Category

REPORTS

Fact Sheet: Medicaid Non-Emergency Medical Transportation for Older Adults: A Critical Benefit at Risk

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

Non-Emergency Medical Transportation (NEMT) is a federally required Medicaid benefit. Within certain guidelines, each state Medicaid program is given significant discretion in crafting the NEMT benefit for Medicaid beneficiaries. This important program currently serves over 7 million Medicaid enrollees who, due to cognitive and physical changes, may have a reduced ability to drive or use public transportation. It is now under threat.

The Centers for Medicare and Medicaid Services (CMS) has signaled that it will propose a regulation in May 2019 to make the mandatory NEMT benefit optional for states. States could then choose to amend their Medicaid rules to eliminate or reduce the benefit.

A new Justice in Aging fact sheet provides advocates with information about why NEMT is important, how it is administered, and the current threat to this vital benefit, as well as information on where to go for more information and advocacy tips for preserving the NEMT benefit in their states.

Justice in Aging is working in coalition with partners like Community Catalyst to raise awareness about the importance of Medicaid transportation to ensure it remains a covered benefit.

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.

Fact Sheet: Seniors and People with Disabilities Who Receive SSI Can Apply for CalFresh in Summer 2019

By | CA Health Network Alert, Economic Security, FACT SHEET, REPORTS, Supplemental Security Income

Due in part to advocacy from groups like Californians for SSI, the 2018-2019 state budget included a policy change allowing California seniors and people with disabilities who receive SSI to be eligible for CalFresh (SNAP) benefits starting June 1, 2019.

Access to federal SNAP nutrition assistance will increase food security for California’s low-income SSI seniors and people with disabilities, leading to fewer people being forced to choose between basics like food and medicine, and giving people more flexibility to direct money toward other needs such as finding and being able to afford housing. The expansion will be particularly important for seniors age 60 or older, who represent more than half of the over 1.2 million low-income Californians who receive SSI to help meet their basic needs.

Aging services providers can learn more details about this important and historic change in a new fact sheet from Justice in Aging. The five-page fact sheet helps providers understand the details of the change in order to better support their clients. The fact sheet also includes information on CalFresh rules that will be particularly relevant for enrolling SSI seniors and people with disabilities this summer and beyond.

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

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.

Report: Older Women & Poverty

By | Economic Security, Health Care, Health Care Defense, Health Disparities, Health Equity, Long Term Care, Medicaid, Medicare, Nursing Homes, Oral Health, Safety Net Defense, SENIOR POVERTY, Social Security, Special Report, Supplemental Security Income

Because of structural inequities that impact women more than men, a significant percentage of older women are struggling to stay out of poverty.

There are 7.1 million older adults living in poverty in the United States, with nearly two out of three of them being women. Women like Venorica, who is working three jobs at the age of 70, and Vicky, who once ran a successful business with her husband, are struggling to stay afloat.

A new Justice in Aging report surveys the reasons more women are aging into poverty than men, discusses the support systems that are in place to help older women, and recommends ways we can strengthen and expand those support systems. The brief is accompanied by videos of women telling their own stories. Older women have cared for us and worked hard all of their lives. It’s imperative that we enact policies so they don’t have to struggle to make ends meet.

READ THE REPORT
WATCH THE VIDEOS HERE