Elder Law Task Force

Elder Law Task Force content posted in order of most recent to oldest.

SSA Urges Same Sex Couples To Apply for Social Security Now

Carolyn Colvin, the Acting Commissioner of the Social Security Administration (SSA) has issued a statement on Social Security benefits for same sex couples, stating that some applications for spousal benefits are now being processed. In the statement, she also says, "I encourage individuals who believe they may be eligible for Social Security benefits to apply now, to protect against the loss of any potential benefits."

The important benefits she refers to include 1) the Social Security spousal benefit which can provide the lower earning spouse with a benefit equal to one half the benefit of the higher earning spouse, 2) the survivor benefit which provides the lower earning spouse with a benefit equal to that of the deceased, and 3) the $255 death benefit.

The applications, which can now be processed, are limited to spousal retirement benefits and then only if the marriage was performed in the state in which the higher earning spouse is domiciled at the time of application. SSA plans to begin processing additional categories of applications in the next several weeks and months.

Straight Talk for Seniors on Health Care Reform

Many older adults are wondering - how is health care reform going to affect me?  If your clients, friends or relatives are asking about whether health care reform will hurt their Medicare, or what it means for them -be sure to share these great educational materials from the National Council on Aging (NCOA). 

Let them know how health care reform helps with prescription drug costs, provides free preventive care for seniors, makes Medicare more solvent, and improves long term services and supports.

Fact Sheets

CMS Releases Final Rule on Medicaid, CHIP and Health Insurance Marketplaces

HHS Intergovernmental and External Affairs Notification

 July 5, 2013


From: Paul Dioguardi

            Director, Office of Intergovernmental and External Affairs

            U.S. Department of Health and Human Services

RE:   CMS Releases Final Rule on Medicaid, CHIP and Health Insurance Marketplaces

 Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing provisions of the Affordable Care Act related to eligibility, enrollment, and benefits in Medicaid, the Children’s Health Insurance Program (CHIP) and the Health Insurance Marketplace.

 This final rule addresses aspects of the Medicaid, CHIP and Marketplace eligibility notices and appeals processes; provides additional flexibility regarding benefits and cost sharing for state Medicaid programs; codifies several eligibility and enrollment provisions included in the Affordable Care Act and the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and provides operational guidance to help states implement their Health Insurance Marketplaces.

 This final rule does not address all of the proposed regulatory changes included in the notice of proposed rulemaking (NPRM) released on January 22, 2013.  In order to best assist states in preparation for the availability of new coverage beginning January 1, 2014, this rule focuses on those provisions that are most critical for implementation.  CMS intends to address the remaining provisions of the January NPRM in future rulemaking.

 The final rule is available on display at the Federal Register here:

http://www.ofr.gov/(X(1)S(1vpecb3pcilomwwvusd4jf2b))/OFRUpload/OFRData/2013-16271_PI.pdf

The accompanying fact sheet about the final rule:

 http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-Fact-Sheets-Items/2013-07-05.html

  

 

Questions or Concerns? Contact HHSIEA@hhs.gov

 

Healthcare.gov - Open for Business

From the National Health Law Program

Today HHS relaunched https://www.healthcare.gov/ with an emphasis on providing information related to eligibility and open enrollment (98 days away!).  A press release announcing the relaunch is here.

Healthcare.gov will help individuals get ready for October 1 and link them to available coverage now.  For individuals in states with state-based marketplaces (SBMs), the site provides a link to the SBM’s website. For states using the federally facilitated marketplace (FFM), healthcare.gov will be the on-line portal.

 By October, healthcare.gov will allow consumers to create accounts, complete an online application, and shop for qualified health plans.  Between now and the start of open enrollment, the Marketplace call center will provide educational information and, beginning Oct. 1, 2013, will assist consumers with application completion and plan selection. 

For Spanish speaking consumers, CuidadoDeSalud.gov will be updated to match healthcare.gov’s consumer focus.  “Resources in Other Languages” at the bottom of healthcare.gov links to 12 “taglines” that provides the phone number for the federal call center so limited English proficient consumers can receive information directly in their non-English languages. More languages should be added soon and the call center can provide interpreting services in over 150 languages.

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FINAL HC Relaunch press release 6-21-2013.pdf177.19 KB

New Healthy Housing Standards Released

From the Maryland State Health Improvement Process:

Approximately 30 million families live in unsafe and unhealthy housing with an array of problems and necessary repairs including broken heating and plumbing, holes in walls and windows, roach and rodent infestation, crumbling foundations, and leaking roofs. These housing conditions can lead to serious health and safety hazards that can cause allergies, asthma, injuries, cancer, and lead poisoning, which increase health care costs and negatively impact children's health, development, and well-being. A new standard recently published by the American Public Health Association and the National Center for Healthy Housing ensures the health and safety of U.S. homes by defining appropriate livable housing conditions. The National Healthy Housing Standard identifies hazardous living conditions and offers safety protections to address these problems, with recommendations for household systems, including plumbing; lighting and electricity; heating, ventilation and energy efficiency; moisture and mold control; pest management; and chemicals such as radon, lead, formaldehyde and asbestos. The standard is intended to be used by government agencies and property owners to make certain that the nation's housing stock is adequately maintained and protects the health and safety of residents. The National Committee on Housing and Health, which monitored the standard's development, is requesting comments on the standard through July 31.

Click here to read the entire press release.

HUD Issues New Guidance to Encourage Integrated Housing

From the Administration on Community Living: The U.S. Department of Housing and Urban Development (HUD) last week issued new guidance to HUD-assisted housing providers on how they can support state and local Olmstead efforts to increase the integrated housing opportunities for individuals with disabilities who are transitioning from, or at serious risk of entering, institutions and other restrictive, segregated settings.

 Read more.

 

More on this from the Bazelon Center for Mental Health Law:

New HUD Olmstead Guidance Step in Right Direction

Washington -- June 5, 2013 -- The U.S. Department of Housing and Urban Development (HUD) has issued new guidance on how the U.S. Supreme Court's ruling in the

Olmstead case applies to HUD's programs and activities. The guidance makes clear that HUD and entities that receive financial assistance from HUD must provide housing for people with disabilities in the most integrated setting appropriate to their needs. Integrated settings, according to the guidance, are "those that provide individuals with disabilities opportunities to live, work, and receive services in the greater community, like individuals without disabilities."

 Examples of integrated settings include scattered-site apartments providing supportive housing, rental subsidies that enable individuals with disabilities to obtain housing on the open market, and apartments for individuals with disabilities scattered throughout housing developments. "By contrast," the guidance states, "segregated settings are occupied exclusively or primarily by individuals with disabilities."

 The guidance is intended to better educate state and local housing agencies, housing developers, and housing providers on their obligations under the "integration mandate" of the Americans with Disabilities Act (ADA).  To make real the promise of the ADA, the guidance instructs, "additional integrated housing options scattered throughout the community" are needed.       

 In issuing the guidance, HUD Secretary Shaun Donovan recognized that the "Olmstead decision-and subsequent voluntary Olmstead planning and implementation, litigation by groups representing individuals with disabilities, and Department of Health and Human Services and Department of Justice enforcement efforts-is creating a dramatic shift in the way services are delivered to individuals with disabilities." He affirmed that "HUD is committed to offering housing options that enable individuals with disabilities to live in the most integrated settings possible and to fully participate in community life."  

 "We are encouraged by the issuance of this guidance and its important recognition that HUD-subsidized housing must afford people with disabilities the chance to live in the most integrated setting," said Jennifer Mathis, director of programs for the Judge David L. Bazelon Center for Mental Health Law. "The vast majority of people with disabilities want to live in ordinary housing. We hope this guidance will spark development across the country of mainstream housing for people with disabilities."  

 The HUD guidance can be found at  

http://portal.hud.gov/hudportal/documents/huddoc?id=OlmsteadGuidnc060413.pdf

Finding Lost Pension Plans: Webinar

Date: 
Tue, 06/18/2013 - 12:30pm

For those who wished you could come to our pension rights training in March, or who are yearning for more, here's your chance!  See information below about a new webinar on finding lost pensions! - help your clients get the money they are owed.

The webinar Finding Lost Pension Plans is hosted by the Pension Rights Center, a grantee of the U.S. Administration for Community Living/Administration on Aging.  Participants in this webinar will learn about the problem of lost pension plans and the resources available to find these plans.

 Speaker:  Emily Spreiser, Staff Attorney, Pension Rights Center

 Date: June 18, 2013

Time: 12:30 p.m. EDT

 Register.

 

Sponsor: 
Pension Rights Center

Maryland Health Progress Act Ensures Access to Quality, Affordable Care

From the SHIP Health Action Newsletter

Effective June 1st, 2013, the Maryland Health Progress Act completes a three year process to ensure that hundreds of thousands of Marylanders that formally had little to no access to quality, affordable health care now have options that have never existed before.  The bill promotes transparency, non-discrimination, and fiscal responsibility that will help create a robust marketplace and provide feasible options for many Marylanders left out in the cold.  This legislation also makes sure that we continue the progress of 2007 that expanded Medicaid thousands of residents.

 Signed into law in May of 2013, the Maryland Health Progress Act expands Medicaid to 133% of federal poverty, establishes a dedicated funding stream for the Maryland Health Benefit Exchange, provides for the migration of Maryland Health Insurance Plan (MHIP) members in order to ease their transition and moderate the potential impact on rates, allows for the development of a state reinsurance program to counteract potential short term pressures on rates, establishes policies to promote continuity of care when individuals move in and out of Medicaid and commercial insurance, and makes other changes necessary for the Maryland Health Benefit Exchange to achieve final certification as a state-based exchange.

 Click here for an advocate's guide to the Maryland Health Progress Act of 2013.

 View the SHIP measures and tools for increasing the proportion of people with health insurance.

Maryland Ranks 10th for Senior Health

From the Maryland SHIP Health Action Newsletter:

The recent UnitedHealthcare Foundation's America's Health Rankings Seniors 2013 Report evaluated senior health based on weighted health indicators, including obesity, smoking and chronic illnesses. Other measures in this evaluation included the number of doctors and other medical professionals serving the community, hospital use and medical procedures. According to the findings of the report, Maryland ranked 10th among states for senior health with low levels of debilitating arthritis pain and falls, and a proportionate supply of geriatricians across the state.

 

The reported challenges in Maryland's senior health surround the limited supply of home health aides. The UnitedHealthcare Foundation suggests that Maryland has room for improvement in the following indicators: getting better prescription drug coverage for seniors, improving healthy eating habits among seniors and increasing the supply of home health workers. Since the population of older adults in Maryland is expanding, improving services and resources targeted toward this population is essential for continued health improvements in the state.

 

Click here to read the America's Health Rankings Seniors Report.

 

Click here to view the SHIP featured topic for healthy aging.

 

View the Mental Health and Depression, Alzheimer's, and Oral Health issue briefs focusing on older adult health.

World Elder Abuse Awareness Day UN Event

Date: 
Fri, 06/14/2013 (All day)

JOIN US IN RECOGNIZING 

“WORLD ELDER ABUSE AWARENESS DAY”

 Friday, June 14, 2013

  GOVERNMENTAL AND UN PERSPECTIVES

 Speakers include representatives from the United Nations,

 the United States, Canada and other governments

 1:15 pm to 2:30 pm,

Conference Room 5, North Lawn Building

United Nations, 46th Street & 1st Avenue

 

This will be live streamed and archived at http://webtv.un.org/

 

***********************************************

                NGO PERSPECTIVES and RECEPTION

Speakers include representatives from AARP, HelpAge International

and the UN NGO Committee on Ageing

 

3:00 pm to 4:30 pm

U.S. Mission to the United Nations, 799 United Nations Plaza

between E. 44th & E. 45th on First Ave.

across the street from United Nations Headquarters

 Space is limited and RSVPs are required

Please contact Marla Bush at 202-357-3508 or marla.bush@acl.hhs.gov.

 

World Elder Abuse Awareness Day was launched on June 15, 2006 by the International Network for the Prevention of Elder Abuse (INPEA) and the UN’s World Health Organization.  On March 9, 2012, the UN General Assembly resolution 66/127 established June 15 as a UN International Day.

 

This event is hosted by the Administration for Community Living, U.S. Department of Health and Human Services, Human Resources and Skills Development Canada, the UN Department of Economic and Social Affairs, the U.S. Mission to the UN, the UN NGO Committee on Ageing and AARP. 

New Analysis Shows Maryland's Share of Seniors Living in Poverty is at Least Double the Official Rate

Maryland's Supplemental Poverty Rate is 17%, compared to the official rate of 8%.  See news release below from the Kaiser Family Foundation.

New Analysis Finds Share of Seniors Living in Poverty at Least Double the Official Rate in 12 States Under Census Bureau's Supplemental Poverty Measure

The Census Bureau's official poverty measure estimates that 9 percent of seniors nationally live in poverty. However, some have criticized that measure for not taking into account health care costs, the impact of taxes, and in-kind government assistance (such as assistance with energy costs) and for not varying poverty standards regionally based on the cost of living. To address those concerns, the Census Bureau in 2011 released an alternative "supplemental" poverty measure that shows 15 percent of seniors nationally living in poverty. The increase in the poverty rate is largely due to the consideration of health care costs in the supplemental measure.

A new Kaiser Family Foundation analysis presents state-by-state poverty rates among seniors, based on the supplemental measure. Under this measure, the share of seniors living in poverty is higher in every state than under the official measure, and is at least double the official rate in 12 states: California, Colorado, Connecticut, Hawaii, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, Nevada, Wisconsin, and Wyoming. The District of Columbia has the highest rate under the supplemental measure, with about one in four (26%) seniors living in poverty.

The study includes examples that show how a senior who is not classified as living in poverty under the official measure is considered to be living in poverty under the supplemental measure, because of high out-of-pocket medical costs or because of high housing costs where they live, for example.

The analysis provides context for assessing the implications of proposals under consideration in the deficit-reduction debate that would affect seniors with modest incomes, including proposals that would raise costs for people on Medicare or scale back Social Security benefits. Proposals to raise Medicare cost-sharing requirements or premiums, if enacted, would likely contribute to higher poverty rates for seniors under the supplemental poverty measure. The work is part of the Foundation's Project on Medicare's Future.

When Medicare launched, nobody had any clue whether it would work

Interesting column for those who wonder - will health care reform work?  This is a historic opportunity ....

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/17/when-medicare-launched-nobody-had-any-clue-whether-it-would-work/

Older Adults Report Increased Memory Loss

From the DHMH State Health Improvement Process (SHIP) newsletter:

According to data just released from 21 states that used the optional Cognitive Module as part of the 2011 Behavioral Risk Factor Surveillance System (BRFSS), 9.5% of adults aged 60 and over reported increased confusion or memory loss in the previous 12 months. Among those reporting increased confusion or memory loss, over 85% of Marylanders said they had not discussed these changes with a health care provider. Memory loss varied by population groups but was highest among those unable to work, individuals with disabilities, and Hispanics.

 Memory problems are often the first signs of greater cognitive health issues, such as Mild Cognitive Impairment (MCI) and dementia, including Alzheimer's disease. Maryland advocates encourage early and accurate detection and diagnosis. Talking about memory problems and possible cognitive decline with health care providers enables earlier diagnosis, which in turn enables individuals and their families to plan for the future and allows for the better management of co-occurring chronic conditions.

 To read the full Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC) click here.

 To access the Maryland specific fact sheet click  here.

 For more information on the Cognitive Module, or surveillance in general, contact Catherine Morrison.

NPR Series on Elder Abuse

Elderly Couple's Tale Of Abuse Not So Uncommon

http://wamu.org/news/13/05/03/Elderly-Couples-Tale-Of-Abuse-Not-So-Uncommon

By: Rebecca Blatt // May 3, 2013

WHERE TO GET HELP

AGING AND ABUSE SERIES

James and Etta Jennings moved to the Forest Hill neighborhood of Richmond in 1959.  They were young - just married - and the first owners of their red brick ranch house.  They had children and then grandchildren, who gathered in their family room for holidays and learned to swim in their backyard pool.

But when their granddaughter, Jeannie Beidler, approached the home on July 27, 2010, she was confronted by a grim reality.  Paramedics, police and Adult Protective Services social workers were on the scene.

"You could smell the stench of urine and feces," she says, standing at the foot of the driveway.  "From this point, we already knew what we were about to walk into."

The Jennings' son, Beidler's uncle, was supposed to be caring for them, but it became clear very quickly that something had gone horribly wrong.  The Jennings were living without running water or even a fan.  James was confined to a chair.  His blood pressure was high and he was fading in and out of consciousness.  Etta was living on a broken bed crawling with maggots.  

Beidler was overwhelmed.

"To think how could this have happened to her?  I can't think of a sadder moment in my life or a heavier moment in my life than that," she says.

It's hard to imagine how a family home could sour and rot as the Jennings' had, or how somebody could watch two elderly parents wasting away.  But neglect is not uncommon, especially for seniors with dementia and complicated medical conditions who are also at risk for physical and emotional abuse, as well as financial exploitation.   

In a study funded by the National Institute of Justice, approximately 1 in 10 seniors reported being abused or neglected in the previous year, and financial exploitation of seniors is estimated to total $2.9 billion dollars a year.  Victims of abuse are more than twice as likely to die prematurely and more than four times as likely to be admitted to a nursing home or rehab center. 

Kathy Greenlee, Assistant Secretary for Aging at the Department of Health and Human Services and Administrator of the Administration for Community Living, calls elder abuse a crisis.  She says efforts to address elder abuse are 40 years behind those of child abuse and 20 years behind those of domestic violence.

"In this society we started and led with children, and we moved to the area of domestic violence and sexual assault," she says.  "Each of those fields can contribute and inform what needs to happen with regard to elder abuse. But it certainly hasn't been coordinated and a comprehensive approach to put together all of these different resources and really focus specifically on older people."

Greenlee says elder abuse is a problem that is only going to intensify as the population ages.  The number of Maryland and Virginia residents 65 and older is expected to grow by 88 percent in the next 20 years.  The same population in the District is set to increase by 58 percent.

Extended interview: Addressing elder abuse comes down to three questions says Assistant Secretary Kathy Greenlee, Department of Health and Human Services.

"With more older people, we will have more elder abuse," Greenlee says. "That's just the numbers.  Now is the time to pay attention."

There are significant obstacles to addressing elder abuse.  Sometimes victims are dependent on their abusers and fear what will happen if they lose that support.  Many have dementia and are not able to testify in court.  Dozens of federal, state and local agencies are involved, and sharing data among them has been a challenge.

Advocates struggle with funding as well.  In 2010, as part of the Patient Protection and Affordable Care Act, Congress passed the Elder Justice Act, which authorized approximately $750 million dollars in funding.  But Bob Blancato, national coordinator of the Elder Justice Coalition - says advocates are still waiting for lawmakers to release the money.  He says, in the meantime, many local agencies that investigate elder abuse are underfunded and struggle to keep up with the calls they receive.

"The effort now is to enhance reporting across the board," he says.  "But the problem is if you do that too well and you don't have the resources, then you're really creating a difficult problem that was unintended."

Beidler has had to work through many difficult problems of her own.   The day of the intervention, paramedics rushed her grandfather to the hospital, and her grandmother followed later that evening.  Both were malnourished and suffering from dementia.  

After a couple of weeks in the hospital, James and Etta Jennings were stable enough to be transferred to a nursing home near Beidler's house in Charlottesville.  They died within a couple of years, but Beidler says she was grateful they were able to live out their remaining days in comfort.

Beidler ended up resigning from her job in order to manage their health and legal battles.  Her uncle had cashed thousands of dollars in checks from her grandmother, leaving the Jennings deeply in debt, with many accounts in arrears.  

Beidler took control of their finances and, over several months, was able to settle their debts.  She sold their house for a fraction of its previous worth, and she worked with a prosecutor to build a case against her uncle, who pleaded guilty to two counts of abuse or neglect of an incapacitated adult.  He was incarcerated for a little less than three years.

Beidler says, looking back, there were people who could have intervened earlier: police who had been called weeks before and even the cashier at the convenience store who cashed her grandmother's checks.

"Don't ignore that pit in your stomach that something isn't right," she says. "Don't minimize your place."

Beidler says it's a matter of looking out for abuse, and choosing not to look away when you find it.

  https://s3.amazonaws.com/s3.documentcloud.org/documents/695944/aoa-119-yeap-infofact-sheets-warningsigns-nm-1.pdf

http://wamu.org/news/13/05/03/elder_abuse_who_to_contact

 

HHS Releases Enhanced Culturally and Linguistically Appropriate Services standards

From the National Health Law Program:

Today, HHS released the Enhanced Culturally and Linguistically Appropriate Services (CLAS) Standards. The Enhanced CLAS Standards update and expand the original CLAS Standards from 2000. The guiding principle for the 15 standards is to Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

The Standards and other infomration on providing culturally and linguistically appropriate services are available on the Office of Minority Healths website Think Cultural Health. A Blueprint accompanies the new standards, offering additional information and resources.

HHS press release is available here.

iConnect Generations Expo

Date: 
Fri, 05/10/2013 - 10:00am - 6:00pm

iConnect Generations Expo at Stadium Place is being organized by GEDCO (Govans Ecumenical DevelopmentCorporation) and the Y of Central Maryland, in partnershipwith the Baltimore City Health Department, Office of Aging and CARE Services, to expand the resources available for older adults and their families.
Friday, May 10, 2013
10:00 a.m. – 6:00 p.m.
Stadium Place Community
Entrances at Ednor Rd. & E. 33rd St.

Proceeds support GEDCO’s Senior Services and Y programs for vulnerable youth.
Activities include:
• inter-generational sports
and exercise programs like Tai Chi
• seminars
• wellness and health screenings
• financial management seminars
• dance and musical entertainment
• support sessions for care partners
• healthy cooking demonstrations
• volunteering opportunities
• job fair


FREE GIFT!  Free to public!  Sponsors and exhibitors welcome!
For details visit gedco.org/iConnect.

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