Miraloma Life Online – January 2010

  • Best Ever Holiday Party and Pot-Luck Cook-Off
  • Laguna Honda Hospital Policy Questions—Part 1*
  • Clean Out the Medicine Cabinet But Dispose of Drugs Properly
  • Coping With Winter Weather
  • From The Legal Files: What is a Living Trust?
  • Highlights from the MPIC Board Meeting of December 3, 2009

Best Ever Holiday Party and Pot-Luck Cook-Off

by Dan Liberthson
Miraloma Park residents made this year’s Holiday bash the very best we’ve ever had. The Laura Lee Brown and Company band played holiday favorites and popular songs for over 100 folks attending, an all-time record number—from the most senior of seniors to the most junior of juniors, and even a canine buddy. Thirty-seven home-cooked dishes graced the goodie table, supported by ham, roast beef, turkey, champagne punch, and wines provided by the MPIC.

JoanneWhitney-photo

More than a dozen kids were entranced by Boswick the Clown, who delighted adults as well with his loving and wacky antics. This delightful holiday celebration was the creation of our community, without whose generous and tasty culinary contributions and joyful presence we on the MPIC Board could have stood on our heads and spat jelly beans but never managed to assemble such a wonderful crowd for such a lovely event. We thank you, fellow Miralomans, for demonstrating what we on your Board strive above all to enhance and encourage—our community spirit, a shared feeling of belonging and contributing to one another’s happiness and well-being that only you can create.

Everyone who attended this joyous celebration was a winner, and we all made each other winners simply by being there and celebrating together—but following are those whose tasty treats made them, by popular vote, Holiday Cook-Off Prize Winners for 2009.

Chart-Winners

The MPIC Board and the entire Miraloma Park community are grateful to our local merchants in Miraloma Park, Glen Park, and West Portal, for donating the prizes for our Holiday Cook-Off Celebration and for serving us year round with all the fine wares and foods that make life in Miraloma Park a pleasure. Let’s all prioritize these neighborhood merchants as we shop, and so reward their community spirit by favoring them with our patronage.

  • Bird and Beckett Books and Records (Glen Park)
  • Canyon Market (Glen Park)
  • Cheese Boutique (Glen Park)
  • Destination Baking (Glen Park)
  • Glen Park Hardware
  • Glen Park Nails
  • Mollie Stones Portola (a special thanks for Mollie’s generous contribution of four gift certificates  and accompanying gift baskets)
  • Papenhausen Hardware (West Portal)
  • Perch Gifts (Glen Park)
  • Shaw’s Candies and Icecream (West Portal)

JeanneDavisMacKenzie-photo

Following are recipes for two of the first prize winning Cook-Off dishes. We invite all other prize winners to submit their recipes for publication in the Miraloma Life throughout the year as space permits. Please take this opportunity to share your recipe with your neighbors, so even more people get to enjoy it. Submit your recipe to the Miraloma Life as noted on the last page, bottom right; if you email your submission, please put “Recipe” in the subject line.

Appetizer: Salsa Polenta, by Joanne Whitney

Bring 6 cups of chicken broth mixed with 6 cups of water (12 cups total) to a gentle boil. Slowly pour in 3 cups of polenta and heat, stirring until polenta is thickened (about 20 to 30 minutes).  Add 6 tablespoons of unsalted butter and stir.

Grease the bottom of two large baking pans with butter and evenly distribute the polenta between them. Layers should be around 1 inch thick. Bake at 350º F for 1 hour.  Cool.

Cover the top of each polenta tray with 12 ounces of soft goat cheese, such Laura Chenel or Pyramide (24 ounces of cheese total). Cover the goat cheese with a half an inch of salsa. Cut into 2 inch squares.

Entrée: Carl’s Macaroni and Cheese Recipe, by Thad Sauvain

Two 8 oz blocks of sharp cheddar cheese (or package of shredded cheddar)
One 8 oz block of gruyere
One 16 oz box of macaroni noodles
2 eggs
1 1/2 cups milk
1 minced onion (yellow or white)
3 tbsp flour
1 stick of butter or margarine
salt/pepper to taste
paprika

Preheat oven to 350º F.  Boil noodles until tender and set aside. Slice cheese, unless already shredded. In a quart-size pan, brown the butter, flour, and minced onion.  Beat eggs and milk together and add to pan, stirring to thicken.  Then add half the cheddar and half the gruyere to the mixture.  When the cheese has melted, add the macaroni and stir.

Place the mixture in casserole dish, layer with the remaining half of the cheese, and sprinkle the top with salt, pepper, and paprika.  Bake for 40-45 minutes until the top is golden brown but not dry. Serve warm.

Laguna Honda Hospital Policy Questions—Part 1*

by George Wooding, President, West of Twin Peaks Central Council
Policy decisions regarding Laguna Honda Hospital (LHH) are going on behind the scenes. Miraloma Park residents and the City’s voting public are not aware of these decisions because the City doesn’t want to use the hospital for the purposes presented to voters in 1999 to gain passage of the bond measure to rebuild LHH.  Of course, the City doesn’t want to tell you about this.

At its November 23 meeting, the West of Twin Peaks Central Council (WOTPCC)  was presented with an update of Laguna Honda’s changing mission. During the past 10 years of planning and construction, LHH’s project scope has narrowed many times, including cutting 420 of LHH’s planned 1,200 beds, eliminating another 200 assisted living units for people needing a lower level of care, and eliminating the Adult Day Health Center for elderly residents with dementias making it unsafe for them to stay in their own homes during the day.  Now, just 4 months before the new hospital is scheduled to open, LHH appears to be changing the type of patients it will serve, even as construction is all but complete.  It is not even clear whether LHH will continue to call itself a hospital, after spending almost $600 million to rebuild a facility with an initial $401 million budget.

When the City pitched the LHH rebuild bond in 1999, its entire advertising campaign claimed that the goal was to help frail elderly and severely disabled San Franciscans.  The 73% of voters who passed Proposition A thought they were voting to rebuild a nursing home for indigent elderly and disabled San Franciscans.  Now that the rebuilt hospital is almost completed, the Department of Public Health (DPH) is planning to add mental health and substance abuse patients at the eleventh hour.

LHH is not, and has never been, a psychiatric facility, and it doesn’t have a psychiatric license.  But DPH is actively planning to mix in a large number of younger, “behavioral health” patients with LHH’s current population of elderly adults with chronic, complex, and progressive medical conditions.  (“Behavioral health” is defined as providing both mental health and substance abuse treatments).

Heretofore, LHH admitted patients with physical medical conditions who needed medical and nursing treatment or rehabilitation.  Patients with secondary psychiatric problems were also treated, but their primary diagnosis had to be medical in nature to be admitted.  LHH is once again contemplating discarding its long-standing “medical model of care” and embracing a psychosocial rehab, or “social wellness,” model of healthcare (which was introduced in 2003, but failed miserably in 2004) that relies less on medical doctors and more on psychiatrists, social workers, and nurses.  We don’t even know what a “social model” of care is, because nobody seems capable of adequately defining the term.  This is one of the jargon-war terms that DPH’s administrators throw around whenever they want to claim LHH’s model of care is too “medical,” asserting that “medical” is bad and that they know what is good for us.

This is the second time LHH has tried to add psychosocial programming at the expense of the elderly.  In 2003, Mitch Katz, the Director of Public Health, overrode LHH’s admissions policy by sending a variety of younger, ambulatory patients from San Francisco General Hospital (SFGH) to LHH.  Katz claimed huge economic and political pressure to unload SFGH patients into LHH, dubbing the plan as a “flow project.”  Back then, and still today, there has been stunning dishonesty with the public about the flow project, which “flow” appears to be a key component of Mayor Newsom’s “10-Year Plan to End Homelessness” by sweeping the homeless into LHH.

Many of the younger patients admitted to LHH in 2003 had substance abuse or mental health issues, and elderly LHH patients were not only displaced from the facility and dumped out-of-county, but were also often harassed and attacked by the behavioral patients.  LHH staff were attacked as well, a wing of LHH was deliberately set on fire, and a fire was set at the Laguna Honda reservoir.  LHH was completely unprepared for these new patients, since the staff had little training in caring for them and LHH employed only two security guards.  No resources were allocated to manage these behaviorally troubled, younger, male patients who were dumped into LHH with nowhere else to go.

Hospital conditions were so disrupted that the US Department of Justice became involved, mandating specific types of patient care and treatment to prevent “institutionalizing” behavioral patients.  LHH doctors and patient advocates reached out to community neighbors, and neighborhoods such as Miraloma Park became so vocal that Mayor Newsom ordered Dr. Katz to reinstate LHH’s pre-flow-project admission policies, end the flow project, and resume LHH’s previous patient demographics, which the Board of Supervisors now monitors.

LHH is about to reinstate the 2003 flow project by adopting findings from DPH’s new “Ja Report,” which recommends rehabilitating behavioral health patients at LHH, reducing the number of LHH’s doctors, increasing behavioral health staffing, and expanding transitional behavioral health beds.  The Ja Report states: “There is a great concern over patient and staff safety due to a mixing of high-level substance abuse and mental health patients with older lower-level patients in open units.  We recommend some type of separation.”

Interestingly, the Ja Report didn’t consider the safety of surrounding neighborhoods.  Its only mention of LHH’s surrounding neighborhoods was: “The Ja report recognizes that local neighborhood and community concerns have been raised regarding the role of LHH with mental health and substance abuse patients.  However, it is critical that the appropriate balance be struck between neighborhood concerns and the necessity for LHH to respond to the needs of the entire city and DPH as a whole.”  Actually this statement is a lie.  Virtually no one in the surrounding neighborhoods is aware of plans for the “new” LHH, since LHH hasn’t held a public meeting with any neighborhood organization about its potential population changes and probably won’t, unless pressured to do so.  Instead, LHH offers tours of the new facility, but won’t hold town hall meetings to discuss the planned substantive changes to its patient population or its accountability for its bond expenditures.

*Part 2 of this article will appear in the February Miraloma Life. The entire article and additional information can be found at http://www.stoplhhdownsize.com/. Note that the views expressed in this article are the author’s, and the MPIC Board has not yet taken a position on, but will investigate, the matters discussed.

Clean Out the Medicine Cabinet But Dispose of Drugs Properly

by Joanne Whitney, PhD, PharmD

An easy New Year’s resolution is to keep is to clean out your medicine cabinet every January.  If you are like most of us, your medicine cabinet contains unfinished vials of antibiotics and over-the-counter drugs, old band-aids, dirty gauze, some never-to-be-used again makeup, empty lipsticks, congealed deodorants, rusty nail clippers, ancient toothbrushes, and an endless variety of half-empty tubes and bottles with no labels.

Check the expiration date of all products in your cabinet, including herbal, vitamin and homeopathic preparations.  When you find expired products, throw them out, since they will not be effective and will get in the way of finding something you really need.  Moreover, some prescription medications, like tetracycline antibiotics, can form dangerous derivatives after prolonged storage.  Taking such expired products can make you very sick.

Also consider that the hot, humid, and easily accessible bathroom cabinet is not a good place to store medicine. Bathroom conditions hasten the degradation of most medicines. A better place would be somewhere cool, dark, and dry, where children cannot get to them.  A locked closet is an excellent alternative.

That said, the hardest problem arises.  What do I do with the old medications?  You can’t flush them down the toilet or into the kitchen sink because they will then end up in the water supply. In a US Geological Survey, over 80% of all streams sampled were found to contain detectable levels of commonly used medications.

Pharmacies in California will not accept old medications, particularly controlled substances such as narcotics and amphetamines.  They will help you dispose of syringes and needles by giving you a special sharps container to return to the pharmacy.  Many home care companies will do the same. But solid and liquid medications are not handled by commercial pharmacies.

The Hazardous Waste Collection Facility on Tunnel Avenue will no longer accept unused drugs.  Although the San Mateo Police Department will accept dangerous drugs, the San Francisco Police Department will not.  There is a new pilot project for disposing of hazardous drugs called the SF Medical Mail in Program.  You can call 415-330-1405 and request a special envelope.  Tablets and capsules should be emptied from vials into a zip-lock bag and placed in the envelope.

Liquids should be left in their original containers, placed in a zip-lock bag, and then put in the envelope.  This service is for San Francisco residents only, and how long it may be available is unknown at this time.

The California Board of Pharmacy has provided information (supplied by the University of California’s Center for Consumer Self Care) on how to dispose of out-of-date or unused medicine in your regular garbage.  The Board recommends removing labels to maintain your anonymity and conceal what the vial contains.  To further disguise the content, add water to tablets or capsules. Then add a non toxic solid, such as sawdust, kitty litter, flour, salt, mustard, charcoal, Comet, cayenne pepper, or other powdered spice, and then seal the vial with duct tape.  These same solids can be added to liquid medications.  It may be necessary to pour the liquid over the solid substance and then put it in a container. Apply duct tape to blister packs in order to disguise their contents.

Duct-taped vials and packages containing medications prepared as described above should be further enclosed in durable packaging that does not show or hint at the contents. These packages may then be disposed of in your garbage container. It is best to place the packages in your garbage can shortly before scheduled garbage pickup.

The internet provides a great deal of information on the disposal of dangerous drugs, but as always you must be very careful about such information.  It may be out of date, it may not apply to the city or county where you are living, or it might just be dead wrong.

To get the latest updates, access the Board of Pharmacy website (http://www.pharmacy.ca.gov/) or UCSF clinical pharmacy’s Center for Consumer Self Care (http://www.clinicalpharmacy.ucsf.edu/)

Joanne Whitney has retired from UCSF but remains on the faculty of the Department of Clinical Pharmacy.  She has served as an expert witness for the board of Pharmacy and for many corporate and individual cases dealing with the compounding and handling of drugs.

Coping With Winter Weather

by Lt. Louie Cassanego of SFPD’s Ingleside Station

Winter officially began on Dec. 21, but winter weather has been with us longer, and may continue through April. As powerful winter storms move over the City, high winds and heavy rain may pound our neighborhoods.  Trees topple, power lines fall, and the power goes out.  Here are some safety tips for dealing with power outages:

• For lighting, use flashlights rather than candles.  Candles enhance the “wintery atmosphere,” but they are inherently dangerous.  Flashlights are safer, but be sure to keep a fresh stock of batteries on hand.
• Cordless phones are handy, but will fail during a power outage.  Every home should have a conventional “hard line” phone to call out and receive communication during power outages.
• Consider purchasing a hand-cranked radio.  These radios run off batteries recharged by manual power.  They have emergency flashlight and cell phone charging capabilities, and cost around $50.
• Open-hearth fireplaces are inherently dangerous and are inefficient to heat homes.  Keep heavy blankets handy.

Here are tips for getting your home ready for winter:

• Check your exterior lighting, especially at your front door and garage.
• Replace the batteries in your smoke detectors and check the test button.
• Consider purchasing carbon monoxide detectors.  Carbon monoxide is colorless and odorless and most of all lethal.  Prices have come down, and detectors are more affordable.
• Test your home furnace now to see if it is functioning properly.  When the first cold snap hits, furnace repairmen are in short supply.  PG&E is always a resource if a serious problem arises, and will give your furnace a safety check.
• Timers are ideal to illuminate your interior home, when you come home late.

For many of us, our car is like a second home, and we need to be aware that it too may require special preparation for winter weather.

• Check your windshield wipers.  If they are streaking your windshield, replace them. If you can’t see pedestrians and road hazards because your wipers are worn out, you are putting yourself and others at risk. Changing most wiper blades yourself is literally a “snap” and costs very little, and if you are all thumbs, it can be done for you by any service station or auto repair shop for a nominal cost.
• Make sure your tires are not unevenly worn and your tire treads are greater than the minimum required height .

Aside from brakes, good tires are the key element in maintaining control on a wet roadway, enhancing your braking, and avoid hydroplaning (skimming out of control on the surface of the road water).
• Check your headlights, signal lights and hazard lights.  You need to see, to be seen, and to signal your movements to other motorists and pedestrians, and to do that, you need all of your lights working properly.
• Keep safety flares, or even better, battery-operated safety lights, in your trunk.
• Keep a flashlight in your car and periodically check the flashlight batteries.
• Keep a disposable camera in your car to photograph damage on both vehicles in a traffic collision. Cell phone cameras don’t have a flash system, and their night photo capabilities are marginal.  Major drug store chains have disposable cameras for as little as $5.99 on sale. Good pictures of both vehicles after a collision will help your insurance agent and protect you from exaggerated claims by the other driver.
• Watch out for pedestrians.  Winter coats and fall fashion tend to darker color tones. Early darkness in the evenings, rainy weather, and dark clothing mean that drivers and pedestrians need to use more caution.  If you’re a pedestrian, don’t assume drivers see you: they may be distracted or tired. Wearing something bright in color or reflective will increase your visibility.

From The Legal Files: What is a Living Trust?

by Mary Catherine Wiederhold, Esq.

A living trust is a document that at least partially substitutes for a will.  This type of trust is called “living” or “inter vivos” (Latin for “among the living”) because this document is created while you are alive and competent.  The trust lists beneficiaries who will take your property upon your death.  The trust is also referred to as a revocable trust because you can revoke it at any time while you are alive.  You also keep effective control of all property that you have transferred to your living trust.  You can do anything with the property in the trust—sell it, spend it, or give it away.  With a living trust, your property can go promptly and directly to the designated beneficiaries.  This allows them to avoid a probate court proceeding.  Your living trust does not go into effect until you die.  Then, and only then, the living trust allows your property to be transferred, privately and outside of court supervision, to the people you want to have your property.

The first step in setting up a living trust is to place your property in the trust.  This means that ownership of all the property you listed in the trust document is legally transferred from you to the trust.  For example, if I created a trust and put my home in the trust, I would not longer own it as “Mary Catherine Wiederhold.”  It would be owned by “Mary Catherine Wiederhold, as trustee of the Mary Catherine Wiederhold Revocable Living Trust, dated December 13, 2009.”

California does not tax transfers of real property, such as a single family home, put into a trust—so there is no transfer tax liability.  The successor trustee is responsible for the tax.  The federal personal estate tax exemption for 2009 is $3.5 million.  This means that your estate would have to be valued at less than this amount in order for your beneficiaries not to pay federal taxes.  Any amount over $3.5 million is currently taxed at 45%.

Having a trust will not shield your estate from creditors.  In fact, if you have many creditors, it may be better to have your estate pass through probate.  That way, your creditors have a limited time in which to make their claims.  If they do not file a claim against your estate after they are notified upon your death, then they are simply cut off.

Any property for which you want to avoid probate fees can be put into a living trust.  This includes your house and other real estate, money market accounts, valuable items like jewelry, and valuable works of art or other objects.  Property that should not be placed into a living trust include your individual retirement accounts, such as IRAs and 401(K)s, life insurance, joint tenancy property, or pay-on-death bank accounts. You have already named a beneficiary to receive these proceeds when you established them.  Upon your death, ownership of these items automatically goes to the beneficiary you already named, and they do not go into probate.

To be legally valid, the living trust must have a trustee.  A trustee is someone who manages the property in the trust.  In a simple living trust, you would name yourself as the trustee.  You would also name a successor trustee to take over the trust after you die.  The successor trustee would also take over if you become incapacitated and unable to manage the trust property.  This person should be “whomever you feel is most trustworthy to do the job, who’s willing to do it, and can actually do it,” according to a practitioner.

You should also decide how to provide for payment of your debts and taxes after you die.  One way might be to designate certain trust assets to be sold to pay the debts.  One popular misconception is that having a living trust will reduce estate taxes.  While a trust may contain provisions that reduce estate taxes, having similar provisions in a will may accomplish the same thing.

I have provided only a brief overview of what constitutes a living trust. Some legal self-help books provide forms that go through the creation of a living trust step by step.  However, because of the complications of moving property and other items into the trust and setting it up correctly, I recommend consulting an estate planning attorney to help create your living trust.

Highlights from the MPIC Board Meeting of December 3, 2009

by Dan Liberthson

A quorum of Board Members was present.

Umbrella Community Organizations:

The West of Twin Peaks Central Council listened to a presentation about creating a nature and wildlife center in San Francisco but wanted to hear more information before deciding whether to support the idea. The Council voted to put off voting on whether to support or oppose expansion of soccer fields, artificial turf, and lighting at the West end of Golden Gate Park.  District 7 Supervisor Sean Elsbernd and others favor the project on the grounds that there are not enough soccer fields and others are concerned that the expansion is not compatible with the wild state originally envisioned for the west end of the park and by the  lack of solicitation of public input regarding the proposal. Dr. Palmer gave a summary of the state of Laguna Honda Hospital in which he maintained that the hospital is now more involved in care of the psychologically disturbed than in elder care. The MPIC delegate expressed concern and asked that an investigation be made on how the vote of the people can be ignored. The Coalition for SF Neighborhoods discussed the proposed Chinatown subway. The Coalition opposed the idea mainly because of inaccessibility of the subway as planned.  The MPIC Board will do more research on subject. The MPIC Board voted to give $100 for sponsorship of the Coalition, including purchase of a ticket to the Coalition’s Holiday Dinner fundraiser.

Membership: The MPIC now has 518 members; 600 members is the 2010 target.

Events: A budget of $1500 was proposed and approved for the holiday pot-luck party.

Clubhouse: K. Wood and J. Whitney will work up plans for a green clubhouse and a green-dedicated organization.

Planning: The proposed new homes at Bella Vista and Foerster are still being discussed by neighbors and the sponsor. The owner of 201 Teresita has proposed modified plans for an expansion that are more consistent with the Design Guidelines.

Newsletter: Problems with delivery were discussed and the Board decided to replace two delivery persons who were not doing an adequate job.

Old/New Business: J. Lane suggested further research into the concept of a Miraloma Park corridor or safety net for disaster, including approaching Mollie Stone’s, Walgreens, other major stakeholders, and persons who have resources to help.  A proposal that all MPIC Board Members who sit on other boards will make it clear to those boards that they are MPIC representatives was tabled for further discussion.