a tenth of such deaths, according to an analysis of federal data and mortality

studies by the Institute of Medicine.

If you compare our country with other countries in potentially preventable deaths, we perform worse, according to a Commonwealth Fund study reported in Health Affairs. In addition, the pace of improvement in preventing deaths that could be avoided with timely and effective health care is the slowest in the U.S. The critics say consumer education and efforts to influence behavior and assume individual responsibility will only have modest effects without

policy measures like taxes on soda and restrictions on marketing to children to change the food they eat.

Unfortunately, the republicans in congress have ridiculed the prevention program as a slush fund to build jungle gyms and swing sets.

Is this so bad? Don’t we need to embrace the prevention approach and turn our cities into healthy communities?

If we look at the scientific evidence there are only a handful of published studies on obesity interventions that have produced results. These (Life to Years page 15)

positive results occurred when the participants were intensely engaged. You only have to look at the popular TV program, the Biggest Loser, to see the amount of work and effort to shed pounds, but it is critical.

Public health experts say that the kinds of things being tried under the Prevention and Public Health Fund law could help bring a cultural shift. Perhaps the most significant cultural behavioral change in recent times is the dramatic reduction in the share of Americans who smoke. This change took many years of education, regulation and medical intervention. Likewise, only a mixture of these approaches will have an effect on eventually reducing rates of obesity and increasing physical exercise.

By 2030, more than half of Americans could be obese, resulting in millions of new cases of diabetes, coronary heart disease, and stroke -- a constellation of illness that could cost the United States up to $66 billion in treatment and over $500 billion in lost economic productivity.

It's a sobering scenario to say the least. And it is what is now being projected by a new report released in September

by The Trust for America's Health and the Robert Wood Johnson Foundation titled, "F as in Fat: How Obesity Threatens America's Future."

"With 6 million new cases of diabetes, 5 million cases of heart disease and stroke, and more than 400,000 cases of cancer in the next 20 years, we are on a tragic course that will have a horrible impact on the quality of life of millions of Americans and could overwhelm an already over burdened health care system,"

said Dr. Jeffery Levi, study author and executive director of Trust for America's Health.

"Obesity is on the causal pathway to every major chronic disease that plagues our society -- heart disease, cancer, stroke, diabetes, pulmonary diseases, arthritis," said Dr. David Katz, director of the Yale University Prevention Research Center.

"So it is best thought of as the canary in the coal mine of chronic diseases. As goes

obesity, so goes health."

A new survey from the National Council on Aging (NCOA), United Healthcare, and USA TODAY finds that most older Americans feel their best years are still to come, but not all are prepared for the health and financial challenges of aging. More than half of seniors strongly agree they feel safe walking in their communities. Close to 60 percent never walk to places they regularly need to

go. Seniors report mixed feelings about the impact their community has on their health. Half of respondents indicated their community helps them live a happy and healthy life, but nearly as many (42%) said their community has no bearing on their health or happiness.

Clearly the national effort in health promotion and illness prevention that this new law is facilitating needs to be viewed seriously.

October • 2012 • 15

Life to Years / page 15

Communities are critical in the health and happiness of its residents and individuals need to take responsibility.

Therefore, public health education and policy have to go hand in hand to make the cultural change necessary to promote health and decrease death and disability.

Public messages about healthy foods and against bad foods such as sugary drinks need to be plastered on buses and benches. Junk food in vending machines in schools and businesses need to be changed. Activity and exercise programs need to be encouraged. Community health workers need to identify the community’s highest-risk patients, connect them with doctors, and follow up with them. One aspect of this is currently being developed in

16 • 2012 • October

northern Nevada by TCONN – Transitional Care of Northern NV, a collaborative of hospitals, doctors, home health, senior and social services, and other community agencies designed to provide integrated care from one service setting to another.

Unfortunately, poverty is a barrier to prevention. Day to day living and the short-term thinking means many people are shopping at gas station mini-marts where junk food is the staple. More money does not necessarily help when bad food is the easiest choice.

Public health experts say that no real progress on obesity is possible unless governments regulate junk food, and we educate our communities as to what are good foods and the importance of exercise.

One example is New York City. They experimented with

some public policies, but they have been slow to spread, in part because of the lobbying by the food industry.

Unfortunately, many people don’t change their behaviors without a push, so you have to change what drives and directs them through policy.

Do support the public health promotion and illness prevention efforts being promoted in your community.

The Obama administration’s Affordable Care Act has some tremendous positive health care changes. This Prevention and Public Health Fund initiative is one of those. It will help all of us “add life to years”.

Lawrence J. Weiss, Ph.D. is CEO of the Center for Healthy Aging. Dr. Weiss welcomes your comments on this column. Write to him at larry@addinglifetoyears.com

or c/o Center for Healthy Aging, 11 Fillmore Way, Reno, NV 89519.

Toolbox / page 12

Aging and Disability Resource Centers, the single point of entry initiative, work to connect people with information and referral, assistance and advocacy.

“The most important thing is to understand that there are community-based options for care, and that is what people prefer no matter what age,” Ishida said. “They prefer to stay at home, they prefer to be around their family and in their community. All they need is some social supports.”

Ishida said he would hope that the emphasis toward community supports be continued as the Affordable Care Act is implemented.

Nevada Silver Haired Legislative Forum Votes on Priorities for the Legislative Session The Nevada Silver Haired Legislative Forum voted on its priorities in September for the next Legislative Session on behalf of the state’s aging population.

The forum recommended they would support legislation enhancing Home and Community-based Services in Nevada (HCBS); services that enable people to live at home and prevent premature institutionalization. The Nevada Department of Health and Human Services currently offers HCBS to seniors and people with disabilities.

The forum made recommendations to monitor public utility hearings and sup-

port proposed legislation or practices that preserve justifiable utility rate increases and consumer safety.

Legislation to create an Endangered Persons Statewide Alert System was signed into law last session.

The bill was to take effect in January 2012. The forum voted to request the Governor assure the bill be implemented. Additionally, the group wants to revise the program by eliminating the 60 years of age and the residency requirements.

The Forum made recommendations to support legislation that improves health care for seniors, protects seniors from fraud and

scams, legislation that promotes senior employment and the expansion of telemedicine services in the state.

The forum, created in

1997 by the legislature, works to identify and make recommendations to the Governor and legislators on issues of importance to aging persons.

October • 2012 • 17

Centers for Medicare & Medicaid

Getting Answers to Your Medicare Questions

By David Sayen

Health insurance isn’t the easiest thing to understand. But if you have Medicare, there’s a variety of help resources you can turn to.

One is Medicare’s tollfree help line, 1-800MEDICARE (1-800-6334227). Trained representatives are available 24-hours a day, every day of the year to answer your questions about your Medicare coverage.

All people with Medicare receive a copy of the “Medicare & You” handbook in the mail each fall. This booklet has a wide range of David Sayen

18 • 2012 • October

information about what Medicare covers and what it costs. It includes details about Original Medicare as well as privately-run Medicare health and prescription drug plans that you can join.

Another useful resource is Medicare’s consumer-friendly website found at www.Medicare.gov. Among other things, the website has tools that let you compare Medicare health and drug plans. (You can also look for local hospitals, skilled nursing homes, home health agencies, and dialysis centers that best fit your needs.)

Yet another terrific way to get your questions answered is to make an appointment with your local State Health Insurance Assistance Program, or SHIP. SHIP provides free, personalized counseling to people with Medicare. You can speak with a trained SHIP counselor over the phone or in person. The counselor will give you accurate, unbiased advice about your Medicare benefits and how to get the most out of them.

SHIP counselors can help you with questions about Original Medicare, Medicare Advantage plans, Medicare

supplement (Medigap) policies, Medicare Part D prescription drug plans, Medicare Savings Programs, and long-term care insurance.

Got a problem with a medical bill? SHIP can help you deal with it. SHIP counselors are volunteers and they’re often enrolled in Medicare themselves, so they know the issues. They can help you understand your Medicare rights, file a complaint if you feel you got inadequate care from a hospital or other healthcare provider, or file an appeal if (SHIP page 20)

Ask Dr. Marion

Dr. Marion Somers. Ph .D.

Benefits of Volunteering Where do you suggest my 80-year-old father can volunteer his time and experience? In his day, he was a highly respected banker, and he still has a lot to offer. Pete in South Carolina, 49 Im glad you asked, Pete. Volunteering is a great way to keep your father active, engaged with the surrounding community, and interacting with new people.

It will get him out of the house, give him a goal, provide structure, and create a real sense of accomplishment.

It usually doesn’t even make a difference what the volunteer function is. Your father could volunteer at a hospital, in a school, at a local “Y,” be a big brother, a troop leader of boy scouts, lend a hand at the Red Cross, or just be an assistant to someone who needs help. Given your father’s expertise in banking, Dr. Marion Somers

Ophthalmology

maybe he can take local school children on bank tours or even mentor young bankers just getting started in the field. When an elderly individual volunteers time, knowledge, and experience, it usually results in more personal satisfaction than if he/she just gives money to a charity.

Dr. Marion (Marion Somers, PhD) is the author of "Elder Care Made Easier" and has over 40 years of experience as a geriatric care manager, caregiver, speaker, and expert in all things elder care.

Visit www.DrMarion.com for more information.

Uveitis

Michael J. Fischer, M.D. Eye Physician & Surgeon Uveitis is inflammation of the layer of tissue situated between the retina and the sclera (the white of the eye).

This middle layer, the uvea, has three parts: the iris (the colored portion of the eye), the ciliary body (which makes fluid within the eye) and the choroid (a layer of blood vessels that nourishes the retina and other important parts of the eye). Anterior uveitis, the

most common form involves he iris and ciliary body.

Intermediate uveitis affects mostly the vitreous humor (the clear gel that fills the eye), and posterior uveitis affects the retina or choroid at the back of the eye.

Symptoms of blurred vision, eye pain, eye redness, photosensitivity, and dark floaters requires immediate attention.

Note - Uveitis can result in scarring and blindness if left untreated.

October • 2012 • 19

SHIP / page 18

your Medicare health or drug plan denied you a service.

With Medicare open enrollment season coming up (it runs from Oct. 15 to Dec. 7), you may be thinking about joining a Medicare health or drug plan, or switching from one plan to another. SHIP can help you choose a plan that best meets your needs in terms of cost, coverage, and convenience. A counselor can sit down with you and help compare various plans until you find the right one. They also can help you enroll in that plan.

Let’s say you take multiple prescription medications. A SHIP counselor can enter all your drugs into Medicare’s Plan Finder tool (available through www.Medicare.gov) and search for plans that

20 • 2012 • October

cover your drugs. The counselor will then help you compare plans based on monthly premiums, co-pays, and any restrictions that may apply.

If you have a low income, the counselor can help you apply for the “Extra Help” program, which helps pay your costs in a Medicare drug plan.

You can reach the SHIP office nearest you by calling this toll-free number: 1-800307-4444 (in Las Vegas, 4863478).

SHIP is funded through federal grants and operated by the Nevada Aging and Disability Services Division.

David Sayen is Medicare’s regional administrator for Arizona, California, Hawaii, and Nevada. If you have more Medicare questions call 1-800-MEDICARE (1-800-633-4227).

Pilot Project Works on Quality Improvement in Nevada Nursing Homes

Connie McMullen

The Nevada State Health Division, Bureau of Health Care Quality and Compliance (HCQC), the regulatory arm that oversees health facilities in the state, plans to launch a new initiative to improve the quality of health care in Nevada nursing facilities.

HCQC Bureau Chef Wendy Simons, in charge of regulating some 1400 plus

Wendy Simons

for innovation in government,” said Simons, who came from the assisted living industry to work for Health Division Administrator Richard Whitley. Her mother pioneered the first residential home for group care in the state. Experience is just a small part of the arsenal of tools she brings to the job. Simons, herself a former operator of a large assisted living community, has helped write and lobby for regulation years before joining HCQC. Innovating for change is a challenge that seems to come naturally.

“There are opportunities

for more collaboration in a private sector approach to governmental processes,” she states. “For instance, during my tenure of 2-years I created seven advisory councils, bringing partners together to work with the regulatory

agency and the businesses it regulates. The partnerships that we are building have really opened dialogue for a lot of initiatives.”

For Simons, it all comes down to care. “If you ask (Quality Care page 24)

licensed health facilities, says the initiative comes with recognition that the agency needs to think differently about how health providers address quality of care. The goal is to encourage nursing providers to develop a “business model” to improve health outcomes in the delivery of services.

QUIP, or Quality Improvement Partnership, will begin as a pilot in nursing facilities with eventual expansion to other providers in partnership with the Nevada Aging and Disability Services Division (ADSD), and Health Care Financing and Policy (HCFP) or Nevada Medicaid.

“There are opportunities October • 2012 • 21

Quality Care / page 21 someone how they define quality in care, few people give the same answer.” For the consumer it means reliability, comfort and safety.

When the HCQC inspectors survey a facility, they’re looking for quality, safety, and outcomes.

them in regulatory compliance, to avoid expensive penalties and closure. The annual surveys have been controversial and costly to both the division and the provider. She noted "on average periodic inspections in nursing homes run 210 hours, but when facilities are

Simons reviews a list of health care facility inspections and records of performance.

24 • 2012 • October

If QUIP works as planned, it will bring about improved care, serving as a new model for best practices. Simons credits Administrator Whitley for sparking interest in new initiatives, referring to an improved infection control tool that put Nevada on the cutting edge and the development of enhanced sentinel event reporting, events that should never have happened.

“The Ambulatory Surgical Center, infection control issue that blew up in Nevada in late 2008 – 2009 became a catalyst for greater recognition of responsibility. It is still on everyone’s radar, understanding the significance of that event.”

Born out of necessity, QUIP also may curb costly man-hours the division has been expending inspecting nursing homes and other health care facilities to keep

poor performers, up to 500 hours of additional investigation time occurs."

“It is the first time in the history of the bureau that somebody from the outside with a past life of being regulated was brought in. As a result of that, I’ve been having corporate meetings with medical providers on inspection history and findings, determining what the customer perceives they should be receiving from the services provided, and how to marry customer expectations and disappointments in a review of the engine that generates our workload which is complaints. What is disappointing customers to cause them to complain?

What can the industry do through us sharing that information to better manage what the customer is perceiving they are supposed to be receiving?”

Evolution

• 2009 - the Bureau exploded in work and responsibility, including increased periodic inspection requirements.

• May 2011 - Began the development of a Rapid Response Complaint Team approach.

• Fall 2011 - Health Division began Strategic Planning effort for Accreditation - guiding recognition of the need for HCQC to think differently... and a “business model approachʼ was prepared.

“Our job is customer service because we are fee based,” Simons said. “Every entity pays a fee for us to license, regulate and inspect.

They have customers that we, through the regulatory process, want to assure receive the proper care and services. It’s all perception and customer service.”

How QUIP Works

QUIP is a Nevada Health and Human Services endeavor to implement a Prevention Model using a multi-element approach and compliance when needed.

The three agency partners will provide technical support and customer service, recognition and reinforcement of excellence via improved outcomes in delivery of quality health care, and targeted actions to improve provider performance.

The initiative provides a new opportunity to improve health care accountability.

Simons says there are only 42 hospitals and 52 nursing facilities in Nevada. “We are unique that we can change things because we’re not a big state. We don’t have lots of facilities.” QUIP folds in the partner agencies using

ADSD ombudsmen and HCQC surveyors to recognize activities, such as who needs additional help, what are their deficiencies, and those who do not commit to a corrective plan of action. It is a new project that will be rolled out in months to come, with the hiring of manpower and planning.

The project is not expected to bring additional cost to the agencies. Simons says all resources are already in place and can happen without any legislative action.

One chain of nursing homes have already instituted the business approach in their service model. Simons says HCQC will know soon how the approach has faired following inspections and surveys, whether the facility scores better, that residents receive better care.

“It’s about changing behavior, getting a commitment and greater recognition of responsibility.”

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October • 2012 • 25

Medicare’s Pay For Performance Effort Begins, Targeting Quality and Hospital Readmissions

By Jordan Rau Kaiser Health News

M

onday, October 1, is the start of the federal fiscal year, and with it begins Medicare’s biggest effort yet at paying for performance. Medicare is withholding 1 percent of its regular hospital reimbursements in the new ValueBased Purchasing Program, which was created by the 2010 health care law.

Over the course of the year, money will be returned to some hospitals based on how well they follow clinical guidelines for basic care and how they fare in patient satisfaction surveys. Some hospitals will get back some of the money that was held back, others will break even and some will end up getting extra.

Medicare estimates about $850 million will be reallocated among hospitals under the program. The amount will increase in future years and Medicare will add in new measures of quality to the list of measures in place in the program’s first year.

Seventy percent of the ratings are based on “process” measures that show how frequently hospitals performed recommended protocols. A few of the measures include the percent of heart attack patients given medication to avert blood clots within 30 minutes of arrival at the hospital, the 26 • 2012 • October

percent of heart attack patients given percutaneous coronary interventions within 90 minutes of arrival, the percent of heart failure patients given instructions on discharge about how to take care of themselves. These are a few of the measures listed for hospitals to document.

The other 30 percent of a hospital’s value-based purchasing payment will be based on how it scored on random surveys of patients taken after they were discharged. Survey questions include: how well nurses communicated with patients, how well doctors communicated with patients, how responsive hospital staff were to patients’ needs, etc.

Also on October 1, Medicare is applying a separate penalty to 2,211 hospitals with higher than expected readmission rates.

Hospitals with the highest rates for heart attack, heart failure and pneumonia patients will lose 1 percent of their regular reimbursements. The Readmissions Reduction Program was also established by the health care law. Medicare expects hospitals together will forfeit about $280 million this year.

The maximum penalty grows to 2 percent next year and 3 percent in October 2015.

With nearly one in five Medicare patients returning

to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system.

Hospitals have had little financial incentive to ensure patients get the care they need once they leave, and in fact they benefit financially when patients don’t recover and return for more treatment.

Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19 percent for several years, even as many hospitals have worked harder to lower theirs.

The penalties are part of a multipronged effort by Medicare to use its financial muscle to force improvements in hospital quality.

Overall, Medicare has decided to penalize around twothirds of the hospitals whose readmission rates it evaluated, the records show.

The penalties will fall heaviest on hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois and Massachusetts, a Kaiser Health News analysis of the records shows. Hospitals that treat the most lowincome patients will be hit

particularly hard.

Kaiser Health News has published the 2013 readmission penalties for all hospitals. The downloadable PDF can be found at: www.kaiserhealthnews.org/Stories/2012/ August/13/medicare-hospitals-readmissionspenalties.aspx .

Transitional Care of Northern NV

Transitional Care of Northern Nevada is a Center for Healthy Aging program in Reno working to prevent hospital readmissions.

TCONN helps patients manage their health care after they are discharged from the hospital so they can continue on their path of recovery, avoiding additional hospitalization.

To learn more about TCONN, contact Lawrence J. Weiss, Ph.D., CEO of the Center for Healthy Aging, 11 Filmore Way, Reno, NV 89519, or call 775-376-3210.

Write to larry@addinglifetoyears.com for program details.

Lend-A-Hand Senior Services Celebrates Twenty-Years of Caregiving Business

I

n tough economic times, Lend-AHand Senior Services hit a milestone in September celebrating 20-years of doing business in the Reno-Sparks area, providing caregiving services for people in need.

Lend-A-Hand opened its doors September 15, 1992, offering nonmedical care by sending caregivers into the home of seniors to provide assistance with bathing and personal care, grocery shopping, transportation,

and housekeeping.

Lend-A-Hand specializes in dementia care, stroke care, and activities of daily living.

A first to offer caregiver services in the Truckee Meadows, Lend-A-Hand owner Tammy Sisson said, “It is amazing to me that after all these years I’ve never lost passion for the seniors we serve.”

Sisson has also never changed the business practice she says is driven by integrity.

“We are family owned, not a franchise.

Caregivers drive the business.”

While the business practice has not changed, Sisson admits it is harder for families to afford home services. “We’re seeing less people who need services but we’re still providing the care they need to keep them independent in their home.” In spite of high unemployment, LendA-Hand has retained the staff they have employed for several years. “Sixty-three (Caregiving page 28)

Paul and Tammy Sisson

October • 2012 • 27

Tammy and Lend-A-Hand caregivers at a recent gathering.

Caregiving / page 27 percent of the people who work here have been employed two-years or longer. We are keeping the family together,” she said.

“And we just don’t hire caregivers off the street.” Sisson prides the company in setting a standard of care, doing background checks on caregivers and conducting good hiring practices.

“We are a leader.” Caregivers are also strategically matched to people who need the services; they work close to home and live in the community where clients need them.

Lend-A-Hand employs 72 caregivers in the RenoSparks area. Because the business is not a franchise with corporate headquarters located in another state, Sisson says the money the business earns, the people hired, and taxes paid are kept in Nevada.

28 • 2012 • October

A past accomplishment she is proud of is the passage of a bill that required Personal Care Agencies (PCA) be licensed in the state. Today licensing of agencies hiring

personal care attendants to work in the home is a practice regulated by the State Health Division. In the near future, Sisson and husband Paul plan to start a training program for caregivers.

Through their non-profit “Nevada Senior Care Foundation”, they plan to launch the program ICareSafely.com. It will offer personal care attendants employed by a licensed agency training that meets state regulations (NRS 449). The training program will consists of 16 training modules, a final exam, and certificate of completion.

Recently Lend-A-Hand Senior Services passed a state survey with a perfect “A”, meaning there were zero deficiencies found by the Bureau of Health Care, Quality and Compliance. “It was very exciting and a real reflection of what this company is about,” Sisson said.

Lend-A-Hand Senior Services, located at 145 Mt. Rose Street, Reno NV 89509, can be reached at (775) 322-8414.

Calendar October 15 - December 7 - Medicare Enrollment, trained volunteers to assist, Monday - Friday: Mondays Noon - 2 p.m., Tuesdays 10 - 2 p.m., Wednesdays 9 - 1 p.m., Thursdays 10 - 2 p.m. and Fridays 10 - 1 p.m.

Reno Center, 1155 East Ninth Street, call 1-877-3852345.

October 9 - Knitting Group, 5:30 - 7 p.m., Sun Valley Library, (775) 851-5190.

October 9 - Lifescapes Senior Writing Program, Sparks Library, 2 - 4 p.m., (775) 352-3200.

October 9 - Food Bank Truck (CSFP) – Sparks Senior Center - Second Tuesday, 11:45 - 12:30 p.m.

October 9 & 29 - S.T.E.P. Out to High Sierra Swing Dance Club! Let’s cut loose! Seniors Programs is providing transportation to High Sierra Swing Dance Club’s, Club Night! We will depart the Rec. Center at 4:30 p.m. and arrive at El Charro Avitia Restaurant in Carson City to enjoy socializing and dancing. To register please call (775) 832-1310, or come in and visit the Parks & Recreation Counter, 980 Incline Way Incline, Incline Village NV. October 10 - It’s Your Estate, Northwest Reno Library, 11:30 - 1 p.m., (775) 787-4100.

October 10 - Fall Financial Series: It’s Your Money, Downtown Reno Library, 2:30 - 4 p.m., (775) 327-8300.

October 11 - Landlord/Tenant Seminar, 2 p.m., Reno Senior Center, Art Rm., (775) 328-2608.

October 11 - Conversation Cafe, Current Events, 10 -11 a.m.; October 18: Fraud & Abuse of Medicare Card Dena Miguel, Senior Medicare Patrol; October 25: Faith -- Moderated by Michael Keaveny. Aspen Grove, 960 Lakeshore Blvd., Incline Village, (775) 832-1302.

October 11 - Lifescapes Senior Memoir Writing, South Valleys Library, 11:30 - 1:30 p.m., (775) 851-5190.

October 11 - Free Caregiver Support Group, 5:30 - 7 p.m., South Lake Tahoe Senior Center, 3050 Hwy. 50, South Lake Tahoe, (530) 621-6151.

October 12 and 19 - Senior Dance Club, 8-11 p.m., Fridays, Reno Senior Citizens Center, (775) 328-2575.

October 12 - Candidates Forum, Questions & Answer Session, County Commission, City Council candidates, 9:30 - 11 a.m., Reno Senior Center, (775) 328-2575.

October 12 - Bridge Group, South Valleys Library, 1 - 4 p.m., (775) 851-5190.

October 16 - Lifescapes: Senior Writing Program, Spanish Springs Library, 2 - 4 p.m., (775) 424-1800.

October 16 - Emergency Food Pantry – Reno Center, Third Tuesday. Doors open at 7:30 a.m. Gross monthly income limits are: $1,180/mo. (one person) or $1,594 (two people). Only one set of bags per household.

Limited to the first 300 people.

October 16 - Food Stamp Workshop – Reno Center, Third Tuesday - 8:30 - 10 a.m.

(Calendar page 31)

October • 2012 • 29

Sparks Senior Center Gets Needed Renovation More Funding to Keep Center Open in Afternoon

The Sparks Senior Center has a new look! The Chamber of Commerce Reno-Sparks Leadership (RSL) class picked the center to spruce up as a community project.

Michelle McDonald, RSL class, joined community leaders in a ribbon cutting on September 5. McDonald spearheaded the project that included new paint, carpet, a reception counter, and artwork. The RSL class received over $18,000 in donations, and in-kind contributions of $15,000. The Sierra Nevada Job Corp painted the inside building. Paint was donated by the Reno Paint Mart.

The senior center, built in 1991, is the central gathering place where seniors participate in recreational activities, arts

30 • 2012 • October

and crafts, card playing, and congregate meals. Over the past few years, the future of the facility has come in question due to funding cutbacks.

The facility is staffed and programmed by Washoe County Senior Services.

Recently, the Sparks City Council Michelle McDonald (center right) and Shirley Hendrix (left), Sparks Special Seniors, and the approved alloChamber of Commerce Reno-Sparks Leadership class cut the ribbon celebrating the renovations. cating $21,000 Way, in Sparks. The ribbon to help staff the facility to keep center hours were to be reduced from 9-1 p.m. The cutting was an exciting day for it open from 9–3:30 p.m., center is located at 97 Richards the senior center seniors.

Monday through Friday. The

October 16 - Oktoberfest Themed Catered Dinner, the Chateau, 5:30 - 9 p.m., Incline Village, (775) 831-1258.

October 17 - Food Bank Truck (CSF) Sun Valley - Third Wednesday, 9 - 10 a.m. Gross income limits are: $1,180 (one person), or $1,594 (two people) – Sign up at the Truck.

Casino Resort Spa, (775) 824-4467, $35 in advance, $39 at the door.

Sweat, & Beers Tours, Atlantis Casino Resort Spa, (800) 723-6500.

November 9 - BB King, 8 p.m., Silver Legacy Grande Exposition Hall, $80/$65, (775) 325-7401.

November 11 - Veterans Day

November 11 - Eric Church, Blood,

November 20 - January 1 - Aladdin, Eldorado Hotel Casino, 1-800-8798879.

December 1 - Randy Travis, 8 p.m., Silver Legacy Grande Exposition Hall, $59.50/$39.50, (775) 325-7401.

December 3 - Bonanza Casino’s Duckhorn Vineyards, Winemaker Dinner, (775) 323-2724, ex. 134.

October 18 - Living Will Seminar, Reno Senior Center, 2 p.m., RSVP at (775) 3282592.

October 18 - HealthInsight Workshop, 8:30 - Noon, Hyatt Place, Reno.

October 25 - The Incline Village/Crystal Bay Veteran’s Club will be meeting at Aspen Grove, 960 Lakeshore Blvd on the last Thursday of this month from Noon -2 p.m. To register please call (775)832-1310 October 26 - Nevada Day October 30th- The Hunter’s Moon - 55+ Full Moon Hike: Wine & Cheese Socials! Fee is $16, $11 w/IVGID Pass. To register please call (775)8321310, or come in and visit the Parks & Recreation Counter, 980 Incline Way Incline, Incline Village NV. October 31 - Halloween

Entertainment

Now - November 13 - Jersey Nights, Eldorado Hotel Casino, 1-800-879-8879.

October 12 - Carrie Underwood, 7:30 p.m., Reno Events Center, $62.50/$52.50/$42.50.

October 13 - Society of 7, Best Show in Waikiki, Atlantis Casino Resort Spa, (775) 824-4467, $40 in advance, $45 at the door.

October 19 - Jay Leno, 8 p.m., Silver Legacy Grande Exposition Hall, $67.50/$50, (775) 325-7401.

October 20 - Bonanza Casino’s Samuel Adams Brewmaster Dinner, Branding Iron Cafe, (775) 323-2724, ex. 134.

October 26 & 27 - Thunder Down Under, 8 p.m., Atlantis

October • 2012 • 31

Social Security Administration

Supplemental Security Income: Forty Years Of Helping People In Need

Rita Meier Public Affairs Specialist

T

he Social Security Amendments of 1972 created a new federal benefit program. This month, that program — the Supplemental Security Income (SSI) program — celebrates its 40th anniversary.

Administered by Social Security, SSI is a needs-based program for people 65 or older, blind, or disabled who have limited income and resources.

For income, we count things such as wages, Social Security benefits, and pensions. However, Social

32 • 2012 • October

Security does not count all of your income when it decides whether you qualify for SSI. For example, we don’t count food stamps or most home energy assistance.

For resources, we count the things you own, such as real estate (other than the home you live in), bank accounts, cash, stocks, and bonds. A person with resources worth no more than $2,000 may be able to get SSI. The resource limit is $3,000 for couples.

To qualify for SSI, you also must live in the United States

and be a U.S. citizen or national. In rare cases, noncitizen residents can qualify for SSI. If you live in certain types of institutions or live in a shelter for the homeless, you may qualify for SSI. People with blindness or a disability who apply for SSI may be able to get free special services to help them work.

These services may include counseling and job training.

The monthly maximum federal SSI payment is the same nationwide and amounts to $698 for an individual and $1,048 for a cou-

ple. However, the amount you receive depends on factors such as where you live, your living arrangements, and your income. Some states add money to the federal payment.

Funding for the SSI program comes from the general revenues of the U.S. Treasury, not from Social Security payroll taxes.

To learn more about SSI, read the online publication, You May Be Able To Get Supplemental Security Income (SSI) at www.socialsecurity.gov/pubs/11069.html.

BIGGEST little City

Harry Spencer

A Man of His Word

T

he above title refers to the excellent biographical book on the late Bill Raggio as authored by writer Michael Archer.

In his voluminous tome of more than 600 pages Archer does a magnificent job of combining one individual’s life with the riveting history of early day immigrants to Nevada.

Since I first met Raggio in 1957 when he was serving as an Assistant DA and subsequently handled his campaigns for District Attorney and U.S. Senate, I best knew him during the twelve-year span he served as DA of Washoe County. That being the case I was especially interested in that portion of Archer’s book which told many of the DA stories.

Although there were many highlights during those dozen or so years, one incident deserves further elucidation.

One of the most interesting times was the occasion when Bill and I traveled to Hollywood, California to film TV commercials for one of his re-election campaigns.

We were summoned to lotusland by Frank Sinatra who had volunteered to do the filming at Paramount Studios.

Since we were both busy at our regular jobs, we decided it

would be easy to write the scripts for the filming on the airplane ride to Southern California.

Accordingly I brought my trusty yellow pad to the airport, and Bill and I began the writing as the plane took off.

I asked him what copy he wished to do first. He said, “I want to do a full explanation of the burning of Joe Conforte’s Mustang Ranch whorehouse.”

As Bill rambled on I noted that we were approaching ten minutes of TV time. He said that didn’t matter as he wanted to go into complete detail on the event. Finally we

ended the script at about 25 minutes. I explained to him that we would have to buy one-half hour of TV time in order to screen it, and that the only time that a segment of that length was available would be late night or early in the morning. Bill said it didn’t matter since we were going to write about a half a dozen 60-

second commercials to be aired in primetime.

We barely finished all of the scripts before the plane landed. We were met at the airport by several men dressed in fedoras and overcoats and taken to two waiting limousines. I shared one of the cars with the producer (Raggio page 34)

October • 2012 • 33

ly on the teleprompter.”

When I asked him what a teleprompter was he said that it was the technique that had replaced the idiot cards of which I was familiar.

In the meantime Raggio had been placed in the other limo and driven directly to Sinatra’s dressing room for makeup. As Koch and I entered the soundstage I was impressed with Seloc, May 12, 2011 the replication of Raggio’s of Frank’s movie that was office that had been set up. shooting “Come Blow Your The only addition was the Horn” whose name happened placement of an American to be Howard Koch. He asked flag and the Nevada stage flag to see the scripts that we had on either side of the desk. written, and I was sure he fig- Once I had settled in beside ured he would have to do a lot Koch and the full shooting of rewriting or editing for the crew of “Come Blow Your two bumpkins from redneck Horn”, which was on overNevada. As we motored to time, Raggio made his appearthe studio he said, “This is ance. His face was well campretty good. I’ll put in directouflaged behind heavy make-

up. We adjusted the teleprompter to his delivery cadence and Koch asked, “What do you want to do first?” I replied that we should probably shoot the 25 minute segment while Raggio was still fresh. Accordingly the cameras rolled and Bill did the long spot in the first “take”. He received a rousing ovation from the entire crew as well as the director Koch.

Howard then turned to me and said, “I was going to cancel a dinner engagement because I didn’t know how long this would take, but apparently you can handle the rest of the shooting yourself.”

I said that I could. He offered me his chair and said, “Just tell the cameraman when to zoom in and out.”

We wound up the complete shoot in less than two hours following which Bill and I went to dinner. Frank could not join us as he was hospitalized at the time from total exhaustion.

Later when the film arrived at the Reno TV stations, people marveled at the quality. Our cover story at the time was that we had filmed them at an obscure Hollywood location.

Following is a poem that best summarizes Raggio’s life.

An Ode to Billy Jack

It was 1926 in old Reno town When a ray of sunshine coruscated down.

It was a bouncing baby boy That brought his parents such great joy.

34 • 2012 • October

Both friends and neighbors were taken aback When his mom and dad named him Billy Jack.

From the start he excelled in school And proved to be

nobody’s fool.

At scouting he did his very best And proudly wore an Eagle on his chest.

When his country called he went to war But never left his native shore.

At law school he amazed his peers And happily received their many cheers.

As D.A. many miscreants crossed his path And all fell victim to his noble wrath.

He was an excellent MC whenever he saw fit And no one was safe from his piercing wit.

And if you were making a speech this was his advice “Never use one word when 10,000 will suffice.”

He aspired to be gubernatorial But had to settle for senatorial.

He could be serious or even hammy Especially when he rendered “Tammy”.

His coiffure was his crowning glory But its true color was another story.

In Carson City he would sally forth Earning the title “Sentinel of the North”.

He was neither bellicose Nor overly verbose.

He looked forward to roasts with great glee Even when he was the roastee.

During his life he triumphed in every imbroglio After all, his name was William J. Raggio.

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October • 2012 • 35

this ‘n that

by Anne Vargas annevargas3@gmail.com

W

36 • 2012 • October

My first-born is Fifty~ How can that be?

asn’t it just the other day when she was a toddler, a first-grader, a Brownie, a teen-ager? (And aren’t parents of fifty-year olds supposed to be old? I couldn’t possibly qualify!) She doesn’t look fifty; she’s in great shape, slender and lovely, the busy mom of two active boys, a television news anchor juggling maniac schedules but managing to squeeze in trips to the gym.

(Her mom, on the other hand, could probably use a little more exercise.) Now a significant birthday was looming, requiring a significant remembrance. But what?

It didn’t take long to think of the perfect gift.

Unfortunately, I should have thought of it fifty years ago. I have a lot of friends who must have something in their DNA lacking in mine. They return home from trips and compile albums displaying photos of the places they went and the people they met. Those albums are usually neatly stored next to all their other albums cataloguing the events of their lives. When their children want to see what they looked like in kindergarten or at their first prom, those photos can be instantly found. Not so in our house…not so.

Our family lived in 24 houses during the 30 years of my husband’s military career. Our children were students in schools all over the world because we spent 16 of those 30 years overseas. Somewhere there is a photo of this daughter and her brother, at ages 2 and 3, in Kimonos when we lived on Okinawa. Somewhere there are photos of the two of them along with their little sister learning to ski in Austria, playing sports, cheerleading, graduating from High School.

Somewhere. But where?

During all those gypsy years photo taking did occasionally happen, with cameras of a different era that involved rolls of film.

They were often lost before being developed, or if they were, it might be a year or more after the photo had been shot. Photo organizing consisted of dropping the photos that did get developed randomly into boxes, boxes that would usually be re-packed and the contents dumped into yet another box as we roamed around the world.

Reaching into any of them, I could easily find a snapshot from early marriage next to a photo from the rehearsal dinner for our son’s wedding along with a

lot of photos of people I no longer remember. It’s actually a great mental exercise, challenging myself to remember the who, what, when and where in each as I find them. I’m not proud of this serious lack in memorykeeping but I am truthful about it and our far better organized children have become resigned to this deficiency on their mother’s part.

And now I thought I could put together a photo album for her birthday? A dubious venture at best, but it would really be the perfect gift so I decided to go for it .

The subsequent days (and nights) were spent on

Elizabeth Vargas

the floor surrounded by the contents of all of those boxes. Attempts to arrange them in any kind of “people” order were frustrating but it was necessary to look at every single photo in order to ensure I had found everything I could use. (My husband took a photo of me buried in the middle; it will probably end up in one of the boxes.)

When I had located everything I could use, I

went to CVS to scan them onto a CD. It wasn’t difficult but it was extraordinarily timeconsuming, not to mention the resulting aching back.

And that was the easy part. Then I had to sort through and arrange them in the order I wanted, after first selecting an album type and style. At the end of the very second long day, I emerged with a photo book in hand Elizabeth Vargas blows out birthday candle held by her son on Good Morning America. and took it immedimuch as she enjoyed wonderful way this is to ately to the post office for receiving it. I have subsecapture family history, what overnight express; it was quently learned there are a gift It can be to everynow September 5th and easier ways to do it with one…if only I had started the birthday was iPhoto and I am starting to this fifty years ago.

September 6th. Ironically work on albums for each of “A photo has the magic she had called the day her siblings. I realize now, to make a moment last forbefore wistfully asking belatedly but finally, what a ever.” whether I might one day find time to go through old photos and send her some; I assured her I would really get around to doing that soon.

The following morning she was presented with a cake on Good Morning America so the birthday was no secret, although there was just one candle instead of fifty.

When we called that evening to sing our customary, long-established and expected off-key birthday wishes, she told us she was just about to open the package we had sent.

Her father and I got to listen to her delighted (and incredulous) reaction to finding an album full of photos I had put together chronicling her life from babyhood to motherhood.

It was worth every moment of the effort and I enjoyed making it every bit as

October • 2012 • 37

THE ECLECTIC OBSERVER

by Janet Ross

O

ctober, according to the (ancient) Roman calendar, is the eighth month of the year, from the Latin for octo, meaning eight. So how did October end up being number ten on our calendars?

According to Wikipedia, the insertion of January and February by Julian and

38 • 2012 • October

Gregorian calendars, shoved poor old October into the tenth spot. It did get 31 days, though, an honor of sorts reserved for six other months.

This month has a good share of national days, however. China, Cyprus and Nigeria claim the first for their celebrations. Following

on through the month are Germany, Portugal, Croatia, Taiwan, Spain, the State of Alaska on the 18th, Niue (find this country on a map it’s in the South Pacific), Austria, St. Vincent, the Grenadines, Turkmenistan, Turkey, and Slovenia..

What has happened of historical significance during October? Once again, I draw on the ubiquitous Wikipedia to discover that the Russian Revolution took place in

October, 1917, thus giving us the term “Red October”.

Even more significant, at least for sports fans, October is the one month of the year when all four professional North American Sports leagues schedule games with baseball ending and basketball beginning this month.

If you were born in October, your birth stone is commonly pink tourmaline or the sometimes considered unlucky Opal. For a flower you get the golden-yellow Calendula, while your Zodiac sign is either Libra or Scorpio.

There are all kinds of “special” designated days in October including a National Children Appreciation Day on the 9th (are gifts in order?), shared with Leif Erikson Day, followed by Columbus Day on the 10th.

It might be better if Freethought Day on the 12th preceded National Coming Out Day on the 11th. Of course Halloween is always October 31st and back in the late 1960s when we lived in England my children were inconsolable to miss Trick or Treating. Times have changed and this American custom has now crossed the Atlantic to be observed in England, Ireland and France.

For those into social media the abbreviation OCT doesn’t signify the month of October, but “On Company Time.” Who knew? Not me.

In Nevada, October means magnificent fall color and a big parade in Carson City to celebrate Nevada Day on Saturday, October 27th.

(We became the 36th State in the Union during the Civil War, on October 31, 1864.)

Happy October to all!

Eydie’s Excerpts Eydie Scher

Will the Boat float? This is No Joke!

You’re never too young or too old to start reading Senior Spectrum!

windy and rainy. Our minds drift to a nice quiet lunch on the Lake at Chamber Landing. Despite Lake wind advisories, we will

not be deterred.

The dinghy empties out a ½ foot or so of rainwater and is ready for occupancy. No problem rowing her out to

the boat. Ummm, David muses. The boat seems to sit lower in the lake. Promptly I agree. I board first. Nothing (Float? page 40)

Cassie is reading Senior Spectrum at 10 months old.

T

he buoy line sits lifeless. Boats surround it but it has none attached. On the shore, the dinghy languishes on the edge of the lake, unused all summer, a summer filled with the promise of water fun shattered by the severe forces of Mother Nature.

Let me take you back to May. It’s a glorious weekend.

The boat slides into the lake and sits beautifully by the buoy. The photo is taken. I include the picture in my June story. The story comes out with the boat photo.

The boat looks pristine perfection. We can’t wait to take it for a spin around the lake.

Memorial Day Weekend looms ahead.

Memorial Day Weekend puts on its usual show for our area. A few years ago, it gives us snow. This time, it is close. Winds and rain pummel us and we cancel a Saturday date with the Lake.

Sunday proves a bit better but still comes up cold, October • 2012 • 39

Float? / page 39 unusual. David opens the engine compartment. Water floods through it. The boat won’t start. The bilge pumps make an awkward try at pumping out the water but fail. I check out the cabin.

Horror fills my scream. The cabin has over 4 feet of water in it. Questions buzz in our heads. How could this happen? Pumping begins in earnest. Our only saving grace is to bail the water out by hand. Now imagine this!

A scoop fills up quickly and we dump the lake water over the side. No dent is made in the amount we have to get out. A hand pump works just a bit better. We bail in tandem. David pumps and I pour the water back in the Lake. This is not working.

40 • 2012 • October

The boat we depend on for 20 years could possibly sink.

Fear grips me as I scan for a life jacket. The lake is icy cold this time of year and I have no desire to be in it.

The dingy sits ready for action and we may need it!

By this time, David and I pump out the cabin. Much more water sloshes around in the other compartments.

David uses his cell to call our friend who takes care of the boat. “Get the boat out of the lake,” he yells when he calls back! “It needs to be on dry land.” How do we do that? We didn’t even take the truck and we’re clear out almost in the middle of the lake with no power.

Thankful that his cell battery still works, he calls and gets

through to the insurance company on a Sunday during the Memorial Day Weekend.

A towboat is coming and would take us to the marina.

Fortunately, David paid $25 extra to the insurance company in case we needed a tow. Get this! The charge for the tow is $1,600. Can you believe that? Our bottom line is zero for the tow.

Okay, now, once we get to the marina, what happens?

Our friend will pick up our trailer with his truck, and bring it to the marina. He will pull the boat out of the lake.

Could the boat really sink? Someone tells us about boats sinking from the previous day’s storm. It’s a good thing we go up that day or it could have been ours sitting at the bottom of the lake.

Perish the thought!

We visit the boat on land. It is still filled with water. The boat sits on land while we travel to the East Coast for a planned vacation. Upon our return, the news is unbelievable. Repairs on the boat would cost $20,000 to $25,000 and it still may not run properly. This is a job for insurance.

The summer slinks by. The insurance check “is in the mail”. Finally it is in our hands. Poetry in Motion is sold for a mere $3,000 including the trailer but at least it is no longer staring us in the face whenever we go to Tahoe.

The new owner is a mechan-

ic. He will take good care of her and repair her over the winter but she is no longer ours.

This is the first summer in 40 years that we’ve been landlocked. Our puppy Bella has demanded time and attention so we’ve kept busy.

Fall flickers over the Lake.

Soon the winds of winter will wash over it.

Before this happens, we get a new used boat. It is perfect. It runs flawlessly and fast during the demo.

Someone else has taken over our buoy but we get the boat in the lake and tie up to another one nearby. It’s a superior September Day and we are thrilled to be back cresting the Lake. The boat will be moored for the winter here in Sparks.

She will carry the name.

Traditions will continue.

Bye Poetry in Motion

Hello Poetry In Motion 2

Comments are always appreciated: eydies@aol.com

ing, libations and entertainment to fuel the great Robert Boyd and Carolyn Prusa Nevada silver rush. After one hundred plus years of ups and downs, ownership changes and calamities, Fred and Nancy Cline purchased the Mizpah in 2011 and restored it to its former glory. One might not expect to find a fine wine list in rural Nevada. But the Clines, who also own n our family, especially at our ages, birthdays are not Cline Cellars and Jacuzzi Family Winery in Sonoma treated lightly. September 16 was Robert’s 88th birthday. County, have seen to it that if you’re of a mind to unwind Statistically, that is about 10 with a nice glass (or bottle) of years beyond a man’s average life expectancy. A birthday to wine after spending hours riding in the car, the Mizpah will celebrate!

Where better to do so than be happy to provide it.

Mizpah Hotel Las Vegas? We’d lived in the 100 Main St., Tonopah, NV so-called Sin City from 199489049. mizpahhotel.net.

1996 and although we’ve mizpahhotel.wordpress.com. retuned for an occasional Tel.775-482-3030. visit, we hadn’t driven from one end of the state to the Day two-six: Las Vegas. other since our move to Reno.

Thanks to our WorldMark Besides, we’d read about the timeshare membership, opening of the refurbished Mizpah Hotel in Tonopah and home-away-from-home for the next five days was a comwanted to check it out on the fortable one-bedroom condoway. The plan for our Las minium in a quiet neighborVegas road trip was quickly hood near the Strip but not hatched.

Local press rated Socorro's on it, and not in a casino Burger Hut in the community hotel. As we prefer. of Mina as having some of Viva Las Vegas Nevada’s best hamburgers.

We’re attracted to Las We made it our lunch stop.

Vegas for its spectacular Look for a small red building shows. We opted for Le Reve with a window for placing (The Dream, in French) at orders and sheltered picnic The Wynn. The Wynn thetables to eat at (no indoor ater-in-the-round encompassdining). ing a million gallon pool is Socorro's Burger Hut itself something to behold.

710 Front St, Mina, NV While some performers rise 89422. Tel: 775-573-2444. and descend from the ceiling, others perform in and under Word of advice, don’t gas the water. It is a high energy, up your vehicle in Mina multi-faceted show with lavunless you’re desperate. Plan ahead and you’ll find gas forty ish props that kept our attention throughout. We loved it. cents a gallon cheaper in Tonopah. That’s where we We enjoyed Nathan spent two nights – one on the way to Las Vegas and again on Burton, a low budget, comedy/magic show at the the way home.

Flamingo Casino. Burton is a The Mizpah Hotel is on Las Vegas local who got his the National Register of Historic Places. It was built in start on the television show, America’s Got Talent. Two 1907 shortly after Tonopah was founded, to provide lodg- times daily he puts on an

Seniors4Travel

entertaining (and affordable) show for the entire family.

Happy Birthday, Robert!

Robert’s birthday dinner was at the Mon Ami Gabi Restaurant in the Paris Hotel Casino. Given the option of indoor or patio dining, we sat outdoors and were enter-

tained by the hustle and bustle of the Las Vegas Strip as we enjoyed our meal.

Final Thoughts Las Vegas is still a great place to visit but we’re happy to call Reno home.

For more information: VisitLasVegas.com/Entertain ment.

I

October • 2012 • 41

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