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An Advocate’s Guide to New Consumer Rights in Medicaid Home and Community-Based Services

New federal Medicaid rules, for the first time, set standards to ensure that Medicaid-funded home and community-based services (HCBS) are provided in settings that are non-institutional in nature.  These standards, which took effect in March 2014, apply to residential settings, such as houses, apartments, and residential care facilities like assisted living facilities.  The standards also apply to non-residential settings, such as adult day health care programs.

The National Senior Citizens Law Center (NSCLC) has developed a guide to the new rules, entitled Just Like Home: An Advocate’s Guide to Consumer Rights in Medicaid HCBS. The Guide’s discussion and analysis include the rules themselves, along with commentary and subsequently-issued guidance from the Centers for Medicare and Medicaid Services, and will be updated as further information becomes available.

Importantly, many details remain to be determined by individual states, subject to review and approval by the federal government.  Stakeholder involvement and advocacy will be critical as state Medicaid programs transition through implementation of the new rules.  Throughout the transition process, both the states and the federal Centers for Medicare and Medicaid Services (CMS) must accept and consider recommendations from consumers and other stakeholders.

NSCLC is available to assist consumer advocates in thinking through the issues and developing state-specific recommendations.  Under Medicaid law, HCBS funding exists to give consumers the ability to receive necessary long-term services and supports without moving into a nursing home or other healthcare institution.  The value of the HCBS alternative would be destroyed or diluted if HCBS were provided in institution-like settings.

Download the guide here.

Lawmaker Pushes for Restoration of State Funds for Senior Services

by David Gorn

Monday, March 17, 2014

http://www.californiahealthline.org/capitol-desk/2014/3/lawmaker-pushes-for-restoration-of-state-fund-for-senior-services

Assembly member V. Manuel Pérez (D-Coachella) last week said it’s imperative to restore $25 million in funding for senior services cut from previous budgets, particularly from the 2011-12 budget. He wants an Assembly budget subcommittee to put that money back.

“Over the last 10 years, state funding for senior programs within the Older Californians Act has been slashed to the bone,” Pérez said.

That includes elimination or reduction of a long list of senior services, he said, including Alzheimer’s Day Care Resource Centers, Senior Companion, Linkages, Respite Care, Brown Bag, Caregiver Resource Centers and the Long-term Care Ombudsman program.

Fully restoring funding for all of those services would come with a relatively low price tag, Pérez said — $25 million of general fund dollars would translate into $41 million, when matched with federal money, Pérez said.

The issue is expected to be reviewed at next week’s hearing of the Assembly Budget Subcommittee on Health and Human Services.

Pérez said life has changed for seniors in California in recent years — and not for the better.

“Community-based programs … enable seniors to remain independent in their own homes, avoiding costly placement into institutional settings,” Pérez said. “The drastic cuts … have done serious harm to the infrastructure of the aging services network.”

Pérez cited statistics from the Kaiser Family Foundation that rank California seniors as having the second-highest poverty rate in the nation. One in five California seniors live in poverty, he said, and more than half the seniors in the state live below 200% of poverty. The number of seniors is increasing in California so over the next few decades the overall number of people affected likely will climb dramatically, he said.

“I believe the restoration of funds to the Older Californians Act fits squarely with the core values of the [Democratic] Caucus’ Blueprint for a Responsible Budget,” Pérez said.

“Especially now with the state’s older population on the rise,” he said, “we must make essential state investments to repair and revitalize this network of flexible, locally driven, person-focused services.”

Reader Comments (1) Post a Comment

Debbie Toth

Thank you for this article. I am happy to see an elected official taking an interest in the systematic decimation of the senior safety net; albeit 6 years late. The problem is it’s only one tiny spec of the senior safety net that has been unraveled to balance the budget. Programs, like MSSP and ADHC, which serve a primarily nursing facility level of care population, have seen elimination and the number of seniors able to be served due to millions in funding cuts plummet. If and when the electeds are really ready to talk restoration of the senior safety net, they might first look at remaining infrastructure, the frailest and most at risk, and for necessary programs like the Alzheimer’s Day Care Resource Center and other Older CA Act funding – a better way to ensure the greatest number of dollars are going to direct service, not more uncoordinated oversight. It’s a new day: we need to spend more thoughtfully to have a greater opportunity to preserve more independence and dignity.

March 17, 2014 at 9:45 AM

Nancy Volpert

Director of Public Policy

Jewish Family Service of Los Angeles

3580 Wilshire Blvd Suite 700

Los Angeles, CA 90010

Direct Phone: 213.260.7906

Phone: 323.761.8800

Fax: 323.761.8801

nvolpert@jfsla.org

www.jfsla.org

MEDI-CAL MANAGED CARE UPDATE

IF YOU LIVE IN SHASTA, SISKIYOU, LASSEN OR MODOC COUNTIES, THIS IS FOR YOU:

All persons living in the northern half of our service area who have Medi-Cal, Medi-Cal/Medicare, Healthy Families or Temporary Assistance for Needy Families for health insurance will receive their healthcare services as administered by Partnership Health Plans starting on September 1.

Work in Progress

PHC has a Member Services Department that is available Monday – Friday, 8:00 am – 5:00 pm. You can call them at (707) 863-4120 or (800) 863-4155. The Member Services Representatives are there to answer your questions about PHC and help you with any problems you may have related to your medical care.

You should call the Member Services Department if you:

  • Want to transfer to a new primary care provider.

  • Are getting a bill for medical care.

  • Need a new PHC ID card

  • Would like to file an appeal or complaint about PHC, your medical care, or your medical provider.

  • Have any questions about PHC or the services PHC provides.

  • Have a problem getting a medical appointment.

  • Have a problem getting a prescription filled.

  • Have paid for medication and/or a co-pay.

PHC_logo

Multi-lingual services and services for hearing, speech and visually impaired members are available through the PHC Member Services Department. For more information about these services, call our Member Services Department or refer to the appropriately titled sections of this website for additional information.

Additional information is available at the website for Partnership HealthPlan of California (http://www.partnershiphp.org/index.htm or http://www.partnershiphp.org/Members/MC_MbrExpan.htm)

Information from the California Department of Health Care Services can be found at: http://www.dhcs.ca.gov/provgovpart/pages/mmcdruralexpansion.aspx or http://www.dhcs.ca.gov/services/pages/healthyfamiliestransition.aspx

 

IN-HOME SUPPORTIVE SERVICES (IHSS) SUIT SETTLED

NOTICE REGARDING IN-HOME SUPPORTIVE SERVICES (IHSS)

In 2009, the State of California tried to cut IHSS domestic and related hours and to cut funds for IHSS workers who make more than $9.50 an hour. In 2011, the State tried to cut IHSS hours by 20%.

Consumer feeding

In response, IHSS recipients and labor unions filed lawsuits. They won temporary orders stopping the cuts. The State appealed the lawsuits. No one knows if the courts would allow the cuts or not. Now there is a settlement. If the court approves the settlement:

• There will be no 20% cut in IHSS hours. There will be a one-year cut of 8% starting around July 1, 2013. This is 4.4% below current hours because there is already a cut of 3.6% that is not part of these lawsuits. (3.6% + 4.4% = 8%).

wheelchair-dog
• Around July 2014, the cut in IHSS hours will go down to 7%. (3.4% on top of the 3.6% current cut).

• There will be no cuts in State funding for IHSS wages.

• You CAN ask the county for extra hours if your circumstances change.

 

TO GET MORE DETAILS OR FILE AN OBJECTION WITH THE COURT:

You can get a copy of the class notice and the settlement agreement from your county welfare office, public authority or online at: DOWNLOAD IHSS SETTLEMENT CLASS NOTICE

Also, you can get details at these websites: www.disabilityrightsca.org, www.altshulerberzon.com, www.dss.cahwnet.gov, and www.dhcs.ca.gov.
banner-ihssYou can also leave a message for the lawyers representing IHSS recipients at 1-866-752-6679.

THE DEADLINE TO OBJECT TO THE SETTLEMENT IS MAY 3, 2013.

You don’t have to do anything if you do not object to the settlement.

DISABILITY TOPS WORLD HEALTH TRENDS

EARLY DEATH REPLACED BY DISABILITY AS MOST SIGNIFICANT HEALTH RISK

“The health of most of the planet’s population is rapidly coming to resemble that of the United States, where death in childhood is rare, too much food is a bigger problem than too little, and life is long and often darkened by disability.

Delicious

Delicious


“High blood pressure is now the leading ‘risk factor’ for disease around the world.  Alcohol use is third.  Low-back pain now causes more disability than childbirth complications or anemia.

“We are in transition to a world where disability is the dominant concern as opposed to premature death, said Christopher Murray, who headed the Global Burden of Disease Study, published on [December 13, 2012].

“The pace of change is such that we are ill prepared to deal with what the burden of disease is now in most places.

“The risk of dying prematurely from many ‘adult diseases’ (such as heart attacks and cancer) has also fallen because of better treatment and prevention.  As a result, the average age of the world’s population is getting older.  Soon after 2015, for the first time in history, there will be more people older than 65 than younger than 5.  That has had two consequences.

“More people are surviving to die of diseases that occur only in old age. . . . At the same time, people are living with conditions that don’t kill them, but that do affect their health.

obesity rate increase cartoon-resized-600


” . . . the study should prompt us to think hard about what are the major causes of disability today, and what are the possible solutions that can accelerate progress against them.”


The independent living movement will be challenged to modify our advocacy to account for these changes.  During the first half of the 20th Century, polio was one of the most dreaded childhood diseases.  A handful of polio survivors were among the first leaders of our movement.  As polio and other infectious diseases are reduced or eliminated, new mostly chronic diseases occupy our attention and healthcare resources.  Going forward, we will be required to expand our scope of practice to include advocacy for the full range of disabled citizens.  In order to maintain our effectiveness, it seems to be incumbent upon us that we play a partnership role in reducing the incidence and severity of these mostly preventable diseases.  


The full newspaper account can be read at:
  http://www.dailyherald.com/article/20121217/entlife/712179975


To access the summaries or full studies from The Lancet, go to:
http://www.thelancet.com/themed/global-burden-of-disease

DOMESTIC WORKERS BILL OF RIGHTS VETOED

In what may be a victim of election season politics, a landmark bill dubbed “The Domestic Workers’ Bill of Rights,” Gov. Jerry Brown vetoed Assemblymember Tom Ammiano’s AB 889 at the last minute on Sunday 9/30/12, stalling efforts to provide common workplace protections to workers – mostly women – who have historically labored without guarantees of overtime or meal breaks.

It needs to be pointed out that sincere efforts were made to ensure that the rights of disabled people employing their own assistants would not be harmed in the process of granting rights to domestic workers in other situations.  “We worked very hard to make sure that the employers, as well as the workers and the disability rights community who ended up removing opposition, were heard in producing this bill,” Ammiano said.

“It’s long overdue for these workers to get these rights,” Ammiano said. “Almost everyone else has had them for decades. There will be new efforts to bring them protections, but we must always remember that justice delayed is justice denied.”

The bill, AB 889, was the product of months of work and negotiation, culminating with a late agreement that would have sent the matter to the Department of Industrial Relations for formulation of regulations.

California would have been the second state to enact labor protections for domestic workers. New York enacted a Domestic Workers Bill of Rights in 2010.  The California bill was supported by more than 100 labor, women’s, faith and community groups including National Domestic Worker Alliance, Mujeres Unidas y Activas, CHIRLA, NAACP, AFL-CIO, and Pilipino Workers Center, and has received prominent endorsements from The New York Times and “Parks and Rec” celebrity Amy Poehler.

Click HERE for a link to the entire bill.  The Governor’s veto message can be viewed HERE.