September 30, 2008

CARIE Policy Update and Meeting Announcement

Quote of the Month
"Never put off until tomorrow what you can do the day after tomorrow.” - Mark Twain  

Medicare Updates 
For the first time since 2000, the standard monthly Medicare Part B premium will not increase in 2009. The premium will remain at the 2008 rate of $96.40; the deductible for Medicare Part B in 2009 will also remain at the 2008 rate of $135. The figure stays the same next year because Medicare unintentionally collected more than it needed over several years mostly since Medicare reimbursed the Part B reserves for hospice services that should have been charged to another Medicare program. A few higher income Medicare beneficiaries will experience premium increases in 2009. The Social Security Administration’s (SSA) website answers questions about Part B premiums. Other Medicare rates will increase for 2009 including:
• Part A deductibles will increase from $1,024 to $1,068.
• Co-payments for a hospital stay rises from $256 per day to $267 for days 61-90, and from $512 per day to $534 after 90 days.
• The co-payment for skilled nursing care (days 21 through 100) increases from $128 per day to $133.50.

New information and resources are available to help both beneficiaries and advocates about all of the notices, including links, which the Centers for Medicare & Medicaid (CMS) and SSA are sending to beneficiaries.  CMS and SSA mailings include: "SSA Review of Your Eligibility for Extra Help" redetermination notices, which are being sent to about 253,000 beneficiaries currently receiving the Part D Low-Income Subsidy (LIS)/Extra Help; "Change in Extra Help Co-Payment Letter" (Orange letter), being sent to beneficiaries who will still qualify for Extra Help in 2009, but whose co-payment levels will change as of January; "Loss of Deemed Status Letter" (Grey letter), which will be sent to beneficiaries who no longer automatically qualify for Extra Help as of January. CMS has posted numerous materials related to these mailings on its Limited Income and Resources webpage.  The National Senior Citizens Law Center has posted a recently revised free tool for advocates, “The Low Income Subsidy: Redetermination and Redeeming.” 

Most Part D beneficiaries' monthly premiums will increase, if they stay with the same insurer next year. It is estimated that those enrolled in the ten most popular drug plans will see an increase from a low 8% to a high of 64%. The most popular Medicare Part D plan, AARP’s Medicare Rx Preferred Plan, is scheduled to increase 15%. Another popular plan offered by Humana will rise 60%. According to CMS, most participants will be able to access Part D coverage for the same amount or less if they shop around. CMS estimates that the average monthly Medicare Part D premium for standard prescription drug plans in 2009 will be $28. Medicare participants can enroll in drug plans for next year from November 15 through December 31. Final and interim rules to protect Medicare beneficiaries from deceptive and high-pressure marketing during the 2009 Medicare Advantage (MA) and Medicare prescription drug plan open enrollment period have been issued by CMS. The new rules also prohibit financial incentives that encourage agents to increase commissions by moving beneficiaries from one plan to another each year. Fact sheets with more information about each rule are posted online.  Click here to read the September 15 CMS press release. 

Caregiver Advocacy Alert and Federal Update
Pennsylvania’s caregivers need your help! The Family Caregiver Support Bill, House Bill 1830, has passed the House as well as the Senate Aging and Youth Committee. It has been waiting for action in the Senate Appropriations Committee since January. The Senate is scheduled to adjourn for the year on October 8. It is the end of a legislative session in Pennsylvania which means that any bill that hasn’t passed through both chambers of the General Assembly will “die” and need to be introduced during the next session that begins next year. It is important to contact members of the Senate Appropriations Committee now, particularly the Chair, Senator Armstrong, to ask that the bill be voted out of Committee. Clicking on the name on the Senate Appropriations Committee list will take you to another webpage that has each Senator’s contact information. Please call or email Senator Armstrong and any member of the Senate Appropriation Committee that represents your district.  CARIE, in conjunction with the Pennsylvania Elder Economic Security Initiative™ Program, has developed a fact sheet about House Bill 1830 that includes important information such as family caregivers have not seen an increase in support since the bill’s inception in 1990. House Bill 1830 would allow the Family Caregiver Support Program to take advantage of all available federal funding that currently isn’t used because of conflicts with the current law. Please contact Kathy Cubit at CARIE if you have any questions and let me know what, if any, response you receive.

On a national level, the Family Caregiver Alliance recently released two free databases with tools and resources to help informal caregivers and professionals.  The databases are organized as charts with brief descriptions of each tool or resource and links to get more information. 

EPA Aging Initiative Resources 
The United States Environmental Protection Agency (EPA) has an initiative on the environment and aging. There is a wealth of resources on their website including information about chronic health conditions and how to reduce exposure to environmental hazards such as air pollution and drinking water contaminants. For example, there is a series of fact sheets in English and many other languages for older adults and their caregivers about environmental health issues for older Americans. To download these fact sheets or other resources, visit EPA’s website or click here to order free hard copies. In addition to news, grant opportunities, and other information about the environment and aging, there is a listserv distributed each month to highlight federal and non-governmental funding opportunities as well as news items regarding older adults and the environment. To subscribe, visit EPA’s Aging Initiative homepage.   

PA Assisted Living Update 
As described in the last issue of CARIE Connection, the Department of Public Welfare (DPW) submitted the proposed assisted living regulations to the Independent Regulatory Review Commission (IRRC). The PA Health Law Project has organized the PA Assisted Living Consumer Alliance (PALCA) comprised of consumers, caregivers, and advocates who want to ensure that the rights and needs of consumers are addressed in the assisted living regulations being developed in response to Act 56 of 2007. CARIE is pleased to be a member of the PALCA and fully supports its goals. Act 56 created a new assisted living license that will be distinguished from personal care homes in that residents with higher level of health care needs will be able to “age in place” or be served in assisted living rather than being transferred to a nursing facility. PALCA launched a website that includes links to news articles and information regarding the proposed assisted living regulations. 

CARIE submitted comments to DPW and IRRC about the proposed regulations. CARIE also joined the members of PALCA in support of their comments as well. Over 175 organizations, providers and individuals submitted public comments to DPW and IRRC. All comments and other related regulatory information may be found on IRRC’s website. 

The Pennsylvania House Aging and Older Adult Services Committee held a hearing about the proposed regulations on September 18, 2008. Click here to read the testimony submitted by Diane Menio, CARIE’s Executive Director.  Click here for a transcript of the hearing.  

Pennsylvania State Plan on Aging 
The Pennsylvania Department of Aging (PDA) is required by both federal and state laws to develop a “State Plan on Aging.” As part of the process, a series of town meetings were held throughout the Commonwealth between January and March as well as public hearings this past spring to receive stakeholder input into the draft 2008-2012 State Plan on Aging. PDA has posted the final 2008-2012 plan on its website. Secretary Dowd Eisenhower has also written an article highlighting the goals and objectives of the plan.

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

• The Long Term Care Resource Center at the University of Minnesota has posted “Research on State Management Practices for the Rebalancing of State Long-Term Care Systems: Final Report.”  Links to all of the information produced as a result of this project may also be found on their website.  
• More than 90% of U.S. nursing homes were cited for federal health and safety violations in 2007. Click here for the Office of Inspector General report.    
• The Department of Health and Human Services’ Office for Civil Rights has published separate guides for health care providers and consumers about the Health Insurance Portability and Accountability Act (HIPAA) privacy rule that describe when a provider may share a consumer’s health information.   
• The General Accounting Office issued the following report: "Medicare Part D Low-Income Subsidy: Assets and Income Are Both Important in Subsidy Denials, and Access to State and Manufacturer Drug Programs Is Uneven" (GAO-08-824, September 2008).  
• The Social Security Administration has released the agency's new five year strategic plan.
• NCOA has posted a recent free webinar held on September 18, 2008, “A Conversation with an Elder Statesman - NCOA Board Chair, Msgr. Charles Fahey - Personal Reflections on Service, Advocacy, and Professional Development in the Field of Aging.”  You can also download a PDF file of the presentation.
• The Population Reference Bureau (PRB) has posted the following free webcasts: “U.S. Trends in Disability in Late Life” and “Recent Trends in U.S. Mortality and Population Aging.” Linda Martin, a senior fellow at RAND Corporation talked with PRB about her recent work on trends in the health of older people. Click here to view a 26-minute webcast interview with Linda Martin.  Ron Lee, a professor from the University of California-Berkeley, talked with PRB about his research on trends in mortality and aging. Click here to view a 20-minute webcast interview with Ron Lee.
• The Agency for Healthcare Research and Quality (AHRQ) has a “Health Literacy and Cultural Competency” website and a “HHS Resource Links” related webpage.    
• The U.S. Department of Health and Human Services has released a more user-friendly version of healthfinder.gov. The site offers user friendly information and tools to help people stay healthy and prevent disease. The new “myhealthfinder” tool which provides personalized health recommendations based on sex and age. This feature offers evidence-based recommendations from the U.S. Preventive Services Task Force.      
• The Center on Budget and Policy Priorities issued a report: “Preserving Safe, High Quality Public Housing Should Be a Priority of Federal Housing Policy." 
• The U.S. Food & Drug Administration (FDA) posted a new consumer guide, “Is It Really FDA Approved?”  
• The Pennsylvania Office of Long-term Living has launched an updated website for those seeking information and resources about long term living services as well as its special initiatives.       

CARIE News 
Fall marks the start of work-place giving campaigns such as the United Way of Southeastern PA. While we all share concerns about the economy and its effects on our ability to give, these campaigns offer a relatively painless way to help those who are hurting the most. If your workplace participates in an annual campaign, please consider designating CARIE to receive part of your gift through the Donor Choice program. CARIE’s United Way donor designation number is 01885; our State Employee Campaign (SECA) Number is 4101-0223; and our Combined Federal Campaign number is 12341. CARIE receives much of its individual giving this way, and it is so important to help us succeed with our mission! If your workplace is not involved in a United Way campaign, you can donate securely online by clicking here, or by check. Please don’t forget to let us know if your employer will match your gift!  Thanks for your support of CARIE.

CARIE and the Bryn Mawr Graduate School of Social Work and Social Research are sponsoring ethics workshops for social work professionals. This workshop will focus on professional standards and values in relation to aging and health care and will offer a process for resolving ethical dilemmas in social work practice. Issues include: client self-determination and cognitive impairment, confidentiality in the health care environment, client advocacy/client best interests, end-of-life decisions, and professional boundaries and conflicts of interest. This half-day workshop offers 3 Social Worker CEUs. Click here for more information including how to register.  

Just for Fun 
Whether you’re planning to see a movie or perhaps borrow a DVD from your local library, you may want to check the online review from “Reel Geezers.” The reel is a reference to movie reels and the critics are both octogenarians who have been friends for over 40 years. Reel Geezers includes Lorenzo Semple, one of Hollywood's top screenwriters in the 1970s, who helped write many notable movies including "The Parallax View" and "Three Days of the Condor." The other half of the duo is Marcia Nasatir, an agent and producer of films such as "The Big Chill" and "Hamburger Hill." Their website claims that their “YouTube movie commentary is based on nearly a century of combined experience in the film game.” While people are amused with their frequent disagreements about a particular film, viewers are nonetheless impressed with their insights about the movie being reviewed. Visit their Reel Geezers website to view their reviews and click here for an interview from ABC’s Good Morning America to learn more about the couple and hear their commentary about some of this summer’s movies. Even if you aren’t planning to go to a movie, you may enjoy seeing one of their reviews!  

October Legislative Committee Meeting Announcement
The Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on October 2, 2008 at CARIE. Click here for the agenda.  Please feel welcome to join us.

As always, don't hesitate to contact me if you have any questions.

Thanks,
Kathy