Wednesday, April 26, 2017

Webinar: Elder Financial Abuse & Medicaid Denials

Justice in Aging has announced a free webinar for May 17th, 2017 from 2-3 edt on Elder Financial Abuse & Medicaid Denials.   Here is a description of the webinar

Financial exploitation can devastate low-income older adults, especially those who rely on Medicaid for their health and long-term care. For example, older adults who are victims of financial abuse may be denied eligibility for Medicaid because their abuser won’t turn over their bank records. Without Medicaid eligibility, the older adult may be threatened with eviction or involuntary discharge from a nursing home because of nonpayment. Legal services are critical to helping older victims of financial exploitation receive the medical care and services to which they are entitled. Join us for Elder Financial Abuse and Medicaid Denials to learn how to identify victims of elder financial abuse, what problems this exploitation can cause for Medicaid eligibility, and how legal services attorneys can help their older clients receive the benefits they need and prevent future problems accessing Medicaid.

To register for the webinar,https://attendee.gotowebinar.com/register/5875005469626032643?source=SALSA.  Did I mention, it's free!

April 26, 2017 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Programs/CLEs, Webinars | Permalink | Comments (0)

Sunday, April 23, 2017

Spouse & Survivor Benefits for Same Sex Spouses

Justice in Aging has released a new fact sheet, New Guidance from SSA on Spousal & Survivors Benefits for Married LGBT Individuals. "On March 1, 2017, the Social Security Administration (SSA) announced it would reopen any decision to deny spousal or survivors benefits to a same-sex spouse based on a discriminatory marriage ban, which resulted in a loss of benefits to the individual who filed the claim." The fact sheet notes an SSA ruling and POMS.  "This policy change applies to applications for spousal or survivors benefits that SSA denied prior to the Windsor and Obergefell decisions because it did not recognize their marriages. Even those who began receiving SSA benefits following the Supreme Court decisions may be due retroactive benefits for the period between when they first applied (and were denied) and when SSA finally recognized their marriage." The fact sheet also explains who is not affected as well as who might be. The fact sheet concludes explaining that SSA is in the process of reaching out to 800 beneficiaries whose benefits were denied to tell them their applications are being reopened.

Click here to read the full fact sheet.

April 23, 2017 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Retirement, Social Security | Permalink | Comments (0)

Monday, April 17, 2017

Older Adults & Immigration: Free Webinar

Register now for Justice in Aging's latest webinar, Older Adults & Immigration. The webinar is set for Friday April 21, 2017  from 2 p.m. to 3 p.m. edt.  Oh, and did I mention, it is free!  Here's a description of the webinar

Are your immigrant senior clients coming to you with immigration-related questions? Recent events may leave your immigrant senior clients understandably confused. Need clarification on an immigrant older adult’s eligibility for safety net programs like Medicaid or SSI? Join Justice in Aging as we host a special immigration law webinar with our partners from the National Immigration Law Center. Intended for an audience who work with low income seniors but who are not familiar with immigration law, this webinar will cover basic topics, like:
• Different types of immigrants in our communities;
• Rights and protections for immigrant seniors;
• Immigrant senior eligibility for SSI, Social Security, Medicare, and Medicaid; and
• Resources for individual assistance

This free webinar will also highlight some of the recent events affecting immigrant seniors and how they may be affected by changes in government policies. 

To register, click here.

April 17, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, International, Programs/CLEs, Webinars | Permalink | Comments (0)

Thursday, April 13, 2017

Register Now: Webinar on Fundamentals of SNT Administration

Registration is now open for Stetson's annual Fundamentals of SNT Administration webinar.  This half-day webinar is scheduled for May 5, 2017 from 1-5 p.m.  The 4 speakers will cover topics on how to become a SNT administrator,  Tax issues when making distributions, services and products a SNT administrator can provide, and an update on the laws, regs and POMS.  The agenda is available here and registration is available here. (you can register online and fill out and submit a pdf). 

Full disclosure, I'm the conference chair. Hope to see you virtually at this webinar!

April 13, 2017 in Consumer Information, Current Affairs, Estates and Trusts, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Programs/CLEs, Webinars | Permalink | Comments (0)

Friday, April 7, 2017

More Issue Briefs on the Revised Nursing Home Regs

Justice in Aging, the Center for Medicare Advocacy and the National Consumer Voice for Quality Long Term Care have issued two more issue briefs on the revised nursing home regs CMS released last year.

The first brief is on visitation rights and is available here.  This is the executive summary for this brief: 

The revised nursing facility regulations affirm the rights of residents to receive visitors of their choosing at the time of their choosing, and require the facility to provide immediate access to the resident in accordance with the regulations. Access to spouses and domestic partners now specifically includes same-sex spouses and domestic partners.

The Centers for Medicare and Medicaid Services maintained the resident’s right to deny or withdraw consent for visitation of family members, other relatives, and other visitors at any time. The facility must ensure all visitors have full and equal visitation privileges (subject to resident preferences) and not discriminate against visitors based on race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.

The resident representative is added to the list of people and government representatives who have immediate and unrestricted access to the resident. However, visits from non-family visitors are now subject to "reasonable clinical and safety restrictions," which is a change from "reasonable restrictions."

The revised regulations require the facility to have a written visitation policy and inform residents of their visitation rights, the facility policy, any restrictions, the reasons for the restrictions, and to whom the restrictions apply.

The second issue brief is on rehabilitation services and is available here.  Here is the executive summary

The substantive requirements for specialized rehabilitative services are largely unchanged from the prior version of the regulations, with the exception of "respiratory therapy," which is added to the list of services that a facility must provide to its residents who need them. In responding to a question regarding whether respiratory therapy should include ventilator care, CMS emphasized that a nursing facility is obligated to meet residents’ needs.

Thanks to these 3 organizations for providing all of us with this very helpful information!

 

April 7, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, April 6, 2017

Financial Services Response to Fighting Financial Exploitation

We all know that financial exploitation is a serious and significant problem in the U.S.  I was interested in this article from Investment News detailing efforts that the financial services industry and others are taking to help their elder clients protect themselves from financial exploitation. Advisers taking steps to protect elderly explains although "[t]here's widespread acceptance in the financial services industry that elderly financial abuse is a growing problem, but there's no universally accepted game plan for how to respond... Many times firms' internal procedures will involve adviser education and training, and gathering third-party contact information for accounts."  The article highlights the efforts of Wells Fargo Advisors which the article explains: "Wells Fargo launched an 11-member team more than two years ago within its compliance department that serves as an internal clearinghouse and case manager when advisers see a potential problem with a client. ... The unit has taken about 4,000 reports from the field, about half of which were incidences of abuse. Wells' Elder Care Initiatives often involves state adult protective services or securities regulators in the matters.:

Bank of America Merrill Lynch has also launched efforts to help protect their elder clients, according to the article. For example, one step Merrill Lynch has taken is to have "created a contact authorization form that gives advisers a trusted person to reach out to in case of suspected fraud or to obtain more information about behavioral changes linked to possible exploitation."

The article also highlights the efforts of Morgan Stanley, Charles Schwab, Edward Jones, and Fidelity Investments.  As for smaller firms, they aren't lagging behind.  For example, "[s]maller firms also are responding to the elder-abuse threat. For more than a year, Romano Wealth Management has had in place steps that its nine advisers follow in reporting potential abuse to the compliance officer, who then decides whether to involve adult protective services or regulators."

The article also discusses the efforts at the federal level. "The industry is starting to get protection from regulators. In February, the Securities and Exchange Commission approved a Financial Industry Regulatory Authority Inc. rule designed to curb elder abuse. It requires brokers to make “reasonable efforts” to identify a “trusted contact” for investment accounts. It also permits them to prevent the disbursement of funds from the account and to notify the contact if the broker suspects the client is an abuse victim." The article also mentions several states that have passed laws that require investment advisors to notify APS as well as state regulators if financial exploitation is suspected.

The article discusses some other efforts and provides a good picture of various efforts taking place both by legislation and industry efforts.

 

April 6, 2017 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, State Statutes/Regulations | Permalink | Comments (0)

Sunday, April 2, 2017

Free Webinar: Reverse Mortgages Emerging Issues

Justice in Aging has announced a free webinarReverse Mortgage Servicing & Foreclosure: Emerging Issues. The webinar is set for April 19, 2017 at 2 p.m. edt.   Here is the webinar description

Reverse mortgages allow older homeowners to age in place by supplementing income, providing funding for repairs or modifications to the home, or other necessary expenses by converting equity in their homes into cash. Recently there has been an uptick in reverse mortgage foreclosures due to property charge defaults and other issues, leading to the displacement of older adults from their homes. Homeowners and their families also face challenges when dealing with the companies that service reverse mortgage loans.

This free webinar, Reverse Mortgage Servicing & Foreclosure: Emerging Issues outlines issues facing reverse mortgage borrowers and offers strategies to address the challenges. This session will highlight recent changes to the Home Equity Conversion Mortgage (HECM) program.

To register, click here.

April 2, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Housing, Programs/CLEs, Webinars | Permalink | Comments (0)

Wednesday, March 22, 2017

Nursing Home Regs: Admission

Justice in Aging has released a new brief on the revised nursing home regulations this one focusing on admissions,  A Closer Look at the Revised Nursing Facility Regulations Admission. Here's the executive summary:

The revised regulations broadly prohibit facilities from using admission agreements or other documents that waive a resident’s rights. A resident cannot waive the protections of federal nursing facility law, or protections derived from any state or local nursing facility law. A resident also cannot waive his or her right to Medicare or Medicaid coverage, or any responsibility that the facility may have for the resident’s personal property. A facility cannot obligate a family member or friend to become liable for the nursing facility bill, although the facility can require the resident’s agent to agree to pay the resident’s money for the nursing facility expenses. The revised regulations prohibit pre-dispute arbitration agreements, but this consumer protection currently is blocked by a court order. Prior to admission, a facility must give notice of any special characteristics or service limitations.

The brief concludes with 4 suggestions for advocates and residents: careful review of the contract, sign the contract after residency in the SNF has begun, contest contract paragraphs that are improper and get a lawyer.

March 22, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Tuesday, March 21, 2017

Health Care Bill & Impact on Elders

It's not final, it's not been passed, and changes are likely, but the current health care bill, known as the American Health Care Act, has a significant impact on elders.  Last week's CBO report engendered a lot of discussion about the impact of this new health care proposal. The New York Times ran an article last week discussing it, No Magic in How G.O.P. Plan Lowers Premiums: It Pushes Out Older People.  The article explains that lower premiums are on the way for some under this proposal. But, the way the lower premiums are achieved? "[T]he way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured."

We know that insurers want to have a broad pool to spread the risk. Typically, "older customers cost substantially more to cover than younger ones because they have more health needs and use their insurance more. By discouraging older people from buying insurance, the plan will lower the average sticker price of care."  Ready for some sticker shock?  Under the proposal, according to the story, the plan "increases the amount that insurers can charge older customers, and it awards flat subsidies by age, up to an income of $75,000. ... On premiums alone, prices would rise by more than 20 percent for the oldest group of customers. By 2026, the budget office projected, 'premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old — but 20 percent to 25 percent higher for a 64-year-old.'"

The story explains that it's not just the premiums that give the whole picture. Tax credits factor into this as well.  Here is where the real sticker shock comes in. "[T]he change in tax credits matters more. The combined difference in how much extra the older customer would have to pay for health insurance is enormous. The C.B.O. estimates that the price an average 64-year-old earning $26,500 would need to pay after using a subsidy would increase from $1,700 under Obamacare to $14,600 under the Republican plan."  Did you see that-an increase from $1,700 to $14,600...

The article also discusses out of pocket costs and more.  The CBO report in pdf is available here.

The semester is quickly drawing to a close, but the bill could be a basis for an interesting class discussion on social policy, if you have time.

 

March 21, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink

Monday, March 20, 2017

The New Health Care Bill

Wonder what is in the new health care bill?  New Health Plan Broken Down appears in the Centre Daily Times on March 12, 2017. The article is written by Amos Goodall, a prominent elder law attorney (and graduate of Stetson's LL.M. in Elder Law). The article explains changes to the individual mandate (penalty repealed and replaced), preexisting conditions protection (none), age-based premiums (5:1 ratio & will be up to states which ration), cost-sharing subsidies (will be eliminated), over the counter drugs (adding reimbursement from HSA, FSA or Archer MSA), Medicaid expansion (changes financing) and per capita caps.

To read more about these and other proposed changes, click here.

Thanks to Amos for sending me the link to the story.

March 20, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink | Comments (0)

Thursday, March 16, 2017

Call Congress Today on Medicaid and Medicare

Today is Call Congress About Medicaid day. Here is the information from the Medicare Rights Center:

Tell Congress to protect our care by joining today’s national call-in day. Urge your representative to vote “no” on the American Health Care Act... Call 866-426-2631 to contact your member of Congress.

The message is to vote no for changes to Medicaid and Medicare. The Medicare Rights Center also offers a one page issue brief on the proposed changes to Medicare, available here.

Regardless of your views, it is always important to make  your voice heard.

Thanks to Kim Dayton, the elderlawprof blog founder, for sending me a note on this.

 

March 16, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink

Wednesday, March 8, 2017

Are Inadequately Funded Retirement Plans the Latest Ponzi Scheme?

The teachers' pension fund in Puerto Rico is the latest example of an under-funded government-operated retirement plan. A unique complication of the Puerto Rico teachers' plan is the decision to opt out of Social Security as a separate form of retirement income.  In a recent New York Times article, the reporter makes the the analogy to a Ponzi scheme:

Puerto Rico, where the money to pay teachers’ pensions is expected to run out next year, has become a particularly extreme example of a problem facing states including Illinois, New Jersey and Pennsylvania: As teachers’ pension costs keep rising, young teachers are being squeezed — sometimes hard. One study found that more than three-fourths of all American teachers hired at age 25 will end up paying more into pension plans than they ever get back.

 

“I think they’re really being taken advantage of,” said Richard W. Johnson of the Urban Institute, a co-author of the research. “What’s so tragic about this is, often the new hires aren’t aware that they’re getting such a bad deal.”

 

The problem is magnified by the fact that the Puerto Rico teachers union — like many teachers and police unions around the country — opted out of Social Security long ago, hoping it could save both workers and the government money by not paying Social Security taxes.

 

That decision was predicated on the assurance that the workers’ pensions would be well managed and adequately funded. But in Puerto Rico, as in some other places, that has not been true for decades.

For more, read In Puerto Rico, Teachers' Pension Fund Works Like a Ponzi Scheme.

 

March 8, 2017 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Retirement, Social Security | Permalink | Comments (0)

Monday, February 27, 2017

Will "Everyday Americans" Lose Potential Protections re Investment Advice?

NPR had a good recent summary of the politics behind opposition to full implementation of fiduciary duty standards for investment brokers in providing retirement advice: 

Over the past two weeks, the Trump administration has taken steps to delay and perhaps scuttle a new rule designed to save American workers billions of dollars they currently pay in excessive fees in their retirement accounts.

The Obama administration spent 5 years crafting the rule through the Labor Department. It requires that financial advisers and brokers act in their customers' best interest when offering them investment advice for their workplace retirement accounts. Firms must comply by April [2917 under the current rule].

As the commentary pointed out, early-on Trump pledged to support the interests of ordinary working Americans and to take on Wall Street:

In his inauguration speech, President Trump talked about giving America back to everyday working Americans. In one of the more memorable moments, the president said, "The forgotten men and women of our country will be forgotten no longer."

The fiduciary duty rule for investment brokers directly signals the tension between President Trump's pledge to working Americans and his career-long focus on big business.

AARP supports the rule, recognizing that the U.S. has an "under savings" problem. Distrust of investment advisers plays into the reluctance of ordinary Americans to engage in professionally-assisted planning for the future.  Will AARP rally retirees to resist repeal or delay of the fiduciary duty rule? 

For more, read or listen to Trump Moving to Delay Rule that Protects Workers from Bad Financial Advice.Trump Moving To Delay Rule That Protects Workers From Bad Financial Advice and White House to Investors: Put Savers' Interests First.

Warren Buffett has been counseling -- for years -- to avoid high fee "experts" for investment advice, recommending the use of index funds instead.  See e.g. Newsday's "Warren Buffett Says Don't Waste Money on Investment Fees." 

 

February 27, 2017 in Consumer Information, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Retirement | Permalink | Comments (0)

Sunday, February 26, 2017

CNN Report: Sexual Assaults in Nursing Homes

CNN has published an investigative report on sexual assault of residents in nursing homes.  Sick, dying and raped in America's nursing homes opens with these paragraphs "Some of the victims can't speak. They rely on walkers and wheelchairs to leave their beds. They have been robbed of their memories. They come to nursing homes to be cared for... Instead, they are sexually assaulted... The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them."

The report looks at a variety of issues and the failings of the system in responding to the attacks.

In cases reviewed by CNN, victims and their families were failed at every stage. Nursing homes were slow to investigate and report allegations because of a reluctance to believe the accusations -- or a desire to hide them. Police viewed the claims as unlikely at the outset, dismissing potential victims because of failing memories or jumbled allegations. And because of the high bar set for substantiating abuse, state regulators failed to flag patterns of repeated allegations against a single caregiver.

The facts of the cases are hard to read but important in understanding the scope and significance of these crimes.   The perpetrators were as young as teenagers or as old as the victims.  Some were caregivers, others residents.

Rather than summarizing any further, just read the story.  Nothing I can add here would give you the same impact.

Responses to the report from the National Consumer Voice for Quality Long Term Care and others can be accessed here.

February 26, 2017 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Wednesday, February 22, 2017

Fundamentals of Special Needs Planning webinar

Registration is now open for Stetson's annual Fundamentals of Special Needs Planning webinar (full disclosure, I'm the conference chair) scheduled for May 5, 2017.

Topics include :

  • Becoming a SNT Administrator
  • A Primer on Tax When Making Distributions 
  • Changes in Laws and SSA Regulations (you know, the POMS) and How Those Impact the Administration of Your SNT 
  • SNT Administrators:  More Choices Than You Think
  • Question and Answer Panel

To register, click here. More information, click here.

 

February 22, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Programs/CLEs, Webinars | Permalink | Comments (0)

Are Seniors the Target of Unfair Foreclosures in Florida Reverse Mortgage Cases?

The marketers of reverse mortgages often paint a rosy picture of how seniors will be able to draw on the equity in their homes to cover daily expenses, without risk of repayment before death.  But details of these mortgages can be overlooked and as we've reported before, seniors can be surprised when terms and conditions create traps that can lead to foreclosure.  However, from Florida, we're now hearing about cases where one of the simplest conditions -- the borrower continuing to live on site -- has become the subject of litigation.  

From Law.com:

“All of a sudden, we saw a spate of foreclosures where the mortgage companies alleged the seniors no longer lived in the home,” said Gladys Gerson, supervising attorney for Coast to Coast Legal Aid of South Florida’s senior unit. “This has been happening around the state.”

 

About a dozen similar cases reached Gerson and other attorneys at Coast to Coast, who have helped a growing number of low-income seniors fight and win dismissals despite aggressive lender litigation.

 

Florida is ground zero for seniors’ issues, but as the strategy has often proved effective, it’s likely to spread, according to defense attorneys. “If you see the volume of national advertising that’s geared to seniors, I can’t believe this is limited to Florida,” Corona’s father and partner, Ricardo, said. “The servicers are not even based in Florida, so I don’t see why they would limit themselves.”

 

Corona admits he didn’t expect a hard fight when he first reviewed El Hassan’s case, but court records show he was wrong. Over the last 10 months, the ongoing litigation yielded two hearings, 40 docket entries and attempts by both sides to collect attorney fees.

For more, read the full article, Foreclosure Litigation Strategy Takes Aim at Seniors, Attorneys Say.

Thank you to my colleague, Dickinson Law Professor Laurel Terry, for this source.  

February 22, 2017 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Housing, Retirement | Permalink | Comments (0)

Monday, February 20, 2017

How Do "Domestic Partnerships" Fare for Elderly Couples?

George Washington Law Professor Naomi Cahn recommended an interesting new article from the Elder Law Journal, "The Precarious Status of Domestic Partnerships for the Elderly  in a Post-Obergefell World."

Authors Heidi Brady, who is clerking for the Fifth Circuit Court of Appeals, and Professor Robin Fretwell Wilson from the University of Illinois College of Law, team to analyze key ways in which elderly couples in domestic partnerships may be treated differently, and sometimes more adversely, than same sex couples who are married.  From the abstract: 

Three states face a particularly thorny question post-Obergefell [v. Hodges, the Supreme Court's 2015 decision recognizing rights to marry]: what should be done with domestic partnerships made available to elderly same-sex and straight couples at a time when same-sex couples could not marry. This article examines why California, New Jersey, and Washington opened domestic partnerships to elderly couples. . . . This Article drills down on three specific obligations and benefits tied to marriage -- receipt of alimony, Social Security spousal benefits, and duties to support a partner who needs long-term care under the Medicaid program -- and shows that entering a domestic partnership rather than marrying does not benefit all elderly couples; rather, the value of avoiding marriage varies by wealth and benefit. 

Thank you, Naomi, for this recommendation.  

February 20, 2017 in Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Social Security, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, February 13, 2017

The Elder Justice Act from the Congressional Research Service

Late last month the Congressional Research Service published the following: The Elder Justice Act: Background and Issues for Congress.  Here is an excerpt from the executive summary

Elder abuse is a complex issue that often requires a multifaceted policy response that combines public health interventions, social services programs, and criminal law enforcement for abusive behavior. To address this complexity, the Elder Justice Act was enacted on March 23, 2010 as part of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended). The act attempt s to provide a coordinated federal response by emphasizing various public health and social service approaches to the prevention, detection, and treatment of elder abuse. The Elder Justice Act also represents Congress’s first attempt at comprehensive legislation to address abuse, neglect, and exploitation of the elderly at the federal level.

To date, most activities and programs authorized under the Elder Justice Act have not received federal funding through the annual appropriations process. For the first time, Congress appropriated $4 million for a new Elder Justice Initiative in FY2015 and $8 million in FY2016. However, the authorizations of appropriations for most provisions under the act expired on September 30, 2014. Despite the lack of discretionary appropriations prior to FY2015, some elder justice activities have received funding from mandatory funding appropriated through the ACA Prevention and Public Health Fund (PPHF). As a result of this limited federal funding, the federal government has not substantially developed and expanded its role in addressing the prevention, detection, and treatment of elder abuse.

For FY2012, the Secretary of the Department of Health and Human Services (HHS) transferred $6.0 million to the Administration for Community Living (ACL) from the PPHF for new grants to states and tribes to test elder abuse prevention strategies. Funded projects included using forensic accountants to prevent elder financial exploitation, increasing medication adherence to prevent elder self-neglect, and developing screening tools to identify elder abuse. For FY2013, $2.0 million was transferred to ACL from the PPHF for elder justice activities, which funded development of the National Adult Protective Services Data Reporting System Project. No PPHF funds were transferred to ACL for elder justice activities for FY2014 or subsequent fiscal years.

For FY2017, the President’s budget request included $10.0 million in discretionary funding for Elder Justice/Adult Protective Services (APS) that would be used to fund APS, research, and evaluation activities. The 2017 budget request did not specify an intended transfer of funding from the PPHF for elder justice activities. For FY2017, the Senate Appropriations Committee recommended $10.0 million for the Elder Justice Initiative in its FY2017 Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) appropriations bill. The House Appropriations Committee recommended $8.0 million in its FY2017 LHHS appropriations bill. Neither House nor Senate floor consideration of the bill occurred in the 114th Congress. Since the start of the fiscal year (October 1, 2016), funding for LHHS programs and activities has been provided by two continuing resolutions (CR; P.L. 114-223 and P.L. 114-254). The second FY2017 CR provides continuing appropriations for LHHS appropriations through April 28, 2017, or until full-year appropriations are enacted.

***

The report offers some observations for Congress as well as some concluding thoughts:

The Elder Justice Act represents one set of policies that exist in the broader context of domestic social policy to address the complex issue that is elder abuse. That is, as a federal legislative response, the Elder Justice Act may best serve as a catalyst for further federal coordination and action that can bring about greater public awareness and attention to the needs of a growing, and potentially vulnerable, aging population. According to GAO, the Elder Justice Act "provides a vehicle for setting national priorities and establishing a comprehensive, multidisciplinary elder justice system in this country."44 Such a response touches on a range of domestic policy programs and issues that are not specific to one congressional committee’s jurisdiction or area of expertise. Furthermore, congressional oversight into federal administration, implementation, and related activities must rely on different committees of jurisdiction as well as the experience of select committees such as the Senate Special Committee on Aging....

 

February 13, 2017 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Other | Permalink | Comments (0)

Wednesday, February 8, 2017

New Issue Briefs from Justice in Aging

Justice in Aging has released two new issue briefs concerning the new nursing home regs.  One is on involuntary transfers and discharges and is available here. The other is on unnecessary medications and antipsychotic meds, and is available here. The briefs were done with the Center for Medicare Advocacy and the National Consumer Voice for Quality Long-Term Care.

Here's the executives summary for the transfer/discharge brief

The involuntary transfer/discharge regulations have changed, but not dramatically. Facilities still can force a transfer/discharge only under one of six specified circumstances, and a resident continues to have the right to contest a proposed transfer/discharge in an administrative hearing. The revised regulations narrow the facility’s ability to base a transfer/discharge on a supposed inability to meet the resident’s needs, by requiring increased documentation by the resident’s physician. The regulations also limit transfer/discharge for nonpayment, by stating that nonpayment has not occurred as long as Medicaid or another third-party payor is considering a claim for the time period in question. All transfer/discharge notices must be sent to the resident, resident representative(s), and (in a new requirement) the Long-Term Care Ombudsman program. The revised regulations now explicitly state that a facility cannot discharge a resident while an appeal is pending.

Here's the executive summary for the medications brief:

Regulations about unnecessary drugs and antipsychotic drugs have been moved from the quality of care section to the pharmacy services section. Some provisions have been moved but not otherwise changed: these include protection from unnecessary medications, requirements for gradual dose reductions, and the use of behavioral interventions in order to discontinue drugs, "unless clinically contraindicated." In addition, the pharmacy services regulation includes a new discussion of a broader category of psychotropic drugs, along with new controls over "as needed" (PRN) psychotropic drugs. The revised regulations also expand requirements for drug regimen reviews.

These and the first brief in the series are available here.

February 8, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink | Comments (0)

Thursday, February 2, 2017

Got an Opinion on the Future of Medicare? Then Share Your Opinion.

We've heard that Speaker Ryan has a plan to change Medicare, but that the President had made campaign promises about preserving it. So, have an opinion? Should it remain unchanged? Should it be changed? Here's your chance to make your voice heard. AARP is organizing a "thunderclap" campaign, asking those with an opinion share it with the President by Twitter, Tumblr or Facebook and they will all be posted on the same day, February 21, 2017. The website has more information about the specifics on how this works. Don't want to wait until then to make your opinion known? AARP also has a site for folks to contact  Congress that makes it about as simple as can be with a prepared message for those who want Congress to support Medicare . (If you think Medicare should be changed, you may not be able to change the AARP standard message and you will need to email your elected representatives) 

February 2, 2017 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)