CARIE Connection – March, 2017

CARIE Connection

Quote of the Month

“History is merely a list of surprises. … It can only prepare us to be surprised yet again.” – Kurt Vonnegut

New Nursing Home Regulations
On October 4, 2016, the final regulations for nursing homes participating in the Medicare and/or Medicaid programs were published in the Federal Register. The National Consumer Voice for Quality Long-Term Care, along with Justice in Aging and the Center for Medicare Advocacy, created a brief overview of the regulations, including positive and negative effects for nursing home residents. The regulations are being phased in over four years – PHASE 1 – November 28, 2016; PHASE 2 – November 28, 2017 and PHASE 3 – November 28, 1019.

Some of the highlights include:

Improvements to eviction protections including effective in Phase 1, nursing homes must cc the ombudsman on all discharge letters.
Facilities cannot require or request a third-party financial guarantee.
More emphasis on person-centered planning and discharge planning; a baseline care plan is required within 48 hours of admission and a comprehensive plan within 7 days.
It is now easier to challenge arbitration agreements ad financial guarantees.*
Visitation rights are strengthened i.e. if a guardian wishes to limit visitation by family, they need to file for a court order.

*While the new regulations do not allow pre-dispute arbitration agreements, the American Health Care Association (AHCA) has filed a legal challenge and the court granted an injunction pending appeal.

Observation Status (MOON)
The Medicare Outpatient Observation Notice (MOON) informs all Medicare beneficiaries when they are an outpatient receiving observation services, and are not an inpatient of the hospital or critical access hospital (CAH). Effective 2-21-17, the MOON must be delivered to beneficiaries in Original Medicare (fee-for-service) and Medicare Advantage enrollees who receive observation services as outpatients for more than 24 hours. The hospital or CAH must provide the MOON no later than 36 hours after observation services begin. This includes beneficiaries who do not have Part B coverage (as noted on the MOON, observation stays are covered under Medicare Part B), beneficiaries who are subsequently admitted as an inpatient prior to the required delivery of the MOON, and beneficiaries for whom Medicare is either the primary or secondary payer. For more information visit the Center for Medicare Advocacy.

How will repealing the Affordable Care Act impact Medicare?
Bundled within the Affordable Care Act (ACA) of 2010 are provisions that both directly assist Medicare beneficiaries and strengthen the long-term solvency of the Medicare program. Indeed, Medicare beneficiaries saw substantial decreases in their payments for preventative measures such as wellness visits, and mammograms. In addition, the ACA significantly lowered the cost of prescription drugs, especially for low income beneficiaries, and those with high prescription drug burdens. The ACA also extends the solvency of the Medicare program. First, the ACA has provided for programs, and measures designed to cut waste, and fraud in the Medicare program. Secondly, by expanding the Medicaid program, an additional 12 million Americans now have access to quality health care, increasing the likelihood of positive long-term health outcomes. The Congressional Budget Office projects that the savings provided by these aspects of the ACA will allow Medicare to remain solvent 11 years longer than prior to the law’s enactment.

The passage of the Affordable Care Act of 2010 has been met with consistent Republican opposition. Emboldened by current majorities in both houses and a new Republican administration in the White House, Republicans have redoubled their efforts by passing legislation in January to begin dismantling parts of the ACA. Although there is currently no consensus on what would replace the law if repealed, a significant number of Americans, including Medicare beneficiaries, stand to be effected. Firstly, Medicare beneficiaries could lose many of the preventive and prescription drug benefits they have come to rely upon. Secondly, many of the measures designed to contain Medicare fraud and waste are threatened. Thirdly, repealing the ACA threatens the 12 million Americans who now receive health insurance through the law’s Medicaid expansion. Without, adequate healthcare, it is possible that these individuals will be considerably sicker by the time they reach Medicare age, which is likely to increase the burden on the Medicare program. This, along with the loss of programs designed to combat fraud and abuse, could have devastating consequences on the long term financial health of the program. A Special Report by the Center for Medicare Advocacy provides information about the need to renew rather than repeal the ACA.

Medicaid Block Grants: What does this mean and how will it impact Older Adults?
House Republican leaders have incorporated a revision to the federal funding support to states for Medicaid in their Affordable Care Act (ACA) repeal and replacement plan. Currently, Medicaid costs are shared between federal and state governments, with the federal government paying more than 54% of Pennsylvania Medicaid costs. The proposed reform would change federal Medicaid spending from percentages based on cost to either block grant or per capita cap models. Under the block grant model, the federal government would give states a yearly set lump sum of money, while the per capita cap would provide a set sum of money per person per year. Proponents of the revision see this change as an opportunity to curb federal spending and give more flexibility to the states to manage their own Medicaid programs.

The risks, however, far outweigh any benefits proposed. 6.9 percent of adults over 65 rely on Medicaid for long term care services including home and community based services, help in paying Medicare premiums and copays, and filling in coverage gaps from Medicare. The block grant model and per capita caps would greatly reduce funding for Medicaid, leaving states with few options other than to limit eligibility, reduce or eliminate services, or pay providers less. All such options would result in serious access problems, leaving older adults and people with disabilities the most vulnerable to not receiving the care they need.

In addition, with block grants and per capita caps, funding across states would vary, resulting in health disparities across the nation. Federal funding would be allocated to states based on historical spending not on current need, therefore locking states into possibly low allotments solely based on what they have spent in the past. This would eliminate the critical need for spending flexibility to accommodate contingencies such as recessions, natural disasters, and the changing healthcare needs of the growing aging population.

The majority of Medicaid spending is used for older adults and people with disabilities. These proposed reforms would shift costs to states, providers, and the beneficiaries themselves, leaving many people without the needed access to coverage and care they depend on every day. For more information on how Medicaid works for older adults and the proposed reforms please use these links:
Medicaid Financing: The Basics
Straight Talk for Seniors: Medicaid
Justice in Aging Policy Brief: Medicaid Funding Caps Would Harm Older Americans
Urban Institute: Block Grants and Per Capita Caps, the Problem of Funding Disparities among States.

Senate Special Committee on Aging
Pennsylvania’s Senator, Bob Casey is now the Ranking Member of the Senate Special Committee on Aging. He and Chair, Senator Susan Collins of Maine have made fighting Financial Exploitation, Fraud and Scams a priority establishing a Fraud Hotline – 1-800-855-9470. The Committee’s investigators have experience in fraud concerning retirement savings, identity theft, phone scams, Medicare, Social Security, and a variety of other consumer issues important to seniors and the elderly. Due to the nature of the fraud that has been committed or is suspected, individuals often do not know where to turn for assistance. The hotline is staffed by a team of committee investigators weekdays from 9 a.m. to 5 p.m. EST.
CARIE’s Executive Director, Diane Menio was invited to speak at the first hearing held since Senator Casey became Ranking Member. The hearing, “Stopping Senior Scams: Developments in Financial Fraud Affecting Seniors” was held on February 15, 2015 and also featured, Philip Hatch, an IRS Impersonation scam victim from Maine, Lois Greisman, Associate Director, Division of Marketing Practices, Bureau of Consumer Protection, Federal Trade Commission, and Tim Camus, Deputy Inspector General for Investigations, Treasury Inspector General for Tax Administration.

Pennsylvania Updates

Fiscal Year 2018 Budget
It’s budget season again and Pennsylvania is facing a $2.3 billion budget deficit. At his budget address on February 7^th, Governor Wolf outlined his budget for Fiscal Year 2018. As expected, the budget does not include new taxes but does cut expenses. Many of the cuts are realized through consolidation of agencies, the largest of which is the merger of four agencies into a single agency, the Department of Health and Human Services. The agencies included are: the Department of Aging, the Department of Drug and Alcohol Programs, the Department of Health, and the Department of Human Services. This new agency will account for nearly one-half of all spending in the Commonwealth. We shared our concerns in a letter to the Governor, the Secretaries and the chairs of the House Aging and Adult and the Senate Aging and Youth Committees.

Managed Long-Term Supports and Services – Community Health Choices Implementation
After issuing an RFP and reviewing proposals the Department of Human Services chose AmeriHealth Caritas, Pennsylvania Health and Wellness (Centene), and UPMC for You for negotiations to cover all regions in the state.
The timeline for the introduction of Community Health Choices, the name for Pennsylvania’s Managed Long Term Care Services and Supports program, has been pushed back. The new effective dates are as follows: Southwest PA: January 1, 2018; Southeast PA: July 1, 2018; and the remaining zones January 1, 2019.

The change in the timeline is the result of delays related to four bid protests by managed care organizations (MCOs) that were not chosen in the Commonwealth’s bidding process. This has prevented required steps in the implementation process, including the readiness reviews required of the MCOs. Three of the protesters filed appeals but the courts found that the process could move forward pending the resolution. So, it seems that readiness reviews can begin at any time – we have been told that this process takes at least six months. Information about Community Health Choices is archived and updated on the web.

Independent Enrollment Broker
The Office of Long Term Living (OLTL) is in the process of gathering detailed data related to the timing of processing applications for the Aging waiver and other home and community based waiver services. Specifically, OLTL is working to identify factors contributing to lags in time between participant application and eligibility determination and between eligibility determinations and service provision. There was a large increase in December, 2016. The department considers this an anomaly, attributed anecdotally to provider agencies heavily marketing in the Southeast. The RFP for a permanent enrollment broker was developed and sent for comment. OLTL last announced that they expected to provide an update in January. No word yet. On February 19, 2017, the Chairpersons of the House Older Adult Services and the Senate Aging and Youth Committees recently sent a letter to Secretaries Ted Dallas and Teresa Osborne CHC and the Independent Enrollment broker urging the department to make more information public on its website including public comment.

Impact on Pennsylvania if the Affordable Care Act is repealed
On February 22, 2017 Insurance Commissioner Teresa Miller, Secretary of Health Dr. Karen Murphy, and Secretary of Human Services Ted Dallas joined Pennsylvania consumers to discuss the implications of repealing the Affordable Care Act for consumers around the commonwealth. More than 1.1 million Pennsylvanians currently receive coverage through the Affordable Care Act’s health insurance exchange and Medicaid expansion.

If the ACA were to be repealed, Pennsylvania could lose 137,000 jobs in 2019, almost all in the private sector and would reduce gross state product by $76.5 billion and state and local tax revenue by $2.4 billion between 2019 and 2023. Over the next 10 years, ACA repeal is estimated to result in nearly $36 billion less federal funding for health care for Pennsylvanians and $7.8 billion more in state spending. A press release with information about how ACA repeal will impact Pennsylvania has been prepared by the Pennsylvania Health Funders Collaborative. A full report and data book with facts for the state, each Congressional district, and Philadelphia, Allegheny, Montgomery and Delaware counties is available on the Collaborative’s website.

Webinars and Conferences
New Rules for Medicare Appeals 2017, Webinar – Thursday, March 9, 2017, 3:00-4:00 PM EST
On March 20, 2017, new Medicare appeals regulations will take effect. This webinar will include a discussion of key changes made to the Medicare appeals regulations with a focus on how the changes will impact Medicare beneficiaries and those who represent Medicare beneficiaries and advocacy tips shared by attorneys who have collectively appealed thousands of Medicare denials.

PCA’s 6th annual Senior Education Day “Engage Your Body and Brain” will feature Dr. Dan Gottlieb, host of WHYY radio’s Voices in The Family. Enjoy 60-minute classes, free parking and a healthy snack! March 18, 2017 at PCA 642 N. Broad St. Philadelphia, PA. Tickets are $5. Register here to buy tickets online or call 215-765-9000, ext. 5055.

American Society on Aging, Aging in America Conference (AiA17) March 20-24, 2017 in Chicago, IL. More than 3,000 professionals attend AiA17 to learn, network and participate in the largest multidisciplinary conference covering issues of aging and quality of life for older adults.

The 2017 National Voices of Medicare and Senator Jay Rockefeller Lecture will be held in Washington, DC on March 30th. Senator Sherrod Brown will give the Senator Jay Rockefeller Lecture and Senator Rockefeller will be present to introduce him and join in a Q&A session after the Lecture. The Summit will also feature personal stories from beneficiaries and families interspersed throughout a day filled with valuable information, insights, and best practices from the following experts and national leaders.

Just the Links
Medicare: Time to Renew Not Retreat, an issue brief by the Center for Medicare Advocacy provides a compelling case for why we need to strengthen Medicare. As one Pennsylvania beneficiary noted, “Privatized Medicare to seniors that are already on a fixed income would be a disaster for senior citizens who are already having to choose between food and medical care and prescriptions.”

Families USA, in partnership with the DentaQuest Foundation, has launched an intensive, multi-faceted advocacy campaign, Oral Health for All, to expand access to oral health coverage to the more than 130 million Americans who currently lack coverage. They plan to achieve this ambitious goal through a series of strategic policy changes to be enacted on the federal and/or state level including adding an oral health benefit to Medicare and Medicaid, including oral health coverage in subsidized marketplace health insurance plans; and improving access to oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP).

There is a new and particularly disturbing form of elder abuse happening in nursing homes and other long-term care settings. ProPublica identified 47 instances since 2012 in which workers have shared inappropriate, dehumanizing, and unauthorized digital content of residents (Ornstein & Huseman, 2015). The National Center for Elder Abuse has released a fact sheet presenting the findings from this report as well as resources and ideas for action.

The National Council on Aging’s Elder Economic Security Standard™ Index (Elder Index) offers a tool to increase our understanding of the costs of growing older in the US. The Elder Index present local expenses, savings requirements, and what incomes are needed to achieve economic security by family type, and at the city, county, and state levels. Anyone can use the database to find out how much is needed to be economically secure, by location and family type, compare expenses across locations and family types, download national, state, county and city index data, and access additional information on elder economic security.

Carol Netzer, a psychologist, is a 90-year-old resident of an assisted living facility in New York City. Before she made the decision to leave her home, she and her daughter did a lot of research on what it would be like to live in such a facility from a resident’s perspective. They found nothing. Carol’s book, Assisted Living: An Insider’s View aims to fill that void. In addition, she maintains a blog where you can read excerpts from her book and Carol’s regular posts.

Kaiser Family Foundation recently talked to Trump voters covered by the Affordable Care Act about what they want in a health plan, Listening to Trump Voters with ACA Coverage: What They Want in a Health Care Plan.

February 22, 2017 – Governor Wolf visited Wilson Park Senior Center in Philadelphia to announce $2m in grants to Pennsylvania’s Senior Centers for Fiscal Year 2016-2017.

An op-ed was published February 8, 2017 in Newsworks by Philadelphians Against Bed Bugs (PHABB). PHABB is a collective of advocacy and legal organizations, including CARIE, asking the City of Philadelphia to adopt a comprehensive policy to address the rising rate of bed bug infestations. CARIE understands not just the physical and psychological toll a bed bug infestation can have on older consumers, but the barriers in place in exterminating the problem. PHABB is calling for the adoption of policy recommendations from the Philadelphia Bed Bug Task Force which convened in 2015. It includes implementing code enforcement for property owners who neglect serious bed bug infestations, educating the city about best practices to combat infestations, and implementing policies to keep homes, places of work, social gathering, and schools safe from potential bed bug problems. The policy recommendations can be found on PHABB’s website.

Services & Advocacy for GLBT Elders (SAGE) https://www.sageusa.org/ is the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults.

Just for Fun

Flo Meiler, of Shelburne, Vermont is a pole-vaulting, hurdle-jumping track and field star. At 82, she’s also a grandmother to five and a great-grandmother to two. Meiler has set 25 world records, 19 American records and has won more than 750 medals since she began her track and field career at age 60.

CARIE News
While CARIE is, and always will be non-partisan, we believe it is our responsibility to acknowledge that some of the changes happening at the federal level have the potential to dramatically impact the quality of life of the consumers that we serve. CARIE’s work will always be guided by the best interests of the people we serve, and we will continue to have a seat at the table as a voice for consumers.

SHARE IN THE CELEBRATION OF CARIE’S 40 YEARS OF ELDER ADVOCACY! Please join us on the evening of April 20, 2017 for a wonderful reception and auction supporting CARIE and celebrating CARIE’s 40 years of advocacy on behalf of elders throughout our communities! The event will be held at WHYY studios, 150 N. 6^th Street, Philadelphia, PA 19106 from 5:30 – 8:30 PM on April 20^th. In addition to great food, drink and company, the evening will include both silent and live auctions offering exceptional (and much sought after!) silent and live auction items, including fantastic vacation destinations, evenings on the town, art, jewelry, home entertainment, sporting and cultural events and many other items. We are honored also to be recognizing at the event two outstanding advocates and long-time friends of CARIE with the Spirit of CARIE award: Ray Landis, AARP Pennsylvania’s Advocacy Manager and Bill Benson, Principal, Health Benefits ABCs, LLC. You can purchase tickets to join CARIE’s 40^th anniversary celebration and bid on your favorite auction items at our dedicated event website. And – coming soon! -even if you are not able to join us on April 20th, you can participate in the fun of the auction online. Please check our event website in the coming days as wonderful auction items will be added. Thank you so much for supporting CARIE and helping to ensure our next 40 years! For more information contact Michele Mathes at (267) 546-3436 or [email protected].

CARIE establishes a new project, Providing Advocacy for Victimized Elders in Long Term Care

CARIE’s is expanding its victim advocacy program to long term care consumers including those living in nursing homes and personal care homes who have fallen victim to a crime. Physical disabilities, language barriers and mental health issues already contribute to a vulnerability to crime and can make the criminal justice process overwhelming. If an older adult experiences physical violence or sexual assault, they face an uphill battle of ensuring the crime is properly reported and often are unaware of available services.

The Long-Term Care Advocate will ensure that residents are educated about their rights to report a crime to law enforcement, ensure that victims receive assistance navigating the process, offer to accompany them to court, assist them in filing for Crime Victim Compensation and help to develop a victim impact statement. The advocate will also ensure that there is a stay away order in place against perpetrators who threaten a resident’s safety if needed. With assistance from project partner, Community Legal Services, the PAVE Advocate will address additional legal issues a victim may encounter related to receiving long term care. This project is funded by the Pennsylvania Commission on Crime and Delinquency. To learn more, please contact Juliane Holz at 267-546-3061 or [email protected].

CARIE is hiring
Long Term Care Ombudsman. The Ombudsman serves as an advocate for long term care consumers by handling complaints and educating residents and families about their rights. Responsibilities of position include investigating complaints made by and on behalf of residents, responding to calls providing information and advocacy about issues related to long term care, making regular visits to long term care facilities to observe safety, cleanliness, staff/consumer interaction etc., outreach, and public policy analysis. For a full job description please visit: https://www.carie.org/contact/careers/. Send resume with cover letter and salary requirements to Lori Walsh, Program Manager at [email protected]. No phone calls please. CARIE is an Equal Opportunity Employer.

CARIE Connection Archives
Are you looking for a past issue of CARIE Connection? Click here to access past newsletters.

Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, March 2, 2017 at CARIE’s office at Two Penn Center – Suite 1500. Please click here for March’s agenda. All are welcome. Hope you can join us.

As always, please contact us if you have any questions.
Diane Menio for Kathy Cubit
[email protected]
267-546-3438 or 1-800-356-3606, ext. 3438
[email protected] 267-546-3434

CARIE Connection – February 2016

CARIE Connection

Quote of the Month
“Advocacy can be – and often is – a messy business. It is not for the faint of heart and it can’t be half-hearted.” – Bill Benson. (FromAging Advocacy and the Older Americans Act in the January/February 2016 issue of Aging Today)

New CMS Prior Authorization Rule for DMEPOS
The Centers for Medicare & Medicaid Services (CMS) released a new rulerequiring prior authorization for some durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) for Medicare beneficiaries to help prevent fraud while ensuring access to medically necessary equipment and supplies. These regulations are effective February 29, 2016. There is a list of 135 items (see Table 5) that are specifically identified in the final rule. CMS plans to “issue specific prior authorization guidance in subregulatory communications” and will update the list each year. Items on the DMEPOS prior authorization list will have an average purchase cost of $1,000 or more, or an average rental fee of $100 or more, and be the subject of an OIG or GAO report of a national scope or a future “CERT DME Service Specific Report.” Items requiring prior authorization will be published in the Federal Register with 60 days’ notice before prior authorization begins for those items.

The new rule is another example of CMS moving away from the “pay and chase” model of reimbursement in its effort to prevent fraud. Physician documentation to meet authorization requirements for DMEPOS will not change but will be needed earlier in the process to get needed items, such as motorized wheelchairs and certain prostheses.

According to the CMS fact sheet, “Medicare or its review contractor will make a reasonable effort to render an initial prior authorization determination within 10 business days and will make a reasonable effort to render a resubmission prior authorization determination within 20 business days. These are maximum timeframes and will be adjusted downward for items that require less time for making a determination. An expedited review process will be available to address circumstances where applying the standard timeframe for making a prior authorization decision could seriously jeopardize the life or health of the beneficiary. The request for an expedited review must provide rationale supporting the request.”

Advocates have expressed concern that the final rule may delay access for needed DMEPOS items compromising consumers’ health or well-being, and it doesn’t provide beneficiaries a way to access a high appeal level if an item is denied. It is critical that the initial documentation be complete and accurate to avoid any denials. For more information see the Center for Medicare Advocacy’s alert, CMS Final Rule for Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).

Medicare Quality Measures
CMS released additional physician and hospital quality measures to help consumers make informed choices. Physician Compare’s new measures focus on the quality of care provided by Medicare physicians and other health care professionals. Hospital Compare now includes information on more than 100 quality measures and over 4,000 hospitals.

CMS’ Home Health Compare now posts star ratings, ranging from one to five stars, based on patients’ surveys. The information is in addition to the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey measures.

The National Quality Forum (NQF) Measure Applications Partnership (MAP) released its final recommendations to the Department of Health and Human Services (HHS) on measures under consideration for the 2015-2016 pre-rulemaking cycle. The recommendations include into two components, a report that describes the approach to recommending measures as well as a sortable, searchable spreadsheet (XLSX) of all recommendations, and public comments provided throughout this process.

Fiscal Year 2016 Budget Update
Congress passed a final fiscal year (FY) 2016 omnibus budget bill (H.R. 2029, the Consolidated Appropriations Act), a $1.149 trillion package of all 12 annual appropriations bills, to provide funding for federal government operations through September 2016. In short, there were proposed major cuts to services for older adults but the final bill averted those cuts and even provided some much needed increases.

Here is a summary of items of interest to older Americans in the final agreement.

The legislation increases funding from FY 2015 levels by $2 billion for the National Institutes of Health. Alzheimer’s disease research is increased by $350 million. This is the largest increase ever for federal Alzheimer’s research funding. It also includes specific increases for the BRAIN Initiative research to map the human brain by $85 million, antibiotic research, and the Precision Medicine Initiative.
Alzheimer’s Disease Demonstration and Initiative has an increase of $1 million above FY 2015. This funding supports competitive grants to expand the availability of evidence-based interventions and long-term care services for individuals with Alzheimer’s disease. The funds also support an Alzheimer’s disease outreach campaign to educate caregivers about community resources.
The Elder Justice Initiative doubled its first time appropriation from last FY and will receive $8 million in funding. In addition, funding for the Victims of Crime Act (VOCA) Crime Victims Fund will see an almost $700 million increase in the cap for FY 2016 to $3 billion, and after allowing for a transfer of some of these funds, it will leave funding of $2.65 billion for VOCA, which is an increase of $302 million for state VOCA assistance programs over FY 2015.
The Office of Medicare Hearings and Appeals (OMHA) received an increase of $20 million above FY 2015 for the Medicare appeals process to add more Administrative Law Judge (ALJ) teams to combat the considerable backlog of Medicare appeals currently pending at OMHA.
Older Americans Act Caregivers Support Formula Grants are funded at $6.5 million more than FY 2015.
Older Americans Act Senior Nutrition Program is funded at $20.1 million above FY 2015.

Funding for these programs was held level at FY 2015 levels:

Long Term Care Ombudsman Program at $20.6 million
OAA Title VII Elder Rights Support Activities at $3.8 million
Social Services Block Grant at $1.7 billion

PA Updates
Pennsylvania continues to move forward with its Managed Long Term Services and Supports (MLTSS) proposal, now called Community HealthChoices (CHC). (Please see CARIE Connection archives for more background information.) The Department of Human Services (DHS) released the draft CHC Request for Proposal (RFP) and draft program requirements for public comment on November 16, 2015 that were due on December 11. Additional draft agreement sections were released for comment in December that were due on January 8, 2016. All CHC related drafts and other information may be found on DHS’ CHC webpage. CARIE submitted comments for both the (CHC) Draft Agreement Sections and theCHC program draft Request for Proposal (RFP) and program requirements. CARIE was successful in its “Freedom of Information Act” request to obtain the University of Pittsburgh Medical Research Center’s MLTSS concept paper commissioned by DHS. If you would like a copy of this research analysis, please contact Kathy at [email protected].

DHS plans to release the official RFP sometime during the week of February 22 and also plans to release another draft agreement at the same time. While the RFP will be final, DHS is planning to accept comments on the new draft agreement to obtain additional feedback. The implementation in Southwestern Pennsylvania is still on target to begin in January 2017.

DHS is accepting comments on Pennsylvania’s revised proposed statewide transition plan for Home and Community-Based Settings. On September 16, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a letter regarding the statewide transition plan submitted by the Department on April 1, 2015. The Department revised the statewide transition plan to address CMS’ recommendations and provide updated information on the progress made in implementing the plan. Comments must be submitted by February 16, 2016. Recently, a coalition of national aging and disability advocacy organizations posted a toolkitto help advocates push for the strongest implementation of CMS’s home and community-based setting regulations.

DHS is delaying its RFP for the Independent Enrollment Broker (IEB) for its Home and Community-Based waiver (HCBS) programs. The current contract with Maximus will continue until November 2016 with additional requirements, including a 60-day enrollment process to mirror the goals of the RFP and mandatory performance measures. Starting April 1, Maximus will expand its IEB role to include the Aging Waiver shifting this responsibility from the Area Agencies on Aging (AAA).

Webinars and Videos
On February 16, from 2:00 to 3:30 PM, Justice in Aging is conducting a free webinar, Elder Financial Abuse in Medicaid Denials.

On February 29 from 12:00 to 1:30 PM, The PA Behavioral Health and Aging Coalition will present a free webinar, LGBT Older Adults: Unique Issues and Healthcare Needs.

The University of Maine Center on Aging is offering a new online certificate Grandfamilies Leadership program for those who work with grandfamily caregivers. The first online series will be free and will accept registrations on a first come first served basis. The course begins February 29 and includes 9 modules over a 12-week period. (Course ends on May 23.)

A new MLN Connects video (23 minutes) provides an overview of theImproving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014that requires patient assessment data used in post-acute care settings be standardized to improve quality of care. Visit the IMPACT Act website for more information.

The National Quality Forum posted a video, Quality Measures at Work. (3 minutes)

The Training Resources on Elder Abuse (TREA) site is a collaboration between the Keck School of Medicine of USC and the NCEA. The site provides a wide range of training materials for a variety of audiences.

Just the Links
“MedNexus is a medical search engine for patients – think “Google for Medicine”. Through our search engine, you can find the most relevant content from a variety of sources: medical journals, patient forums, government health sites, etc. We want to empower patients to educate themselves and cut through the noise and pseudo-science of typical online health information. No more WebMD scares, no more endless Googling. Whether you are looking for the latest evidence, or to learn from fellow patients, you can find actionable and reliable answers atMedNexus.”

The National Academy of Social Insurance posted a white paper, The Aging Network in Transition: Hanging in the Balance.

The Bipartisan Policy Center posted its Initial Recommendations to Improve the Financing of Long-Term Care.

The U.S. Senate Committee on Finance released its Bipartisan Chronic Care Working Group Policy Options Document.

The White House has released the final report for the 2015 White House Conference on Aging.

Easter Seals and the National Association of Area Agencies on Aging launched the National Aging and Disability Transportation Center.

2014-2015 Alzheimer’s Disease Progress Report: Advancing Research Toward a Cure is now available online.

The Kaiser Family Foundation posted Medicaid and Long-Term Services and Supports: A Primer.

The Congressional Research Service completed an analysis, Medicaid Financing and Expenditures.

ASA’s recent edition of Generations includes an article,Family Caregiving: Looking to the Future, that describes key principles for caregiver assessment among other needs.

The Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission released updated data, Beneficiaries Dually Eligible For Medicare And Medicaid: Data Book.

Medicare updated its publication, Medicare Limits on Therapy Services, for 2016.

Medicare Learning Network revised its publication, Prohibition on Balance Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program.

An article in Forbes, How Aging Affects Financial Decision-Making, describes research about the impact that the aging process has on people’s cognitive ability to make financial decisions. Here is a link to related research, Sources of Lower Financial Decision-making Ability at Older Ages.

“Identity theft victims can now go online and get a free, personalized identity theft recovery plan as a result of significant enhancements to the Federal Trade Commission’s IdentityTheft.gov website. The new one-stop website is integrated with the FTC’s consumer complaint system, allowing consumers who are victims of identity theft to rapidly file a complaint with the FTC and then get a personalized guide to recovery that helps streamline many of the steps involved.”

EDDIE is a new online self-service tool to be utilized by data users for accessing and analyzing Pennsylvania health statistics.

Philadelphia’s Senior Hunger Task Force released a Senior Hunger Relief Toolkit. (It has useful information for those beyond Philadelphia.)

Just for Fun
Pete Souza, Chief Official White House Photographer, released the most memorable photographs from the White House for 2015.

CARIE News
Save the date! CARIE’s annual auction and benefit reception will be held at WHYY studios on April 20, 2016. Come and have a wonderful evening while supporting CARIE’s vital elder advocacy. This year’s theme, From Generation to Generation, celebrates favorite family traditions. The evening will honor two outstanding advocates as recipients of this year’s Spirit of CARIE Award, Philip Marshall and Beryl Goldman. Purchase tickets, become a sponsor and get lots more information at www.501auctions.com/carie. Hope to see you there! For more information contact Michele Mathes at (267) 546-3436 or[email protected].

CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.

Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, February 4, 2016 at CARIE’s office at Two Penn Center – Suite 1500. Please click here for February’s agenda. All are welcome. Hope you can join us.

As always, please contact me if you have any questions.

Thanks,
Kathy
[email protected]
267-546-3438 or 1-800-356-3606, ext. 3438

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CARIE Connection – December 2015

CARIE Connection

Quote of the Month
“Aging is not lost youth but a new stage of opportunity and strength.” – Betty Friedan

Medicare Coverage of Advance Care Planning
Beginning in 2016, the Centers for Medicare & Medicaid Services (CMS) will pay for advance care planning (ACP) services provided to Medicare beneficiaries by physicians or other health care professionals. The services can also be provided through a team approach by both physicians and other staff. ACP is a voluntary option for Medicare beneficiaries that includes conversations between patients and their practitioners, “both before an illness progresses and during the course of treatment.” These discussions may include a review of options for end-of-life care, under what circumstances, if any, the individual may want to be kept alive if unable to express their wishes, and education about tools such as advance directives. The Medicare statute currently provides coverage for ACP under the “Welcome to Medicare” visit but this may not be at a time the consumer wants or has a need to talk about these issues so CMS is creating separate payment codes for ACP to allow practitioners to have these conversations with beneficiaries at the most appropriate time based on patient need. It is important to note that when a beneficiary chooses to receive ACP services, Part B cost sharing will apply as it does for other physicians’ services unless ACP is provided as part of Medicare’s Annual Wellness Visit.

NCOA has a fact sheet that describes what advance care planning is, and how it differs from advance directives and hospice care. The American Bar Association’s Bifocal has an article summarizing CMS’ ACP rule.

RAISE Family Caregivers Act
Yesterday, the U.S. Senate unanimously passed the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1719)introduced by Senator Collins. “This bill directs the Department of Health and Human Services (HHS) to develop, maintain, and periodically update a National Family Caregiving Strategy. HHS shall convene a Family Caregiving Advisory Council to advise it on recognizing and supporting family caregivers.” The bill was amended to remove a section related to the sharing of data among federal agencies and shorten the sunset date of the Act from December 31, 2030 to December 31, 2025. The bill was sent to the House today for “floor consideration.”

Committee on Health, Education, Labor and Pensions (HELP) Ranking Member Patty Murray said, “By launching a National Family Caregiving strategy and advisory council, the RAISE Family Caregivers Act would help us better understand and meet the needs of numerous people across the country who are making an enormous contribution to their families and to our health care system – and who, too often, are overlooked.”

According to AARP’s Public Policy Institute, about 40 million family caregivers in the United States provided approximately 37 billion hours of care to adults in 2013, with an estimated economic value of about $470 billion in 2013, up from approximately $450 billion in 2009.

Thank your U.S. Senators for their vote and contact your member in the House to ask for support in passing the RAISE Act!

PA Community HealthChoices Update
Pennsylvania continues to move forward with its Managed Long Term Services and Supports (MLTSS) proposal, now called Community HealthChoices (CHC). (Please see CARIE Connection archives for more background information.) DHS released the draft CHC RFP and draft program requirements for public comment on November 16, 2015. Comments are due on December 11. All CHC related drafts and other information may be found on the CHC webpage. At a joint PA House Health and Aging & Adult Services Committee meeting on November 23, OLTL Deputy Secretary Burnett stated that DHS plans to release additional information and draft materials for public comment on December 14 related to the enrollment/eligibility process, quality, and protection & rights. These comments will be due January 8. Once DHS has reviewed the comments, it plans to officially release the RFP giving Managed Care Organizations (MCOs) 60 days to respond.

DHS announced that it decided to pursue concurrent 1915(b) and 1915(c) waivers to implement CHC. A 1915(b) waiver allows DHS to implement mandatory managed care, while a 1915(c) waiver addresses eligibility and providing LTSS in home and community-based settings. There are five 1915(c) waivers, including the Aging Waiver, that Pennsylvania plans to combine into one 1915(c) waiver for CHC and DHS will also develop a 1915(b) waiver.

CARIE is working with other advocates throughout the state to raise concerns about Pennsylvania’s aggressive plan to implement CHC. PENNLIVE posted an op-ed submitted by Community Legal Services of Philadelphia, PA Health Law Project, Disability Rights Network of PA, PA Health Access Network, and CARIE.

CARIE also updated its CHC consumer flyer to reflect information released by DHS. The changes include adding the new name Community HealthChoices, identifying the exclusion of LIFE participants from the plan, and updating DHS’ new website address. Please continue to help us educate consumers and their caregivers throughout Pennsylvania by distributing this flyer.

Webinars and Videos
Justice in Aging is conducting a webinar, Assisted Living: State Strategies for Meeting
Residents’ Health Care Needs, on Thursday, December 17 at 11:00 a.m. PT/2:00 p.m. ET. Click here to register.

Here is a two minute animated video, Falls in Older Adults.

Just the Links
NCOA has posted a chart that shows the Medicare premiums and cost-sharing amounts for 2016.

The Kaiser Family Foundation released an issue brief, What’s in Store for Medicare’s Part B Premiums and Deductible in 2016, and Why? that explains the premium increase, the hold harmless provision, and a $3 repayment surcharge to cover the cost of the reduced premium rate in 2016.

U.S. News and World Reports posted an article, How Retirement Benefits Will Change in 2016.

The Consumer Financial Protection Bureau has a new Planning for Retirement tool to help decide when to claim your Social Security benefits. For more retirement and pension benefits questions, visitUSA.gov.

The 2016 SSI and spousal impoverishment standards have been released.

The CMS Program Statistics website replaces the former Medicare and Medicaid Statistical Supplement. “The website will include over 100 detailed, easy-to-access data tables on national health care, Medicare populations, utilization, and expenditures, as well as counts for Medicare-certified institutional and non-institutional providers.” Users can search for Medicare data through a new interactive Medicare Enrollment Dashboard and can narrow the search by geographical areas, including national, state/territory, and county.

Due to the Supreme Court’s Obergefell decision, CMS issued guidance to state Medicaid Directors in this letter requiring states to apply Medicaid law and regulations, such as spousal impoverishment rules, for spouses in same-sex marriages in the same way as applied to opposite-sex marriages.

The Kaiser Family Foundation posted Medicaid Home and Community-Based Services Programs: 2012 Data Update.

The SCAN Foundation, in collaboration with AARP and LeadingAge, funded economic and actuarial long-term services and supports (LTSS) policy modeling. Several reports were written by different financing organizations as a result. Various resources are available including a video about the impact of high costs for consumers and caregivers. “The potentially catastrophic consequences of becoming disabled and needing long-term care is arguably the gravest financial risk that older adults face,” said the authors of the Urban Institute’s research report, Microsimulation Analysis of Financing Options for Long-Term Services and Supports.

Money Magazine posted a series of articles about the costs of dementia throughout three stages – early, middle, and late.

Dr. Mark Lachs, and Dr. Karl Pillemer published an article in The New England Journal of Medicine summarizing recent research and issues related to elder abuse.

The Bipartisan Policy Center’s Health and Housing Expert Forum posted a series of articles on falls prevention.

Four articles about person-centered care were published in the recent edition of the Journal of the American Geriatrics Society.

The Institute for Research on Poverty released four policy briefs about current research on the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, including: The Basics of SNAP Food Assistance, SNAP Trends and Antipoverty Impacts, SNAP, Food Security, and Health, and SNAP and the Low-Income Safety Net.

Needhelppayingbills has information on thousands of non-profit agencies, government and public assistance programs. (Just be cautious of the ads.)

The Congressional Research Service released report, Researching Current Federal Legislation and Regulations: A Guide to Resources for Congressional Staff.

Just for Fun
Tour the world with Google’s Cultural Institute and Food52’s “Cookies of the World.” According to Google’s blog, you can now virtually “step on stage” with the Google Cultural Institute. The website now features world’s leading performing arts venues such as Carnegie Hall and the Bolshoi Theatre. “In a new virtual exhibition from the Google Cultural Institute and more than 60 performing arts organizations, you can experience dance, drama, music and opera alongside some of the world’s leading performers – onstage, backstage and with a 360 degree-view of the action.”

Food52’s cookie map features 46 cookie recipes and related stories from throughout the globe. Find an old family favorite or try something new this holiday season.

CARIE News
CARIE wants to extend our heartfelt thanks to all of our volunteers and supporters in helping us have another productive year serving older adults. With the state at a stalemate in passing a budget and hurting our bottom line, we appreciate your end-of-year donations more than ever. Best wishes to all for a happy, joyful, and peaceful holiday season!

On November 9, CARIE submitted comments on proposed nondiscrimination in health programs and activities regulations to the Department of Health and Human Services, Office for Civil Rights.

WWDB featured CARIE’s SMP program on its Boomer Radio show yesterday. The first thirty minutes features a discussion about SMP and fraud. Diane Moskal, a SMP volunteer, and Hal Brody and Rebecca Nurick from CARIE’s staff were guests on the show.

CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.

As always, please contact me if you have any questions.

Thanks,
Kathy
[email protected]
267-546-3438 or 1-800-356-3606, ext. 3438

Click here to view the original newsletter

CARIE Connection – November 2015

CARIE Connection

Quote of the Month
How beautifully leaves grow old. How full of light and color are their last days. – John Burroughs

Advocacy Alert – Funding for Crime Victims Threatened
Advocates for victims of all ages are being asked to contact members of Congress to prevent potential funding cuts as a result of the passage of the Bipartisan Budget Act of 2015. While some parts of the bill, signed by President Obama this week, are good for vulnerable people, steady funding for the Victims of Crime Act (VOCA) is at risk. VOCA spending may be cut from last year’s $2.36 billion to $1.2 billion for FY 2016 to help pay for the overall increase in funding for the bill. VOCA funds are based on fines and penalties collected from offenders and not on taxpayer funds. These funds are dedicated for victim services. If this deal is sustained, the amount of VOCA funds allocated each year could be much lower than last year’s appropriations. For more information about national organizations working together to stop this cut, read these letters to House and Senate Appropriators.

Please call your members of Congress now with this message:
“Please do not reduce the funds allocated for VOCA. We count on VOCA to fund direct services such as legal services and victim services for older adults. This money comes from criminal fines, not taxpayer money and barely meets the needs of programs and services to victims. In 2015, VOCA was increased to help the many victims who have been going without critical support services. There is at least a $12 billion balance in this fund and VOCA dedicated funding is a small part of that. If VOCA is cut from the 2015 level, it will be devastating. It will harm programs by reducing the numbers of victims who can get help. In this year’s Appropriations process and beyond, Congress must maintain its commitment to helping the victims of crime and abuse rebuild their lives.” Find your Senators and Representative here and enter your full nine-digit zip code for the best results. You will be taken to their contact info, including phone number. Be sure to say you are a constituent! You can also call the Capitol switchboard: (202) 224-3121. Choose Representative and then enter your zip code to be transferred. When you are done leaving a message for your Representative, call back and follow the same process to leave messages for your Senators. Special attention should be given to the Senate and House Appropriations committee members. Thank you for your help with this advocacy effort.

PACE Bill Passes Congress
Congress recently passed the Providing Programs of All Inclusive Care for the Elderly Act (PACE) Innovation Act, S. 1362. Here is a fact sheet and a summary of the bill. The Senate passed the bill by unanimous consent on August 5.) The bill is awaiting President Obama’s signature to become law. The PACE Innovation Act will allow CMS to include PACE, known as the LIFE program in Pennsylvania, to conduct demonstration projects through the Center for Medicare and Medicaid Innovations (CMMI). It prohibits HHS from waiving: (1) the requirement to offer items and services under Medicare and Medicaid without limitation to PACE program enrollees, and (2) certain requirements regarding enrollment in and disenrollment from PACE programs. PACE is an alternative to nursing home care providing coordinated care to dually eligible beneficiaries who are 55 or older with the health and long term services and supports they need. The program is built around an adult day model, covering all aspects of care to help the beneficiary live at home. There are 116 PACE programs in 32 states. Click here to locate a PACE program in your state. The PACE Innovation Act will help increase enrollment and give states the ability to create PACE demonstration projects for other groups who could benefit from the program, such as people under 55 years of age with disabilities.

PA Community HealthChoices
Pennsylvania continues to move forward with its MLTSS proposal, now called Community HealthChoices (CHC). (Please see CARIE Connection archives, the June, August, September, and October editions for more background information.) DHS plans to release the draft CHC RFP and draft program requirements for public comment on November 16, 2015. Comments will be due on December 11. DHS also plans to release additional draft materials and information relative to the enrollment/eligibility process for public comment on December 14. These comments will be due January 8. Once DHS has reviewed the comments, it plans to officially release the RFP giving MCOs 60 days to respond.

On October 7, CARIE sponsored a follow-up webinar, PA’s Community HealthChoices Proposal: What Advocates Need to Know, with Eric Carlson, Directing Attorney for Justice in Aging, who reviewed the Community HealthChoices Program Concept Paper that briefly describes Governor Wolf’s proposed design for PA’s new Managed Long Term Services and Supports (MLTSS) system. Here is a copy of the presentation slides. The last two slides were added after the webinar to share additional information Eric provided in response to questions asked during the webinar. CARIE submitted comments on Community HealthChoices on October 16 and continues to work with other consumer advocates on this issue.

Webinars and Videos
“If Alzheimer’s cannot be prevented, cured, or even slowed, why promote early detection and diagnosis?” This common question will be answered from a public health perspective during a webinar on November 12 from 2:00-3:00 pm EST. Learn why public health needs to take action on this issue and what can be done. Registration is open.

Here is a CBS News video about plans for Medicare to pay for end of life care.

Just the Links
November is Alzheimer’s Awareness Month and Government Book Talk is highlighting two new eBooks discussing Alzheimer’s disease and memory loss. Click here to download Understanding Alzheimer’s Disease (ePub)and Click here to download Understanding Memory Loss (ePub).

The Kaiser Family Foundation has issued a new brief on Medicaid’s Role for People with Dementia. The report features caregiver perspectives, identifies how beneficiaries with dementia are using Medicaid to gain access to LTSS, and provides information on costs and spending related to this population.

London’s publication Guardian posted a compelling article, The deviousness of dementia.

Ageism in America, read the entire Fall 2015 Issue of Generations online.

Justice in Aging posted, Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process.

The Wall Street Journal posted, Abuses Plague Guardianship Systems Across the Country.

The Economist posted its Quality of Death Index 2015, ranking palliative care provided across the world.

Next Avenue posted, Don’t Sign Away Your Rights In Long-Term Care

MedPAC announces the release of the updated 2015 Medicare Payment Basics series, which provide an overview of 19 payment systems

CMS Fact Sheet: Two-Midnight Rule

Two years ago the Consumer Financial Protection Bureau (CFPB) released the Managing Someone Else’s Money guides for financial caregivers all over the country. Because the powers and duties of financial caregivers vary from state to state, the CFPB has been working to create state-specific guides. Now the CFPB released new tools to help experts adapt the original guides for states that have not yet been adapted. If you would like free print copies of the tips document, you can order single copies or place bulk orders. Click here to read more about the new tips and templates.

Market Watch posted an article about the recent budget bill, Millions of Americans Just Lost Key Social Security Strategy and ElderLaw Answers posted, New Federal Budget Ends Two Spousal Social Security Claiming Strategies.

Journal of the American Geriatrics Society posted the American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

SAMHSA announced the release of a new pocket guide for health professionals, Medication for the Treatment of Alcohol Use Disorder.

From the U.S. Census: “This interactive visualization allows users to understand how race and ethnicity categories have changed over time since the 1790 Census. For more information, see Random Samplings Blog post

On October 14, CARIE submitted comments to CMS about its proposed new regulations for nursing facilities.

Just for Fun
Do you enjoy watching documentaries? DocumentaryHeaven, “food for your brain,” offers and endless number of films on a variety of topics for you to enjoy at no cost.

CARIE News
Diane and CARIE’s advocacy work was featured in the Philadelphia Inquirer, Diane Menio: Protecting the elderly amid big health-care changes. CARIE is pleased to see Diane recognized for her dedication in advocating for older adults.

CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.

Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, November 5, 2015 at CARIE’s office at Two Penn Center – Suite 1500. Here is the agenda. All are welcome. Hope you can join us. Please note that December’s meeting has been cancelled and may be replaced with a webinar. Stay tuned.

As always, please contact me if you have any questions.

Thanks,
Kathy
[email protected]
267-546-3438 or 1-800-356-3606, ext. 3438

Click here to view the original newsletter

CARIE Connection – October 2015

CARIE Connection

Quote of the Month
“I would also like to enter into dialogue with the many elderly persons who are a storehouse of wisdom forged by experience, and who seek in many ways, especially through volunteer work, to share their stories and their insights. I know that many of them are retired, but still active; they keep working to build up this land.” – Pope Francis’ remarks to Congress

Prevent Service Cuts in Consumer-Directed Programs
Last month, the United States Court of Appeals for the District of Columbia upheld a Department of Labor regulation governing home care services for people with disabilities and seniors that requires most home care workers to receive minimum wage and overtime pay. The Department of Labor has a website with resource information. The home care rule is expected to become effective in mid-October. This new rule may impact Medicaid “consumer-directed” programs in states that allow the person receiving services to hire his or her own worker and can direct the care the worker provides. Advocacy is needed to ensure each state implements this rule in a way that helps consumers and avoids adverse outcomes such as cuts to services or dismantling these programs.

The American Association of People with Disabilities, the Association of University Centers on Disability, the Bazelon Center for Mental Health Law, Justice in Aging, the National Association of Councils on Developmental Disabilities, the National Council on Independent Living, and the National Disability Rights Network has issued Action Steps for Consumers and Advocates Regarding the Home Care Rule and an accompanying summary, Home Care Rule Advocacy Fact Sheet, to help with advocacy efforts.

Medicare Open Enrollment is Here!
Medicare open enrollment starts every year on Oct. 15, and it runs through Dec. 7. Medicare beneficiaries should review their coverage during this time. Since Medicare Advantage and Part D plans make changes to coverage and costs each year, staying with the same plan as most people tend to do may not be the best option. Plan information for 2016 should be available starting on October 1. Choices that consumers make during this open enrollment period will take effect on January 1 and will cover all of 2016 unless the beneficiary is eligible for a special enrollment period such as those who are also eligible for Medicaid. It’s important to consider the total costs of care including out-of-pocket costs like co-pays rather than simply looking at the monthly premium cost. For example, some Medicare Advantage plans with higher premiums may have lower deductibles and co-pays, resulting in lower costs for the year.

Medicare.gov has useful comparison tools to help in comparing plans. CARIE and other SHIP programs (known as APPRISE in PA) are a helpful free resource to help understand all options. Before contacting CARIE or another SHIP program, it’s best to have a list of all medications, including dosage information, as well as any providers that are important to be able to continue to use so the counselor can identify the best options. Open enrollment is always a very busy time of year so another helpful tip is to avoid waiting until the end of open enrollment, i.e., the first week of December to make initial contact. U.S. News and World Report posted an article, Choosing the Right Medicare Plan, which provides basic information. NCOA has updated itsMedicare Open Enrollment Guide to Mailings & Key Events for the 2016 Open Enrollment Period that is an excellent resource for professionals.

Pennsylvania News
On June 1st, the Pennsylvania Department of Human Services (DHS) made a major announcement about a new initiative to pursue Managed Long-Term Services and Supports (MLTSS) in Pennsylvania. (Please see CARIE Connection archives, the June, August, and September editions for more background information.) Since this proposal will lead to a major system change in a short period of time, CARIE created a MLTSS fact sheet to help educate older adults about some of the changes and how they can participate in the planning process. Please help us educate consumers and their caregivers by distributing this flyer.

Pennsylvania released its Concept Paper for the Community HealthChoices (CHC) program on September 16, 2015 that briefly describes Governor Wolf’s proposed design for PA’s new MLTSS system and is soliciting comments through October 16. (Click here for the Concept Paper PowerPoint presentation slides.) The state plans to release an RFP in November 2015 with the first phase of implementation set to begin on January 1, 2017 in Southwestern PA. For more information, see Penn’s RegBlog article, Pennsylvania Seeks New Approach to Long-Term Medicaid Services.

To help advocates understand the proposal and prepare comments, CARIE is sponsoring a follow-up webinar with Eric Carlson, Directing Attorney for Justice in Aging, who will review the recently released Community HealthChoices Program Concept Paper. Registration is required and limited to the first 150 registrants. CARIE is not charging a fee for the webinar and you can listen for free through your computer’s speakers or a headset. However, if you need to call-in for the audio, please be aware that this is a toll call and you will incur any related charges on your phone bill. (You may also view the first webinar,Pennsylvania’s MLTSS Proposal: Key Considerations for Advocates, held on June 30, 2015. Click here for all of the webinar slides.) The proposed plan is on a fast track so it’s vital that advocates provide input to DHS about the proposal and timetable for implementation.

DHS has convened a Managed Long Term Services and Supports Subcommittee. If you’re interested in receiving MLTSS Subcommittee email communications distributed by DHS, visit the ListServ Archives page to update or register your email address. (You can choose to subscribe to whichever listserves you want to be on.)

Webinars and Videos
Under the auspices of the Institute of Medicine (IOM), an ad hoc committee will conduct a two-day workshop, Meeting the Dietary Needs of Older Adults: A Workshop, on October 28 and 29, in Washington, DC, about factors in the physical, social, and cultural environment that impact the ability of older adults to meet their daily dietary needs. The event will also be webcast.

MedPage Today posted Time to Get it Right at the End of Life: Differences between DNRs, ADs, and POLSTs illustrated in video parody. (Scroll down page for original video.)

The Fine Art of Balancing Protection with Self Determination is now archived and well worth listening to. Very useful information was presented including a new “PRACTICAL” model to avoid guardianship being released by the ABA at a conference later this year.

Just the Links
Consumer Reports posted an article, Lies, Secrets, and Scams: How to Prevent Elder Abuse.

The Administration for Community Living (ACL) has launched the ‘What is Brain Health?’ campaign. More information also available at ACL’s brain health webpage.

Alzheimer’s and Dementia: Resources You Can Use webinar slides have been posted. This is a good resource for new or seasoned professionals.

The Bipartisan Policy Center – Health and Housing Task Force released report, America’s Growing Senior Population: Assessing the Dimensions of the Demographic Challenge.

ARCH released a new fact sheet, Fact Sheet 63. Respite for Caregivers of Veterans.

The Kaiser Family Foundation posted an issue brief, Serving Low-Income Seniors Where They Live: Medicaid’s Role in Providing Community-Based Long-Term Services and Supports.

The Kaiser Family Foundation created a new tool, Preventive Services Tracker. There are separate trackers for each condition including chronic conditions. The charts also provide links for each required service to explain more details. For more information, see their article on Preventive Services Covered by Private Health Plans Under the Affordable Care Act and the accompanying fact sheet.

Health Affairs issued a health policy brief, Rebalancing Medicaid Long-Term Services And Supports.

The International Labour Organization (ILO) documents that more than half of the global population aged 65 and above, representing 300 million people, is excluded from urgently needed long-term care in its report, LTC protection for older persons: A review of coverage deficits in 46 countries.

The Health Care Cost Institute released data that measure the economic performance of health care markets across the country.

The National Hospice and Palliative Care Organization (NHPCO) released its 2015 NHPCO’s Facts & Figures on Hospice Care in the U.S.

CMS created a new website that includes information and resources for employers to help Medicare-eligible employees and retirees understand Medicare.

The University of Pittsburgh’s Health Policy Institute (HPI) launched the Stern Center for Evidence-Based Policy and released of the Center’s first report, Addressing the Health Needs of an Aging America. Click here for the Executive Summary.

PCA is once again hosting the Regional Conference on Aging from Oct. 19 – 21. Click here for more information and to register.

Just for Fun
Pixabay has over 470,000 free photos, videos, vectors and art illustrations that can be used for free without attribution in most instances. “Finding free images of high quality is a tedious task – due to copyright issues, attribution requirements, or simply the lack of quality. This inspired us to create Pixabay – a repository for stunning public domain pictures. Your source for royalty free stock photos and copyright free vector graphics. You can use any Pixabay image without attribution in digital and printed form, even for commercial applications.”

For Philadelphia area folks – this is the last chance to get the 2015 Philly Fun Guide’s Funsavers Memberships and Subscriptions at 35-50% off. The sale ends on Friday, 10/2.

CARIE News
CARIE wants to express our thanks to the residents, donors, and volunteers who helped make this year’s Golden Games a successful event!

CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.

Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, October 1, 2015 at CARIE’s office at Two Penn Center – Suite 1500. Here is the agenda. All are welcome. Hope you can join us. The remaining meeting dates for 2015 are November 5 and December 3.

As always, please contact me if you have any questions.

Thanks,
Kathy
[email protected]
267-546-3438 or 1-800-356-3606, ext. 3438

Click here to view the original newsletter

Categories: Carie Connection

CARIE Connection – March, 2017