Gray Matters Fall 2014

Gray Matters

Help With Medicare 3 Surgery Center 4 End-of-Year Giving 6 Free Workshops & Trainings 8

A quarterly publication of Area 1 Agency on Aging

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he Retired and Senior Volunteer Program is searching for volunteers eager to contribute to the creation and stewardship of the new 1,000-acre McKay Community Forest located southeast of Eureka.

Trail construction is expected to start early next year, but Dave Hayes of Humboldt Trail Stewards says the current volunteer list of 150 people may not be enough to keep up with what will be a major and ongoing volunteer effort.

Humboldt Trail Stewards will organize monthly work days of 25 to 40 people.

“This piece of property is relatively uncharted,” Hayes said.

“There are some logging roads out there and a couple of trails on the periphery, but most of what we do is going to be all new for the people working on it and also for the people using it. There’s a huge demand for recreational areas, and that is what

this will be – a very special place.”

“It’s a gem right in Eureka’s backyard; a tremendous and unique opportunity,” said Hank Seemann, Deputy Director of Public Works for Natural Resources for Humboldt County. “It’s quiet and peaceful – a great place to walk among the redwood trees and get away from all the background noise and traffic.”

The community forest property wraps around Redwood Acres, narrows down east of Redwood Field in Cutten, heads south and east of Winship School and then widens to continue to Ridgewood Heights.

Ryan Creek, a key salmon-bearing stream, marks the eastern boundary of the new community forest, which was carved out from Green Diamond Resource Company’s 7,600-acre McKay Tract.

“It’s an old forest, but a new public land, and our volunteers have an opportunity to really be part of

it,” said Maureen McGarry, program leader for RSVP, the local arm of the national volunteer group of people age 55 and older.

In addition to building and maintaining trails, volunteers are needed for garbage clean up, patrols, restoration activities, educational programs, fundraising, and meal

preparation and logistical support during work days.

Seemann said several months of planning are needed before trail building can begin, but Humboldt Trail Stewards and RSVP are already recruiting to form a list of volunteers 

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HOURS DEDICATED TO CAREGIVING AGE OF CAREGIVERS

RSVP Makes McKay Forest Volunteer Focus

FALL 2014

AVERAGE HOURS OF CARE PROVIDED EACH WEEK

Source: Partnership for Solutions, Chronic Conditions: Making the Case for Ongoing Care.

Johns Hopkins University, Baltimore, MD. (2004).] - Updated: November 2012

SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

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ready to go when the county calls.

“From establishing well-designed trails in appropriate locations to restoring areas of erosion to removing invasive species, there’s a lot to do and a lot of excitement among the 35 RSVP volunteers who are already part of Humboldt Trail Stewards,” McGarry said.

“Downed trees, lost animals, homeless encampments, trash pickup: we need to build a real caring community around the forest to make sure it is fed, watered and loved,” Hayes said. “Once it’s constructed, the county will rely in large part on volunteer efforts to keep it the way we like it.”

Seemann said he’s currently looking at how existing logging roads can be converted to trails, how loops can be linked to access points and parking, and how to accommodate walkers, joggers, bikers and equestrians while minimizing conflicts between users and avoiding conflicts with adjoining landowners and neighborhoods.

“We took title to the land – the

first big step – in mid August,” he said. “There are many steps ahead to make it ready for public use in the way that people currently enjoy the Arcata Community Forest. We hope in the early part of next year to have some sort of partial opening.”

Seemann said developing trails and access points and upgrading logging roads are a major cost.

Timber harvest revenues will be re-invested for up to 30 years to provide the needed infrastructure, he said.

“In addition to the recreational space, it gives Eureka an opportunity to take pride in having the responsibility of managing forest land and connects us to our region’s history of logging and what is so unique about coast redwoods,” Seemann said.

Environmental stewardship is one of six focus areas for RSVP. To volunteer through RSVP, call 4423763. Dave Hayes can be reached at h_d_hayes@yahoo.com or 831-3342488 and trail updates are posted at www.humtrails.org. 

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2 SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

Need Help With Medicare Annual Enrollment?

Try Phone, Mail, Drop-in or Online Options

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n-person appointments for free HICAP counseling during Medicare’s annual Part D enrollment period are long gone, but there are plenty of other options for locals who need help during the Oct. 15 through Dec. 7 registration.

Medicare unveiled the new Part D drug plans Oct. 1, setting in motion a year-end scramble among Humboldt County’s almost 30,000 Medicare recipients to make sure they check their prescription drug needs against the new plans to find out which will get them the best coverage at the lowest cost.

“The plans change every year, the premiums change, the drugs covered change, the costs change and so do the restrictions,” HICAP Program Manager Nancy Cloward said.

“People have found it very, very expensive if they didn’t change their plans when they needed to. That’s why so many people called early this year to get appointments. You don’t want January 1 to roll around and find out you’re stuck with some really high drug costs because your plan doesn’t cover your drugs anymore.”

HICAP reported 5,458 contacts with clients — worksheets included — from Oct. 1 though Dec. 31, 2013.

For the fiscal year ending July 2014,

Cloward said HICAP staff saved local beneficiaries more than $1.2 million in health care costs.

Cloward provided the following list of options for those who couldn’t get an in-person appointment.

1. Call Medicare directly

Telephone assistance is available 24 hours a day, seven days a week, through Medicare’s toll free number, 1-800-633-4227 (1-800-MEDICAR).

A hint: call Medicare during evenings or weekends for shorter wait times, and call well before the Dec. 7 deadline.

2. Complete a worksheet and mail it to HICAP

“We can’t help everyone in-person, but our volunteers analyze these very carefully during the prescription drug plan rush,” HICAP counselor and volunteer coordinator Suzi Hendry said. “In some ways, it’s more efficient for everyone who wants local help to rely on the worksheet.”

To request a worksheet, call 707444-3000 in Humboldt County and 707-464-7876 in Del Norte County.

Or go online at a1aa.org to fill out the form, print a hard copy and mail to the A1AA-HICAP office at 434 Seventh Street in Eureka.

“You’ll be asked to provide a list of your medications and dosages and return it to us,” Hendry said.

HICAP will input the information into the Medicare website, assess the various options for coverage, and mail back to the sender comparisons of the top three plans that meet client medication needs in the most economical fashion.

“Then all you have to do is call Medicare to enroll,” Hendry said.

Worksheets are now being accepted.

3. Do it yourself online at medicare.gov.

“A lot of 65-year-olds are very computer literate and capable of doing it themselves,” Cloward said.

“After you do it a few times, it’s not so intimidating.”

As of Oct. 1, the website was updated with 2015 plan information so comparisons could begin.

4. Attend a Drop-in Clinic

Bring your medications and/or a medication list and your Medicare card with you to one of three dropin clinics set for 9 a.m. to 1 p.m. on Saturday, Oct. 25, Nov. 15 and Dec. 6.

“We’ll have three or four HICAP counselors available,” Cloward said.

This is the first year for drop-in clinics at the A1AA office. Cloward has no idea how popular they will be.

“We’ll serve as many as we can, but there’s no way of knowing how many will show up,” she said. 

All you need is the information on your Medicare card and a personal identification code you create to access your account.

“We encourage anyone who is comfortable with the computer to do it that way, or to do it with or for a Power & Fitness loved one,” Hendry Strength & Balance = Independence for a Lifetime said. “You can put No initiation fees your medication Monthly senior rates: information in this $30 age 60-69 week, or make changes $25 age 70+ $45 couples to your existing Mon.-Fri.: 5 a.m. to 10 p.m. account, and be ready Sat., Sun.: 7 a.m. to 8 p.m. to go on the first day of 211 5th Street, Eureka • 442-5399 enrollment.”

SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

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4 SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

New Center To Help People Weigh Surgery, Alternate Treatments and Personal Values

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ocal residents are celebrating the expected fall opening of a shared-decision making center in Eureka and hopeful that seniors and boomers will take advantage of it prior to undergoing so-called “preference sensitive procedures” such as knee replacement, carotid endarterectomy and coronary artery bypass grafts.

The center was the top recommendation from a community report that addressed North Coast surgery rates that exceeded the state average on some elective procedures.

“It will have a huge value in our community, and it will be a huge educational process to get people to know it’s there,” said Nancy Cloward, program manager for the Health Insurance Counseling & Advocacy Program at Area 1 Agency on Aging.

The center is based at the Humboldt Del Norte Independent Practice Association at 2662 Harris, across from Safeway, and is expected to open by mid-November.

Primary care providers will refer people to the center, but the general public will be welcome to phone for an appointment without referral.

Services will be free to people of all ages, with or without health insurance. Decision aids written in easyto-understand language and health care professionals who can answer questions will be available on site.

The goal is to give patients a place to go to get current, neutral and often quantitative information about endof-life treatment decisions and roughly 14 generally elective procedures around cardiovascular and orthopedic conditions for which there are multiple treatment options that are roughly equivalent.

“This is exactly what we need,” said Bonnie MacGregor, former HICAP counselor and member of the Senior Action Coalition and A1AA Advisory Board.

“Consumers must ask good questions about consequences,” said Dawn Ellsbree, former executive director of the Headwaters Fund and a member of the group of primary care providers, surgeons, specialists and community lay people who authored the 2013 Surgical Rate Project report.

“It surprised me to learn that in many cases, outcomes for alternate treatments are every bit as good as elective surgery.”

“Everyone wants to know what the doctor recommends, but part of the paradigm must be to engage and ask questions,” added Jay Reed, partner at Aalfs, Evans & Company and another member of the Surgical Rate Project committee.

Adults age 65 and older – the ones most likely to undergo some of the procedures – may have the most difficult time adapting to the concept of shared decision-making. It’s a national movement to help patients navigate, understand and weigh alternative treatment options within their own value systems.

“The way the system works, doctors don’t have a lot of time to sit with patents to answer questions, and often times, the patient doesn’t have the ability to listen to all that’s being said or to form the questions right then,” Reed said.

Mary Ella Anderson, the local Assembly representative to California Senior Legislature, said some seniors have told her “they can feel like cattle launched down a chute” as they make their way through a health care system that incentivizes “expensive procedures or medications for everything.”

“More good information is always

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Medicare?

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better than not enough,” she said.

“If you are a senior living alone with no one to go with you to the doctor, it can be hard to feel empowered,” Can Help You: •HICAP Understand Medicare • Choose the Right P Have Questions Aboutof Medicare?

Cloward said. “This will give people • Make Sense Medigap Plans Have Questions About Medicare?

• Understand • Understand Medicare Medicare Understand Medicare somewhere to go.”

• Choose •the Right Prescription HICAP CanDrug Help Plan You: • Get Extra H HICAP Can HelpPlan You: The IPA received a $105,000 grant •• Choose Choose • Choose the the Right Right Prescription Prescription Drug Drug Plan Free Counseling Available the Right Drug Plan Medicare • Get Extra Prescription Help• Understand with Costs • Make Sense o from the California HealthCare Foun• Understand Medicare • Get • Get Extra Extra Help Help with with Costs Costs • Choose the Right Prescription Drug Plan • Get Extra Help with Costs • Make Sense of Medigap Plans dation to develop the center.

Free Counseling Available • Sense Choose the RightPlans Prescription Drug Plan • Make • Make Sense of of Medigap Medigap Plans That’s the same foundation that • Get Extra Help with Costs • Make Sense of Medigap Plans • GetSense Extra Help with Costs funded the 2011 study of elective Free Counse • Make of Medigap Plans Free Counseling Available procedure rates in California by Stan• Make Sense of Medigap Plans Free Free Counseling Counseling Available Available ford University health care economist Free Counseling Available Free Counseling Available Laurence Baker. In five of the 13 procedures studied statewide 2005-09, Free Counseling Available one or more of Humboldt’s three hospital services areas in Arcata, Eureka The production of this document was supported by a federal grant from the Administration for Community Living (ACL). Its and Fortuna had rates greater than 150 contents are solely the responsibility of Area 1 Agency on Aging percent of the state average. and do not necessarily represent the official views of ACL. The rates were based on where the patient resided, not where the surgery was done.

The numbers prompted the IPA and Aligning Forces Humboldt, a program based at Humboldt State University, to initiate the Surgical Rate Project.

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SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

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Many Senior Programs Can Benefit from End-of-Year Giving

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haritable giving always spikes in the last quarter of the fiscal year. Area 1 Agency on Aging’s executive director encourages all North Coast residents to look hard at the transparency, governance, leadership and results that make community nonprofits worthy of support.

“Everyone always thinks of fundraising and administration as overhead that should be kept low and isn’t worthy of support,” said Maggie Kraft. “We all want our donations to go directly to needed services, but someone has to administer services and keep track of how the money is spent to ensure accountability.

“Overhead isn’t about trips and tea parties and overly inflated salaries, at least not for Humboldt-based nonprofits. Programs don’t run, create or market themselves.”

As an example, Kraft pointed to the five years of administrative time and effort to bring the Program of All-Inclusive Care for the Elderly to Humboldt County. Joyce Hayes, executive director of Humboldt Senior

6 SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

Resource Center, spearheaded the campaign with no guarantee that it would come to fruition, but on Sept. 1, Redwood Coast PACE opened its doors to eligible people age 55 and older.

PACE is a comprehensive health care model that focuses on preventive care and regular health monitoring to enable frail older adults to be able to stay in their homes, and out of skilled nursing facilities, as long as possible.

Having an Alzheimer’s Center in operation – the result of a massive fundraising campaign led by HSRC – was key to getting PACE certification.

“Neither PACE or the Alzheimer’s Center could exist without fundraising and administration,” Kraft said.

Kraft also cited A1AA’s Volunteer Driver Program, which matches volunteer drivers with people age 50 and older who need transportation to medical appointments. In the fiscal year ending in June, volunteer drivers rolled up 32,333 miles and 2,014 hours escorting 183 people on 1,872 one-way rides.

“Our software system allows drivers to sign up for rides directly without calling staff, which is a great timesaver and gives the drivers the flexibility they need,” Kraft said.

“Still, a staff person needs to recruit, screen, train, match and support our drivers. Staff also screen riders and refer them to other resources if they don’t fit our criteria.”

Kraft said the program relied on “generous” long-time support from the Russ Lytel Foundation and a twoyear Cy Pres award. Both ended June 30, though Kraft said some end-ofyear frugality enabled A1AA to carry over a bit of the Cy Pres award while searching for donor funds to replace the $20,000 formerly received from Russ Lytel.

“We are charging rider fees, but the reality is, if we don’t come up with enough to cover costs, we will have to curtail the rides we are able to give, especially to people living in the outlying areas of the county because of the higher gasoline costs to provide those rides,” Kraft said. “These are the people who already have few transportation options.”

Kraft also sees a need for unrestricted money to allow nonprofits to meet needs identified by their staffs and local citizen boards.

“Overhead is training, planning and evaluation – all important to sustain and improve so that high performance and quality programs continue,” Kraft said. “But for so many nonprofits, overhead is also doors, windows, paint, and roofs that don’t leak.”

Kraft knows all about doors, opting to install in May an ADA-compliant back door to ease access to A1AA from the back parking lot. The $7,700 expense is rooted in planning and evaluation of needs – administrative expenses.

“Considering the clientele we serve, we wanted to make it easier to get in and out,” she said. “It’s a lighter door, has a delay to close and is easier to open with and without the button. It’s a good, sensible design that better serves our clientele.”

Area 1 Agency on Aging is also doing major work on the front of the building, made necessary by an unusual water leak. Kraft said the cost of that, since A1AA co-owns the building, is going to cut into reserves designed to meet already existing program shortfalls due to lack of adequate funding for federally mandated services.

The money for the door, volunteer driver administration, a home-delivered meal, an Alzheimer’s Center, or a major building repair doesn’t come without a generous community.

“Pay it forward,” Kraft said.

“There’s so much need in this community, and the only way to make sure these programs will be around when you are older is to support them now.”

For more information about planned giving and senior needs, contact Maggie Kraft at 442-3763 or e-mail mkraft@a1aa.org. 

SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

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Free Workshops, Trainings for Family Caregivers

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he Stanford University expert on chronic disease self-management has created a Building Better Caregivers workshop that will be rolled out to 250 volunteers from Los Angeles, San Jose, Sacramento and Humboldt by the end of March 2015.

Aligning Forces Humboldt, which is based in the California Center for Rural Policy at Humboldt State University, is partnering with Dr. Kate Lorig and Stanford to recruit 10 to 15 local family caregivers for each of the five free workshops scheduled over the next six months.

The first workshop began last month and concludes Oct. 13 in Eureka.

The next workshop starts Oct. 17 in Arcata and the remaining three workshops will start in midJanuary and early February. Space is available in all.

Workshops meet for 2.5 hours once a week for six weeks at the same day and time and are facilitated by trained caregiver leaders.

Anyone 18 years and older who is a caregiver for a family member or friend with cognitive impairment such as Alzheimer’s or other dementia, traumatic brain injury, Parkinson’s, post-traumatic stress

ACA has HICAP Phone Ringing

T

he Affordable Care Act has produced a steady wave of calls to A1AA’s Health Insurance Counseling and Advocacy Program.

“It is so complicated and confusing,” said Nancy Cloward, program manager for HICAP. “We get questions every day about the ACA and how it affects Medicare.”

Cloward said the most common surprise happens to people who turn 65 and are transitioning to Medicare after signing up for a Covered California plan for which they qualified for a premium subsidy.

“Many middle to mid-lower income seniors qualified for a Covered California subsidy because the income for a single was roughly $45,000 a year with no asset test,” Cloward said.

That changes at age 65 when those eligible for Medicare discover a $105 premium for Part B, a premium for Part D prescription drug coverage, and, for those who desire full insurance coverage, a payment for a supplemental insurance plan also known as Medigap.

Then, Cloward said those who fall within the income limits for Medi-Cal undergo an asset test.

“A client can end up paying more for the Medicare premium than they had to pay for the subsidized premium under Covered California,” she said.

Medi-Cal asset limits are $2,000 for an individual and $3,000 for a couple. Cloward said some personal assets – primary home, one vehicle, household goods and belongings, to name a few – are not counted as assets.

“They are getting older, but the insurance will not necessarily get cheaper,” Cloward said. “It can be a shock to many, but especially to those who don’t realize that Medicare isn’t free.”

Medicare isn’t part of Covered California, either, and health insurance exchanges set up through the Affordable Care Act will not be selling supplemental insurance policies known as Medigap plans.

“Medicare beneficiaries do not need to sign up for Covered California,” Cloward said. “It is illegal under federal law to knowingly sell a Medicare beneficiary health insurance that duplicates Medicare’s benefits.”

If you have a question, call HICAP at 444-3000.

8 SPECIAL INSERT TO THE NORTH COAST JOURNAL • THURSDAY, OCT. 2, 2014

disorder, stroke, or other diagnosed memory impairment may participate in the workshop.

The workshops are free and part of a research study conducted by Stanford and funded by the Archstone Foundation. In addition to attending each of the six workshop sessions, participants will complete three questionnaires by mail over the next year.

Area 1 Agency on Aging Executive Director Maggie Kraft is upbeat about the five BBC workshops and their focus on helping caregivers help themselves.

“They are a great complement to the Caregiver Training Series we offer,” she said. “You cannot offer too much support to caregivers. You just can’t.”

A1AA offers its 32-hour, four-series course free to family caregivers to build their skills and understanding of the job. An Arcata Series began in July and the fourth and final part of that series begins Oct. 23 from 5:30 to 7:30 p.m. at Adult Day Health of Mad River.

The A1AA Caregiver Series begins the cycle again with Series 1 in Fortuna Jan. 8 from 6 to 8 p.m.

To learn more and register for one of the Building Better Caregiver workshops, call Aligning Forces Humboldt at 707-445-2806, ext. 4.

Space is limited and pre-registration is also required for the A1AA Caregiver Training Series. Call 442-3763 to enroll or arrange respite assistance to attend the series. 

Gray Matters is a quarterly publication of the Area 1 Agency on Aging.

Maggie Kraft, Executive Director • mkraft@a1aa.org Carol Harrison, Editor • cah5@humboldt.edu A1AA is located at 434 Seventh Street in Eureka, 95501, across the street from Eureka Inn. Phone: 707-442-3763 Gray Matters is designed by graphic artist Amy Barnes of the NCJ and is posted on the NCJ website at www.northcoastjournal.com

The next edition of Gray Matters is Thursday, January 1, 2015.