VA Home Yountville Update

I've been too busy to write here lately, but much progress has been made toward completing Bill's three-part application form for housing at the VA Home in Yountville.

Thanks to Georgia and Brian, I have parts A and B completed and in hand. We are waiting for the VA Clinic/SB to finalize the doctor's report (Part C), which is pending the results of Bill's TB test. I expect to receive that in the second week of April.

Nurse Christina Hauck at the VA Clinic/SB has been most helpful through this process! She has given  me access to a personal phone line, and has been supportive every step of the way in getting these medical forms taken care of. She notified me that Bill's VA doctor, Dr. Wilson, is leaving the clinic at the end of  April, and had assigned Bill's case to her. I have been most grateful for her help, care, and support.

Another pending item
Other than PART C, there is one additional document, VA Form 10-5345, that Brian had sent to me with Part B. It was provided by VA Clinic, and not part of original application packet.  This form lacks Bill's signature. I have asked Brian to resend the form fully signed.

Here's the form:

https://www.va.gov/VAForms/medical/pdf/vha-10-5345-fill.pdf

Happy Update from Veterans' Housing - Yountville

I spoke to my contact at Yountville Veterans Housing, Dick Sutton, and received a positive update, plus answers to some questions that Bill had specifically asked.

1. Is there healthcare onsite at Yountville, or do veterans have to travel to VA Hospital in San Francisco for services? VA Clinics are onsite. Vets are assigned a primary care physician once admitted. If they need hospital care, VA contracts out to hospitals in Napa county (St. Helena and Napa). So, no travel to SF for healthcare.
2. What happens if the veteran dislikes his assigned roommate? They move vets around once they are there. If not a good fit, they move them. You are not expected to live with someone you dislike. There is a federal mandate to move double occupancy to single, so there is movement in this direction.
3. Are meals brought into the veterans' living units, or must they go somewhere (like to a mess hall)? For resident status vets, there is a shuttle bus that picks them up and takes them to meals at cafeteria. First level assisted living gets meals on wheel. Second level assisted living has food brought in. Many vets use motorized scooters to get themselves around.
4. Is the wait for admission (for vets whose status is "resident") still about a year? Good news -- they have just hired two new doctors to replace two who retired, so the admissions process is moving more swiftly than it was before. They used to admit 4-5 resident vets per month, and it's now moving toward 12-14 per month. Admissions for assisted living level vets are progressing more quickly, too.

More Resistance

Spoke to Bill this morning. Our conversations usually linger for 40+ minutes, as my dad likes to talk, and he often goes off on tangents. But today we stayed on topic mostly.

Bill expressed something about not knowing what's going on regarding the idea of moving, and seemed a bit unsettled about it. He acknowledged that his openness to moving is a 180 degree turn from what he had been thinking before, but he's still okay with it.

We talked about the UC Berkeley social worker with whom I met yesterday, and the challenges to spending down his money so that he can qualify for Medi-Cal. Bottom line: he does not think he NEEDS Medi-Cal and does not see the value in getting "extra" care or support. Things are fine as is, status quo. That is not to say that he doesn't acknowledge that he'll NEED more help later on, but for now, things are okay with Brian coming by a few times a week to help.

We also talked about the VA home in Yountville, and I said that Geo would visit next weekend and help him get his application together. To me, this is the Holy Grail of senior living, and I hope fervently that he gets in. Bill expressed concern about the possibility of getting in, and then not liking his roommate. This came up before and he asked if he HAD to live there if he got in. I said, "No, you don't have to do anything, but the goal is to get you in, and then make adjustments once you're there." He seemed to understand.

What he does not seem to understand at all is how to manage his finances. I wonder when it would be appropriate for me to step in and take more control of his money.

In summary, Bill is still on board with moving, but has no idea how it will work;  it all seems like a big, addled project that he does not understand. He said something like, "things will all work themselves out," to which I disagreed: "No, somebody has to manage it and make it happen."

Onward.

Elder Care Support @ Work

Today I met with a social worker, Maureen Kelly, who is employed by UC Berkeley (my employer). She specializes in elder care counseling (for caregivers) and understood every aspect of Bill's situation that I shared with her. Such counseling is a wonderful benefit offered by UC to its employees.

Maureen and I talked through some possible next steps and I came away with more knowledge about my options, and how to navigate the Medi-Cal and VA benefits that might be able to help my dad age in place (w/ assistance) until it comes time to move.

A big problem is that Bill was disqualified from Medi-Cal because of a very small overage of money in his checking account. First step might be to appeal Medi-Cal's denial (find a way to spend the extra $2K on health/care related expenses) and get him benefits. Then, he would be eligible to receive in-home assistance until it's time to move. Once he sells El Zoco, however, he'd have some cash that would disqualify him from Medi-Cal. He should retain his VA health benefits always, to cover gaps in future care.

Some ideas for blowing through the $2K so that he can be qualified for Medi-Cal.

1. Pay for an assistant to come give Bill relief a couple of days a week (say, $75/day, twice a week).
2. Send Bill to a senior daycare program -- get social time, stimulation, support, exercise, phys. therapy.
3. He cannot just give me the $2K to save for him to use later. There has to be a documented paper trail proving that he spent the money on care-related expenses.

Maureen also referred me to a campus workshop next week that deals with the very issues of health insurance and care coverage that I'm dealing with right now.

One thing I learned is that "A Place for Mom," a referral service that I have signed up for, are greedy bastards and won't allow me to work w/ another referring organization for a year. UC Berkeley has free referral services for employees, and I could be using this service rather than A Place for Mom.

I also learned that Medi-Cal does not pay for assisted living, but they DO pay for full-on nursing hospital care, if a client has no money. So, until a person is totally unable to take care of himself, they are pretty much on their own (payment wise), with some relief available through VA's "Aid and Attendance" benefit (about $1100/month).

Got the name of a elder care (gerontologist) consultant, Alan Morgenstern, whose services could help recommend a "board and care home" in the East Bay. This is an alternative to an assisted living facility that's basically a house where a few senior residents live and receive care from staff on site.

There are a lot of financial pieces to Bill's situation, and having an expert guide me through some options and outline possible next steps was tremendously helpful!

Stephanie Doane's Oakland Housing Referrals

Georgia wrote to share about a

friend/neighbor who is from Oakland and she went through all this housing search for her dad ten years ago there. Here are some recommendations:

Piedmont Gardens--she says it's a wonderful place

Sunrise--up on Skyline Blvd. Her aunt lived there

Chateau--in Pleasant Hills. Her dad was there and they loved it

If you'd like to speak with her about any of the resources in the area or these asst. living places she would be very happy to talk with you. Her name is Stephanie and her email is

stephaniedoane@earthlink.net

Sue I.

Today I spoke with an old family friend, Sue I., who lives in Santa Barbara.  I just learned from Bill that Sue's mother passed away on January 25th (same day as Mary Tyler Moore) and that her father, a WWII vet, has applied to be housed at Yountville Veteran's Home in Napa County. Sue's father currently lives in Napa, not far from Yountville, and is familiar w/ the veteran's housing facility. Apparently, it's a wonderful place and has a great golf course.

It was good to talk to Sue today. Not only are we both seeking the same veteran's housing for our dads, but Sue is also a realtor, and would be pleased to be work with me and Bill when it comes time to sell his unit at El Zoco.

I'm very happy to have another member of my network/team, as we make progress.

On March 10th, Sue wrote to share this:

"Just a quick note to let you know that Bill and I have received the basic information about the city requirements on how to  handle a sale at El Zoco. I will have  it on file for your future reference!"