Elder Law Prof Blog

Upcoming Elder Law and Related Conferences

Via the NAELA.org website:

August 18 - 20, 2006	2006 Elder Law Basics This program, co-sponsored by the Tennessee Bar Association and the National Academy of Elder Law Attorneys (NAELA), covers the breadth of elder law. The distinguished faculty for this program includes past NAELA presidents and authors of several national treaties on elder law. Level of instruction is basic and intermediate. A unique aspect of this program is its focus on a case study, in which participants will develop a long-term care plan under the tutelage of experienced elder law attorneys. The course provides 15.75 hours of general and one hour of dual/ethics CLE credit. For more information, a complete schedule of events and/or more information on how to register, visit  https://www.tba.org/onsiteinfo/elderlaw_2006.html      Where: Nashville TN
September 14 - 17, 2006	NAPGCM Annual Meeting For more information on the National Association of Professional Geriatric Care Managers Annual Confererence, please visit http://www.caremanager.org/calendar.cfm    Where: Newport Beach Marriott Newport Beach CA
October 20 - 25, 2006	National Citizen's Coalition for Nursing Home Reform 31st Annual Meeting CARE Matters    For more information, a complete schedule of events and/or to register, visit  http://www.nursinghomeaction.org or call (202) 332-2949.        Where: Hilton Crystal City Hotel 703-418-6800 2399 Jefferson Davis Highway Arlington VA
November 02, 2006	NAELA Certification Review Course Developed and taught by Certified Elder Law Attorneys     The cost of the course is $250.00 and includes lunch. Separate registration is required by Friday, September 29, 2006.       For more information on the NAELA Certification Review Course or NELF Certification Exam, visit the NELF website at www.nelf.org or contact Lori Barbee, NELF Certification Coordinator at (520) 881-1076, ext. 120, by fax at (520) 325-7925, or e-mail at [email protected].   Where: The Grand America Hotel (801) 258-6000 555 South Main Street Salt Lake City UT 84111 For Reservation information please contact: Navigant International (800) 229-8731
November 02 - 05, 2006	2006 Advanced Elder Law Institute "Re-Visioning the Practice"    Register today for this very special Advanced Elder Law Institute created specifically for advanced level attorneys in mind. Special thanks to the 2006 Advanced Elder Law Institute Steering Committee:    Barbara S. Hughes, Esq., Chair Kent B. Alderman, Esq. William J. Brisk, CELA Martha C. Brown, CELA Calvin C. Curtis, Esq. Lawrence A. Frolik, Esq. Nancy P. Gibson, Esq. James M. Higgins Jr., Esq. Rachel Hirschfeld, Esq. Doris E. Hawks, Esq. Ian S. Oppenheim, CELA, NELF Liaison Noel Palmer Simpson, Esq. Lauchlin T. Waldoch, CELA Shirley Berger Whitenack, Esq. Marta J. Williger, CELA A full Institute registration brochure is available now. Simply click on "More Informaton" below. Be sure to register before September 15, 2006 to take advantage of the early-bird registration fees. Full registration fees ($595 for NAELA members/$795 for non members) includes entrance to all educational sessions, the opening reception, three breakfasts, two lunches, and a copy of the conference materials in hard copy or CD-Rom. Additional meal tickets are required for your guests and may be purchased with your registration. For reservations at the group rate of $219, call The Grand America Hotel at (800) 621-4505 no later than September 15, 2006 and be sure to mention that you are with NAELA to receive this special conference rate. For more specific flight information and SLC Airport guides, visit their website at http://www.slcairport.com/    To request a free visitor's kit or to find more information on local shopping, dining and/or entertainment and attractions, visit http://www.visitsaltlake.com/      To register for the NAELA Advance Elder Law Institute now, click here      Where: The Grand America Hotel 555 South Main Street Salt Lake City UT 84111 For Reservation information please contact: Navigant International (800) 229-8731 More information is available in Adobe PDF format.

KFF Report: Profiles of Nursing Home Residents on Medicaid

This report illustrates through case examples the experiences and challenges of low- and modest-income people who rely on Medicaid to pay for nursing home expenses. These case examples were developed through in-person interviews with nursing home residents and their families in three states: Georgia, Kansas and Virginia. The first section of the report summarizes the themes and issues shared across the interviews Kaiser conducted, while the second section presents the individual stories of a subset of those Kaiser interviewed.

Get it here.

Conflicting reports on Part D beneficiaries' satisfaction: are they or aren't they?

How do Part D enrollees feel about the new drug benefit?  How many of them have experienced problems with the enrollment process or accessing benefits?  The CMS version:

The Centers for Medicare & Medicaid Services (CMS) today posted sponsor-level data about complaints it has received about the services provided by the Medicare prescription drug plans in June.  Nationally, during the month of June, 2006, CMS received approximately 2.3 complaints per 1,000 Medicare beneficiaries enrolled in prescription drug plans.   Complaint rates averaged about 2.6 per 1,000 beneficiaries for stand-alone prescription drug plans (PDPs) and about 1.4 per 1,000 beneficiaries for Medicare Advantage drug plans.

“The relatively low number of complaints that we are receiving from beneficiaries is another indication that the vast majority of beneficiaries are getting a high level of service,” HHS Secretary Mike Leavitt said.  “While this is an important result, we are making sure that complaints and any underlying problems are being addressed and resolved as quickly as possible.”

“Almost all of our beneficiaries are in plans with complaint rates substantially less than one percent,” said CMS Administrator Mark B. McClellan, M.D., Ph.D.  “To assure very low complaint rates, we are using these data to address plans’ weaknesses, to continue to find and fix problems and drive for excellence in the service they are providing to their enrollees.  We are particularly concentrating on the plans with relatively high rates.”

But the Center for Medicare Advocacy tells a different story:

Last week, the Centers for Medicare & Medicaid Services (CMS), the agency that administers the Medicare Part D prescription drug program, released statistics on the number of complaints about Part D received by 1-800-MEDICARE, by CMS regional offices, and by Medicare Integrity Contractors.  CMS reports that they received 2.3 complaints per 1,000 beneficiaries during June 2006.  Most complaints were about problems with enrollment and disenrollment.  Data were also collected for three other complaint categories: benefits/access, pricing and co-insurance, and other.  The Center for Medicare Advocacy (the Center) questions whether these numbers accurately reflect the scale and scope of the problems beneficiaries are experiencing with Part D.  As reported in the Center?s Report, "Medicare Part D Progress Report: Six Months Later Headaches Persist" (http://www.medicareadvocacy.org/PartD_6MonthReport072006.pdf), the Center's experience with beneficiaries enrolling in plans, accessing plan benefits, and being charged improper cost-sharing amounts indicates a significantly higher rate of complaints. 

Read more from CMA here.

And the latest Kaiser Family Foundation poll found that almost 20% of beneficiaries have experienced problems with Part D.


As Chris Isaak would say, "Somebody's lyin'..."

Advice on Aging Well

From an advice column in the Philadelphia Evening Bulletin:

Question: Can you give me a formula for having a satisfied and happy old age?

Answer: I've been looking for it, and will spare you my advice. But here is some authoritative advice from a book by a Harvard Medical School professor, Muriel R. Gillick, The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies (2006). Here's how she summarized the right approach: "We know something about what works from a study carried out by the psychiatrist George Vaillant, who interviewed 800 older individuals to try to figure out what allowed them to find meaning and fulfillment as they aged. The most satisfied old people he interviewed cared about and reached out to other people, to whatever extent they could. They accepted dependence, but maintained hope and believed in doing things for themselves if they could. They retained a sense of humor, took pleasure in their past achievements, and remained curious about the world. Most important they retained contact and intimacy with old friends, continuously renewing their relationships."

Kaplan on Means Tested Medicare

Dick Kaplan (Illinois), who can write two articles simultaneously (one with each hand--he's ambidextrous), has just published “Means-Testing Medicare: Retiree Pain for Little Governmental Gain” in the May-June issue of The Journal of Retirement Planning.   The article can be accessed on SSRN at: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=918100

Not elder law: World's oldest condom..?

From All Headline News:

A museum in Austria has put on display a condom made from pig intestine. The Tirolean County Museum said it is the oldest surviving condom in the world.

Museum curators said the reusable condom dates back to 1640. It is complete with the original users manual that is written in Latin.

In the manual, users are advised to soak the condom in warm milk before using to avoid contracting any diseases.

The museum said they found the condom in Lund, Sweden and is one of the 250 ancient items related to sex on display this summer.And in more World's Oldest news, Australia's Blue Mountains are the home of the oldest caves on the planet.  Read all about it at 

The museum said they found the condom in Lund, Sweden and is one of the 250 ancient items related to sex on display this summer.And in more World's Oldest news, Australia's Blue Mountains are the home of the oldest caves on the planet.  Read all about it at http://tinyurl.com/feyrs

Report says 7 million will reach donut hole this year

The Institute for America's Future has issued a report indicating that 7 million seniors and disabled persons will reach the Part D donut hole  this year, meaning that they will be responsible to pay the next $2850 of their drug costs.  This 7 million figure is comparable to those predicted by other groups, including the Kaiser Family Foundation. 

Get the report here: 
http://home.ourfuture.org/reports/medicare/0607-DoughnutHole.pdf

NCEA Newsletter Archives

The National Center of Elder Abuse E-newsletter archives are available at

http://www.elderabusecenter.org/default.cfm?p=newsletterarchives.cfm

This publication is chock-full of information and links.  Check it out.

Feingold to introduce universal health care legislation

Sen. Russ Feingold said Monday he will push legislation that would set up pilot projects to help states provide universal health coverage, delving into an area that could help broaden his appeal as he contemplates a presidential run.

"The time has come to see if we can get across our ideological differences — which are serious — and to see if we can at least get off the dime with the idea of pilot projects," Feingold, D-Wis., told the Associated Press in a telephone interview. "I thought it was time basically to break a logjam."

An estimated 46 million Americans lack health insurance.

Feingold plans to introduce the legislation in Congress later this week or early next week. He acknowledged it has no chance of passing this year but said he wants to have something ready for when a new Congress takes over next year.

Feingold, a potential presidential candidate in 2008, said the health care plan is one of a series of domestic proposals he will introduce during the next six months.

Read more in the St. Paul Pioneer Press.

 

TOC: Spring 2006 Elder's Advisor

7 MARQUETTE ELDER'S ADVISOR, NO. 2, SPRING, 2006.

Mead, Robert A.  St. Rita's and lost causes:  improving nursing home emergency preparedness.  7 Marq. Elder's Advisor 153-201 (2006).

Melcher, Peter and Matthew Zuengler.  Maximizing the benefits of estate planning bet-to-die strategies:  CLATS and private annuities.  7 Marq. Elder's Advisor 203-236 (2006).

Aday, Ronald H. and Jennifer J. Krabill.  Aging offenders in the criminal justice system.  7 Marq. Elder's Advisor 237-258 (2006).

De St. Aubin, Ed, Sheila Baer and Joan Ravanelli Miller.  Elders and end-of-life medical decisions:  legal context, psychological issues, and recommendations to attorneys serving seniors.  7 Marq. Elder's Advisor 259-291 (2006).

Larsen, Rikk and Crystal Thorpe.  Elder mediation:  optimizing major family transitions.  7 Marq. Elder's Advisor 293-312 (2006).

Kwiecinski, Maureen.  To be or not to be, should doctors decide?  Ethical and legal aspects of medical futility policies.7 Marq. Elder's Advisor 313-355 (2006).

Rosenblatt-Hoffman, Miriam.  Student article.  The Schiavo odyssey:  a tale of two legislative reprieves.  7 Marq. Elder's Advisor 357-380 (2006).

Not elder law: 94 year old plays in All-Star game

John Jordan "Buck" O'Neil never got a free pass in life.

The grandson of a man brought to this continent as a slave, O'Neil moved to Kansas City to avoid racial persecution in the Deep South and played baseball during an era of segregation.

It figures that on Tuesday night, when the 94-year-old steps into the batter's box during a minor league all-star game, nobody will quibble over an intentional walk.

Except maybe O'Neil.

"I just might take a swing at one," he said before Tuesday night's Northern League event.

The Kansas City T-Bones signed O'Neil to a one-day contract, likely making him the oldest professional baseball player. He would surpass 83-year-old Jim Eriotes, who struck out in a minor league game in South Dakota earlier this month, by more than a decade.

"I imagine the bat's a little heavier than that club I've been swinging," said O'Neil, who maintains he can still shoot his age in golf. "It's been a long time since I've picked up a bat."

Nobody disputes that O'Neil's involvement in the game borders on a gimmick. But his supporters hope it also provides a boost in their quest to get him into Cooperstown.

Read the rest at MLive.com.  Then find out what happened here.

UAB team develops financial capacity test

A team of UAB doctors has developed a 25-minute test that physicians can use to determine the competence of dementia patients to handle financial affairs.

The test, described as the first designed specifically to evaluate financial capabilities, was introduced Wednesday by Dr. Daniel C. Marson at the 2006 International Conference on Alzheimer's Disease and Related Disorders in Madrid, Spain.

Marson, a University of Alabama at Birmingham neuropsychologist with a law degree, led the team of five doctors who examined the financial skills of a study group in developing the test.

"Impairment and eventual loss of financial abilities are an important and often devastating consequence of Alzheimer's disease and related dementia," Marson said. "As the disease progresses, patients lose arithmetic and other basic money management skills, and the ability to make both complex and simple financial decisions.

Read the rest at Yahoo News.

Long term care is a women's issue

A study by Genworth Financial indicates long term care impacts women, both as care providers
and recipients, more profoundly than men.  Genworth's study, The Impact of Long Term Care on Women -- An Analysis of Women as Care Providers and Care Recipients, found women were 60 percent more likely than men to enter a nursing home at some point in their lives.
It also documented that women may experience large financial sacrifices in
their roles as America's predominant unpaid care providers. The new
gender-specific long term care research was presented to the Congressional
Women's Caucus in a Capitol Hill briefing today.

Key findings of Genworth's study of the impact of long term care on women include:    

• Estimates suggest there are around 23 million unpaid care providers in the U.S.  Seven in ten are women.    
• Nearly one in five unpaid caregivers (19 percent) in America provide "constant care" of at least 40 hours of care per week.  Of those who provided constant care, 80 percent are women.    
• Women 65 years or older today have a 44 percent chance of entering a nursing home at some point in their lives compared to 27 percent of men.    

Get more info via PR Newswire.  Sadly, the full report does not seem to be available. 

Update on Health Policy Fellowships

Now it the time to start thinking about applying for a health policy fellowship.  Check current offerings at KaiserEDU. 

NASI Medicare Academy--Webcast now available!!

The National Academy of Social Insurance (NASI) hosts a 2-day Medicare Academy in Washington, DC, to engage students in discussion on Medicare. The presentations feature discussion on the structure of the Medicare program, current policy issues in Medicare, and the new prescription drug benefit under Medicare.

Part 1: (video - 56k) (video - 256k)
“Getting Involved in Medicare Policy”
Speaker: Dr. Maya Rockeymoore, President and CEO, Global Policy Solutions

“Medicare: The Basics”
Speakers: Tricia Neuman, Vice President and Director, Medicare Policy, Kaiser Family Foundation
                Jack Ebeler, President and CEO, Alliance of Community Health Plans (ACHP)

Part 2: (video - 56k) (video - 256k)
“Medicare Part D: A New Approach to Medicare Benefits” 
Speaker: Bob Rosenblatt, Senior Fellow, National Academy of Social Insurance

Marilyn Moon's presentation is not available on the webcast.

Listen at the KFF site: http://www.kaiseredu.org/nasi_tutorial.asp?id=572

Bush Administration Proposes Massive Medicare Reimbursement Cuts

The Bush administration says it plans sweeping changes in Medicare payments to hospitals that could cut payments by 20 to 30 percent for many complex treatments and new technologies. The changes, the biggest since the current payment system was adopted in 1983, are meant to improve the accuracy of payment rates.

But doctors, hospitals and patient groups say the effects could be devastating. Federal officials said that biases and distortions in the current system had created incentives for hospitals to treat certain patients, on whom they could make money, and to avoid others, who were less profitable.

Michael Leavitt, the secretary of health and human services, said the new system would be more accurate because payments would be based on hospital costs, rather than on charges, and would be adjusted to reflect the severity of a patient's illness. A hospital now receives the same amount for any patient with a particular condition, regardless of severity. Medicare pays more than $125 billion a year to nearly 5,000 hospitals.

The new plan is not expected to save money, but will shift billions of dollars, creating winners and losers. The effects will ripple through health care, because many private insurers and state Medicaid programs follow Medicare's example. Dr. Alan Guerci, president of St. Francis Hospital in Roslyn, N.Y., said the new formula would cut Medicare payments to his hospital by $21 million, or 12 percent.

Read more in the San Francisco Chronicle/New York Times.

Japan surpasses Italy as the world's oldest nation

Japan has outpaced Italy as the world's oldest country, with the elderly population hitting a new high and fewer young people choosing to start families, according to census figures released on Friday.

Japan has been racing to find ways to motivate people to have more children amid fears of a future demographic crisis as a smaller working population supports a mass of pensioners.

Japan's elderly population rose to 21 per cent, or 26.82 million, of the total population of 127.76 million in 2005, up 3.7 points from the previous census taken in 2000, the Internal Affairs Ministry said.

The rate topped the one in Italy, where the elderly form 20 per cent of the population. The third oldest country was Germany, where the elderly defined as people aged 65 or older accounted for 18.8 per cent, it said.

"The population is dwindling across the entire nation," the ministry said in a report accompanying the figures.

"Compared with the level in 2000, the aged population rate is rising in all prefectures with society greying in the entire nation," it said.

The findings coincided with the start of a two-day meeting in Tokyo of Asian ministers tasked with improving gender equality seen as a critical issue in encouraging young women to have children.

Read more at the People's Daily (English edition).

Ed:  Comprehensive information on world demographics and the global aging crisis is available from many sources, including US Census Bureau, IDB (population pyramids); the United Nations; and the Population Reference Bureau.

MedPAC report on Medicare Part D

Via the Center for Medicare Advocacy:

The Medicare Payment Advisory Commission (MedPAC) was created by the Balanced Budget Act (1997) to report on issues affecting Medicare. The June 2006 Report to Congress: Increasing the Value of Medicare http://www.medpac.gov/publications/congressional_reports/Jun06_EntireReport.pdf>) includes an analysis of Medicare Part D plans including enrollment in plans, plan benefits and formularies.  The report also includes a discussion of how beneficiaries chose the drug plan in which they enrolled, which will be examined in a later Weekly Alert.

Read more at CMA.

Additional data on Part D enrolllment issues are available from the Kaiser Family Foundation.

CCELS announces student writing competition

The Canadian Centre for Elder Law Studies is pleased to announce its Student Paper Award in Elder Law for its second Annual Student Paper Prize on an Elder Law topic. The CCELS is committed to promoting student work in the areas of study which consider legal issues affecting older adults. Papers in both official languages are welcome. The prize includes a $500 Cdn honourarium, guaranteed Conference presentation of the accepted paper, Conference expenses and some travel assistance.          

The Student Paper Award will be presented at the Gala Dinner at the Canadian Conference on Elder Law on Saturday, October 14, 2006. Submissions should be made electronically in Word format in 12 point font with an abstract / executive summary in English. The accepted paper will be included in the 2006 / 2007 publication of the Canadian Journal of Elder Law. Papers should be of Journal length, double-spaced, between 15 and 40 pages in length.         

To learn more link to our Steele Prize Information and Submission Form or contact [email protected].

Steele Prize Poster (PDF format) 

Steele Prize Information and Submissions Form (Word format)

Steele Prize Information and Submissions Form (PDF format)          

 

Fewer Workers with Disabilities in Federal Civilian Jobs

The federal government considers itself a model employer of people with severe disabilities, but a continued decline in the number of such employees working for Uncle Sam threatens that image.

The latest numbers from the Equal Employment Opportunity Commission show that disabled workers make up less than 1 percent of the federal workforce despite the Bush administration's efforts to reverse the trend.

In 2005, federal agencies employed 25,142 workers who were deaf, blind, mentally ill or mentally retarded, or had other serious disabilities, according to an annual EEOC report on the federal workforce, released last week. That was a 16 percent decrease from 29,930 such federal workers in fiscal 1996, the EEOC found.

The steady decline occurred when overall civilian federal employment rose by 3 percent, to 2.6 million workers (including the U.S. Postal Service).

Last week Cari M. Dominguez, the EEOC chairman, said the government should take aggressive steps to halt the decline, and tapped EEOC Commissioner Christine M. Griffin to lead the effort. "By highlighting the issue, we hope to accelerate efforts toward finding solutions that will open the doors to federal employment for more people with disabilities," Dominguez said in a statement.

Historically, the federal government has done much to accommodate disabled workers. The Rehabilitation Act of 1973 banned discrimination against disabled people in federal hiring and required agencies to develop affirmative action plans to hire and promote more people with disabilities. It mandated that agencies provide "reasonable accommodations," such as interpreters, modified work schedules and voice-recognition software, to help disabled workers do their jobs.

Read more at ADA Watch and the Washington Post.