Berkshire Senior
Elder Services of Berkshire County
March
1998

 

Eleanor Marie Persip

From the Director

Seeking to Protect Seniors' Income

Tips for Consumers on Mutual Funds

Medicare - Questions & Answers

Take Charge of Your Hospital Discharge

Older Women's Project

Pittsfield COA

Communicating With the Hearing Impaired

Eleanor Marie Persip -"A Jill of All Trades"

Eleanor Marie Persip is known affectionately as "Ellie" at the Ralph J. Froio Senior Center in Pittsfield. Her 5' 11" stature attests to her athletic ability and her 63 year-old smile, to her friendliness. As a good athlete and now retired Pittsfield High School coach, she reflects a team spirit in her Senior Center participation along with a willingness to help out wherever she can.

Her day starts at five a.m. and is shared by her friends. Monday is bowling. Tuesdays she teaches woodworking; it's Scrabble Thursdays and Pitch is on Fridays. She also serves on the Pittsfield Council on Aging. Persip works on a float for the annual Fourth of July Parade, plants flowers around the Berkshire Museum in the summer, plays golf and represents the Senior Center in the Senior Olympics. She likes music and plays the piano. Matter- of-fact she confides that friends could always tell what kind of day she had by emotions she interjects into her playing.

Jean Beauchemin, Senior Center Director, states, "Ellie is extremely energetic, a real dynamo. We are so lucky to have her here at the center."

Many of her traits and friends have been with her over the years. One of her former students is once more being taught by her in the woodworking class. And she still plays bridge regularly with a group organized 20 years ago.

Persip strives for a sense of fulfillment in not only herself but also in those she teaches. Former students speak respectfully of her. Jodi Caesar comments, "Miss Persip was "cool." Not that she acted like a kid but rather she talked to us -- not down to us." Jena Caesar says, "Miss Persip was tough -- but fair. She wanted us to do our best."

Persip is the only female athlete in the Persip family. She attributes her athletic ability to her father. Voted as the outstanding athlete in grammar school, she went on to receive the same title in high school.

Woodworking is not a recent fad. During her grammar school years she converted a former chicken coop into a two-room clubhouse, affectionately dubbed "the hut." She calls herself a "saver," and says it is possibly a characteristic passed down from her grandfather, a junk dealer. For instance, she finds it difficult to pass up an opportunity to pick up discarded wood. "It can be any size -- I just want to hang on to it until I find a use for it in my woodworking shop at home or in a remodeling project." Recently, when faced with additional costs during window replacements at her house, Persip told the contractor she would frame the new windows herself. Around the holidays, she makes and sells small decorative items.
Reflecting on the rewards and habits of her life, Persip is quick to credit the supportive atmosphere created at home by her parents. "They were always there for us, encouraging us to do what we were good at and enjoyed. Our values were taught to us as we listened and participated in talks at meal times and by our parents' example."

When asked what advice she would give to those about to retire, she comments, "I'd tell them not to hurry into commitments but rather look around and get a sense of what they enjoy. And if for some reason they find themselves in a commitment that doesn't give them a sense of fulfillment, then admit it, give it up -- go on to something else."

Most Mass Long Term Care Dollars go to Nursing Homes

Fact: 87.3 cents of Massachusetts Long Term Care Dollar Goes to Nursing Homes, 12.7 cents to Care at Home.

A study by the Federal Administration on Aging comparing state spending on home and community based care with spending on nursing home care finds that Massachusetts is still a bastion of the governmental bias to pay heavily for institutional care, while making far less state money available to help older people at home.

The federal study found that in 1992 Massachusetts ranked 25th out of the fifty states when compared with others relative to spending on care at home. (See chart below or adjacent-KS choose placement)
Oregon leads all states in making it possible for older people to have care in the community; New York also does well in community care.

This low ranking for Massachusetts clearly points out the "institutional bias" that still exists in how and where state monies are used to help elders who need long term care - 87.3 cents of every dollar spent on long term care is spent on care in an institution.

Not surprisingly, in a study by Health Data Associates released in 1994, Massachusetts had a very high percentage of its elderly population in nursing homes when compared to other states. In 1992, thirty five states had a lower percentage of their elderly in nursing homes than did Massachusetts.

Some other significant data, on per capita spending per person age 65+, indicated that Massachusetts is a big spender on nursing home care. A study by the University of Minnesota School of Public Health, done in 1995, found that Massachusetts had the fourth highest nursing home expenditures per person age 65 in the nation. The Massachusetts per capita figure of $1,342 is almost twice the national average of $735 per person.

As a primary provider of state funded home care services, Elder Services' daily struggles with the disconnect between where the Executive and Legislative branches of state government direct the money to be spent (nursing homes) and where most elders want to receive care (at home). Elder Services has $196 per month to purchase services for a Home Care client; that same person's care will cost the state about $4,500 per month in a nursing home.

The state's Home Care system (Elder Services is the Berkshire County provider) is seeking an increase of nearly $7 million statewide to increase the per month spending for each client by $10.00, to $206. per month. Currently, Elder Services clients, at $196 per month, receive an average of only 3.5 hours of homemaker or personal care per week.

Of the 40 states with a home care program, Massachusetts has the lowest benefit level in the nation; as stated above, Massachusetts per capita spending per person 65 and older for nursing homes is twice the national average.

The legislature and the Governor are developing the state budget for fiscal year ‘99, beginning July 1st. If the big disconnect between monies available for care at home and elder's preference for care at home is to be fixed, the legislators and the Governor must be told this.

Now, while the budget is being developed, is an excellent time for calls to the Governor and the Berkshire legislative delegates, asking for more Home Care funding. If enough voices are heard, we may reduce the big disconnect and make a big difference in many elders' lives.

Seeking to Protect Seniors' Income
By U.S. Rep. John Olver (D-First District)

John Olver
U.S. Representative John Olver

 One of the most difficult issues the Congress will take up over the next couple of years concerns the best way to strengthen the Social Security Trust Fund for current and future retirees.

It is important that we begin to think about making the system secure for our children, as well as for people now retired. While Social Security takes in more than it pays out, there is growing awareness that the country's retirement system is coming under increasing pressure due to the looming retirement of "baby boomers." The Social Security Board of Trustees projects that over the next 75 years, expenditures from the Social Security Trust Fund will exceed its income, on average, by 16 percent.

Because competing proposals to "fix" Social Security have differing impacts on different segments of the population, there has been little consensus on the best method to ensure the system's long-term stability.
In an effort to develop a solution, the House Ways and Means Subcommittee on Social Security held an ongoing series of hearings this Congress on "The Future of Social Security for this Generation and the Next." These forums focused on the experiences of other countries to reform their retirement systems, the views of policy experts, and organizations with different generational perspectives, business and labor representatives, as well as Members of Congress on Social Security reform.

In addition, in his State of the Union address, President Clinton announced his intention to hold nonpartisan forums throughout the country to try to develop a national consensus on the best way to tackle the issue. A White House conference on Social Security has also been scheduled for December.

Most important, however, President Clinton proposed to reserve all of the surplus resulting from next year's budget until we have taken all of the necessary measures to strengthen the Social Security system. I applaud the President's initiative. It is imperative that we protect the long-term security of this essential program, which is relied upon by so many, instead of using the surplus for short-term political gains, such as additional tax cuts that may cause the deficit to climb back up again.

I strongly believe we must protect the incomes of our senior citizens who rely on Social Security, and we must be certain that nothing puts the future of Social Security at risk. It is imperative that all who have worked hard to contribute to the system should receive the assistance they need and are counting on when they retire.

My interest and my vote on any reform proposals before the Congress will be directed toward optimizing the financial future of our country's retirees.

(For more information about what Congressman Olver's office can do for you, or if you have a specific request, please contact the Congressman's Pittsfield office at 442-0946.)

Tips for Consumers on Mutual Funds Sold at Banks

There are no guarantees, no bail-outs and no insurance "safety nets" to protect you against losses in the mutual funds and stocks now being sold at an increasing number of U.S. financial institutions. Many Americans mistakenly assume that all products sold within the four walls of a bank are protected by the Federal Deposit Insurance Corporation. (FDIC).

What are the facts?
Consumers who buy mutual funds, stocks and annuities at banks do not benefit from the Federal Deposit Insurance Corporation (FDIC) coverage available for deposits of up to $100,000 per customer. This means that investors are not eligible for the same federal insurance that protects depositor who put their money in traditional bank products, such as savings accounts and certificates of deposit (CDS). And just as there is no insurance coverage from the federal government for mutual fund investors who lose money, your bank is not obligated in any way to return all of what you first invested in an uninsured product.

Be clear, not confused.
The major areas of consumer confusion is about uninsured bank products, according to a major national public opinion survey conducted by the American Association of Retired Persons (AARP) and the North American Securities Administrators Association (NASAA).

How mutual funds work...
Mutual funds offered at banks are no different from those sold directly by investment companies or by salespeople at brokerage firms. Like any other uninsured investment, mutual funds involve risk, which is what makes it possible for an investor to make money. The same risk also means that you can lose money you've invested In a mutual fund. Unlike a certificate of deposit, which offers a fixed return for a specific period of time, mutual funds may go up or down in value during every day of trading. A mutual fund is a company that pools the financial resources of thousands of investors. Instead of just buying a single security, the mutual fund buyer gets a "basket" holding dozens of stocks or bonds. (Mutual funds sold at banks include both stock and income funds.) Mutual fund managers decide when to buy, sell and hold investments in the securities that go into the baskets. The idea here for small investors is that mutual funds help to minimize risk through diversification and also make available the expertise of the fund manager. Each day, the fund must determine the value of the stocks in its portfolio. The overall value of the "basket" of securities divided by the number of outstanding shares in the mutual fund yields the Net Asset Value or NAV. The NAV is what tells you how much each share of a mutual fund is worth.

Money market funds are a type of mutual fund. Among all uninsured products sold by banks, money market mutual funds are the investments consumers are most likely to believe are FDIC insured. They are not. However, there have been no major losses in money market funds in the U.S. to date. (Money market mutual funds should not be confused with interest-bearing "money market accounts," which are insured by the FDIC. Make sure that you are clear on which type of "money market" you are considering.) Another special category: so-called "insured" mutual funds in the tax-exempt municipal fund market. Do not be confused by the reference to insurance, which is not extended by the FDIC. The limited, private insurance in such funds extends only to credit risk for the mutual fund issuer and is not intended to return money to investors in the event of a decline in the value of mutual fund shares.

About bank mutual funds...
Mutual funds are sold at banks in two major ways. Some banks rent out space in their lobbies so that outside brokerage firms and investment companies can set up shop. Others make arrangements to offer "private label" mutual funds, which may be very closely linked to the identity of the bank. (Be careful! Some funds offered through banks bear names that are confusingly similar to those of the financial institutions.)

Too many first-time investors rely almost exclusively on sales pitches and slick promotional materials in buying a mutual fund. A prospectus disclosure document is available for all mutual funds. The prospectus can be the key to your understanding of the mutual fund and whether it is a good match for you. Examine the investment objective section and compare it to what makes the most sense for you. Review the types of risk associated with the mutual fund. Look at the fees and compare them to similar funds with comparable objectives.

This information was provided by the Commonwealth Securities Division.

Medicare Answers

Q: When does Medicare pay for an ambulance?

A: Medicare will pay for ambulance service only if:
the ambulance transportation is provided by a Medicare certified ambulance service,
transportation in any other vehicle could endanger your health,
a physician certified that ambulance transport is medically necessary.
Most emergency situations meet this criteria. Ambulance coverage is generally restricted to transportation between your home and a hospital, your home and a skilled nursing facility, or a hospital and a skilled nursing home.

Q: Do I have to call Medicare prior to surgery for pre-authorization?

A: No. There is no requirement for Medicare beneficiaries to pre-certify surgical procedures. Your doctor is responsible for determining the medical necessity for a procedure in the appropriate site, e.g., inpatient hospital, ambulatory care unit or doctor's office. A hospital may deny inpatient admission if a procedure can be safely performed in a less acute setting. In this instance, beneficiaries will be advised how to appeal the denial.

Q: Every organization I read about tells a different story regarding mammograms. I'm confused. How often should I have a mammogram and does Medicare pay? I'm 67 years old.

A: Don't be confused. Have a mammogram! About half of all new cases of breast cancer are in women aged 65 and older. Mammograms help to detect breast cancer in very early stages when it can be treated. At the present time Medicare covers screening mammography every two years for women without symptoms of breast disease. If there is any history in your family or signs of breast cancer, your doctor can order a mammogram more often as necessary. If you need more information about mammograms, call IPRO at 1-800-331-7767, or your local Breast Health Partnership.

Q: How can I disenroll from a Managed Care Plan?

A: You may disenroll by sending a signed request to your plan or to your local Social Security or Railroad Retirement office. Keep a dated copy of your request for your own records. (Send request certified, if possible.) You return to regular Medicare the first day of the month following the month your request is received at the plan or the offices mentioned above.

This information was provided by IPRO, a not-for-profit corporation committed to assessing and improving the quality of healthcare services.

Take Charge of Your Hospital Discharge
Before you go to the hospital - plan for coming home


Preparing for a hospital procedure or stay in a hospital can be a confusing experience. There are many things you should ask about in advance. In addition to discussing the specific medical procedure with your doctor, it is also important to take charge of your hospital discharge planning before you are in the hospital.

That means talking with your doctor or a hospital discharge planner, sometimes called a case manager, who is a nurse or social worker employed by the hospital to help you and your family decide about your care following a hospital stay. After your hospital stay, you may be able to go home, or you may need to go to an aftercare facility such as a rehabilitation unit or nursing home. Ask the discharge planner to explain the range of options you have and whether your insurance will pay for the services you choose.

Plan ahead for when you leave the hospital:
Here are some questions you should ask your doctor before you go into the hospital:
Will I need skilled nursing or therapy services? Can I choose the organization I use?
When will I be able to resume normal activities?
Should I arrange for a ride home, or for transportation during my recovery?
Will I need someone to stay with me during my recovery?
Will I need help with bathing, dressing or toileting when I arrive home?
Will I need help buying groceries or preparing meals?
Will I need help with housekeeping or yard work?
Will I need help coping with my operation, illness or recovery?
Will I need to go to a rehabilitation center or nursing home? May I choose the center?
Will my insurance pay for my procedure and aftercare needs?
Are there community programs that provide these services or help pay for these services?

When you are in the hospital - involve yourself in your discharge planning.

If you did not have time to plan before you enter a hospital, you still have the opportunity to participate in your discharge plan. Ask to speak with the discharge planner. Any patient of any age can ask the discharge planner to evaluate their need for discharge planning.

If you need continuing care, your doctor, nurse, and discharge planner will work with you and your family to develop a special plan to meet your needs. Share with the discharge planner any concerns you have about your ability to manage your own personal care, your medications, housekeeping, caregiving duties, mobility, and recovery needs once you are at home.

If you need continuing care services, the hospital discharge planner must give you a written discharge plan before you leave the hospital. Special Rule: In Massachusetts, if you are a Medicare beneficiary leaving a hospital, then the hospital usually must give you the written plan 24 hours before you leave the hospital.
The discharge plan must contain information on:

1. the continuing care services you need, including medical treatments, medical transportation, and homemaker services
2. detailed information about the services that have been arranged
3. names, addresses and phone numbers of the service providers
4. a schedule outlining when nursing, therapeutic or custodial care services will begin
5. medications you will need and instructions on their use
6. information about special diets and treatments
7. the schedule for any of your follow-up medical appointments

If you are told by the hospital staff that you are ready for discharge, but you have not yet received a written discharge plan, ask for it. You must sign the plan to indicate you received the plan. This signature does not mean you agree that the plan is appropriate for you.

In some cases, you may not agree with the discharge plan. For example, you may think the plan does not arrange for all the services that you will need at home, or your family caregiver will not be able to help you as you originally thought. If you are dissatisfied with your discharge plan, immediately notify the discharge planner. Talk with the discharge planner and your doctor about your concerns. If you still are not satisfied, then you may contact the Massachusetts Department of Public Health, Division of Health Care Quality at 1-800-462-5540.

Special Rule: In Massachusetts, if you are a Medicare beneficiary and you are dissatisfied with your written discharge plan, then you have the right to a formal appeal.

Steps for a Medicare Discharge Planning Appeal:
1. Tell the discharge planner immediately, while you are still in the hospital, that you do not agree with the plan.
2. She/he must arrange a meeting with you and try to develop a plan that is acceptable.
3. If you are still dissatisfied, you have the right to appeal to the Advocacy Office of the Massachusetts Department of Public Health.
4. Contact the Advocacy Office at 1-800-462-5540 or 617-753-8150 by noon of the first day after you receive your discharge plan. They will work with you and the hospital to resolve your problems if at all possible.

A different problem occurs when you feel that you are not medically ready to be sent home. If this happens, you should contact your discharge planner and doctor immediately. Special Rule: If you are a Medicare beneficiary and you feel you are not ready for discharge, then ask for a written "Notice of Non-Coverage." Call MassPRO to request an immediate review of the notice. You must call MassPRO at 1-800-252-5533 by noon of MassPRO's first business day after receiving the written notice to receive an immediate review.

At last! You are home

Once home, you still may have many questions about your care, either your medical needs or in-home services. There may be several agencies or health care professionals (doctors, nurses, therapists) involved in delivering the care you need. The hospital's discharge plan that you received lists these agencies and/or health professionals. It is important to know the names, addresses, and telephone numbers of those who will be working with you. Refer to this list when you need to speak to someone about your care.
Do not hesitate to call your doctor, nurse, discharge planner or managed care case manager whenever you have questions about your recovery, discharge plan, or when there are problems with the services being provided. Ask them to help you resolve the problem.

This Elder Health Alert was prepared in conjunction with the Discharge Planning Committee of the Massachusetts Beneficiary Services Work Group, a coalition of state and federal agencies organized by the Health Care Financing Administration to improve beneficiary services for Medicare and Medicaid beneficiaries. The committee is co-chaired by staff from the Executive Office of Elder Affairs and the Department of Public Health and was established to study discharge planning systems and patient rights to discharge plans. Part of the committee's work is to increase patients' awareness of their rights to comprehensive and individualized discharge plans.

REMEMBER - YOU CAN TAKE CHARGE OF YOUR HOSPITAL DISCHARGE!

Massachusetts Department of Public Health, - Advocacy Office - 617-753-8150 or 1-800-462-5540 Investigates quality of care complaints, and reviews discharge planning in acute care hospitals.

MassPRO - Massachusetts Peer Review Organization - 1-800-252-5533
Investigates complaints about poor quality of care and reviews hospital decisions to deny admission or discharge patients prematurely.

Executive Office of Elder Affairs - Information and Referral - 1-800-882-2003
Information on a range of community support services for elders, including homemakers, home-delivered meals, respite care, transportation, and health insurance coverage.

SHINE - Serving Health Insurance Needs of Elders - Health Insurance Counseling Program - 1-800-882-2003 SHINE Counselors help individuals understand their health insurance coverage and rights to appeal medical decisions.

Health Care Financing Administration - Beneficiary Services Branch - 617-565-1232
If you are unable to resolve a problem, contact HCFA staff.

Medicare Advocacy Project - 1-800-323-3205 Free advice and representation to Medicare beneficiaries with Medicare-related concerns.

Medicare Part A Claims - Associated Hospital Service of Maine - 1-888-896-4997
Processes hospital, home health, and hospice claims for Massachusetts Medicare beneficiaries.

Reprinted from a publication of the Massachusetts Department of Public Health and AARP

Older Women's Project

During the month of March, the Older Woman's Project (OWP) with Pamela Faith Lerman and friends, will be presenting a series of workshop/performances in honor of Women's History Month. Co-sponsored by the Elizabeth Freeman Center, OWP will offer workshops and performances in the Berkshires to promote intergenerational communication and awareness of the issues of older women. Morning intergenerational dance workshops and afternoon performances will take place at Monument Mountain High School in the Berkshire Hills Regional School District on Monday, March 2nd and Mt. Everett Regional High School in the Southern Berkshire Regional School District on Wednesday, March 18th. The performance, entitled "Our Mothers, Our Grandmothers, Ourselves" uses dance, poetry, music, and autobiographical stories to explore the living history of women in the community and their experiences being female and growing older. Students, community members, and area senior citizens are invited to participate in the workshops and attend performances. These two programs will also include a speaker/presenter from the Elizabeth Freeman Center (formerly Women's Services of Western Massachusetts and the Rape Crisis Center). On Wednesday, March 25th at 1 p.m., the Ralph Froio Center in Pittsfield will also sponsor "Women: The Many Faces of Aging" featuring the Older Woman's Project performance and speakers from the Elizabeth Freeman Center and from Elder Services of the Berkshires. These programs are supported in part by grants from the Massachusetts Cultural Councils of Great Barrington, Egremont/Alford, New Marlborough, Monterey, Otis, Sandisfield, and Pittsfield. For more information, call 413-229-8080.

Pittsfield COA

It's one p.m. on the third Wednesday of the month, and as usual, the chairs around the large table in the "board room" of the Ralph Froio Senior Center are occupied by an intent-looking group of people. This is the monthly meeting of the Pittsfield Council on Aging and Chairman Albert Ingegni III gets everyone's attention, "We have a full agenda today, so let's begin."

The group first hears from Director Jean Beauchemin. She highlights some of the past month's activities ranging from the ever popular computer classes, to the very successful new member introduction sessions at the Senior Center. Beauchemin discusses the recently initiated Saturday lunches, and reports that more than 20 individuals are enjoying this new program each week. Of course, Beauchemin shares some of the difficulties encountered this month, too: the crowded parking lot; building security issues; the ongoing request for more, and new programs and services; and the concern that soon the building will be at excess capacity.

The next item up for discussion is raised by Theresa Bianchi, a COA member since 1983 . Bianchi chairs a number of committees but is reporting on the recent Senior Ball planning meeting. Although this major event does not occur until September, the committee meets year round. There are so many tasks involved in getting such a big production off the ground: choose and secure a location; plan a menu; select a band; fundraise, fundraise, FUNDRAISE! Theresa's group, comprised of COA members and many active senior center attendees utilizes many fundraising strategies...including orchestrating spaghetti dinners, and approaching local businesses for contributions. Theresa's home and professional schedule is so demanding that she often schedules her committee meetings for weekends!

Louis Paris, a COA member for ten years, quietly oversees the organization of a few key events sponsored each year by the COA. The annual children's holiday party attended by nearly 55 children is one of his areas of expertise. Louis works with committee members Ollie Levesque, Marge Campbell and Theresa Talarico and other active Center members to host a party that children and elders remember year round. There are gifts galore courtesy of Kay-Bee Toys and the Milton Bradley Co. and Santa always shows up for this party too.

Paris is also an active member in the Fourth of July float decorating committee. The Pittsfield COA often comes in first in one of the award categories and the enthusiasm, energy and elbow grease this group commits is indeed impressive! This year's parade float was organized by Ellie Persip. Some of the usual decorators include: Vin Hebert, Theresa Talarico, Marge and Ray Campbell, Roseanne Frieri, Joseph Lacker, Robert Hogue, Rosemary Chaiffre, Mary and Ralph Frieri, Sally Panetti, Fred Strelin, Ollie Levesque, Glen Guachiione, and Pauline Moon.

The financial report is presented by Treasurer, Robert Green. The COA is informed that all is running smoothly and the organization is fiscally sound. Other committee reports follow: The Goals and Objective Committee members have drafted a survey to be used soon at the Center to gather information about current users ... who is the "typical" attendee; what programs do they enjoy, what new programs are needed, what needs fixing...?

A special guest at today's meeting is Pittsfield's newly inaugurated mayor Gerry Doyle. The Mayor answers questions posed by COA members and reports that he is looking forward to working with this dedicated group. As in all municipalities, it is the Mayor who appoints members of the Council on Aging, with approval by the City Council. Mr. Doyle is sure to want to see the long history of hard working members continued in Pittsfield.

And this group certainly has history! Some members of the Pittsfield COA have been on board and actively involved for many years. Some of these highly esteemed long-tenured members include: Walter Malins and Odessa Daoust; Vincent Hebert, appointed in 1956, and Guy Pelligrinelli, appointed in 1958, continue to actively serve the Pittsfield Council on Aging!

Chairman Al Ingegni accepts the motion that the meeting be closed, but first thanks everyone for coming. "Only those people who have served on a board know what a time and energy commitment this can be. I appreciate all of the great Pittsfield COA members and enjoy working with them," he says.

Communicating With the Hearing-Impaired

There are many techniques that you can use to make it easier to communicate with a person who has a hearing loss. You may want to experiment to see what works best for you from the following list of suggestions: