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January 2, 2008

CARIE Policy Update and Meeting Cancellation

Quote of the Month
“The time is always right to do what is right.” – Dr. Martin Luther King, Jr.

Washington Update
On December 19, the House and Senate adjourned for the year after completing action on several legislative priorities during the final days of the first session of 110th Congress. Bills that did not pass Congress in 2007 will continue into the 2008 session. Congress passed a $555 billion omnibus appropriations bill for fiscal year (FY) 2008 (H.R. 2764) that began on October 1. H.R. 2764 provides funding for 11 of the 12 spending bills Congress is required to pass each year. The spending bill that funds the Pentagon passed earlier this year. To avoid a presidential veto of the omnibus bill, Congress had to reduce spending levels to get closer to the overall spending level amount the President proposed. This reduction resulted in a less than 3% increase on average in domestic spending over FY 2007. The Labor-HHS-Education section of the bill totals $600.1 billion with $145.1 billion in discretionary spending. The Administration on Aging (AoA) received a funding increase of $30.4 million, about 2.2 percent above last fiscal year. Unfortunately, the Family Caregiver Support Program was cut by $2.7 million. President Bush proposed eliminating the Community Services Block Grant but Congress actually increases funding above FY 2007. The omnibus bill also maintains the current funding level for the Social Security Block Grant even though the President proposed cutting funding by about $500 million. The Low Income Energy Assistance Program (LIHEAP) fared well and is funded at $2.57 billion, over $788 million more than what the President proposed.

Congress also approved S. 2499, the “Medicare, Medicaid and SCHIP Extension Act of 2007.” S. 2499 includes a six-month delay of the Medicare physician 10 percent payment cut that was scheduled to become effective in January 2008, an extension of the Qualified Individual (QI) program (a Medicare Savings Program that pays Part B premiums) through June 2008, and federal funding for the State Children’s Health Insurance Program (SCHIP) through March 2009.

USASpending.gov was launched in December to meet the requirement of the Federal Funding Accountability and Transparency Act of 2006 to provide a single searchable public website on government spending that includes information about federal government contracts, grants and awards data.

The House is scheduled to reconvene on January 15 and the Senate on January 22. President Bush plans to deliver his State of the Union address on January 28.   

Nursing Home Reform
The Alliance for Health Reform and the Kaiser Family Foundation co-sponsored a Washington D.C. briefing to commemorate the twentieth anniversary of the passage of the Omnibus Budget Reconciliation Act of 1987 (OBRA), landmark federal legislation to improve the quality of nursing home care. A complete webcast of the briefing is available online (running time 1 hour, 43 minutes).  Both Kaiser and the Alliance for Health Reform released a number of resources that look at the impact of OBRA '87. Kaiser also produced a short 12 minute film, "Nursing Home Reform: Then and Now," that can be viewed online or a DVD can be ordered for free.  Of particular interest is the new report, “Nursing Home Care Quality: Twenty Years After the Omnibus Budget Reconciliation Act of 1987,” which explains key components of OBRA ’87 related to nursing home reform, looks at the progress made, and describes problems that still exist in the provision of quality nursing home care.

The Centers for Medicare and Medicaid Services (CMS) has compiled a list of 128 Special Focus Facilities (SFF), nursing homes that continually have problems with regulatory compliance. However, CMS has only released the names of 54 of these facilities to the public.  (The list includes two Pennsylvania facilities.) CMS stated that they do not want to publicly release the other 74 names because these homes either are new to the list or may only be on the list temporarily, although CMS acknowledged providing copies of the full list to state health departments and the nursing facility trade associations claiming the need to challenge them to police themselves. The Center for Medicare Advocacy (CMA) has posted an alert “Senators Focus on Poor Quality Care in Nursing Homes” describing the Special Focus Facility (SFF) initiative and including various links for more information. Of related interest, CMA has also issued an alert, “Facing Discontinuation of Skilled Nursing Facility Care? Know Your Appeal Rights for Traditional Medicare.”

According to USA Today, CMS data shows that the number of nursing homes cited for immediate jeopardy citations increased 22 percent between 2000 and 2006, although many states increased the number of nursing home inspections during this time. Based on incomplete CMS data, more than 1,300 immediate jeopardy citations have already been recorded in 2007.   

Medicare Part D Resources 
Even though CMS stated that they are prepared for the millions of changes older Americans made to their Medicare Part D insurance coverage during open enrollment, advocates know that January will prove to be a busy month resolving prescription drug problems. The National Senior Citizens Law Center has posted a comprehensive alert with resource information, “Low-Income Advocate Alert on Medicare Part D.”  The Kaiser Family Foundation issued new Medicare Part D analyses and resources.  Additionally, CMS has created a new consumer tip sheet, in both English and Spanish, for beneficiaries that may need a prescription filled before they receive their new plan ID card.
Additional CMS resources that may be useful include: 
Medicare Prescription Drug Coverage: How to File a Grievance, Request a Coverage Determination or File an Appeal and Handling Medicare Part D Prescription Drug Plan Complaints.

The Office of Inspector General (OIG) for the Department of Health and Human Services posted a report, “Tracking Beneficiaries’ True Out-of-Pocket Costs for the Part D Prescription Drug Benefit” that found Medicare Part D prescription drug plans have not met all requirements for tracking beneficiaries’ true out-of-pocket (TrOOP) drug costs. Accurate tracking is critical to ensure correct cost sharing under the Part D program.    

Resources for Victims of Financial Crimes
There are several new victim assistance resources that may be helpful for older victims of identity theft and financial crimes. The Office for Victims of Crime (OVC) recently funded four projects to assist victims of identity theft and financial crime, one is a national program and the others are regional. The Identity Theft Resource Center is a national organization that provides phone and email assistance to victims of identity theft at no cost. AARP has an online resource for ID Theft.  The National Consumers League has a new website devoted to counterfeit check fraud.  The Federal Trade Commission’s website on identity theft is a good first resource for anyone who is a victim of identity theft.  Finally, for those working with victims of mortgage fraud, there is a national hotline that works to help homeowners avoid foreclosure. It can also refer victims to local HUD approved housing counselors who are trained in working with victims of mortgage fraud and predatory lending, including rescue foreclosure schemes. Contact the Homeownership Preservation Foundation at 1-888-995-HOPE. A new “Facts for Consumers” publication issued by the Federal Trade Commission, How to Manage Your Mortgage If Your Lender Closes or Files For Bankruptcy, is another useful resource to help advise consumers about what to do if their mortgage company closes or files for bankruptcy.

Pennsylvania News
The Secretary of Aging has announced plans to prepare the 2008-2012 State Plan on Aging.  The process includes a series of town meetings that have been posted. A discussion guide and on-line survey will be posted soon. Additional details may also be found in the latest edition of the “Secretary’s Newsletter.”  The Department of Health and Human Services recently released its strategic plan, “HHS Strategic Plan FY 2007-2012,” that may be a useful reference to the process.

The Office of Long Term Care Living is also sponsoring listening sessions in January and February 2008 about the Attendant Care and Aging Waivers. 

Two new reports of note for Pennsylvania have been recently posted. The Legislative Budget and Finance Committee has released, “Growth in Medicaid Enrollment and Expenditures”  (Click on What’s New?) and The Pennsylvania Medicaid Policy Center has posted, “Long-Term Care in Balance: The Role of Medicaid Policy in Pennsylvania.”   

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

CARIE News
CARIE has posted its most recent “Annual Report,” celebrating 30 years of accomplishments and envisioning our future.

CARIE is on the move and anticipates to be relocating this March to 100 S. Broad Street/1500 Land Title Building in Philadelphia. Please stay tuned for more details and “pardon our appearance” the next time you visit us at our current location.

CARIE is looking for a VISTA Volunteer to provide outreach to low income seniors about the low income subsidy for Medicare. The position requires an individual who has experience working with older adults and those who care for them and is comfortable with public speaking. Please click here for the job description, educational requirements and how to apply. 

Just for Fun 
Put on your “golden slippers” and enjoy a new year’s tradition Philadelphia style with the 2008 Mummers’ string bands or highlights from years past.  

January Meeting Cancellation
The January meeting is CANCELLED! As always, don't hesitate to contact me if you have any questions. Thanks to everyone who supported CARIE in 2007 and throughout our 30 year history. Best wishes for a happy, healthy and prosperous 2008! 
Kathy 
 

Kathy Cubit
Director of Advocacy
Initiatives
cubit@carie.org
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