Elder Law Prof Blog

Weems says withholding from the public of nursing home problems is not his fault

The acting head of the nation's Medicare and Medicaid programs said Wednesday that he would not have distributed a list of the nation's worst nursing homes to industry lobbyists and trade groups while withholding that information from the public.  "That was not my choice. Things happen in agencies, where individuals for very good reasons take the initiative," said Kerry Weems, acting administrator for the U.S. Centers for Medicare and Medicaid Services, at a breakfast meeting with reporters. said that when he asked agency officials why the list had been given to trade groups, "the answer was that the trade groups can offer specific technical assistance to facilities." He said he did not know who distributed the list, or when it occurred.  "It may have been before my tenure," said Weems, a career employee of the U.S. Department of Health and Human Services who was appointed to his new post by the president in September. "It would not have been my choice."

The agency, which oversees health care for low-income, disabled and elderly Americans, has put together a list of 128 nursing homes around the country that have repeatedly fallen in and out of compliance with government health and safety regulations and caused harm to their residents.  However, it has released the names of only 52 of the facilities to the public and press, while giving the complete list to an industry-funded trade group, the Alliance for Quality Nursing Home Care, as well as lobbyists at the American Health Care Association.  Weems defended the decision to keep the entire list of what are called "special-focus facilities" from public disclosure.

Sen. Tom Harkin, D-Ia., along with Democratic presidential candidate Hillary Clinton, has introduced legislation that would force the agency to release the list to the public.

Source and more:  Des Moines Register, http://www.desmoinesregister.com/apps/pbcs.dll/article?AID=/20071220/NEWS09/712200376/-1/SPORTS09

AMA says Medicare payment reform is critical

Renewed urgency around balance billing comes amid increasing frustration with efforts to reform the Medicare payment formula—especially the component that requires Medicare to remain budget neutral. 

With health system reform looming as a central issue in the 2008 presidential race, members of the AMA House of Delegates focused on strategies to advance the AMA's own proposals. Medicare reform, state health care reform initiatives, the AMA's longstanding opposition to a "single-payer" system of health care, and pending legislation to reauthorize the State Children's Health Insurance Program dominated debate at last month's interim meeting of the AMA House of Delegates in Honolulu (see also Physicians Face Drastic Cut in 2008 Medicare Payment). Indicative of the urgency felt by delegates surrounding health care reform efforts was a resolution that would have had the AMA sponsor a forum on health care reform for all the major presidential candidates at the AMA's annual meeting in June 2008.

Source/more:  Psychiatric News, http://pn.psychiatryonline.org/cgi/content/full/42/24/4?etoc

Bill will allow families to place markers on veterans' graves

Legislation that guarantees U.S. Department of Veterans Affairs gravestone markers for the families of deceased veterans has won Congressional approval.  The bill, which a West Hartford man pushed for nine years in his father's memory, also provides medallions or bronze plates for families to attach to headstones they purchased privately for their loved ones who were veterans.  "This was my Christmas gift. I'm going to remember this Christmas as very special," said West Hartford resident Tom Guzzo, who had worked with members of Connecticut's congressional delegation on the issue since 1998. Guzzo, 47, became involved in the issue after his father, Agostino Guzzo, died in 1998 at age 70. The elder Guzzo spent 14 months during World War II in the Philippines, rebuilding roads until his honorable discharge in 1947.  The Guzzos had already purchased a civilian headstone for Agostino, but a 1990 federal law disqualified them from receiving a government-funded veterans marker. Under that bill, the VA provided headstones or markers only for unmarked graves of veterans who died after Nov. 1, 1990.  Federal officials estimated about 20,000 families were prevented from obtaining VA markers simply because they did not request them before purchasing a private marker, U.S. Sen. Christopher Dodd, D-Conn., has said.

Source:  Newsday, http://www.newsday.com/news/local/wire/connecticut/ny-bc-ct--veterans-graves1225dec25,0,4694560.story

Aging population threatens China's economy

hina's position as the world's major supplier of low-cost labour could be eroded by an ageing population, the authorities have warned.  There are six workers for each retiree in China, but that could narrow to two-to-one between 2030 and 2050, the National Committee on Ageing says.  Officials say the economy will suffer as there will be fewer people working and more older people to support.  China's low-cost labour has provided the base for its economic growth.  Improved living standards and strict family planning laws have contributed to the demographic change.  "We might encounter the heaviest burden especially after 2030, when the demographic dividend is set to end," Yan Qingchun, deputy director of the office of the ageing committee, told China Daily.  "With fewer people of working age and more pressure in supporting the elderly, the economy will suffer if productivity sees no major progress," he added.

Source:  BBC, http://news.bbc.co.uk/1/hi/world/asia-pacific/7149330.stm

Nursing home citations climb by 22%

More nursing homes are being cited for serious violations as inspectors face increasing pressure to crack down on dangerous conditions, a USA TODAY analysis shows.  From 2000 through 2006, the number of citations for putting patients in "immediate jeopardy" increased 22%, according to the records from the U.S. Centers for Medicare and Medicaid Services, which regulates nursing homes. Those citations are the most serious reprimand inspectors can issue and often follow cases in which patients were physically or sexually abused or left without medications.  The increase came as many states stepped up nursing home inspections. Homes that put their patients in immediate jeopardy risk fines or being told they cannot accept new Medicaid patients, a major source of their income.  "It doesn't necessarily mean things are getting worse. It means we're finding more of the problems," said Richard Mollot, executive director of Long Term Care Community Coalition, which advocates for nursing home patients.  Inspectors found nearly 2,000 violations last year that jeopardized patients at nearly 850 of the nation's 16,000 nursing homes, according to the records. They account for about 6% of the total violations uncovered in nursing homes.

Source/more: USA Today, http://www.usatoday.com/news/nation/2007-12-18-nursinghomes_N.htm

KFF Health Policy Picks for December 2007

KFF Health Policy Picks for Dec. include (but are not limited to)

Medicare Part D 2008 Data Spotlights

The Faces of Medicaid II

Nursing Home Quality 20 Years After OBRA

View the full listing of publications at http://www.kaiseredu.org/picks/health_policy_picks.aspx

Uninsured cancer patients will die more quickly...duh

Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.  People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.  The research by scientists with the American Cancer Society offers important context for the national discussion about health care reform, experts say _ even though the uninsured are believed to account for just a fraction of U.S. cancer deaths. An Associated Press analysis suggests it is around 4 percent.

Source and more:  Houston Chronicle/AP, http://www.chron.com/disp/story.mpl/ap/fn/5393027.html
The article will eventually be accessible at http://caonline.amcancersoc.org/

OIG report says Part D plans aren't accurately tracking out of pocket costs as required by law

In a recent study, the Office of Inspector General (OIG) for the Department of Health and Human Services found that Medicare drug plans have not met all requirements for tracking out-of-pocket spending by beneficiaries in the Medicare Part D prescription drug program. Accurate tracking of beneficiaries’ true out-of-pocket (TrOOP) costs is critical to ensuring appropriate cost sharing under the Part D
program.

See the press release  or the full report.

A really old law: Magna Carta sells for 21 plus million

710-year-old copy of the declaration of human rights known as the Magna Carta — the version that became part of English law — was auctioned Tuesday for $21.3 million, a Sotheby's spokeswoman said.  The document, which had been expected to draw bids of $30 million or higher, was bought by David Rubenstein of The Carlyle Group, a private equity firm, the spokeswoman said.  Sotheby's vice chairman David Redden called the old but durable parchment "the most important document in the world, the birth certificate of freedom."  The document was owned by the Perot Foundation, created by Texas billionaire H. Ross Perot, since the early 1980s. It had been on exhibit at the auction house for the past 11 days.

Source/more:  Comcast News, http://www6.comcast.net/news/articles/entertainment/2007/12/19/Magna.Carta/

ABA Comm'n on Law and Aging publishes Volunteer Guardianship Monitoring report

Volunteer Guardianship Monitoring Programs: A Win-Win Solution, published this month by the ABA Commission on Law and Aging with a grant from the AARP Foundation, is a study of volunteer guardianship monitoring projects initiated by AARP in 1990.  The study aimed to determine the extent to which the AARP volunteer guardianship monitoring projects are still functioning, and to examine their experiences and effectiveness in the 10 years since AARP discontinued support.

Volunteer Guardianship Monitoring Programs: A Win-Win Solution is an important resource for courts and persons interested in guardianship monitoring. 

The study found:

· More than half of the programs are still active and their volunteers are satisfied.

· Volunteers are critical to a program’s success and failure.

· Programs maximized scarce resources to successfully intervene and provide remediations for incapacitated adults at risk of abuse, neglect, or exploitation, and assisted guardians. 

· Volunteers-while not free-provide an enormous value, bring a new perspective and energy to the work the court does, and often have skills and experience that paid staff does not have.

· Programs enhance the court’s capacity to monitor cases and to assist guardians without substantially increasing staff and budgets, and help the volunteers make important contributions to their own well-being.

The study urges courts interested in ensuring a program’s success do the following:

• Make room for the program.
• Have a paid program coordinator.
• Recruit volunteers.
• Form partnerships with the state and local AARP offices. 
• Recognize volunteers.
• Adequately supervise volunteers. 
• Conduct comprehensive training for volunteers on a regular basis.
• Track results of the program and use this information to regularly inform the court of the program’s importance. 
• Integrate the volunteer program into the larger monitoring program at the court.

Volunteer Guardianship Monitoring Programs: A Win-Win Solution is available by calling (202) 662-8690.  (For a more comprehensive report on a range of guardianship monitoring practices, see Guarding the Guardians: Promising Practices for Court Monitoring, by the AARP Public Policy Institute with the collaboration of the ABA Commission on Law and Aging, available on the AARP Public Policy Institute website http://www.aarp.org/research/legal/guardianships/2007_21_guardians.html.)

Via the Elderbar listserv....

Retired 64-year-old rodeo queen hates the sedentery life

If her battered joints are stiffening with the approach of winter, Jan Youren isn't complaining.  It's a deeper ache that pains her.  "I am not a person who sits around twiddling my thumbs," she says. "I'm not good at that."  But like it or not, Youren is getting older -- her 64th birthday has come and gone. She's like legions of others having trouble adjusting to retirement's slower pace. And yet, because of what she's retiring from, the challenge is uniquely her own.  "You know, when I quit rodeoing it's a big hole. This year it's harder...," says the five-time world champion bareback bronc rider, who only climbed out of the competitive saddle two years ago -- and would go back in a minute, if not for her kids, and grandkids.  "I never thought I'd stay doing it as long as I did. It's just hard to stop because it's very addictive once you start."  A lifetime of roughstock riding has left her with shattered bones, several fused vertebrae, plenty of scar tissue and shoulders that dislocate whenever she raises her arms above her head. The dislocating shoulders mean that at the end of a bronc ride -- when most riders would grab on to a pickup man, riding close by to whisk them to safety -- Youren must hang on until the bronc bucks her off. A hard landing on the arena's well-churned dirt floor has sometimes left her unconscious for a minute or two.  Five decades of watching this physical torture is enough, her family has decided. 
But Youren fears that once she really stops, the years of prophecies from orthopedic surgeons and emergency room doctors will come true.

Source/more:  Utah Daily Herald/AP, http://www.heraldextra.com/content/view/248311/

Medicare fraud reaches epidemic proportions, but CMS doesn't care....

Through a variety of billing schemes, phony medical supply companies and payoffs to unscrupulous doctors and patients, these thieves now steal an estimated $60 billion a year in taxpayer money that is supposed to finance health care for 43 million American seniors and the disabled.  "The legitimate Medicare recipient is hurt— the legitimate business that's dispensing this and serving patients is hurt, every taxpayer is hurt, and we need to come down on this with both feet," said U.S. Secretary of Health and Human Services Michael Leavitt.  Another official, putting it more bluntly, said, "The system is broken."  And referring to the level of fraud, he added, "It's an epidemic."

False billing continues despite complaints
One of the patients dramatically affected by the widespread fraud is 82-year-old Muriel Sherman. During the last three years, Sherman received dozens of statements from Medicare indicating that the system was billed for tens of thousands of dollars in medicine and medical equipment in her name — care and equipment she never got and didn't need. It began after someone stole her Medicare patient identification number. She suspects the theft occurred at a facility where she went for treatment.

Flipping through page after page of Medicare benefits statements, Sherman insisted that none of the charges were real. "It's all phony," she said. Among other things, the bills indicate she is taking medicine for AIDS, a disease she doesn't have. "The FBI says if I was getting this amount of medicine, I'd be dead," she said. On her behalf, Medicare was also billed for a wheelchair, artificial knees, ankles and an eye, plus other medicines for diabetes. "None of it is real."

Sherman's biggest gripe is that her repeated complaints to Medicare were not acted upon quickly. "They don't want to know you when you call on the telephone," said said.  She also complained that discussions with law enforcement officials never resulted in the prosecution of any of the fraudulent billers. "For these people to do this and not be apprehended is an absolute insult to me and to everyone else," she exclaimed. 

Source/more:  http://www.msnbc.msn.com/id/22202073/

Ed:  Is CMS more concerned with encouraging "personal responsibility" for health care costs than with prosecuting criminals?  I think so...

People:  if you think Medicare fraud is being accomplished using your personal information, contact a lawyer who specializes in "qui tam" actions, pronto!  You'll get up to 1/3 of the total amount recovered!

How cool is this--Tom Waits to perform at Bet Tzedek benefit

Tom Waits makes a rare Los Angeles appearance when he takes the stage to perform at a benefit for the Bet Tzedek Legal Services House of Justice on January 22 at the Century Plaza Hotel. This event is honoring attorney Kevin Marks with the Luis Lainer Founder's Award, Melveny & Meyers LLP with the Rose L. Schiff Commitment to Justice Award, and Anna Burns with the Jack H. Skirball Community Justice Award.  Tickets for the benefit are $400 and may be purchased at www.bettzedek.org. Cocktails are at 9:30pm and dinner at 6:45pm.  When asked of how he became aware of Bet Tzedek, Waits replied in a statement,"Kevin Marks is a longtime friend and ally. A champion of artist and human rights. He has pulled my goyim tuchas out of many a fire."

Founded in 1974, Bet Tzedek Legal Services today is one of the nation's most respected poverty law firms, with a stated mission of ensuring equal justice for all. Each year the organization serves more than 10,000 elderly, indigent and disabled Los Angeles-area residents of all racial and religious backgrounds with critical legal needs, who otherwise would be without access to representation. Clients are represented by a dedicated staff of 62 and more than 600 active volunteers, who last year committed 40,000-plus hours of service.

Source/more:  Harpers, http://harpmagazine.com/news/detail.cfm?article=12036

NIH publishes "Making Your Printed Health Materials Senior Friendly"

Making Your Printed Health Materials Senior Friendly is a new publication from the National Institute on Aging, part of the National Institutes of Health. The tip sheet offers suggestions for how to write and design health information to accommodate cognitive and physical changes that often accompany old age. It provides specific examples and includes resources for more information. Print copies of Making Your Printed Health Materials Senior Friendly are free and available in bulk while supplies last. It is also available online.

To preview, download or print Making Your Printed Health Materials Senior Friendly go to: http://www.nia.nih.gov/HealthInformation/Publications/srfriendly.htm

You can also order a free print copy:

• Order online at: http://www.nia.nih.gov/HealthInformation/Publications/srfriendly.htm  
• Call the NIA Information Center at 1-800-222-2225,   OR  
• E-mail us at [email protected]

New GAO report discusses issues with defined contribution plans and lower-income workers

PRIVATE PENSIONS:  Low Defined Contribution Plan Savings May Pose Challenges to Retirement Security, Especially for Many Low-Income Workers

Over the last 25 years, pension coverage has shifted primarily from “traditional” defined benefit (DB) plans, in which workers accrue benefits based on years of service and earnings, toward defined contribution (DC) plans, in which participants accumulate retirement balances in individual accounts. DC plans provide greater portability of benefits, but shift the responsibility of saving for retirement from employers to employees. This report addresses the following issues: (1) What percentage of workers participate in DC plans, and how much have they saved in them? (2) How much are workers likely to have saved in DC plans over their careers and to what degree do key individual decisions and plan features affect plan saving? (3) What options have been recently proposed to increase DC plan coverage, participation, and savings? GAO analyzed data from the Federal Reserve Board’s 2004 Survey of Consumer Finances (SCF), the latest available, utilized a computer simulation model to project DC plan balances at retirement, reviewed academic studies, and interviewed experts.

What the GAO found: 
GAO’s analysis of 2004 SCF data found that only 36 percent of workers participated in a current DC plan. For all workers with a current or former DC plan, including rolled-over retirement funds, the total median account balance was $22,800. Among workers aged 55 to 64, the median account balance were $50,000, and those aged 60 to 64 had $60,600 (see figure below). Low-income workers had less opportunity to participate in DC plans than the average worker, and when offered an opportunity to participate in a plan, they were less likely to do so. Modest balances might be expected, given the relatively recent prominence of 401(k) plans.

Projections of DC plan savings over a career for workers born in 1990 indicate that DC plans could on average replace about 22 percent of annualized career earnings at retirement for all workers, but projected “replacement rates” vary widely across income groups and with changes in assumptions. Projections show almost 37 percent of workers reaching retirement with zero plan savings. Projections also show that workers in the lowest income quartile have projected replacement rates of 10.3 percent on average, with 63 percent of these workers having no plan savings at retirement, while highest-income workers have average replacement rates of 34 percent. Assuming that workers offered a plan always participate raises projected overall savings and reduces the number of workers with zero savings substantially, particularly among lower-income workers.

Recent regulatory and legislative changes and proposals could have positive effects on DC plan coverage, participation, and savings, some by facilitating the adoption of automatic enrollment and escalation features. Some options focus on encouraging plan sponsorship, while others would create accounts for people not covered by an employer plan. Our findings indicate that DC plans can provide a meaningful contribution to retirement security for some workers but may not ensure the retirement security of lower-income workers.

Get the full report (temporary address):  http://www.gao.gov/new.items/d088.pdf?source=ra

When families are together, take time to discuss advance health care directives

The topic families avoid over holiday dinners or while opening presents; how Mom and Dad should be cared for when they can no longer care for themselves. "We plan for so many things in our lives; holidays, weddings, careers, families, retirement, travel, and financial security, yet we do not plan for our future healthcare, or for life after illness or injury," says Paula Harder Kenemore, a national expert on aging and caregiver issues, and author of the recently released book, My Life, My Care, My Way, My Advance Personal Care Plan. 

"Ten minutes before sitting down to open presents, or just as Mom begins to carve the holiday turkey with a twelve inch electric knife may not be the best time to approach the subject," Kenemore adds. "Plan your conversation well after the holiday dinner, the opening of presents, or the football game, but before anyone heads home." It is important that all family members be included in this conversation, so everyone hears the same thing. If the whole family is not able to attend, consider video or audio recording the conversation. Informing the whole family in advance of the meeting gives everyone a chance to think about it, write down their own concerns, and prepare emotionally for a topic that may be difficult for them. For a free list of what to talk about from both the parent's and children's perspective, visit Lake Effect Media.
   
Having this future healthcare conversation is the first step. Once families are clear on the care and decisions a family member has made, the next step is to get those wishes in writing. "When families are aware of a loved ones wishes, it helps, but it is not enough to keep difficult healthcare decisions out of the legal system and out of the media spotlight, as we saw with Terri Schiavo," warns Kenemore. My Life, My Care, My Way allows an individual to get their wishes in writing.

Source/more:  EMedia-Wire, http://www.emediawire.com/releases/2007/12/emw575415.htm

Remember seniors this holiday season

An excerpt from a plea to remember the isolated seniors in our communitites:

In southeastern Michigan, in about 300 licensed long-term care facilities and in countless unlicensed and unregulated facilities, thousands of seniors who are mothers and fathers, grandmothers and grandfathers will be forgotten -- and in too many cases, neglected or abused. Some, left for months with little or no stimulation or who have been overmedicated to keep them quiet, will slip deeper into dementia.  This forgotten phenomenon is of great concern to those of us who value our aging population and who advocate on their behalf. We continue to be shocked at the neglect and abuse that continues in nursing homes, homes for the aged and foster-care facilities for seniors.  Our community should be deeply concerned about the staffing ratio in long-term care facilities; often they carry a 1-to-12 ratio of staff to residents. More often than not, staff members are not tending to residents' most-personal needs, such as changing soiled undergarments, providing comforting baths or tending to open bedsores. Many times, residents who cannot feed themselves will go hungry.

During the holiday season, many of us will be overcome with the giving spirit -- the urge to find another human being to help. Often, we are drawn to the faces of children.  But this year, perhaps we should focus at least part of our attention on the forgotten population. We should make the mental leap and consider the volume of baby boomers who will be considering long-term care in the near future. Will there be adequate facilities? Will staffing laws be changed to better meet the needs of individuals who cannot help themselves?

Take a moment to visit a senior whose family is no longer valuing the gift of age. Consider spending an hour every other week simply reading to a nursing home resident, or call your grandmother or grandfather to thank them for all that they have done.  Equally important, begin to advocate for change in laws now designed to minimally protect the most vulnerable in our society and generously line the pockets of corporations that have begun to purchase dozens of nursing homes.  We can fix what is happening in these long-term care facilities. We can do it for the seniors who live in these facilities today, or for the baby boomers who will be living there tomorrow.

Source/full commentary:  Detroit Free Press, http://www.freep.com/apps/pbcs.dll/article?AID=/20071211/OPINION02/712110325/1070

Is morphine "comfort for dying" or pain control?

Cancer patients are suffering unnecessarily because they wrongly believe that morphine and other opioids are only used as “comfort for the dying” and as a “last resort” rather than seeing them as legitimate pain killers that can improve their quality of life.  In a study published online today (Tuesday 11 December) in the cancer journal, Annals of Oncology [1], experts in palliative care also say “the belief that opioids hasten death is widely held” amongst patients and this “has a significant impact on pain management, as patients felt that an offer of opioids signified imminent death”. Previous studies have estimated that between 40-70% of cancer patients may not have their pain properly controlled with the right medication for a variety of reasons.

Dr Colette Reid, the lead author of the study, said: “If we are to employ the range of available opioids in order to successfully manage pain caused by cancer, we must ensure that morphine does not remain inextricably linked with death. If this connection stays in place then morphine will continue to be viewed as a comfort measure for the dying rather than a means of pain control for the living.”

Dr Reid, a consultant in palliative medicine at the Gloucester Royal Hospital, Gloucester, UK, conducted in-depth interviews with 18 patients with metastatic cancer, aged between 55 and 82, who were asked to take part in a cancer pain management trial. She wanted to examine how patients reacted when first offered an opioid drug described as similar to morphine. Dr Reid also wanted to understand the factors that influenced patients’ decisions whether to accept or to reject morphine. The interviews were analysed along with an experienced social scientist Rachael Gooberman-Hill, and Geoffrey Hanks, professor of palliative medicine, both from the University of Bristol.

The patients interviewed were all white and half of them were women. Their views and experiences about morphine fell into four distinct but inter-related categories: anticipation of death, morphine as a last resort, the role of the professional, and no choice but to commence.

Morphine as a “last resort” was the central theme to emerge from the interviews. The authors write: “We found that patients with cancer who were offered morphine for pain relief interpreted this as a signal that their health professional thought they were dying, because opioids were interventions used only as a ‘last resort’. Because participants themselves were not ready to die, they rejected morphine and other opioids as analgesics, despite the pain experienced as a consequence. Participants’ descriptions of the role of professionals indicated that patients value professionals’ confidence in opioids. Some patients may therefore become more frightened when offered a choice, since this indicates a lack of confidence in the opioid as an analgesic.”

Source/more:  EurekAlert, http://www.eurekalert.org/pub_releases/2007-12/esfm-mac121007.php
Full journal article:  http://annonc.oxfordjournals.org/cgi/reprint/mdm462v1?gca=mdm462v1&sendit=Get+All+Checked+Abstract%28s%29&

SIPP funding in jeopardy

Two of the country's sources of policy relevant data on health insurance coverage, the Current Population Survey (CPS) and the Survey of Income and Program Participation (SIPP), are both facing funding shortfalls this year.  Without additional funding for the Census Bureau, the new SIPP panel that was scheduled to go into the field in February, will not start until September. In addition, a funding shortfall may force the Bureau to begin cutting the CPS sample size as early as February 2008.  The original SCHIP legislation added $10 million to the CPS to collect data on the number of uninsured children living in low-income families in each state. To get reliable estimates, the Census Bureau had to add 10,000 households to the survey. Over the past ten years, the cost of fielding the survey has increased. This year the Census Bureau requested $20 million to cover this cost. The request was included in Congress' SCHIP Reauthorization, however, President Bush vetoed the bill.

Researchers and policy makers at the federal and state levels rely on the March sample of the Current Population Survey for estimates of the number of adults and children who are uninsured, as well as those on Medicaid or private insurance.  These data have proven critical to understanding reasons that people are uninsured and variations across the states.  If the Census Bureau does not receive additional funding by January, they will be forced to cut the sample size by 5,000 households by February 2008. This would substantially reduce the reliability of data in 27 states. (The most affected states would be CO, CT, DE, IA, ME, MD, MN, NE, NH, RI, and VT, as well as DC.)  Funding for the SIPP, another nationally representative survey that provides data on health insurance coverage, was included in the House and Senate appropriations bills for 2008, but has not become law.

SIPP has been important in understanding how long people are uninsured, and gaps in their insurance coverage.  Findings from SIPP have helped analysts and policy makers realize that continuity of health insurance coverage is critical and has helped encourage efforts to simplify renewal procedures for children on Medicaid or SCHIP, so that they can retain their health insurance coverage. The current level of funding for the SIPP has forced the Census Bureau to cancel its plans to start a new panel of the survey in February 2008. As the debate over SCHIP and broader health care reform continue, it is essential that researchers have access to reliable, contemporary data.

In order to ensure the availability of policy relevant data as we head into 2008, it is critical for Congress to include $2.5 million for the CPS and at least $11 million for the SIPP in the next Continuing Resolution. These funds would prevent cuts to the CPS sample and would allow the Census Bureau to begin fielding the SIPP in June rather than September. Please call your Representative today and ask him/her to fully fund the SIPP and the CPS in the next Continuing Resolution. You can find contact information for your Representative at www.congress.org. Please feel free to contact me if you have any questions. And of course...spread the word.

In winter months, seniors lack shovelers

For each of the past four winters, whenever the snow flies, Karl Rohlich makes a stop or two on his way to his job as a state public defender in Milwaukee County to shovel snow for some elderly Milwaukee residents. He's never been paid, "although once in a while they'll throw a 12-pack at me," he said. Rohlich is a volunteer shoveler through the Interfaith Older Adult Program of Milwaukee County's Good Neighbor project. The program was started four years ago to help connect neighbors with seniors who need help year round with chores, said Renee Jaeger, public relations director for Interfaith.  In its first winter, the program had 185 seniors requesting snow shoveling. Before the Dec. 1 storm, more than 400 people had signed up for help. But the group had fewer than half that many volunteers, she said.  "Older adults call in July" to sign up, she said. "Volunteers call the day it snows. I don't know how to stop that."

Source/More:  Milwaukee Journal/Sentinel, http://www.jsonline.com/story/index.aspx?id=695170