Dec 26, 2009
BUSINESS TAX RATE FALLS
The state’s business corporation tax rate of 9.5 percent falls to 8.75 percent on Friday, Jan. 1, 2010 and the financial institution tax rate of 10.5 percent drops to 10 percent. The rate reductions were included as part of a corporate tax law reform bill last July that included a pair of major changes – the so-called combined reporting and check-the-box reforms – sought by Gov. Deval Patrick to bolster state tax collections and close what he called loopholes in the tax code. The Patrick administration at the time promoted that rate cut as a way to help businesses in Massachusetts, especially smaller ones, stay competitive. It was paired with tax law reforms that at the time were projected to generate $285 million in fiscal 2009, $390 million in fiscal 2010 and $269 million in fiscal 2011. At the time of the bill’s passage, Sen. Cynthia Creem estimated between 15,000 and 20,000 Massachusetts businesses would benefit from overall tax rate reductions that take effect next week.
Dec 15, 2009
Preliminary Survey Results
During September and October 2009 Central Massachusetts Agency on Aging undertook a survey of elder residents throughout the region to gather information on issues with which elders might need assistance.
Based on the sampling drawn from local street lists, it appears that the elder population of Central Massachusetts was approximately 144,000 as of January 1, 2009. The state estimate for 2010 is 148,000 so this seems to be a reasonably accurate figure
A sharp increase in the percentage of elders with incomes below the poverty line was noted. The preliminary figure for 2009 is 12.4% in comparison to 8.1% in the 2005 survey.
Overall, the top needs ranked by CMAA’s “need index”, which considers both the number of respondents with specific needs and the degree to which these needs are unmet, include the following:
Help with applying for financial assistance
Preparing tax forms
Home repairs
Finding employment opportunities
Finding volunteer opportunities
Paying property taxes
Problems dealing with large debt
Problems dealing with depression/loss
Problems coping with a disability
The majority of these are related to financial circumstances and all of them show an increase in the proportion of respondents identifying the need in comparison to the 2005 survey. Clearly, the current recession has had a significant impact on elders in Central Massachusetts.
Based on the sampling drawn from local street lists, it appears that the elder population of Central Massachusetts was approximately 144,000 as of January 1, 2009. The state estimate for 2010 is 148,000 so this seems to be a reasonably accurate figure
A sharp increase in the percentage of elders with incomes below the poverty line was noted. The preliminary figure for 2009 is 12.4% in comparison to 8.1% in the 2005 survey.
Overall, the top needs ranked by CMAA’s “need index”, which considers both the number of respondents with specific needs and the degree to which these needs are unmet, include the following:
Help with applying for financial assistance
Preparing tax forms
Home repairs
Finding employment opportunities
Finding volunteer opportunities
Paying property taxes
Problems dealing with large debt
Problems dealing with depression/loss
Problems coping with a disability
The majority of these are related to financial circumstances and all of them show an increase in the proportion of respondents identifying the need in comparison to the 2005 survey. Clearly, the current recession has had a significant impact on elders in Central Massachusetts.
Dec 4, 2009
From The Auburn VNA Extended Care, Inc
Earlier this year the Greater Worcester Community Foundation approved a grant to Auburn VNA Extended Care to be used to assist low-income elders and their caregivers with home care services. Through this grant elders in our community have been able to continue receiving home care services, and not have to do without or have family members stretching to provide. We've been able to assist income eligible elders bridging to home care services provided through agencies contracted with Elder Services of the Worcester Area or Tri-Valley Services. We are planning on having a fund raiser in the spring to replenish this fund, so we can continue to provide with the these needed services. Auburn VNA Extended Care is a non-profit private duty home care agency, and the sister agency of the Auburn Visiting Nurse Association (also known as Auburn District Nursing).
Nov 9, 2009
Nov 6, 2009
HUMAN SERVICE ADVOCATES EXPECT GUV TO DETAIL MEDICAID CUTS TODAY:
Human services advocates are bracing for details of cuts to Medicaid programs they say the Patrick administration may announce Friday. Officials from several human services organizations say the details of proposed cuts are still uncertain but fear that subsidized Medicaid plans may see co-pay increases and personal care attendant hours for eligible patients may be reduced. The officials are preparing to pepper the administration with letters, should Gov. Deval Patrick pull the trigger on the cuts, a possibility they said was up in the air Friday afternoon. Officials in the Executive Office of Health and Human Services did not respond to requests for comment. Patrick cut nearly $82 million from health and human services programs during an October round of budget cuts aimed at partially closing a $600 million midyear spending imbalance. Developing 12:06 P.M.
Nov 5, 2009
Need Help Understanding 2010 Medicare Plans?
We are in the middle of the Medicare Annual Open Enrollment period, which lasts until December 31. During this time, all Medicare beneficiaries can change their Medicare health coverage as well as their Medicare Prescription Drug Plans (Part D Plans).
Some Medicare Advantage plans will no longer be offered in 2010. If you are in one of these plans, you must choose a new plan. In most cases if you do nothing, in January you will be put back in Original Medicare with no drug coverage. If you have any questions on your Medicare Advantage Plan feel free to contact us and we will assist you with selecting another plan.
If you have a Medicare Stand Alone Drug Plan, you need to check that your drugs will continue to be covered by your drug plan and how much they will cost you (your co-payments) in 2010. Most plans have increased monthly premiums, but a number of plans have significantly increased co-payments also. If you would like to compare Drug plan or look for a cheaper plan that covers your drugs. You can contact Medicare at 1-800-633-4227. You can also contact MassMedLine at 1-866-633-1617 these folks will input your medications into the system to help determine the best plan for you.
Although you have until December 31 to make changes, we recommend making any changes as early as possible, so you will have paperwork from your new plan showing you are covered on January 1, 2010.
The good news is that help is available:
Call Central Massachusetts Agency on Aging at (800) 244-3032 and ask to schedule a SHINE appointment. SHINE Counselors are available to help you make choices. You may also call the regional SHINE office at (508) 422-9931.
Some Medicare Advantage plans will no longer be offered in 2010. If you are in one of these plans, you must choose a new plan. In most cases if you do nothing, in January you will be put back in Original Medicare with no drug coverage. If you have any questions on your Medicare Advantage Plan feel free to contact us and we will assist you with selecting another plan.
If you have a Medicare Stand Alone Drug Plan, you need to check that your drugs will continue to be covered by your drug plan and how much they will cost you (your co-payments) in 2010. Most plans have increased monthly premiums, but a number of plans have significantly increased co-payments also. If you would like to compare Drug plan or look for a cheaper plan that covers your drugs. You can contact Medicare at 1-800-633-4227. You can also contact MassMedLine at 1-866-633-1617 these folks will input your medications into the system to help determine the best plan for you.
Although you have until December 31 to make changes, we recommend making any changes as early as possible, so you will have paperwork from your new plan showing you are covered on January 1, 2010.
The good news is that help is available:
Call Central Massachusetts Agency on Aging at (800) 244-3032 and ask to schedule a SHINE appointment. SHINE Counselors are available to help you make choices. You may also call the regional SHINE office at (508) 422-9931.
Oct 25, 2009
Seniors Get The UnCOLA
Because of the low growth in consumer prices, senior citizens will see no Cost of Living Adjustment in their checks this January.
Social Security and Supplemental Security Income (SSI) benefits are adjusted annually to reflect the increase, if any, in the cost of living as measured by the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) prepared by the Bureau of Labor Statistics. The purpose of the annual cost-of-living adjustment
(COLA) is to ensure that the purchasing power of Social Security and SSI benefits is not eroded by inflation.
But now the recession has claimed another victim: Social Security recipients.
In response, on October 14th, President Barack Obama asked Congress to legislate a second round of $250 economic recovery payments to Social Security recipients in 2010. This year’s stimulus bill (the American Recovery and Reinvestment Act, or ARRA) included those payments, which went out to all Social Security beneficiaries in the summer. The President
is now urging Congress to authorize a repeat of that program for the coming year, citing continued economic hardship among the Social Security population.
The $250 figure is equivalent to approximately 2% of the average annual Social Security retirement benefit. It is estimated that the cost of this proposal is $13 billion. This is the White House’s first ARRA extension request. The announcement came on the heels of the news that there will be no cost-of-living adjustment (COLA) in 2010, given the country’s negative inflation rate.
“Older adults struggling to make ends meet in this recession will be directly aided by this relief, and we hope the expenditure of these payments will have a stimulative effect on the economy, as well," said Paul J. Lanzikos, President of Mass Home Care. "Given the lack of a cost-of-living adjustment in 2010 for Social Security recipients, this one-time payment will be especially
helpful to those living on a fixed income," Lanzikos said.
According to the Social Security Administration, under present law there is a COLA for Social Security and SSI benefits provided only when there is an increase in the average of the Consumer Price Index-W from the third calendar quarter of the prior year to the third calendar quarter of the current year of at least one-tenth of one percent (0.1 percent). If the CPI-W increases by less than 0.05 percent, or if the CPI-W decreases, there is no COLA. If there is no COLA, Social Security and SSI benefits remain the same. That means for every year after 2010, the Social Security will be lower than it would have been if there had been a COLA in 2010. Since there is no COLA in 2010, the starting point for the measuring period for the 2011 COLA will remain the third calendar quarter of 2008.
There has been an on-going debate in Congress about whether or not the CPI-W accurately measures the impact of inflation on seniors, since their expenditures on consumer goods is much more weighted on medical services and drugs than younger workers. Congress has yet to agree on creating a special CPI for elders, and as a result the CPI-W is not seen as a fair indicator of the rising costs for drugs and health care out of pocket expenses that seniors face.
Social Security and Supplemental Security Income (SSI) benefits are adjusted annually to reflect the increase, if any, in the cost of living as measured by the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) prepared by the Bureau of Labor Statistics. The purpose of the annual cost-of-living adjustment
(COLA) is to ensure that the purchasing power of Social Security and SSI benefits is not eroded by inflation.
But now the recession has claimed another victim: Social Security recipients.
In response, on October 14th, President Barack Obama asked Congress to legislate a second round of $250 economic recovery payments to Social Security recipients in 2010. This year’s stimulus bill (the American Recovery and Reinvestment Act, or ARRA) included those payments, which went out to all Social Security beneficiaries in the summer. The President
is now urging Congress to authorize a repeat of that program for the coming year, citing continued economic hardship among the Social Security population.
The $250 figure is equivalent to approximately 2% of the average annual Social Security retirement benefit. It is estimated that the cost of this proposal is $13 billion. This is the White House’s first ARRA extension request. The announcement came on the heels of the news that there will be no cost-of-living adjustment (COLA) in 2010, given the country’s negative inflation rate.
“Older adults struggling to make ends meet in this recession will be directly aided by this relief, and we hope the expenditure of these payments will have a stimulative effect on the economy, as well," said Paul J. Lanzikos, President of Mass Home Care. "Given the lack of a cost-of-living adjustment in 2010 for Social Security recipients, this one-time payment will be especially
helpful to those living on a fixed income," Lanzikos said.
According to the Social Security Administration, under present law there is a COLA for Social Security and SSI benefits provided only when there is an increase in the average of the Consumer Price Index-W from the third calendar quarter of the prior year to the third calendar quarter of the current year of at least one-tenth of one percent (0.1 percent). If the CPI-W increases by less than 0.05 percent, or if the CPI-W decreases, there is no COLA. If there is no COLA, Social Security and SSI benefits remain the same. That means for every year after 2010, the Social Security will be lower than it would have been if there had been a COLA in 2010. Since there is no COLA in 2010, the starting point for the measuring period for the 2011 COLA will remain the third calendar quarter of 2008.
There has been an on-going debate in Congress about whether or not the CPI-W accurately measures the impact of inflation on seniors, since their expenditures on consumer goods is much more weighted on medical services and drugs than younger workers. Congress has yet to agree on creating a special CPI for elders, and as a result the CPI-W is not seen as a fair indicator of the rising costs for drugs and health care out of pocket expenses that seniors face.
Oct 20, 2009
HOME CARE WAIT LIST TOPS 1,000
STATEWIDE---As Governor Deval Patrick considers what additonal cuts to make in the state budget, cuts already incurred this year in the elderly home care program have forced more than 1,000 people on a waiting list for services.
According to Mass Home Care, the wait list in the home care and enhanced home care program stood at 1,077 elders as of October 19th. The group said the number is understated, because seniors must be visited at home and assessed for need before their name can go on a wait list.
The waiting list was imposed on September 8th. Forty one days later, more than 1,000 people are waiting. Mass Home Care says that cuts already implemented will push the waiting list up to as many as 6,000 people by the end of June.
"It is ironic that the door to nursing home care is wide open, but the door to home care has been slammed shut for hundreds of seniors," said Al Norman, Executive Director of Mass Home Care. Norman said the Commonwealth's official policy for long term supports is "Community First," but that has translated into 'cut community first' instead.
Norman said that the typical home care client is a woman in her mid 80s who needs significant help with her activities of daily living, such as bathing, dressing, eating, walking and toileting.
Cutbacks this year have been made to the home care program, the Enhanced Community Options Program, and Community Choices---the three programs that help keep people living in the least restrictive setting.
Based on the 2006 "Equal Choice" law that Mass Home Care wrote, seniors and individuals with disabilities are supposed to be given a choice of where they wish to be served---at home or in an institution. Because of these budget cuts, seniors now have the choice of nursing home care or a waiting list. "We are narrowing some people's choices to a nursing home," Norman noted. "This is exactly what state policy says we should avoid."
Norman said seniors across the state have been contacting the Governor's office urging him not to make another round of cuts to community services. "'Hands off Home Care'" was the message, Norman said. "The hits we've already received have a taken a toll on very vulnerable seniors. It's fiscally short-sighted to cut the programs that keep people out of the more expensive levels of care. In a budget crunch, this is precisely the time to keep home care open, and divert people away from institutions."
According to Mass Home Care, the wait list in the home care and enhanced home care program stood at 1,077 elders as of October 19th. The group said the number is understated, because seniors must be visited at home and assessed for need before their name can go on a wait list.
The waiting list was imposed on September 8th. Forty one days later, more than 1,000 people are waiting. Mass Home Care says that cuts already implemented will push the waiting list up to as many as 6,000 people by the end of June.
"It is ironic that the door to nursing home care is wide open, but the door to home care has been slammed shut for hundreds of seniors," said Al Norman, Executive Director of Mass Home Care. Norman said the Commonwealth's official policy for long term supports is "Community First," but that has translated into 'cut community first' instead.
Norman said that the typical home care client is a woman in her mid 80s who needs significant help with her activities of daily living, such as bathing, dressing, eating, walking and toileting.
Cutbacks this year have been made to the home care program, the Enhanced Community Options Program, and Community Choices---the three programs that help keep people living in the least restrictive setting.
Based on the 2006 "Equal Choice" law that Mass Home Care wrote, seniors and individuals with disabilities are supposed to be given a choice of where they wish to be served---at home or in an institution. Because of these budget cuts, seniors now have the choice of nursing home care or a waiting list. "We are narrowing some people's choices to a nursing home," Norman noted. "This is exactly what state policy says we should avoid."
Norman said seniors across the state have been contacting the Governor's office urging him not to make another round of cuts to community services. "'Hands off Home Care'" was the message, Norman said. "The hits we've already received have a taken a toll on very vulnerable seniors. It's fiscally short-sighted to cut the programs that keep people out of the more expensive levels of care. In a budget crunch, this is precisely the time to keep home care open, and divert people away from institutions."
Oct 19, 2009
Oct 11, 2009
Job Worries
With 105,000 jobs lost over the past year, the Massachusetts economy and the state’s taxpayers continue to struggle and are unable to afford the spending levels prescribed on Beacon Hill. Despite a steady stream of laws in recent years touted by proponents as job generators, lawmakers received a report Thursday showing Massachusetts ranks 46th among states in job creation between 2000 and 2009, a sobering fact that undercuts some arguments about the state’s diverse economy. As Sen. Steven Panagiotakos, the Senate budget chief, pointed out repeatedly at this week’s revenue review hearing, the income tax provides about 60 percent of the state’s tax revenues and the state’s largest pool of tax revenue is inextricably linked to its success or failure in creating jobs. House Republicans, who portrayed a series of approved tax increases as job killers, on Friday began agitating to bring attention to cost-saving proposals the Democrats have turned aside previously, saying the ideas deserve attention again. With immediate budget problems to go along with the gaping fiscal 2011 gap, the proposals –managed care in MassHealth, rules to expedite the sale of surplus land, state employee furloughs, revisiting the Pacheco privatization law, and encouraging medical facilities to return unused, unexpired medications – are likely to get a second look in the months to come. More immediately, House Speaker Robert DeLeo says the next major economic development bill will be centered around legalization of casinos and slot machines at racetracks, a proposal that has generated emotional debate from both sides and which is expected to draw lots of attention in the weeks leading up to an October 29 public hearing. Despite the tough long-term numbers, the rate of job growth has slowed and Patrick says Massachusetts is positioned well to rebound from the recession more quickly than other states. The latest unemployment and jobs data will be released on Thursday. Legislative leaders continue to keep their fall agenda largely under wraps, with DeLeo seeking out initiatives that don’t cost any money and top Hill officials working behind the scenes on an education bill. The Senate has one formal session next week on its radar, a tentative formal on Thursday. The House plans a formal session for Thursday, which could feature consideration of a bill, now before the House Ways and Means Committee, to close out the books on fiscal 2009. Fiscal conservatives will be on the lookout for spending expansions. “I don’t know how we’ll get beyond the fiscal insanity if there’s any new spending in this,” Rep. John Rogers (D-Norwood), a former Ways and Means chair, said Friday. Rogers said the soon-to-be-downgraded revenue estimate would be “screaming at us to do the exact opposite.”
Oct 10, 2009
The Buzz on Beacon Hill
The buzz on Beacon Hill next week is over the contraction state government will soon undergo as Gov. Deval Patrick deals with an eroding tax base, which state revenue officials say could carve between $400 million and $600 million out of this year’s expected collections. Patrick and the Legislature have already deployed waves of tax increases and spending cuts and poured billions of dollars from the state rainy day fund and federal stimulus dollars into the budget, leaving them with few popular choices to address the new red ink in the $27 billion budget and next year’s gap, estimated preliminarily at between $2 billion and $3 billion. Groups of developmentally disabled individuals have taken over the governor’s lobby in a regular vigil to protest potential cuts, which appear inevitable by month’s end. Administration officials are making no promises about which services and programs might be preserved as Jay Gonzalez, Patrick’s new budget chief, looks to officially lower the fiscal 2010 revenue estimate by Thursday. “We’re going through a process. We need to know what our options are,” Health and Human Services Secretary JudyAnn Bigby told the News Service Friday. “Obviously, the governor is going to hear a lot of recommendations, a lot of cases made for particular things. It’s going to be a couple weeks before we even know what the level of cuts will need to be. We are very hopeful we can make sure that we do the most we can to maintain the supports that people are looking for.”
Oct 8, 2009
Sep 30, 2009
ANN L. HARTSTEIN TO HOLD A LISTENING TOUR IN WORCESTER
| ||||||
Governor Deval Patrick’s newly-appointed Secretary of the Executive Office of Elder Affairs, Ann Hartstein, will be holding a public forum at the Worcester Senior Center. Secretary Hartstein will meet with elders and their families for an interactive dialog about issues important to the region, their families and themselves. The Central Massachusetts Agency on Aging Elder Services of Worcester Area, Inc. the Executive Office of the Worcester City Manager, Division of Elder Affairs and The Massachusetts Senior Action Council are proud to host this event. No reservations are required unless you wish to have lunch at noon. To reserve lunch, call 508-799-8070 by October 12th. The Executive Office of Elder Affairs promotes the independence and well-being ofMassachusetts’ elders and people needing medical and social supportive services. By providing advocacy, leadership and management expertise, Elder Affairs is able to maintain a continuum of services responsive to the needs of their constituents, their families, and caregivers. | ||||||
Sep 14, 2009
Nonprofit Groups Upset at Exclusion
From Health Bills
Nonprofit organizations say they are upset that Congress and the Obama administration have not addressed their rising health care costs in the various health care proposals being floated on Capitol Hill.
The main bill in the House would award a tax credit to small businesses that provide their employees with health insurance - but nonprofits do not pay income taxes and thus would not benefit.
"Why should employees of nonprofits be treated worse than employees of for-profit businesses?" said Jonathan A. Small, government affairs consultant at the Nonprofit Coordinating Committee of New York.
Nonprofit groups were hoping that the president would include them in his speech to Congress on Wednesday, but instead he mentioned only "families, businesses and government."
"There was nothing in that much-repeated trilogy of those needing help that spoke to nonprofits," said Lester M. Salamon, director of the Center for Civil Society Studies at Johns Hopkins University.
Some nonprofit groups have called for a subsidy along the lines of the Earned Income Tax Credit, in which money would be returned to organizations that demonstrate they have paid for an employee's health care.
As a group, nonprofit organizations are the nation's fourth-largest employer. But their advocates say policy makers know little about the workings of nonprofits, which pay payroll taxes and, in rare instances, taxes on unrelated business activities, but are exempt from taxes on their income.
"In this administration, there are so many people who came from the nonprofit community, but they don't really seem to think about the unique laws and rules that govern it," said Diana Aviv, president and chief executive of the Independent Sector, a nonprofit trade association.
When the concerns of nonprofit groups were raised on a conference call after the president's speech on Wednesday, representatives from the White House Office of Public Engagement and Intergovernmental Affairs were taken aback, and nonprofits have reported similar reactions from staff members in House and Senate offices.
"We had our nonprofit lobbying day on Capitol Hill in July, and our members spoke to their elected officials about this issue," said Tim Delaney, chief executive of the National Council of Nonprofit Associations. "We heard a constant refrain: 'Gee, we never thought about nonprofits as employers before.' "
Linda Douglass, a White House spokeswoman, said she had no comment because the policy was still being analyzed.
A recent survey of nonprofit groups by the Listening Post Project at Johns Hopkins found that the impact of rising health care costs was "mammoth."
Only 2 percent of the organizations responding to the survey said they were "not too concerned" about health care costs, and 72 percent of the respondents said those costs had risen - with roughly one-third of those reporting increases of 10 percent or more.
New York Times
Sep 12, 2009
Keeping People at Home, Out of Nursing Homes
Anita Cole knows that her life of 75 years is coming to an end.
Still, she says from the hospital bed near the DVD player she uses to watch “The King and I” in one of six bedrooms in the Blackstone home of her daughter and son-in-law, “I’m lucky” because there are so many people who are worse off.
She did not feel so lucky during the year she spent in a nursing home just over the state line in Woonsocket. By the time she left it and arrived nearly two years ago in the six-bedroom home of Jackie and Alan Morrissette, with the help of Tri-Valley elder services in Dudley, she had bedsores you could put your hand in, said Jackie Morrissette, Mrs. Cole’s daughter.
Mrs. Cole, who used to fix knitting machines in the mills, said that some aides and nurses were kind and attentive, but Mrs. Morrissette said that some of them abused her mother.
Tri-Valley was a godsend, Mrs. Morrissette said. Even though Mrs. Morrissette used to work as a certified nursing assistant in nursing homes and as a certified medical technician, clearing the trail through paperwork by herself and coming up with a proper plan to bring her mother home would have taken far longer without the agency’s help, she said.
The Morrissettes sold their pizza restaurant and Mr. Morrissette became a personal care assistant about two years ago. Now he makes a living from the paid shared living arrangements they have taking care of Mrs. Morrissette’s mother, who has latter-stage Parkinson’s disease; a 74-year-old woman with physical ailments and mental disabilities; and a 37-year-old Vietnamese woman with severe physical and cognitive problems.
Mrs. Cole and her two housemates are benefiting from the home atmosphere and family-style care that the Morrissettes provide, but so are taxpayers.
Albert Norman, executive director of Mass Home Care, an association of 30 nonprofit agencies serving the elderly, said that “somewhere around 15 percent of people in nursing homes today could come out” if there were proper support. That would be about 5,000 of the 30,000 nursing home residents on Medicaid, he said.
Many nursing homes charge $58,000 a year, Mr. Norman noted. The annual cost of serving disabled elderly people in the community averages $26,000, less than half the cost, he said
Already support programs enable 10,000 Massachusetts nursing home-eligible people to live in homes in the community, Mr. Norman said. That saves the state and federal governments $580 million a year.
Massachusetts Senior Care Association, whose members include nursing homes, questions whether 5,000 nursing home residents could live in the community, according to Scott Plumb, senior vice president. The state, with its “cataclysmic budget” is not adding services but cutting back adult day health and other programs, creating waiting lists to get community services, he said.
“If somebody can be cared for safely and effectively at home, that’s where they should be cared for. Nursing homes are not in the business of taking care of people who don’t need to be there,” Mr. Plumb said. “There are some people in nursing homes, particularly with mental illness, who if the state were to make a strong, funded commitment to community care, that they could be cared for in the community.”
Since February or March, five agencies in the Worcester area have formed the Aging and Disabilities Resource Consortium, according to Ellen M. Messier, director of programs for the Center for Living & Working in Worcester. Besides Center for Living & Working, they are Central Massachusetts Agency on Aging, Elder Services of Worcester Area, Montachusett Home Care and Tri-Valley Inc.
“The point is to have no wrong door,” Ms. Messier said. The agencies are collaborating, so they know each others’ services.
If an elderly person or someone with disabilities who needs help living on their own calls the “wrong agency,” that agency will connect the right agency to the caller, she said.
Mr. Norman said the 11 consortiums across the state will fight the “silo” concept of service provision that separates services for elderly people from those for people with disabilities, when some people may need both. “Individuals don’t age in silos,” he said. The same person may need services to transition from middle age into old age.
Ginger Wills Howe, Tri-Valley program director for home and adult family care, said that long-term options counselors under the consortium will be an important addition to the outreach work the agencies already do. With a $2.5 million infusion from the state Legislature, the options program will go to people, usually when they are in a hospital, to counsel them on how they can return to the community rather than enter a nursing home, Mr. Norman said.
There has been a 20 percent drop in nursing home patient days in Massachusetts over the past nine years, he said. He’d like to see that trend continue, believing the state can reverse its ratio of 61 percent of Medicaid money — $1.5 billion — going to nursing homes and 39 percent spent on community care, much as he said Oregon and Washington state already have done.
Sometimes all that people who are not nursing home-eligible need is three hours a week of personal care services, the Mass Home Care executive director said.
Karen S. Monroe, 60, spent three months in UMass Memorial Medical Center — Memorial Campus after a motor vehicle accident that left her in a wheelchair, and then 3-1/2 years in the Odd Fellows Home. She said that her daughter’s home in Dudley, where she lived before the accident, was not accessible, and that she languished in the Odd Fellows home 2-1/2 years longer than she thinks she needed to be there. Finally on June 1, with the help of the Center for Living & Working, she got an apartment on Pleasant Street from the Worcester Housing Authority.
While Ms. Monroe said she was well taken care of at Odd Fellows, “I have more freedom here,” she said. She can cook for herself or sit outside or go to the nearby CVS, she said.
Ms. Messier of Center for Living & Working said the tragedy of living in a nursing facility when you don’t need to is that “You’re isolated, when you can be out in the community and doing things and living independently. There’s nothing better than being able to live independently.”
http://www.telegram.com
Still, she says from the hospital bed near the DVD player she uses to watch “The King and I” in one of six bedrooms in the Blackstone home of her daughter and son-in-law, “I’m lucky” because there are so many people who are worse off.
She did not feel so lucky during the year she spent in a nursing home just over the state line in Woonsocket. By the time she left it and arrived nearly two years ago in the six-bedroom home of Jackie and Alan Morrissette, with the help of Tri-Valley elder services in Dudley, she had bedsores you could put your hand in, said Jackie Morrissette, Mrs. Cole’s daughter.
Mrs. Cole, who used to fix knitting machines in the mills, said that some aides and nurses were kind and attentive, but Mrs. Morrissette said that some of them abused her mother.
Tri-Valley was a godsend, Mrs. Morrissette said. Even though Mrs. Morrissette used to work as a certified nursing assistant in nursing homes and as a certified medical technician, clearing the trail through paperwork by herself and coming up with a proper plan to bring her mother home would have taken far longer without the agency’s help, she said.
The Morrissettes sold their pizza restaurant and Mr. Morrissette became a personal care assistant about two years ago. Now he makes a living from the paid shared living arrangements they have taking care of Mrs. Morrissette’s mother, who has latter-stage Parkinson’s disease; a 74-year-old woman with physical ailments and mental disabilities; and a 37-year-old Vietnamese woman with severe physical and cognitive problems.
Mrs. Cole and her two housemates are benefiting from the home atmosphere and family-style care that the Morrissettes provide, but so are taxpayers.
Albert Norman, executive director of Mass Home Care, an association of 30 nonprofit agencies serving the elderly, said that “somewhere around 15 percent of people in nursing homes today could come out” if there were proper support. That would be about 5,000 of the 30,000 nursing home residents on Medicaid, he said.
Many nursing homes charge $58,000 a year, Mr. Norman noted. The annual cost of serving disabled elderly people in the community averages $26,000, less than half the cost, he said
Already support programs enable 10,000 Massachusetts nursing home-eligible people to live in homes in the community, Mr. Norman said. That saves the state and federal governments $580 million a year.
Massachusetts Senior Care Association, whose members include nursing homes, questions whether 5,000 nursing home residents could live in the community, according to Scott Plumb, senior vice president. The state, with its “cataclysmic budget” is not adding services but cutting back adult day health and other programs, creating waiting lists to get community services, he said.
“If somebody can be cared for safely and effectively at home, that’s where they should be cared for. Nursing homes are not in the business of taking care of people who don’t need to be there,” Mr. Plumb said. “There are some people in nursing homes, particularly with mental illness, who if the state were to make a strong, funded commitment to community care, that they could be cared for in the community.”
Since February or March, five agencies in the Worcester area have formed the Aging and Disabilities Resource Consortium, according to Ellen M. Messier, director of programs for the Center for Living & Working in Worcester. Besides Center for Living & Working, they are Central Massachusetts Agency on Aging, Elder Services of Worcester Area, Montachusett Home Care and Tri-Valley Inc.
“The point is to have no wrong door,” Ms. Messier said. The agencies are collaborating, so they know each others’ services.
If an elderly person or someone with disabilities who needs help living on their own calls the “wrong agency,” that agency will connect the right agency to the caller, she said.
Mr. Norman said the 11 consortiums across the state will fight the “silo” concept of service provision that separates services for elderly people from those for people with disabilities, when some people may need both. “Individuals don’t age in silos,” he said. The same person may need services to transition from middle age into old age.
Ginger Wills Howe, Tri-Valley program director for home and adult family care, said that long-term options counselors under the consortium will be an important addition to the outreach work the agencies already do. With a $2.5 million infusion from the state Legislature, the options program will go to people, usually when they are in a hospital, to counsel them on how they can return to the community rather than enter a nursing home, Mr. Norman said.
There has been a 20 percent drop in nursing home patient days in Massachusetts over the past nine years, he said. He’d like to see that trend continue, believing the state can reverse its ratio of 61 percent of Medicaid money — $1.5 billion — going to nursing homes and 39 percent spent on community care, much as he said Oregon and Washington state already have done.
Sometimes all that people who are not nursing home-eligible need is three hours a week of personal care services, the Mass Home Care executive director said.
Karen S. Monroe, 60, spent three months in UMass Memorial Medical Center — Memorial Campus after a motor vehicle accident that left her in a wheelchair, and then 3-1/2 years in the Odd Fellows Home. She said that her daughter’s home in Dudley, where she lived before the accident, was not accessible, and that she languished in the Odd Fellows home 2-1/2 years longer than she thinks she needed to be there. Finally on June 1, with the help of the Center for Living & Working, she got an apartment on Pleasant Street from the Worcester Housing Authority.
While Ms. Monroe said she was well taken care of at Odd Fellows, “I have more freedom here,” she said. She can cook for herself or sit outside or go to the nearby CVS, she said.
Ms. Messier of Center for Living & Working said the tragedy of living in a nursing facility when you don’t need to is that “You’re isolated, when you can be out in the community and doing things and living independently. There’s nothing better than being able to live independently.”
http://www.telegram.com
Sep 11, 2009
Message from Assistant Secretary for Aging Kathy Greenlee on National Day of Remembrance and Service
On September 11, 2001, our nation experienced the worst terrorist attack in our history. On that day, families, friends and all Americans citizens were torn apart by the loss of the innocent individuals who perished in New York City, at the Pentagon in Arlington, Virginia and in a field in southwestern Pennsylvania. Eight years later, we continue to mourn their loss and celebrate their lives. We also pay tribute to the heroes and first responders who gave so much when their fellow citizens needed them the most.
The Administration on Aging(AoA) is proud to join President Obama and the entire nation as we acknowledge September 11 as National Day of Remembrance and Service. Today we reflect on how blessed we are to live in the United States. We come together to continue to show strength in unity and courage in the face of adversity. We remember the past, but we look to tomorrow. We are Americans. We will endure.
Today, America's spirit of compassion and generosity continues to shine.
All across the country, people are taking time today to lend a hand to those who need a boost. I am very proud that AoA staff and members of our national network of state, tribal and community-based organizations that serve older Americans are fanning out in communities across the country to perform meaningful service activities on behalf of at risk and frail older persons, their caregivers and their families. Whether it's serving a meal to a hungry senior, running errands for those who are homebound or just spending some time with those who are alone and isolated, these gestures make a big difference in their lives. I ask everyone to take some time today and throughout the year to help someone less fortunate. Together we can help tackle the tough challenges our country faces now and in the
future.
Aug 23, 2009
When Is It Time To Stop?
As a senior citizen was driving down the freeway, his car phone rang. Answering, he heard his wife's voice urgently warning him, "Herman, I just heard on the news that there's a car going the wrong way on 280. Please be careful!" "Hell," said Herman, "It's not just one car. It's hundreds of them!"
This joke is becoming decreasingly humorous as the media covers more and more fatal car accidents involving elderly drivers. As a caregiver, you might have three generations of drivers to be concerned about: your children, yourself, and now your elders. You feel the heavy burden of trying to keep everyone safe. Telling your elder that they cannot drive may be even more difficult than telling your children that they can.
Rather than gaining freedom, as in the case with new drivers, losing a license would be taking that same freedom away. Driving may be the means by which elders go shopping, visit friends and family, attend medical appointments, or go to a show. If you take away their license, they have to rely on others in order to continue with their usual schedule. If you don’t take away their license, they may be putting themselves and others in danger, possibly without knowing that they are doing so.
The issue of elderly driving is controversial. While some people claim that driving skills vary from one elder to another, just as with any other age group, there are deficits in aging that very much affect the way someone is capable of driving. Aging Parents and Elder Care cites that there can be a slowing of response time, hearing and/or vision loss, muscle strength and flexibility loss, and drowsiness as a side effect of medication or a lower tolerance to alcohol.
The National Motor Association “does not support frequent re-testing or age-based restrictions” based on their reasoning “neither has been found to be effective in identifying and preventing problem drivers, in any age segment of the population (NMA). Another article presents the opinion that “this isn't about statistics. This is about common sense. The idea that, after an initial road test, the only thing the state of Massachusetts tests drivers for is their eyesight is patently ludicrous. Massachusetts is one of only three states that has no additional requirements or road tests as drivers’ age” (Cullen, 2009).
One option is being put into action in Iowa. They have introduced a requirement that drivers age 70 and older renew their licenses in person. If a DMV official suspects a problem, drivers may be asked to take a road test. They may then choose between taking the standard test or a newly devised “local” test. If they opt for the latter, an examiner will evaluate them on their usual route—to the store, to church, to the doctor and so on. Those who pass the local test are licensed only on that route and may also be restricted to lower speeds and daylight-only driving (Russo, F., 2005).
If either you or your elder are not convinced that the subject of elderly driving needs more attention now and in the future, here are some facts provided by “Night Vision and Driving: How Safe Are Older Motorists”:
· “The National Highway Traffic Safety Administration says 6,512 people — 15 percent of all Americans who were killed on the road in 2005 — were 65 or older.”
· “According to a Vision Council report released in the fall of 2006, the 10 states with the highest rate of fatal crashes included four that required no vision screening for license renewal and four that require only screenings at intervals of eight or more years.”
· “Motor vehicle crashes are the leading cause of injury in adults between 65 and 75 years old, and the second leading cause of injury to those 75 or older, according to the CDC.”
· “When measured by crashes per mile driven, data show a substantial rise in crashes by driver over age 70, according to the American Association of Retired Persons.”
By 2030, one of four drivers will be 65 or older so the more effectively we address elderly driving issues, the safer the roads will be (Russo, F., 2005). Be a responsible citizen and use your best judgment to do what is best.
This joke is becoming decreasingly humorous as the media covers more and more fatal car accidents involving elderly drivers. As a caregiver, you might have three generations of drivers to be concerned about: your children, yourself, and now your elders. You feel the heavy burden of trying to keep everyone safe. Telling your elder that they cannot drive may be even more difficult than telling your children that they can.
Rather than gaining freedom, as in the case with new drivers, losing a license would be taking that same freedom away. Driving may be the means by which elders go shopping, visit friends and family, attend medical appointments, or go to a show. If you take away their license, they have to rely on others in order to continue with their usual schedule. If you don’t take away their license, they may be putting themselves and others in danger, possibly without knowing that they are doing so.
The issue of elderly driving is controversial. While some people claim that driving skills vary from one elder to another, just as with any other age group, there are deficits in aging that very much affect the way someone is capable of driving. Aging Parents and Elder Care cites that there can be a slowing of response time, hearing and/or vision loss, muscle strength and flexibility loss, and drowsiness as a side effect of medication or a lower tolerance to alcohol.
The National Motor Association “does not support frequent re-testing or age-based restrictions” based on their reasoning “neither has been found to be effective in identifying and preventing problem drivers, in any age segment of the population (NMA). Another article presents the opinion that “this isn't about statistics. This is about common sense. The idea that, after an initial road test, the only thing the state of Massachusetts tests drivers for is their eyesight is patently ludicrous. Massachusetts is one of only three states that has no additional requirements or road tests as drivers’ age” (Cullen, 2009).
One option is being put into action in Iowa. They have introduced a requirement that drivers age 70 and older renew their licenses in person. If a DMV official suspects a problem, drivers may be asked to take a road test. They may then choose between taking the standard test or a newly devised “local” test. If they opt for the latter, an examiner will evaluate them on their usual route—to the store, to church, to the doctor and so on. Those who pass the local test are licensed only on that route and may also be restricted to lower speeds and daylight-only driving (Russo, F., 2005).
If either you or your elder are not convinced that the subject of elderly driving needs more attention now and in the future, here are some facts provided by “Night Vision and Driving: How Safe Are Older Motorists”:
· “The National Highway Traffic Safety Administration says 6,512 people — 15 percent of all Americans who were killed on the road in 2005 — were 65 or older.”
· “According to a Vision Council report released in the fall of 2006, the 10 states with the highest rate of fatal crashes included four that required no vision screening for license renewal and four that require only screenings at intervals of eight or more years.”
· “Motor vehicle crashes are the leading cause of injury in adults between 65 and 75 years old, and the second leading cause of injury to those 75 or older, according to the CDC.”
· “When measured by crashes per mile driven, data show a substantial rise in crashes by driver over age 70, according to the American Association of Retired Persons.”
By 2030, one of four drivers will be 65 or older so the more effectively we address elderly driving issues, the safer the roads will be (Russo, F., 2005). Be a responsible citizen and use your best judgment to do what is best.
Aug 20, 2009
Jul 29, 2009
Advocates Say Elders Still Face “Unequal Choice”
Three years ago this Monday, August 3rd, elderly and disability rights advocates gathered at a State House ceremony as Governor Mitt Romney signed into law Chapter 211, the Equal Choice Law. Despite passage this law on August 3, 2006 the promise that elders and individuals with disabilities would be cared for in the least restrictive setting, still has not been fully achieved. The major provisions in the law have hardly advanced. Even though the Romney and Patrick Administrations have coined the term “community first” to describe long term care services, advocates charge that in many ways this is still an “institutions first” state. As examples:
* The General Court this week adopted a FY 2010 supplemental budget that added $10 million for nursing home rates, but only $200,000 for care managers in the home care program. Institutions got 50 times the funding that community care received.
* A new report from the state’s Executive Office of Human Services indicates that MassHealth spending on long term care supports is still dominated by institutions. In FY 2008, a total of $2.88 billion was spent by MassHealth for long term care---of which 61% ($1.748 billion) went to institutions, and only 39% went to community programs ($1.131 billion). If the two sectors had been in a 50/50 balance, community based services would have received an additional $308.6 million that year.
Fiscal Year Community Institutional Total % spent in % spent in
Spending Spending Spending community nursing homes
FY 2008 $1,131.627,326 $1,748,839,747 $2,880,467,073 39.3% 60/71%
Source: Massachusetts State Profile Tool, July, 2009. EOHHS
Three years after the Equal Choice Law was signed, here is a report on what has been implemented, and what has not:
1. PRE-ADMISSION COUNSELING. Chapter 211 created a Pre-Admission Counseling service for long term care which includes an assessment of community based service options for people in hospitals who are heading towards nursing homes. The purpose of this counseling is to help divert people into the community, and save Medicaid the expense of nursing home days. These assessments are mandatory for people seeking MassHealth payment, and must be offered to private paying consumers. The state is required to report the number of diversions to the community generated by pre-screening.
STATUS: Only 3 regional areas have a preliminary program---and only in selected hospitals on the North Shore, Metrowest, and Merrimack Valley regions. Less than $500,000 was allocated in FY 2009 for this project. In FY 2010, the legislature funded $2.5 million for expansion of this program. As of the 3rd. anniversary of the Equal Choice law, none of the new funds have been allocated to the field. The state has indicated that the so-called “Long Term Care Options” program will be pushed out statewide this year, but no timetable or contracts have been awarded. Consumers should have been able to access this program three years ago, regardless of where they live in the state.
2. ADOPT MASSHEALTH REGULATIONS. Chapter 211 requires the Division of Medical Assistance to adopt regulations to implement the “least restrictive and most appropriate”setting language.
STATUS: No activity. No changes to the regulations for Medicaid have been made.
3.SUBMIT AN 1115 WAIVER that establishes MassHealth eligibility at 300% of SSI and $10,000 asset level.
STATUS: This waiver was submitted to the federal Center of Medicare and Medicaid Services (CMS) in December, 2006. Two years and half years later, the 1115 waiver has been scrubbed for FY 2010, and there is no funding in the FY 2010 budget for this waiver. House 1 proposed to start the waiver in July, 2009. At one point in the budget process, a total of $41 million was requested by Governor Patrick—of which $20 M was from federal stimulus funds. The Governor’s budget said this waiver would seek “to encourage flexible service options in the community for those who might otherwise need to seek services in a facility setting. The proposed strategies will enable some individuals to continue to live independently in community settings and support others in returning to community settings from institutions.” In June, 2009 the Governor pulled his budget request for the waiver, reduced the line item to $0, and the item was not funded by the General Court.
“The recession alone cannot be blamed for the lack of progress in this civil rights law,” said Mass Home Care Executive Director Al Norman, who helped write the law. “Civil rights do not disappear in lean fiscal times. The fact is, keeping people at home is saving the state more than half a billion dollars annually in avoided nursing home costs. The Equal Choice law is part of the solution, not part of the problem.”
Norman said Mass Home Care will continue to urge the Patrick Administration to shift funds into the community. Although nursing home patient days have fallen nearly 20% since the year 2000, Norman said the state still needs to shift funds for elders into community settings, much as the state has already done for other populations, like the developmentally disabled. Norman said that funds for the developmentally disabled are 85% spent in the community. “Advocates for the developmentally disabled have shown us the way this should be done,” Norman said. In FY 2008, the state spent a total of $1.18 billion on Developmental Services, of which 84.5% went to community care. “That’s where we need to get with elderly long term care,” Norman admitted. “If community long term care got 84.5% of the spending as developmental services did,” Norman said, “we would have received an additional $1.3 billion in FY 2008. That’s a huge imbalance.”
“We should be much further along the path of ‘rebalancing’ how our tax dollars are spent in the community,” Norman noted. “Twenty-seven other states have a greater percentage of their long term care clients living at home.” As of 2006, the percentage of MassHealth long term care expenditures going to community care services in Massachusetts was only 22%---which ranked the state 20th in the nation. The top five states for “rebalancing” their expenditures into the community are:
State Percent of 2006 Medicaid LTC Expenditures going to community care services for adults with disabilities Rank
Oregon 55% 1
New Mexico 54% 2
Washington 54% 3
Alaska 51% 4
California 47% 5
Massachusetts 22% 20
“Whether it takes three years or thirty years---we’re going to keep on pushing for all individuals with disabilities to have the right to live in the most integrated settings appropriate to their needs. That’s what the Equal Choice law is really all about.” Norman concluded. “We are still living in a state with an unequal choice of care, and are still discriminating against individuals with disabilities by spending more of our tax dollars on the most restrictive form of care, instead of the most integrated form of care.”
* The General Court this week adopted a FY 2010 supplemental budget that added $10 million for nursing home rates, but only $200,000 for care managers in the home care program. Institutions got 50 times the funding that community care received.
* A new report from the state’s Executive Office of Human Services indicates that MassHealth spending on long term care supports is still dominated by institutions. In FY 2008, a total of $2.88 billion was spent by MassHealth for long term care---of which 61% ($1.748 billion) went to institutions, and only 39% went to community programs ($1.131 billion). If the two sectors had been in a 50/50 balance, community based services would have received an additional $308.6 million that year.
Fiscal Year Community Institutional Total % spent in % spent in
Spending Spending Spending community nursing homes
FY 2008 $1,131.627,326 $1,748,839,747 $2,880,467,073 39.3% 60/71%
Source: Massachusetts State Profile Tool, July, 2009. EOHHS
Three years after the Equal Choice Law was signed, here is a report on what has been implemented, and what has not:
1. PRE-ADMISSION COUNSELING. Chapter 211 created a Pre-Admission Counseling service for long term care which includes an assessment of community based service options for people in hospitals who are heading towards nursing homes. The purpose of this counseling is to help divert people into the community, and save Medicaid the expense of nursing home days. These assessments are mandatory for people seeking MassHealth payment, and must be offered to private paying consumers. The state is required to report the number of diversions to the community generated by pre-screening.
STATUS: Only 3 regional areas have a preliminary program---and only in selected hospitals on the North Shore, Metrowest, and Merrimack Valley regions. Less than $500,000 was allocated in FY 2009 for this project. In FY 2010, the legislature funded $2.5 million for expansion of this program. As of the 3rd. anniversary of the Equal Choice law, none of the new funds have been allocated to the field. The state has indicated that the so-called “Long Term Care Options” program will be pushed out statewide this year, but no timetable or contracts have been awarded. Consumers should have been able to access this program three years ago, regardless of where they live in the state.
2. ADOPT MASSHEALTH REGULATIONS. Chapter 211 requires the Division of Medical Assistance to adopt regulations to implement the “least restrictive and most appropriate”setting language.
STATUS: No activity. No changes to the regulations for Medicaid have been made.
3.SUBMIT AN 1115 WAIVER that establishes MassHealth eligibility at 300% of SSI and $10,000 asset level.
STATUS: This waiver was submitted to the federal Center of Medicare and Medicaid Services (CMS) in December, 2006. Two years and half years later, the 1115 waiver has been scrubbed for FY 2010, and there is no funding in the FY 2010 budget for this waiver. House 1 proposed to start the waiver in July, 2009. At one point in the budget process, a total of $41 million was requested by Governor Patrick—of which $20 M was from federal stimulus funds. The Governor’s budget said this waiver would seek “to encourage flexible service options in the community for those who might otherwise need to seek services in a facility setting. The proposed strategies will enable some individuals to continue to live independently in community settings and support others in returning to community settings from institutions.” In June, 2009 the Governor pulled his budget request for the waiver, reduced the line item to $0, and the item was not funded by the General Court.
“The recession alone cannot be blamed for the lack of progress in this civil rights law,” said Mass Home Care Executive Director Al Norman, who helped write the law. “Civil rights do not disappear in lean fiscal times. The fact is, keeping people at home is saving the state more than half a billion dollars annually in avoided nursing home costs. The Equal Choice law is part of the solution, not part of the problem.”
Norman said Mass Home Care will continue to urge the Patrick Administration to shift funds into the community. Although nursing home patient days have fallen nearly 20% since the year 2000, Norman said the state still needs to shift funds for elders into community settings, much as the state has already done for other populations, like the developmentally disabled. Norman said that funds for the developmentally disabled are 85% spent in the community. “Advocates for the developmentally disabled have shown us the way this should be done,” Norman said. In FY 2008, the state spent a total of $1.18 billion on Developmental Services, of which 84.5% went to community care. “That’s where we need to get with elderly long term care,” Norman admitted. “If community long term care got 84.5% of the spending as developmental services did,” Norman said, “we would have received an additional $1.3 billion in FY 2008. That’s a huge imbalance.”
“We should be much further along the path of ‘rebalancing’ how our tax dollars are spent in the community,” Norman noted. “Twenty-seven other states have a greater percentage of their long term care clients living at home.” As of 2006, the percentage of MassHealth long term care expenditures going to community care services in Massachusetts was only 22%---which ranked the state 20th in the nation. The top five states for “rebalancing” their expenditures into the community are:
State Percent of 2006 Medicaid LTC Expenditures going to community care services for adults with disabilities Rank
Oregon 55% 1
New Mexico 54% 2
Washington 54% 3
Alaska 51% 4
California 47% 5
Massachusetts 22% 20
“Whether it takes three years or thirty years---we’re going to keep on pushing for all individuals with disabilities to have the right to live in the most integrated settings appropriate to their needs. That’s what the Equal Choice law is really all about.” Norman concluded. “We are still living in a state with an unequal choice of care, and are still discriminating against individuals with disabilities by spending more of our tax dollars on the most restrictive form of care, instead of the most integrated form of care.”
Jul 28, 2009
Health Care Reform Leaves Out Seniors
The current debate over health care reform in Washington, D.C. has left many seniors scratching their heads---because the major worry of older people is not even being discussed. As of 2010, an estimated 40 million Americans will be over the age of 65—and that number will double to 80 million by the year 2040. By 2020 one in six Americans will be age 65 and older. The fastest growing segment of the aging population is individuals over the age of 85---often the most vulnerable older adults needing long-term care services and supports, and whose numbers will reach 7.3 million by 2020, and 15.4 million by 2040. Health care solutions in 2010 are totally out of touch with the graying of our population by 2040. An engineer might say we are designing for the wrong event. Whether or not there is an employer mandate to provide health care, for example, it is of little consequence to millions of seniors who are living in retirement, and have no employer. Just over a month ago, legislation was introduced in Congress that would reform the way long term care is provided to individuals with disabling conditions. For many seniors, the financial burden of long term care is more frightening---because Medicare covers very little long term care---and many seniors are not poor enough to get onto MassHealth. For seniors, health care reform is not the burning issue---it’s long term care reform. During this debate, Medicare has been called “socialized medicine,” so the obvious move to expand Medicare to younger populations is off the table.
The long term care legislation introduced is called Project 2020 (S. 1257/H.R. 2852), and its purpose is to improve the way consumers in all points of life (age, disability, income) access information on long-term care; to provide cost-effective health promotion and chronic disease management programs in every community to keep older adults healthier and thus save Medicare dollars, and to preventing people from spending their life’s savings to qualify for Medicaid nursing home eligibility by offering those most at-risk of nursing home care a range of home and community-based services to keep them off Medicaid in their own homes for as long as possible. This nursing home diversion program is estimated to create net savings of $27 million in Massachusetts from 2010 to 2014 by keeping people out of institutions.
Project 2020 provides the first coordinated national long-term care strategy that will generate savings in Medicaid and Medicare at the federal and state levels. At the same time, Project 2020 will enable older adults to get the support they need to successfully age where they want to—in their own homes and communities.
Project 2020 is estimated to reach over 41 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.8 billion over the first five years, resulting in a net savings to the federal government of nearly $250 million. The program would also generate significant savings for state governments.
This legislation builds on the existing network of community-based long-term care agencies. In Massachusetts, community based care has helped to drive down the number of Medicaid nursing home days by roughly 20% since 2000.
Project 2020 provides the nation’s rapidly increasing aging population, as well as persons with disabilities, with enhanced home and community-based support services while at the same time saving Medicaid and Medicare dollars.
The limited context of the health care debate is leaving many seniors cold. It’s time for Congress to remember long term care. One way to do that is to include Project 2020 in whatever health care reform bill has legs.
Until this happens, 40 million Americans are being left out of the debate.
(Courtesy of Mass Home Care)
The long term care legislation introduced is called Project 2020 (S. 1257/H.R. 2852), and its purpose is to improve the way consumers in all points of life (age, disability, income) access information on long-term care; to provide cost-effective health promotion and chronic disease management programs in every community to keep older adults healthier and thus save Medicare dollars, and to preventing people from spending their life’s savings to qualify for Medicaid nursing home eligibility by offering those most at-risk of nursing home care a range of home and community-based services to keep them off Medicaid in their own homes for as long as possible. This nursing home diversion program is estimated to create net savings of $27 million in Massachusetts from 2010 to 2014 by keeping people out of institutions.
Project 2020 provides the first coordinated national long-term care strategy that will generate savings in Medicaid and Medicare at the federal and state levels. At the same time, Project 2020 will enable older adults to get the support they need to successfully age where they want to—in their own homes and communities.
Project 2020 is estimated to reach over 41 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.8 billion over the first five years, resulting in a net savings to the federal government of nearly $250 million. The program would also generate significant savings for state governments.
This legislation builds on the existing network of community-based long-term care agencies. In Massachusetts, community based care has helped to drive down the number of Medicaid nursing home days by roughly 20% since 2000.
Project 2020 provides the nation’s rapidly increasing aging population, as well as persons with disabilities, with enhanced home and community-based support services while at the same time saving Medicaid and Medicare dollars.
The limited context of the health care debate is leaving many seniors cold. It’s time for Congress to remember long term care. One way to do that is to include Project 2020 in whatever health care reform bill has legs.
Until this happens, 40 million Americans are being left out of the debate.
(Courtesy of Mass Home Care)
Jun 30, 2009
Drug Companies Pledge $80 BILLION FOR OLDER ADULTS IN Health Care Reform
The White House announced an agreement with brand-name drug manufacturers to provide discounts of up to 50 percent for older adults and people with disabilities when they reach the coverage gap, or “doughnut hole,” in the Medicare Part D prescription drug benefit. The discount agreement would take effect only if it is part of successful health reform legislation.
Drug companies said they would give most people with Medicare a discount of up to 50 percent on brand-name and biologic medicines, but not generic drugs, that they purchase when they are in the coverage gap. Currently, Medicare Part D plans cover 75 percent of drug costs until the total amount (what the enrollee pays plus what the plan pays) reaches $2,700, and then individuals with Medicare must pay the full price for their drugs until their out-of-pocket spending exceeds $4,350.
The commitment came in a deal with the White House and Senator Max Baucus, Democrat of Montana and chairman of the Senate Finance Committee. However, the White House estimated that out of the $80 billion, $30 billion would be used to assist people with Medicare when they are in the doughnut hole, according to the New York Times. The other $50 billion reflects savings to the government that could be used as part of the health care reform package, but these savings have not yet been identified.
According to reports by the White House, people with Medicare Part D will not need to complete complicated paperwork to obtain the drug discounts directly from their pharmacies. Although individuals with Part D will pay half the cost of their drugs while they are in the coverage gap, the full cost of medicines will count toward their out-of-pocket limit. Courtesy of Medicarerights
Jun 24, 2009
"The Reverse Mortgage Man"
"The Reverse Mortgage Man"
07/07/09 @ 10:00 AM
What is a Reverse Mortgage? Would it be right for you or your loved one? Do you have questions about how reverse mortgages work? If you are an elder, a caregiver or a professional we have all the answers to these and other related questions. The Central Massachusetts Agency on Aging will collaborate with Joe DeMarkey, MetLife Bank to offer . . . [Learn More]
07/07/09 @ 10:00 AM
What is a Reverse Mortgage? Would it be right for you or your loved one? Do you have questions about how reverse mortgages work? If you are an elder, a caregiver or a professional we have all the answers to these and other related questions. The Central Massachusetts Agency on Aging will collaborate with Joe DeMarkey, MetLife Bank to offer . . . [Learn More]
Jun 21, 2009
Music Therapy Might Soften Depression Symptoms
Music therapy might help ease the symptoms of depression, though its effectiveness as a stand-alone intervention is not certain, according to a recent review of five small studies.
Four of the studies found reduced depression symptoms in participants receiving music therapy compared to those who did not. The fifth study did not find any difference.
The benefits of music appeared greatest when providers used theory-based therapeutic techniques rather than “winging it.”
Jun 17, 2009
Jun 1, 2009
Stimulus Check Scams
Q: Are seniors being targeted by stimulus check scams?
A: Yes. It’s scam time across America, because in May the federal government sent out $250 economic recovery payments to more than 50 million people who receive Social Security, Supplemental Security Income (SSI), Railroad Retirement (RRB) or Veterans Administration (VA) disability benefits. No action on your part was required to get the payment, which was sent separately from your regular monthly payment. But all that money has attracted scam artists on the internet.
To be mailed a payment, you must have received a Social Security, SSI, RRB or VA benefit during the months of November 2008, December 2008, or January 2009. You should not contact the Social Security Administration (SSA) unless a payment is not received by June 4th.
Anytime millions of people are waiting for checks, scam artists are waiting to take advantage of them. In one scam, an email was sent out bearing a picture of President Barack Obama, promising a “free stimulus check” of varying amounts, from $613.27 to several thousand dollars. Recipients of the email were directed to another website, where they have to “participate in the program” in order to get a check. Participation requires that they complete several “reward offers,” such as magazine subscriptions the consumer has to buy, or getting a credit card that’s only activated with a purchase.
Another scam sends consumers something that appears to be a stimulus check. Instructions tell consumers to call a toll-free number. When they do, they’re told to deposit the check---but to wire a certain amount back, either to enter into foreclosure rescue or to get information on how to use stimulus money to buy foreclosed properties in the area.
The Federal Trade Commission reports that scam operators ask you to send a small processing fee, supposedly to get a much larger check in return. Or, scammers ask for your bank account number so they can “deposit” your check. Then, they use the information to clean out your account or open new ones using your identifying information. Some stimulus scams encourage you to click on internet links, open attached forms, or call phony toll-free numbers. But simply clicking the link or opening the document can install harmful software, like spyware, on your computer. The result could be your personal information ending up in the hands of an identity thief.
If you come across suspected scams, there are various places for you to file complaints. To file a complaint about frauds, go to the Federal Trade Commission (FTC) website, https://www.ftccomplaintassistant.gov/ or email your report to the Internal Revenue Service (IRS) at phishing@irs.gov. E-mail scams referred to as “phishing” seek personal data and financial account information that enables another party to access your bank account or to engage in identity theft.
The important thing to remember is that the Treasury Department, the IRS, your bank, and your credit card company----none of them---will call you up or email you for private account information---because they already have it. If you get an email or a phone call asking for bank account numbers, credit card numbers, or offering you economic stimulus money---report them. For more on stimulus check scams, go to www.recovery.gov
A: Yes. It’s scam time across America, because in May the federal government sent out $250 economic recovery payments to more than 50 million people who receive Social Security, Supplemental Security Income (SSI), Railroad Retirement (RRB) or Veterans Administration (VA) disability benefits. No action on your part was required to get the payment, which was sent separately from your regular monthly payment. But all that money has attracted scam artists on the internet.
To be mailed a payment, you must have received a Social Security, SSI, RRB or VA benefit during the months of November 2008, December 2008, or January 2009. You should not contact the Social Security Administration (SSA) unless a payment is not received by June 4th.
Anytime millions of people are waiting for checks, scam artists are waiting to take advantage of them. In one scam, an email was sent out bearing a picture of President Barack Obama, promising a “free stimulus check” of varying amounts, from $613.27 to several thousand dollars. Recipients of the email were directed to another website, where they have to “participate in the program” in order to get a check. Participation requires that they complete several “reward offers,” such as magazine subscriptions the consumer has to buy, or getting a credit card that’s only activated with a purchase.
Another scam sends consumers something that appears to be a stimulus check. Instructions tell consumers to call a toll-free number. When they do, they’re told to deposit the check---but to wire a certain amount back, either to enter into foreclosure rescue or to get information on how to use stimulus money to buy foreclosed properties in the area.
The Federal Trade Commission reports that scam operators ask you to send a small processing fee, supposedly to get a much larger check in return. Or, scammers ask for your bank account number so they can “deposit” your check. Then, they use the information to clean out your account or open new ones using your identifying information. Some stimulus scams encourage you to click on internet links, open attached forms, or call phony toll-free numbers. But simply clicking the link or opening the document can install harmful software, like spyware, on your computer. The result could be your personal information ending up in the hands of an identity thief.
If you come across suspected scams, there are various places for you to file complaints. To file a complaint about frauds, go to the Federal Trade Commission (FTC) website, https://www.ftccomplaintassistant.gov/ or email your report to the Internal Revenue Service (IRS) at phishing@irs.gov. E-mail scams referred to as “phishing” seek personal data and financial account information that enables another party to access your bank account or to engage in identity theft.
The important thing to remember is that the Treasury Department, the IRS, your bank, and your credit card company----none of them---will call you up or email you for private account information---because they already have it. If you get an email or a phone call asking for bank account numbers, credit card numbers, or offering you economic stimulus money---report them. For more on stimulus check scams, go to www.recovery.gov
May 13, 2009
ElderCare 2009
ElderCare 2009 was a great success, attended by many seniors, caregivers and professionals. The entertainment was surpurb and the event was well represented by agencies throughout the aging network.
Mar 28, 2009
Foot Care
When we are in love, we may be "swept off our feet." When we don't want to do something, we are said to have "cold feet." A sensible person "has both feet on the ground." Sometimes we even "vote with our feet."
It's important to put "your best foot forward." Be kind to your feet. Years of wear and tear can be hard on feet. So can disease, bad circulation, poorly trimmed toenails, and wearing shoes that don't fit right. Foot problems are sometimes the first sign of more serious medical conditions such as arthritis, diabetes, and nerve or circulatory disorders.
Step in the Right Direction
Practice good foot care. Check your feet often, or have a member of your family check them. If you have a problem with your feet, your family doctor can help or you can see a podiatrist (doctor who treats feet). Sometimes, the special skills of an orthopedic surgeon or dermatologist are needed.
One easy step to take is to remember to put your feet up when you are sitting down. This helps keep blood moving to your feet. So can stretching, walking, or having a gentle foot massage. A warm foot bath is also helpful, but make sure your feet are dry before you put on your shoes. Try to avoid pressure from shoes that don't fit. Don't sit for a long time or keep your legs crossed for too long. Don't smoke.
Make Sure the Shoes Fit
Protect your feet by wearing shoes whenever you go outdoors. Wearing comfortable shoes that fit well can prevent many foot problems. Here are some tips for making sure your shoes fit:
- Shoe size may change as you age so always have your feet measured before buying shoes. The best time to measure your feet is at the end of the day when your feet are largest.
- Most of us have one foot that is larger than the other; fit your shoe to your larger foot.
- Don't buy shoes by the size without trying them on first. The size marked inside the shoe may not fit you.
- Walk in the shoes to make sure they feel right.
- Choose a shoe that is shaped like your foot. Styles like high heels or pointed toes can hurt feet.
- Stand up when trying on shoes to make sure there is about ½ inch between your toe and the end of the shoe.
- Make sure the ball of your foot fits comfortably into the widest part of the shoe.
- Don't buy shoes that feel too tight and hope that they will stretch.
- The heel of the shoe should not slide up and down on your heel when you walk.
- The upper part of the shoes should be made of a soft, bendable material to match the shape of your foot.
- Soles should give solid footing and not slip. Thick soles cushion your feet when walking on hard surfaces.
- Low-heeled shoes are more comfortable, safer, and less damaging than high-heeled shoes.
Something's Afoot: Common Problems...To read the entire article click here: Four Corners
For more information about health and aging, contact: National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, Maryland 20898-8057
800-222-2225
800-222-4225 (TTY/toll-free)
www.nia.nih.gov
To order publications (in English or Spanish) or sign up for regular email alerts, visit www.nia.nih.gov/HealthInformation.
Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. There are also special features that make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.
National Institute on Aging; U. S. Department of Health and Human Services; Public Health Service; National Institutes of Health; May 2007
Mar 26, 2009
Leader Article on Four Corners
Massachusetts Groups Reach Out to Gay and Lesbian Elderly Population
Cathryn Domrose
Even in Massachusetts, which is considered a beacon of tolerance and diversity for many gay, lesbian, bisexual, and transgender Americans, the older members of this group remain in the shadows, as in the rest of the country.
Many fear going into assisted-living or skilled nursing facilities, or getting home health care, say those who work in agencies serving gay and lesbian elders. They retreat into the closet rather than face scornful remarks of fellow residents or possible discrimination from caregivers.
But a growing number, led by aging gay and lesbian baby boomers, are starting to assert themselves. They are familiar with anti-discrimination laws and are not afraid to make sure those laws are enforced. They are looking for retirement complexes, assisted-living facilities, and skilled nursing facilities that not only tolerate them, but welcome them.
"I think people are gradually coming out more," says Linda S. George, RN, MA, CAN, executive director of Boston Senior Care, a home health agency that serves about 3,000 people in the city. "And young gay people are very much out. I think things will be equal in 50 years, maybe 40."
To read entire article please go to Connection for Caregiver
Mar 24, 2009
Massachusetts Groups Reach Out to Gay and Lesbian Elderly Population
Even in Massachusetts, which is considered a beacon of tolerance and diversity for many gay, lesbian, bisexual, and transgender Americans, the older members of this group remain in the shadows, as in the rest of the country.
Many fear going into assisted-living or skilled nursing facilities, or getting home health care, say those who work in agencies serving gay and lesbian elders. They retreat into the closet rather than face scornful remarks of fellow residents or possible discrimination from caregivers.
But a growing number, led by aging gay and lesbian baby boomers, are starting to assert themselves. They are familiar with anti-discrimination laws and are not afraid to make sure those laws are enforced. They are looking for retirement complexes, assisted-living facilities, and skilled nursing facilities that not only tolerate them, but welcome them.
"I think people are gradually coming out more," says Linda S. George, RN, MA, CAN, executive director of Boston Senior Care, a home health agency that serves about 3,000 people in the city. "And young gay people are very much out. I think things will be equal in 50 years, maybe 40."
Agencies Join Efforts
In the meantime, some agencies and companies that serve the elderly - including Boston Senior Home Care - are actively working with staff and clients to become more welcoming to lesbian, gay, bisexual, and transgender elders, including offering training for nurses and other healthcare workers. A skilled nursing facility in the Boston area, the Chelsea Jewish Nursing Home, plans to break ground next year for a unit specifically for elderly gay and lesbian residents.
About 2.4 million Americans older than 55 are gay, lesbian, or bisexual, according to researchers at the University of California in Los Angeles. But many hide behind a wall of fear and isolation, says Lisa Krinsky, director of the LGBT Aging Project in Massachusetts. The project's services include cultural competency training sessions for agencies and facilities that work with aging adults.
Gay and lesbian elders are more likely to live alone, without children or other family members to care for them. They may limit visits from friends for fear their neighbors may guess they are not heterosexual. "I know how older people have a secret life," says Michael Ridolfi, RN, BSN, MEd, director of health services at BSHC. "They weren't raised to be out in the open the way people are today."
Friendly Visits
Studies of gay, lesbian, bisexual, and transgender elders show their greatest fear in going into retirement communities, assisted-living, or skilled nursing facilities is for their safety. The next greatest fear is they won't be cared for properly. If gay and lesbian elders know a facility will be friendly and welcoming to them, many of them are more likely to self-identify rather than return to the closet, say those who work with lesbian, gay, bisexual, and transgender elders.
Krinsky says a lot of nurses want to know why they should care whether someone is gay or lesbian, if all they are doing is managing a patient's health.
"The fact is that folks may simply feel better about their treatment if they're not holding a secret and if they know that their provider knows and respects them."
If gay and lesbian elders know a facility will be friendly and welcoming to them, they are more likely to self-identify rather than to return to the closet, say those who work with lesbian, gay, bisexual, and transgender elders. They are more likely to have friends visit and less likely to become isolated, lonely, or depressed.
On home-care visits, Ridolfi looks for certain clues - someone living alone with no children or photos featuring a specific person. They may never openly tell him they are gay, he says, but they often relax and start talking. "They are always glad to have somebody to talk to," Ridolfi says. "And they always look forward to my visits.
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