CHANGES ARE COMING TO HEALTHCARE

ON MEDICARE?  ON MEDI-CAL?  ON BOTH?

BIG CHANGES ARE COMING TO CLIENTS & CONSUMERS WHO RECEIVE HEALTHCARE AND SOCIAL SUPPORTS THROUGH MEDI-CAL ONLY OR MEDICARE & MEDI-CAL.

A new super agency, called the Administration for Community Living, was created in 2003 by combining three agencies under a single umbrella.  These are the Administration on Aging (AoA), the Office on Disability (OD) and the Administration on Developmental Disabilities (ADD).  There is a local manifestation of these three support networks in the forms of Passages, Independent Living Services of Northern California (ILSNC) and the State Council on Developmental Disabilities – Area Board 2

People who receive straight Medi-Cal or both Medicare & Medi-Cal, the so-called “dual eligibles,” will be switched from a “Fee-for-Service” method of payment to a “Managed Care” method by 2013-2014 in our area, according to plans from the California Departments of Health Care Services and Health & Human Services, in conjunction with the U. S. Health & Human Services.  To add to the confusion, military veterans, along with the dual eligibles and straight Medi-Cal clients will soon be directed to a new agency, called the Aging and Disability Resource Connection (ADRC).  All long-term support services requiring public funding will be referred to through a local ADRC.  Eventual plans call for an ADRC for all of California’s 58 counties.

In 2007, a contract was signed between ILSNC and Passages establishing an ADRC in a 5-county area served by Passages and ILSNC (Plumas, Butte, Colusa, Glenn and Tehama).  4 of our counties are served by a separate AoA based in Siskiyou County, serving Shasta, Modoc and Lassen counties as well, for which no ADRC exists.

These are momentous changes for our consumers and clients, who have been operating under a fee-for-service model whether utilizing Medicare or Medi-Cal for healthcare and attendant social supports.

How will people with disabilities and their families and caregivers going to be affected by the proposed changes?  How will the outcomes in the “Demonstration Project” in 8 counties affect healthcare and social supports in our service area?  Even among the professionals there are far more questions than answers.  Stay tuned for future developments as these initiatives are rolled out and the inevitable bumps in the road are smoothed out to create an operational network designed to provide a more efficient referral and service delivery process.

Additional information is available at:  http://www.communitychoices.info and http://www.hhs.gov/acl

AB 889 GOES TO BROWN FOR SIGNATURE

Legislation that would give California’s domestic workers such as housekeepers and nannies overtime pay, rest periods and other state labor protections was sent to Gov. Jerry Brown on Thursday for either a signature or a veto.

The legislation, Assembly Bill 889, went to Brown on a 42-27 vote along party lines. It’s sponsored by the California Domestic Workers Coalition and dozens of labor unions and civil rights groups and is being carried by Assemblyman Tom Ammiano, D-San Francisco.

Ammiano and other advocates said the legislation would protect domestic workers against exploitation and insisted that when the state Department of Industrial Relations adopts regulations to implement it, it would not be applied to teen-age babysitters and other casual workers.

Republicans, however, said that it would raise costs for parents and the elderly who depend on household help.

Supporters of a Domestic Workers’ Bill of Rights

Throughout the campaign, there was controversy amongst advocates for disability rights regarding the effects of the bill.  Objection #1 for private pay employers of home care attendants was the fear that some employers would not be able to afford to pay the increased benefits required by the bill.  There was also some concern that unintended consequences would occur to further harm private pay employers of lesser means.

Proponents of AB 889 point out that having hundreds of thousands of workers without a basic labor agreement is a major cause for the abuses, i.e. labor and pay violations, outright abuses and threats to personal dignity, suffered by home care workers.

During the last week of the session, a compromise was reached which struck most of the firm statutory language from the bill and replaced that with a framework agreement to require the Department of Industrial Relations to create a fair basic labor regulatory structure by January 1, 2014.

The California Domestic Workers’ Bill of Rights was endorsed by the New York Times on August 10, 2012.

Read more here: http://blogs.sacbee.com/capitolalertlatest/2012/08/california-assembly-oks-overtime-pay-rest-breaks-for-domestic-workers.html#disqus_thread#storylink=cpy

Joni Rowe, Unsung Hero

On her rural property east of Redding, a lone wheelchair by the road alerts visitors they’re nearing the home of Joni Rowe.  It’s a fitting yard ornament. For a dozen years, Rowe has seen to it that people in need have gotten all manner of medical equipment at no cost.

Closer to the house, a stockpile of walkers, canes, crutches and the like await adoption. She’s still a little puzzled as to how she became head wrangler, as some call her, for all these castoffs.

“I’ve been asked that so many times, and I’ve never quite figured it out,” said the resourceful redhead, who declined to give her age.  “I admit to 49,” she said, grinning.

Requests come from far and wide. It might be a death in the family that prompts families to recycle health aids.

After the 2010 earthquake in Haiti, one relief group hauled away more than 100 pieces of equipment Rowe had collected. And one time Rowe was contacted by someone in Portland, Ore., and ended up handing off an electric scooter to someone from Corning.

Her dining room table serves as her office, where she keeps a jar full of pens, a magnifying glass, a Rolodex with her contacts and her all-important spiral notebook containing dates, names and needs. Some people have suggested she get email, but she’s having none of that.  “I don’t have time,” she said. “I can’t be bothered.”

When she’s not picking things up or making deliveries in her van, she’s working at the All Saints Thrift Shop in Redding or chairing the Shasta Stroke Support Group at Shasta Regional Medical Center.

People of Progress Executive Director Melinda Brown and Katie Bullock, assistive technology coordinator for Independent Living Services of Northern California, met recently to better get the word out to organizations and the public about Rowe’s work.

To that end, Rowe now has her own voice mailbox through POP’s Connect Message Center.

“Joni saw that there was a gap, so she’s doing what some of the organizations used to do,” Brown said, noting that many groups no longer have staff or space to accommodate the medical donations.

“Joni is incredible. She’s just a little heroine.”

Rowe also has worked closely with the American Cancer Society’s Discovery Shop in Redding. Judi Rumsey, part-time sales associate at the store, first connected with Rowe two years ago after someone donated $2,000 of supplemental nutrition and feeding tubes.

“She’s just turned into our angel, pure and simple,” Rumsey said. Whether it’s a shower chair, commode or hospital bed, Rowe has been able to find someone in need.

Bullock’s agency, a nonprofit organization that offers support and advocacy for the disabled, also has worked closely with Rowe. It also has launched its own medical equipment program.

In addition, Rowe is networked with nursing homes and other facilities.

Rowe lost her 77-year-old husband, David, in 1997, after he’d suffered a stroke seven years earlier. And having had both cancer and polio herself, she finds empathy comes naturally.

But she’s nothing, if not modest, about her contribution.

“I am glad I’m able to help someone who needs it,” she said.

To view a YouTube video of Joni Rowe:  http://www.redding.com/news/2012/jul/08/from-canes-to-wheelchairs-joni-rowe-will-find-a/

To read the original article: http://www.redding.com/news/2012/jul/08/from-canes-to-wheelchairs-joni-rowe-will-find-a/

Originally published by the Redding Record-Searchlight on-line   Posted July 8, 2012 at 11:16 p.m.

NEW BUDGET REALITIES IN CALIFORNIA

DREADFUL CUTS MAY STILL COME AFTER NOVEMBER VOTE

CALIFORNIA HAS A BUDGET, ON TIME AND FULL OF HOPE(FUL ASSUMPTIONS)

Governor Jerry Brown signed the budget bill for 2012-13 into law on June 27.  What will be the effects on people with disabilities?  Here is our summary:

In-Home Supportive Services: Rejected Brown’s plan to cut caregiver hours by 7% across-the-board and eliminate domestic services in shared households while continuing current 3.6% cut in hours.  Shifts pay negotiations for workers from counties to a state board, which organized labor hopes will lead to higher and more uniform wages across the state.

Healthcare:  Eliminates Healthy Families program by moving clients to Medi-Cal.  Reduces payments to hospitals and nursing homes.  Approves the expansion of managed care for recipients of Medicare & Medi-Cal from original 4 counties to 8 counties.  What was once called a “pilot study” is now called a “demonstration project.”  This was a compromise with the Governor, who wanted authorization to expand this model to all 58 counties.  The 8 counties slated for implementation are: Los Angeles, Orange, San Diego, San Mateo, San Bernardino, Riverside, Alameda & Santa Clara.  These 8 counties comprise approximately 60% of the population for the entire state.

Additional information on the implementation of the “California Coordinated Care Initiative” can be found at: http://www.calduals.org

Venn Diagram of Dual Eligible