May 29, 2015

How to find a new doctor

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By Jim Miller

Dear Savvy Senior,

What resources can you recommend to help me find and research some doctors in my area? I’m looking for a good primary care doctor or internist for my elderly parents, and need to locate a good orthopedic doctor for me.  

—Shopping for Doctors

Dear Shopping,

Thanks to the Internet, finding and researching doctors is a lot easier than it use to be. Today, there’s a wide variety of websites you can turn to that provide databases of U.S. doctors, their professional medical histories and ratings and reviews from past patients on a number of criteria. Here are some of the best sites available, along with a few additional tips that can help you find the right doctors.

Locating Tips

To help you locate doctors in your area, a good first step, and one that doesn’t require a computer, is to ask for a referral. Contact other doctors, nurses or health care professionals that you know for names of doctors or practices that they like and trust. 

You should also call your insurance provider, or visit its website directory to get a list of potential candidates. If you or your parents are Medicare beneficiaries, you can use the Physician Compare tool at medicare.gov/physiciancompare. This will let you find doctors by name, medical specialty or by geographic location that accept original Medicare. You can also get this information by calling Medicare at 800-633-4227. 

Once you find a few doctors, you need to call their offices to verify that they still accept your insurance, and ask whether they are accepting new patients. 

Research Tools

After you find a few doctors you’re interested in, there are lots of online resources you can turn to, to help you check up on them.

For example, you can find out if a doctor is board certified at the American Board of Medical Specialties at certificationmatters.org or call 866-275-2267. And to learn about malpractice claims and disciplinary actions taken against doctors, you can use your state medical board—see fsmb.org/state-medical-boards/contacts to search your state. 

Here are some other good websites that can help you find and/or research doctors in your area for free.

Healthgrades.com: This comprehensive easy-to-use site provides doctor’s information on education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans. It also offers a 5-star rating scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more. 

Vitals.com: Provides background information on doctor’s awards, expertise, hospital affiliations and insurance, as well as patient ratings on measures such as bedside manner, follow-up, promptness, accuracy of diagnosis, and average wait time. There’s also a patient comment section.

RateMDs.com: Provides information on training as well as patient ratings on staff, punctuality, helpfulness and knowledge. Patients can also post questions and answers about doctors and get doctor’s ratings based on patient reviews.

Look Up Tool: If you want to find out how many times a doctor did a particular service and what they charge for it, go to data.cms.gov and click on “Medicare Physician and Other Supplier Look-up Tool” at the top of the page. 

AngiesList.com: If you don’t mind spending a little money ($20/per year), Angie’s List is a membership service that provides doctor reviews using an A through F scale. 

When searching for a doctor, it’s wise to check out several of these sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.   

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Vermont ranked healthiest state for seniors

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Vermont is the healthiest state for seniors, rising from fourth place last year, according to the third edition of United Health Foundation’s America’s Health Rankings Senior Report, “A Call to Action for Individuals and Their Communities.”

“Vermont’s seniors should be congratulated for doing a lot of things well to stay healthy, such as low rates of physical inactivity, hospital readmissions, and half of all our seniors rank their health as either very good or excellent,” said Health Commissioner Harry Chen. “As always, there are also areas we need to improve such as a high prevalence of chronic drinking, low hospice care use and a high rate of falls.”

Vermont ranked among the top 10 states in 21 of 43 overall measurements that included behaviors, community and environment, policy, clinical care and outcomes. New Hampshire ranks second, improving one spot from last year. Minnesota fell to third after being ranked first for two years in a row, while Hawaii (4) and Utah (5) round out the top five states. Louisiana ranks 50th as the least healthy state for older adults, followed by Mississippi (49), Kentucky (48), Arkansas (47) and Oklahoma (46).

Vermont’s strengths include low intensive care unit (ICU) use and ready availability of home-delivered meals. This is due, in part, to the efforts of the state’s area agencies on aging, according to Susan Wehry, commissioner of the Department of Disabilities, Aging & Independent Living. Vermont also has the nation’s best Supplemental Nutrition Assistance Program (SNAP) enrollment, which demonstrates that seniors are aware of and using the program.

“Increasing participation in the supplemental nutrition program for those over 60 who live in poverty has been a top priority of the Agency of Human Services, and to now rank number one for participation is a huge accomplishment,” Wehry said. “I’m grateful to all our partners who helped us achieve this milestone. Vermont has always been a tight-knit community state. We take care of each other, and we take care of our seniors.”

The departments of Health and Disabilities, Aging & Independent Living began collaboration on a screening and brief intervention, referral substance abuse project targeting older adults to help address chronic drinking among seniors in Vermont.

Nationally, the report shows that seniors are improving in key care trends, pointing to a health system that may be working better for seniors, according to the United Health Foundation.

“It is heartening to see seniors’ health is improving, but our societal challenge remains finding ways to encourage more seniors to be more active,” said Rhonda Randall, senior adviser to United Health Foundation, and chief medical officer and executive vice president, UnitedHealthcare Retiree Solutions. “Strong community support is an essential part of promoting positive health among seniors. We must work together —across states, communities and our own families—to encourage all seniors to find ways to be as active as they’re able to be.”

Chen said the fact that more seniors nationwide received the flu vaccine compared to last year—rising from 60.1 percent of seniors in 2014 to 62.8 percent this year—is encouraging, because they are particularly susceptible to flu and flu-related complications.

“Every Vermont senior should get vaccinated against the flu,” Chen said. Vermont ranked 18th for flu vaccines for seniors at 65 percent.

To read the full report, visit www.americashealthrankings.org/reports/senior

Around Town

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New faces on Recreation Committee

During its May 18 meeting, the Selectboard appointed residents Michael Clauss and Danielle Doucette to the Recreation Committee for terms beginning in July and ending in 2018.

Stormwater bills go out

The Williston Stormwater Department sent out the second quarterly bills for the town’s stormwater fee this week. While the town recently opted to eliminate its two-tiered fee structure for single family homes—the 10 percent of homes with the largest amount of impervious surface paid more—the change doesn’t go into effect until the third billing cycle. So, residents will see the same amount on their bills this quarter as they did in February.  

Special Olympics this weekend

The 2015 Special Olympics Vermont Summer Games will be held this weekend at Williston Community Park and the University of Vermont’s athletic complex. Nearly 500 athletes will compete in track and field, aquatics, and bocce at UVM, and softball will be held at the recreational fields in Williston.

The event kicks off with a commencement ceremony on May 29, featuring the culmination of the Law Enforcement Torch Run, a three-day running event during which hundreds of law enforcement and public service personnel carry the Flame of Hope from the four corners of the state to Burlington. 

Feedback sought on education equity plan

The Vermont Agency of Education has completed the first draft of its plan to respond to inequities in access to quality educators in high-poverty areas.

The plan is posted on the Educator Equity page, education.vermont.gov/federal-education-programs/educator-equity, and is accompanied by a survey for stakeholders to provide feedback at www.surveymonkey.com/s/EquityPlanFeedback. Feedback must be submitted by noon on May 29 to be considered for this year’s plan.

Stormwater strife: VTrans says it won’t pay

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By Stephanie Choate
Observer staff

The town is working through a snag in its efforts to address water quality issues and comply with federal and state stormwater management mandates.

Two state agencies—the Vermont Agency of Transportation and the Vermont National Guard, which owns the Williston Armory—have refused to pay the town-wide stormwater fee, saying the town does not have the authority to charge them. However, other state agencies or state-affiliated groups—the Vermont State Police and Vermont Technical College—have already paid.

Selectboard members expressed frustration during their May 18 meeting that agencies within the state government—which directed Williston to implement costly stormwater improvements and recently passed a water quality bill—are refusing to pay their share of the stormwater fee.

The fees assessed to the two agencies total $52,000.

“It is the opinion of both staff and legal counsel that the Town does have the legal authority to impose the Stormwater charge,” Town Manager Rick McGuire wrote in a memo to the Selectboard. “Williston is the third community to assess this charge.”

Williston’s fee is the lowest, compared to those of Burlington and South Burlington. Burlington officials told the Williston Stormwater Department that the city does not have any VTrans-owned roads; they are all under city management. South Burlington’s stormwater department said it made a three-year agreement with VTrans in which VTrans pays $50,000 a year, comparable  to the amount it would have been assessed using South Burlington’s fee. However, South Burlington provides specific services as part of the agreement that Williston is not in a position to provide, according to McGuire.

Williston staff said state statute gives the town authority to assess the fee.

“It is clear that all state properties, like any other property within the Town borders has runoff from their impervious surfaces into the streams and/or other bodies of water,” McGuire wrote in the memo. “These properties therefore contribute to the environmental damage caused by the discharge of stormwater into the streams. The state then benefits from efforts to maintain a system that reduces the damage to the receiving waters. This includes properties and rights-of-ways owned and/or maintained by the state Transportation Agency.”

VTrans, however, argues that the statute does not give the town the authority to levy a fee against the state, especially when VTrans is not receiving any direct benefit. It argues that the town’s efforts to raise the funds required are akin to a tax, from which the state is exempt.

McGuire said Williston’s system meets the legal definition of a fee, not a tax.

Last summer, the Selectboard established a stormwater fund—filled by levying a town-wide fee—for stormwater system upgrades intended to improve water quality, avoid property damage and comply with state and federal mandates. Residents received their first bills in February.

The Selectboard opted to use a fee to raise the funds required so that the cost burden would be more equitably shared among all landowners in town—including tax-exempt property, such as schools, churches, non-profits and the state.

“All those contributing to the environmental damage caused by the discharge of stormwater runoff into the receiving body of water should be held financially responsible for the pollution that they cause,” McGuire wrote in his memo. “It is unfair for the state government to require municipalities to undertake these investments and then exempt themselves from payment.”

Perpetually cash-strapped VTrans is facing funding pressures of its own. The U.S. Congress passed a two-month extension of the Highway Trust Fund last week, but it has yet to come up with a long-term solution to address funding for the nation’s transportation and infrastructure.

The Selectboard on May 18 instructed McGuire to reach out to other state agencies—especially Department of Environmental Conservation Commissioner David Mears—to make sure they are aware of VTrans’ position. The town then has several options: take the state to court; accept that the state will not pay, which would likely mean higher fees for residents; or try to work out an alternate agreement with VTrans.

Thousands boost Bernie Sanders onto the campaign trail

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Observer courtesy photo Williston residents (from left) Alison Kahn, Sarah Leister and Jake Kahn cheer for Bernie Sanders during his presidential campaign kickoff on Tuesday.  (Observer courtesy photo)

Observer courtesy photo
Williston residents (from left) Alison Kahn, Sarah Leister and Jake Kahn cheer for Bernie Sanders during his presidential campaign kickoff on Tuesday. 

By Morgan True
For Vermont Digger

Standing on a platform on the Lake Champlain waterfront he helped preserve, in the city where he forged his political career, Sen. Bernie Sanders, I-Vt., asked thousands of supporters to elect him president and help him build a new political movement.

That movement, Sanders said, will restore democracy in America, rebuild the middle class, protect the environment and, ultimately, reclaim the future for ordinary citizens.

In his inimitable blunt style, Sanders outlined the starkness of the nation’s situation as he sees it.

The wealth gap between rich and poor in the United States is “greater than any other major country on Earth,” he said, and continues to grow. That wealth is being used to rig the political system in favor of the wealthy and corporations, undermining democracy and ultimately American prosperity, Sanders said.

“Not only will I fight to protect the working families of this country, but we are going to build a movement of millions of Americans who are ready to stand up and fight back,” he thundered from the sound stage, with his earnest gesticulating delivery.

Sanders chose a sweltering late-spring day at Burlington’s Waterfront Park to launch his Democratic bid for the U.S. presidency Tuesday. The festival-like event drew more than 4,000 people, according to the Burlington Police Department. The crowd was exuberant and sweaty, with demographics one might expect in Vermont—mostly white, with a range of ages. The setting was idyllic, with sailboats gliding on Lake Champlain and the blue peaks of the Adirondacks looming in the background.

The Kahn family of Williston arrived at the waterfront at 3 p.m. to stake out a place in the front row. Alison Kahn, a college student, told the Observer it was the first time she connected to politics. 

“My whole family had the privilege of shaking Bernie’s hand,” she said. “I don’t think that would happen in any other state. It was so obvious that Bernie truly cares about the people. The combination of his extremely powerful words, our beautiful lake and mountains behind the podium, Ben and Jerry (and their ice cream), and so many happy people made this event truly ‘Vermont.’”

Surrounded by labor leaders and progressive activists of all stripes, Sanders pledged his campaign would take its message “directly to the people” across the country in town meetings, door-to-door, in the streets and online.

Sanders railed against familiar foils — the billionaire class, congressional Republicans, corporate greed and the fossil fuel industry. Williston resident Ben Cohen, of Ben & Jerry’s, who introduced the senator, said Sanders’ refrains would be boring if they weren’t so inspirational.

It is “profoundly wrong” that 99 percent of all new income goes to the top 1 percent of earners, Sanders said. Income inequality is the great moral, economic and political issue of our time, Sanders said, and he promised a presidency that would redistribute wealth in America.

That process will start with “jobs, jobs and more jobs,” he said.

Sanders touted a $1 trillion investment in rebuilding America’s “crumbling infrastructure” over a five-year period, which would create 13 million good-paying jobs — essentially a New Deal 2.0.

Sanders said he would also push to increase the minimum wage to $15 per hour over “several years” to take workers from a “starvation” wage to a “livable” wage. No one who works a 40-hour week should live in poverty, he said.

Expanding Social Security, offering universal pre-kindergarten and making higher education free, or at least not contingent on assuming massive debt, would also top a Sanders presidential agenda, he said.

He called for comprehensive tax reform to ensure corporations and the wealthy finally “pay their fair share,” and pledged to break up the largest financial institutions in the country, because “too big to fail is too big to exist.”

To get money out of politics, Sanders said he would advocate for a constitutional amendment to overturn the Supreme Court’s Citizens United decision that equates money with free speech, and he would only appoint justices to the high court who are committed to its reversal. Long-term he said, the U.S. needs to switch to a publicly financed election system.

The nation must also address climate change by leading the transition away from fossil fuels and toward renewable energy.

Sanders renewed his longtime commitment to universal health care, noting that “despite the modest gains” of the Affordable Care Act, there are 35 million uninsured people in the U.S. and the country continues to spend more than other industrialized nations, he said.

He called on his supporters to help spread the message: “Now is not the time for thinking small.”

For those who doubt his viability as a presidential candidate, Sanders asked them to consider the location he chose for his campaign launch as an allegory for his presidential aspirations. When he took office as mayor of Burlington in the 1980s, the waterfront was an “unsightly” rail yard, and not the beautiful public space it is today.

“We took that fight to the court, the Legislature, and the people, and we won,” he said. The lesson to be learned, he said, is that “when people stand together, when people are prepared to fight back, there is nothing that cannot be accomplished.”

State Sen. Anthony Pollina, P/D-Washington said the conventional wisdom among pundits and much of the national media discounts the degree to which Sanders’ message will “resonate” with average voters.

“He talks directly about issues that other candidates are scared to talk about,” he said. The Vermont Legislature, he said, wasn’t able to pass a joint resolution on income inequality this year.

That’s how Nick Wilson, 27, of Burlington said he felt.

“There might be other candidates who talk about those issues,” the Howard Center mental health worker said, “but [Sanders] is the only one who is committed to acting on them in any meaningful way.”

Sanders still trails significantly in early polling for Democratic primary candidates in New Hampshire and Iowa, and it remains to be seen if his early fundraising can be sustained. Hillary Clinton is favored and former Maryland Gov. Martin O’Malley is expected to announce his candidacy this week.

Sanders’ first campaign stop as an official presidential candidate was Wednesday in New Hampshire, home of the nation’s first primary. He will be in Iowa on Thursday.

Sanders was not circumspect about the political challenges he would face in winning his presidential campaign: low voter turnout, general political malaise and the moneyed interests he’s spurned.

In one meme posted to the Bernie Sanders for President 2016 Facebook page, white text over a gesticulating Sanders says, “If everyone who says ‘I’d vote for him but he can’t possibly win,’ would vote for him … He would win.”

Whether or not that’s true, it neatly summarizes the sentiment among supporters, that if the fair-weather fans could be brought into the fold, the Vermont senator has a chance.

As he exited the stage to Pete Seeger’s rendition of Woody Guthrie’s “This Land Is Your Land” and people streamed out — or waited to get free Ben & Jerry’s ice cream (the company’s catering coordinator estimated they gave out 70 pounds) — the excitement that Sanders might be able to once again beat the odds was palpable.

Town to reappraise property

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By Stephanie Choate
Observer staff

It’s time for all Williston properties to be reappraised.

Town Assessor Bill Hinman said the state recommends that towns hold a full reappraisal every 10 years. Last week, the town began its first full reappraisal in 13 years.

“The most significant reason we’re doing it is to ensure that property owners have their depreciations and the value of their house is reviewed,” Hinman said.

In 2008, the town held a statistical reappraisal, meaning it did not conduct interior inspections. Hinman used sales data and other information to calculate the value of homes.

This time, the town has hired Appraisal Resource Group, based in Essex, to conduct interior inspections and check exterior measurements. The process will cost the town $204,300.

Hinman expects the inspections to go on though November.

Homeowners and commercial property owners will receive a letter at some point between now and November, requesting they call the town to set up an appointment. Inspections will take approximately half an hour.

In 2008, appraised home prices increased by an average of 43 percent and those of commercial property went up 20 percent. Hundreds of homeowners appealed their new appraisals, many of them unwilling to believe their property value had increased during a sluggish housing market.

This year, Hinman said he is not expecting major changes to home values.

“Some property owners will see minor changes either up or down. We don’t think it’s going to be significant for most property owners,” he said. “We want to be able to capture the current market value of properties so when (residents) are paying their taxes, they’re paying based on what the market value is.”

He also noted that approximately half of Williston’s homeowners qualify for income sensitivity, meaning they pay property taxes based on their income and will be affected less by fluctuations in their home value.

Hinman encouraged any residents with questions or concerns to call the town assessor’s office at 878-1091. The office is open 9 a.m. to 1 p.m. Monday through Friday.