Friday, July 1, 2022

New Nursing Home Report from National Academies

The National Academies on Sciences, Engineering, and Medicine has released a new report, The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff (2022).

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. Ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents. The devastating impact of the COVID-19 pandemic on nursing home residents and staff has renewed attention to the long-standing weaknesses that impede the provision of high-quality nursing home care.

With support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff identifies seven broad goals and supporting recommendations which provide the overarching framework for a comprehensive approach to improving the quality of care in nursing homes.

You can download a pdf of the report for free (need to create an account or download as a guest), read it online, or purchase a print copy

July 1, 2022 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (0)

Thursday, June 30, 2022

Oregon AG 6th Annual Elder Abuse Conference Announced

The 6th Annual Oregon AG Elder Abuse conference will be held October 20-21, 2022 in Bend, OR. Conference organizers are seeking proposals. Here is the info

Request for Presentations is NOW OPEN! Presenters at Attorney General Rosenblum’s Annual Elder Abuse Conference are the heart and the soul of this annual event. Each year over 20 professionals with expertise related to elder abuse are selected to present to nearly 200 attendees. If you would like to be a presenter at the 2022 conference, please complete the Request for Presentations by July 1, 2022 and submit it electronically to ElderAbuse@doj.state.or.us.

If you want to submit a proposal, remember the deadline is tomorrow!

June 30, 2022 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

National Clearinghouse on Abuse in Later Life Webinar Series

It's been a few weeks since I blogged. There is just so much "bad" news these days, that I wanted to blog about more cheerful things.  Upcoming events that expand our knowledge, especialy free ones, seem to be a cheerful subject for today's post, so just as an FYI,  the National Clearinghouse on Abuse in Later Life (NCALL) is offering a 5 part series for civil attorneys on abuse.

In this five-part webinar series for civil attorneys and legal advocates, attendees will learn about a range of topics related to civil remedies for abuse in later life.

Presented by the National Clearinghouse on Abuse in Later Life (NCALL) and the American Bar Association Commission on Domestic & Sexual Violence (ABA CDSV) and sponsored by the U.S. Department of Justice, Office on Violence Against Women (OVW).

All webinars will be held from 1-2:30 p.m. Eastern Time. There is no cost to attend.

  • Monday, July 11: Module 1: Abuse in Later Life Overview  This module explores forms of abuse in later life, common abuser tactics, and dynamics of power and control that exist in many abuse in later life cases.
  • Monday, July 25: Module 2: Forming the Relationship with Your Client -This module discusses the importance of using a victim-centered approach to screening for abuse in later life and critical challenges to client communication, including accessibility and cultural barriers. The key concepts of privilege, confidentiality, and mandated reporting are also discussed.
  • Monday, August 1: Module 3: Client Goal-setting and Non-litigation Responses – This module discusses the need for civil attorneys to listen to client priorities and goals to achieve desired outcomes. Engaging in multi-disciplinary collaboration and client advocacy are also reviewed.
  • Monday, August 8: Module 4: Legal Resolutions and Remedies – This module identifies available civil legal remedies that serve both vulnerable and competent older victims.
  • Monday, August 15: Module 5: Bringing the Case – Trial Skills – This module discusses the identification and preservation of evidence and testimony and helps viewers to understand methods to develop an effective elder abuse case theory and prepare witnesses for direct and cross-examination.

Click here to register for any/all of the webinars.

June 30, 2022 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Webinars | Permalink | Comments (0)

National Clearinghouse on Abuse in Later Life Webinar Series

It's been a few weeks since I blogged. There is just so much "bad" news these days, that I wanted to blog about more cheerful things.  Upcoming events that expand our knowledge, especialy free ones, seem to be a cheerful subject for today's post, so just as an FYI,  the National Clearinghouse on Abuse in Later Life (NCALL) is offering a 5 part series for civil attorneys on abuse.

In this five-part webinar series for civil attorneys and legal advocates, attendees will learn about a range of topics related to civil remedies for abuse in later life.

Presented by the National Clearinghouse on Abuse in Later Life (NCALL) and the American Bar Association Commission on Domestic & Sexual Violence (ABA CDSV) and sponsored by the U.S. Department of Justice, Office on Violence Against Women (OVW).

All webinars will be held from 1-2:30 p.m. Eastern Time. There is no cost to attend.

  • Monday, July 11: Module 1: Abuse in Later Life Overview  This module explores forms of abuse in later life, common abuser tactics, and dynamics of power and control that exist in many abuse in later life cases.
  • Monday, July 25: Module 2: Forming the Relationship with Your Client -This module discusses the importance of using a victim-centered approach to screening for abuse in later life and critical challenges to client communication, including accessibility and cultural barriers. The key concepts of privilege, confidentiality, and mandated reporting are also discussed.
  • Monday, August 1: Module 3: Client Goal-setting and Non-litigation Responses – This module discusses the need for civil attorneys to listen to client priorities and goals to achieve desired outcomes. Engaging in multi-disciplinary collaboration and client advocacy are also reviewed.
  • Monday, August 8: Module 4: Legal Resolutions and Remedies – This module identifies available civil legal remedies that serve both vulnerable and competent older victims.
  • Monday, August 15: Module 5: Bringing the Case – Trial Skills – This module discusses the identification and preservation of evidence and testimony and helps viewers to understand methods to develop an effective elder abuse case theory and prepare witnesses for direct and cross-examination.

Click here to register for any/all of the webinars.

June 30, 2022 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Webinars | Permalink | Comments (0)

Thursday, June 16, 2022

Billing Issues with Some Medicare Advantage Plans?

The Washington Post ran an article recently,  Beat cancer? Your Medicare Advantage plan might still be billing for it.

According to the article, the U.S. filed a false claims lawsuit in California against a health system, which is just one of others filed by the Government "on abusive billing practices in Medicare Advantage ...  [by] pursuing civil lawsuits against multiple companies that participate in the privatized system, from huge insurers to prestigious nonprofit hospital systems, alleging they have cheated the system for unfair profit."  The article notes that the industry's position is that the "firms adhere to Medicare’s rules and follow the system’s guidance on regulations that are not always clear. Moreover, the industry says that listing all health issues on medical records is a crucial part of Medicare Advantage’s promise to anticipate health problems, proactively manage disease and reduce hospitalizations."  Read the full article to learn more.

June 16, 2022 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Wednesday, June 15, 2022

New Article on Reverse Mortgages

CNBC ran an article last month  Here’s what you need to know about reverse mortgages. Here's what the article points out

With the stock market getting volatile but the housing market still hot, reverse mortgages have become a more attractive tool for older Americans who need cash for retirement but want to stay in their homes.

Home Equity Conversion Mortgage loan volume was up 26% in March, according to data from the U.S. Department of Housing and Urban Development reported by service provider Reverse Market Insight. It dropped 3.8% in April but remained well above 6,000 loans for the month — above the average in the last few years.

As the article notes, a significant number of elders have home equity, "about 66% of the average retired American’s wealth," although costs are higher as a result of  a 2017 HUD rule change. The article lists and discusses the pros and cons of reverse mortgages. 

June 15, 2022 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Housing | Permalink | Comments (0)

Tuesday, June 14, 2022

World Elder Abuse Awareness Day 2022

Tomorrow is the day-World Elder Abuse Awareness Day 2022. Lots of activities are happening in observation of the day.  Here are just a couple.  Register for the 8th Global Summit here. Or check out the Connecticut program, "On World Elder Abuse Awareness Day, June 15, Danbury Age Well Community Council presents a panel of experts to identify, prevent, and address financial exploitation of older adults in our community." To register for this Connecticut zoom program, click here. (Thanks to Judge Yamin (one of the speakers) for alerting me to the Connecticut program).  What are you doing to observe the day?

June 14, 2022 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International | Permalink | Comments (0)

Monday, June 13, 2022

Advice for Caregivers

The New York Times recently published a guide for caregivers, How to Be a Caregiver.

The article contains 6 tips from caregivers: "1. Let the patient lead... 2. Focus on comfort...3. Listen to the experts. ..4. Talk to other caregivers...5. Take care of yourself...6. Shed the guilt."  Don't think you will find yourself caregiving? Consider this information from the article: "21.3 percent of U.S. adults are caregivers, according to Caregiving in the U.S. 2020, a report from the National Alliance for Caregiving and AARP. The report defines a caregiver as someone who has provided care to an adult or a child with special needs at some time in the past 12 months. The number of caregivers is growing, and now totals about 53 million adults, up 20 percent from 43.5 million caregivers in 2015."

The article provides these facts

  • Most caregivers (about 90 percent) take care of a relative, usually a parent or spouse, while 10 percent care for a friend or neighbor.
  • Women are more likely to be caregivers than men, and make up about 60 percent of unpaid caregivers.
  • While most caregivers of adults take care of just one person, nearly one in four (24 percent) takes care of two or more people, up from 18 percent in 2015.
  • More young people are taking on caregiving roles. About a third of caregivers are 39 or younger, and 6 percent of them are from Generation Z — age 23 or younger.
  • Caregiving is time consuming. On average, today's caregivers provide about 24 hours of care each week. And most of them (61 percent) have another job.
  • Caregiving takes a toll on health. More Americans (23 percent) say caregiving has made their own health worse, up from 17 percent in 2015.

The article includes suggestions on how to prepare, what you need to organize, and where to find help. Bookmark the article!

June 13, 2022 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink

Saturday, June 11, 2022

Two Hundred Years of Guns.... What if you knew the outcome when you were writing the Second Amendment?

Alexander Merezhko, a good friend since he was a visiting Fulbright Scholar at Dickinson Law from his home country of Ukraine, is now a member of Ukraine's parliament and a senior legal advisor to President Zelenskyy.  We email regularly about events in our respective countries; of course, there is a lot for us to discuss.  Recently, Alexander mentioned that discussions were underway about legalizing individual gun ownership in his country.  Suffice it to say, Professor Merezhko is worried about what happens after the war.  It seems likely the assault by Russian forces motivates those debates in Ukraine, but what about the future?  A similar struggle, America's own then-recent war for independence, was part of the context for the language of the Second Amendment to the U.S. Constitution, beginning with the words, "A well regulated Militia, being necessary to the security of a free State...."  

Could America's Founding Fathers have dreamed that the contextual phrase would be dismissed as significant and the remaining words of the Second Amendment would be treated as a mandate that permits unrestricted sales of weapons to individuals who are not part of any well-regulated system?  There is a very interesting article with historical  details I've never considered in The New Yorker, titled How Did Guns Get So Powerful?From the article by Phil Klay:

We wonder how we got here. How did guns grow so powerful—both technically and culturally? Like automobiles, firearms have grown increasingly advanced while becoming more than machines; they are both devices and symbols, possessing a cultural magnetism that makes them, for many people, the cornerstone of a way of life. They’re tools that kill efficiently while also promising power, respect, and equality—liberation from tyranny, from crime, from weakness. They’re a heritage from an imagined past, and a fantasy about protecting our future. It’s taken nearly two hundred years for guns to become the problem they are today. The story of how they acquired their power explains why, now, they are so hard to stop.

Why am I writing about guns (again) in the Elder Law Prof Blog?  The need for better support for mental health for youth and elders is part of what needs to be addressed.  Sadly, guns are part of a larger story not just for 18 year-olds in New York or Texas, but also for older Americans, as "firearm suicides are one of the leading causes of death for older Americans."  See Firearm Suicides in the Elderly: A Narrative Review and Call for Action, published in 2021 in the Journal of Community Health.  

June 11, 2022 in Cognitive Impairment, Crimes, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, International, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Friday, June 10, 2022

Webinar on Person-Centered Decision-making as Alternative to Guardianship

Here's one more webinar to close out this week.  Pathways to Person-Centered Decision-Making and Alternatives to Guardianship is scheduled for June 21 at 3 eastern. Here is the description:

Person-centered practice is grounded in the idea that people with disabilities are the decision makers in their own lives. Supporting people to make choices is a priority for person-centered systems. Too often people with disabilities are appointed guardians. When people have guardians, their ability to make choices may be significantly constrained in the name of keeping them safe.

This webinar will explore how disability systems are expanding alternatives to guardianship, such as supported decision-making where people choose supporters to help them make important decisions in their lives. Current efforts across the country and internationally to implement supported decision-making and other alternatives provide an historic opportunity to help people take control of their lives. In this webinar, national experts, state representatives, advocates, and people with lived experience of disability from Colorado, Georgia, and Wisconsin, will outline strategies for systems and a new NCAPPS resource to expand supported decision making so that more people can benefit from these alternatives to guardianship.

To register, click here.

 

June 10, 2022 in Cognitive Impairment, Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Webinars | Permalink | Comments (0)

Wednesday, June 8, 2022

FDIC & CFPB Upcoming Webinar

Mark your calendars for a June 15  3 p.m. eastern webinar from the FDIC and the Consumer Financial Protection Bureau for a webinar on  learning about ways to fight elder financial exploitation by using "Money Smart for Older Adults." Click here to register. If you aren't familiar with the FDIC's Money Smart program, click here to learn more.

 

 

June 8, 2022 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Webinars | Permalink | Comments (0)

FBI & Others Offer Elder Justice Initiative Webinars

With World Elder Abuse Awareness Day fast approaching, I'm getting several emails about various educational opportunities during the month of June. Several agencies have partnered to offer a health care fraud webinar series.  The upcoming webinars include Elder Justice: A Case Study of Abuse/Neglect  on June 15, Elder Justice: A Case Study in Health Care Fraud on June 22, and Elder Justice: A Q&A about health care fraud, abuse, and neglect on June 29.  The webinars are all free and open to everyone.

June 8, 2022 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Webinars | Permalink | Comments (0)

Monday, June 6, 2022

Call for Papers: Journal of Elder Policy Issue on Technology as an Underutilized Late-Life Resource

Distinguished Professor and Editor-in-Chief Eva Kahana at Case Western University has advised us of the the most recent "call for papers" for her Journal of Elder Policy.  As most of us who work in law and aging recognize, our field is inherently cross-disciplinary and that is why it is so nice to hear from the sociology field when it is seeking new articles.  The focus for the upcoming issue is Technology: An Underutilized Late-Life Resource.  

The journal, which is peer reviewed, is seeking papers that address policy challenges and implications related to technology use and older adults. They welcome both empirical and conceptual papers from diverse disciplines and have a preference for pieces that employ policy approaches. 

Topics may include but are not limited to:

  • Internet use/access
  • Digital exclusion/inclusiveness
  • Interventions using digital platforms
  • Intergenerational learning
  • E-Health Literacy
  • Cultural influences on technology use in later life
  • Digital monitoring of frail older adults
  • Digital data collection
  • Scams/Fraud

Now the important part: 

Abstracts due by August 15, 2022 (500 words)
Full papers due by October 31, 2022 (8,000-10,000 words)

June 6, 2022 in Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Grant Deadlines/Awards, Statistics | Permalink

Thursday, May 26, 2022

Cognitive Aging, Maturity and Guns

Yesterday I wrote a blog post about gun use that several of my friends correctly characterized as heartfelt.  Of course, legal research is merited, and I find that my view echoes what is written in a key section of a very recent opinion:

Beyond these significant safety concerns, contemporary scientific research increasingly sheds light on the relative immaturity and incomplete cognitive development of young adults. California cites to evidence that young adults are less mature than older adults, which leads them to take more risks and behave more reactively than their elders. Young adults are thus quicker to anger than older adults and more vulnerable to intense mood swings and to making instinctive, rather than considered, decisions. This cognitive immaturity makes young adults more likely to use firearms in situations of significant emotional arousal or perceived threat, or other situations that require rapid, complex information processing. Other Circuits have credited similar evidence to uphold regulations on firearms affecting 18 to 20-year-olds. NRA, 700 F.3d at 208; Horsley v. Trame, 808 F.3d. 1126, 1133 (7th Cir. 2015). The semiautomatic rifle regulation helps to “ensure that access to these weapons is restricted to mature individuals who have successfully completed safety training,” such as members of law enforcement and the military, “furthering the public safety objectives and ensuring that the Founding Era balancing of Second Amendment rights with safety concerns continues today.” Jones, 498 F. Supp. 3d at 1328.

Unfortunately, this is from the dissenting opinion in Jones v. Bonta, decided by the 9th Circuit with an opinion issued less than two weeks before the shooting in Uvalde, Texas.  Sigh.  

Or, as the always astute Professor Naomi Cahn observes, "The irony of the timing of such a ruling is beyond distressing." 

May 26, 2022 in Crimes, Current Affairs, Ethical Issues, Federal Cases, Science, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Wednesday, May 25, 2022

When It Comes to Guns, Age Matters

I suspect I'm not alone in thinking about guns this morning in the wake of the Texas shooting at a grade school in Uvalde Texas.  This post reflects matters I've been thinking about for a long time.  Indeed, thirty years ago I considered making gun violence a core academic research topic, until I realized how potent is the lobby supporting gun sales, and therefore gun ownership.

First, this morning I listened to a young man, David Hogg, speaking to an NPR interviewer about his own frustrations in opposing gun violence.  He urged legislators at state and national levels to do at least "one thing" to move forward on gun safety legislation.  My first reaction was "one thing?"  How is that going to help?  

Second, I heard a bit more about the background of the 18 year old shooter in Texas, as well as the background of the similarly-aged shooter in Buffalo New York.   More memories.  In one of my previous lives, I volunteered for a neighborhood tutoring program in New Mexico.  My first two students, in high school, had been sent to the program by judges trying to help youths in crime-related incidents.  One young man attended once -- and then disappeared.

I managed to have a good session with the other student, a junior in high school, who at my request wrote a short essay about what he saw as his future.  The 500 word piece was quite well written, and gave us something we could definitely use to gently work to improve his reading and writing skills.  The focus, however, proved to be a window into the bleak outlook of a young man who was involved in a so-called gang.  To put it simply, he saw no future for himself after high school.  He said with utter confidence that his high school "had" to graduate him regardless of whether he did any more work, as long as he merely attended class.  I didn't want to believe that, but he had plenty of evidence to support his hypothesis. He didn't have any post graduation plans.  He had equal confidence that he probably wasn't going to make it to age 21.  The following week during our tutoring session, he was creative in his resistance to my role as a tutor.  He turned in his next essay, but it was written entirely in what was some sort of "tagger's script," the stylized script he used when spray-painting his messages on public building.  Tagging was his only crime at that moment.  

I eventually decided to volunteer for younger students, and in fact I had a two-year working student-tutor relationship with a grade school boy who was in the program at his mother's insistence.  Actually, I got to know the whole family, including his parents and a sister who also sometimes attended our reading sessions (and she helped turn reading into a competitive adventure).  To mark the success of his "graduation" from the program, we went to a Phoenix Suns basketball game, because the opposing team that day had a player much admired by my student.  At his comparatively "youthful" age, he had written about his plans for the future, including somehow, against all genetic odds, planning to "grow" tall enough to be a professional basketball player, like his idol, Nate Archibald.  We talked about coaching as an alternative -- just in case.

I remember the difference in these individuals as I listen to the troubled histories of the two "boys" who bought guns as part of their 18th birthday celebrations.  I don't know what happened to most of the other the students involved in the tutoring program.  The second student dropped out of the program for reasons I never learned, but I later saw his name in the newspaper when he was accused of being the driver in a car-jacking where his "friend" shot the woman who resisted having her car taken.  Sadly, that student's essay was prophetic, as any true dreams for a future may have ended with that crime.

So, if we are going to do at least "one thing," could we -- should we -- focus on raising the threshold age for gun ownership?  Should we give young people in their late teens more  time to grow older (and "taller" or more mature) and thus to reach a point where the future seems brighter?  I'm not suggesting they cannot participate in shooting sports, hunting, and the military, where we hope their use and skill building would be supervised by knowledgeable people. I am suggesting making it unlawful for them to "own" or at least to purchase guns until they are older. Research suggests that substantially more crimes of gun violence against others are committed by individuals between the ages of 17 and 21.  There is research to support restricting gun ownership (and therefore gun sales) to individuals over 21 as one step forward in terms of safety. 

For example, in June 1999, a "collaborative report" under the auspices of the U.S. Department of Justice noted in part:

In 1996, 26,040 people in the United States were killed with guns.  In 1997, offenders age 18, 19, and 20 ranked first, second, and third in the number of gun homicides committed.  Of all gun homicides where an offender was identified, 24 percent were committed by this age group, which is consistent with the historical pattern of gun homicides over the past 10 years.  

Other statistics suggest that gun-related suicide death rates are highest for females age 45 to 64 and for males age 75 and older, statistics that point to another form of age-specific gun tragedies. Age matters.

That first boy who "disappeared" after the first tutoring session?  I later learned he had been killed in a neighborhood shooting.  Would younger adults support delayed lawful-ownership as one form of protection against gun violence?   Certainly, more is needed on so many other levels including mental health supports. But could "one thing" -- at least -- include blocking gun sales to people who are still in the process of learning to plan for the future, for their futures?  

 

May 25, 2022 in Cognitive Impairment, Crimes, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Science, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Friday, May 20, 2022

Researcher Explains: Misuse of Data Can Lead to "Pariah-Tizing" the Elderly While Failing to Provide Key Information for All Ages

In September 2021, I listened to a great set of speakers at the Aging, Health, Equity and the Law Conference hosted by Touro College in New York.  One session in particular captured my attention.  Barbara Pfeffer Billauer, JD, MA (Occ. Health), PhD, who is currently Professor of Law and Bioethics at the University of Porto and Research Professor at the Institute of World Politics in Washington DC. spoke about the misuse of statistics regarding COVID-19 on an international scale.  We exchanged emails, and it was clear she was deep into the emerging data from countries around the world.

Dr. Billauer's most recent analysis has received its first publication on May 19, 2022 by the American Council on Science and Health at ACSH.org, with the appropriate yet provocative title of Pariah-Tizing the Elderly: Another Casualty of COVID.

Here she takes on recent news media coverage, including the Washington Post, as well as some scientific community publications, to raise the significant concern that exaggerating the risk of COVID-19 stigmatizes one group -- here the elderly -- while failing to fully inform all age groups about the efficacy of vaccination.  She opens with this explanation:

I call a mistaken, targeted focus and overemphasis on any population group “pariahtization.” As recent evidence demonstrates, this "pariah-tized” focus on the elderly regarding COVID-19 is certainly misplaced. It also has resulted in untoward policies that caused more deaths in both the younger segments of the population. . . .  

 

Contrary to popular opinion . . . COVID is not a disease of the elderly—like dementia, or cataracts, or osteoarthritis. Indeed, older people are less likely to die of COVID than heart disease or cancer. This is not so for the younger cohort, for whom during several months last year COVID was the leading cause of death.

 

For six months of 2021—half the year, COVID was the leading cause of death in those 45-54. In three months of the year, COVID was the leading cause of deaths forages 55-64, but only in two months was it the leading cause of death for those 65-74, the same as for those 35-44; and only in one month was COVID the leading cause of death for those over 75. . . .

 

The misplaced focus [of the media] on the aged being especially vulnerable has led younger people to unwisely eschew vaccination on the grounds that the disease is not generous to them.

Dr. Billhauer clearly has a way with words and she makes effective use of data and charts to explain important data concerns.  The implications of her findings go beyond the problem of the current crisis.  

May 20, 2022 in Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care, Science, Statistics | Permalink | Comments (0)

Wednesday, May 18, 2022

Supporting Law Students Looking for Jobs During the Summer

I get a lot of fun calls, both from attorneys and from law students, looking for the right employment match in "elder law."   For lawyers who are looking for "new attorneys" to help staff their growing law practices, the calls sometimes come just after the law school year is over in early May, when the students have already scattered to the winds or to their homes to study for July Bar Exams.  Law Schools' Career Services offices welcome these calls year-round, but we can often be of more help to both sides of the employment equation when people reach out early in the spring or fall semesters.  

Nonetheless, one of my favorite "secret" ways for students and attorneys to find each other is through Bar Association programming and Continuing Legal Ed programs.  While students usually roll their eyes when, for example, I suggest attending an "educational" program such as Pennsylvania's Elder Law Institute (July 21-22, 2022), most of the students who do attend soon realize that these offer multiple opportunities to get to knew great practitioners and to network.  I often "sponsor" my own summer research assistants to attend at least one full day of programming, especially if there is a meet-and-greet lunch or reception at the end of the day.  Elder Law attorneys are just plain friendly.  This is a win-win for students and prospective employers.

But even beyond elder law, I also recommend that law students reach out during the summers to potential "employers" via State and County Bar organizations in the area of the country where they hope to practice.  For example, I recently noticed that in Arizona, the Maricopa County (Phoenix area) Bar Association is hosting a 2022 Diversity Summer Social on June 9, 2022 expressly for "interns, externs, summer and first year associates."  I'm sure that "prospective" interns, externs, summer and first-year associates would also be welcome to "mingle with other summer associates, local judges and bar leaders." 

I know that one of Pennsylvania's very respected "young" Elder Law attorneys is someone I first got to know as a student because we were both attending a State Bar Association meeting while he was "just" a first year law student.  That's the kind of smart networking that can take people very far.  

May 18, 2022 in Consumer Information, Current Affairs, Legal Practice/Practice Management, Programs/CLEs | Permalink | Comments (0)

Monday, May 9, 2022

Pandemic Retirees Unretiring?

The Washington Post recently published Millions retired early during the pandemic. Many are now returning to work, new data shows. Although a significant number of folks retired early, 

An estimated 1.5 million retirees have reentered the U.S. labor market over the past year, according to an analysis of Labor Department data by ... an economist.... That means the economy has made up most of the extra losses of retirees since February 2020, a Washington Post analysis shows.

Many retirees are being pulled back to jobs by a combination of diminishing covid concerns and more flexible work arrangements at a time when employers are desperate for workers. In some cases, workers say rising costs — and the inability to keep up while on a fixed income — are factoring heavily into their decisions as well.

But those reentering the work force are not just those who retired during the pandemic. 

The percentage of retirees returning to work has picked up momentum in recent months, hitting a pandemic high of 3.2 percent in March, according to Indeed. In interviews with nearly a dozen workers who recently “un-retired," many said they felt comfortable returning to work now that they’ve gotten the coronavirus vaccine and booster shots. Almost all said they’d taken on jobs that were more accommodating of their needs, whether that meant being able to work remotely, travel less or set their own hours.

The article provides a number of interesting examples of individuals who are "unretiring" and why they chose to do so.

May 9, 2022 in Consumer Information, Current Affairs, Other, Retirement | Permalink | Comments (0)

Sunday, May 8, 2022

HHS Inspector General Report on MA Plans

The Inspector General of HHS recently released this report,  Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care.

Here's the OIG explanation why they did the study:

A central concern about the capitated payment model used in Medicare Advantage is the potential incentive for Medicare Advantage Organizations (MAOs) to deny beneficiary access to services and deny payments to providers in an attempt to increase profits. Although MAOs approve the vast majority of requests for services and payment, they issue millions of denials each year, and CMS annual audits of MAOs have highlighted widespread and persistent problems related to inappropriate denials of services and payment. As Medicare Advantage enrollment continues to grow, MAOs play an increasingly critical role in ensuring that Medicare beneficiaries have access to medically necessary covered services and that providers are reimbursed appropriately.

What the OIG found shows that "MAOs sometimes delayed or denied Medicare Advantage beneficiaries' access to services, even though the requests met Medicare coverage rules. MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules." They also found that 13% of denied prior authorizations met the coverage rules and that additionally some denials were made based on lack of documentation but OIG found sufficient documentation had been provided. 18% of payment request denials met the Medicare coverage rules.

Here are their recommendations

Our findings about the causes and circumstances under which MAOs denied prior authorization or payment for requests that met Medicare coverage and MAO billing rules provide an opportunity for improvement to ensure that Medicare Advantage beneficiaries have timely access to all necessary health care services, and that providers are paid appropriately. Therefore, we recommend that CMS:

  • issue new guidance on the appropriate use of MAO clinical criteria in medical necessity reviews;
  • update its audit protocols to address the issues identified in this report, such as MAO use of clinical criteria and/or examining particular service types; and
  • direct MAOs to take additional steps to identify and address vulnerabilities that can lead to manual review errors and system errors.

The full report is available here.

May 8, 2022 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Residents Are Asking a Lot of Questions -- Tough Questions -- about CCRCs

It is Sunday, and I'm looking at a long list of things to do next week, with grading exams at the top of my list.  Significantly, however, in the last six to eight months, at increasing rates, I'm hearing from current and prospective residents of Continuing Care Retirement Communities (CCRCs, also sometimes called Life Plan Communities).  Here are examples of some of the most often asked questions:

  • "The company that runs my CCRC is about to engage in development of a new CCRC.  Is the money I've already paid in the form of an admission fee, or the money I continue to pay as monthly service fees, going to support this new development?"
  • "During the lock-down associated with protecting residents and the public from COVID-19, we were asked to give up services that were the very reason we choose this community.  But now that we are no longer locked down, the services either are not returning or the fees we are charged are actually increasing.  Is there some effective way to object to this disconnect between the promises and the delivery of services?"
  • "My parents are thinking about moving into a CCRC.  On the one hand, I like the idea of the active community they are choosing.  But on the other hand, the amount they are expected to pay in the form of an admission fee is astounding.  Why are some communities calling this a refundable fee and others are saying it isn't a refundable fee? What are the protections for the 'refundable' fee?"
  • "We have just learned that our nonprofit CCRC is being transferred to a for-profit company as the owner-operator.  How is this likely to impact my wife and I as residents?"

Answers to many of these questions depend on the state's laws governing this form of senior living operation and, even more, on the particular contracts between the resident and the provider.  State regulators have concerns here too.  For those looking for legal assistance in their particular community, I sometimes recommend looking for attorneys in the caller's home state, someone who understands CCRCs from a resident perspective. I first wrote about the need for attorneys who understand resident perspectives in 2006.  

Sometimes "elder law" attorneys have this expertise, but not always.  Plus, it can be important to consult with an attorney who understands consumer protection laws, and not "just" CCRC law.  Finally, if litigation is actually on the horizon, the choice for legal advice can depend on whether the attorneys have expertise in litigation or dispute resolution and not "just" contract law. 

So, all of this is a short way of saying that even though, as an legal academic,  I often write about the importance of resident rights in CCRCs, and even though I believe the future of CCRCs is very much tied to the answers, I'm not in a position to respond to individual questions. The very fact that I'm writing this Blog Post is a potential indication that something important could be going on in the industry.  Perhaps that "something" should be addressed by the industry itself, especially if it wants the CCRC concept not just to survive, but thrive.  In my opinion, it is not enough for the industry to say that "every CCRC is different."  

May 8, 2022 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Property Management, Retirement, State Cases, State Statutes/Regulations | Permalink | Comments (0)