May 1, 2007

CARIE Policy Update and Meeting Announcement

Quote of the Month
“Ageism is as odious as racism and sexism.” – Senator Claude Pepper

Assisted Living and Personal Care Homes in PA
Please click here to read CARIE’s “Featured Policy” article about personal care homes and assisted living in Pennsylvania.  Included are links to an article in the Pittsburgh Post-Gazette that describes the Rendell administration’s plans to introduce assisted living legislation in Pennsylvania and a recently released Legislative Budget and Finance Committee report, “An Assessment and Cost Review of Personal Care Homes in Pennsylvania.”

2007 Annual Trust Fund Reports for Medicare and Social Security
It is no surprise that the annual Medicare and Social Security Trust Fund reports indicate that the programs are not sustainable. Treasury Secretary Paulson stated the following at a press briefing regarding the 2007 Social Security and Medicare Trust Fund reports, "...This year's Social Security report again demonstrates that the Social Security program is financially unsustainable and requires reform. In just 10 years, cash flows are projected to turn negative, and the Trust Funds are projected to be exhausted in 2041. Reform is needed and time is of the essence. The longer we delay, the larger the required adjustments will be – and the burden of making those adjustments will fall more heavily on future generations. Social Security's unfunded obligation - the difference between the present values of Social Security inflows and outflows less the existing trust fund - equals $4.7 trillion over the next 75 years and $13.6 trillion on a permanent basis. The actuarial imbalance expressed as a percent of taxable payroll is 1.95 percent over 75 years and 3.5 percent over the indefinite future. This means that, to make the system whole on a permanent basis, the combined payroll tax rate would have to be raised immediately by about one-third from 12.4 percent to about 15.9 percent, or benefits reduced immediately by 22 percent. This report confirms the need for action; the sooner we take action to strengthen Social Security's financial footing, the less drastic the needed reforms will be..."

“The 2007 Medicare Trustees Report shows even greater financial challenges. Medicare faces the same demographic trends as Social Security, and, in addition, the system must cope with large increases in health care costs. Cash flow for the Hospital Insurance (HI) Trust Fund is projected to be negative this year and for all subsequent years. The HI Trust Fund is projected to become insolvent in 2019, one year later than projected in last year's report …”

• 2007 Medicare Annual Report (PDF, 234 pages)
• 2007 Social Security Annual Report (PDF, 226 pages) 
• Summary of Medicare and Social Security Reports 

Consumer Reports Best Buy Drugs Program
The Consumer Reports Best Buy Drugs Program was initiated in 2004 and seeks to provide unbiased information about prescription drugs to consumers and healthcare professionals. The mission of this program is multifaceted. First, Consumer Reports seeks to provide unbiased in-depth information on prescription drugs to consumers, doctors, pharmacists and others. Second, is to increase access and affordability to needed medicines. Third, is to help relieve the financial burden caused by high drug prices to consumers and business.  A goal is to get the informational brochures from this program into the hands of as many consumers and healthcare professionals as possible. The research shows that the information provided through this program can save an individual up to $2,000 per year depending upon the type of prescription drugs they are taking. It is also important for consumers to remember that while this program does not evaluate a person’s health problems, consumers can use the literature available on Consumer Reports’ website or in hard copy from CARIE to begin a dialogue with their physicians about their individual needs.

Information about this program is free and downloadable by visiting the Consumer Reports Best Buy Drugs’ website or contacting Lynn Heitz at CARIE. Lynn is also available to provide presentations to senior groups about the program. 

CMS Proposes DRG Changes
On April 13, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule change to the Inpatient Prospective Payment System (IPPS) identifying its plans to restructure the hospital Diagnosis Related Groups (DRGs) to better account for the severity of a patient's illness among other significant changes outlined by CMS. CMS is also proposing that Medicare no longer pay hospitals for the cost of treating hospital-acquired conditions such as infections. It is also expanding the list of publicly reported quality measures and all hospitals will have an incentive to report specific quality data. CMS' rates for inpatient operating expenses will increase by an average 3.3 % in Fiscal Year (FY) 2008 and for some hospitals, such as urban hospitals treating more critically ill patients, rates will increase by about 3.5 %. The final rule is expected to be published in August and the changes will become effective October 1, 2007.

SEPTA Public Hearing
On April 12, CARIE’s transportation advocate provided testimony at the Southeastern Pennsylvania Transportation Authority’s (SEPTA’s) “FY 2008 Operating Budget Proposal” public hearing.  Specifically, CARIE’s testimony (insert link here) reflects concerns regarding the proposed massive fare hikes for SEPTA Shared Ride and Paratransit services as well as SEPTA’s proposed service cuts. In addition to proposing increased fares for fixed route service, SEPTA is proposing to raise Shared Ride fares. Their proposal is a bit misleading in that it only shows the 15% co-payment portion, raising the group ride co-payment from $3.20 to $3.70 and the individual ride from $3.50 to $4.00 as opposed to the full lottery funded subsidized fare. CARIE strongly opposes any increase in fares for the Shared Ride Program or Paratransit. In addition, the testimony explains how service cuts have the potential of causing serious consequences to older adults. 

Just the Links.....
The following are links to potential resources or documents of interest:

• The Jewish Employment and Vocational Service (JEVS) and the Governor’s Office of Health Care Reform have partnered to develop and support a “Home Modifications in Pennsylvania” website for consumers to learn about home modifications and how to finance them.
• Public Citizen has issued a report, “Unsettling Scores: A Ranking of State Medicaid Programs,” that shows a wide disparity among states that is worsening in part due to the Deficit Reduction Act of 2005.  Pennsylvania ranked 33 overall but was in the bottom 10 states for reimbursement and “has earned a reputation for miserliness.”
• The Institute of Medicine (IOM) issued a report, “The Future of Disability in America,” that concludes that the United States needs a better system to care for people with disabilities. The report builds upon two previous IOM studies and looks at progress and continuing issues of concern. The book may be purchased or read in sections.
• The Center for Retirement Research at Boston College has released an issue brief, “Medicaid and Long-Term Care: How Will Rising Costs Affect Services for An Aging Population?”
• The Office of Inspector General issued a report, “Medicare Hospices: Certification and Centers for Medicare & Medicaid Services Oversight” that found 14% of Medicare hospice providers were overdue for certification, some have not been surveyed for over nine years.
• The Congressional Research Service’s report, “Long-Term Care: Consumers, Providers, Payers, and Programs,” provides an overview of long term care, describes financing and funding mechanisms, and concludes that “challenges include uneven availability of home and community-based services across and within states, and an uncoordinated service delivery system that is funded by many sources with differing eligibility requirements and service requirements.”
• Genworth Financial released its “2007 Cost of Care Survey” and found that the “vast majority of Americans are not prepared for the costs of long term care.” In Pennsylvania, the average annual cost of care for 50 hours per week of care from a Medicare-certified and licensed home health aide is $48,100 compared to the average for the Philadelphia area at $98,592. Other locations and costs may be found on an interactive map at Genworth Financial’s website.
• On April 23, the Government Accountability Office (GAO) issued a report, “Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents” (PDF, 100 pages, and, Highlights, 1 page) and concludes there was little improvement in enforcement against facilities for infractions of federal regulations. Pennsylvania was among the states reviewed.
• The International Longevity Center has published its 2006 annual report, “Caregiving: As Its Population Ages, America Looks To Its Caregivers.” The report includes information about caregivers, ageism, and the Center’s publications.
• AOA’s most recent edition of “Profile of Older Americans 2006” is now available.
• The Kaiser Family Foundation released new primers on the Medicare and Medicaid programs.

CARIE News
On Thursday, May 10, 2007, Diane Menio, CARIE’s Executive Director, is being honored by the SeniorLaw Center as one of two “2007 Outstanding Advocates.” Please join us in honoring Diane at the “Bet on a Winner” fundraising event to benefit the SeniorLaw Center. The event will be held at the Mellon Bank Center, 8th floor, 1735 Market Street, from 5:00 – 8:30 PM. For ticket information, please go to the SeniorLaw Center's website or call (215) 701-3203. There are a limited number of tickets available at a non-profit rate.

Just for Fun ... "The Zimmers"
Smashing aging stereotypes along with their guitars is the latest band to join the “British invasion,” the Zimmers. The Zimmers will be featured in a BBC documentary about the problems faced by older adults in England to be aired in May. The average age of the band is 78, with some members who are 99 and 100. The conclusion of the documentary features the band singing their version of “My Generation” and this music video has taken YouTube and the internet by storm. Enjoy!

May Meeting Announcement
Please click here for the agenda for the Committee’s May 3rd meeting. Please feel welcome to join us. As always, don't hesitate to contact me if you have any questions.
Thanks,
Kathy