University Park, PA. On Tuesday, May 3, 2011 at 10a.m. Penn State’s Department of Architectural Engineering and its Smart Spaces Center for Adaptive Aging in Community celebrated progress made in a coordinated effort to reduce the cost of housing for Pennsylvania’s elderly and disabled residents today and in the future.
The celebration took place at the virtual reality Immersive Construction (ICon) Laboratory. The celebration:
Demonstrated the use of full-scale 3-D virtual models on large display screens for evaluating cost-effective designs to allow for aging in place. The animated model, based on the Blueroof Technologies housing initiative in McKeesport, PA, is the work of graduate student Sonali Kumar. The virtual reality approach allows for an avatar to enter the wheel-chair accessible cottage and evaluate tasks such as making coffee in a kitchen to appropriately design for residents who desire housing where they can grow old without having to move to a costly institution.
Allowed participants to meet the leaders of Blueroof Technologies in McKeesport, PA using a live video connection. Blueroof is using prefabricated housing with embedded sensors for improving user interaction with their residence. The environment can inform a resident when to take medication, monitor for falls (then, call 911 if the resident slips in the shower and does not get up), and provide televised links to medical facilities reducing routine medical care cost.
Show the work of the Computer Integrated Construction Research Program, directed by John Messner, associate professor of architectural engineering, focusing on the application of advanced computer modeling to improve the design, construction, and operation processes for buildings.
Present the work of architectural engineering students trained in using 3-D experienced-based design. Virtual modeling is rapidly becoming an important tool for the construction industry, providing the ability to make changes in health care and other facilities before construction actually takes place.
Provide an opportunity for residents of Addison Court, a State College independent living facility for elderly and disabled individuals, to see what the future will bring and serve as critics who can use their life experiences to aid in the design process.
Highlight the work of Penn State’sSmart Spaces Center, directed by Richard Behr, who leads an interdisciplinary effort to address the needs of the rapidly increasing number of baby boomer Americans who wish to age successfully in their own homes.
Recognize contributions made by the Raymond A. Bowers Program for Excellence in Design and Construction of the Built Environment, the Smart Spaces Center, the Partnership for Achieving Construction Excellence, and other private and public organizations working with Penn State to improve life for Pennsylvania’s elderly and disabled.
Using a scooter from Amigo Mobility, Blueroof will begin to experiment on how to help residents with mobility disabilities make better use of the technology around them. The Amigo scooter will have an iPad 2 and other remote devices so residents can turn the lights on and off and perform other functions without leaving the chair.
After Florida, Pennsylvania has the highest per capita of elderly of any state in the union. Not all news about health care costs is bad news. Come learn about some of the good news.
Computer Integrated Construction Research Program:
Ambulance parked in front of my bedroom window waiting to pick up a neighbor
Ambulance parked in front of my bedroom window waiting to pick up a neighbor
Today is Sunday, February 26, 2012. I took the photograph above last week. My apartment is within an eight-story building housing 90 low-income elderly and disabled individuals, an ambulance parks outside my window at least once a week. Sometimes my neighbors and I return. Sometimes, not. The cost for Medicare, Medicaid, and other services to go on the gurney ride to the hospital and beyond is many times higher than the cost of preventing and treating.
The following article appeared in the October, 2011 issue of HME News and it still reflects an ongoing concern. Following the article, I will provide a memorial note on one of the residents who did not return.
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The money saved as a consequence of concentrating on what is right will astonish the body politic
” I have saved up enough pills to kill myself,” a neighbor told me, “if I ever have to go to Centre Crest.”
I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor–the more affluent are on Social Security or Social Security Disability and Medicare.
At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante’s inscription over Hell: “Abandon hope, ye who enter here.”
Last year, Pennsylvania’s Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.
The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare‘s purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain’s adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.
“The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science,” by Columbia University’s Norman Doidge, M.D., points to the brain’s ability to recover from strokes and other disorders with rehabilitation and concern.
“Traditional rehabilitation,” Doidge writes, “typically ended after a few weeks when a patient stopped improving, or ‘plateaued.’ And doctors lost the motivation to continue. But…these learning plateaus were temporary…Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined.”
The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare‘s frequent citations of the Congressional Budget Office‘s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out-of-state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.
Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.
“Individuals with disabilities remain one of our nation’s greatest untapped resources,” said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.
–Joel Solkoff is the author of “Learning to Live Again, My Triumph over Cancer” and is adjunct research assistant at Penn State’s Department of Architectural Engineering.
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Memorial Note: Tonight, November 14, 2011, Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assistive care facility in Bellefonte, PA, 11 miles from Addison Court.
Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year He will be buried beside his wife in Harrisburg at a private funeral.
Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, “I have been studied enough.”
His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.
[The following was originally published in the February, 2011 edition of HME News as a Valentine to the Durable Medical Equipment industry. The love continues.]
I was so angry, wild with fatigue, that I lifted my ugly drug store cane intending to destroy my employer’s computer printer. This was in California’s Silicon Valley. The printer was networked to nine computers. After a late night writing a portion of a manual on silicon wafer inspection, I commanded the computer to print.
After I weaved my way to the printer (seemingly miles away from the computer), there was no document. Five trips back and forth (nothing each time) and my level of frustration caught up to my level of exhaustion. My control was at the breaking point.
Six months previously, I had lost my ability to walk. The concepts I was writing about were hard to understand even when I had been healthy and well-rested. My ability to physically support my body was shaky. I fell several times a day. My right arm had been badly dislocated in a fall. What I needed was a fore-arm crutch with properly fitted prosthetics or a scooter. My doctors focused on understanding how I lost the ability to walk and little on how I could live without walking.
Mortgage payments were due. Home was North Carolina where a wife and two elementary-school-aged children waited. The local economy determined technical writers were not currently needed. At the same time (1996), California needed my skills as of yesterday and I was promptly hired for KLA-Tencor, a company paying large sums to do fascinating work.
I did not break the printer. I drove to my apartment, slept and thumbed the yellow pages praying for relief. I did not know what I was looking for. After a while, I left a voice mail with a dealer in wheelchairs and scooters (not knowing then what a scooter was). That is how I purchased my first mobility device.
Scott returned my call and listened to my situation. We talked price. He recommended a used front-wheel drive scooter. I was skeptical. “Let me show you how it works,” he said, crossed town quickly and lifted a scooter from his truck. I sat down and drove circles around the empty street. My able-bodied college friend David Phillips, in whose house I had an apartment, was fascinated. Keeping David from driving my scooter was hard.
I had discovered three important things about mobility devices:
They are fun.
They take away the drudgery of not being able to walk.
They remove the image that I am someone to be pitied.
I arrived at KLA-Tencor, having:
Given Scott a down payment (the beginning of many, mostly personal, expenditures, on equipment, including rear-wheel drive scooters, power chairs, wheelchair lifts and ramps)
Taken the scooter apart myself and shakily inserted the parts into the trunk
Slid sidewise hugging the Pontiac’s body
Reversed the process
My colleagues applauded. I had solved a physical problem with a technical solution and in the Silicon Valley that was worthy of commendation.
As I look back on the past 14 years, especially worthy of commendation are you, the suppliers of DMEPOS. My time with you here is almost up. Traditionally a column is about 750 words. I have used most of them. A 750-word column can express effectively only one major idea. That idea is that you, the medical suppliers, and people like me, your customers, are a family.
We are a family surviving in a world where David Stockman, Ronald Reagan’s former budget director, said in November on ABC News that the United States can no longer afford to provide its disabled citizens with “scooters.” As competitive bidding illustrates, clearly a bipartisan effort is underway to make it difficult for the disabled to receive mobility and other DMEPOS devices and for you, our local medical suppliers, to get paid for them or even to stay in business.
The pain is especially felt by indigent consumers and small suppliers. In this month where every day is Valentine’s Day, it is helpful to remember the words of Benjamin Franklin (an amorous man if ever there was one) on the signing of the Declaration of Independence: “We must all hang together or assuredly we shall all hang separately.”
–Joel Solkoff is a monthly columnist on disability and elderly related issues for Voices in State College, Pa. He is the author of three books, including The Politics of Food and Learning to Live Again: My Triumph Over Cancer. He served in the Carter Administration as Special Assistant to the Under Secretary of Labor. He has a bipartisan loathing of anyone trying to keep assistive technology from individuals with disabilities—a loathing he is trying to turn into corrective love.
“In 1900, Pennsylvania was the nation’s second largest state [now, sixth largest]….Pennsylvania steel began its decline four decades ago, when management decided not to keep up with new technology”….–Almanac of American Politics 2012 by Michael Barone and Chuck McCutcheon
Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.
June 19, 2012 update on Marilyn Tavenner’s confirmation (don’t hold your breath) hearings:
“So what did Sen. Max Baucus (D-Mont.) say when HHS Secretary Kathleen Sebelius asked him to hold a confirmation hearing for Marilyn Tavenner, acting administrator of CMS?
“’It’s going to be difficult to proceed with the Republican opposition,’ said Baucus, chairman of the powerful Finance Committee, when I asked him about the conversation.'”
You call the enthusiastic endorsement of Tavenner by Rep.Eric Cantor, House Republican Majority Leader, “Republican opposition.” Give me a break Senator Baucus.
Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.
Here is what I told Katrina vanden Heuvel , the editor and publisher of the Nation Magazine [who appeared this Sunday as a refreshingly articulate advocate for abandoning the current foolish policy of austerity above all else on This Week with George Stephanopoulos ] when she asked me to give my younger daughter a gift subscription as a college graduation present:
“Katrina:
“I am shocked by The Nation’s failure to report on the deterioration of the current Medicare system which as a recipient and a left-of-center Democrat, I can report on what is actually going on (despite the Nation’s unexamined rhetoric). Indeed, I have suggested that I write about it for you to no avail. Hence, no subscription for my daughter Amelia: https://joelsolkoff.com/blueroof-reality/countdown-to-amelias-graduation/”
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In response to the report from the Wall Street Journal below: 11:52 pm May 21, 2012 Joel Solkoff wrote :
The failure of Max Baucus and the 12 Democratic members of the Senate Finance Committee, many of whom are liberals whose rhetoric on saving Medicare is voluminous, to hold hearings on Marilyn Tavenner to be head of Medicare and Medicaid is a disgrace. As a paraplegic who has experienced the deterioration of Medicare as it currently exists under President Obama, the fact that his Administration has not had a confirmed Administrator reveals the sharp disparity between a President who lauds Medicare while cutting its budget by half a trillion dollars as part of the cynical price paid to ensure passage of Obamacare. Eric Cantor’s support of Tavenner would have forced Senate Republicans to think twice about voting against her. As one who enthusiastically supported the President four years ago, my unenthusiastic vote for his re-election is indicative of the lukewarm support that could cost him the election. The Nation, The Progressive, and other presumed defenders of Medicare have failed to be critical of the President’s penny-wise, pound foolish administration of a program which he is currently destroying while speaking eloquently about preserving its future. A genuine confirmation hearing for an Administrator whose budget is larger than the Pentagon’s is long overdue. Failure to hold hearings undermines the Democratic pretense that Medicare is worth saving and makes me ashamed to admit that I am a Democrat. What happened to the party of Adlai Stevenson and Eleanor Roosevelt? The best way for Obama to prove his credibility is to push for the support of his nominee and to indicate his commitment to what used to be Democratic values.
Presidential Nominations
112th Congress (2011 – 2012)
PN1165-112
Nomination: PN1165-112
Date Received: December 01, 2011 (112th Congress)
Nominee: Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned.
Referred to: Senate Finance
Legislative Actions
Floor Action: December 01, 2011 – Received in the Senate and referred to the Committee on Finance.
Organization: Department of Health and Human Services
Now for some background information. In December, I published the following article in HME News, the publication for the home medical equipment industry which may help you understand the circumstances behind the nomination of Marilyn Tavenner to head the half trillion-dollar agency which significantly affects the life and health of all Medicare and Medicaid recipients.
Who is in charge of Medicare?
The wide-ranging debate over Medicare, a major factor in the presidential election next year, primarily focuses on whether future generations will benefit in the same way that the current 46 million recipients like me benefit. Politicians, critics and would-be-recipients express the illusion that the health care I receive from Medicare represents the ideal. I believe that the only way to save Medicare is to dramatically improve the way it is run today so that it remains a program worth saving.
The primary audience for this commentary is the men and women who provide DME other equipment necessary to sustain and maintain the quality of life. Recently, 87-year-old Lilian Hutchinson, who gets around on an unstable walker, fell and broke her elbow in an independent living facility for 90 elderly and disabled residents where I live in State College, Pa. I believe that if Lillian had access to a scooter or a power chair in her apartment, she would not have fallen. The tales of needless suffering you could tell resulting from a Medicare bureaucracy that increasingly limits access to mobility equipment and medical oxygen seem beside the point.
Durable medical equipment represents only a small fraction of the Medicare budget. The whole system for providing medical care for the elderly, disabled and poor is not working efficiently in large part because of the absence of leadership at CMS, an agency of the U.S. Department of Health and Human Services. My intention here is to answer the question: Who runs Medicare? In theory, Dr. Donald Berwick, a distinguished Harvard physician with an outstanding reputation as an advocate for efficient health care, runs CMS.
Last year, President Obama named Dr. Berwick to be administrator of CMS, a position one senator described as the nation’s health czar since the job also includes putting in place much of the legislation passed last year, which, by one estimate, will extend health care to 32 million Americans who do not have coverage.
Sadly, the president had failed to appoint an administrator early on in his administration, when Senate confirmation would not have been a problem and when an adviser with the expertise and gravitas Dr. Berwick has in the medical community would have proven useful. The major flaw in the president’s landmark legislation was how he intended to pay for it. He decided against raising taxes, which might have doomed passage.
Instead, half the estimated trillion dollars required to extend healthcare coverage was targeted to come from savings to the Medicare budget as a result of achieving cost savings, reducing fraud and abuse, and increasing efficiency. Anyone who has ever made a New Year’s resolution to save money can tell you it is imprudent to spend it before the money is actually saved.
By the time Dr. Berwick arrived at Medicare, he was in the impossible situation of being required to save $500 billion, a requirement for which he had not been consulted and in a situation where the president had given him neither the time nor the authority to implement.
The political comedian Mark Russell observed, in a similar context, that exercising leadership without the necessary authority is equivalent to sending a eunuch to an orgy. Fearful of Republican reaction to Dr. Berwick’s appointment and unsure of the allegiance of Democrats on the Senate Finance Committee, the president refused to fight for Berwick’s confirmation or to find a replacement who would achieve bipartisan support.
Using the recess appointment mechanism, which allows a president to appoint an official on a temporary basis while Congress is not in session, Berwick currently serves as acting administrator and will be replaced next year by his deputy Marilyn Tavenner. Tavenner, while respected for her organizational skill, her background as a nurse and a hospital and state health care administer, does not have the stature required to lead what is in effect a cabinet level position.
Although CMS has a larger annual budget than the Pentagon, as I write this, there has not been a confirmed head of Medicare since 2006. For the purposes of comparison, if the Defense Department did not have a confirmed secretary for five years, there would be a national outcry.
–Joel Solkoff was a political appointee in the Carter Administration, serving as special assistant to the Under Secretary of Labor. He believes a bipartisan solution to the problems of Medicare is achievable.
On February 3, I sent the following letter to Senator Max Baucus (D Montana), chairman of the Senate Finance Committee which has oversight over Medicare and has the power to conduct confirmation hearings on President Obama’s nominee to run Meadicare:
The Honorable Max Baucus
Chairman
Committee on Finance
United States Senate
219 Dirksen Senate Office Building
Washington, D.C. 20510
Dear Senator Baucus
I am writing to request an invitation to testify at the confirmation hearing of Marilyn Tavenner to be Administrator of the Centers for Medicare and Medicaid Services.
I am a paraplegic who is a Medicare recipient. While I am generally supportive of Acting Administrator Tavenner’s appointment, especially since it has been so long that CMS has had a confirmed Administrator; I have considerable concerns about durable medical equipment. As a user of mobility devices and as one who has researched other equipment in the durable category, especially medical oxygen, I think it important that my concerns be discussed.
Specifically, I am concerned about the cumbersome procedures involved in obtaining medical equipment. The current competitive bidding program, the absence of assurances that award winners will provide batteries, other necessary equipment, and maintenance are among the issues on which I would like assurance—both from Acting Administrator Tavenner and from the Senate Finance Committee with its oversight responsibilities.
I realize that no hearings have been scheduled as of this writing. However, given the importance of Medicare and Medicaid I would appreciate my voice being heard, especially on the subject of indigent disabled individuals who have suffered most from current and proposed CMS practices.
I write frequently on disability issues for Voices of Central Pennsylvania, HME News, the monthly publication of the home medical care industry, and for a variety of other publications. I am the author of three books including Learning to Live Again My Triumph over Cancer. My disability writing can be accessed easily by keyboarding my name into Google.
Thank you.
Sincerely,
Joel Solkoff
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Of course I cannot testify unless there are hearings.
For a number of reasons, it seems likely that Marilyn Tavenner is not a controversial nominee and the committee and the Senate would vote to confirm her.
It is hard to run something when you do not have the necessary authority.
Politicians are using this election season to talk about the important of Medicare and Medicaid. If they really believe what they say they would hold confirmation hearings.
There has not been a confirmed had of Medicare since the Bush Administration.
The following was published in June of 2010 shortly before my mother died. It appeared in my monthly column From Where I Sit, produced on a monthly basis for Voices of Central Pennsylvania, my spiritual home here in State College, PA.
The column appeared regularly for over a year, written sometimes between hospitalizations but submitted on time and limited, believe it or not, to 750 words.
Sometimes, I used the Voices Web Site to expand on material contained in the monthly printed column. My appreciation to the brilliant Suzan Erem, then Managing Editor of Voices, and to Bill Eichman, the gifted Webmaster and current President of Voices, is considerable.
The issue of travel barriers for people like me who cannot walk and require battery-powered scooters and power chairs is considerable. It is worthy of note that the State College airport refuses to allow disabled individuals to board who are confined to power chairs.
Travel barriers limit lives of those with disabilities
“Are you really my son?” my 84-year-old mother, who suffers from dementia, asks. Six weeks ago my mother, Dr. Miriam Pell Schmerler, stopped answering the telephone by herself. Our weekly calls were models of the bizarre, with my combining Hebrew and English into the conversation, knowing that hearing my name in Hebrew sparked recognition not otherwise available.
The once a week calls followed a pattern. I would tell her that I was her son. “Really?” she said, “how nice.” Then we would talk about some aspect of her life: her career including a doctorate in Hebrew letters (received in her late 50s) from the Jewish Theological Seminary.
In our calls I repeatedly identified everyone, Mother’s daughter, grandchildren, and husbands. “You know you were married three times.” “Three times,” she said “that’s a lot, isn’t it?” I then described each of her husbands, including my father who was 27 years older than she. “Isn’t that a big difference in age?” she asked.
The ongoing saga of her life amused her. It filled me with a tenderness for my mother I do not recall ever having felt.
I remember Gerald Sakamoto, my Buddhist minister from the San Jose CA Buddhist Betsuin, saying he had “issues” with his mother.
The word “issues” seems so refined and polite I adopted the word instantly. During our conversations, the issues disappeared. My cousin Michael once commented about how witty and charming my mother is. I said I had never observed it. Michael said, “Of course not. She is your mother. She cannot allow herself to be witty and charming in front of you.”
Now that she did not recognize me, other than as a friendly caller telling stories about her life, my mother became a real person for me. My children, Joanna and Amelia, found distress in Mother’s inability to recognize her grandchildren. While I tried to explain my perspective, I could not alleviate their distress.
Nor could I alleviate my own distress in mid-March when I called Mother and she did not answer the phone. I began a new routine, calling the staff at the excellent Blumenthal Jewish Home for the Aged in Greensboro, NC and asking Jackie, Brooke, Marina, Mary Anne or Kim to go to mother’s room and hand the ringing phone to Miriam. My mother’s voice conveyed a sense of confusion and distress. The conversation was largely gibberish. It became clear that I had to see her. But how?
The answer is circuitous. My 1993 Buick was broken. I entrusted it to Gary D. Green’s College Heights Exxon, a wonderfully reliable institution. My mechanic Jeff told me he needed more time to figure out what was wrong. Nevertheless, I needed to go to Altoona, headquarters of the Blair/Clearfield Association for the Blind and Visually Impaired, for which I work.
I researched bus service to Altoona which would take me downtown (and my power chair has enough battery power to take me to and from the office), but I could not get to a safe accessible motel where I planned to stay the week. There is no train.
I had heard about a disability van service called Wheelchair Getaways. After talking to Shannon Markley, I decided to pay for the incredibly expensive rental, knowing my creditors would and would not understand. When Shannon mentioned a slight discount for a week or more, I decided to spend the weekend seeing my mother—something I could not do otherwise. For a lengthy drive, neither my Buick nor my stamina could be relied upon to hold up while going from the wheelchair lift at the rear of the car to the driver’s door, brushing my body against the car in the process.
The van has a button on the ignition key, which when pressed twice, opens the passenger-side panel door and a wheel chair ramp unfolds. I drive my power chair (the airlines at the State College airport refuse to accept power chairs on their flights) up the ramp. After closing the door with two key presses, I use the controls for the driver’s seat to move the seat back, sideways and up, so I can transition from power chair to driver’s seat without difficulty.
Without the van, I would not have been able to go to work, see my mother and have lunch with my two children. This month’s column raises an ongoing theme: the critical nature of travel for those of us with disabilities. Employment opportunities require going to where the work is located. Families separated by miles need to be together even if only on occasion. The worst thing for the economic survival and the individual feeling of self-worth is being confined to one’s room without the opportunity to earn an income and see loved ones. Travel must be made easier for those of us with disabilities.
Rep. Glenn Thompson discusses his nearly 30-year long career as a manager of rehabilitation therapists, as a rehabilitation therapist, and as a health worker, which included changing bed pans at Centre Crest, an assistive living facility near State College, PA.
I interviewed the Congressman on February 6, 2010. Rep. Thompson called me at State College from Tuscon, AR where he was visiting his son who had been wounded during military service. He was unable to return to Washington, DC because the DC area which had received two feet of snow closing airports and requiring Congress to readjust its voting schedules.
At the time, I was a columnist for Voices of Central Pennsylvania, a publication that has been extremely kind to me. My monthly column, entitled From Where I Sit, ran for over a year and concentrated exclusively on disability-related issues. This voice interview, published on the web page of the publication, was an adjunct to the following March, 2010 printed column:
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Strangers, snow and rehabilitation
Thanks to a failure to act in January, the Obama administration has made a serious mistake in allowing competitive bidding for durable medical equipment such as oxygen canisters, wheelchairs, power chairs and other devices.
I believe that if President Obama had a Medicare adviser of stature to explain the
consequences, Obama would not have made this mistake that will continue to hurt people with disabilities—including me.
As a result of this competitive bidding process, T&B Medical and Dick’s Homecare—the only two companies providing power chairs, scooters and other equipment in State College—are in danger of losing to outside competitors, including competitors outside the state. What they are at greatest risk of losing are contracts to provide Medicare recipients such as myself with equipment and maintenance reimbursements.
Maintenance is the issue I worry about most. Some legislators have put together a plan, supported by a sizeable non-partisan group in the House, that would end the bidding process.
One of the authors of the legislation is Rep. Glenn (“GT”) Thompson, who represents Pennsylvania’s Fifth Congressional district, of which Centre County (his home) is one of 17 counties in a huge, 11,000 square mile district.
I asked Tina Kreisher, Thompson’s press secretary, for a 20-minute exclusive telephone interview because I thought we could cover the details on Thompson’s health care background so readers can see the link between what our congressman knows and the unsolved problems he is equipped to solve.
Thompson and I spoke by telephone for over an hour on Tuesday, Feb. 9 at 6 p.m. I did not realize the degree of detail we would get involved in, especially since Thompson is himself the father of a disabled Iraqi war veteran. Thompson does not make a practice of talking in public about 22-year-old Logan, who was wounded when shrapnel and explosives caught him by surprise.
Thompson called me from Tucson, Ariz. where he was attending Logan’s graduation from Army intelligence training, an experience that filled him with the special gratitude we in the disability community feel when someone we love makes progress toward independence. The two feet of snow in Washington had left him stranded in Tucson and he observed, “There are worse places to be stranded.”
Thompson’s advancement in health care followed two tracks. Academically, he received a bachelor’ degree from Penn State in Therapeutic Rehabilitation, a master’s degree from Temple for Health Science Recreation and a certification from M a r y w o o d University in Nursing Home Administration.
M e a n w h i l e , Th o m p s o n ’s career involved working in central Pennsylvania as a residential services aid, a recreation therapist and a rehabilitation services manager at Susquehanna Health Services in Williamsport.
Thompson was at one time an orderly at Centre Crest Nursing Home, and for three years cleaned out bed pans, changed patients out of soiled clothes and changed bedding. He worked with his wife Penny, who did similar work as a nursing assistant. At the same time, Thompson’s mother was a patient at Centre Crest’s Alzheimer’s facility.
Glenn Thompson [everyone calls him (“GT”)] developed a reputation for good work and excellent managerial abilities, including people skills. When GT visited State College on Labor Day weekend, his charm was evident. He talked about health care in the social hall and bingo parlor (across the hallway from where I am keyboarding this column) of Addison Court, which is an apartment house for senior citizens and those with disabilities. The Congressman arrived for the 8 a.m event just as the Webster’s coffee and goodies arrived. (It helps turnout for these events when food is present and Elaine Madder-Wilgus has been most obliging in providing the coffee Thompson was so grateful to drink.) The 10 additional members of the audience were mostly men and women in their 70s, 80s and 90s.
GT charmed everybody—83-year-old Lilian Hutchison, put her hand on my shoulder and said, “I like that fellow” and Lilian is very influential at Addison Court. Win Lilian Hutchison and you have won votes at Addison Court. Lilian is a registered Republican who voted for Obama.
In my interview with Thompson, I asked about each portion of his 31-year career, which ended when he was supervising 25 rehabilitation specialists and coming up
with strategies for improving ongoing rehabilitation.
For me, sitting in a power chair right now, Thompson is the guy to know. I am at a point where I can now go back to rehabilitation to Dr. Colin McCaul, a brilliant rehabilitation physician at Healthcare South, because I recently passed a cardiac stress test. Since I cannot walk, cannot stand without holding on to something and can dislocate my shoulder if I throw my right arm straight in the air, I need a specialist to adapt special exercising tools so I can get the cardiovascular exercise I need. In my considerable experience with physical rehabilitation in three states, the people who do the hands-on work, the people who touch my body to show me how to do special exercises, when touching is appropriate (a pat on the back is always useful)—these people are uniformly kind and helpful.
I am impressed by the kind of work Glenn Thompson did and taught other rehabilitation specialists how to do. Based on his experience, his testimonials, his conversation and his education, I feel sufficiently trusting to put my exercise program in his hands if he has time.
Obama, the president I helped elect, is doing some truly bad things to Medicare that will have severely negative effects on the disabled. They have potentially disastrous effects on me. I use my power chair frequently; I require battery replacements every six months. What if the competitive bidding process the Obama administration is implementing results in requiring me to get batteries from an out-of-area supplier and I have to wait too long?
Right now, Travis would be right over with the batteries. With competitive bidding, I have to depend on some anonymous supplier. During that wait, if my batteries won’t take a charge and I soil my bed repeatedly, I might have to move to CentreCrest, which would severely limit my opportunities.
The failure of the Obama administration to reach across the aisle, as it promised to do, is shocking when Glenn Thompson’s special knowledge is going to waste. At the time of my interview with Rep. Thompson on Feb. 6, the President had yet to announce an Administrator for Medicare and Medicaid. Medicare is the largest health insurance company in the United States. Medicare needs an administrator who can be confirmed by the Senate. Thompson would be confirmed by the Senate.
Or, President Obama, please find him a better job. Or wake up the Republican House Leadership and have him put on the Ways and Means Committee where he will have oversight over Medicare. Given the overwhelming Republican composition of the Fifth Congressional District, Thompson will eventually gain the seniority he needs.
I don’t want to wait. I want Thompson‘s special skills available to me now because I believe he can assure me a more secure future.
“People do not wish to learn about how to deal with death until they are confronted by death, and when they are confronted with death they are not inclined to study how religion approaches it,” writes Maurice Lamm in The Jewish Way in Death and Mourning.
My mother, Miriam Pell Schmerler, died this morning September 6, 2010 at about 3 AM. She died after a lengthy stay at the Blumenthal Jewish Nursing Home and Rehab Center where the chart says she suffered from Alzheimer’s disease and dementia.
For all Mother’s professional life, which began at the age of 16, she was a Hebrew school teacher, principal, and administrator in the Jewish bureaucracy—known jocosely as “the Jewish civil service.”
Her thesis focused on Pope John XXIII’s efforts to rid the Roman Catholic Church of its poisonous teaching that the Jews killed Jesus, and the thesis describes how the Pope enlisted the help of Rabbi Abraham Heschel, a theologian who at the time had taught at the Jewish Theological Seminary, the center of the Conservative Jewish movement, with the title Professor of Theology and Mysticism. (He also smoked cigars.) Heschel is best known for his friendship with the Rev. Martin Luther King, Jr. and for his opposition to the War in Vietnam.
Mother’s academic writing on ecumenicism began with her master’s degree from Barry University in Florida where her thesis concerned the daily life of Jesus and the ways in which he followed Jewish teachings.
At Greensboro North Carolina, Mother served as an ambassador to Temple Beth David’s Rabbi Eliezer Havivi speaking at churches on protestant ecumenical statements revising doctrine on who killed Jesus, showing church leaders and congregants how Jesus celebrated Jewish holidays, and becoming a lifelong member of Greensboro’s interfaith council. Mother’s love for the Hebrew language and her knowledge of it was employed on a regular basis as she attended Beth David’s services and corrected the Hebrew of celebrants, leading, indeed, to the current culture of her synagogue where the quality of Hebrew is excellent. Mother spent a summer at State College PA working on the Jewish Publication Society’s landmark translation of the Bible into English.
Mother is also survived by my sister Sarah Schmerler, who is an artist in her own right, a widely published art critic, and an instructor to artists on how to use language to describe their work, especially in grant proposals, Sarah is the mother of one of Miriam Schmerler’s three grandchildren, Asher Simonson, age 8 who is crazy about Legos products with a Star Wars theme.
The other two are my children Joanna Marie Solkoff, 25, an EMT who is about to begin nursing school at Chapel Hill after receiving an honor’s BA in English, where she wrote about obscure novels by the guy who wrote Robinson Crusoe. Amelia Altalena Solkoff, 20, is currently spending her junior year abroad in Spain and we recited the Jewish mourner’s prayer over a Skype connection earlier today. Both Mother’s granddaughters smoke cigars.
I plan to sit shiva, a Jewish custom of mourning during which I will say prayers in Hebrew and Aramaic and receive visits from my friends. The Jewish community at Congregation Brit Shalom, under the direction of Rabbi David Ostrich, a wonderful rabbi, will take good care of me. I will continue to cry as I think about my mother and mourn her death.
–Joel Solkoff
My mother in 1925
The following was published in June of 2010 shortly before my mother died. It appeared in my monthly column From Where I Sit, produced on a monthly basis for Voices of Central Pennsylvania, my spiritual home here in State College, PA.
The column appeared regularly for over a year, written sometimes between hospitalizations but submitted on time and limited, believe it or not, to 750 words.
Sometimes, I used the Voices Web Site to expand on material contained in the monthly printed column. My appreciation to the brilliant Suzan Erem, then Managing Editor of Voices, and to Bill Eichman, the gifted Webmaster and current President of Voices, is considerable.
The issue of travel barriers for people like me who cannot walk and require battery-powered scooters and power chairs is considerable. It is worthy of note that the State College airport refuses to allow disabled individuals to board who are confined to power chairs.
Travel barriers limit lives of those with disabilities
“Are you really my son?” my 84-year-old mother, who suffers from dementia, asks. Six weeks ago my mother, Dr. Miriam Pell Schmerler, stopped answering the telephone by herself. Our weekly calls were models of the bizarre, with my combining Hebrew and English into the conversation, knowing that hearing my name in Hebrew sparked recognition not otherwise available.
The once a week calls followed a pattern. I would tell her that I was her son. “Really?” she said, “how nice.” Then we would talk about some aspect of her life: her career including a doctorate in Hebrew letters (received in her late 50s) from the Jewish Theological Seminary.
In our calls I repeatedly identified everyone, Mother’s daughter, grandchildren, and husbands. “You know you were married three times.” “Three times,” she said “that’s a lot, isn’t it?” I then described each of her husbands, including my father who was 27 years older than she. “Isn’t that a big difference in age?” she asked.
The ongoing saga of her life amused her. It filled me with a tenderness for my mother I do not recall ever having felt.
I remember Gerald Sakamoto, my Buddhist minister from the San Jose CA Buddhist Betsuin, saying he had “issues” with his mother.
The word “issues” seems so refined and polite I adopted the word instantly. During our conversations, the issues disappeared. My cousin Michael once commented about how witty and charming my mother is. I said I had never observed it. Michael said, “Of course not. She is your mother. She cannot allow herself to be witty and charming in front of you.”
Now that she did not recognize me, other than as a friendly caller telling stories about her life, my mother became a real person for me. My children, Joanna and Amelia, found distress in Mother’s inability to recognize her grandchildren. While I tried to explain my perspective, I could not alleviate their distress.
Nor could I alleviate my own distress in mid-March when I called Mother and she did not answer the phone. I began a new routine, calling the staff at the excellent Blumenthal Jewish Home for the Aged in Greensboro, NC and asking Jackie, Brooke, Marina, Mary Anne or Kim to go to mother’s room and hand the ringing phone to Miriam. My mother’s voice conveyed a sense of confusion and distress. The conversation was largely gibberish. It became clear that I had to see her. But how?
The answer is circuitous. My 1993 Buick was broken. I entrusted it to Gary D. Green’s College Heights Exxon, a wonderfully reliable institution. My mechanic Jeff told me he needed more time to figure out what was wrong. Nevertheless, I needed to go to Altoona, headquarters of the Blair/Clearfield Association for the Blind and Visually Impaired, for which I work.
I researched bus service to Altoona which would take me downtown (and my power chair has enough battery power to take me to and from the office), but I could not get to a safe accessible motel where I planned to stay the week. There is no train.
I had heard about a disability van service called Wheelchair Getaways. After talking to Shannon Markley, I decided to pay for the incredibly expensive rental, knowing my creditors would and would not understand. When Shannon mentioned a slight discount for a week or more, I decided to spend the weekend seeing my mother—something I could not do otherwise. For a lengthy drive, neither my Buick nor my stamina could be relied upon to hold up while going from the wheelchair lift at the rear of the car to the driver’s door, brushing my body against the car in the process.
The van has a button on the ignition key, which when pressed twice, opens the passenger-side panel door and a wheel chair ramp unfolds. I drive my power chair (the airlines at the State College airport refuse to accept power chairs on their flights) up the ramp. After closing the door with two key presses, I use the controls for the driver’s seat to move the seat back, sideways and up, so I can transition from power chair to driver’s seat without difficulty.
Without the van, I would not have been able to go to work, see my mother and have lunch with my two children. This month’s column raises an ongoing theme: the critical nature of travel for those of us with disabilities. Employment opportunities require going to where the work is located. Families separated by miles need to be together even if only on occasion. The worst thing for the economic survival and the individual feeling of self-worth is being confined to one’s room without the opportunity to earn an income and see loved ones. Travel must be made easier for those of us with disabilities.
—Joel Solkoff, author of The Politics of Food.
Mother and me, 1959
My father and mother on their wedding day 1945
Standing, left to right: My mother, daughter Joanna, sister Sarah, me holding daughter Amelia, grandmother Celia, 1990
Waiting for the energy to crawl along the car into the driver’s seat
[Note: I was planning to show the last photograph I took of my mother, but it pains me so and she would not want you to see it.]
