Thursday, January 30, 2020
My colleague and dear friend, Mark Bauer sent me this article, An orphaned teen is being forced out of his grandparents' senior community because he's too young. Here's what happened. The kid's parents both died and he moved in with his grandparents in Prescott, Az, where they live in a 55+ community. "[T]he homeowner's association said it could face legal issues if he stayed." He has about 5 months to move out. Although younger folks can live there, the minimum age noted in the article is 19. Both sides have representation and no solution was noted in the article. My sense from the article is the positions boil down to these: have some compassion from the one side, and from the other-there are rules and those who live there have an interest in the purpose of the rules. The young man is 15 years old. I do understand both sides of the argument-there are those who chose to live there because they wanted to live in a community with age restrictions. But on the other hand, both of his parents died..... This is a great fact pattern for our students, and I'm planning to assign them to represent each of the sides and make their arguments.
Thursday, January 23, 2020
Kaiser Health News ran a story about hospice for individuals dying at home and the role of families. Patients Want A ‘Good Death’ At Home, But Hospice Care Can Badly Strain Families explains how Hospice home care works:
Hospice allows a patient deemed to have fewer than six months to live to change the focus of their medical care — from the goal of curing disease to a new goal of using treatments and medicines to maintain comfort and quality of life. It is a form of palliative care, which also focuses on pain management, but can be provided while a patient continues to seek a cure or receive treatments to prolong life.
But the Hospice folks don't do all of the caregiving, with "many family caregivers [responsible for] most of the physical work to [the family, with one daughter noting] that during the final weeks of her mother’s life, she felt more like a tired nurse than a devoted daughter."
Acknowledging that more and more folks want to die at home, the article notes the tasks that fall to family members caring for the person in the final days of life. "Hospice agencies primarily serve in an advisory role and from a distance, even in the final, intense days when family caregivers, or home nurses they’ve hired, must continually adjust morphine doses or deal with typical end-of-life symptoms, such as bleeding or breathing trouble. Those decisive moments can be scary for the family... "said one expert. From personal experience, I can confirm that this happens and it is scary. We were lucky-one of our family was a nurse. I'm not sure how we would have gotten through the process without her. But not everyone has their own family medical professional.
Here's the thing. The person needs 24 hours care but that may not be something Hospice will provide because "hands-on help is scarce. According to Medicare, hospice benefits can include home health aides and homemaker services. But in practice, that in-person help is often limited to a couple of baths a week. Medicare data reveals that, on average, a nurse or aide is only in the patient’s home 30 minutes, or so, per day."
The article looks at the costs and Medicare coverage rates, Hospice residences and nursing home care. There's something of a Catch-22 happening. "As researchers in the field look to the future, they are calling for more palliative care, not less — and, at the same time, they are advocating for more support for the spouses, family members and friends tasked with caring for the patient." As one expert noted, there's a real need "to expand — in general — our approach to supporting caregivers, [pointing out] that some countries outside the U.S. pay for a wider range and longer duration of home health services."
Tuesday, January 21, 2020
The New York Times an an article scrutinizing the status of the Part D coverage gap (a/k/a the Donut Hole), in Medicare’s Part D Doughnut Hole Has Closed! Mostly. Sorta.
The donut hole was weird and unlike other types of insurance and as the article explains, "“designed that way because Congress had a self-imposed budget target,” said Tricia Neuman, who directs the Medicare policy program at the Kaiser Family Foundation.... In order to afford a low deductible, catastrophic coverage and protection for those with low incomes, lawmakers agreed to the doughnut hole. But what other kind of insurance works like that?"
The Affordable Care Act (ACA) contained a provision that gradually closed the donut hole. "The final reduction, for generic drugs, slid into place on Jan. 1. Now, supposedly, there is no coverage gap. Federal regulations require that your plan (most Medicare beneficiaries can choose from nearly 30) average 25 percent cost-sharing for any drug." But remember closing the donut hole is not the same as reducing the cost of prescription drugs.
There's still remaining weirdness with the Part D program, as the article highlights:
This year, after meeting the $435 deductible, you generally pay a flat price for each covered drug during the so-called initial coverage period. Different plans assign drugs to different tiers for which you pay specified amounts.
But once your total drug expenditures hit $4,020, you’re responsible for 25 percent of the plan’s negotiated cost per drug — not a gap, exactly, but a shift.
If you were paying $45 for a prescription that costs $200, your share is now $50 — not a major change. But for a $500 drug, you’ll owe $125 until you reach the catastrophic threshold.. .
It will now take longer to climb out of the not-exactly-a-hole.
Last year, you qualified for catastrophic coverage when your out-of-pocket expenditures reached $5,100.
This year, you don’t qualify until they hit $6,350, a big jump. The Affordable Care Act had maintained a lower threshold; this year, that provision ended.
Once there, your co-payment is a flat $3.60 to $8.95, or 5 percent of the drug’s cost, whichever is higher. (Not lower.)
Part D has never capped out-of-pocket costs, even when you reach the supposedly safe shore of catastrophic coverage. Your 5 percent co-payment lasts the rest of the year.
. . .
All of this takes place against the backdrop of rising drug prices generally. From 2015 to 2017, more than a million Medicare beneficiaries each year passed the threshold for catastrophic coverage — more than twice the number when Part D began, according to a Kaiser Family Foundation analysis.
Oh and choosing the right Part D program is complicated. The article notes that Congressional action is needed to reduce the drug prices. And what if the ACA is repealed??
Saturday, January 18, 2020
HHS has released the 2020 Poverty Level Guidelines.
2020 POVERTY GUIDELINES FOR THE48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
Persons in family/household Poverty guideline
"For families/households with more than 8 persons, add $4,480 for each additional person."
Alaska and Hawaii are also available in the publication.
Friday, January 10, 2020
Kaiser Health News (KHN) recently published a story about a PACE program, Government-Funded Day Care Helps Keep Seniors Out Of Nursing Homes And Hospitals.
The services provided by PACE, a national program primarily funded by Medicaid and Medicare, are intended to keep people 55 and older who need nursing home levels of care at home as long as possible and out of the hospital.
The program is more important than ever as baby boomers age, its proponents say.
“The rapidly growing senior population in California and across the country will put enormous strain on our current fragmented, and often inefficient, health care delivery system,” said Tim Lash, president of Gary and Mary West PACE. California officials consider PACE an integral part of the state’s strategy to upgrade care for aging residents.
Consider the cost-savings to states with PACE programs, as well as the number of folks, typically dual eligibles, who participate. According to the story,
The National PACE Association said data it collected for 2019 shows seniors enrolled in PACE cost states 13% less on average than the cost of caring for them through other Medicaid-funded services, including nursing homes.
. . .
PACE participants who do not receive government medical benefits can pay out of their own pockets. At Gary and Mary West, the tab ranges from $7,000 to $10,000 a month, depending on the level of care.
Nationally, 50,000 enrollees participate in PACE programs at over 260 centers in 31 states. In California, PACE serves nearly 9,000 vulnerable seniors at 47 locations.
PACE provides the same services as under Medicare and Medicaid, and use of team from various disciplines to provide care. Patients often have chronic conditions and almost 2/3 of them have some level of cognitive difficulty.
Check it out.
PACE enrollees commonly have conditions such as vascular disease, diabetes, congestive heart failure, depression and bipolar disorder.
Wednesday, January 8, 2020
Register now for an upcoming webinar from the Department of Justice webinar on Mapping Elder Justice Networks. The webinar is scheduled for January 21, 2020 at 2 p.m. est. Here is info about the webinar
Join us for the webinar, Mapping Elder Justice Networks, where we will introduce the new Elder Justice Networks Locator.
The Locator is a map designed to help elder justice professionals to locate and collaborate with elder justice networks/teams across the nation. Networks will be added in an on-going fashion.
This webinar will discuss the development of this resource, walk through how to find and use the Locator, and explain how to submit your network for inclusion.
Mapping Elder Justice Networks
Talitha Guinn-Shaver, Presenter
The Locator represents the teams that have provided information to participate in this project. Networks interested in being included in the Locator may submit their network name, type, address, web address and email to firstname.lastname@example.org. Please note that for-profit organizations and dot coms cannot be included. Other rules may apply. Submission is not a guarantee of inclusion in the Locator.
To register for this webinar, click here.
January 8, 2020 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Programs/CLEs, State Cases, Webinars | Permalink | Comments (0)
Monday, December 9, 2019
Last week Kaiser Health News reported on mistakes on the Medicare website, which may have causes probelms for beneficiaries chosing their plans during open enrollment. Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment explains the extent of the problem.
The overhauled Plan Finder debuted at the end of August, and 2020 plan information was added in October. Over the past three months, Plan Finder problems reported to CMS by the National Association of Insurance Commissioners, the National Association of Health Underwriters, and state and national consumer advocates included inaccurate details about prices, covered drugs and dosages, and difficulty sorting and saving search results, among other things.
CMS made almost daily corrections and fixes to the website, which is the only tool that can compare dozens of private drug and medical plans ― each with different pharmacy networks, covered drugs and drug prices. The website provides information for more than 60 million people with Medicare and their families, as well as state Medicare counselors and the representatives who answer the 800-MEDICARE help line.
Unsurprisingly, the article notes that some folks signed up before corrections were made, which may not become apparent to them until they use the plan in 2020. Which leads me to my next point.
Sen. Bob Casey of Pennsylvania, the senior Democrat on [the Senate Special Committee on Aging], also said Medicare needs to reach out so people know they can request a “special enrollment period” if they discover next year they made a wrong choice due to inaccurate Plan Finder information.
“People with Medicare must be aware that this reprieve exists and should not have to jump through hoops to qualify,” he said. The administration should “use all means necessary” to let beneficiaries know about their options for a special enrollment period.
Fifteen Senate Democrats, led by Casey, sent a letter Thursday to Medicare Administrator Seema Verma asking the agency to “widely publicize the existing SEP for people who were misled by information” in the Medicare Plan Finder and to make switching plans easy.
The Associated Press reported on that at the end of last week. Senators urge Medicare to allow seniors a drug plan do-over:
In its statement Friday, Medicare said it wants to ensure that seniors “are confident in their decisions and happy in the coverage they choose.”
Medicare said it’s always had the ability to grant do-overs, “but this year we’re doubling down on ensuring that choosing their Medicare coverage is a simple and painless experience for beneficiaries.”
Medicare officials told AP that if seniors had problems with the plan finder and were unhappy with the outcome, they could call 1-800-MEDICARE and request to make a switch.
Agency officials said beneficiaries don’t need to use any technical language, only explain what their issue is to the call center representative. No documentation or screen shots will be required.
Stay tuned. This may not be over.
Monday, December 2, 2019
Although our semester has ended, my students are still paying attention to the elder law issues in the news, including those issues that are being mentioned as part of the presidential candidates' platforms. During the semester, we talk abut news stories regarding elder law issues or elders. We may have started with a discussion of Medicare for All, but we soon moved beyond that onto other issues. Most recently, a student send me a link to a YouTube video about the importance of long-term care, put out by one of the Democratic candidates for President (it's important right now to state that I'm not focusing on politics or a particular candidate, but that candidates are realizing the importance of issues affecting elders in the U.S.). In this video, the 102 year old, Dorothy, has run out of money for her care. Even though it's ultimately an endorsement about a specific candidate, the points made in the video are important and are faced by so many older Americans.
Thanks Jenna for sending this to me and good luck on your exams!
Sunday, November 24, 2019
In case you missed this, a couple of weeks ago CMS released the Medicare premium and deductibles amounts for 2020.
Here are some of the more important numbers for 2020 from the CMS notice:
The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,408 in 2020, an increase of $44 from $1,364 in 2019. ... In 2020, beneficiaries must pay a coinsurance amount of $352 per day for the 61st through 90th day of a hospitalization ($341 in 2019) in a benefit period and $704 per day for lifetime reserve days ($682 in 2019). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $176.00 in 2020 ($170.50 in 2019).
As for Part B, "[t]he standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10 from $135.50 in 2019. The annual deductible for all Medicare Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019."
The release also includes the 2020 Part B monthly premium adjusted amounts for higher-income beneficiaries.
Tuesday, November 19, 2019
The Kaiser Family Foundation has released its November, 2019 issue brief, focused on the costs of Medicare Part D. Medicare Part D: A First Look at Prescription Drug Plans in 2020 offers these key findings
The average Medicare beneficiary will have a choice of 28 PDPs in 2020, one more PDP option than in 2019, and six more than in 2017, a 29% increase.A total of 948 PDPs will be offered in the 34 PDP regions in 2020(plus another 11 PDPs in the territories),an increase of 202 PDPs since 2017.
PDP premiums will vary widely across plans in2020, as in previous years(Figure 1). Among the 20 PDPs available nationwide, average premiums will range sixfold from a low of $13 per month for Humana Walmart Value Rx Plan to a high of $83 per month for Express Scripts Medicare Choice
Two-thirds of Part D enrollees without low-income subsidies (9.0 million enrollees) will see their monthly premium increase in 2020 if they stay in their same plan, while one-third (4.3 million) face premium decreases. As an example, the 1.9million enrollees without low-income subsidies in the Humana Walmart Rx Plan, the third most popular PDP in 2019,will see their monthly premium double in 2020, from $28 to $57, unless they switch plans.This is due to plan changes and consolidations, with Humana consolidating two of its DPs (Humana Walmart Rx and Humana Enhanced) into one PDP or 2020 and renaming it Humana Premier Rx, with a $57 monthly premium.
The estimated national average monthly PDP premium for 2020 is projected to increase by 7% to $42.05, weighted by September 2019enrollment. The actual average premium in 2020 may be lower if current enrollees switch to, and new enrollees choose, lower-premium plans during open enrollment.
In 2020, all PDPs will have a benefit design with five or six tiers for covered generic, brand-name, and specialty drugs,and cost sharing other than the standard 25% coinsurance, similar to 2019. More than eight in 10 PDPs (86%) will charge a deductible, with most PDPs charging the standard deductible of $435 in 2020.
Among all PDPs, median cost sharing is $0 for preferred generics and just $3 for generics, but$42 for preferred brands and 38% coinsurance for non-preferred drugs(the maximum allowed is 50%), plus 25% for specialty drugs (the maximum allowed is 33%).
Medicare beneficiaries receiving the Low-Income Subsidy (LIS) will have a choice of seven premium-free PDPs in 2020, on average, one more than in 2019. In 2020, nearly 20% of all LIS PDP enrollees who are eligible for premium-free Part D coverage(1.3 million LIS enrollees) will pay Part D premiums averaging $18 per month unless they switch or are reassigned by CMS to premium-free plans.
The full issue brief is available here.
Wednesday, November 13, 2019
HR 4334, Dignity in Aging, which provides appropriations for the Older Americans Act through 2024, passed the House of Representatives on October 28, 2019. The text of the bill is available here. According to a press release from the Elder Justice Coalition which brought this good news to my email box,
EJC National Coordinator Bob Blancato said, “The bill retains the all-important Title VII of the Older Americans Act, especially maintaining funding for the work of the long-term care ombudsman program. We support a new provision in the bill which updates elder justice activities to include community outreach and education and ensures innovative projects capture programs and materials for developing partnerships in communities.”
Blancato continued, “Further, we are hopeful that the 35 percent increase in authorization provided for the five-year life of the bill will be followed by adequate appropriations to allow this new initiative to go forward without reducing any existing funding related to elder abuse prevention.”
The EJC also appreciates the continued authority contained in the bill for the National Center on Elder Abuse and the National Long-Term Care Ombudsman Resource Center, as well as the new codification of the National Resource Center on Women and Retirement.
Other new provisions in the bill include first-time social isolation screening, further coordination of services to address this issue, and creation of an advisory council on social isolation. Since social isolation is a leading risk factor for elder abuse, neglect, and exploitation, these interventions are critical to preventing abuse and neglect.
You can sign up to track the bill and get updates here.
Blancato also had special praise for the Education and Labor Committee’s Civil Rights and Human Services Subcommittee Chair Suzanne Bonamici for her leadership on this bill and noted that she is also the co-chair of the House Elder Justice Caucus.
Sunday, November 10, 2019
Everyone agrees that we need a stronger national commitment to "retirement security" in America. But what, exactly does that mean? This topic will be a central focus for discussion during a Public Forum hosted at Penn State's Dickinson Law on Tuesday, November 12, 2019. The keynote speaker is former Maryland Lt. Governor Kathleen Kennedy Townsend, who is currently the Director of Retirement Security at the Economic Policy Institute, as well as serving as a research professor at Georgetown University.
Along those very lines, last week I read a news article about the latest stalemate at the federal level on specific legislation that could promote better retirement savings. The measure in question is H.R. 1994, the "Setting Every Community Up for Retirement Enhancement" Act -- and of course that name was chosen to reinforce the goal of SECURE futures. The bill passed the House with strong, bipartisan backing in May 2019, but is now mired in the Senate. Excerpts from The Hill describe the roadblocks to passage:
GOP senators on Thursday attempted to bring a House-passed retirement savings bill to the Senate floor with votes on a limited number of amendments, but the effort was rejected by Democrats.
The Republican effort and Democrats' rejection highlighted how, despite widespread bipartisan support and backing from industry groups, it is still unclear when the retirement bill will be enacted.
The House in May in a nearly unanimous vote approved the bill, known as the SECURE Act. The bill includes a host of provisions aimed at making it easier for businesses to offer retirement plans and for people to save for retirement. It also reverses a provision in the 2017 Republican tax-cut law that inadvertently raised taxes on military survivor benefits paid to children....
Sen. Patty Murray (D-Wash.) objected to the Republican request, saying that Senate Democrats want the chamber to pass the House-passed bill as-is, without any amendments.
“We have a few Republican senators who want to sidetrack it with last-minute amendments, including proposals that are not in the interest of working families and will kill any chance this bill has of becoming law,” she said.
Murray asked Toomey to modify his request in order to allow the bill to pass as-is, but Toomey said he wouldn’t modify his request.
For another perspective, see "What is the SECURE Act? How Could It Affect Your Future?"
Thursday, November 7, 2019
The Federal Trade Commission (FTC) recently sent a report to Congress, Protecting Older Consumers 2018-2019: A Report of the Federal Trade Commission. Here is the introduction to the 40 page report:
As the nation’s primary consumer protection agency, the Federal Trade Commission (“FTC” or “Commission”) has a broad mandate to protect consumers from unfair, deceptive, or fraudulent practices in the marketplace.1 It does this by, among other things, filing law enforcement actions to stop unlawful practices and, when possible, returning money to consumers. The FTC also protects the public through education and outreach on consumer protection issues. Through research and collaboration with federal, state, international, and private sector partners, the FTC strategically targets its efforts to achieve the maximum benefits for consumers, including older adults. Protecting older consumers in the marketplace is one of the FTC’s top priorities. Unfortunately, in numerous FTC cases, older adults have been targeted or disproportionately affected by fraud. For example, the FTC has brought numerous enforcement actions in federal court to stop deceptive technical support schemes that affected older consumers.As the population of older adults grows,the FTC’s aggressive efforts to bring law enforcement action against scams that affect them, as well as provide useful consumer advice, become increasingly important.
The FTC submits this second annual report to the Committees on the Judiciary of the United States Senate and the United States House of Representatives to fulfill the reporting requirements of Section 101(c)(2) of the Elder Abuse Prevention and Prosecution Act of 2017. The law requires the FTC Chairman to file a report listing the FTC’s enforcement actions “over the preceding year in each case in which not less than one victim was an elder or that involved a financial scheme or scam that was either targeted directly toward or largely affected elders.” Given the large number of consumers affected in FTC actions, this list includes every administrative and federal district court action filed in the one-year period. Appendix A to this report lists all of the FTC’s enforcement actions over the preceding year. In addition to the list, the FTC files this report to provide detail on the agency’s efforts to protect older consumers, including its research and strategic initiatives, its law enforcement actions that noted an impact on older adults, and its targeted consumer education and outreach.
The full report is available here.
Monday, November 4, 2019
Social Security recently posted on the SSA Blog a quick explanation of the basics of Medicare. Medicare, A Simple Explanation first explains original Medicare which "includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Part D plan. To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage." The blog then explains Part C (Medicare Advantage):
Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Part C plans may have lower out-of-pocket costs than Original Medicare. They also may offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.
If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer programs for people eligible for or entitled to Medicare who have low income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance. To qualify, you must have limited income and resources.
I assigned the post to my students. I think it will help them get the parts right in their heads before we start drilling down into the details of each program.
Friday, October 18, 2019
Here's a new fact sheet from the Keck School of Medicine at USC on an important topic. What I should know about opioid pain medicine is a valuable 2 page fact sheet in an easy-to-use format. The topics include pain meds vs. opioids, items that interact badly with opioids, signs of overdoses and more.
Check it out!
Tuesday, October 8, 2019
The GAO recently issued this report, Veterans Benefits: Actions VA Could Take to Better Protect Veterans from Financial Exploitation. Here are the highlights from the report
Why This Matters
Veterans with disabilities who receive benefits from the Department of Veterans Affairs (VA) can be tempting targets for exploitation and scams. Veterans and their survivors who need help performing everyday activities, like bathing and dressing, can receive increased pension benefits known as aid and attendance.
VA paid $3.2 billion in total pension benefits to 232,000 recipients of aid and attendance in fiscal year 2018. Most recipients were over 80.
Scams that target them include:
- being overcharged for home care, or charged for services they did not receive, and
- getting bad investment advice from financial services organizations.
VA does not centrally collect and analyze information, such as complaints made against companies, that could show the prevalence of these scams, help VA target outreach to veterans, and help law enforcement go after scammers.
Other threats to veterans include:
- VA’s applications do not warn them about exploitation or scams: For example, forms do not warn veterans that they cannot be charged fees for filing claims.
- Misdirected benefit payments: VA does not always verify direct deposit information on applications, which could lead to payments being stolen. In contrast, the Social Security Administration verifies this information by reviewing individuals’ checks or account statements.
What GAO Recommends
We made four recommendations to VA, including that it collect better information on potential financial exploitation, post warnings on applications, and examine if it should take more steps to verify veterans' direct deposit information. VA agreed in principle with the need to collect better information, but its proposed actions do not fully address our concerns. VA agreed with the other three recommendations.
The full report is available here.
Monday, October 7, 2019
The article opening with anecdotes involving patients at a Denver hospital,
In the first half of this year alone, the hospital treated more than 100 long-term patients. All had a medical issue that led to their initial hospitalization. But none of the patients had a medical reason for remaining in the hospital for most of their stay.
Legally and morally, hospitals cannot discharge patients if they have no safe place to go. So patients who are homeless, frail or live alone, or have unstable housing, can occupy hospital beds for weeks or months — long after their acute medical problem is resolved. For hospitals, it means losing money because a patient lingering in a bed without medical problems doesn’t generate much, if any, income. Meanwhile, acutely ill patients may wait days in the ER to be moved to a floor because a hospital’s beds are full.
What's a hospital to do? In some cases, provide or pay for housing for those patients. According to the article, a number of hospitals are "exploring ways to help patients find a home. With recent federal policy changes that encourage hospitals to allocate charity dollars for housing, many hospitals realize it’s cheaper to provide a month of housing than to keep patients for a single night." Think about that statement again.... one month of housing may be cheaper than one night's hospital stay.
So the Denver hospital featured in the story is taking this a step farther, "partnering with the Denver Housing Authority to repurpose a mothballed building on the hospital campus into affordable senior housing, including about 15 apartments designated to help homeless patients transition out of the hospital."
Examine these numbers: One night in the hospital featured in the story "costs ... "$2,700 a night [and] ..... [p]atients who are prime candidates for the transitional units stay on average 73 days, for a total cost to the hospital of nearly $200,000. The hospital estimates it would cost a fraction of that, about $10,000, to house a patient for a year instead."
The KHN article references a recent report from the Urban Institute on the correlation between health and housing. Fascinating info!
The GAO recently released a new report, Social Security Benefits: SSA Needs to Improve Oversight of Organizations that Manage Money for Vulnerable Beneficiaries. Here are the highlights:
What GAO Found
The Social Security Administration (SSA) approves organizational payees—such as nursing homes or non-profits that manage the Social Security benefits of individuals unable to do so on their own—by assessing a range of suitability factors, such as whether the organizations have adequate staff to manage benefits for multiple individuals. However, GAO found that SSA's policy does not specify how to assess more complex suitability factors, such as whether an organization demonstrates sound financial management. Without clearer guidance, unqualified or ill-prepared organizational payees could be approved to manage benefits. Also, SSA does not currently require background checks for key employees of an organizational payee. In contrast, SSA requires background checks for individual payees—such as a relative or friend of the beneficiary. A comprehensive evaluation could help SSA determine whether and how to expand their use of background checks to organizational payees.
To ensure organizational payees are managing funds appropriately, SSA uses several monitoring tools, including resource-intensive onsite reviews. Certain organizational payees, such as those that charge fees for their services or have 50 or more beneficiaries (high-volume), receive onsite reviews every 3 to 4-years. In contrast, payees that serve fewer than 50 beneficiaries (low-volume)—the vast majority—are selected for review based on their estimated likelihood of misusing beneficiary funds, and a relatively low percent of them receive onsite reviews (see figure). SSA uses a predictive statistical model to identify higher risk low-volume payees, but the model's effectiveness cannot be fully assessed by GAO or others due to missing documentation on how it was designed. SSA officials said they will update the model in the future, but do not have a time frame for doing so. Establishing such a time frame and documenting design decisions are key steps toward assessing the model's effectiveness.
. . .
What GAO Recommends
GAO is making nine recommendations in this report, including that SSA: clarify how to assess complex suitability factors; assess requiring background checks for organizational payees; establish a timeframe for reviewing the predictive model and document design decisions resulting from that review; and establish timeframes for, and conduct revisions of the accounting form. SSA agreed with all nine recommendations and provided technical comments that GAO incorporated as appropriate.
The full report is available here.
Wednesday, September 25, 2019
Kiplinger recently ran an article, How a Special Needs Trust for Your Child Can Fall Apart, which explains
Parents of disabled children must juggle a lot of responsibilities: work, bills and of course caregiving. But one ball they can’t afford to drop is special needs planning. One wrong move in this complicated ballet balancing benefits and services with asset rules could be disastrous. While every family’s situation is unique, the laws regulating special needs trusts are complex and can require some strategizing by families and trust companies — and if necessary, utilization of available government and nonprofit support programs.
The article reviews the laws, the requirements for a valid third party SNT and highlights one person's experiences, an attorney's advice for the person and advice for parents of children with special needs.
The key takeaway from this story is that it is essential that parents of a disabled child learn about federal, state, local community, charitable and other nonprofit support programs that may help. They must also discuss eligibility rules with relatives who may want to make gifts for the child, leave a share of their estate, include the child in a beneficiary designation for a retirement plan or life insurance or provide other types of in-kind support and maintenance.
Finally, setting up a special needs trust requires planning, legal and financial expertise, and the proper and compassionate administration of a professional trustee.
September 25, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Property Management, State Statutes/Regulations | Permalink | Comments (0)
Tuesday, September 24, 2019
"[t]he elder justice legislation found in this document was elicited and finalized from the National Center on Elder Abuse (NCEA) Listserv and independent websites in August 2019. The compilation is intended to reflect highlights across the nation and does not include all legislation related to elder justice. However, updates will be sent quarterly and states are encouraged to send updates on significant legislative action to Ageless Alliance. This document reflects activity in 17 states and highlights at the federal level.
The report divides the information by federal and state, includes a summary for each development as well as a link to view the information online. It also includes a section of pending activity that deserves a look.
This is a great resource and provides students with a quick snapshot of activities across the country.
September 24, 2019 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (0)