Elder Law Prof Blog

KFF on Medicare and dual-eligibles

The Kaiser Commission on Medicaid and the Uninsured (KCMU) has prepared two new 
publications that examine those who are eligible for both Medicare and Medicaid, 
known as dual eligibles. The first, /Dual Eligibles: Medicaid Enrollment and 
Spending for Medicare Beneficiaries in 2003/ 
<http://www.kff.org/medicaid/7346.cfm>, finds that Medicaid programs spent 
roughly $105 billion on the 7.5 million Medicare enrollees who were eligible for 
Medicaid in 2003 and includes detailed charts and state-by-state data tables on 
enrollment and eligibility group and spending by service. The second, an updated 
fact sheet <http://www.kff.org/medicaid/4091-04.cfm>, describes the over 7.5 
million dual eligibles, why this population needs Medicaid, what services they 
receive from Medicaid, and the current policy challenges related to dual 
eligibles, including the new Medicare prescription drug benefit. The data can 
also be found on Statehealthfacts.org <http://statehealthfacts.org/r/duals.cfm> .

'Nine Lives' book project gives a voice to isolated elders

From SFGate.com

The Internet has transformed communication, the polar ice caps are said to be melting and globalization has become a dirty word  --  all in the space of the time it has taken today's elders to outlive their peers and become isolated from the rest of society.

"That isolation shouldn't be inevitable," says Brent Nettle, whose San Francisco nonprofit, Eldergivers, has published "Nine Lives," (Eldergivers, $25) a book about Moreno and eight other Bay Area seniors whose deeply tapestried lives suggest what they can offer to our youth-driven culture.

"Older lives are much richer, deeper, broader," says Nettle, executive director of Eldergivers. "Elders are just much more interesting people. Yet they have been cowed into thinking they don't have a role in our society, when, in fact, they have the most important role: challenging the superficiality and self-centeredness in our society."

Nettle also initiated Art With Elders, which holds weekly art classes in nursing homes and exhibits the artwork of elders. Call it his stealthy way of making the world sit up and notice seniors.

"Nine Lives" has a similar aim, enlisting a volunteer team of professional writers who spent the past year visiting their subjects in nursing homes from Mountain View to Danville.

"Nine Lives," Vol. 1 ($20) and Vol. 2 ($25), is available online at www.eldergivers.org or by calling (415) 441-2650. Vol. 2 will be available after Sept. 6.

New Report: What kinds of drugs do the elderly need?

The Top Five Therapeutic Classes of Outpatient Prescription Drugs, by Total Expenses for the Elderly and Near Elderly in the U.S. Civilian Noninstitutionalized Population, 2002

          Statistical Brief #91
           Household Component
          July 2005

Using data from the Household Component of the 2002 Medical Expenditure Panel Survey (MEPS-HC), this Statistical Brief provides a summary of the top five therapeutic classes of outpatient prescription drugs for the elderly (age 65 and older) and the near elderly (age 55–64), when ranked by total expenses, as reported by households in the U.S. civilian noninstitutionalized population in calendar year 2002, as well as estimates for these population groups on the percentage of total prescribed drug expenses the top five therapeutic classes represent, the percentage having an expense in these classes of drugs, and the mean expenses in these classes of drugs for those with an expense.

Author(s):           Marie N. Stagnitti, MPA
Agency:           Rockville (MD): Agency for Healthcare Research and Quality

Get the full report from the Medical Panel Expenditure Survey website.

Medicare and Medicaid at 40

Check out KFF's new publication, Medicare and Medicaid at 40, published 7-26-05. 

The Medicare and Medicaid health coverage programs were signed into law July 30, 1965. The Kaiser Family Foundation has some new resources that examine how Medicare and Medicaid came into existence and how they have evolved over the past 40 years. You will find new documentaries and extended interviews with key policymakers and government officials examining the origins of Medicare and Medicaid, new interactive historical timelines, a chart pack of key information and statistics, a webcast of a retrospective of the two programs with historian Robert Dallek and key government officials responsible for the programs over the past 40 years, and many other background resources on the two programs.

There's even a movie trailer!

Missouri AG to host end-of-life conference for MO legislators and policymakers

Kansas City INfoZine reports that

The Missouri End of Life Coalition and Attorney General Jay Nixon are partnering with the National Hospice and Palliative Care Organization and Lt. Gov. Peter Kinder to host a statewide event in October for legislators and other policy makers to review Missouri's laws surrounding advance directives, living wills and other end-of-life issues. The Coalition and the Attorney General previously partnered on the publication Life Choices, a resource to help Missourians learn about end-of-life resources and planning.

The End of Life Coalition is also hosting seven regional town hall meetings across Missouri in the three months leading up to the summit, beginning with a meeting in Springfield on Thursday, July 28. During these regional meetings, the coalition and its partners will take public feedback on end-of-life issues, which will be included in policy discussions at the October event.

Details aboout the event are available from the AG's office.

PRIVATE ACCOUNTS WOULD SUBSTANTIALLY INCREASE FEDERAL DEBT AND INTEREST PAYMENTS

All of the major proposals to replace a portion   of Social Security with private accounts would require large increases in   federal borrowing for many decades.  This increased borrowing is not necessary   to restore Social Security solvency.   Instead, the increased borrowing would   be needed to finance the creation of the private accounts, which by themselves   would not do anything to restore solvency, and under some circumstances would   worsen solvency. Some plans with private accounts, like the   President’s, would shrink the solvency gap by reducing Social Security   benefits (over and above the benefit reductions that are designed to   compensate for the loss of payroll taxes diverted to private accounts).  These   benefit reductions would partially offset the increased borrowing that would   result from the private accounts.  Even when these benefit reductions are   taken into account, however, all of the proposed plans that include private   accounts would substantially increase the federal debt and the interest   payments on the debt.

Read the rest of this report from the Center for Budget and Policy Priorities.

Then, tell elected officials what you think.

   

All About Australian Elderly Women Living Alone

In Australia, elderly women accessing community services to remain at home outnumber men three to one.

This is revealed in the latest overview of who is benefiting from commonwealth-funded programs designed to help elderly and frail people stay in familiar neighbourhoods instead of taking the often traumatic step into nursing homes.

The Australian Institute of Health's report on who is getting community services, to be released today, shows that women are three times more likely than men to be living on their own.

Get the full story from The Australian.   Then, get a scholarly analysis of this phenomenon as discussed in Gender, ageing, and injustice: social and political contexts of bioethics from the Journal of Ethics and Medicine.

 

91 Year Old is Nation's Oldest Female Inmate

NPR, in the second of two reports on elderly inmates in U.S. prisons, takes a look at the case of the oldest female prisoner in the country. Lucille Keppen is 91 and is serving time in a state prison in Minnesota.                

                                   

San Diego Law receives 1.75 million gift to create chair in elder law

The University of San Diego School of Law today announced a pledge commitment of $1.75 million from Susan S. and Jerry G. Gonick of San Diego to endow a chair in the field of elder law at the School James C. and Gale Krauseof Law. In recognition of their leadership and generosity, the law school will name the chair the Susan S. and Jerry G. Gonick Chair in Elder Law.

Susan Gonick, who was awarded her juris doctor degree from USD in 1986, is a member of the law school's Board of Visitors. Jerry Gonick received his master of laws in taxation from USD in 1984.

"We are very grateful to Susan and Jerry Gonick for this generous planned gift and for Susan Gonick's valued service on the law school's Board of Visitors," said Interim Dean Kevin Cole. "This chair will help us attract and retain distinguished teachers and scholars in an area that is increasing in importance not only to law students but also to a growing yet underserved part of the community."

"Seniors are the largest growing segment of the population," said Jerry Gonick. "Who is going to be protecting their rights? I see elder law as an area of growth and the wave of the future, and I want to help USD get to the forefront of it."

"We see a lot of elderly people living on fixed incomes — people who have worked hard and paid taxes all their lives — whose rights are not being protected," said Susan Gonick. "Many law schools don't offer courses in elder law. This can be an area in which USD shines."

Read more in the July 25 press release.

Stetson Law completes high tech accessible courtroom for elder advocacy

Stetson University College of Law is completing construction on the nation’s first elder-friendly, high-tech courtroom on its Gulfport campus. The completed courtroom will be dedicated Sept. 16, 2005, in honor of Professor Emeritus William R. Eleazer, who spent his career training ethical advocates.
 
The barrier-free courtroom, a joint effort of Stetson’s Centers for Excellence in Advocacy and Elder Law, is designed as a national model to increase courtroom access to the elderly and disabled. It uses cutting-edge technology including flat-panel monitors to display evidence, hearing amplification devices to make speech more audible, and a multi-lingual software speech synthesizer that will read aloud words displayed on a computer screen, translate them into multiple languages, and even output words to refreshable Braille displays if needed.
 
The teaching courtroom features a double jury box with one-way glass, which will allow students to monitor mock juries and focus groups. A flat-panel touch screen outside the courtroom will explain the roles of court personnel in the proceedings.
 
The courtroom will be used first by Stetson’s Elder Consumer Protection Program, which offers free public seminars to raise awareness of consumer scams as well as programs to train law enforcement, protective services workers, and assistant state attorneys on investigating and prosecuting consumer frauds against elders.

Read more at Stetson's website.  Stetson's Elder Law Program is directed by Professor Rebecca Morgan.  The school is hosting a national symposium on elder exploitation in September.
 

The Nation's Oldest Male Criminals

NPR has a story on the aging of the nation's prison population.

For more information on this subject, , see NELN Bibliography, The Quality of Care of Elderly Inmates in Prison. 

How soon we forget: Post-Schiavo interest in living wills wanes

The Cincinnati Post reports:

In the months following the highly publicized family feud over the life and death of Terry Schiavo, interest in living wills seems to have faded in Greater Cincinnati after an initial surge. "I would say the interest has probably completely died down. Anyone who was motivated (by the Schiavo case) has probably taken care of it, or it's on the back burner again," said attorney Matt Darpel, of Fort Mitchell, who prepares living wills and handles estate law and financial planning.

Ed:  In some states, the lack of an advance directive means that courts will necessarily become involved in medical decisionmaking.  In others, surrogate decision-maker statutes establish the priority of various family members and others who will be empowered to make those decisions.

For more information, see NELN.org's advance directives information.

ADA Watch Declares "Rights Still at Risk"

“On the 15th Anniversary of the Americans with Disabilities Act"

Statement of Jim Ward, ADA Watch Founder and President:

On this day we recognize all who worked tirelessly to pass the Americans with Disabilities Act (ADA) which was signed into law by President George H. W. Bush on July 26, 1990.  We seek to honor all who worked to make this dream a reality -- the advocates, elected leaders, lawyers, lobbyists and especially the members of disability community’s grassroots which is comprised of individuals with disabilities, parents, families, friends and employers.

While this is a time to acknowledge the advances made by people with disabilities as a result of this historic civil rights law, it is essential that we examine what has not been accomplished, and what we are at risk of losing.  Indeed, just last year, a study by a commission of the American Bar Association found that employers prevailed in more than 94 percent of the 327 ADA employment-related cases decided last year in federal courts. The study concluded that the legal standards within the law were being interpreted by the courts in ways that "still create obstacles for plaintiffs to overcome." Despite this imbalance in the courts, ADA opponents continue their campaign to further weaken disability rights. States continue to claim “Sovereign Immunity” – the tired doctrine of “States’ Rights” previously used to oppose civil rights protections for African Americans. Many of these cases have risen from the lower courts to the Supreme Court resulting mostly in close 5-4 decisions. Some of these decisions have eliminated the damages state employees could previously win as compensation for on-the-job discrimination. Others have narrowed the definition of disability eliminating protections for individuals with diabetes, epilepsy and mental illness.  All of these 5-4 decisions remind us of the power that will be held by the current President Bush’s decision to nominate John Roberts – himself an attorney who has worked to weaken the ADA – to a lifetime seat on the Supreme Court. When President George H. W. Bush signed the Americans with Disabilities Act into law in 1990, he declared that our nation "will not accept, we will not excuse, we will not tolerate discrimination in America."  Fifteen years later, individuals with disabilities and our supporters, know that “tolerance” is still being defined.   

Japanese Women Have World's Longest Life Expectancy

From Reuters Health:

Japanese women had a life expectancy of 85.59 years in 2004, making them the world's longest living group for the 20th consecutive year, the government said on Friday.

Japanese men trailed with a life expectancy of 78.64 years, which placed them second for longevity after Icelandic men, who live an average of 78.8 years.

The government attributes Japanese longevity to a range of factors, including a healthy diet and improving medical care, a spokeswoman for the Health Ministry said.

The Japanese diet tends to be rich in vegetables and fish products and relatively low in animal fats.

But long life expectancies combined with a tumbling birth rate may be storing up problems for Japan, where one in five of the population is over 65 and the figure is expected to jump to one in four in the next decade.

Women in Hong Kong were the second longest living group in the world, according to Japanese government figures, followed by Swiss women.

Sushi, anyone??

Untangling pensions--get help in locating "lost pensions"

Today's CSM has an excellent story on resources for locating "lost pensions" when a former employer has folded, but pension funds are held in trust for beneficiaries. 

The pension benefit many workers casually scan over early in their careers becomes increasingly important as they near retirement. Whatever career stage you are in, the following resources may help you to maximize this benefit or resolve problems collecting it:

• Personal documents: Preserve notification that you are vested in a plan, an exit letter describing plan benefits, and a summary plan description. Also save W-2s. Documentation of income earned and dates worked can prove your pension eligibility. Also save your company's official name and tax ID number, which can be used to track down successor companies.

• The US Department of Labor - Employee Benefits Security Administration (www.dol.gov/ebsa 866-444-3272) offers a free booklet, "What you should know about your pension plan." It provides explanations of various types of retirement plans and your rights under the Employee Retirement Income Security Act. It also covers survivor benefits and addresses what happens if your plan terminates or your company merges.

• Pension Benefit Guarantee Corp., the trustee of 3,500 pension plans, takes over plans for certain companies if they dissolve. It also takes over the administration of benefits for plan administrators who lose contact with retirees. If you lose touch with a former employer, a quick visit to www.pbgc.gov/search may lead you to missing benefits.

• Pension Counseling Projects can help you track down a missing pension or resolve a pension dispute. For a list of pension counseling centers across the country, visit www.pensionaction.org/publications/ lostpension/appendixc.htm. These pension experts work for free.

• The National Retiree Legislative Network (www.nrln.org 866-360-7197) is a nationwide activist group that provides a network to lobby legislators on pension and other retiree-related issues.

• The Association of BellTel Retirees (www.belltelretirees.org, 800-261-9222) helps employees or retirees of any descendant company of Bell Telephone. This nonprofit group fights for pension and other related benefits through proxy motions and regular communication with corporate executives.

• Kirstein Library (617-523-0860) in Boston is one of the nation's first business libraries. Mention "pension" to its librarians and they will direct you to several useful publications and directories to help you track down lost companies or plan administrators.

GAO Report: A Look At Our Future: Social Security and America's Long-term Fiscal Challenge

A quick look at the very scary numbers on elderly dependency ratio and other stats.
Published July 21, 2005

Not elder law: new cycling world 1-hour record

With so much attention focused on the Tour De France, you might have missed this big story from the world of cycling.  From Velo News:

Czech rider Ondrej Sosenka set a new world hour cycling record at the Krylatskoye Olympic indoor track on Tuesday, Russian cycling federation deputy president Yury Kucheryavy told AFP. 

Sosenka covered a distance of 49.700km, beating British cyclist Chris Boardman's mark of 49.441km, set in 2000 in Manchester, England. 

The Czech rider was under Boardman's record from the outset, recording a time of 1:15.01 (to 1:17.891) for the opening kilometer. He went through the 5km point over three seconds up, and by 25km had extended his advantage to just under seven seconds. This continued to grow to 18 seconds by 40km. 

The 29-year-old Acqua e Sapone rider is a time-trial specialist. The current Czech TT champion, he won the prologue of the Uniqa Classic and the stage 4 time-trial in the Tour of Belgium this season. He also is a past winner of the Tour of Poland and the Tour of Slovakia.

Editor's note:  Riders in this event are required to use old-time technology approximately equivalent to that used by Eddie Meryxx in 1972. 

KFF Medicare Health Plan Tracker Now Available

Kaiser Family Foundation has updated its Medicare Health Plan Tracker to include current year information about participating Medicare Advantage plans, payment rates and enrollment. The Plan Tracker is an interactive online resource that provides basic information about Medicare HMOs and other private plans, including plan participation and beneficiary enrollment at the national, state, and county levels. The new update includes payment rates for 2005, and data about enrollment and participating plans as of March 2005. Online users can get quick facts about these plans, examine key historical trends and compare their state or county to others.

The plan tracker is available at KFF's website.

Greenspan Opposes Estate Tax Cuts without Compensating Offsets

From the CBPP:

Federal Reserve Chairman Alan Greenspan reiterated his opposition   to tax-cut proposals that increase the deficit and made clear that this   opposition applies to proposals that repeal or drastically reduce the estate   tax without fully offsetting the costs. 

With the reappearance of high deficits, Greenspan has called for   reinstating the “pay-as-you-go” rule (often-called PAYGO) that require the   cost of all entitlement expansions and tax cuts to be offset, so that they do   not increase the deficit.  Senator Charles Schumer (D-N.Y.) asked Greenspan   about the affordability of estate tax repeal if the cost were not offset.    Greenspan stated that, despite favoring “reducing taxes on capital,” he only   supports such tax cuts “under PAYGO” and would advise Congress not to repeal   the estate tax if the cost of repeal were not offset.

Schumer also asked Greenspan about estate tax reform proposals that cost   nearly as much as repeal.  For instance, Senator Jon Kyl has proposed allowing   the first $8 million of an estate to be tax free ($16 million for a couple)   and setting the estate tax rate equal to the capital gains rate, which is   currently 15 percent.  This proposal would cost 93 percent as much as repeal,   according to the Urban Institute-Brookings Institution Tax Policy Center.   Greenspan responded that he also would oppose such costly estate tax reform   proposals if they were not offset.

Get the facts on the budget consequences of "the Paris Hilton tax cut."    

Coalition on Human Needs to Host Medicaid Birthday Parties...

...and more.  See the CHN.org website for details on the following events: 

Actions to Fight Cuts:
Around the country, advocates are planning actions this summer to tell Congress and the public about the need to protect low-income children, families, the elderly, and people with disabilities from service cuts. To get involved or organize more activities, find state budget contact people in your state at http://www.chn.org/pdf/statebudgetcontacts.pdf.             

Medicaid Birthday Parties: AR, IA, MO, MT, NE, NV, OR, PA, RI, TX, UT, WV.
In the states listed above, groups are planning Medicaid birthday parties (Medicaid’s 40th anniversary is July 30), with cake and birthday cards delivered to senators and representatives. To find a Medicaid party in your state, contact Liz Ryan, Center on Budget and Policy Priorities, at [email protected], or (202) 408-1080.      

Federal Budget Forums: CO, IA, MN, UT.
Groups in these states are holding forums to publicize the threats to Medicaid, Food Stamps, housing, and other services. To learn more, email or call the state budget contact person in your state, listed at http://www.chn.org/pdf/statebudgetcontacts.pdf.

Release of State Hunger Data or other Food Stamp events: MT, OH, OR, NV, PA.  State groups are holding press events about hunger in these states. To learn more, email or call the state budget contact person in your state, listed at http://www.chn.org/pdf/statebudgetcontacts.pdf.             

Emailable letter to Congress.
Tell Congress protect services for low-income families. This email letter is provided by the Coalition on Human Needs at http://www.chn.org/campaign.jsp?campaign_KEY=1001