Category

Health Care

Fact Sheet: CMS Regulations Set Ground Rules for D-SNP

By | DUAL ELIGIBLES, FACT SHEET, Health Care, Medicaid, Medicare, REPORTS

The Centers for Medicare and Medicaid Services (CMS) recently finalized rules implementing regulations governing minimum integration standards for Dual Eligible Special Needs Plans (D-SNPs) pursuant to the Bipartisan Budget Act of 2018. D-SNPs are Medicare Advantage plans that limit enrollment to individuals who are dually eligible for Medicare and Medicaid. With the permanent authorization of D-SNPs, we expect to see an increase of D-SNPs entering the market across the country.

Justice in Aging has analyzed the new regulations and created a new factsheet summarizing the major integration requirements including special considerations for advocates.

Issue Brief: Older Immigrants and Medicare

By | Health Care, Health Care Defense, ISSUE BRIEF, Language Access, Medicare

Accessing the Medicare program as an older immigrant can be a complex and confusing process – especially when an immigrant is not a citizen, has limited work history, and limited English proficiency. Justice in Aging’s new issue brief, Older Immigrants and Medicare, is intended to provide advocates who work with older immigrants a summary of the policies and practices to help immigrants enroll in and pay for Medicare coverage.

The issue brief specifically covers the following topics and includes numerous hypothetical examples to illustrate the myriad of rules and scenarios older immigrants face when attempting to access Medicare:

  • Eligibility and enrollment, with particular attention to rules affecting non-citizens
  • Help paying for coverage
  • Post-enrollment issues potentially affecting immigrant beneficiaries
  • Language access rights and resources in Medicare

Free Webinar: California Legislative and Budget Proposals that Affect Low-Income Older Adults

By | Economic Security, Health Care Defense, WEBINAR

When: Thursday, March 21, 2019 from 3pm-4pm PT

Join us for a discussion of California budget and legislative proposals this year that could make concrete improvements to the economic security and health care of low-income older adults. This webinar, California Legislative and Budget Proposals that Affect Low-Income Older Adults, provides an overview of a number of key proposals, and offers advocates information on how they can engage in the process.

One package of bills has been introduced that would work together to make Medi-Cal more fair and equitable and create more stability for seniors and people with disabilities. You can read about those bills here. Justice in Aging will be releasing additional materials on 2019 California legislative proposals and their impact on older adults soon.

Who Should Participate:

Aging and legal advocates, community-based providers, local government partners, and others wanting to learn more about economic security and health care proposals that impact low-income older adults.

Presenters:

Trinh Phan
Senior Staff Attorney, Justice in Aging

Claire Ramsey
Senior Staff Attorney, Justice in Aging

This webinar took place on Thursday, March 21, 3:00-4:00 PM.

WATCH THE WEBINAR
DOWNLOAD THE POWERPOINT

Fact Sheets: California Senior Legislative Package 2019

By | CA Health Network Alert, Health Care, Health Care Defense

California legislators have introduced a number of budget and legislative proposals that, if enacted, would work together to improve the health and long-term care system that serves the state’s older adults, and help advance greater economic security for the most vulnerable older adults who are grappling with some of the nation’s highest housing costs.

One package of bills has been introduced that would work together to make Medi-Cal more fair and equitable and create more stability for seniors and people with disabilities. Read about those bills here. For more detail on each bill, you will find a series of fact sheets below.

We will keep advocates updated as these and other proposals move through the process.

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.

Fact Sheet: Make the Expanded Spousal Impoverishment Protection Permanent

By | FACT SHEET, Health Care, Home & Community Based Services, Medicaid, REPORTS

Married seniors and adults with disabilities overwhelming want to live at home and age in place. Increasingly, federal and state Medicaid rules have prioritized home and community-based services (HCBS) which allow people to stay in their homes and in their communities. Congress recently helped these efforts by expanding a Medicaid eligibility rule, known as the spousal impoverishment protection, to individuals eligible for HCBS. The protection makes it possible for an individual who needs a nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. However, the expansion of the spousal impoverishment protection is set to expire on March 31, 2019 unless Congress acts. This means that individuals who qualified under the expanded protection may lose access to Medicaid and to their HCBS and may be left with no choice but to move into institutional long-term care, away from their spouses.

Letting the spousal impoverishment protection expire will hurt families and force more people out of their homes and their communities. We urge Congress to make the expanded spousal impoverishment protection permanent so seniors and people with disabilities can age in place and with dignity.

Justice in Aging has created a fact sheet on the importance of the expanded HCBS spousal impoverishment protection and calling on Congress to make it permanent so seniors and people with disabilities can age in place and with dignity.

Guide: 25 Common Nursing Home Problems and How to Resolve Them

By | Advocate's Guide, Nursing Homes, Person-Centered Care Planning, REPORTS

Learn to spot and resolve the most common problems

The 25 problems identified in this guide are common across the country and in all types of nursing homes. Even supposedly “good” nursing homes often follow standard procedures that violate federal law and put residents at risk.

This reader-friendly guide gives residents, family members, friends, and other advocates the tools they need to identify and solve the problems residents most frequently face. Whether you’re fighting an eviction, seeking a personalized care plan, or being pressured to sign an arbitration agreement, this guide will give your advocacy teeth to ensure that you, or a resident you’re advocating for, receive the high quality, person-centered care that the law requires.

Get the Guide

Issue Brief: Creating an Oral Health Benefit in Medicare

By | ISSUE BRIEF, Medicare, Oral Health, REPORTS

Fewer than half of older adults have access to oral health care each year. One in five older adults has untreated tooth decay and 70 percent have gum disease. Poor oral health and lack of access to health care are even more acute for low-income seniors, seniors of color, and rural seniors. Because oral health is an integral part of overall health and untreated dental problems can cause and/or exacerbate other serious health issues, it is critical to expand older adults’ access to oral health care.

Because all older adults rely on Medicare for their health care needs, integrating oral health benefits into Medicare Part B is the most effective way to deliver comprehensive benefits to all Medicare beneficiaries. Justice in Aging’s statutory analysis shows how such a benefit could be structured and where statutory language could be changed to accommodate such a benefit.

Read the Brief

Fact Sheet: Medicare Plan Enrollment Changes for Dual Eligibles and Low-Income Subsidy Recipients in California

By | CA Health Network Alert, FACT SHEET, Health Care, Medicaid, Medicare

The Centers for Medicare and Medicaid Services (CMS) issued new rules that limit enrollment and disenrollment from Medicare Advantage and Part D prescription drug plans for low-income Medicare beneficiaries. Previously, dual eligibles – individuals with Medicare and Medi-Cal coverage – and beneficiaries who receive the low-income subsidy (LIS) to make Part D prescription drug coverage more affordable could make enrollment changes any time throughout the year. The new rule, which became effective January 1, 2019, limits enrollment changes to once per quarter.

Justice in Aging has created a factsheet that explains these changes in detail and how they impact low-income Medicare beneficiaries in California.

More older residents on Medicaid wait list in Florida than any other state, attorney says

By | Health Care, Home & Community Based Services, IN THE NEWS, In-Home Supportive Services, LITIGATION, Long Term Care, Medicaid

Florida Record: More older residents on Medicaid wait list in Florida than any other state, attorney says (January 7, 2019)

A lawsuit has been filed against the state of Florida over extremely long wait time in accessing in-home Medicaid care. Justice in Aging, along with Disability Rights Florida and the Southern Legal Counsel, is representing the six plaintiffs currently suing the state.

“According to national statistics, there are more older adults and adults with disabilities on the wait list for community-based services in Florida than any other state,” Regan Bailey, litigation director for Justice in Aging. “The failure to provide long-term care places people at risk of unnecessarily entering a nursing facility just to get the care they need which should be provided at home.” Read the full article.