Monday, June 17, 2013

Trusting Instincts

Yesterday was a Sunday like any other - I was working on my Masters thesis and transferring various loads of laundry from washer to dryer and contemplating vacuuming my house instead of watching The Golden Girls marathon on tvland (The Golden Girls won, by the way) when I remembered that my dog Beckett was out of his favorite beef-flavored treats. Since there is very little Beckett can eat thanks to a finicky digestive system that is probably the combined result of his slow-to-develop “runt of the litter” organs and my reliance on the most natural (read: most expensive) foods and treats on the market, I didn't want him to go through the week without the little freeze dried chews he looks forward to whenever he goes into his crate. So, even though I contemplated staying inside where it was warm and quiet, my “mommy guilt” got the best of me as I grabbed Beckett’s harness and leash. “Wanna go to Petco?” I asked. An unnecessary question, since I could barely get him into the car he was so excited.

The second we walked into the store, Beckett, who has memorized the layout and is, like me, a creature of habit, dragged me over to our regular first stop: the ferret cages. We always visit them first, and he loves to stand on his hind legs and peer at them while they slither around and play with each other and pretend to ignore him. He whines and paws and seems to think they can’t see him, though I suspect they fancy themselves better than him, as they turn their little noses up toward the ceiling and go about the business of simply being ferrets. As usual, though, his attention for the ferrets was short-lived yesterday, and within minutes he was pulling me toward the bird cages. Once again, he was on his hind legs, front paws in the air, head titling from side to side whenever the birds tweeted at him. I can never tell whether he is happy or sad to be outside their cages while they are locked inside, and I often wonder, when I look at him wanting so desperately to play with his little friends, which side seems more like captivity to him.

After Beckett sniffed a cute little cocker spaniel and failed to amuse an older, lethargic looking golden retriever, I finally coaxed him into the “cookie aisle” where he enjoyed his usual sniffing expedition of all the rawhides and meat-scented chewy things displayed at nose level. While I searched for the correct package and contemplated a new brand of biscuits, Beckett smelled and groaned and did his best to lick everything his little tongue could reach. Finally, I pulled the regular cookies off the shelf and did my best to tug Beckett toward the cash register. As usual, I had planned on a quick in-and-out, and, as usual, Beckett had planned on tasting everything (and everyone) he could reach.

As we headed to the front of the store, I stopped to price a package of squeaky toys hanging on the end of an aisle. And that was when a woman who looked to be about my age approached me. 

“He’s a sweet dog,” she smiled and nodded toward Beckett, who by then was frantically pawing at the pork bones just beyond his paws.

I thanked her, always worrying that I sound immodest when I admit that I actually do, in fact, have the sweetest dog on the planet. 

“Is he good with children?” she went on. I wasn't expecting that question, so I stuttered a bit before responding that, yes, he loves children, though he tends to jump and lick any person short enough to serve as a potential playmate, so perhaps not all children would agree.

“My little boy … was wondering ...” she hesitated. “He asked if he could pet the black doggie. So I just thought I’d see …”

“Oh of course he can,” I replied, saving her from what seemed to be an awkwardness I couldn't quite understand. After all, I was dressed in my Sunday sweat pants, unimposing pony tail, feeling relaxed and approachable and open to conversation (which isn't always the case, I admit with some regret), so I wasn't sure where her discomfort was coming from. 

Until her son walked around the corner. He was a beautiful little boy dressed in overalls and a turtleneck. He had a sweet, diamond-shaped face that looked too small for his large, square glasses. And he would not – could not – look at me, even when I said hello. He did, however, fix his gaze on Beckett while he pointed and repeated “pet the black doggie, pet the black doggie, pet the black doggie” over and over and over again.

“Yes,” his mother said. “You can pet the black doggie.”

Then she looked at me, seeming to struggle for words, until she was finally able to explain that her adorable son, who is seven, was diagnosed with autism several years ago. She and her husband had been wanting to get him a therapy dog, but he was so terrified of dogs that he become inconsolable and often aggressive anytime a dog was nearby. On the advice of one of the child’s counselors, the parents had been bringing him to Petco as a way of gradually exposing him to leashed, well-behaved dogs in a controlled environment, and so far, the mother told me, it had been working pretty well. The little boy could now walk through the store, could see and hear and even be in the same aisle with another dog, and not get upset. “Most of the time,” she added with a chuckle.

“But your dog is the first one he has ever wanted to pet,” she almost whispered.  She was trying not to cry, and, in all honesty, I was fighting back some tears myself.

“How wonderful,” was all I could manage, before squatting a safe distance away from the little boy so I didn't crowd him. “His name is Beckett,” I said. “And he would love for you to pet him.”   

Inside I was panicking. At seventeen months of age, Beckett is just now coming to terms with some of his training – probably because, after fifteen months as Beckett’s mom, I have finally learned how to train him (which first involved training myself). Even so, he still suffers occasional lapses, particularly in public places where he is overstimulated and more than willing to suffer the inevitable “Time Out” later for the sheer pleasure of misbehaving now. But this moment was critical. A lapse for Beckett could become a lifelong fear of dogs that this little boy would always trace back to today.

As I thought about all the things that could go wrong in this scenario, imagining every possible negative outcome, I suddenly realized that Beckett had stopped sniffing and pulling and begging for the bones and toys spilling out of the rack above him. Instead, while I had been talking to the boy’s mother, Beckett had been sitting perfectly still, staring at the little boy, the little boy staring back at him, both of them looking away from each other now and then, but neither of them reacting to anything outside of whatever communication they were having. Not even when other dogs walked by.

So I did the only thing I could do. I knelt beside Beckett and said “It’s ok, buddy.  Approach.” I was ready to pull his leash tight if he started to jump, but I could see, without a doubt, that he knew. He couldn't jump. Not this time. And he wouldn't. Instead, he approached the little boy slowly, gently, pushing his nose toward the tiny, outstretched hand until, eventually, child and dog touched. The little boy wiggled his fingers and Beckett licked them. The little boy waved his arms and Beckett followed them. The little boy crossed his legs and Beckett laid beside them. The little boy put his hands in his lap, and Beckett rested his head on top of them.

And we stayed like this, in silence, for twenty minutes. There was nothing else in the world except a mother and me, watching a little boy stroke Beckett’s head, his back, his tail.

“We've been working on this for years,” was all she seemed able to say. Though she was doing better than I was, as I stood there speechless, relieved, proud, inspired.

Before we parted, I gave the mom my phone number and told her that I would be happy to arrange get-togethers between her son and Beckett, if she thought it would help. She thanked me and assured me that she would call. And I hope she does. But more than anything, I hope that this beautiful little boy will now be open to the possibility of a therapy dog, and I like to think, if he is, that maybe Beckett had something to do with that.

It's funny how, even though instinct never fails me when I pay attention to it, I often doubt myself and others, always letting my fears interrupt the natural flow of things. Thankfully, Beckett knew what to do yesterday. And, despite my panic, I knew it was time to let him try. Even the mother who approached me knew that, scary as it was, she had to let her son pet a strange dog, and she had to have faith that he would be alright. Still, it was the little boy who taught all of us to put away our worries and our preconceived ideas and our fears about what may have happened in the past. To simply experience that single moment, when his instincts told him that Beckett was safe, when his instincts told me that all I needed to do was believe in my dog and trust that he would do the right thing. I am so glad I listened.

Guest Post, Heather Haskins

Tuesday, June 11, 2013

Estimating Your Healthcare Costs Using FAIR Health® Consumer Tools

For those who have chronic conditions, managing your health usually involves ongoing care and treatment.  And although your health is the main focus, it’s also important to manage and plan for costs related to your care.  This has always been true for patients without health insurance. And now, more and more insured patients including those with chronic conditions are assuming a larger portion of their healthcare costs, whether they’re enrolled in high deductible health plans or in other types of plans that require greater cost-sharing through co-pays and co-insurance.  Knowing how much you may owe for care can help you make informed healthcare decisions.  Use FAIR Health’s free website at  to research your out-of-pocket costs before getting a service or procedure that’s either not covered by insurance or that is out-of-network.  The website offers cost lookup tools that can be used to estimate out-of-pocket costs for medical and dental services in every area of the United States.  The estimates reflect common plan benefits and can be adjusted to match specific plan provisions.  The amounts estimated are based on the FAIR Health database of billions of billed charges for medical and dental services.

The website also offers educational features, such as the Reimbursement 101 curriculum, glossaries and healthcare resources to help consumers learn about, and better navigate, the healthcare system.  These tools and resources are also available in Spanish at and on a free mobile app, which you can download from iTunes and Googleplay.  
We invite you to use the FAIR Health consumer tools to estimate and plan your healthcare expenses, to inform discussions with your healthcare providers and insurers and to learn about the health insurance system.  We also encourage you to stay in touch with us by subscribing to our free quarterly consumer e-newsletter that offers tips on understanding and managing your healthcare costs and via Facebook and Twitter.
FAIR Health is an independent, not-for-profit organization created in 2009 with a mission to bring transparency to healthcare costs and health insurance information.  Learn more about FAIR Health’s mission here

Guest Post from FAIR Health, Inc.

Monday, June 10, 2013

Maintaining a Legacy

As you are aware, Jennifer Jaff passed away in September of 2012. As the founder of Advocacy for Patients with Chronic Illness, Inc., she left behind not just an agency that she created and nurtured, but a set of ideals and practices that have become the very foundation on which the agency rests. What I have learned about Jennifer is that her life was truly dedicated to helping others in a way that generated not only a fierce loyalty but an incredible network of individuals who helped support the very work she spent her all too short life devoted to doing. The types of accolades I hear about her where things like: 

“She was a super hero for my son, he truly felt like giving up in school until she came into his life.”

“Jennifer was always available and even if there was nothing she could do legally she listened and that truly made a difference.”

“If it wasn't for Jennifer helping me with my insurance appeal I would not have the dignity and quality of life I have now, I can never forget her.”

“What can you say about a total stranger who takes the time to listen, help and truly really care about someone they never met? Is saint too strong? Is hero inappropriate? I don’t know but she was both to me!”

These and so many more wonderful things were said about Jennifer by everyone I meet who knew her or who were in some way touched by her zeal for advocating. What an incredible legacy to leave behind, what a life truly well lived and how powerful a statement that you were someone's hero!

It is unfortunate that I never had the pleasure of meeting Jennifer Jaff. However, I am sure if I had, I would be another of the multitude of individuals who were loyal and dedicated to her vision and mission at Advocacy for Patients. Instead, I have been tasked with the Herculean mission of continuing her legacy, and, in very real terms, of helping those who are truly vulnerable in our society – the chronically ill who often suffer in silence and expect little in terms of understanding from others.

By now you must be asking yourself: Who is this person? So let me tell you a little about myself. I, like Jennifer, have spent most of my adult life advocating for those less fortunate or those who simply have a harder time for one reason or another. I have come to Advocacy with 27 years of experience in social services and management, dedicating many years to working with disadvantaged people as a professional in social services and health care, as well as the law. In the late 1980’s, I left a successful career working at a mutual fund company on Wall Street to begin my career in social services, working for several New York City agencies dealing with concerns such as homelessness and literacy. I had decided that this was truly my life's work – helping those in need. As a result, I decided to pursue a Master’s Degree in Education and Rehabilitation Counseling and entered the health care field, focusing on the mentally and physically disabled. As Administrator on Duty at Jacobi Medical Center, as well as Director of Rehabilitation at North Central Bronx Hospital Center, I gained extensive experience in hospital management and patient advocacy. A growing desire to advocate for disadvantaged people led me to attend law school, and I obtained my J.D. degree from the City University of New York School of Law, whose motto spoke to me completely: Law in the Service of Human Needs.

Upon graduating from law school, I served as a Prosecutor for the Bronx District Attorney's Office for over three years. While there, I worked in the Domestic Violence and Sex Crimes Unit, prosecuting cases and advocating for the rights of victims. I continued my work with poor and indigent individuals as a legal services professional with Legal Services of the Hudson Valley (LSHV), where I handled a diverse caseload of domestic violence, custody, housing and disability matters. While at LSHV, I became the Deputy Director and program-wide Domestic Violence Coordinator. In addition to my legal representation of clients, I was responsible for developing a training and evaluation program for staff attorneys and other stakeholders within the domestic violence prevention and legal field. In 2007, I went to work at the New York State Office for the Prevention of Domestic Violence, an Executive level agency on policy, among other functions. At OPDV, I was the Director of Public Policy and Administration. While there, I was responsible for the development and implementation of statewide training of law enforcement, the judiciary, advocacy agencies and other stakeholders. With my team, I successfully wrote a million dollar grant to develop a one of a kind, online, web-based training for police officers in domestic violence case handling. In addition, I wrote policy for the State of New York in the areas of officer-involved domestic violence, probation, parole and victim advocacy agencies. In my role as the Director of Administration, I was responsible for successfully steering the agency through the recent fiscal crisis.

What does this all say, other than I obviously wanted to help others? It means I hold in my heart the same passion and dedication that Jennifer Jaff had for helping others and championing those  in need. It says that, in hiring me, the Board of Directors at Advocacy thought that I could and would keep the agency and Jennifer’s legacy alive and fully operational. I am so honored to walk in the footsteps of someone so well respected and so highly thought of. I will do everything within my means to keep her memory, legacy, and mission alive and well, and I invite you all to please help us do the same in any way you know how: refer clients, spread the word that we are here to help, and, where possible, please donate, as we count on your support to make this all happen.

Eileen F. Swan, Executive Director