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Vanessa Barrington

Issue Brief: Cal MediConnect-Unmet Need and Great Opportunity in

By | Health Care, ISSUE BRIEF, Medicaid, mltss

CalMediConnect, launched in 2014, is California’s dual eligible demonstration and seeks to integrate Medicare and Medicaid benefits under one health plan. One of its purposes is to better meet the needs of dual eligibles by increasing access to long-term services and supports (LTSS) and providing other value-added services, known in the demonstration as Care Plan Options (CPO). However, evaluation data and beneficiary experience indicate that more can be done to provide care for dual eligibles enrolled in the program. Justice in Aging recently obtained data via a Public Records Act request from California’s Department of Health Care Services that includes LTSS referrals and the number and type of CPO services plans are providing members.

Our issue brief, Cal MediConnect: Unmet Need and Great Opportunity in California’s Dual Eligible Demonstration, provides a brief overview of the Cal MediConnect program and examines the health plan referral data for LTSS and CPO services obtained through the Public Records Act request. It concludes with recommendations for policymakers on ways to strengthen Cal MediConnect through improving access to LTSS and CPO services. These recommendations are of interest to those following Cal MediConnect as well as advocates and stakeholders in other states with their own dual eligible demonstrations.

Read the brief.

Advocates Seek Medically Necessary Oral Health Care, CMS Eyes Issue

By | IN THE NEWS

Inside Health Policy January 29, 2019
This story leads with the news that CMS is taking a look at medically necessary dental benefits for Medicare beneficiaries. The article then goes on to describe advocate efforts (including Justice in Aging) to push for an inclusion of oral health benefits in Medicare Part B.  The article also mentions Justice in Aging’s brief on including an oral health benefit in Medicare as well as a bill that Senator Ben Cardin introduced to provide an oral health benefit. The article is behind a paywall. This is a summary.

Florida Faces ADA Lawsuit Over Medicaid HCBS Wait List

By | IN THE NEWS, Uncategorized

Open Minds: Florida Faces ADA Lawsuit Over Medicaid HCBS Wait List (January 27, 2019)
This health care trade publication article summarized our complaint in the case Alexander et al., v. Florida Agency for Health Care Administration, including the key facts of the case and noted Florida’s lack of an Olmstead Plan to guide the delivery of services for class members in the least restrictive placement to meet their needs. The article is behind a paywall that can be accessed by members here.

 

 

AARP Celebrates Justice in Aging’s Denny Chan, Recipient of the Asian American Pacific Islander Hero Award

By | IN THE NEWS, Uncategorized

On Wednesday, January 23rd. AARP honored Justice in Aging attorney Denny Chan with its Asian American Pacific Islander Hero Award for his work to advance language access for limited English proficient older adults. Several members of the media attended the event at AARP’s California headquarters in Pasadena. See the list of clips below.

  • ETTV News News segment aired on Jan 29, 2019
  • Sampan.org January 24, 2019
  • MeiMin.us January 24, 2019
  • ChineseDaily.com January 26, 2019
  • ESO411.com January 28, 2019
  • Chinese L.A. Daily News Jan 26, 2019 Print Issue
  • Zhong Guo Daily News January 26, 2019 Print Issue
  • World Journal, January 24, 2019

Cardin, Neal Express Interest in Medicare Oral Health Coverage

By | IN THE NEWS

Inside Health Policy: Cardin, Neal Express Interest in Medicare Oral Health Coverage (January 14, 2019)

Oral health is critical to overall health, yet, fewer than half of older adults have access to oral health care in a given year. In 2018, Justice in Aging contributed to a white paper released by Oral Health America. In the white paper, we discussed how incorporating an oral health benefit into Medicare Part B could expand access to oral health care to older adults.

On January 4, 2019, Senator Ben Cardin (D-MD) introduced legislation to add oral health to Medicare Part B. Justice in Aging Deputy Director, Jennifer Goldberg, was quoted in the article saying that stakeholder support is coalescing behind adding an oral health benefit to Medicare Part B. The article is available online only to subscribers of Inside Health Policy. This is a summary.

Letter in Support of the Medicare Dental Benefit Act

By | Statements

In January , 2019, Senator Benjamin Cardin introduced the Medicare Dental Benefit Act of 2019, which amends the Social Security Act to provide for coverage of dental services under the Medicare program. Oral health is a key component of overall health and this new legislation is a critical step in improving the health and well-being of older adults and people with disabilities. Justice in Aging joined with Families USA, Oral Health America, and Center for Medicare Advocacy to thank Senator Cardin for his leadership on the issue. Read the letter.

Justice in Aging Statement on Affordable Care Act Decision in Texas

By | Statements

Last Friday, a Federal District Court in Texas issued a decision declaring the Affordable Care Act (ACA) in its entirety unconstitutional. The judge’s reasoning has been widely criticized and legal scholars contend that it is unlikely the decision will be upheld on appeal. Nevertheless, the ruling sowed confusion and uncertainty on the eve of the ACA Marketplace enrollment deadline and furthers the harm caused by the Trump Administration’s and Congress’s actions to undermine the ACA.

If the ruling were to stand, the implications for older adults would be catastrophic. Over 4.5 million older adults age 55-64 who have coverage through the Marketplaces and Medicaid expansion would lose access to health care. For millions more, health care would become either unaffordable or unattainable because health insurance companies would again be permitted to charge older adults more based on age and deny coverage to the 8 out of 10 older adults with a preexisting condition.

The ACA’s Medicare provisions would also be rolled back. Medicare enrollees would face higher prescription drug costs and out-of-pocket spending on preventive services that are currently free pursuant to the ACA. Further, the savings from the ACA that extended the life of the Medicare trust fund would be eliminated, placing Medicare at risk for dramatic cuts through the budget, vouchers, and privatization. These are costs that seniors simply cannot afford.

Despite the judge’s ruling, the ACA remains the law today and older Americans can continue to rely on the ACA’s protections and coverage. By joining together, we have successfully prevented previous attempts strike down the ACA. That fight continues to ensure older adults have access to affordable and quality health care as they age.

Advocacy Groups Sue State of Florida for Violating the Americans with Disabilities Act

By | News Releases, Newsroom

A class action lawsuit filed today against Florida’s Agency for Health Care Administration asserts that the state’s management of its Medicaid long-term care system violates Title II of the Americans with Disabilities Act. By perpetuating the institutionalization and segregation of older adults and people with disabilities and severely limiting their access to community-based services, the state forces people to unnecessarily enter nursing facilities to get care.

Justice in Aging, a national non-profit legal advocacy organization that fights senior poverty, and Southern Legal Counsel, a Gainesville, Florida-based, statewide nonprofit law firm, filed the suit on behalf of their clients, who are on the state’s waiting list for home-based long-term-care services and are currently at risk of unnecessary and unwanted institutionalization. Disability Rights Florida, private attorney Nancy Wright, and lawyers from the firm of Cozen O’Connor are co-counsel.

“The Americans with Disabilities Act provides that people with disabilities are entitled to receive needed health care in the most integrated setting. Yet in Florida, many older adults and adults with disabilities are stuck on a wait list, unable to get the care they need to stay in their homes, and face having to go into a nursing facility to get that care. This case seeks an expansion of lower-cost home and community-based services and a rebalancing of the long-term care system so people can avoid institutionalization,” said Regan Bailey, litigation director for Justice in Aging.

Florida’s Long-Term Care Medicaid Waiver program provides in-home services and supports for frail older adults and persons with disabilities. Many of these Floridians prefer to remain at home and in their communities and receive help at home with daily activities like eating, bathing, and cooking. But the state prioritizes funding institutional care, and there are currently thousands of people on the wait list for home-based services. As a result, many eligible applicants will die or be forced to move to a nursing home before they get off the waiting list.

“Home and community-based services allow individuals with disabilities to stay in their homes, with or near their families, and remain a part of their community. Such services are integral to maintaining the dignity and humanity of older adults and people with disabilities. It’s no wonder there is such a great demand for these services,” said Amanda Heystek, director of systems reform for Disability Rights Florida.

Lengthy wait times for essential care put lives at risks and cause families to make impossible choices between institutionalizing their loved ones and bankrupting themselves paying out-of-pocket for care.  The vast majority of those on the waiting list are over 60, more than half are over 74, and a quarter are 85 or older. Depending on the level of need and existing support, these individuals could wait up to three and a half years before getting the care at home that they need.  Between July 1, 2016, and March 8, 2018, more than 1,400 people on the wait list had to move to nursing facilities. In this same period, more than 8,600 people died while on the wait list.

“The state can’t say it’s limiting home-based care services because of a lack of funding, because it actually saves the state money for people to receive care at home,” said Southern Legal Counsel Executive Director Jodi Siegel. “Florida’s administration of its Medicaid Long-Term Care Waiver program is therefore not only in violation of the ADA, but also fiscally irresponsible.”

Read the Complaint

About Justice in Aging

Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. Since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency. Through targeted advocacy, litigation, and the trainings and resources we provide to local advocates, we ensure access to the social safety net programs that poor seniors depend on, including Medicare, Medicaid, Social Security, and Supplemental Security Income (SSI).

About Cozen O’Connor

Established in 1970, Cozen O’Connor has more than 700 attorneys who help clients manage risk and make better business decisions. The firm counsels clients on their most sophisticated legal matters in all areas of the law, including litigation, corporate, and regulatory law. Representing a broad array of leading global corporations and middle market companies, Cozen O’Connor services its clients’ needs through 28 offices across two continents.

About Disability Rights Florida

Disability Rights Florida was founded in 1977 as the statewide designated protection and advocacy system for individuals with disabilities in the State of Florida. We provide free legal and advocacy services to people with disabilities through the authority and responsibility of nine federal grants. Our mission is to advance the quality of life, dignity, equality, self-determination, and freedom of choice for people with disabilities.

About Southern Legal Counsel

Southern Legal Counsel is a statewide, nonprofit law firm that works proactively to ensure fairness, social justice and government accountability for Floridians through focused, high-impact initiatives, policy advocacy and civil litigation.

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The Truth About Older Consumers: Household Budgets

By | IN THE NEWS

Stria: The Truth About Older Consumers: Household Budgets (November 26, 2018)

This piece challenges some of the “successful aging” narratives about older adults that are common in U.S. media. The author explores some of the different expenses older adults encounter (such as higher health care costs) that make them vulnerable. The author also acknowledges that many older adults start out as poor, and aging makes them poorer, and that some older adults, such as LGBT older adults, are more likely to age into poverty. The author interviewed Justice in Aging Executive Director, Kevin Prindiville, for insight into senior poverty, who said, “The cost of housing and health care keeps rising. Pensions are smaller than had been promised and some have disappeared altogether. Social Security is a bedrock, keeping 15 million older people out of poverty—but just barely. We have not strengthened or expanded Social Security and it’s not keeping up.” Read the full article.