Healthy Hudson Valley OCTOBER 23, 2014 ● ULSTER PUBLISHING ● HEALTHYHV.COM Healthy Body & Mind

Getting better? How we gauge our communities' mental-health needs, what's up with local hospitals, vaccination schedules, what's enough now, and the secrets to survival and home medicine cabinets. Health news for the Hudson Valley... October 23, 2014 2 | Healthy Body & Mind Keeping an eye on the season’s real health issues

A wellness focus on munities we cover, and the readers we aim to ser- on hand for the cold and flu season ahead. We vice. Our primary focus this issue has been on the find that, by and large, the local universe hasn’t Columbia, Dutchess, state of mental-health where we live, not in terms changed as much as we may have thought. of what our problems might be but in terms of Finally, we offer up some basic health tips and Greene & Ulster counties how we deal with them when situations arise. We health news, from the changes under way in our have done so by focusing in on the main areas our region’s hospitals and leading medical groups, a ho’s not thinking about weekly newspapers report on in Ulster County as growing majority of them on the east side of the health these days? Is it possible a microcosm for the entire region where we are Hudson River. We focus also on Kingston-based to put out a special supplement distributed. Health Alliance’s continuing push to find partners like this edition of Healthy We also look into several items that are key to with whom it can focus its service to its commu- Body & Mind without mention- our healthcare needs this time of year. We look nity. ing once that big national scare into what’s considered too much in various areas How are we doing in the Hudson Valley health- Wfor which we might eventually remember this pe- these days ... perfect considering that we are en- wise these days? According to the fifth edition of riod in history? tering our annual season of abundance. We also the county health rankings released last spring We have taken a different route for the com- take a warm glimpse into what local moms keep by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Insti- tute, it depends. Dutchess County, for example, is ranked eleventh in the state in terms of its health outcomes, judged by how long people there live and how healthy they are while alive, and ninth in overall health rankings, which combines data involving clinical care options, social and economic factors, and the natural environment. Ulster County came out 29th in the state in health outcomes, and the same in overall ranking; Columbia County came out 47th overall and 13th in terms of rankings; Greene was 57th out of 62 counties in outcomes and 51st in overall rankings. Looking better in the overall region was Putnam County, at fourth in both rankings; while nearby Sullivan County came out 61st and 60th in each. Looked at in terms of some of the issues dis- cussed in these pages, it turns out that Ulster County has one of the highest numbers of mental- health professionals in the area, with a ratio of one professional per 388 residents, while Dutchess County has one per 487 residents, Columbia County has one per 812, and Greene County comes in very low at one professional per 1432 residents. In terms of bad habits, Ulster County leads the percentage of excessive drinking, at 25 percent, while Dutchess and Greene clock in at 19 percent. In terms of access to exercise, Dutchess County is strongest, with 85 percent of the county having such access, and Columbia County is weakest, at 47 percent access (Ulster County is at 75 percent access to exercise facilities).

inally, in terms of clinical-care options, including access to hospitals, doctors, Fmental-health professionals, and percentage of uninsured residents, Dutchess County ranks 14th in the state, Columbia County 32nd, Ulster County 36th and Greene County 49th. As for overall quality of life in terms of health, Dutchess County ranked 14th, Ulster County 23rd, Colum- bia County 36th, and Greene County 52nd in the TIME FOR YOUR FLU SHOT? state. Lending a sense of comparison, Putnam County ranked fourth in the state and Sullivan County 59th.

LEAVE IT TO THE PROFESSIONALS. Our staff photographers We are grateful for the contributions to this issue of local photographers Dion Ogust, Lauren No matter where you are in the Hudson Valley Thomas and Rich Corozine. this flu season, Health Quest is ready when you About our cover... are. Just walk in to Health Quest Urgent Care or The current Healthy Body & Mind cover comes to us care of Woodstock-based The Image Works, see your Health Quest Medical Practice physician. a leading photo agency and bank specializing in issues-oriented image searches.

health-quest.org/FluShot MARG GARVILA, MSW, LCSWR, CT Counseling, Psychotherapy Trauma ~ Abuse ~ Depression Anxiety ~ Self-Esteem Life Transitions ~ Relationships Group Therapy Certiﬁ ed Grief Counselor HEALTH QUEST MEDICAL PRACTICE, P.C. 3631 Main St., Stone Ridge • 845-687-2322 October 23, 2014 Healthy Body & Mind | 3 Your Health Aware Calendar…

ational Health Observance (NHO) days started out in the same way that the United Nations began sponsoring World Observation days in the latter half of the twen- tieth century – as a means of rais- Ning awareness of specific issues for fundraising and self-observational purposes. The only way to break the spread of many diseases, runs the un- derlying idea, is to be vigilant of one’s own behavior and aware as well of the incidence of disease in one’s own community. As this publication comes out towards the end of October, it does so in the midst of National Bullying Prevention Month, National Down Syndrome Awareness Month, National Physical Therapy Month, Sudden Infant Death Syndrome (SIDS) Awareness Month, and after Mental Ill- ness Awareness Week, Drive Safely Work Week, International Walk to School Day, National De- pression Screening Day, Bone and Joint Health National Awareness Week, National Health Edu- cation Week, World Food Day, International In- fection Prevention Week, Respiratory Care Week, International Stuttering Awareness Day and World Psoriasis Day. Coming up in November are COPD Awareness Month, Lung Cancer Awareness Month, National Although many of our county health departments have already run through most of their traveling Alzheimer’s Disease Awareness Month, National vaccination appointments, ﬂ u and pneumonia shots -- just in time for the season -- are still available Family Caregivers Month, National Healthy Skin through local doctors' ofﬁ ces, medical groups, and hospitals. It's better to be saafe than sick! Month, National Stomach Cancer Awareness Month, Drowsy Driving Prevention Week, Great Greene County had its vaccination clinics in For November… Keep in mind that it is Ameri- American Smokeout, International Survivors of September. can Diabetes Month, which has become one of Suicide Day, Gastroesophageal Reflux Disease The Centers for Disease Control (CDC) rec- the leading causes of disability and death in our Awareness Week, and National Family Health ommends annual vaccinations for everyone six nation. If it’s not controlled, diabetes can cause History Day on Thanksgiving followed by World months of age and older. All the counties charge blindness, nerve damage, kidney disease, and oth- AIDS Day on December 1 (followed later that for shots. Most take most insurance and Medicare, er health problems; and one in twelve Americans month by National Influenza Vaccination Week). but do not accept credit cards. The seasonal flu with another 79 million adults, or almost three Apart from the big national and world aware- vaccine is designed to protect against the main flu out of that dozen, at high risk of developing type 2 ness days, there’s also lots of local health hap- viruses that research suggests will cause the most diabetes. Why is awareness so key? Those at high penings, including the tail end of the flu vaccine illness during the upcoming flu season and those risk for type 2 diabetes, or in its earliest stages, season, which has been hosting community days immunized last year are not protected against this can lower their risk by more than half if they make throughout the season, and various lectures, work- year’s virus. Children between 6 months and 8 healthy changes including eating healthy, increas- shops and support group meetings sponsored by years of age may need two doses of flu vaccine to ing physical activity, and losing weight.How can and often at our region’s hospitals and key medi- be fully protected from the flu. A doctor or other American Diabetes Month make a difference? It cal practices, as well as through our counties’ Of- healthcare professional can advise you if that is backs up those struggling with those life change fices of the Aging and most school districts. the case. choices... The top ways our local health departments sug- Thursday, November 20... Navigating the Some key dates: gest to avoid flu this season, in addition to shots, is state health marketplace at Northern Dutchess Now through December 15. The annual open to regularly wash your hands with soap and warm Hospital in Rhinebeck, taking place from 6 and enrollment period to change Medicare health water. Use alcohol-based hand sanitizers or wipes 7 p.m., is a reminder and tool for those seeking or prescription drug coverage for 2015 is from if soap and water are not available. Try to stay in to enter or reenter the state healthcare exchange mid-October to December 7, during which time good general health by getting plenty of sleep, be- for the coming year. At this free event, experts current Medicare beneficiaries can change from ing physically active, and managing your stress, will be available to help individuals with the en- Original Medicare to a Medicare Advantage Plan, and eating nutritious food. Drink plenty of fluids. rollment website and to discuss how to select a switch or drop a Medicare Advantage Plan, and Avoid close contact with people who are sick and plan. Open enrollment takes place from Novem- join, switch or drop a Medicare Prescription Drug try to not touch surfaces that may be contaminat- ber 15 through February 15. Plan. Local folks are urged to call their local offic- ed with the flu virus. And get your annual flu shot. es for the aging for help navigating the system. For info in Ulster County call 340-3456 or toll free 1-877-914-3456. Now through New Year’s… The Dutchess Coun- ty Department of Health clinic will be offering flu vaccine by appointment on Mondays at its new location at 29 North Hamilton Street in Poughkeep- sie. To schedule an appointment, call 486-3535 or email [email protected]. In Ulster County, flu and pneumonia vaccination clinics are still scheduled from 10 to 11:30 a.m. on Friday, October 24 at Woodland Pond in New Paltz; from 10 to 11 a.m. on Friday, October 31 at the Woodstock Rescue Squad building; from 10:30 to 11:30 a.m. on Monday, November 10 at the Wallkill Fire Department; from 10 to 11:30 a.m. on Wednesday, November 12 at the Lake The Perfect Gift Katrine Senior Center; and from 10 to 11 a.m. on Chose from one of our gift baskets or create your own! Monday, November 24 at Shandaken’s town hall. We ship anywhere in the US! Call 1-800-277-7099 for info. In addition, a flu hotline is available at 340-3093. The Columbia County Health Department is www.HudsonValleySkinCare.com currently offering flu vaccines for children aged 6 months to 18 years of age by appointment at a available at: Dermasave Labs regularly scheduled immunization clinic every ly Tuesday from 1 to 3:30 p.m. PM at 325 Colum- Fre sh eda 3 Charles Street, Ste 4 bia Street, Hudson, on the first floor. An eve- mdnaH in the Pleasant Valley, NY ning immunization clinic is also available on the nosdu 845-635-4087 Open Monday - Friday 3rd Wednesday of each month from 4 to 6 p.m., H and also by appointment. Pneumonia vaccines Valley will also be available at the community clinics to Like us on individuals 65 or older. Contact the Health De- partment at 518-828-3358. October 23, 2014 4 | Healthy Body & Mind Health briefs

Listen for Enterovirus D68

All the news is about other viruses, but the big one to keep an eye out for over the coming indoor months – besides the flu – is Enterovirus D68, which is sweeping through populations of school age kids this autumn. The illness is seen through such mild symptoms as fever, runny nose, sneez- ing, cough, and body and muscle aches; although in more severe cases symptoms may include wheezing and difficulty with breathing. It should start to wane in winter. To keep your kids and teenagers from catching EV-D68, have them avoid close contact with sick people as much as possible; ensure regular wash- ing of hands often with soap and water; the covering of all coughs and sneezes; avoiding touching one’s face with unwashed hands; the cleaning and disinfecting of surfaces; and being sure to stay home when sick. There is no specific treatment for people with respiratory illness caused by EV-D68 and some people with severe respiratory illness such as asthma who contract EV-D68 may need to be hos- Health Quest pushing regional wellness pitalized.There are no antiviral medications currently available for people who become infected with EV-D68. ealth Quest, which is branding itself as “the Hudson Valley’s largest integrated family For more information, see www.cdc.gov/non- of hospitals and healthcare providers,” is pushing regional wellness and overall preventive care through polio-enterovirus/EV68/. Hseveral new campaigns this fall. The six-week Walkway Fitness Challenge calls for enrollees to exercise on the Walkway for at least 30 minutes a week through November 15. Participants can enter a drawing for prizes each time they completes a workout. More than a million steps were taken and an estimated 47,744 MHMG physicians calories were burned during the first effort last spring. Prizes include a Mike Arteaga’s Health and Fitness Centers membership or one-hour massage at Northern Dutchess Hospital. Winners will be drawn November migrate to MKMG 17 and announced on Health Quest’s social-media sites. The Fishkill-based Mid Hudson Medical Group “A little physical activity each week can prevent or minimize health issues. Yet, the majority of adult Ameri- (MHMG) is combining as of January 1 with the cans spend their day sitting at a desk,” said Roufia Payman, supervisor of outpatient nutrition education at Mount Kisco Medical Group (MKMG), a multi- Northern Dutchess Hospital, a Health Quest affiliate. “Pick up your feet on the Walkway during this chal- specialty healthcare provider serving Westchester, lenge and decrease your chance for long-term health problems.” Putnam and Dutchess counties. Founded in 1946 There are four ways to enter, including a downloadable “Health Quest U” app available for smartphones, and consists of over 300 physicians, MKMG is the taking of “selfies” from the midway point of the Walkway marked with a teal For more info visit www. a clinical affiliate of the Massachusetts General hqwalkwayfitnesschallenge.com. Hospital and the Mount Sinai Health System. Health Quest is also running a fall Wellness Lecture Series through November at its facilities throughout MHMG currently works with approximately 120 the Hudson Valley. Health Quest physicians and professionals from the greater medical community will specialist physicians working out of 20 sites in speak on such subjects as The Healing Power of the Personal Narrative, Getting Rid of Winter Blues, Inno- various fields in Dutchess and Ulster counties. vative Techniques in Spinal Disc Replacement, Egg Freezing for Fertility Preservation, and gynecology and MHMG recently announced the stationing of colon cancer. All talks are free. Multiple locations throughout Dutchess and Putnam counties will be used, nine rotating practicing physicians from Albany including Northern Dutchess Hospital in Rhinebeck and Vassar Brothers Medical Center in Poughkeepsie. Medical Center at its facility opposite Adams-Fai- Registration is required by calling 877-729-2444. racre Farms in Ulster. “We are excited about the physicians of the Mid Hudson Medical Group becoming a part of from the multiple malpractice suits that Dr. Spy- the buildings that MHMG occupies. And Hey- MKMG”, stated Scott D. Hayworth, president and ros Panos, a founder of MHMG, faces. This is not worth added that “the vast majority” of MHMG CEO of the Mount Kisco Medical Group. “Both an asset purchase. The MSMG staff will join the support staff are being offered jobs by MKMG. groups have a shared passion and commitment new organization as individuals. Dr. Hayworth Government regulators have sometimes con- for clinical excellence and improving our patients’ told the Poughkeepsie Journal that “We’re not re- tested deal arrangements made to avoid the as- health and quality of life.” lated at all to the suits.” sumption of the liabilities of a predecessor orga- The absorption of the HMG physicians into MHMG’s medical equipment is included in the nization MKMG seeks to distance the combined entity transaction. Mount Kisco will continue to lease HealthAlliance conducts regional survey Residents of the mid-Hudson Valley, including Westchester, Rockland, Putnam, Orange, Sulli- van, Ulster and Dutchess counties, have been invited to take a short survey about their health and the services they use. The goal of the survey is “to learn more about the healthcare needs of the community to identify and plan localized healthcare delivery in the future,” according to news of the survey released by HealthAlliance of the Hudson Valley.. The survey is anonymous, will take less than ten minutes to complete, and is available online. Par- ticipants are encouraged to share the survey link and information about the survey with friends, family and other residents of the Hudson Valley. It is being launched as part of a comprehensive community needs assessment focused on local healthcare, an element of the state Delivery System Re- form Incentive Payment program (DSRIP), which is designed to “transform” the state’s healthcare delivery system, reduce avoidable hospital use, and improve access to other healthcare services as a means of reducing Medicaid spending. The survey is being administered through a collaborative effort between HealthAlliance of Hudson Valley, the Center for Regional Health- care Innovation at Westchester Medical Center, Montefiore Medical Center, and Refuah Health October 23, 2014 Healthy Body & Mind | 5 Columbia Memorial Hospital grows its affi liations ack in the late 1980s, Columbia Memorial Hos- Bpital tried to ride to the rescue of Greene County Community Hospital in Catskill, which eventually closed and merged many of its functions into the Hudson- based regional entity. Ever since, CMH has worked to bolster its own strengths, and provide for its sister county across the river. First it provided services, and then two years ago bought the again struggling Greene Medical Arts entity. This autumn, a newly renovated and expanded Columbia Memorial Pediat- rics center opened at what is now known as the Greene Medical Arts building in Catskill, bringing to $8.5 million the investment that Columbia Memorial has in- vested into what’s becoming its second campus. CMH is now characterizing itself as “an advanced multi-specialty health care system” serving more than 100,000 residents in Columbia, Greene and Dutchess counties at 40 care centers, including 17 primary care and 23 specialty care centers, located throughout the region, including a 120-bed long-term care facility, Kaaterskill Care in Catskill. with industry partners to meet community healthcare needs and to achieve op- Announced this past summer is Columbia Memorial’s new “strategic alliance” erational efficiencies. These formal discussions demonstrate our proactive ap- with Albany Medical Center, a process “designed to lead to better coordination of proach to addressing the changes ahead.” care for residents of Columbia and Greene counties and greater operational ef- “We’re proud to be working with the leadership of Columbia Memorial to de- ficiency for both organizations.” Planned are number of stages designed to better velop a health system that will build on our respective strengths and enhance the coordinate CMH and AMC clinical services, develop care integration practices, access to high-quality care for patients throughout the region,” added Dr. Steven and find operational efficiencies between the two entities while their governing Frisch, MD, Albany Medical Center hospital systems general director. “In building boards, medical staffs, employees and fundraising arms remain separate. its local healthcare system, Columbia Memorial, like Albany Med, has taken im- “This move allows us to explore how we can work together with Albany Med to portant steps to succeed in a world where reimbursement models are beginning deliver better-coordinated patient care and improved access to specialty services,” to reward and emphasize clinical effectiveness and positive outcomes. Working said Columbia Memorial president and CEO Jay P. Cahalan. “As the healthcare together will help enable both institutions to move further in this direction under landscape changes, virtually all providers will need to build stronger alliances regionally based governance.”

Center Performing Provider Systems (PPS). It lenge seeks to capitalize on this wealth of infor- publicly available data sets into one unified in- will be made available through several Hudson mation to help consumers make better informed terface, won $30,000 for first place after judges Valley healthcare provider websites and offices, health care choices.” lauded it for being clear and simple in its utiliza- including HealthAlliance, the Institute for Fam- The initiative, pushed by the governor last tion of data from Health Data NY, Data.Medicare. ily Health and the Ulster County Department of spring, “aims to make state government more gov, state medical boards, hospital and clinic phy- Health and Mental Health. Results of the commu- open, innovative, and cost-effective.” Under the sician directories, and reviews from the web, giv- nity survey will be available by November. innovation contest’s guidelines, multidisciplinary ing users the ability to compare providers using a teams of coders and developers were invited to variety of metrics. create tech-based solutions to help consumers Taking home the $10,000 second-place prize Innovation challenge access useful information about the quality, cost, was HealthRank, an application that enables picks three winners and efficiency of healthcare services. Six judges patients to manage their own care by providing then selected from “more than 18 submissions” them with the ability to prioritize among cost, The New York State Department of Health re- and evaluated them based upon decision making, quality, and access on a five-point scale. Graphi- cently announced winners of its inaugural New creativity, feasibility of implementation, target au- cal displays of the data are also available to better York State Health Innovation Challenge – a four- dience, and how data were utilized. depict how each of the top-ranked hospitals com- month contest among tech companies vying to Three winners were announced. pare with regard to the four criteria. create the most useful technological tool to help DocSpot, a website which seeks to simplify con- The $3000 third-place prize was awarded to consumers make sense of health data. “Gover- sumers’ decision making by weaving numerous NaviNext, which utilizes Google Maps to pinpoint nor [Andrew] Cuomo’s OPEN NY initiative has made more of New York’s data available than ever before,”said acting state health commissioner Dr. Howard Zucker. “The Health Innovation Chal- The Culinarians Home Your Smile. It’s what people notice ﬁrst... and remember the longest.

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Getting your elders the care they need County and state health departments are currently assisting ease of contact online for senior care, pushing two sites in particular that can serve as introductions to the many programs available for all. At www.Govbenefits.gov, one should be able to enter as much material as one can, from parent’s health, disability, income, wealth (as in property owned), military veteran status, education level and more – and then push a button and get, within minutes, a list, details and access information for many, even scores, of beneficial government programs, supplements and/or services. At www.Benefitscheckup.org, a non-profit site, use of the same material may report added programs, details and contacts. The top ten programs everyone who is caring for an aging parent should know about, according to those at county and state departments of health, include: Medicare, which encompasses more than just the Part A hospital and Part B medical insurance Poughkeepsie’s Vassar Brothers expands its emergency room coverage. If your aging parent is 65 or older and collecting Social Security, the insurance premi- assar Brothers Medical Center opened a new 7,000-square-foot addition to its state-of- ums are deducted from monthly benefits. Part D the-art Emergency Department this Fall, along with renovations to the 127-year-old hospital’s first- prescription drug coverage is subsidized by Medi- Vfloor corridors and lobby. “Our staff is proud of our long history of providing exceptional care to the care through payments to private company insur- community,” said Robert Friedberg, president of Vassar Brothers Medical Center. “This addition will enhance ers who then fund an average of 90 percent of the what is already the largest, most capable Emergency Department between New York City and Albany.” The cost of prescription drugs. If your parent is con- $2 million expansion increases the treatment space by 15 bays for a total of 57. All bays have mounted com- sidered low income, receiving only Social Security, puters, TVs and new equipment. The original ER was designed for approximately 55,000 visits annually. Medicare may subsidize all but about $10 of the This year, it will treat well over 68,000 patients, according to projections. Vassar Brothers Medical Center, monthly premiums. with 365 beds, is part of Health Quest, a nonprofit integrated family of hospitals and healthcare providers Social Security, which may include a larger that includes Northern Dutchess Hospital in Rhinebeck, Putnam Hospital Center in Carmel, plus multiple monthly benefit than indicated by one’s lower- Health Quest Medical Practice primary care and specialty locations, two Health Quest Urgent Care locations paying jobs via the Supplemental Security Income for walk-in urgent care, skilled nursing facility the Thompson House and affiliates that include Hudson Val- (SSI) program and Medicaid program, which is ley Home Care and The Heart Center. also administered through the Social Security Ad- ministration. Administration on Aging (AoA) administers be submitted. There are several types and levels with the physician, he or she cannot do such, even many national programs and services for elders, of VA compensation and pension programs. if you prove your family connection. Better sooner including health insurance counseling, legal assis- The Health Insurance Portability and Ac- than later, access the HIPAA website for the in- tance, protection from elder abuse and long-term countability Act of 1966 provides your elderly formation and forms, or secure the forms from a care. The banner on the website has a link to El- parent privacy of his or her medical records. It is a physician, and file copies with every healthcare ders and Families, a good starting point, as well as regulation-and-restriction program for healthcare professional involved in your parent’s care. a specific link and service For Caregivers. providers. The protection should be of concern The United States Department of Justice is The Department of Veterans Affairs is par- to you and other family members because, un- important to contact if one’s parent has a disabil- ticularly strong with those whose parents have a less your parent signs a form designating each of ity, particularly with physical movement worsening disability. Prescription drug needs may you as approved to discuss your medical concerns The Food and Drug Administration is a key site to look into if one’s aging parent is taking five to ten different prescription drugs, perhaps pre- scribed by different doctors. Caregivers should be aware of every one of the drugs, know their mis- Claudia’s Day Spa sion in the body and, particularly the side effects and conflicts with other medications. You want to ~ Opening November 1st ~ watch for a danger known aspolypharmacy. 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Registered organizations Finally, be in regular touch with one’s county of- The state is also exploring mechanisms that will be required to comply with strict security and fice of the aging, which is staffed by profession- may accelerate access to medical marijuana for record-keeping requirements. als who know every elder program and service, children suffering from epilepsy, and may expand The law allows for up to five registered orga- including available funding sources, in your area. the list of eligible conditions for which medical nizations, located in New York State, to grow, Staff is often aided by volunteers who serve as driv- marijuana certifications may be issued by practi- manufacture, distribute and dispense marijuana ers for transport and Meals-on-Wheels, for respite tioners based on current research and lobbying. for medical use. Each registered organization may services and other duties. Gather up the same in- Under the program, practitioners will be re- operate up to four dispensing facilities statewide, formation you collected for the two sites detailing quired to complete a training course and register for up to an initial total of 20 geographically-dis- the national, and even state, programs for which with DOH to issue certifications to their patients persed dispensing facilities. your parent may qualify and make an appoint- for medical marijuana. Practitioners must certify Registered organizations must contract with ment to meet with a counselor at the Area Agency that their patients have a serious condition and an independent laboratory located in New York on Aging. The staff person can advise regarding the patients are likely to receive therapeutic or pal- State to test medical marijuana products. Regis- programs and qualifications and even help pre- liative benefits from the use of medical marijuana tered organizations will be able to dispense up to pare applications and documentation. Often, the for the serious condition in order to issue the cer- a 30-day supply of medical marijuana to certified counselor will even call a recommended agency, tification. This process will ensure that medical patients with a valid registry identification card. program or service to advise that your applica- marijuana is available only to patients with serious Patients may only possess up to a 30-day supply tion is headed their way. Access your Area Agency conditions who will benefit from the treatment. of medical marijuana, in pill, liquid or vaporizing- on Aging through your telephone book and call Certified patients must also apply to DOH for friendly formats. The medical marijuana will be the office for an appointment, at which time you a registry identification card. Certified patients dispensed in a sealed and properly labeled pack- should also ask if they have a website that you can may designate a caregiver, who must also apply to age, with a safety insert included. Patients must access in advance of an in-person visit. DOH for a registry identification card. The card keep the medical marijuana in the original pack- will contain the practitioner’s dosing recommen- aging in which it was dispensed. dations for the patient. DOH will be able to sus- Comments are currently being taken by the Medical marijuana pend or revoke the card of a patient who willfully state regarding its proposals. To date, several po- is coming to New York! violates any provision of the law. tential growers of medicinal marijuana have ex- Organizations that wish to manufacture and pressed interest in establishing their businesses in In July the state enacted the Compassionate dispense medical marijuana must apply for state Orange County and have spoken to county execu- Care Act, committing the Department of Health registration. If approved, they must conform to tive Steve Neuhaus about setting up grow houses to implementing a comprehensive, safe and effec- specific requirements. Registration will be valid in the Newburgh and Goshen areas. tive medical marijuana program that meets the needs of New Yorkers but is handled “with safety and care.” Under the New York program, which is currently in the review and policy-setting stage, medical marijuana will be accessible to patients with conditions including cancer, HIV/AIDS, Lou Gehrig’s disease (ALS), Parkinson’s disease, multiple scle- HOLISTIC GYNECOLOGY rosis, damage to the nervous tissue of the spinal cord with objective neurological indication of in- Hormone Balancing s Teens s Menopause tractable spasticity, epilepsy, inflammatory bowel disease, neuropathies and Huntington’s disease. The law includes these conditions when there is TREATING WOMEN Ages 10 100 a clinical association with or complication of the condition resulting in cachexia or wasting syn- Stone Ridge Healing Arts s 3457 Main St., Stone Ridge

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What’s too much … now

Connecting with our inner vice squad by Jennifer Brizzi s our connection to our vices evolves, that classic nightly pitcher of martinis from the 1960s is re- placed by a mug of Sleepytime herbal tea or a bottle of kombucha (which does contain traces of alco- holA and caffeine). Historic times when man, wom- an and child would drink alcohol all day (often because the water was toxic) have evolved into a good percentage of us being confirmed teetotalers. That pack of cigarettes that was once ubiquitous on every restaurant table and bar has been re- placed by the smart phone, perhaps just as addicting. Starbucks’ coffees have double the caffeine of regular coffee, and we supplement them with caffeine shots or caffeine inhalers to amp it up. “Screen time,” which our ancestors never had to worry about, is something that experts now man- date limits on. Sugar, which we’ve loved in many forms over the years, reaches crazy levels these days in sodas and many processed and fast foods. Times have changed in how we perceive just how much of something is good or bad for us. How much is too much of a good thing? Sugar, salt, carbs, caffeine, alcohol, tobacco and being nose up to our electronic devices … who’s to say the correct amounts for any of us? It may depend on the person. While most would claim these days that any tobacco is too much, should 300 mg or 500 mg of caffeine be the daily limit? Should you have a drink a day, or more, or none? Is an hour a day of screen time — or seven — too much? Let’s start with dietary limits. With current trends from cutting out carbs to anything our Pa- to cut out and what to keep. minerals (although some alternative sweeten- leolithic ancestors didn’t eat, to banning sugar or ers do) and doesn’t stick to our ribs, so to speak. soy or fat from our table, it’s challenging to wade Sugar, salt and fats The spike in blood sugar it gives us leaves in its through all the recommendations and know what The simplest carb, sugar, has no vitamins or wake a low that leaves us craving something more October 23, 2014 Healthy Body & Mind | 9

Boozing it down a lot, all day long, according to historian Ed Crews, When it comes to alcohol, consumption by at weddings, funerals and at work or college. They Americans ranges from the total teetotalers to believed booze to be good for their health. Not those who down more than ten drinks a day, and only did it keep you warm and make you strong, many levels in between. The early colonists drank they thought, but it helped digestion and eased 2014 Eating Disorder Conference

substantial. The American Heart Association Promoting last year issued a recommendation of no more than 100 calories per day (about 6 teaspoons/24 A Body-Positive grams) of sugar, for women, and no more than 150 calories per day (about 9 teaspoons/36 grams) a day for men. Sugar can be as addictive as anything Community else but we can wean ourselves off it and be happy with the natural sweetness of whole foods, from cauliflower to peas to pears. As with salt: getting used to less is a gradual Sponsored By The Ulster County Eating Disorders Coalitionn process and well worth striving for. Sodium itself isn’t evil and occurs naturally in many foods, but FREE Conference & Complimentary Lunchh we can taper it down and need less, especially if we have medical reasons to avoid it. Soy is contro- funded by the Ulster County Legislaturee versial; although it has many health benefits, it, too, should be consumed in moderation, especial- Friday,FWednesday,riday, NovemberNo Novembervember 5,11,, 2014 22013013 ly by some segments of the population. And carbs of any kind have a bad rap, from the Atkins craze 9:00am - 4:00pm to current trendy grain-avoiding. 8:30am8:30am - 44:00pm:00pm “Instead of reading labels to see how many At The Garden Plaza Hotel carbohydrates are in our food,” says Dr. Eric AtAt TheTh503e GardenG Washingtonarden PPlaza lAvenueaza HHotel ino tKingstonel iinn KKingston NYingston Ashburn, “we should really look at the quality of the carbohydrates and make sure they’re whole food, high quality carbs.” Dr. Ashburn is an expert and speaker on health and wellness To Register Please Call (845) 339-9090 Ext.115 Or Visit and proprietor of Ashburn Family Chiropractic Center in Fishkill. www.EatingDisordersNY.com “And that goes for fats as well,” he adds. “The higher the quality of the fat, the better it is for you. Also whether it’s in whole foods versus trans fats or hydrogenated fats, those would be the things to look for.”

Hyped up When it comes to caffeine, on the other hand, it seems these days that the sky’s the limit. My mother-in-law never smoked and was very mod- Young Survivors erate in her wine consumption — one glass with dinner — but she would drink cup after cup of cof- Breast Cancer Conference fee all day long during her working days running her busy costume shop in the big city. My own doc Saturday, November 8, 2014 Ɔ 8:30am to 3pm suggested cutting down due to anxiety, so I halved my morning intake and only fill her back up if I St. Lukes Cornwall Hospital Ɔ19 Laurel Avenue, Cornwall, NY have an especially sleep-deprived day. Coffee keeps us lively, but the Mayo Clinic says Sponsors: we should keep our caffeine intake under 400 mg Breast Cancer Options, PROS, Young Survival Coalition, Genomic Health, St Luke’s Cornwall Hospital per day, the amount in ten cans of cola or four average cups of coffee. Other experts say up to 500 Conference is Free Registration Required mg is okay. But Mayo claims that some of us are Ɔ more sensitive than others and may tolerate less. 8:30am Registration Or may not realize how much caffeine is in that 9:00am Opening remarks 20-ounce Venti from Starbucks (415 mg). 9:15am Fertility issues, premature menopause and sexual dysfunction. In 1830 we consumed three pounds of coffee a - Corinne Menn, DO. She is a GYN and young breast cancer survivor year, then by 1859 it was eight pounds. The current average intake is 300 mg of caffeine per day, 10:00am Panel: Overview of Young Survivors and breast cancer. What well below that 400 mg maximum recommended are the elements that are different for women diagnosed at an early age? by Mayo. Those of us who are 50 to 64 years old Moderator: Hannah Brooks, MD get the most caffeine, more than any other age Panelists: Beth Tapen, MD; Corinne Menn, DO; Diana Silverman, DO group, according to the Department of Nutrition- 11:00am Break al Sciences at Penn State. Although some are immune to its effects, fall- 11:15am Follow-up: Screening Protocols, Genetic Risk Assessment. ing asleep readily after an espresso, for example, - Diana Silverman, DO some of us, if we overdo — per the Mayo Clinic 12:00 LUNCH (Lunch will be provided) — may get the jitters, or, worse, experience irrita- 1:00pm Breast Cancer Rehabilitation - A focus on recovering from breast bility, restlessness, nervousness, insomnia, muscle cancer surgery and treatments and getting back in good physical tremors, rapid heartbeat or an upset stomach. It shape. can get in the way of the seven to eight hours of - Susan Riordan, PT, MS, ATC, a Women’s Health Physical therapist sleep we need, which can in turn affect our alert- 1:45pm Timing of Environmental Exposures and Breast Cancer Risk. ness during the day and contribute to a vicious Learn how to protect yourself and your children from cycle of needing more coffee which in turns affects environmental exposures. sleep which affects concentration. - Professor Janet Gray, PhD, Vassar College Also, some medications interact adversely with 2:30pm Living with uncertainty - Coping techniques. caffeine, like some antibiotics, the bronchodilator - Ajamu Ayinde, MA, ACH theophylline and even the herb echinacea. But if we cut down or quit, we can get heachachey and ir- ritability from withdrawal. Cutting back gradually can help, as can realizing where it lurks besides the obvious coffee and soda, like in some pain re- Breast Cancer Options lievers, in lip balm and various energy drinks like For more information, call 845.339.4673 Red Bull and such. If we keep to the right amount for our individual needs, it can not only help amp Email: [email protected] up physical energy and provide antioxidants but also boost mental tasks as well. October 23, 2014 10 | Healthy Body & Mind colds, cholera, colic, laryngitis and labor pains. ment figures showed that annual per-capita al- amounted to 34 gallons of beer and cider, five “In 1790,” says Crews, “United States govern- cohol consumption for everybody over fifteen gallons of distilled spirits and one gallon of wine.” George Washington himself opened a distillery in 1798. “Mount Vernon’s whiskey production went from 600 gallons in 1797 to 4500 gallons in 1798 to 11,000 gallons in 1799,” says Crews. Although the Puritans and Ben Franklin called for moderation or abstinence, that alcohol could be addicting didn’t cross most people’s minds. Since then, as a nation, we’ve cut down consid- erably, especially in the past few decades. At least, most of us have. Gallup, who has tracked alcohol use for 71 years, recorded in 1939 that 58 percent of adults confessed to being drinkers. That number hit a low, in 1958, of 55 percent, and then the high point was 71 percent from 1976 to 1978. Dr. David J. Hanson, a sociology professor at SUNY Potsdam, reports via the National Institute on Alcohol Abuse and Alcoholism, “The per capita Why do I have consumption of alcohol by Americans age 14 and older has dropped from 2.75 gallons in 1980 to to have a long 2.31 in 2007 (the latest date for which statistics are available).” distance relationship Throughout the world, Dr. Hanson adds, men drink more than women and childless couples and those with adult children spend 30 percent with my OB/GYN? more on hooch than the household average. Ab- stention is inversely proportional to social class HQMP OB/GYN is now and level of education, with the wealthier and close to home in New Paltz more educated drinking more. Catholics and We hear you. At Health Quest Medical Practice, our knowledgeable at 652 Route 299. non-Christians drink more than Protestants and board certified OB/GYNs, Certified Nurse Midwives and Nurse church attendees less than those who go rarely Practitioners specialize in women’s health and are easily accessible or never. And younger people are drinking less, with now 5 locations to choose from. For more information visit health-quest.org/OBGYN and ﬁ nd with numbers still dropping, from 50 percent in a convenient ofﬁ ce near you. 1979 to 14.7 percent in 2009 for ages 12 through 17, and 62 percent down to 38 percent of college freshmen, with per capita consumption in general dropping 23 percent since 1990. Of those who drink, the median consumption is three drinks a week, according to data from the National Epidemiologic Survey on Alcohol and Related Conditions, as reported in Philip J. Cook’s FISHKILL POUGHKEEPSIE RHINEBECK KINGSTON NEW PALTZ “Paying the Tab.” In a September 25 Washington Post piece by Christopher Ingraham, while 30 percent of Americans don’t drink at all and anoth- HEALTH QUEST MEDICAL PRACTICE, P.C. er 30 percent have less than one drink per week,

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Pack to screen Which leaves us to that ever-present smart phone and its predecessor the pack of cigarettes, or screen time eclipsing tobacco. I don’t think any studies show that any amount of tobacco is good for us, since the Surgeon Gen- eral’s 1964 report that cigarette smoking causes chronic bronchitis and cancer, with bans on ad- vertising in broadcast media and required warn- ings on cigarette packages following shortly there- after. And now the Centers for Disease Control reports that although 438,000 of us die every year because of tobacco and 45 million still smoke, many are quitting, and almost half of the people who have ever smoked have since quit. But don’t be too hasty to replace that pack with a phone. Between handheld devices, computers and TV, we spend much of our days glued to the screen. The average child spends more than seven hours a day that way, according to Victoria L. Dunckley, M.D., in a Psychology Today article from February 27, and “too much” causes brain damage, affecting emotional processing, executive attention, decision making, cognitive control, planning, prioritizing, organizing, impulse control and empathy and compassion for others. “I observe that many of the children I see suffer

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Treatment modalities such as treatment of gum disease, root canal therapy, DQGUHVWRUDWLYHVHUYLFHVVXFKDV¿OOLQJVFURZQVDQGEULGJHVFDQKHOSSDWLHQWV WRZDUGVEHWWHUGHQWDOKHDOWK:HSURYLGHWKHVHVHUYLFHVDW7LVFKOHU'HQWDO 7KHUHDUHWLPHVKRZHYHUZKHQLWPLJKWPDNHPRUHVHQVHIURPDORQJWHUP VROXWLRQVWDQGSRLQWWRUHSODFHWHHWKZLWKDSRRUSURJQRVLVZLWKGHQWDOLPSODQWV 7KLV GHWHUPLQDWLRQ FDQ RQO\ EH PDGH DIWHU D FRPSUHKHQVLYH FRQVXOWDWLRQ ZKHUHWKHULVNVDQGEHQH¿WVRILPSODQWWUHDWPHQWDUHUHYLHZHGDQGDOOSRVVLEOH WUHDWPHQWRSWLRQVDUHGLVFXVVHG&DOOXVIRUDFRPSOLPHQWDU\FRQVXOWDWLRQWR TISCHLER DENTAL GHWHUPLQHZKDWLVEHVWIRU\RX October 23, 2014 12 | Healthy Body & Mind Healthcare partnering

Health Alliance, formed from the forced merger of Kingston's two hospitals, keeps searching — as with all regional hospitals -- for the right partners, and feels it's again close to ever-better working alliances.

to combine with Poughkeepie-based HealthQuest. David Scarpino discloses Some HAHV board members are believed to favor this choice, though the board does not normally David Scarpino, Health Alliance President and present options for make its deliberations public. Neither HAHV or CEO. HealthQuest is defined as a tertiary or full-service Kingston system hospital system, although HealthQuest has some next signal of the Kingston hospital system’s in- of the characteristics of one. Scarpino only noted tentions, including with whom and how it intends By Geddy Sveikauskas at the YMCA that with this option “we still won’t to partner. In the past, such affiliations have often have everything.” not been irreversible. Given the serious amount of ingston-based Health Alliance However the process ends up, it’s clear that the dowry money involved and the importance of the of the Hudson Valley has narrowed its century-old model of the standalone hospital in state health department (DOH) in the process, choices in its search for organizational smaller New York State communities is coming to however, the new partnerships, once established, partners. President and CEO David a swift close. That era is over. may not be easily reversed. Scarpino last Wednesday told an au- Chief strategy officer Josh Ratner cautioned that Here’s how HAHV’s application. for which it dience of 20 persons at the Kingston the options, which the HAHV board has not made received $340,000 in a state project design grant KYMCA that HAHV’s first affiliation option was official policy, could change. No rigorous due-dil- on September 3, put it: “Our ability to drastically coming together with two tertiary hospital sys- igence audit of the preferred options has yet been reform the delivery of healthcare in Ulster Coun- tems, St. Peter’s Health Partners in Albany to the conducted. Various state permissions and funding ty rests with our ability to consolidate to a single north and Westchester Medical Center in Valhalla approvals are necessary for any course of action. campus from two hospitals less than a quarter- to the south. Earlier planning documents indicate A federal anti-monopoly waiver may be required. mile apart, and to repurpose hospital infrastruc- that the kinds of partnerships, if consummated as And beyond that, Scapino said, “we need a bank to ture to be used as a medical village,” it said. “How described, will differ from each other to some de- lend us money.” and when we consolidate hospital operations is gree, with the former focusing on a system of pri- The funding award from HAHV’s application dependent upon coming to an agreement with an mary care and the latter laying greater emphasis for its share of the eight billion dollars statewide affiliate partner.” on community health services. in DSRIP (Delivery System Reform Incentive Pay- A second option for HAHV, Scarpino said, was ment) funding in early December will contain the “No longer alone” Scarpino and his colleagues envisage the HAHV hospital system shrinking from being the largest Healthy Aging and purveyor of healthcare in its service area to be- November 7, 2014 ing something less, mostly a coordinator of local Caregiving through healthcare. On the bricks-and-mortar side, Scar- 8am to 4pm pino said that would probably mean 200 beds GARDEN PLAZA HOTEL, KINGSTON, NY in one Kingston hospital facility rather than 150 Positivity and beds each in two. “How small will we get from where we are now Mindfullness to zero?” asked Scarpino rhetorically at the YMCA 7th Annual meeting. It was a question that HAHV has until now been loathe publicly to entertain. There it

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DR. BRUCE JAY MILNER T 845 679 4000 212 751 6428 F 845 679 4015 269 Route 375, West Hurley NY 12491 57 west 57th St, suite 1008 NY NY 10019 www.transcenddental.net October 23, 2014 Healthy Body & Mind | 13 suddenly was, out in the open. planning grant to “actively explore partnering cal home that provides patients with timely, well- Scarpino explained that healthcare in the future with HealthAlliance.” organized and integrated care, and enhanced ac- will involve an increase in non-physician medical Westchester, which got a million dollars of state cess to teams of providers,” was the foundation for care (“medical extenders”), in treatment of chron- money to design its planning model to integrate a high-performing health system. ic diseases, and in outpatient visits. Decreases are health care in the lower Hudson Valley region. It The relationship between the choice of a part- expected in in-patient stays and in patients with too promises to help build “a network of medi- ner (or partners) and the operational consolida- acute diseases. cal neighborhoods (or hubs) comprised of local tion of the bricks and mortar in Kingston could HAHV says it has enlisted 35 community part- professionals supported by shared infrastructure not have been more clear. First the partnership, ners in its reorganizational efforts. The December and resources.” The local delivery hubs, Westches- then the detailed planning, and finally the con- application to the state, he said, “will tell the state ter’s application said, “will develop collaborative figuration of the two Kingston campuses. In that how we’ll coordinate them.” working relationships, integrate community and respect, Scarpino’s community update last week “It isn’t just us any more,” Scarpino said. “We’ll public-health resources, work with providers to broke no new ground. no longer be alone.” implement workflow changes to implement evi- dence-based practice guidelines, engage patients Design planning and families, and support workforce transforma- John M. Carroll The prospective active partners currently un- tion.” Westchester earnestly promised “to recog- der consideration are significantly larger than nize the particularity of each locality.” the Kingston health system, even with HAHV’s The state’s December 2013 health innovation Woodland Pond retirement community and its plan had described its goal as “at its heart an ad- Margaretville facilities included). At about 600 vanced primary-care model that integrates care Healer, beds, three hospitals and a considerable outreach with all parts of the healthcare system, including network, HealthQuest is the smallest. Westches- behavioral health and community-based provid- ter Medical, which has 895 beds, recently bought ers, and aligns payment with this care model.” The Teacher, St. Francis Hospital in Poughkeepsie. And St. Pe- premise of the plan was a belief that such a model, ter’s, itself a merger of four Albany-area hospitals defined as “an augmented patient-centered medi- Spiritual Counselor three years ago, is about seven times as large as HAHV. With state encouragement St, Peter’s is also “John is an extraordinary healer whom I have working closely with Schenectady-based Ellis Columbia been privileged to know all my life. His ability to Medicine, a 430-bed hospital with other facilt- use energy and imagery have changed as well as ies and a similar primary-care model to HAHV’s. SPECIALIZING IN WIGS FOR saved the lives of many of my patients. Miracles This summer Ellis received a $500,000 DSRIP WOMEN WITH HAIR LOSS still do happen (with John’s help).” • Human & Synthetic Wigs & Pieces — Richard Brown, M.D., author, • Turbans and Hats Stop Depression Now Visit Our Wig Shop • Wig Care Products Private Consultations by trained, professional, caring staff “John Carroll is a most capable, worthy and excellent healer of high integrity, compassion and love.” PROFESSIONAL BEAUTY SUPPLIES — Gerald Epstein, M.D., author, Welcomes You and COMPLETE COSTUME SHOP Healing Visualations

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Where does one turn in a crisis these days?

he delivery of mental health care in our society is challenging. Though people with enough money can seek private psychotherapy, many individuals facing mental health issues cannot afford treatment and Tmay fear the stigma of a diagnosis. Because state budget cuts have reduced funding for governmental mental health services — by a full $8 million over the last five years in Ulster County alone — the situation has become even more difficult. Below, our reporters look at the current state of local mental health care in the communities of Woodstock and Shandaken, New Paltz, Saugerties and the Kingston school district.

Woodstock and Shandaken struggle to provide services

By Violet Snow Woodstock is where the region's mental health giant, Family, started as a means of taking care of the s the county seat, Kingston is a hub many young people fl ocking to the area in the early 1970s and still maintains a major presence for for delivery of services. Woodstock is those in need of help. Now the not-for-profi t is headquartered in Kingston with active offi ces in New Atwelve miles from Kingston, and parts of Paltz and Ellenville as well. Shandaken are 30 miles away. Family of Woodstock, the local social-services people in Woodstock who can no longer afford to challenges. organization, has a county reach and fills in a good live in town but consider themselves part of the PEOPLe, Inc. (Projects to Empower and Or- deal of the gap to serve local needs. “Because we community,” said Cooper. “They come to shop at ganize the Psychiatrically Labeled) was started have a hotline and a walk-in center, there’s a va- our free store or hang out in the front room, which a decade ago as a peer-based informal resource riety of ways we might be an entry point into sys- is a cooling or warming center, depending on the and runs programs such as the Rose Houses. This tematic treatments,” said Tamara Cooper, Family’s weather.” hospital diversion program houses people with program coordinator. She sees people obtaining Both on the hotline and at the walk-in center, mental health diagnoses for a few days as a short- help from three categories of resources: formal, explained Cooper, “we talk with people about their term alternative to hospitalization. The group also informal, and internal. concerns and help them think about what steps to supplies advocates to accompany and support in- “As monies dry up, with fewer affordable mental take. We have information about where resources dividuals when they go to an emergency room for health options for people, those informal and in- might be, and we encourage them to come in and psychiatric evaluation. ternal resources take on more importance,” Coo- call us. Sometimes we are the resource, since we Mental health issues may come to light when per said. “It’s important to really understand how have some people in our county and our town who the police are called to deal with volatile situa- to use those resources.” are system-resistant, fearful of going for more for- tions. If an individual is showing signs of mental The hotline, staffed 24/7, is an informal re- mal resources.” imbalance, a police officer may refer him or her to source. With phone plans now including free Family has a limited capacity to offer formal county mental health services. long-distance, the line receives calls from all over counseling. “If someone wants to sit down and If the problem is acute, ambulance staff may be the country. The majority of callers, however, are talk with one person once a week,” said Cooper, called for evaluation or for assistance in avoiding from all parts of Ulster County. Individuals seek “we can hook them up with someone who works potential violence, according to Shandaken su- immediate support for emotional distress, in- on our staff.” For more extensive psychotherapy, pervisor Rob Stanley, who added that sometimes cluding suicidal feelings. Or people call for advice clients must go through private practitioners or the person might be transported to a hospital in on how to get help for a family member, friend, through the county. Kingston for assessment. neighbor, or someone they see on the street. Over the past three years, the budget cuts have “It’s a hard call for first responders,” said Coo- Family’s walk-in center on Rock City Road prompted Ulster County to reorganize its mental per. “In our society, personal rights outweigh pub- serves a similar function and is open 9:30 a.m. to health service delivery system. A public-private lic concerns except under specific criteria. The 9:30 p.m., seven days a week. “We have a lot of partnership was established with Hudson Valley person has to be a clear danger to self or others to Mental Health (HVMH) to operate the county’s be taken against their will for formal assessment. clinics in Kingston, Ellenville, and New Paltz. As- They can be held up to 72 hours while the assess- Blue Stone Natural Health sistance for children and adolescents is provided ment is happening.” Naturopathic Care for the Whole Family through Astor Family Services. At the hospital, the person or team performing Other formal resources are available through the assessment converses with the individual and Dr. Eli Morales, N.D. the Institute for Family Health, which has clin- speaks to other people in their life to determine ics in Highland, New Paltz and Kingston, and whether the person is a danger. “The evaluators www.bluestonenaturalhealth.com the Mental Health Association of Ulster County. might say, ‘Yes, this person needs mental health Woodstock, NY The support group system is widespread in Ul- treatment whether they want it or not, in order to ster County, providing meetings of Alcoholics stay safe or safeguard the community,’” elaborated Call for a FREE 15-minute consultation. Anonymous and other twelve-step programs from Cooper. “Or they could say, ‘This person doesn’t 845.372.5033 Al-Anon to Narcotics Anonymous. The National meet the criteria, they seem to know who they are, Alliance for Mental Illness offers assistance for where they are, and they’re not expressing suicidal families and friends of people with mental health ideation or threats of violence.’ Then the person

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By Terence P. Ward

esources are available for those experiencing a mental health crisis in New Paltz, Rand for those close to someone who is. Ex- actly what resources are immediately available depends largely upon who you are, though. The New Paltz community is experiencing a crisis. Some segments of the population – in particular, college students and senior citizens -- have a more robust safety net around them, meaning that problems may be caught before they spiral out of control. Other residents have options only if they know who to call. Exactly who should be called is a question that employees of various different government agencies answer differently. Three responses are the most common: call the police, the Ulster County Department of Mental Health, and Family of New Paltz. SUNY New Paltz provides key services for Family of New Paltz is the local office of Family its large student body, although it still comes of Woodstock. Among the many programs it of- down to dispatchers in most towns, as seen at fers, the New Paltz office has trained volunteers right, to guide people in crisis to the aid they staffing a crisis hotline and according to director need. Kathy Cartagena anyone answering the phone is would be released.” able to do triage to determine what kind of help While evaluation at a hospital or clinic is the first the caller needs, and how urgent it is. step in entering the county system, it’s a step that “They’re able to quickly determine what the most people find intimidating and is seldom tak- problem is, and decide if they need a referral to a en voluntarily. To address this problem, the state local professional, or to talk to one of the counsel- recently approved over $400,000 in funding for ors we have on staff,” Cartagena explained. “Some a new mobile mental health crisis response team of our volunteers have a background in mental for Ulster County. Designed to provide emergency health, and they’re often willing to take a lot of intervention, connect patients with services, and that calls for community members to be trained time talking to someone if necessary.” lessen the burden on emergency rooms, mobile in mental health support. “We teach you how to Cartagena said that some clients, such as the units have been shown to reduce the number of approach and engage people who are having men- honeless, are more at risk than others, and not unnecessary psychiatric hospitalizations, accord- tal health challenges,” said Cooper. “It could be a everyone can be given the help they need easily. ing to county executive Michael Hein’s office. neighbor, someone on the street, a family mem- “Some people are so ill, they try to avoid treat- Similar teams already exist in Orange County ber. The training specifically looks at depression, ment,” she said. “They’re afraid of being locked up, and in Dutchess County, where the service may anxiety, substance abuse, suicide, and psychosis. or their medications are so strong they have pow- be accessed through a helpline. The details of ac- It goes through an action plan for each of these erful side effects.” If there is a concern that some- cess are still to be worked out in Ulster County. It’s issues, including immediate response in a crisis.” one is likely to become violent, calling the police expected that the mobile unit will be called upon Trainees learn how to listen and give reassur- is the option. by police and ambulance crews, and it will also be ance and information, encouraging appropriate Cartagena has a lot of confidence in the New available to families, who can request intervention professional help while engaging in self-help and Paltz Police. “They are the most gentle, caring in moments of crisis, possibly through 911. The other support strategies. The eight-hour training, individuals,” Cartagena said. “If we have to call team will have a medical director on call and will often spread out over two days of a weekend, has provide face-to-face clinical assessment, facilitat- received more attention since the tragedy at San- ing referrals to community services. dy Hook Elmentary School in Connecticut, where Internal supports may be the most important a young man with mental health problems killed resources for all individuals. “I always remember over a score of children and teachers. Integrative Healing Arts that people facing mental health challenges still “As other resources become less obtainable, we Erika S. Gabriello, L.Ac. MSTOM have inner strengths they can rely on,” empha- need to learn how to recognize problems and how -- sized Cooper, “including their hope for recovery to be of assistance,” said Cooper. “How do we, as  Main St., New Paltz, NY and their belief in God or some other spiritual a community, identify and help people in need?” www.holisticnaturalmedicineny.com belief. For some, it’s optimism, or their love of na- Anyone interested in the training should call TAKE BACK YOUR HEALTH ture, pets, or family. People have the ability to seek the Family hotline. A session is currently being help and build relationships.” considered for the first weekend in November. Acupuncture Whole Health Nutrition To augment the potential of those relation- Functional Meridian Analysis ships, Family is turning to a new first-aid model Eastern/Western Herbal Medicine In New Paltz, Detoxification Homeopathy Bladder out We accept most insurance of Control? 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a scenario that Saugerties police chief Joseph Sinagra says once played out on his community’s streets not so long ago. In such events, concerned family members or bystanders would most likely call the Saugerties police. Although there is no town policy in place on how to handle situations such as these, town supervisor Greg Helsmoortel says his suggestion would be for residents to do just that: call the police. Chief Sinagra confirms that residents often alert the department that someone has suffered a mental break or a lapse. What happens from there, Sinagra says, depends on a number of factors. A person who has harmed himself or others is placed under arrest. During intake, the officers determine whether this behavior is out of character for the perpetrator. If the police think that he or she has lapsed on taking medications or perhaps needs an adjustment to medications, the police will transport the person to the hospital. There, they will receive a mental health evaluation and devise a safety plan for adjusting or ensuring remaining on the correct dosage of medication. Last year, Sinagra said, Saugerties had 96 mental health transports. Saugerties may be unique in the area in that the police department transports Saugerties is a town, like many throughout the region, where local police are the front line for mental these citizens in a police vehicle. In most localities, health crises and take their added responsibility seriously, through training and gentle interactions an ambulance is dispatched to transport. Howev- with those on the edge. er, after paramedics employed by Diaz Ambulance Services were injured by a mentally unstable per- them, they spend so much time talking the per- someone else,” she said, “because they don’t want son a year and a half ago, the new policy was put son down, so that they leave willingly instead of to put the idea in their head. But the research into place. Only police personnel and vehicles can strapped to a gurney. I sometimes get teary-eyed, shows that that isn’t going to happen.” be used for mental health transfers now. they’re so kind and well-trained.” The university police work closely with the The year before this policy was initiated, the de- According to lieutenant Rob Lucchesi of the counseling center and the office of residence life to partment assisted in only a dozen such transfers. New Paltz Police, the officers are given some train- keep tabs on students on campus, and if they are Sinagra sees additional benefits to this town poli- ing in evaluating the mental state of people they asked to connect someone to the emergency coun- cy. For one thing, it eliminates the possibility that encounter, and react appropriately. “As first re- selor on duty “they just ask for the person’s name an ambulance a resident with a serious medical sponders, we try to assess the person’s needs and and number.” If transport to a hospital is warrant- emergency would otherwise have used has been determine the most appropriate course of action.” ed, the college has a close relationship with Kings- taken out of service for a mental health transport. If there is a real concern about violence to self ton Hospital, and is able to follow closely the case A mentally ill person taken to the hospital might or another person, that’s probably going to mean of any student brought there. stay there a few days, and then be turned away, a trip to the hospital. Talking the individual down In short, if someone is in crisis in New Paltz, most of the time for financial reasons. Often, these has the goal of getting them to agree to being trans- call Family if possible, or the police if violence is folks end up back onto the streets again, where ported there, though state mental health law au- a concern. On campus or for a student, a call to there is no one there to ensure that they are taking thorizes officers to compel the person if necessary. the university police will get a quick connection their medication or acting rationally. If officers have concerns which don’t rise to that to the counseling center. And don’t be afraid to As Sinagra puts it with a sigh, “The cycle be- level, the county mental health office is called ask someone directly if they think they may cause gins again.” He says he receives calls for the same instead. The chief of that department regularly themselves harm. people repeatedly. His officers watch behaviors meets with the police, and officers receive in-ser- deteriorate until once again a physical crime is vice training around working with those in crisis committed. The Saugerties chief concedes that it’s and with longer-term mental health issues. How the Saugerties Police frustrating to watch the same scenario play out The town and village governments have no deal with the mentally ill time and time again. But “my hands are tied,” he formal role to play in mental health issues in the explains. He puts the department at potential risk community, but the concern is still there. Despite By Dawn Green of liability for intervening too early. cutbacks, the county is still the appropriate level Sinagra knows there is a better way. When he of government to address these concerns because ental illness can consist of many be- worked as a paramedic in the 1980s, he said, he of its size, said village mayor Jason West. haviors. It might be a person threatening and his team would transport people directly to Town supervisor Susan Zimet agreed that her Mto harm himself or others. It might be a di- the county’s office of mental health services for government, while not technically responsible, sheveled person pacing up and down a busy street help. Now, he says, it is his department who most provides funding to Family for its work, as well as in the village, muttering obscenities. It might even often must deal with this population. the town youth program (which has a staff trained be a man chasing a taxi with a hammer in hand, Although police officers have some training with to counsel teens) and activities for senior citizens (which can reduce the isolation that contributes to depression and other problems). Still, local officials do sometimes need to make a determination. West pointed to the building department as one with employees that may be the first to contact someone in need. The village’s director of planning, building and code enforcement, Bren White, acknowledged that this is the case. “Our code enforcement officers deal with it on a case-by-case basis,” she said. They will try to contact “someone who can help,” be it a family member, the offices of mental health or the aging at the county level, or some other resource. “Each case is going to be different,” she said. Stacy Delarede, a building inspector for the town, said, “We’re not certified to determine someone’s mental condition,” but will contact the office of the aging for an elderly person in need, or the police if their own safety is in jeopardy. On the SUNY New Paltz campus, the counseling center has set an ambitious goal, according to director Gwen Lloyd: get every employee trained to assess students for a possible crisis. The number of stressors on college students can be large. Often their level of independence is greater than they have ever experienced. In addition, a psy- chotic break is more likely to happen to a person between 18 and 30 years of age. By next year, Lloyd wants everyone from custodians to profes- sors to be able to ask simple, direct questions and to make an assessment. As the county seat, Kingston has long been a magnet for those drawn by social services. From its “People are uncomfortable asking someone di- schools to such private entities as Mental Health Associates, the city works to meet and surpass its rectly if they are planning to hurt themselves of challenges. October 23, 2014 Healthy Body & Mind | 17 mental health issues, such as how to talk someone “Students will sometimes listen to another student to be able to help others.” down from a harmful act or how to physically re- more than they’ll listen to an adult,” said Padalino. The county Mental Health Association is inte- strain someone, Sinagra stresses that they are not “Knowing that they’re not alone, it’s good for other gral to mental health care in the school district. mental health experts. The mentally ill are not people her age to know. They’re not the only people “Being in Kingston and the Town of Ulster is very criminals, he says, and they shouldn’t be in the struggling, and there are people they can go and important to us,” said Ellen Pendegar, CEO of criminal justice system. According to him, fund- speak to. Some kids haven’t even identified things Mental Health Association in Ulster County, pri- ing needs to be restored to mental health services, that are issues for them, but when they hear from marily based on Aaron Court in Kingston. “We find something which could, he says, prevent some one of their peers who says, ‘This is what I’m going that location is extremely valuable in that people problems before they arise. through,’ they might say, ‘That’s me.’” who have had mental health issues over a period of Sinagra tells of an incident in which his depart- Paladino added that he’s thankful for Brown- time in their life often do not have a lot of financial ment had to issue an order of protection against a ing’s work, and also for the many other partner- resources, so they don’t always have reliable trans- mentally ill man who had defecated on the floor ships that helps his large district stay ahead of the portation. A great number of people can get to of a church. The man’s parents told him they had sorts of mental health issues the nation seems to that site, and from there we can provide services to tried for years to get him help, but had been met return to on a national basis via reoccurring trage- people with limited income. At the same time, we with obstacles at every turn. dies. He noted, as an example, how Mental Health also provide community support groups for any- Sinagra says it is as though we have “washed our Association of Ulster County provides services body in the community, and it’s a well-known spot hands as a society” of the mentally ill. and educational opportunities for elementary in the City of Kingston that anybody can get to.” school children throughout the Kingston school The MHA began as a not-for-profit organiza- district. Their work is augmented by that of so tion in 1959 with the goal of promoting mental Kingston mental health many others. health issues and working to ensure improved as seen through student eyes “We have a lot of community resources in our resources were available for people with mental buildings, and all that helps us in our overall goal, illness. Focusing on adults, children and families, By Crispin Kott to meet the needs of our students,” said Padali- MHA offers residential services, mental health no, also pointing to partnerships with Children’s education, rehabilitation, therapeutic foster care, or many teenagers, opening up about Home of Kingston, the Family Health Institute, support groups, and community initiatives like their feelings can sometimes be weighed and Family of Woodstock, the last being integral the Youth Booth in the Hudson Valley Mall. Fdown with shame or embarrassment. One to the Student Success Center at the high school. As is true of many community-based services, Kingston High School junior is hoping that by “We can’t do that alone.” MHA doesn’t go it alone. “We work very much with opening up a dialogue on the topic, other students The school district also employs School Re- law enforcement in both the city and the town, and will feel more comfortable discussing and ad- source Officers in the middle schools and high we have very good relationships with them,” said dressing mental illness. school through partnerships with the police de- Pendegar. “In fact, we gave the Town of Ulster an “I’ve suffered from anxiety my entire life,” said partments of Ulster and Kingston. “Their value award for their professionalism and the dignity Natalie Browning, a member of the girls’ varsity cannot be understated,” said Padalino. “Their be- they’ve always treated us and our residents.” swim team, student government, the Spanish ing here is helpful in so many ways. People think Some off-duty officers from the Town of Ulster Honor Society, Math Team and Pillow Fight for they’re policemen walking around dealing with work with MHA in a security capacity at resi- Cancer. Diagnosed with an anxiety disorder at the safety issues, and they do that. But they also deal dences operated by the organization, primarily age of nine, Browning had a difficult time feeling with other issues. They work on many different to ensure the safety of the residents. This close- like she belonged in middle school until she began things with our students and families.” ness allows police officers the chance to get to opening up about her struggles to friends. For the school district, Padalino said, it’s about know some of the people in the community with After hearing about Bring Change 2 Mind, a more than simply ensuring a student gets good mental health issues in an environment less po- non-profit initiative for mental health advocacy grades, something with which not everyone in the tentially chaotic than they might otherwise expe- involving actress Glenn Close, Browning decided community agrees. “A lot of people don’t think it’s rience. When the police have seen people who’ve to bring that spirit into Kingston High. With as- the school’s responsibility to deal with some of dealt with mental health issues over the course of sistance from school social worker Amy Kapes these issues, that our job is A-B-Cs and 1-2-3s,” their lives, when they are called at times it’s usu- and English teacher Christina Krzywonos, she he said. “But my philosophy is that it is our job ally when people are in crisis and don’t have the began creating PSA’s to be shown on KHS-TV to to deal with every aspect of a student, and if we opportunity to see the person as a whole person, bring awareness to the student body. can provide services here or help a student here, said Pendegar. “Being around in our facility, it’s a “Mental illness is so common, and I think a lot whether it’s mental health or physical well-being, win-win on both sides, and we feel it’s for the best of people don’t realize it because it’s not spoken we should do it. We have the students here, they’re for the community.” about and it wasn’t until I came to high school our responsibility and we care about them, and Family of Woodstock walk-in centers are at 16 that I realized that there were other people my not only to have them be academically successful, Rock City Road in Woodstock, 51 North Chestnut age who struggled with it, and a lot of people who but also to make sure that they are well-rounded Street in New Paltz, and 221 Canal Street in El- were ashamed of it,” said Browning in a PSA. “And and getting everything that they need.” lenville. The hotline can be reached at 679-2485 I’ve decided not to be ashamed of my disorder. The district works hard to achieve that bal- or 338-2370. So I really wanted to bring awareness to that and ance, said Padalino. “We take a multiple-path ap- For information on other local resources, see who even people who don’t struggle through men- proach,” he explained. “We have school psycholo- http://familyofwoodstockinc.org. For Mental tal illness that it is the kid sitting next to you in gists and have social workers in every building. Health Association of Ulster County call 339- class, your best friend or the kid you play soccer Sometimes its roots are in the family, and being 9090. For Ulster County Mental Health call 340- with, and that you should be supportive of every- able to engage the entire family in conversations 4100 from 9 to 5 on weekdays. body and be aware of the words you use and the is sometimes the way to do it.” things you say.” He reiterated how important an added effort Kingston schools superintendent Paul Padalino such as Browning’s mental health awareness ac- said that hearing about mental health issues from a tivities can be, in the greater picture. “It’s great,” classmate may get the point across better even with he said. “She was really adamant about getting all the resources the high school can offer students. that word out. It changed her life, and she wanted Healthy pets OurOur Pet Pe s t are s are Everything Friends We can’t imagine life without them. 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PHOTOS BY LISA CARROLL Medicine cabinet

A mother’s guide to surviving common colds, stomach bugs and everything in mite football. between. And Shelby — since she knows how to use a tis- colds, coughs and drips I remember time on the sick couch — we weren’t sue — employs the high-pitched nasal whine to allowed to stay in bed — with a glass of ginger ale signal a need for Tylenol, and a nap, STAT. Within at my side. Cartoon characters danced in my head the first few weeks of Pre-k, she has already need- By Lisa Carroll as I would slip into and out of sleep. Within a day ed one sick day, which prompted me to stockpile or two, my parents’ regimen would work wonders, the necessities for this cold season. here is a lot I can handle on the and I would be trotting off to school again. My husband and I are not big believers in medi- sickbed front. So, it’s no wonder that four-year-old Shelby cine. We store very little in the house — mostly I can hold my children’s hair back and two-year old Sammie have seen little of their out of fear that one of our children would think it as they vomit. Sometimes they make pediatrician aside from necessary vaccines and was candy despite the fact that any medicine we it to the provided receptacle and wellness visits. We’ve been blessed with very few do keep, we keep well out of reach. sometimes they miss. I can manage illnesses, aside from Sammie’s odd bug-bite reac- Plus, we usually consult grandma, our go-to- Tpoop with the best of them — explaining why it tions that leave her body in a rash. person for any medical problems for her sage comes in so many shapes, forms and colors as But as healthy as my kids tend to be, they are wisdom, which nine times out of ten stems from though I were discussing fine art. I can fend off not immune to the many sniffles and bugs that common sense and experience rather than medi- high fevers with a mixture of Tylenol and TV time. surround them — especially going into the fall cal textbooks. To many, my medicine cabinet must On a whole, my two kids and their vast sniffles, season, and Shelby’s first year in school. look pretty sparse. coughs and bugs have fazed me little. I can attri- There have already been the telltale signs of a I have a thermometer. Two, in fact, a digital bute that to my parents, both nurses. good cold season brewing ahead of us. I can see thermometer that serves the family (armpits for As children, my brother and I saw very little of it in the faces of my children. Sammie often em- kids, mouths for adults) —and yes, it’s washed of- the doctor’s office. Beyond my parents’ mantra of ploys the snot-salute, wiping her nose directly ten — and a temple-reading thermometer that I “whatever doesn’t kill you only makes you stron- across her check. When caked with sandbox sand, don’t quite trust. When the kids are a little older ger,” they were well-versed on the ways of curing she looks like she’s prepared for a game of mighty- and can abide by temperature-taking rules like October 23, 2014 Healthy Body & Mind | 19 not talking with it in their mouths or chewing on lovey or special toy. Sleep and comfort being the ter and bouncing around the house like ping-pong it, I’ll upgrade. best medicine I’ve encountered thus far. balls, I’m going to be shuffling around the house And, I’ve got acetaminophen — Tylenol, in While the kids are sleeping (hopefully), I wash in my old bathrobe, heating up a cup of soup for name brand lingo. Shelby will take the grape- all the bedding and clothes and get a big pot of myself. flavored medicine like a champ. Sammie on the chicken noodle soup simmering. And enjoy a hot other hand requires restraint or bribery. cup of coffee. That sums up my kid-medicine cabinet, aside I know in a day or two, when the kids are all bet- TENNIS LESSONS from various-shaped bandages strewn around which seem to do well band-aiding both real and John H. Grant, lcsw-r Steve Josephs imaginary wounds. But don’t let the lack of cabinet fillers fool you. 845.657.6004 I take a full-on approach to kicking bugs’ butts. Counseling When either kid, or both as it seems to happen mostly, are too sick for bed they are directed to & indoors the couch. They are lavished with attention — one Psychotherapy reason why I think they don’t mind being sick — outdoors and given plenty of fluids. We start with ginger ale, the ginger calming an upset tummy. I dole out INDIVIDUALS / COUPLES ginger ale regardless of the symptoms, whether I’m dealing with a head cold or a stomach bug. For sniffles, running noises and all things snot- ~ Most insurances accepted ~ related, we use lots of pillows to keep their heads Digestive Issues? up and have a stock pile of tissues at the ready. 845-339-5572 When the kids were younger, we used that rubber 291 Wall St Gas, Bloating, bulb-syringe hospitals give out as baby-delivering gift favors. They’re gross but effective. We also Kingston, NY 12401 Acid Reflux? would fold a beach towel and stick it under the head of the crib mattress to get their little heads Relax Your Body & Mind higher. with the sounds of windchimes... If it’s stomach related — and frequent bathroom visits or diaper changes ensue — we enforce the :RRGVWRFN&KLPHV BRAT diet: bananas, rice, applesauce and toast. Once the ginger ale goes down and stays in, we :$5(+286(6$/( move on to one of the BRAT items, subsequently off Rt. 28 in Shokan, NY adding from the list until the kids get better or Nov. 6, 7, 8, 9 something comes back out. When fevers get high or they’re just too uncom- Thurs,T Fri, Sat & Sun Janet Draves, ND, CDN fortable, I dole out meds. 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We also offer programs addressing the unique issues relating to 845-339-3200 adolescents, women, and a dual 900 Ulster Avenue focus for patients with addictive disease complicated by Kingston psychological problems. 1-888-CARING-1 Seminary Hill Road, Carmel, NY 10512 845-463-3900 10 IBM Road Plaza Poughkeepsie For On-Site Assessments, call Catina Bohmann (845) 216-0980 EdibleArrangements.com A LIBERTY MANAGEMENT GROUP INC. MANAGED FACILITY Edible Arrangements®, the Fruit Basket Logo, and other marks mentioned herein are registeredstered ttrademarksrademarks ooff EEdiblediblle AArrangements,rrangements, LLLC.LC. © 22014014 EEdibledible AArrangements,rrangements LLLC.LC AAllll rrightsights rreserved.eserved October 23, 2014 20 | Healthy Body & Mind

Better emergency preparedness

ager Steve Peterson, and Raphael. Information booths Red Cross community event demonstrates new resilience aims focused on local aid organizations, citizen CPR, fire safety awareness, “Masters of Disaster” children’s ac- t’s not every political season that govern- community approach’ to disaster preparedness and tivities, and a blood drive, with free food and music. mental health preparedness becomes a key cam- response,” said Michael Raphael, disaster program Raphael has also been named lead for health servic- paign issue. In Kingston on October 18, the Amer- manager for the American Red Cross in the region. es and mental health services throughout all 17 coun- ican Red Cross hosted a Community Emergency “Over the past year, many community partners have ties in the northeastern New York region two years ago Preparedness Event at Alcoa Fastening Systems come together to address local emergency issues, and after coming to the region from the Project Hope disas- in tandem with the county Office of Emergency we are pleased to be working in partnership with Al- ter mental-health program funded by FEMA following IManagement and the U.S. Department of Home- coa to continue this important work in the county.” Hurricane Irene and a career of community outreach, land Security. The idea was to not only train involved The day-long forum and open house recognized es- project management and conflict resolution work with emergency response workers in the Red Cross’ new tablished programs with a focus on available commu- governmental and non-governmental agencies in East- “Building Resilience” push, inaugurated in the post- nity services and county-wide volunteering opportu- ern Europe, Central Asia and the Middle East. Katrina years, but also to celebrate the various ways nities. Speakers included Richard French of the Office “My goal is to be as efficient and responsive as I that preparedness and coordination efforts work. of Emergency Management and the Department of possibly can,” said Raphael, “to meet the needs of “Ulster County is a great example of the ‘whole Homeland Security; Ulster County emergency man- the community during times of disasters.”

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