Category

REPORTS

Issue Brief: Medicaid Enrollees Put at Risk When State Medicaid Programs Assume Support from Family Caregivers

By | Health Care, Health Care Defense, ISSUE BRIEF, Medicaid

A new Issue Brief reveals how states’ assumptions often deprive Medicaid recipients of needed assistance.

Under Medicaid law, all assistance by friends and family members must be voluntary. This brief, based on a review of over 100 administrative decisions in several states, shows how Medicaid programs violate this law to the detriment of people on Medicaid. Medicaid programs often deny services based on family assistance that is not available. This puts lives at risk, increases the chances that a beneficiary will have to be institutionalized, and forces families to make impossible choices between caring for a family member and going to work.

The issue brief outlines states’ responsibility to respect the voluntary nature of assistance, examines how some states approach the issue, and suggests public policy responses to ensure that states authorize adequate assistance.

Rachel Gershon, of the University of Massachusetts Medical School’s Center for Health Law and Economics co-authored this paper with Justice in Aging attorney, Eric Carlson. The paper is part of a post-fellowship project with Justice in Aging and the Borchard Foundation Center on Law and Aging. 

Fact Sheets: New Resources on How Trump’s Public Charge Impacts on Older Adult Immigrants

By | CA Health Network Alert, Economic Security, FACT SHEET, Health Care, Medicaid, Social Security

Advocates are preparing to respond to a new “public charge” rule from the Trump Administration that would put immigration status at risk if an immigrant seeks access to an array of programs that support health, nutrition, and economic stability.

If implemented, this rule would harm older immigrants, their families, and caregivers. The rule would make it much more difficult for U.S. citizens and residents to welcome aging parents or other family members into the country. Seniors and their families may be afraid to go to the doctor or get helping paying for food or rent. Additionally, many immigrant older adults work as caregivers for very low pay. This rule would make it harder for them to access benefits like Medicaid and SNAP (Supplemental Nutrition Assistance Program).

Justice in Aging has a new fact sheet that provides an overview of the harms to older adults, their families, and caregivers that the Trump Administration’s changes to the “public charge” rule pose.  A California fact sheet provides an overview of these harms looking at California-specific data and programs.

Fact Sheet: SSA Clarifies Handling of Medicare Part A Conditional Applications

By | FACT SHEET, Health Care, Medicare, Social Security
Many people do not have enough work history to qualify for premium-free Medicare Part A benefits, however there is still an option for low-income individuals to get their Medicare Part A premiums paid.

A new Justice in Aging fact sheet details how they can enroll in the Qualified Medicare Beneficiary (QMB) Program to get their Medicare premiums paid through their state Medicaid program. Enrolling in QMB can be confusing for people without Part A coverage and often requires visits to both the Social Security Administration office and the state’s Medicaid program offices. A further complication is that many Social Security offices have used conflicting and incorrect procedures or provided misinformation to applicants. Read More

Advocate Guide: Accessibility in Medicaid Managed Care

By | Advocate's Guide, Health Care, Medicaid, mltss

States require managed care plans who serve Medicaid enrollees to establish and maintain an internal grievance and appeal and fair hearing system. As states begin to incorporate new federal regulations into their Medicaid rules, there’s opportunity for advocates to help shape those rules to ensure that older adults and people with disabilities have equal access to the grievance and appeal and state fair hearing systems, as mandated by Section 504 of the Rehabilitation Act (“Rehab Act”), the Americans with Disabilities Act (“ADA”), and Section 1557 of the Affordable Care Act (“ACA”).

Disability Rights Education and Defense Fund (DREDF), Justice in Aging and National Health Law Program (NHeLP) collaborated on a new Advocates Guide to Accessibility in Medicaid Managed Care Grievances, Appeals, and State Fair Hearing. This new Advocates’ Guide, provides guidance on how the federal framework can be made fully accessible to Medicaid beneficiaries who are older and/or have disabilities.

Links to three accessible versions of the guide can be found below.

 

White Paper: An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care

By | Health Equity, ISSUE BRIEF, Medicare, Oral Health

Oral health is an integral part of overall health. Oral health problems can adversely affect one’s ability to maintain optimal nutrition, self-image, social interactions, and mental and physical health. Oral health problems can lead to chronic pain, tooth loss and serious infections. Poor oral health can even worsen chronic medical conditions such as heart disease and diabetes.

Older adults need timely and affordable access to dental care in order to maintain their health and well-being, yet, there is currently no mechanism for most older adults to access care. Contrary to what many believe, Medicare does not include an oral health benefit. Most older adults cannot afford to purchase private oral health insurance or pay out-of-pocket for the care they need. As a result, 70 percent of Medicare recipients have limited or no dental coverage, and fewer than half see a dentist each year.

A new White Paper, An Oral Health Benefits in Medicare Part B: It’s Time to Include Oral Health in Health Care discusses how a Medicare Part B dental benefit would close disparities in dental use and expense between the uninsured and insured and among older adults with few financial resources and limited oral health education. The paper also details how such a benefit could be structured and the legislative changes that would need to happen before such a benefit could be established.

Oral Health for Older Adults in California: Advocacy Guide

By | Advocate's Guide, Health Care, ISSUE BRIEF, Oral Health

New Advocacy Guide: Oral Health for Older Adults in California

Oral health affects overall health – this is particularly true for older adults. Yet, access to oral health treatment is limited and complicated by factors such as lack of dental coverage, complicated rules, and lack of dental providers. To assist California advocates in connecting their clients with oral health treatment, Justice in Aging has developed an Advocacy Guide for Oral Health for Older Adults in California.

The Guide includes a summary with advocacy tips on the following topics:

  • Why oral health matters
  • The state of oral health for older adults in California today
  • Health insurance coverage options for older adults including Medicare, Denti-Cal, and other forms of coverage
  • Unique barriers sub-populations of older adults encounter in accessing oral health including dual eligibles and nursing facility residents
  • Treatment alternatives for individuals without dental coverage
  • Additional resources

It is our intention that this Guide will help advocates navigate the system and empower them to identify and address systemic barriers to care.

Visit Justice in Aging’s Oral Health page for additional resources and help us celebrate #OralHealthMonth by forwarding this resource to your networks.

How Medicaid Work Requirements Will Harm Older Adults & Family Caregivers

By | FACT SHEET, Health Care, Health Care Defense

The Centers for Medicare & Medicaid Services issued guidance allowing states to condition Medicaid eligibility on fulfilling work and “community engagement” requirements. Under this policy, states can require adults to work in order to receive Medicaid if they are under age 65 and not disabled under the Social Security Administration’s strict definition. Although states are required to exempt some individuals who cannot work based on their health conditions, and encouraged to allow caregiving hours to count as work, all of these individuals will still be subject to onerous reporting requirements. This presents a significant barrier to health care access for many of the nearly 9 million adults ages 50 to 64 who rely on Medicaid, as well as nearly 5 million people with disabilities and chronic health conditions who do not receive Social Security Disability or Supplemental Security Income, and family caregivers. Learn more with our factsheet!

Supporting Older Americans’ Basic Needs: Health Care, Income, Housing and Food

By | FACT SHEET, Health Care, Health Care Defense, ISSUE BRIEF, Medicaid, Medicare, SENIOR POVERTY, Social Security, Supplemental Security Income

Older adults and their families strive each day to pay for health care and medicine, keep food on the table, have a roof over their heads, and have enough cash on hand to pay the utilities, get where they need to go and meet other basic needs. As families work together to meet these challenges, they are supported by a broad range of federal programs that provide Americans with the means to thrive as they grow older and remain at home and in their communities.

This issue brief discusses how these various programs work, who is eligible for them, and how they support the health and economic well-being of older Americans. For a quick overview, check out the fact sheet.

In-Kind Support and Maintenance in the SSI Program

By | Economic Security, REPORTS, Supplemental Security Income

Why do some individuals receiving Supplemental Security Income (SSI) benefits only receive $500 a month instead of $750? In many cases, the reason is “in-kind support and maintenance” (ISM).

As SSI is a means-tested program, applicants and recipients must meet several financial eligibility criteria on an ongoing basis. The income and resource rules, including in-kind support and maintenance, are particularly complicated. These rules can cause significant hardship for low-income people trying to survive on SSI.

This new guide, In-Kind Support and Maintenance in the SSI Program, gives advocates tools to successfully navigate ISM on behalf of their clients. They can make a big difference by making sure that clients can maximize their SSI benefits to better meet their needs for shelter, food, health care, and other necessities.

Read the guide, and watch the recording of today’s webinar on In-Kind Support and Maintenance here.

SSI 101: A Guide for Advocates

By | Advocate's Guide, Economic Security, ISSUE BRIEF, Supplemental Security Income

Supplemental Security Income (SSI)—a need-based program administered by the Social Security Administration – provides a very basic income to over 8.2 million people, including 2.2 million seniors age 65+. As more seniors struggle to make ends meet in today’s economy, getting access to SSI can help low-income seniors escape deep poverty and avoid or move out of homelessness. Justice in Aging’s Supplemental Security Income 101: A Guide for Advocates introduces advocates and individuals who provide assistance to older adults to the SSI program and focuses on the basics of the program for those who qualify based on age (65 years or older).

Released today, the Guide includes:

  • A description of the SSI program and benefits
  • An overview of the application and appeals processes
  • A discussion of key eligibility criteria, including examples

And in case you missed our SSI Basics webinar last month, the video is now available.