As you may know, Medicare will pay for a patient to receive rehabilitation in a facility if they have a qualifying stay in a hospital: being admitted to the hospital for two nights. The first 20 days of rehabilitation are completely covered by Medicare. The 21st through the 100th day will have a co-payment of $161 per day. This co-payment may be covered by a Medicare supplemental plan.
However, it is important to note that while there is a potential to receive 100 days of rehabilitation, it may be determined that rehabilitation is no longer needed and the discharge will be set up.
The facility is required to give written notice that they believe Medicare will no longer cover the patient. This comes as a “Notice of Medicare Non-Coverage.” This notice gives the patient the right to appeal the decision. In order to make an effective appeal, it is important to know the appropriate standard that the law requires the facility use in making a determination.
That standard was inconsistent with Medicare regulations. The true standard is whether the patient needs the rehabilitation to maintain activities of daily living.
In 2011, a federal court case was decided on this issue. In that case, Medicare skilled nursing service recipients challenged the failure to improve the standard. The settlement agreement by the parties rejected the failure to improve the standard and stipulates that the standard for terminating services is not whether the patient’s condition is likely to improve but rather whether the condition will worsen if services are terminated.
Therefore, skilled services should be continued so long as skilled therapies are needed to maintain the patient’s ability to perform routine activities of daily living or to prevent deterioration of the patient’s condition. This represents the current legal standard for denying skilled nursing coverage under Medicare.
Even though this issue was settled by the courts years ago, many patients are finding it is not being followed by facilities. It is important for the patient and their advocates to know the proper standard so they can make an appropriate appeal.
On Feb. 2, 2017, a new federal court decision stated that the standard is established but it is not being adhered to by facilities. The decision is forcing an educational campaign to be enacted so professionals at facilities and individual Medicare recipients are aware of the appropriate regulations. The plan will include a Centers for Medicare and Medicaid Services website dedicated to this issue and the explanation of the appropriate standard.
Receiving the maximum amount of rehabilitation days possible is the right of all Medicare recipients.
Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.
Adrian Krainer with Emma Larson earlier this year. Photo from Dianne Larson
The prognosis hit Dianne Larson of Middle Island hard. Within three weeks, anxiety attacks, a lack of sleep and fear caused her weight to plummet from 135 to 120 pounds. She found out her daughter Emma, who was 17 months old at the time, had a potentially fatal genetic condition called spinal muscular atrophy in which the motor nerve cells of the spinal cord progressively weaken. Normally, the SMN1 gene produces the survival of motor neuron protein, which, as its name suggests, helps maintain motor neurons. People with SMA, which has four types and severity, produce a lower amount of the functional protein.
“My mind went to the darkest of dark places,” said Larson, whose daughter couldn’t crawl or sit up to eat. “There was no hope. There was nothing I could do.”
At the time of Emma’s diagnosis, there was no treatment for a disease that is the leading genetic cause of death among infants and affects about 1 in 10,000 newborns. Thanks to the work of Adrian Krainer, a professor and program chair of cancer and molecular biology at Cold Spring Harbor Laboratory, that changed early enough to alter the expectations for Emma and children around the world battling a genetic condition that causes progressive weakness and can make moving and even breathing difficult.
Turning to a back up gene called SMN2, Krainer hoped to fix a problem with the way that gene is spliced. On SMN2, exon 7 is normally skipped and the resulting protein has a different sequence at the end. Krainer developed an antisense olignocleotide that binds to a sequence in the intro following exon 7, blocking the splicing receptor. The treatment, which is called Spinraza, helps guide the splicing machinery, which carries out one of the steps in gene expression that is necessary to build a functional protein.
The Larson family of Middle Island, from left, Dianne, Emma and Matthew. Photo from Dianne Larson
Larson had heard of Krainer’s work and was eager to see if his success with animal models of the disease would translate for humans. As soon as Emma reached her second birthday, Larson enrolled her daughter in a clinical trial for Spinraza. After her daughter had a few shots, Larson was stunned by the change. “I was in the master bedroom and she was in the den and I heard a voice getting closer,” Larson recalls. “Next thing I know, she was in my bedroom. I couldn’t believe she crawled from the den to the bedroom. I put her in the den and told her to do it again,” which she did.
The SMA community and Krainer received an early holiday present in late December when the Food and Drug Administration not only approved the treatment, but it also gave doctors the green light to prescribe it for all types of SMA and for patients of all ages. While the SMA community, doctors and Krainer have been delighted with the FDA approval, the excitement has been tempered by concerns about the price tag Biogen, which manufactures and commercializes Spinraza and funded the drug’s development, has placed on the treatment.
For the first full year of injections, the drug costs $750,000. Every year after that will cost $375,000, which Biogen has said publicly is consistent with the pricing for other drugs for so-called orphan diseases, which affect a much smaller percentage of the population.
Knowledge Ecology International, a nonprofit advocate for affordable medicines, sent a letter to the Office of the Inspector General at the Department of Health and Human Services, seeking an investigation. The letter claims that the inventor and maker of Spinraza failed to disclose that the treatment received federal funding. KEI urges the government to use that alleged disclosure failure to end the patent and authorize a generic manufacture of the treatment.
Biogen didn’t return a call and email for comment. Patients and their families, meanwhile, are looking for immediate access to a life-altering treatment. “To be honest, I really don’t know what we’re going to do,” said Larson, whose daughter has four injections left as part of the extension trial soon. “I’m hoping insurance will cover it.”
Insurer Anthem announced late in January that the treatment was only medically necessary for patients with Type 1 SMA, which include people diagnosed with the disease within six months of birth. Anthem created a pay for performance model, which will require patients or their families to prove that the treatment is improving the lives of the recipients.
Larson said she has been in touch with a personal liaison at Biogen, which has been “helpful and supportive,” she said. “They have been going out of their way to reach out to the community to make sure everyone gets access.”
Larson, who is a financial advisor, said she understands the need for the company to generate a profit. “A lot of money goes into” research and development Larson said. “If they’re not gong to make money, they’re not going to” support the efforts to create a treatment.
Emma Larson will be turning 4 this month. Photo from Dianne Larson
Joe Slay, who is the chairman of FightSMA, a group he and his wife Martha founded in 1991 after they learned their son Andrew had Type 2 SMA, sounded hopeful that people who need this treatment will receive it. “I understand there’s constructive, good conversations between insurance companies and Biogen,” Slay said. “We’re monitoring that.”
While Andrew, who is now 30, considers the potential benefits of Spinraza, Slay is pleased the treatment is an option for people and is proud of Krainer’s work.Krainer is “by any definition of the word a hero,” Slay said. “He’s taken his natural gifts, his brilliance in science, his discipline year in and year out approach to his work and has applied himself 100 percent.”
Slay and FightSMA, which has raised over $8 million since its founding, helped provide seed money to Krainer more than 15 years ago, attracting a promising scientist to what was then an intractable medical challenge.
Tom Maniatis, who is the chairman of the Department of Biochemistry and Molecular Biophysics at Columbia University, said Krainer, who did his doctoral work in Maniatis’s lab, showed considerable scientific promise early in his career. Krainer “clearly had the intelligence, drive and experimental skills to make important contributions,” Maniatis said. His work is “a perfect example of how deep basic science studies can lead to profound understanding of a disease mechanism and that, in turn to the development of a treatment,” explained Maniatis in an email.
Within Krainer’s own family, there is a connection to patient care. Krainer’s daughter Emily, who is a pediatric neurology resident at Rochester, may one day prescribe a treatment her father developed. “It will be quite something for me if she eventually prescribes Spinraza to one of her patients,” Krainer said. Even as other scientists and companies like AveXis continue to search for ways to treat SMA, Krainer enhances and refines his research.
“We continue to work on understanding aspects of SMA pathophysiology, the role of SMN levels outside the central nervous system and the potential for prenatal therapy,” he explained in an email. “We are also working on antisense therapies for other genetic diseases and cancer.”
Larson, who is overjoyed with her daughter’s progress, calls Krainer her “superhero” who “saved my daughter’s life.” “It’s such a different feeling when you know you can do something,” she said. When she found out that the FDA approved the treatment, it was “the best day.”
On Jan. 20, 2017, a new and bold chapter began in American history. The 45th president of the United States was sworn in as the new leader of the free world. The America we knew is now radically changing course. It will take time to know if this new course is life-giving and if it truly is able to make “America Great Again.”
During his inauguration speech, Donald Trump spoke about giving the people back the power. The people responded the day after his speech by marching on Washington, D.C., over a million strong; with hundreds of thousands of voices walking/marching around the country and around the world.
Their voices spoke loudly about building bridges not walls and affordable health care for all that does not discriminate against those with pre-existing conditions and/or the poor. Those voices spoke about respect for women and the undocumented; for our Muslim brothers and sisters, for all people no matter what their sexual orientation or gender identification. Their voices loudly echoed concerns for civil rights and human rights.
The people heard the president’s voice; I hope that the president heard their voices and during the next hundred days responds to those important issues they spoke to on that Saturday after the inauguration.
Change is difficult no matter when it occurs. We all become very comfortable and at times complacent. The landscape of our nation is riddled with conflict and division. The rhetoric is hateful and divisive. The leadership of our nation from both sides of the aisle must come together and lead by example. The tone and language of dialogue must change. We must embrace a language that speaks of respect and integrity for every American, no matter what their social, economic or political perspective might be.
The leaders of our faith community, both locally and nationally, must move out of their coma of silence and not become political or feed the rhetoric of hate and divisiveness; rather they must stand up and call us to civility and to a discourse that supports and respects the human dignity and integrity of every American citizen.
Trump is our president, whether we like it or not. He was fairly elected. We must support the unity and healing he spoke about at his inauguration. As citizens, we must hold him accountable for what he says and what he does. He is not above the law. We must urge him to engage in a civil discourse about our complicated social issues and the future of our nation.
As this new chapter of American history unfolds, we have a powerful opportunity to engage and/or reengage in our democratic process. If you are not happy with the way things are, get involved; make a contribution; run for public office. Recognize that your voice counts and that you can make a difference in our nation and in our world.
Remember hope does not abandon us! We abandon hope! I am hopeful that if we all take responsibility for the future of our country, this new chapter in our history can make our great nation even greater!
Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.
Nothing says “I love you” more than a home-cooked dinner on Valentine’s Day. Well, of course, there are certain tokens of love that come in tiny boxes, I suppose. Let’s not underestimate them! There are also dinners out in fancy restaurants with champagne, candlelight and bills the size of your mortgage payment, gargantuan heart-shaped boxes of chocolate that blow away your New Year’s diet resolutions, and sexy lingerie that may be anything but after you’ve eviscerated the box of chocolates.
Except for those tiny-boxed things, forget the other stuff. Get out the vacuum, throw all the usual clutter under the bed or in the hall closet, make yourself a shopping list, tie on an apron and whip up your own elegant candlelight dinner.
Chill the champagne and whip up an elegant and delicious dinner that won’t break the bank or your back. Leave time for a nice long bubble bath or shower and squeeze into that dress or suit you bought for that occasion last year and haven’t worn since.
Start with a dozen oysters (you know what they say about oysters!) and some champagne. Move on to citrus-flavored chicken with a nice dry white or red wine, and finish up with a chocolate-raspberry cake. And don’t forget to light the candles.
Oysters Rockefeller
They say these oysters are so named because they’re “as rich as Rockefeller.” Time to update the name maybe?
YIELD: Makes 2 servings
INGREDIENTS:
2 tablespoons butter
One garlic clove, minced
2 tablespoons bread crumbs
1 tablespoon extra virgin olive oil
2 rounded tablespoons grated Parmesan cheese
One shallot, peeled and minced
½ cup frozen chopped spinach, cooked
1 tablespoon anise liqueur
Salt and freshly ground white pepper, to taste
Dash hot pepper sauce
One dozen fresh oysters, opened on the half shell
2 cups kosher salt
DIRECTIONS: Preheat oven to 450 F. Melt one tablespoon butter in small skillet. Add garlic and cook for 30 seconds. Remove from heat and mix with bread crumbs, oil and Parmesan cheese. Melt remaining tablespoon butter in same skillet. Add shallot and spinach and cook, stirring frequently, until shallot becomes translucent, one to two minutes. Remove shallot and spinach.
Add liqueur to pan and stir to scrape up any browned bits. Stir in salt and pepper and hot pepper sauce, stirring constantly over low heat for 30 seconds. Add to bread crumb mixture. (There will probably be only a little bit); mix thoroughly.
Generously spread kosher salt around bottom of small shallow baking pan. Set oysters in salt and surround each one with enough salt to keep it from tilting. Distribute the spinach mixture evenly over oysters, then top with bread crumb mixture. Bake until tops are golden, about 10 minutes, but check often. Serve with lemon wedges and crusty bread.
Citrus Roasted Chicken
I wrote about this chicken almost two decades ago and when I run into people from way back then, they still mention how much they love this recipe. It’s also great re-heated the next day.
YIELD: Makes 4 servings
INGREDIENTS:
One 2-3 pound chicken, cut up
Salt and freshly ground black pepper, to taste
½ cup sugar 1½ tablespoons all-purpose flour
One egg, beaten
¾ cup orange juice
¾ cup grapefruit juice
¼ cup dry white wine
½ cup toasted sliced almonds
One orange, sliced
Fresh parsley
DIRECTIONS: Preheat oven to 350 F. Wash chicken and pat dry with paper towels. Sprinkle with salt and pepper. Place in a shallow baking pan.
In a small or medium saucepan mix sugar and flower. Add egg, orange juice, grapefruit juice and wine. Stir thoroughly. Cook over low heat, stirring constantly, until mixture is slightly thickened. Pour over chicken. Bake, uncovered for one hour or under tender and done.
Sprinkle with almonds. Garnish with fresh orange slices and parsley. Serve with rice, and a crisp green salad or cooked green vegetable such as broccoli or green beans.
Chocolate Fudge Cake with Strawberries
Chocolate and strawberries are so Valentine-y. If there are any leftovers, you can cut the cake into squares and pass it off to the kids as brownies.
YIELD: Makes 6 to 8 servings
INGREDIENTS:
3 squares unsweetened baking chocolate
One stick unsalted butter
2 eggs
¾ cup sugar
¾ cup flour
1 teaspoon vanilla extract
¾ cup chocolate chips
One pint fresh strawberries, washed, dried, hulled and halved top to bottom
¼ cup currant jelly, melted
DIRECTIONS: Preheat oven to 325 F. Grease an 8-inch springform pan. In a double boiler, melt the chocolate squares and butter over low heat. Cool. In mixer bowl, beat the eggs. Add the sugar, then the melted chocolate and butter; continue beating till blended. Stir in the flour and the vanilla extract. Pour the batter into the prepared pan. Smooth with spatula.
On outer rim of batter, sprinkle a one-inch-wide circle of the chocolate chips; then make a small circle of them in the middle. Bake 25 minutes. Cool 10 minutes, then remove from pan. Arrange halved strawberries, cut side down, around remaining surface of cake, overlapping if necessary. Brush tops of strawberries with melted currant jelly.
Serve with sweetened whipped cream or vanilla ice cream and a nice cup of espresso.
My great-grandfather Louis arrived at Ellis Island at the onset of the Great War. He grew up in the predominantly Jewish community of Sighet. This small region of Hungary (now Romania) had been occupied and reoccupied by many countries throughout the 20th century. Sighet, however, remained largely the same. Its tight Jewish community maintained its traditions, history and, most importantly, faith.
Louis’ family sent him away in fear he would be drafted into the brewing conflict. So with what money he had, he traveled 1,000 miles from Hungary to the bustling port of Hamburg in Germany. One can only imagine how dangerous that trip must have been — navigating Europe as it began to rip at the seams. He survived though and boarded a ship destined for the promised land of America.
Like so many before him he arrived in New York City. Even as I write this, I smile at the thought of his first gaze upon the Statue of Liberty. At the time, just another face among the huddled masses … to me, the very reason I exist.
Assimilation wasn’t easy. He ended up marrying a woman from the same village and they started a family together. Their child Sam was a tremendous source of brightness in an otherwise unforgiving city.
Above, back row, from left, Pauline, Irene, Louis; front row, from left, Melvin and Max, circa 1929. Photo courtesy of the Tessler family
Louis’ family kept him going. He worked long and painful hours for a fur company in Manhattan. Before unions, before labor laws and before regulations — he inhaled dangerous chemicals daily as he dyed the fur, leaving him with chronic health problems.
His American Dream devolved quickly though as his home was consumed by a fire and with it his wife and only child. One can only imagine his dread. Thousands upon thousands of miles away from his only remaining family, he committed himself to rebuilding his life, and by extension, creating mine.
Louis remarried and had two children with my great-grandmother — my grandpa, Melvin Tessler and his brother Max. They grew up on Riverside Drive, both lovers of the city’s growing jazz scene.
Through an unfortunate reality, my great-grandfather wasn’t wanted in this country. Many anti-Semites peddled Jewish conspiracies, believing them to be an enormous danger to American society. When my grandfather was a little boy, Louis took him to work at the fur factory so his son could see what he did. His boss, however, hated the Jews and made a point of humiliating my great-grandfather in front of his son. He never took him to the factory again.
Though Louis was sent to America to be saved from joining a global conflict, it was a painful irony that both his sons were drafted into the army and became American soldiers in World War II.
Mel Tessler while serving in the US Army during WWII. Photo courtesy of the Tessler family
My grandfather Mel served proudly in Europe, where he developed trench foot, almost losing his feet to rot. Around his neck he wore the Star of David, his dog tags and a pillbox containing cyanide tablets in the event he was captured by the Nazis, knowing full well he’d be tortured for information if they knew of his Jewish ancestry. His brother Max served in North Africa where he contracted a malaria type disease. These young boys, the sons of refugee immigrants, served a nation that just a generation prior had not welcomed their father.
My Grandpa Mel would go on to become the head of the English Department at Port Jefferson High School and married my Grandma Sally, a teacher at Scraggy Hill Elementary. No doubt some of my readers had them as teachers.
In his class, he’d have the students read the book “Night” by Elie Wiesel, a celebrated Holocaust survivor who dedicated his life to serving humanity. Several years ago I had the great fortune of being invited to the United Nations, where I heard Mr. Wiesel speak. In the halls of the General Assembly his voice echoed “never again.” It was more than just a phrase but a perpetual call to action, one that we are all responsible to heed. I’ve taken that to heart.
What I did not know at the time was that Elie Wiesel and I shared something in common. He too was from Sighet, my ancestral home. In 1944, the Third Reich occupied Hungary and decimated its Jewish population, first by forcing them into ghettos and then eventually to the concentration camp of Auschwitz. Whatever family remained perished there during the Final Solution.
Whether by gas chamber in Auschwitz or by sniper fire in Aleppo … murder is still murder and is equal in the eyes of God. No man is greater than the other just because of their faith or any more deserving of our compassion. No civilized society, especially one built on the principles of “life, liberty, and the pursuit of happiness” can remain ignorant of the world at large. To do so undermines not just our nation’s values but the essence of our humanity itself.
We cannot forget that our complacency, and more precisely, our fear, allowed countless innocents to die as waves of Jewish refugees were turned away from the United States. We must show bravery like those who risked their lives to hide Jewish families in their basements. If we are so scared that we are unable to help, then we have already lost, for without humanity we are nothing.
Had America not welcomed in my great-grandfather all those years ago, he too would be in the huddled masses lying dead outside Auschwitz. Do not forget, history has its eyes on you.
During the 2016 vice presidential debate, then Governor Mike Pence said “…the old Russian bear doesn’t die, he just hibernates.” This would-be proverb struck a chord with me and led me on a several month research expedition to further understand the collapse of the Soviet Union. How could a global superpower disappear from the Earth with just a few strokes of a pen?
Today, I’m reminded of another hibernating bear — California. Though sparsely mentioned in our textbooks, there were 25 days in 1846 when a sovereign Republic of California existed. Like-minded Californians rose up against Mexico in what is known as the Bear Flag Revolt. Their state flag to this day still proudly waves a grizzly bear above the words “California Republic.” Shortly thereafter they were annexed by the United States and became an integral part of our country.
How does this relate? Well, on Dec. 26, 1991, the Soviet Union dissolved. Its centralized government oversaw 15 Soviet republics that were partially self-governed, not so dissimilar from the function of our state governments. People thought it impossible, but the massive Soviet superpower was toppled (with relative ease) and was replaced with 15 sovereign nations. It raises the terrifying prospect: If it happened there, could it happen here? That brings us back to the other sleeping bear.
Hypothetically, if California were an independent republic, it would have the world’s sixth-largest economy. Its population is greater than that of neighboring Canada. Its agriculture industry surpasses that of any other American state. Its national guardsmen and women are composed of 18,000 soldiers and 4,900 air force personnel. In addition there are over 190,100 Californians enlisted in the United States military and reserves, which is roughly the size of the United Kingdom’s standing military.
There is a growing #CalExit movement that would grant California its autonomy following a voting referendum in 2018. Just three weeks into the Trump Administration, and one out of three Californians are in favor of secession according to a recent poll. This number is alarming, to say the least. In an age when populism rules, when the United Kingdom could exit the European Union and the United States could elect Donald Trump … the prospect is not just hypothetical but a reality we must address.
Californians, like many Americans, are feeling increasingly disenfranchised by the current administration and the congressional gerrymandering that has occurred nationwide. For the second time in 16 years, the winner of the popular vote, the winner in the State of California, was not selected president.
For years, California, unlike many states, has given more tax dollars to the federal government than it has received in return. Fundamentally bankrolling other states and paying for military campaigns are things Californians are staunchly against. Whether or not their grievances are justifiable is a determination for you, the reader. They should, however, be taken seriously, just as Brexit should have been and all populist movements of the past.
Without California, the United States as we know it would fall into disarray. Its electoral votes and ample congressional seats maintain the Democratic Party’s ability to remain competitive. To my Republican and/or conservative readers, I’m sure that sounds wonderful, but we must consider the larger picture. Without competition, our federal government becomes dangerously lopsided. No matter who the supermajority, accountability decreases and entire segments of our society would feel underrepresented. Political isolation has never ended well for any country, look no further than the Soviet Union for that lesson.
Just because we are the United States does not mean we are immune to collapse. Our nation’s bond was forged in the fires of wars. To each man his colony was his country. It took leadership, it took George Washington and Abraham Lincoln to unify us and maintain our nation. Today one can’t help but feel we’ve grown very far apart. How we can we pledge our lives and property to one another if we’re unwilling to show at minimum decency and respect?
Our federal government should strive to make separation an unjustifiable cause. To accomplish that requires patriotism over partisanship, rights over might, leadership not power plays and genuine liberty and justice for all. Disagreements are a natural and healthy part of democracy, but will get us nowhere if we treat compromise as a cuss word. No matter who maintains the majority, the views of the minority must be heard and represented.
President Trump is in a unique position to mend the wounds of a divided land. To cement a legacy far superior than that of any great wall or golden tower. He is the leader of a fractured state, one in which so easily the political majority could enforce its rule upon the minority. He must show himself to be humbled and practice civility and respect with his opposition. In return, they must learn to do the same. They must be brought to the table rather than fired for sharing opposing views.
That’s what separates an American president from a Soviet premier. His actions moving forward are paramount to ensuring the survival of the union as we know it.
No child should ever ask: “What was it like to grow up in the former United States?”
Attract chickadees to your yard in the winter by filling your feeder with a mix of sunflower seeds, peanuts and cracked corn. Stock photo
By Ellen Barcel
Before the holidays I wrote a column on the Christmas Bird Count, a citizen-scientist effort to preserve and count birds, rather than hunt them as had been done in the 1800s. Now it’s time for the Great Backyard Bird Count.
Let the count begin
The GBBC will be held on Friday, Feb. 17, through Monday, Feb. 20. Billed as a “real time snapshot of where birds are,” the count helps not only the Audubon Society but the Cornell Lab of Ornithology as well. The GBBC organizers note that bird populations are in constant flux. Having people count birds in their backyard (or any location they select) does something that scientists can’t do since they are simply not enough to do the job. Last year, over 160,000 people took part in the count.
Participants count the birds they see for at least 15 minutes, or any length of time they chose and report their findings online. This makes the count a “real time” picture of what’s happening. The website for the count notes that some of the questions being studied are:
• How will the weather and climate change influence bird populations?
• Some birds, such as winter finches, appear in large numbers during some years but not others. Where are these species from year to year, and what can we learn from these patterns?
• How will the timing of birds’ migrations compare with past years?
• How are bird diseases, such as West Nile virus, affecting birds in different regions?
• What kinds of differences in bird diversity are apparent in cities versus suburban, rural, and natural areas?
You may be wondering why the GBBC takes place in February, notoriously the coldest month in the United States. The answer is that when the count first started 20 years ago, the goal was to check out the bird populations just before their spring migrations began, usually in March.
Getting started is easy. Go to www.birdcount.org and register. The website is very useful. There’s even a way online to help identify birds and details on a related photo contest. EBird, another program, is a way for Cornell Lab to keep track of bird populations throughout the entire year.
Attracting birds to the garden
Attracting birds to your garden in winter is easy. Just put out one or more bird feeders and keep them filled with seed. A heated water supply is nice, if you can manage it.
Black-eyed Susans provide seed for birds as the growing season comes to a close. Photo by Ellen Barcel
Attracting birds to the garden in late summer and autumn is just a matter of growing plants with seeds that the birds enjoy. Consider, for example, growing sunflowers. They’re beautiful annuals, come in a variety of colors and sizes, and the birds love the seeds in late summer and fall (and sometimes even into winter). Birds also enjoy all sorts of seeds, including the seeds of the black-eyed Susan (Rudbeckia), purple coneflowers (Echinacea purpurea), Liatris, Coreopsis, zinnias, marigolds, poppies and cosmos.
Note that virtually all of these flowers prefers a sunny location to grow to their full potential. Birds are also attracted by plants that produce fruit in the fall, such as the dogwood, elderberry, beautyberry and grape.
Another way to attract birds to the garden is to provide one or more birdhouses and to make sure that some brush and twigs, etc. are available in your yard for birds to use for nesting material. Keep a birdbath or two in the yard as well. Remember to change the water frequently so as not to provide a breeding place for mosquitoes.
So, as you plan next year’s garden, consider adding one or more of these flowers, which add not only lovely color to your garden but lots of nice food for the local birds. Since many birds eat insects as well as seed, attracting birds to the garden is an easy way to help keep those harmful insects in check.
Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.
Jackie is a three-month-old female doxie mix rescued from Puerto Rico and currently residing at Kent Animal Shelter, located at 2259 River Road in Calverton. Jackie was abandoned and left on her own to survive. When a rescue group picked her up, along with 11 other young dogs, she was emaciated and infested with parasites. She is none the worse for wear though and is a happy-go-lucky pup waiting for a new home. Jackie will be spayed, microchipped and receive all her shots before being adopted. For more information on Jackie and other adoptable pets at Kent, please call 631-727-5731.
The big game on Feb. 5 is normally one of the most exciting events of the winter season. Bisecting the drab doldrums of January and February, it glues zealous sports fans to their TVs and ignites passionate tempers to not just a few expletives. In a feeding frenzy that alternately consoles and celebrates the vicissitudes of the afternoon’s plays, this annual game between the two best pro football teams evokes and stimulates the most American of appetites.
Although traditional fare is centered largely on some combo of spicy buffalo wings and blue cheese dips and spreads, many spinoffs of those flavors come to mind. There are Sloppy Joe’s, a goopy ground beef and barbecue sauce concoction served conventionally over open hamburger rolls, but just as good over toasted crusty bread.Then there are iceberg lettuce wedges with blue cheese dressing, bacon, cherry tomatoes and red onion. And because the day wouldn’t be complete without Buffalo something, here’s an easy recipe for wings.
Sloppy Joe’s
Sloppy Joes
YIELD: Serves 8
INGREDIENTS:
¼ cup oil
One large onion, chopped
One medium carrot, peeled and diced
One medium green bell pepper, washed, seeded and diced
2 pounds lean ground beef
Two garlic cloves, minced
¾ cup ketchup
One 28-ounce can diced tomatoes with their juice
2 tablespoons Worcestershire sauce
2 tablespoons A-1 sauce
1 tablespoon balsamic vinegar
2 tablespoons brown sugar
½ cup chopped fresh flat-leaf parsley
Salt and pepper to taste
8 hamburger buns or 16 slices lightly toasted crusty bread
DIRECTIONS: In a large skillet, heat the oil for 30 seconds. Add the onion, carrot, and green pepper and sauté, stirring frequently, until onions are opaque and pepper starts to turn color, about 5 minutes. Crumble the ground beef and spread around the skillet; cook, stirring frequently with vegetables, until meat is browned. Add garlic, ketchup, tomatoes, Worcestershire sauce, A-1 sauce, vinegar, and brown sugar.
Cook over low-medium heat until vegetables are tender and liquid is evaporated, about 15 to 20 minutes. Stir in parsley and seasoning. Serve hot over open buns or bread slices with cole slaw and french fries.
Iceberg Lettuce Wedges with Blue Cheese Dressing
Iceberg Lettuce Wedges with Blue Cheese Dressing
YIELD: Serves 8 to 12
INGREDIENTS:
One head iceberg lettuce, washed, drained and trimmed
1 cup mayonnaise
½ cup light cream or half-and-half
½ cup sour cream or plain yogurt
1 teaspoon Worcestershire sauce
¾ cup crumbled blue cheese
Salt and pepper, to taste
4 to 6 slices crispy cooked bacon, crumbled
Cherry tomatoes, quartered
Thin slices red onion, separated into rings
DIRECTIONS: Slice the lettuce into as many wedges as you desire. Combine the mayonnaise, cream, sour cream, Worcestershire sauce, blue cheese and seasoning. With a wire whisk, beat ingredients for 30 seconds. Arrange wedges on a platter. Pour dressing sparingly, and serve remaining dressing in a small bowl to be passed around. (It can also be used as a dipping sauce for buffalo wings in recipe below). Sprinkle bacon, tomato quarters and onion rings over wedges.
Easy Buffalo Wings
Easy Buffalo Wings
YIELD: Serves 6 to 8
INGREDIENTS:
12 to 16 chicken wings
4 ounces unsalted butter
One large garlic clove, minced
¼ cup Frank’s or Tabasco hot sauce
Salt, to taste
DIRECTIONS: Preheat oven to 425 F. Wash and dry wings. With a knife or poultry shears, separate the wings at the joint. Cut off wing tips and discard or save for another use (such as soup stock). Melt butter with garlic. In a large bowl, combine mixture with hot sauce and salt. Add wings and toss to coat. Place wings in shallow baking pan and drizzle with remaining sauce. Roast 10 minutes on each side, basting often, or until golden brown. Serve with celery sticks and blue cheese dressing.
Wills kept in a safe deposit box are not obtainable to an executor without a court order.
By Linda Toga, Esq.
Linda Toga, Esq.
THE FACTS: I am trying to help my elderly parents organize their affairs. They want things to be as simple as possible for me when it comes time to handle their estates. My parents have wills and other advanced directives in place.
THE QUESTIONS: Other than their wills, are there other documents or any types of information that they should collect and organize now to make the administration of their estates easier?
THE ANSWER: You are lucky to have parents who seem to appreciate the fact that administering an estate is not necessarily easy and who are anxious to have everything in place. Having wills will certainly help you with respect to distributing your parents’ assets after they pass. However, distributing assets is often one of the last things that an executor must do.
Long before distributions are made it will be necessary to make funeral arrangements, contact life insurance carriers and banking and investment institutions, gain access to your parents’ safe deposit box, cancel credit card accounts, as well as all online accounts that your parents may have and locate documents relating to any real estate they may own or lease, to name a few.
While many of these things can be done before your parents’ wills are admitted to probate, you will not be able to marshal assets, close bank accounts or sell property until you are issued letters testamentary by the Surrogate’s Court. If your parents keep their wills in a safe deposit box, you will not be able to even get the will without a court order.
Although not exhaustive, the following is a list of the types of documents and some of the information that your parents may want to put together to facilitate your handling of their estates:
1. Deeds to burial plots
2. Documents relating to any preplanned or prepaid funeral arrangements, including military discharge papers if either parent was in the armed forces and wishes to be buried in a military cemetery or have an honor guard
3. Wills and any codicils to the wills and a list of the addresses of all of the people named in the will and/or codicil.
4. Trust instruments that name your parents as grantors, trustees and/or beneficiaries
5. Life insurance policies, including the beneficiary designation forms
6. Annuities
7. Bank statements and pins for use in ATMs
8. A list of bills that are automatically paid from their bank accounts or charged to their credit card accounts
9. Brokerage statements
10. Statements relating to IRAs, 401(k)s or any similar plans, including the beneficiary designation forms
11. Documents relating to pensions and/or deferred compensation plans
12. Deeds, leases and documents relating to time share properties
13. Loan documents, including mortgages, reverse mortgages, home equity lines, lines of credit (whether your parents are the lenders or the borrowers)
14. Credit card statements
15. Keys to safe deposit boxes and the combination to any safe they may use
16. Pins, security codes and passwords for online accounts, social media accounts and email accounts
17. Account numbers and log-ins for frequent flyer and other rewards programs
18. The names and contact information for their financial advisor, brokerage account manager, insurance agent, accountant and attorney
If your parents are able to gather these documents and provide the information set forth above, handling their estates once they pass should not be overly burdensome. The burden can be further reduced by retaining an attorney with experience in the areas of probate and estate administration. Doing so will ensure that the process goes smoothly and will give you the opportunity to deal with your loss without having to think about what needs to be done.
Linda M. Toga, Esq. provides legal services in the areas of estate planning, probate and estate administration, real estate, small business service and litigation from her East Setauket office.
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