From the CEO.....................................2Childhood Obesity.............................3MO Health Insurance Market Place...................................................4Making Medicare Make Sense .......5Resident Rights Month.....................6

Vol. XL, No. 2 September/October 2013

Continued on Page 3.

The MAP site is presented to the citizens of Missouri as a single point of reference to review how their money is being spent and other pertinent information related to the enforcement of government programs. As you browse the MAP site you will be able to view information about state agency expenditures, the distribution of economic development tax credits, state employee pay information, budget restrictions, revenues and expenditures related to the American Recovery and Reinvestment Act of 2009 and “Who Is Not Paying.”

The data on the MAP site is updated each business day. New features are added as they become available. Please visit the site frequently for new information.

Find out what your tax money is doing – with MAP it’s easy!

Excerpted from the official Missouri state website at: http://mapyourtaxes.mo.gov/MAP/Portal/Default.aspx

A MAP to your tax dollars: the Missouri Accountability Portal

(MAP)About 1 in 8 women born today in the United States will get breast cancer at some point during her life. After skin cancer, breast cancer is the most common kind of cancer in women.

The good news? Many women can survive breast cancer if it’s found and treated early.

Women can help lower their risk of breast cancer in the following ways:

Get screened for breast cancer regularly. By getting the necessary exams, you can increase your chances of finding out early on, if you have breast cancer.

Breast cancer screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. Three main tests are used to screen the breasts for cancer. Talk to your doctor about which tests are right for you, and when you should have them.

Mammogram.• A mammogram is an X-ray of the breast. Mammograms are the best method to detect breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. If you are age 50

to 74 years, be sure to have a screening mammogram every two years. If you are age 40–49 years, talk to your doctor about when and how often you should have a screening mammogram.Clinical breast exam.• A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes.Breast self-exam.• A breast self-exam is when you check your own breasts for lumps, changes in size or shape of the breast, or any other changes in the breasts or underarm (armpit).

Which tests to choose: Having a clinical breast exam or a breast self-exam have not been found to decrease risk of dying from breast cancer. Keep in mind that, at this time, the best way to find breast cancer is with a mammogram. If you choose to have clinical breast exams and to perform breast self-exams, be sure you also get regular mammograms.

Control your weight and exercise. Make healthy choices in the foods you eat and the kinds of drinks you have each day. Stay active.

October is National Breast Cancer Awareness Month

2 July/August 2013

The Central Missouri Area Agency on Aging (CMAAA) is a private, not-for-profit Area Agency on Aging serving 19 counties in Mid-Missouri: Audrain, Boone, Callaway, Camden, Cole, Cooper, Crawford, Dent, Gasconade, Howard, Laclede, Maries, Miller, Moniteau, Morgan, Osage, Phelps, Pulaski and Washington.

CMAAA recognizes the individual capabilities and needs of each older person. Therefore, CMAAA’s mission is to assist communities in establishing a full range of services, which allow older persons to live in the most independent manner possible.

OfficersLorraine Dowler, President

(Miller)Fred West, 1st Vice President

(Audrain)Elinor Snelson, 2nd Vice President

(Crawford)

MembersKenny Harrison (Boone)Jim Ringland (Callaway)

James Kitterman (Camden)Patrice Donehue (Cole)

Vacant (Cooper)Robert Edwards (Dent)

Robert Niebruegge (Gasconade)Debra Miller (Howard)

Jimmie Kilgore (Laclede)Jake Warren (Maries)

James Canter (Moniteau)Bob Raines (Morgan)

Vacant (Osage)Maxine Palmer (Phelps)Ben Hammock (Pulaski)

Maggie Shellabarger (Washington)

Chief Executive OfficerJean Leonatti

Our Mission

CMAAA

Board of Directors

2

From the CEO...By Jean Leonatti

The Heat is ON !!!

Hopefully, by the time you read this our late summer heat wave will be over and we will be enjoying the beautiful autumn weather. That doesn’t mean that we have “cooled down” here at CMAAA --- we have many new challenges and opportunities this fall. The heat is on as we gear up to continue our tradition of quality information and services to more and more Missourians.

We will be undertaking two projects this fall --- one has to do with health insurance and one has to do with Medicare prescription drug coverage.

CMAAA along with many other community partners will be helping uninsured Missourians obtain health insurance through the Missouri Health Insurance Marketplace. These are for persons who currently have NO HEALTH INSURANCE coverage – regardless of age or income. (If you receive Medicare or Medicaid, you HAVE health insurance - you don’t need to enroll in the Health Insurance Marketplace.)

We are currently receiving training and will be licensed to provide information on the Health Insurance Marketplace in our 19-county area. Because we do not sell insurance or receive any money from insurance companies, we can be fair and impartial with the information and assistance we provide.

Although Medicare beneficiaries do not need to be concerned about the Missouri Health Insurance Marketplace, this is the time of year

they must choose a Medicare Part D Prescription Drug Plan for the upcoming year. We are here to help you. Open enrollment begins October 15 and ends December 7. Changes take effect on January 1. We strongly urge you to make your decision early – don’t procrastinate.

To summarize, this fall you will hear a lot about health insurance and prescription drug coverage. It might be on television, the radio, local newspapers, email, and regular mail. You will hear about two “open enrollment” periods this fall. It will be very easy to get confused. Just remember ---

If you don’t have health insurance of any kind you will want to pay attention to information about the Missouri Health Insurance Marketplace. If you do have Medicare coverage, you will want to review your Medicare Part D options.

Regardless of which group you are in, we can help you understand your options and assist you in enrolling in the plan of your choice. We can access information that will help you make an informed decision. Let us help you!

3September/October 2013

Cancer Continued from Page 1.

Older adults need at least: 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Know your family history of breast cancer. If you have a mother, sister, or daughter with breast cancer, ask your doctor what is your risk of getting breast cancer and how you can lower your risk. For more information, visit the Agency for Healthcare Research and Quality for information about medicines to prevent breast cancer and genetic testing for breast cancer.

Find out the risks and benefits of hormone replacement therapy. Some women use hormone replacement therapy (HRT) to treat the symptoms of menopause. Ask your doctor about the risks and benefits of HRT and find out if hormone replacement therapy is right for you.

Limit the amount of alcohol you drink. There is robust evidence from more than 100 studies that suggest a dose-response association between alcohol and breast cancer. A woman who drinks, on average, one drink per day has a 10 percent elevated risk.

This article is excerpted from the Centers for Disease Control and Prevention (CDC) websites at: http://www.cdc.gov/cancer/breast/index.htm

According to the Centers for Disease Control, childhood obesity has tripled in the last three decades and nearly one fifth of United States 6- to 11-year-olds are obese. And, 1 of 3 children are obese or overweight before their fifth birthday.

Childhood obesity has both immediate and long-term effects on health and well-being.

Immediate health effects:Obese youth are more likely •to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease.Obese adolescents are more •likely to have prediabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes.Children and adolescents who •are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.

Long-term health effects:

Children and adolescents •who are obese are likely to be obese as adults and are therefore more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis. One study showed that children who became obese as early as age 2 were more likely to be obese as adults.Overweight and obesity are •associated with increased

risk for many types of cancer, including cancer of the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, and prostate, as well as multiple myeloma and Hodgkin’s lymphoma.

Strategies that parents and grandparents can use to help prevent obesity in their children and grandchildren:

Increase their physical activity•Increase their fruits and •vegetable consumptionReduce their intake of •energy dense food and sugar consumption. (An example of an energy dense food is raisins. A lower-energy dense food would be grapes.)Provide child-size portions•Decrease their television •viewing timeAvoid using food as a reward•

Portions of this article were excerpted from the Centers for Disease Control and Prevention’s website, For more information about how to help prevent childhood obesity in your family, check out the CDC website at: http://www.cdc.gov/obesity/childhood/.

Let’s Help Children Have a Healthier and Brighter Future

4 September/October 2013

What is the Missouri Health Insurance Marketplace?

The Missouri Health Insurance Marketplace is a website where you can compare and buy an insurance plan to fit your budget and health care needs. You can use the Marketplace if you are an individual or family who doesn’t have access to affordable coverage through work. The Marketplace opens on October 1, 2013, with health insurance coverage starting January 1, 2014.

How does the Marketplace work?

It’s a lot like travel websites where you can compare prices and buy hotel or plane tickets. In the Missouri Health Insurance Marketplace you can compare prices and buy quality, affordable health insurance. Private insurance companies offer the health plans sold in the Marketplace.

On The Missouri Health Insurance Marketplace website you can:

Compare health insurance •plans.Get the cost of health insurance •plans before you buy.Find out if you can get financial •help – most people will qualify for some financial assistance.See if you qualify for Medicaid, •a public health insurance program.Buy a health insurance plan •that best meets your needs.

Choosing a plan in the Marketplace

When you go to the Missouri Health Insurance Marketplace, you’ll havethe choice of four types of plans. Insurance plans available through the Marketplace are divided into four “metal” levels based on how

much they will pay for covered health services. Levels include: bronze, silver, gold, and platinum. All Marketplace health plans, at every level, will cover the same essential health benefits.

Gold or platinum plans will •probably cost you more each month, but you may spend less money out of your own pocket when you use health services.Bronze or silver plans will •probably cost you less each month, but you’d spend more money out of your own pocket when you use health services.

What kind of financial help can I get?

If you use the Missouri Health Insurance Marketplace, you may be able to save money on health insurance.

Premium tax credits may lower how much you pay for your health plan.Cost-sharing reductions may lower how much you spend out of your ownpocket for covered health services. This financial help uses a sliding scale, so families making less money pay a smaller amount for health insurance and health care.

You’ll see if you can get financial help and how much you can save whenyou fill out your Marketplace application. The Missouri Health Insurance Marketplace opens October 1, 2013. Insurance coverage and financial help start on January 1, 2014.

How do I get covered?

You can buy insurance through the Missouri Health Insurance Marketplace October 1, 2013 through March 31, 2014. The process will

be simplified – you only need to fill out one application to get coverage and financial help. You can apply online, by phone, or in person.

Help using the Marketplace

If you have questions, need help selecting a health plan, or completing your application, there are several types of help available. You can:

Talk to someone in person.• Navigators and Certified Application Counselors are trained people who can answer questions and help you fill out your application in person. They’re required to provide fair and accurate information. Find help near you by calling CMAAA at 1-800-369-5211 or at the website www.covermissouri.org.

Call the toll-free call center• , open 24 hours a day, 7 days a week. Call 1-800-318-2596 (TTY 1-855-889-4325).

Talk to someone online.• You can have a live online chat at www.healthcare.gov. Spanish speaking individuals can use www.cuidadodesalud.gov.

Talk to an agent or broker.• Insurance agents and brokers can also help you find, choose, and buy coverage. They must be appropriately registered to conduct business in Missouri. It is important to note that agents and brokers can receive money from a health insurance company for enrolling people into their plans.

This article is excerpted from the Missouri Foundation for Health’s website www.covermissouri.org.

The Missouri Health Insurance Marketplace: What Individuals and Families Need to Know

5September/October 2013

Q: It seems like I am hearing more about fraud and identity theft more often, these days, especially against people with Medicare. And the new way to shop for health insurance, the Marketplace, for other consumers is coming in October. I’m worried that I could get scammed. What do I need to know?

A: It’s always wise to be on the lookout for scams, frauds, and con artists and the Centers for Medicare & Medicaid Services encourages you to always guard your personal information. This is especially true in the upcoming enrollment period, because there may be dishonest people who try to take advantage of those who may not understand what is happening and what they should – or should not – be doing. What is most important to remember is that the Marketplace will not affect your Medicare coverage or benefits at all. The Marketplace is primarily for people who do not have health insurance, have had trouble obtaining coverage because of their health history, or who have individual policies now which are expensive. The Marketplace will make quality health insurance more available and more affordable for these people. If you have Medicare you have high-quality, affordable coverage now, and you don’t need to shop in the Health Insurance Marketplace. However, as always, you will have the opportunity to change your Medicare coverage during the Medicare open enrollment period, which runs from October 15 to December 7, 2013. This is the same time period as last year. It’s when you can review your health and prescription drug plans and change them, if you want to. For example, you might find a plan that has lower out of pocket costs for the prescriptions you take. If you’re happy with what you have, you don’t need to do anything. You will stay with your current choices in 2014. The Medicare open enrollment period is a time when there is a higher risk of fraudulent activity. That could be a call, or a knock at your door, from someone offering you free services, or telling you that you need a new Medicare card, or that you can enroll in a new plan by just letting them take the money out of your bank account. Don’t do it!

Medicare will never call you at home, except if you’ve already reported a problem. Medicare will never ask for your Social Security number, because we already have that. And Medicare will never ask for your bank information, unless you have called us, requesting to pay your premiums automatically. Likewise, never share your personal information with someone who knocks on your door, or contacts you uninvited to sell you a health plan. That’s not allowed under Medicare rules. It’s also against the law for someone who knows you have Medicare to sell you a Marketplace health insurance policy, because you don’t need one. Be ready to say “no” if this happens to you. Finally, if you suspect fraud, please report it. You can call your local police, your state’s Attorney General, or the Federal Trade Commission if you suspect identity theft. If it has anything to do with Medicare, call 1-800-MEDICARE [(800) 633-4227] anytime, day or night, to report it to us. Please continue to look to our web resources at www.medicare.gov, www.healthcare.gov, and www.stopmedicarefraud.gov, and watch for future announcements for more information on the Marketplace, and how to protect your privacy and financial information. If you have questions, you can call 1-800-MEDICARE any time for answers you can trust. We want to stop Medicare fraud as much as you do, and together, we can do it.

This article is provided by the U.S. Department of Health Human Services’ Centers for Medicare and Medicaid Services.

“If you have Medicare you have high-quality, affordable coverage now, and you don’t need to shop in the Health

Insurance Marketplace.”

MAKING MEDICARE MAKE SENSEAnswers to Some of the Most Commonly Asked Questions

6 July/August 2013

Ombudsmen answer questions about long-term care, help residents solve problems and assist families on behalf of residents. This service is free and all contacts between ombudsman and caller are confidential. For more information about the Ombudsman program, or to become trained as an ombudsman volunteer, contact the Ombudsman Program staff at CMAAA, 1121 Business Loop 70 East, Suite 2A, Columbia, MO 65201, (800) 369-5211 or (573) 443-5823.

By Beth Busseau, Ombudsman Program DirectorLet’s Celebrate!Resident Rights Month is celebrated in October every year and it brings a symphony of emotion for me. First let me say that one’s right as a resident of any long-term care home is to be respected and be honored with dignity! As we enter the later years of our life beyond the days of our youth, we often find that poor health, frailty and dementia are conditions that need to be reckoned with. It is during these times that people become reliant on others and depend on the care of family, friends, and caregivers. Our expectation is that these people will care.

The homes that I work with provide all the way from some assistance to full care depending on the needs of each individual as it is reflected in

their quarterly care plan. It is a fine balance between providing care and encouraging individuals to exercise their independence. As we offer care, with person-centered care as the hallmark of recognizing each person as an individual with personal needs, each person’s emotional well-being is reflected in how they are treated. I appreciate the staff in the homes that take time to meet the whole person, both emotionally and physically.

People tease one another with the phrase, “Be careful how you treat your children because they are going to pick your nursing home.” The truth is that young people are following the lead of the adults they encounter; and with good direction they will value their elders with dignity and respect. The Service Learning students from the

University of Missouri often exclaim to me after giving service hours as Community Visitors in the nursing homes, “I really enjoy their stories.” or “I plan to include older persons in my career path.” I am delighted to know that the next generation has been given this opportunity to value the older generation.

So let me say with a loud cymbal “Celebrate loudly this month with a caring attitude and act of compassion.” Our elders are depending on you and our youth are watching. Let this be just one month of twelve that adds up to a whole year and many years of caring for our elderly with great honor and dignity! It would be a honor to be recognized as a nation that celebrates their older citizens.

You have the right to information about rights and regulations and about your responsibilities as a resident.

You have the right to attend your care plan meeting, to know your medical condition and to have your questions about your care answered. You have the right to refuse treatment or medications.

You have the right to choose your own doctor.

You have the right to remain in the home, except for the following reasons: you have not paid your bill; your medical needs are not appropriate for the home; you present a danger to yourself or others. The home is required to give you 30 days notice in writing, if they should want to discharge you.

You have the right to complain without fear of retaliation.

You have the right to manage your own finances. No one may tell you how to spend your personal funds.

You have the right to be free from abuse, neglect and restraint.

You have the right to confidentiality of medical records and personal and financial information.

You have the right to privacy: in treatment, in mail and telephone communications, and with visitors.

You have the right to be treated with dignity and respect, with full recognition of your individuality.

You have the right to make choices about how you will spend your day, including participation in activities offered by the home and religious activities inside and outside the home.

You have the right to have personal possessions in your room, as space allows.

You have the right to privacy with your spouse and to share a room with your spouse, if you both want to share a room.

Your Rights As a Resident in a Missouri Long-Term Care Community

7September/October 2013

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SILVER ECLECTIC is published by the Central Missouri Area Agency on Aging and is editedby Kate King. Funds for this project were made available through the Division of Senior and Disability Services of the Missouri Department of Health and Senior Services under provisions of the federal Older Americans Act. The total project is incompliance with Title VI of the Civil Rights Act of 1964 and all requirements imposed pursuant to the Regulation of the Department of Health and Human Services issued pursuant to that Title to the end that no person shall, on the grounds of race, color or national origin be excluded from the benefits of this project.

a monthly publication for senior citizens

and for those who sharetheir concerns.

ADVERTISING POLICY: CMAAA does not endorse or guarantee any of the businesses, products or services advertised herein.

By Kay Barbee, CMAAA Medicare Consultant

Reviewing your Medicare Part D drug coverage is as important as your annual health check-up. Medicare Part D plans change premiums, deductibles, co-pays, and most importantly, formularies every year.

We can help you shop for the Part D plan that best meets your personal needs and financial situation.

Good news. The 2014 Donut Hole discount for brand-name drugs during the coverage gap (aka Donut Hole) will be continue to be discounted 52.5 percent. Pharmaceutical Manufacturers continue to discount 50 percent while the Plan picks up 2.5 percent of the cost. Generic drugs will be discounted 28 percent, which is an additional 7 percent discount from 2013. By shopping Part D plans, you can maximize these discounts.

The average 2014 Medicare Part D Plan premium remains at about $31.00 per month. Your current plan premium may go down or may go up. More importantly, will your current

plan cover your current medications and will the copay (amount you pay at the pharmacy) increase or decrease?

The standard 2014 deductible will be $310.00 which is down from $325.00. Not all plans have an annual deductible; some will have no deductible or a minimal deductible.

Why chose CMAAA to assist you in this important decision:

We don’t sell insurance•We provide unbiased •counselingWe use the Medicare Plan •Finder (www.medicare.gov)We can also review your •eligibility for programs that can help reduce the cost of your prescription drugs/premiums, and maybe your Medicare Part B premium.

Did we say this service is FREE of charge?

Call today for an appointment. Don’t know where to call; you can contact:

Your CMAAA Care Coordinator •to make an appointment today. (See page 8 for a complete listing of Care Coordinators.)

Your local Senior Center can •also assist you in finding an enrollment location/date or get you in contact with a Care Coordinator or the Medicare Outreach Consultant. (See page 8 for a complete listing of Senior Centers.)

For more information about the Medicare Part D Open Enrollment Period call your local County Care Coordinator or Kay Barbee, Medicare Outreach Consultant.

Kay can be reached at (800) 369-5211 or (573) 424-7632 or you can email Kay at BarbeeKK@gmail.com.

Medicare Prescription Drug (Part D): Open Enrollment is October 15 – December 7

8 September/October 2013

Audrain CountyCarol Senor(573) 581-7678

Boone CountyChristie DykstraDonna Jo Hichens(573) 443-5823

Callaway CountyKaren Elwood(573) 642-6772

Camden CountySamantha Sutton(573) 346-1834

Cole CountyTrish Luther(573) 634-8828

Cooper CountyKaren Wright(660) 882-3444

Crawford CountyTanya Johnson(573) 885-2922

Dent CountyJackie Overby(573) 729-5697

Gasconade CountyTonya Lansford (573) 437-2532

Howard CountyKaren Wright(660) 882-3444

Laclede CountyJoan Martin(417) 588-4300

Maries CountyKathleen Humphrey(573) 422-3322

Miller CountyKathleen Humphrey(573) 392-7229

Moniteau CountyMichele Porter(573) 796-4051

Morgan CountyMichele Porter(573) 378-9980

Osage CountyTonya Lansford (573) 437-2532

Phelps CountyScott Shaffer(573) 265-0616

Pulaski CountyMary Ann Mathews (573) 774-3390

Washington CountyRobin McElrath(573) 438-5962

Care Coordination DirectorHugh Smith(800) 369-5211 or (573) 443-5823

CARE COORDINATORS

SENIOR CENTERSBoonslick Senior Center (Boonville)(660) 882-2344

Bourbon Senior Center(573) 732-4268

California Nutrition Center(573) 796-4240

Callaway Senior Center (Fulton)(573) 642-2458

Camdenton Senior Center(573) 346-2776

Conway Senior Center(417) 589-2079

Crocker Senior Cetner(573) 736-5405

Cuba Senior Center(573) 885-2909

Dixon Senior Center(573) 759-6313

Eldon Senior Center(573) 392-6102

Fayette Senior Citizens Center(660) 248-3733

Friendship Hall (Iberia)(573) 793-2747

Glasgow Senior Center(660) 338-2975

Hughes Center (Lebanon)(417) 532-3040

Jefferson City CentersClarke Senior Center(573) 634-8020

Senior Center @ the Mall(573) 635-4120

Linn Nutrition Center(573) 897-4221

Macks Creek Senior Center(573) 363-0153

Mexico Senior Center(573) 581-7743

Moniteau Nutrition Center (Tipton)(660) 433-2715

Oakland Senior Center (Columbia)(573) 449-8000

Owensville Senior Center(573) 437-3096

Rolla Elderly Highrise(573) 341-2929

Salem Senior Center(573) 729-2373

Sayers Senior Center (Potosi) (573) 438-3237

St. James Golden Age Center(573) 265-7072

Stoutland Senior Center(417) 286-3880

Versailles Senior Center(573) 378-6232

Vienna Senior Center(573) 422-3834

Warren Senior Center (Richland)(573) 765-5414

Waynesville/St. Robert Sr. Center(573) 774-2668

Westside Senior Center (Laurie) (573) 372-3588

County Services DirectorLeilani LaCasse(800) 369-5211 or (573) 443-5823

Need Help? Call us.

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Silver EclecticFor information contact:

Kate King, EditorE-mail: kateking@cmaaa.

netCentral MO Area Agency on

Aging (800) 369-5211(573) 443-5823www.cmaaa.net