Thursday, April 15, 2010 New Option for Veterans: Adult Foster Care Homes
This is an idea that I have thought would be coming along. It combines the desireability of remaining outside of an assisted living facility and reduced costs to the Veterans Adminisration. Look for these pilot programs to begin poppig up in the medicaid arena as well.
The federal government's ambitious new drive to cut costs and improve care for disabled military veterans begins not in a big-city hospital, but here in small-town Arkansas, in a tidy brick bungalow set back from a country road. Daffodils bloom outside the bungalow, and a ginger-and-white cat snoozes on the stoop. Inside, Roy Strange, a 90-year-old Army vet, stretches out in a recliner to watch a video about model trains. Mr. Strange suffers several combat-related ailments from his service in World War II and is thus eligible for subsidized nursing-home care, paid for entirely by the Department of Veterans Affairs. Instead, he chooses to spend his own money to stay in this "medical foster home," run by private caretakers, Cristina and Cornell Onecic. The home is one of hundreds across the country that take in veterans who can't care for themselves, but don't want to live in an institution. The vets pay the foster family's expenses, while the VA covers the costs of regular visits from health-care providers, such as nurses, therapists and dietitians. The result is dramatically lower costs—the VA pays just about $52 a day for patients in foster homes, compared with an average of $469 for those in nursing homes. And many vets like Mr. Strange say they're far happier. The medical foster-home program began in Arkansas a decade ago but remained a pilot project until its director, Thomas Edes, began aggressively promoting it as a way to cut costs and boost the quality of life for severely disabled vets. In 2008, Congress set aside $9 million to expand the program. Last year, that expansion began, with the VA bringing programs to 19 states and Puerto Rico, and Dr. Edes aims to launch still more medical foster homes this year.
Source: Wall St. Journal (April 13, 2010)
Full story: http://online.wsj.com/article
/SB10001424052748703909804575124451841717276.html?mod=googlenews_wsj
Friday, April 09, 2010 Health Reform: What Changes Are in Store for the Elderly?
Back in March, I posted a great outline on the implementation of health care reform. The folks at ElderLaw Answers have also issued a primer on its effects on seniors:
After a year of legislative wrangling and premature forecasts of death, historic legislation overhauling the nation's health insurance system has passed the Congress and been signed into law by President Obama. The measure that finally prevailed, the Patient Protection and Affordable Care Act, is the same legislation the Senate had approved on Christmas Eve of 2009, although it was amended somewhat by a separate "budget reconciliation" measure that President Obama also signed into law.
Because the core health reform measure enacted is the Senate version, much of what we wrote in our earlier article, "The Effects of Health Care Reform on Long-Term Care," still applies. Just substitute "the newly enacted law" wherever "the Senate bill" appears in the earlier article. The legislation that President Obama signed still contains:
The nation's first publicly funded national long-term care insurance program, the Community Living Assistance Services and Supports (CLASS) Act. Its original sponsor, the late Sen. Edward M. Kennedy, did not live to see one of his legislative dreams enacted into law;
A number of provisions aimed at ending Medicaid's "institutional bias," which forces elderly and disabled individuals in many states to move to nursing homes;
Provisions that will help protect nursing home residents and other long-term care recipients from abuses, and give families of nursing home residents more information about the facilities their loved ones are living in or considering moving to; and
The Elder Justice Act, which will establish an "Elder Justice Coordinating Council" and provide federal resources to support state and community efforts to fight elder abuse.
Help for Medicare Recipients and Early Retirees
Of perhaps greatest interest to seniors, the law will eventually close the Medicare Part D coverage gap known as the "doughnut hole." As most seniors know, the Medicare Part D prescription drug program covers medications up to $2,830 a year (in 2010), and then stops until the beneficiary's out-of-pocket spending reaches $4,550 in the year, when coverage begins again. Many seniors fall into this "doughnut hole" around Labor Day, at which point they have to pay for the medications out of pocket through the end of the year.
The law starts the process of closing the gap by providing a $250 rebate to Medicare beneficiaries who fall into the doughnut hole in 2010. Then, beginning in 2011 there will be a 50 percent discount on prescription drugs in the gap, and the gap will be closed completely by 2020, with beneficiaries covering only 25 percent of the cost of drugs up until they have spend so much on prescriptions that Medicare's catastrophic coverage kicks in, at which point copayments drop to 5 percent.
In addition, starting January 1, 2011, Medicare will provide free preventive care: no co-payments and no deductibles for preventive services such as glaucoma screening and diabetes self-management. Also, the legislation increases reimbursements to doctors who provide primary care, increasing access to these services for people with Medicare.
The law provides help for early retirees by creating a temporary re-insurance program that will help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Scheduled to run from June 21, 2010 through January 1, 2014, the reinsurance program will pay 80 percent of eligible claim expenses incurred between $15,000 and $90,000.
The law calls for an increased Medicare premium for those individuals earning more than $200,000 a year and married couples whose income exceeds $250,000. The law also applies the Medicare payroll tax to net investment income for couples earning more than $250,000 a year or individuals earning more than $200,000 a year.
Most of the cost savings in the law are in the Medicare program, which has made many seniors fearful that their benefits will be cut. The cost-saving measures do not affect the basic Medicare benefits to which all enrollees are entitled, but they may affect those enrolled in private Medicare Advantage plans. Medicare has been paying insurers who offer these plans more than it spends on average for Medicare beneficiaries. The original idea of Medicare Advantage was to save money by paying them less, the idea being that private insurers could be more efficient than the federal government. The opposite turned out to be the case.
Health care reform will pay the private insurers less, meaning that some will choose not to continue their plans and others will curtail extra benefits they offer enrollees, such as reimbursement for gym membership or free eyeglasses. But the cuts will be gradual, with the largest not beginning until 2015. The law also offers bonuses to efficiently run Advantage plans.
Another provision in the law will cut Medicare reimbursements to nursing homes by about $15 billion over the next decade. While nursing homes get only about 13 percent of their revenue from Medicare, the industry relies on the money to make up for low Medicaid reimbursement.
A combination of the additional revenue and savings are estimated to extend the life of the Medicare Part A trust for an additional 7 to 10 years from its current insolvency date of 2017.
For more on this topic:
http://www.elderlawanswers.com/resources/article.asp?id=8171&Section=4&state= Tuesday, March 30, 2010 Alzheimer's Disease facts and figures-2010 update
The Alzheimer's Association recently released 2010 Alzheimer's Disease Facts and Figures. This report provides U.S. data on Alzheimer's disease and other dementias, including prevalence, mortality, lifetime risk, caregiving information, and use and costs of care and services. This 2010 report focuses on race, ethnicity and Alzheimer's disease. It reveals that, in 2009, there were nearly 11 million informal caregivers providing 12.5 billion hours of care, valued at $144 billion, to people with Alzheimer's disease and other dementias.
Source: Alzheimer's Association (March 2010)
Full story: http://www.alz.org/alzheimers_disease_facts_figures.asp?type=homepage Wednesday, March 24, 2010 Down Syndrome patients may help unlock the mysteries of aging
In 1950, when Marybeth Solinski was born, a diagnosis of Down syndrome was practically a death sentence. Children with the condition often died before their 10th birthday. Yet Solinski, at 59, has outlived her parents. She has even joined AARP. Her longevity illustrates the dramatic progress for people with Down syndrome. Thanks to better medical care, the average life expectancy for a child with Down syndrome is now 60 years, according to the National Down Syndrome Society, which estimates that about 400,000 people are living with the condition in the USA. As they live longer, adults with Down syndrome — who have an extra copy of chromosome 21 — are teaching scientists about the genetic roots of aging, says Ira Lott, head of pediatric neurology at the University of California-Irvine School of Medicine. Scientists today are searching this chromosome, which contains only about 200 of the body's roughly 20,000 genes, to learn why people with Down syndrome suffer disproportionately from some health problems, such as Alzheimer's disease, but are spared many others, such as heart attacks, strokes and certain types of cancer. By studying adults with Down syndrome, researchers hope to find new ways to combat diseases of aging in the larger population as well, Lott says. "It's an interesting detective story," says Lott, head of the science advisory board of the National Down Syndrome Society. "People with Down syndrome are unique when it comes to many aspects of aging."
Source: USA Today (March 22, 2010)
Full story: http://www.usatoday.com/news/health/2010-03-22-down22_CV_N.htm
Wednesday, March 17, 2010 NAPSA survey shows grim consequences of budget cuts for elder abuse prevention
In December 2008, the National Adult Protective Services Association (NAPSA) reported survey results indicating that the national economic crisis was having a negative impact on Adult Protective Services (APS). The survey revealed that state APS programs were experiencing budget reductions which led to cutbacks in service provision and the work force. Of the eighteen states participating in the 2008 survey, eight states reported that they expected to experience APS program budget cuts ranging from two to ten percent for the upcoming fiscal year. Unfortunately, a year later, the findings of a recently released NAPSA survey have reinforced the grim assessments of the 2008 report with evidence of more budget cuts and staff shortages along with an increased need for services. This survey, conducted in November 2009, was sent to APS state administrators and the NAPSA board. Responses were received from thirty states. More than half of the respondents reported APS budget cuts averaging 13.5 percent for the year, which surpassed the predicted budget cuts of the earlier survey. At the same time, two-thirds of respondents said that abuse reports to APS increased by 24 percent. The corresponding increased need for services, along with the reduction of services, is obvious cause for concern and will likely have grave consequences for the most vulnerable adults.
Source: NCEA E-News (March 2010)
Full story: http://ncea.aoa.gov/NCEAroot/Main_Site/Resources/Newsletter/current_newsletter.pdf
I have recently been involved in a couple of cases that involved our local Adult Protective Services unit of the Henry-Martinsville Department of Social Services. In one case, some neighbors may have noticed strange things going on but did not report them. This case ultimately led to two deaths. In the second case, attentive visitors reported strange goings on and the APS Unit was able to remove the elder from the environment, get her needed medical care and now she is in a safe long term care facility.
If you see changes in your elderly friends, pay attention! If they become reclusive or if they won't let you in the home that is a big warning sign! If you notice weight loss, bruises or even unattended sores those are signs that should be reported to APS. The reporting is kept anonymous and could possibly save a life! Wednesday, April 29, 2009 WelcomeWelcome to the VAElderLaw Blog. As you are probably already aware, a "BLOG" is the name given to a web log. Simply put, it's my regulary updated account of ideas, court decisions, and opinions on Elder law, Estate Planning adn Financial Planning.
When I find something interesting, I will post it here iwth a link to where you can explore the issue further if you wish. It is my hope to add posts daily and to add original posts once or twice a week. So, come by often!
If you have a question or wish to know more about an issue, let me know. I will try to do some research and then post it here. |