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Legal Services & Elder Rights Developments
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State Legal Services Development home page, click here
April 12, 2011; 1 note
posted today
Fiscal
Year 2011 Bill Would Cut Legal Aid by $15.8 Million
4/12: The following is from an April 12th note
from the Legal Services Corporation: The Fiscal Year 2011 budget for the
Legal Services Corporation (LSC) would be cut by $15.8 million, reducing funds
for civil legal assistance to low-income Americans, according to legislation
announced today. LSC received $420 million in funding for Fiscal Year 2010, and
the funding bill for 2011 would provide $404.2 million, a reduction of 3.8
percent. The legislation, the result of a negotiated agreement between the
Congress and the White House to avoid a government shutdown, is scheduled for
votes in the House and Senate this week. "Every dollar provided for civil legal
assistance helps low-income individuals gain access to our justice system. We
are grateful that funding cuts will not be as deep as initially proposed, and
we look forward to working with the Congress on Fiscal Year 2012 funding to
provide even greater access to justice for the growing number of low-income
Americans in need of civil legal assistance," LSC Board Chairman John G. Levi
said. The funding reduction would affect the grants that LSC distributes to 136
independent nonprofit legal aid programs across the nation, the District of
Columbia and U.S. territories. Last year, these programs closed nearly 1
million cases, which affected 2.3 million people. The cases involve domestic
violence, foreclosures, landlord-tenant disputes, bankruptcy, consumer issues
and other civil legal matters. For more on this, click above.
Obama's
new approach to deficit reduction to include spending on entitlements
4/11: The following is from an April 11th
Washington Post article: President Obama this week will lay out a new approach
to reducing the nation's soaring debt, proposing reductions in spending on
entitlements such as Medicare and Medicaid and renewing his call for tax
increases on the rich. ... Contrasting the president's approach with what
Republican leaders have put forward, Plouffe said Obama will use a
"scalpel" and not a "machete" as he seeks to preserve
funding for education and other areas he considers crucial to the country's
long-term economic success. ... In a speech scheduled for Wednesday, Obama will
present his most extensive response to date in the debate over controlling
federal spending. ... On Sunday, Plouffe did not specify how much more the
president wants to cut or whether his speech would propose a specific
legislative agenda other than to say he will be looking for savings in both
Medicare and Medicaid. He said that though Obama does not think
Social Security liabilities are a primary driver of the nation's deficit and
debt, the president would be open to discussing that, too. Click above
for the full article.
4/8: The following is from an April 7th Center
on Budget & Policy Priorities
analysis: House Budget Committee Chairman Paul Ryan's budget plan specifies a
long-term spending path that means that, by 2050, most of the federal
government aside from Social Security, health care, and defense would literally
cease to exist, according to figures in a Congressional Budget Office report
that was released on Tuesday [April 5th]. CBO's report, prepared at
Chairman Ryan's request, also reveals that, as explained below, his plan
envisions additional Medicare cuts that were not disclosed in the documents
that the chairman released on Tuesday; and his Medicare "premium
support" and Medicaid block grant proposals differ substantially from
— and have much deeper cuts than — the "Ryan-Rivlin" plan
of last fall, which itself was rejected as too severe by the Bowles-Simpson
fiscal commission. On the chairman's plan to dramatically shrink the size
and scope of government, the documents that he released show that his plan
would shrink federal spending to about 20 percent of Gross Domestic Product
(GDP) by 2015 and to 14.75 percent of GDP by 2050 — the lowest level since 1951, a
time when Medicare and Medicaid did not exist. ... Grover Norquist, president
of Americans for Tax Reform and one of Washington's most influential anti-tax
conservatives, told National Public Radio in 2001, "I don't want to
abolish government. I simply want to reduce it to the size where I can
drag it into the bathroom and drown it in the bathtub." The CBO
report suggests that, other than for Social Security, health, and defense,
Chairman Ryan has much the same vision. To access the full analysis,
click above. See related article directly below.
4/8: According to an April 7th The Hill article: The House Republican Study Committee on
Thursday released an alternative to the 2012 budget resolution from Budget
Committee Chairman Paul Ryan (R-Wis.) that would cut $9.1 trillion over the
next decade. The RSC, a 176-member caucus, will offer the plan, entitled
"Honest Solutions," as a floor amendment to the budget resolution next
week. The GOP budget plan was passed by the House Budget Committee late
Wednesday [April 6th]. Like a failed RSC effort to cut $40 billion more
from 2011 spending in February, the amendment is expected to fail, but it sends
a strong signal to GOP leadership and to Democrats that there's backing for
going even further than Ryan's plan on spending cuts. Whereas Ryan's plan
would balance the federal budget by 2040, the RSC plan would do so by 2020.
It does so by cutting $3.3 trillion more over 10 years than Ryan's plan.
The Ryan budget resolution cuts $5.8 trillion over the next decade, while the
RSC plan would cut $9.1 trillion. ... The RSC budget shores up the solvency of
Social Security by raising the retirement age to 70 by 2045. That timeline is
faster than the one proposed by president's fiscal commission, which would
raise the retirement age to 69 by 2075 while paring back benefit calculations.
... The RSC's Medicare overhaul plan would accelerate Ryan's proposed
conversion of Medicare to a type of voucher system. While the House GOP budget
eliminates the traditional program in 10 years for those currently 55 and under
and replaces it with a "premium support" system, in which Medicare
pays private insurance plans for an option selected by seniors, the RSC budget
speeds up the process. Under the RSC plan, individuals 59 years old and
younger would enter the premium support system, while seniors of any age could
voluntarily opt-in to the voucher-type system in 2017. The RSC
budget also gradually raises the Medicare eligibility age to 67 by 2030, while
the House GOP budget does the same three years later. The RSC, as the
House budget does, transforms Medicaid into a block-grant system that provides
states with a fixed payment and flexibility to manage their programs. The RSC
cuts Medicaid deeper by bringing program spending down to 2006 levels and
limiting its growth just to inflation, while the House GOP budget also allows
spending to grow with the population, Peuquet said. For full article, click
above.
House
Cuts $70 Million in FY'11 LSC Funding
2/22: According to a Feb. 19th e-mail from the
legal Services Corporation: The U.S. House of Representatives today passed a
$70 million cut in Legal Services Corporation (LSC) funding from the current
level, reducing grants to 136 local legal aid nonprofit programs by an average
of 18 percent. The proposed $70 million cut is from the Fiscal Year 2010
funding of $394.4 million provided to LSC programs. An effort to eliminate all
funding for LSC programs was defeated on a bipartisan vote, 259 to 171, on
February 16. Under the House
proposal, about 160,000 fewer low-income people would receive civil legal
assistance and 80,000 fewer cases would be handled by the LSC-funded programs.
The proposed funding cut would force layoffs of about 370 staff attorneys and
shut down some offices in rural areas. "The impact of the proposed
reduction would be devastating to these LSC programs," LSC President James
J. Sandman said. "These proposed cuts would come at a time when many LSC
programs are overwhelmed with requests for civil legal assistance. The
Constitution says in its very first line that a primary purpose of government
is to 'establish justice.' Our country cannot sacrifice equal access to justice
to any year's fiscal pressures." The civil legal assistance provided by
the 136 nonprofit programs across the nation helps women escape domestic
violence, keeps families in their homes by averting unlawful foreclosures and
evictions, helps veterans and the disabled obtain benefits, protects the
elderly from consumer fraud, and provides help with other civil legal problems.
The programs provide legal services to persons at or below 125 percent of the
federal poverty guidelines—$27,938 for a family of four. The House
approved the funding reduction as part of its Continuing Resolution to fund
federal agencies and programs through the remainder of Fiscal Year 2011. The proposal would represent an $85 million
reduction from the White House's Fiscal Year 2011 budget request of $435
million. The bill will now go to the Senate for a vote. The government is currently funded at Fiscal Year
2010 levels until March 4. For more info, go to the LSC web site by
clicking above.
2/18: The following is from a Brennan Center for
Justice e-mail note: On February 14, the Obama Administration
submitted a budget to Congress for fiscal year 2012 that recommends increasing
funding for the Legal Services Corporation to $450 million. At $30 million more than current levels, this
additional funding would provide a much needed boost for civil legal service
providers at a time when they are turning away a record number of low income
Americans due to shrinking state budgets and IOLTA accounts across
the country. In keeping with his previous proposals, the President recommended
that Congress also remove the restrictions on non-LSC funds and class actions. LSC also submitted its formal budget request to the
Congress calling for $516.5 million in funding. Republicans in the
House Appropriations Committee on the other hand, moved in the opposite
direction. Introducing a Continuing Resolution for the remainder of fiscal
year 2011, they proposed a $70 million cut for LSC from current spending levels
of $420 million, which will expire on March 4, 2011. Directed mainly at basic field grants, the proposal
amounts to a nearly eighteen percent reduction in funding for local legal aid
programs across the country, likely forcing programs to downsize their staff
and client pool. The Senate Appropriations Committee has not released its version
of the Continuing Resolution. For more info on this, go to the LSC site
by clicking above.
Proposed
$75 Million Budget Cut by U.S. House Would Devastate Legal Aid to Poor
2/10: The following is from a Feb. 9th Legal
Services Corporation e-mail: A congressional proposal to cut $75 million from
the Legal Services Corporation's (LSC) budget would decimate civil legal aid to
low-income Americans at a time when it is most needed by the tens of millions
suffering economic hardship. The proposed $75 million funding cut would
represent a 17 percent reduction from the White House's Fiscal Year 2011 budget
request of $435 million for LSC and a 14 percent decline from LSC's current
funding level, $420 million. The proposed cutback was announced today by the
House Appropriations Committee as part of its Continuing Resolution to fund
federal agencies and programs through the remainder of Fiscal Year 2011. "The Constitution calls for establishing
justice in its very first line, even before mentioning the common defense. Our
Pledge of Allegiance proclaims our national commitment to 'justice for all.'
Hard times test our values, and we cannot sacrifice equal access to justice to
any year's fiscal pressures," LSC President James J. Sandman said. LSC
Board Chairman John G. Levi said, "Justice is a hollow promise without
LSC. The Corporation and its national legal services network turn the
abstraction of equal access to justice into a living, everyday reality for
millions of low-income Americans. They are the most vulnerable in our society,
and it is our responsibility as a country to make sure that our justice system
works for them irrespective of the state of the national economy." The
impact of the proposed reduction at the mid-point of a fiscal year would be
devastating to the 136 nonprofit legal aid programs across the nation that
receive funding from LSC. The proposed cut could result in the layoffs of at
least 300 legal aid staff attorneys who
help victims of domestic violence, keep families in their homes by averting
unlawful foreclosures and evictions, help veterans and the disabled obtain
benefits, protect the elderly and
others from consumer fraud, and provide other services in civil cases. Programs
would be forced to turn away cases except for those involving immediate issues
of safety and security, and many programs serving rural areas would be forced
to close offices. To learn
more, go to the LSC web site by clicking above.
House
Continuing Resolution Spending Cuts to Go Deep in Current FY'11 Appropriations
2/10: The following is from a Feb. 9th press
release from the U.S. House Committee on Appropriations: House
Appropriations Chairman Hal Rogers today announced a partial list of 70
spending cuts that will be included in an upcoming Continuing Resolution (CR)
bill. The CR legislation will fund the federal government for the seven months
remaining in the fiscal year and prevent a government wide shut-down, while
significantly reducing the massive increases in discretionary spending enacted
in the last several years by a Democrat majority. A full list of program cuts
will be released when the bill is formally introduced. The total spending
cuts in the CR will exceed $74 billion, including $58 billion in non-security
discretionary spending reductions. To access the full press release, with a
partial listing of the agencies to be cut, click above. To access a Washington
Post article, click here.
Medicare
cutoff battle brewing: 'I feel they wrote me off'
2/4: The following is from a February 4, 2011 Detroit
Free Press article: The state's 1.5 million Medicare
recipients, along with thousands of others insured by private plans, could get
some relief under a lawsuit challenging the cutoff of physical and other
therapies if patients cannot demonstrate improvement. The problem particularly
affects people with multiple sclerosis, Parkinson's disease, spinal cord
injuries, heart failure and Alzheimer's disease, among others. Advocates for
patients say the cutoffs are not warranted by Medicare regulations. The
practice is often followed by private insurers, too, because they take their
cue from Medicare. The lawsuit, which seeks to be a class action, was filed
last month on behalf of five national organizations and four consumers.
It charges that the cutoffs deny patients care they need to maintain
their health, even if they are not improving beyond a certain level. They
represent an incorrect interpretation of the law by hospitals, nursing homes,
outpatient centers and others, the lawsuit says.
... Last month,
the Center for Medicare Advocacy filed a class action on behalf of five
national organizations and four consumers to stop what is known in the
insurance industry as the improvement standard. The suit names the Department of
Health and Human Services and its secretary, Kathleen Sebelius. ... Medicare
law and regulations do not require improvement for therapy coverage to
continue, Judith Stein, CEO of the Washington, D.C.-based center, said last
month. In fact, many people benefit from services that keep them from
deteriorating and may save money in the long run, if it helps people stay out
of hospitals and nursing homes, she and others say. A 2008 paper from the
Multiple Sclerosis Society, one of the organizations in the lawsuit, concluded
that rehabilitation services, such as physical therapy, help people achieve and
maintain maximum physical, social and vocational potential. Dr. Robert
Lisak, chief of neurology at the Detroit Medical Center and a nationally
recognized multiple sclerosis specialist, said he believes Medicare is shortsighted
in denying therapy. He also said he sees the issue more with private insurers
than Medicare. Click above to access the full article.
Supreme Court
Agrees to Hear Wal-Mart Bias Case Appeal; Major Class Action Issue Involved
12/6: The following is from a December 6th NY Times report: The Supreme Court on Monday [December
6th] agreed to hear an appeal in the biggest employment discrimination case in
the nation's history, one claiming that Wal-Mart discriminated against hundreds
of thousands of women in pay and promotion. The lawsuit seeks back pay that
could amount to billions of dollars. The question before the court is
not whether there was discrimination but rather whether the claims by the
individual employees may be combined as a class action. The court's decision on
that issue will almost certainly affect all sorts of class- action suits,
including ones asserting antitrust, securities and, products liability and other
claims. If nothing else, many
pending class actions will slow or stop while litigants and courts await the
decision in the case. "We are pleased that the Supreme Court has granted
review in this important case," Wal-Mart said in a statement. "The
current confusion in class-action law is harmful for everyone —
employers, employees, businesses of all types and sizes and the civil justice
system. These are exceedingly important issues that reach far beyond this
particular case." Brad Seligman, the main lawyer for the plaintiffs,
said in a telephone interview after the court decision: "Wal-Mart has
thrown up an extraordinarily broad number of issues, many of which, if the
court seriously entertained, could very severely undermine many civil rights
class actions. We welcome the court's review of this limited issue, and we're
confident that the core of our action will go forward." In their
brief urging the justices to deny review, the plaintiffs had said Wal-Mart's
objection to class-action treatment boiled down to the enormous size of the
class. "Petitioner returns
repeatedly to the refrain that the certified class is very large, a fact that
is indisputably true but legally irrelevant," the brief said. "The
class is large because Wal-Mart is the nation's largest employer and manages
its operations and employment practices in a highly uniform and centralized
manner." Wal-Mart, which says its policies expressly bar
discrimination and promote diversity, said the plaintiffs, who worked in 3,400
different stores in 170 job classifications, cannot possibly have enough in
common to make class-action treatment appropriate. In April, an 11-member
panel of the United States Court of Appeals for the Ninth Circuit, in San
Francisco, ruled by a 6-to-5 vote that the class action could go forward.
Click above for the full article.
Medicare
Advantage provision going smoothly so far
12/1: The following is from a Nov. 30th Washington
Post report: One of the most
significant savings envisioned in the new health- care law - limiting payments
to the private health plans that cover 11 million older Americans under
Medicare - is, so far, bringing little of the turbulence that the insurance
industry and many Republicans predicted. The law, which sets in motion
the broadest changes to the U.S. health-care system in decades, will hold down
the amount of money the government gives to Medicare Advantage plans, which are
available to patients who prefer a managed-care version of the program. The
savings is forecast to amount to $145 billion by the end of the decade.
Whether the payment changes are warranted was a contentious subplot in
the protracted debate over the legislation. Democrats argued successfully that
the private plans were being overpaid and could withstand the changes.
Republicans warned that such plans would raise prices, lower benefits or cause
defections from the program, stranding the elderly people who rely on them. Early
clues to the actual effects have now materialized, as elderly Americans may
sign up for a health plan for 2011 during an enrollment period through the end
of the year, and the warnings of swift, serious damage to the program are not
borne out. Fewer health plans are available for the coming year, but the
decrease is largely for reasons unrelated to the new law. Premiums have not
jumped substantially, and benefits have not tended to erode. Click
above for the full article.
Milestone: Niles
Housing Commission becomes 50th in Michigan to adopt smoke-free policy
11/22: On November 18th, the Board of the Niles
Housing Commission voted unanimously to adopt a smoke-free policy for all its
properties. This action is a milestone in Michigan, as Niles becomes the 50th
local housing commission in the state to adopt a smoke-free policy. The
Board of the Niles Housing Commission voted to make all indoor and outdoor
common areas smoke-free effective on January 1, 2011. The Board also voted
to make all indoor and outdoor areas, including living units, totally
smoke-free as of January 1, 2012. Thus, all 179 units owned by the Niles
Housing Commission will be completely smoke-free in about 13 months; this
includes 129 units in a high rise and 50 scattered site homes. The Cadillac Housing Commission was the first
Michigan housing commission to adopt a smoke-free policy, doing so in July,
2005. Since then, 48 other housing commissions had also adopted
smoke-free policies for some or all their properties. The housing
commissions range in size from ones with 20 or fewer units to the largest in
the state, including Detroit, Grand Rapids and Lansing. With the action
by the Niles Housing Commission, about 8,400 units of public housing will be
covered by smoke-free policies in Michigan. Nationally, about 225 local
housing authorities have now adopted smoke-free policies for some or all their
residential units. Inasmuch as only
about 18 housing authorities had adopted smoke-free policies as of December 31,
2004, there has been a very dramatic increase of about 1250% in less than
6 years, as housing authorities have seen that smoke-free policies are not only
good for the health of their residents, but are good for the financial bottom
line because smoke-free policies reduce maintenance costs and prevent
cigarette-caused fires. Jim Bergman, director of TCSG's Smoke-Free
Environments Law Project, praised the Board of the Niles Housing Commission and
their Executive Director, Mary Ann Bush, for their leadership in promoting a
healthy living environment for their residents. The federal Department of
Housing & Urban Development (HUD) in recent years has strongly encouraged
housing authorities and other HUD-subsidized property owners to adopt
smoke-free policies. Further, hundreds of thousands of apartment units of
market-rate housing are now smoke-free in Michigan. "Clearly, smoke-free
policies in multi-unit housing are rapidly becoming the norm in Michigan and across
the nation," said Bergman. To access a listing of all the housing
authorities in the U.S. that have adopted smoke-free policies, click above.
11/4: The Smoke-Free Environments Law Project
maintains an up-dated listing of all the public housing authorities/commissions
in the U.S. that we know of which have adopted smoke-free policies for one or
more of their apartment buildings. The listing is done largely in the
order in which the policies have been adopted, and with data which is as
accurate as we can make it, but we can't vouch for its total accuracy. As
of October, 2010, at least 215 local housing authorities had adopted smoke-free
policies for some or all of their apartment buildings, with about 199 being
adopted since the beginning of January, 2005; an average of about 2.8 per
month. That constitutes an increase in the number of housing authorities with
smoke-free policies of about 1,200% in 70 months. The 27 states
with such policies, with the number of individual local housing authorities
with smoke-free policies in parentheses, include Michigan (49), Minnesota (34),
Nebraska (24), Maine (20), Colorado (14), Washington (14), Oregon (14), New
Hampshire (10), California (8), Alaska (4), Idaho (3), Utah (3), New Jersey
(2), Wisconsin (2), Arkansas (2), Florida, Montana, Indiana, Kentucky,
Pennsylvania, Texas, Massachusetts, Connecticut, Vermont, Illinois, New York
and Kansas. To access the list, click above.
IMPORTANT
RULINGS: Medicare Standards Are
Too Strict, 2 Courts Find
11/2: The following is from a Nov. 2nd New
York Times article: Two federal
courts have ruled that the Obama administration is using overly strict
standards to determine whether older Americans are entitled to Medicare
coverage of skilled nursing home care and home health care. Medicare
will pay for those services if they are needed to maintain a person's ability
to perform routine activities of daily living or to prevent deterioration of
the person's condition, the courts said. Medicare beneficiaries do not have to
prove that their condition will improve, as the government sometimes contends,
the courts said. The rulings
are potentially significant for many people with chronic conditions and
disabilities like multiple sclerosis, Alzheimer's disease and broken hips.
Skilled care may be reasonable and necessary and covered by Medicare even if
the person's condition is stable and unlikely to improve, the courts said.
The government has not said whether it intends to appeal either
decision. Representative Joe
Courtney, Democrat of Connecticut, welcomed the decisions. "People with
chronic conditions are being denied care in the mistaken belief that Medicare
requires improvement of a person's condition as a prerequisite for
coverage," Mr. Courtney said Monday. "That's not in the law. It's
urban legend." In one case, the Federal District Court in Pittsburgh
said Medicare officials had used the wrong legal standard in denying coverage
of skilled nursing home care to an 81-year-old woman, Wanda Papciak.
After hip replacement surgery, Ms. Papciak received skilled nursing care,
physical therapy and occupational therapy in a nursing home. Medicare
terminated coverage after five weeks, saying her condition had not improved and
was unlikely to improve. In reversing the decision of Medicare officials,
the court said Ms. Papciak needed skilled nursing home care "to maintain
her level of functioning" and to prevent her condition from deteriorating.
Medicare officials had argued that Ms. Papciak was receiving only "custodial
care," for which the program does not pay. The court said Medicare
officials had "failed to apply the correct legal standard," and it
cited court rulings in support of the proposition that the Medicare law
"is to be liberally construed in favor of beneficiaries." To access
the full article, click above.
Public
Housing, Private Vice; Should smoking be banned in people's homes?
10/28: The following is from an article of the
above title in the Fall, 2010 issue of the Harvard Public Health Review: Welcome to the next front in the battle
against Big Tobacco: public housing. Following the passage in 23 states of laws
that ban smoking in workplaces, restaurants, and bars, anti-smoking advocates
are increasingly training their sights on private spaces in public buildings.
Last June, in Boston's Roslindale neighborhood, the Washington-Beech housing
development became the city's debut smoke-free public housing site—the
first step toward the Boston's Housing Authority's ambitious goal of clearing
the air by 2013 at all 64 public housing sites. And in 2009, an office within
the federal Department of Housing and Urban Development issued a memorandum
that "strongly encourages Public Housing Authorities ... to implement
nonsmoking policies in some or all of their public housing units. To be
sure, the trend has sparked dissent. After all, smoking is legal for adults,
and nicotine is known to be one of the hardest addictions to kick. Why should
poor people be asked to give up smoking at home when rich people have the right
to indulge this harmful vice? Is the intrusive government "nanny
state," as libertarians dub it, discriminating against those who are least
powerful? A new wave of published papers from the Harvard School of
Public Health (HSPH) and elsewhere sheds light on why smoking should be banned
in public housing, and how the policy question should be considered. ...
Experience in vanguard states like Maine, Michigan, and Massachusetts shows
that when the public health community turns up the
pressure—"helping, prodding, assisting"—the move towards
smoke-free housing goes much faster, Bergman says. To access the full
article, click above.
Probe shows
court-appointed guardians often not screened or monitored
10/27: The following is from an Oct. 27th CNN
news report: Some court-appointed guardians for incapacitated seniors are not
screened before they're appointed, and many are not monitored by the courts
after they've taken over the affairs of their charges, resulting in hundreds of
allegations of abuse, a federal probe found. An investigation by the Government
Accountability Office found allegations of abuse by legal guardians in 45
states and the District of Columbia, according to an advance copy of the report
obtained by CNN. The report is scheduled to be released Wednesday. In 20 cases studied by the office in which criminal or
civil penalties resulted, investigators found that guardians stole at least
$5.4 million in assets from 158 victims, the report said. In some instances,
these same guardians abused or physically neglected the people they were
supposed to help and protect. In six of the 20 cases examined, the courts
failed to screen guardians before giving them control over the financial
affairs and care of their wards, the federal agency found. In one case in
Missouri, a former taxi driver and convicted bank robber was appointed the
legal guardian of a wealthy customer who had no family. As the elderly man
developed Alzheimer's disease, his guardian stole more than $640,000 from him,
writing checks out of the victim's estate to pay for exotic dancers and a new
Hummer, court records show. To access the full story, click above.
Social
Security benefits will remain flat for 2nd straight year, government says
10/15: The following is from an Oct. 15th Washington
Post article: For the second year in
a row, the nearly 54 million retirees and other Americans who receive Social
Security benefits will not get any cost-of-living increase in 2011 in their
monthly checks, government officials announced Friday morning. The
absence of any growth in Social Security checks for consecutive years is
unprecedented in the 3 1/2 decades that payments have been automatically
adjusted according to the nation's inflation rate. The Social Security
Administration made the announcement moments after the Labor Department released the latest figures for the consumer price index. They show that prices
for the third quarter of this year rose by 1.5 percent compared with a year
earlier, but fell by 0.6 percent compared with the same time in 2008. In
a symptom of the weak economy, last year marked the first time since the
automatic formula has existed that consumer prices fell, so Social Security
recipients were given no increase in their checks. This year, the picture
is more complicated - and likely to produce louder complaints over the lack of
a cost-of-living increase. Click above for the full story.
44
Charged in Huge Medicare Fraud Scheme
10/14: The following is from an October 13th NY
Times report: An
Armenian-American crime syndicate stole the identities of doctors and thousands
of patients and used them and more than a hundred spurious clinics in 25 states
to bill Medicare for more than $100 million for treatments no doctor ever
performed and no patient ever received, the federal authorities announced on
Wednesday. Prosecutors said the case represented the largest
Medicare fraud operation ever carried out by a single group that resulted in
criminal charges. The group succeeded
in stealing $35 million in Medicare reimbursements, officials said, before the
charges were leveled and arrests were made on Wednesday. The "highly
organized massive scheme" is at the heart of a racketeering indictment and
other charges unsealed in federal court against 44 people, including a number
of members of the Armenian crime group, according to the F.B.I. and federal
prosecutors in New York and Georgia. "With 118 phantom clinics
and over $100 million in bogus billings, this group of international gangsters
allegedly ran a veritable fraud franchise," Preet Bharara, the United
States attorney in Manhattan, said in a statement announcing the charges.
"As charged, they stole taxpayer dollars earmarked for the elderly and
infirm and got away with it, until now." As of early Wednesday afternoon,
41 of the people accused had been arrested, 21 of them in the New York City
area, and a number of others in Los Angeles and elsewhere, the authorities
said. Click above for the full report.
Medicare
Advantage Premiums to Fall in 2011
9/22: The following is from a Sept. 22nd NY
Times report: The Obama
administration announced Tuesday that average premiums paid by individuals for
private Medicare Advantage plans, which insure about one-fourth of all
beneficiaries, would decline slightly next year, even as insurers provide
additional benefits required by the new health care law. By contrast,
commercial insurance premiums for many people under 65 and many small
businesses are increasing 10 percent to 25 percent or more. Insurers say that a
significant share of the increases is attributable to requirements of the new
law, a contention that infuriates Obama administration officials and Democrats
in Congress. Many of the law's requirements take effect this week.
President Obama plans to highlight the potential benefits for consumers on
Wednesday. The announcement on Medicare came as something of a surprise.
Some members of Congress and some health policy experts had predicted that
insurers would increase average premiums for Medicare beneficiaries in private
plans. "Despite the claims of some, Medicare Advantage remains a
strong, robust option for millions of seniors who choose to enroll or stay in a
participating plan," said Dr. Donald M. Berwick, the administrator of the
Centers for Medicare and Medicaid Services. Insurers can begin marketing
to beneficiaries on Oct. 1 for Medicare coverage that starts Jan. 1. Medicare
officials said they had held down premiums and co-payments by negotiating with
insurers, which sponsor the Medicare Advantage plans. The law, signed by Mr.
Obama in March, gave officials new power to negotiate and to reject bids, as
they did in a few cases. "We
negotiated more aggressively than in the past," said Jonathan D. Blum,
deputy administrator of the Medicare agency. "As a result, some plans
changed their bids to produce more value for beneficiaries." "On
average," Mr. Blum said, "Medicare Advantage premiums will be 1
percent lower in 2011 than today.
Medicare Advantage plans project that enrollment will increase by 5 percent in
2011." About 11.3 million of the 46 million Medicare beneficiaries
are in private Medicare Advantage plans, which offer comprehensive care in
return for monthly premiums. While premiums for a particular plan in a
particular county may increase next year, beneficiaries may be able to find
other plans offering a better deal. In the yearlong fight over health
care, Mr. Obama said the government was overpaying Medicare Advantage plans.
John K. Gorman, a former Medicare official who is now a consultant with
clients in the insurance industry, said: "Today's announcement shows that
there is a new sheriff in town. Medicare officials were very specific and very
forceful. Insurers succumbed to the government's demands and stayed in the
Medicare market because they have become much more dependent on Medicare
business." Payment rates for
Medicare Advantage plans will generally be frozen next year at 2010 levels,
with rates subject to tighter constraints in subsequent years. The cuts are
expected to save $136 billion over 10 years. To access the full story,
click above.
9/20: On September 15th, the HUD Multi-Family
Housing section issued a Notice in which they encouraged owners and management
agents of HUD Multi-Family Housing rental assistance programs, such as Section
8, to adopt and implement smoke-free policies for some or all their properties.
The Notice provides guidance to owners and managers on how to implement
such policies. The Notice tells owners and managers to implement
smoke-free policies by updating their House Rules. This Notice is similar
to one HUD issued on July 17, 2009 to public and Indian housing authorities and
demonstrates HUD's commitment to protecting the health of residents. To
access a copy of the HUD Notice, click above.
Poll
shows Michigan voters against raising Social Security age
9/17: The following is from a Sept. 16th Detroit
Free Press article: Michigan's got
some ideas about how to fix the nation's fiscal solvency, but when it comes to
raising the age for getting Social Security or Medicare, forget about it.
Nearly three-quarters of those likely to vote in the November election
who were surveyed last weekend in a Free Press/WXYZ-TV poll oppose raising
the age for full Social Security benefits to 70, and nearly as many — 69%
— oppose raising the age to receive Medicare benefits from age 65 to 67.
Both ideas have been offered to keep the programs solvent. But Michigan
voters like some other solutions for the government's fiscal crisis: ... More
than half would lift the cap on the payroll tax for Social Security, meaning
people making more than $107,000 a year would pay more. By a 49%-42%
margin, the likely voters want tax cuts approved while George W. Bush was
president to expire for people who earn more than $250,000 a year. To
access the full article, click above.
Smoke-Free
Multi-Unit Housing: Changing the
Landscape of Michigan & America
9/17: At the 2010 Fall Conference of
NAHRO-Michigan, TCSG's Jim Bergman gave a presentation titled Smoke-Free
Multi-Unit Housing: Changing the Landscape of Michigan & America. The presentation and the accompanying
PowerPoint provided information about the dramatic changes that have occurred
in the past decade in smoke-free housing nationally and in Michigan,
particularly related to public housing and other affordable housing. It
also presented information on how and why to go smoke-free and included many
slides of public housing and other affordable housing entities that have
smoke-free policies. There is also one slide that includes info from the
CDC research released on Sept. 7, 2010 on the % of nonsmokers exposed to
secondhand smoke. You can view and download the PowerPoint presentation
titled Smoke-Free Multi-Unit Housing: Changing the Landscape of
Michigan & America and you can
also view and download a pdf version by clicking above. You can also access the
ppt and pdf version directly here (ppt)
and here
(pdf).
9/8: The following is from a press release from
Cook Inlet Housing Authority in Alaska: Cook Inlet Housing Authority (CIHA)
will celebrate the grand opening of Eklutna Estates, located at 8850 Centennial
Circle on Tuesday, August 3rd at 1:30 p.m. Eklutna Estates is a fifty-nine unit
facility located within CIHA's existing senior community, Centennial Village,
in east Anchorage. Eklutna Estates consists of 46
one-bedroom/one-bath units and 13 two-bedroom/two-bath units and is open to
Alaskans aged 55 and older. Eklutna Estates is a mixed-income property with
most rental units available based on income eligibility guidelines and a
limited number of units available at market rate without income restrictions.
... CIHA is proud to announce that Eklutna Estates is a smokefree building.
"More and more Alaskans want to live in a smokefree environment,"
says Carol Gore, President and CEO of CIHA. "It is our goal to provide
quality, affordable and healthy homes." The Alaska Tobacco Control Alliance will present CIHA with a
Letter of Commendation for their efforts in providing healthy housing options. This
is CIHA's first smokefree property. As of September 1 CIHA will implement a
smokefree housing policy in all of our properties – all new leases will
be smokefree and expired leases will become smokefree as they come up for
renewal. To access the full
press release, click above.
How
to fix Social Security in one graph
9/2: The following is from an August 29th column
by Ezra Stein in the Washington Post:
"The revenue loss over the next 75 years just from extending the tax cuts
for people making over $250,000 -- the top 2 percent of Americans -- would be
about as large as the entire Social Security shortfall over this period,"
writes Kathy Ruffing and Paul N. Van de Water at the Center on Budget and
Policy Priorities. "Members of Congress cannot simultaneously claim that
the tax cuts for people at the top are affordable while the Social Security
shortfall constitutes a dire fiscal threat." We do have fiscal problems in
this country: health care, for instance. We have to get growth in that sector
down or we'll bankrupt the country. But that's not the case with Social
Security. Social Security is just a question of priorities. And the legislators
who are saying that we can extend the Bush tax cuts without offsets but that we
need massive benefit cuts in Social Security are showing where their priorities
lie, not stating a sad economic reality. Click above to access the
column. To access the analysis to which this column refers, see the news
note here.
What the 2010
Trustees' Report Shows about Social Security
9/2: The following is from an August 13th
analysis from the Center on Budget & Policy Priorities: On August 5, the Social Security Board of Trustees
issued the 70th annual report on the program's financial and actuarial status.
The trustees' report shows some mild deterioration in the program's
short-term outlook -- a finding that was widely expected -- and a mild
improvement in its long-run
finances, thanks largely to the recent enactment of health reform.
á
The
trustees continue to estimate that the trust funds will be exhausted in 2037 --
the same date that they forecast in last year's report.
á
Even
after 2037, Social Security could pay more than three-fourths of scheduled
benefits using its annual tax income. Those who fear that Social Security won't
be around when today's young workers retire misunderstand the trustees'
projections.
á
The
program's shortfall is relatively modest, amounting to 0.7 percent of Gross
Domestic Product (GDP) over the next 75 years (and 1.4 percent of GDP in 2084).
A mix of tax increases and benefit modifications -- carefully crafted to shield
recipients of limited means, potentially make benefits more adequate for the
neediest beneficiaries, and give ample notice to all participants -- could put
the program on a sound footing indefinitely.
á
The
75-year Social Security shortfall is about the same size as the cost, over that
period, of extending the 2001 and 2003 tax cuts for the richest 2 percent of
Americans (those with incomes above $250,000 a year). Members of Congress
cannot simultaneously claim that the tax cuts for people at the top are
affordable while the Social Security shortfall constitutes a dire fiscal
threat.
á
Preserving
and building upon the cost-control measures enacted in the health reform law
will be important not only to Medicare, but -- to a lesser degree -- to Social
Security as well.
To access the full report, click
above.
Seniors
opt to stay put; More are adapting homes as needs change
8/17: The following is from an August 15th Detroit
Free Press article: The new catch
phrase among homeowners is "aging in place." Instead of selling
their homes and moving into retirement villages or assisted-living quarters, a
growing number of older Americans are modifying
their homes to make them more user-friendly as they age. The concept has
caught on so successfully that it even has its own National Aging in
Place Week, which falls on Oct. 11-16 this year. "Aging in place is
a near and dear subject," said Karen Kassik, president of Home Accessibilities,
a residential design firm that focuses on building barrier-free homes. Click
above to access the full story.
Detroit Housing
Commission adopts smoke-free policy for all properties, effective January 1, 2011
8/17: We're very pleased to report that the
Detroit Housing Commission — Michigan's largest public housing authority
— adopted a smoke-free policy for all its multi-family properties.
The smoke-free policy goes into effect for all residents — no grandfathering
— on January 1, 2011 in all its 15 properties with a total of 2,118
units. The policy covers 10 elderly buildings with 1,440 units and 5
family buildings with 678 units. Smoking will only be allowed in outdoor
designated smoking areas, if any. The Detroit Housing Commission will
provide assistance to residents to quit smoking. It has been our pleasure
to assist the Detroit Housing Commission in adopting this policy. Michigan
now has 42 housing commissions with smoke-free policies for some or all their
properties. The policies cover about 85 apartment buildings/developments and
over 384 townhouses/scattered site units, with about 7,744 total
apartment units. Three of the
largest housing commissions in Michigan now have adopted smoke-free policies
— Grand Rapids with about 900 units, Detroit with 2,118 units, and
Lansing with 834 units. Nationally, there are now at least 179 local housing
authorities that have adopted smoke-free policies for some or all their
properties. Among the largest
housing authorities to have adopted smoke-free policies for almost all their
properties are the 3 three Michigan ones named above; Portland, Oregon with
1,993 units covered and may be adding 3,760 units soon; and Everett, Washington
with 1,047 units to be smoke-free in June, 2011. Other large housing
authorities that have adopted smoke-free policies, but only for a few of their
properties or are phasing in the smoke-free policies over the next few years
include: Minneapolis, Boston, Denver, and Seattle. To access an
updated listing of all the housing authorities we know of with smoke-free
policies, click above.
New Health
Official Faces Hostility in Senate
7/28: The following is from a July 27th NY Times article: Unlike many other health policy experts, Dr. Donald M. Berwick, the new chief of Medicare and Medicaid, has extensive real world experience. As co-founder of the Institute for Healthcare Improvement in Cambridge, Mass., he worked with doctors and nurses to upgrade care at hundreds of hospitals from Contra Costa County, Calif., to Green Bay, Wis., to Florence, S.C. -- and from Britain to Sweden to South Africa. He led efforts to reduce medical errors, eliminate hospital-acquired infections, standardize treatments and cut waste. One of his students, Dr. John S. Toussaint, former president of ThedaCare in Appleton, Wis., said his hospital had reduced the cost of inpatient care by about 25 percent, "using principles of continuous improvement espoused by Dr. Berwick." But two weeks after taking office, Dr. Berwick is still struggling to tamp down a furor over past statements in which he discussed the rationing of health care and expressed affection for the British health care system. And he is finding his ability to do his job clouded by the circumstances of his appointment, with many Republicans in open revolt over President Obama's decision to place him in the post without a Senate confirmation vote. Dr. Berwick never had a confirmation hearing and has not responded publicly to critics. The White House declined to make him available for an interview. But friends and allies said he was preparing a point-by-point rebuttal, most likely to be delivered when he first testifies before Congress. He wants to focus on the work of his agency, which finances health care for one in three Americans and has a budget bigger than the Pentagon's. As a recess appointee, Dr. Berwick has the same legal authority as a Senate-confirmed appointee. But his supporters worry that he will be a lame duck because agency employees and health care interest groups know he may be gone in 18 months. Unless he is confirmed, his appointment will expire at the end of the Senate's next session. Click above to access the full article.
Boston
Housing Authority pushes for smoke-free housing; Ban in Hub could be nation's
largest
7/28: The following is from a July 27th Boston Globe report: Meena Carr figured out years ago why her young grandson, Malik, was chronically coughing and wheezing: Her home made him sick. Carr, 69, didn't smoke cigarettes, but some of her neighbors in the Washington-Beech housing development did, often in the hallway. The smell permeated Carr's apartment. Last month, Washington-Beech in Roslindale became the city's first smoke-free public housing development. Today, Carr plans to join other community leaders, public officials, and housing advocates to discuss the Boston Housing Authority's more ambitious long-term objective -- clearing the air by 2013 at all 64 public housing developments. That positions Boston to become the first city in Massachusetts, and perhaps the largest housing authority nationwide, to impose such a ban. Under the proposal, still in its initial stages, about 27,000 residents in 12,000 units would be prohibited from smoking in common areas and their own apartments. "This new initiative will go a long way to encourage more healthy living styles for our residents," said Mayor Thomas M. Menino, who earlier this year unveiled the plan to make housing developments smoke free. "You don't live in a single-family home, you are in multiunit housing," Menino said. "What you do there has an effect on all other folks living in that building." Today's meeting at Suffolk University is being billed by officials as a "summit" to launch the campaign. Details, including how a ban would be phased in and how violators would be punished, are still unclear. Housing officials say the process will include community debate and a public comment period. By January, they hope to submit a proposal to the Department of Housing and Urban Development. Nationwide, about 170 public housing authorities -- roughly 5 percent -- have instituted some kind of no-smoking policy in the past few years, according to the Smoke-Free Environments Law Project in Michigan, a nonprofit that tracks the issue. But so far none as large as Boston's has implemented the ban, making the city a leader if it moves more quickly than other authorities of similar size. Click above for the full story.
7/26: The following is from a July 23rd Brennan
Center for Justice alert: On
July 22, 2010, the Senate Appropriations Committee approved (by a vote of
17-12) $430 million in total funding for the Legal Services Corporation (LSC)
as part of the Commerce-Justice-Science (CJS) Fiscal Year 2011 appropriations
bill. This funding level represents an increase of $10 million from the
current year's appropriation for LSC.
However, the $10 increase is contingent upon LSC's implementation of all 17 of
the recommendations made by the Government Accountability Office in its 2007
audit. It is reported that the Senate bill would also almost wholly repeal
the LSC restriction on non-federal funds (the bill would leave in place the
restriction on representing prisoners with any funds). The bill would leave in
place all restrictions on federal funds.
Since 1996, a rider to the federal appropriation for LSC has prohibited
LSC-funded lawyers from using certain tools when advocating on behalf of their
clients and has barred certain categories of people from qualifying for
LSC-funded representation. The restriction on non-federal funds, which the
Senate bill would repeal, is a provision of the rider that currently extends
the set of LSC restrictions to all of the funding that an LSC grantee receives,
including money from state, local, and private sources. This aspect of the LSC
funding restrictions has created waste and inefficiency in the delivery of
legal services and the Brennan Center and its allies have long advocated for
its repeal. The House version of the CJS appropriations bill, which
passed out of subcommittee on June 29, would allocate $440 million for LSC and
includes language that would repeal the LSC restriction currently barring LSC
programs' clients from participating in class action lawsuits. The language in
the House bill leaves the restriction on non-federal funds in place. Read more
about the LSC funding restrictions and about the Brennan Center's campaign to
fix them by clicking above.
LSC
Board Launches Fiscal Oversight Task Force
7/26: The following is from a July 21st LSC
press release: The Board of Directors of the Legal Services Corporation
(LSC) today approved creation of an independent task force to review and make
recommendations to the Board regarding LSC's fiscal oversight responsibilities
and how LSC conducts fiscal oversight of its grantees. LSC Board Chairman
John G. Levi, who proposed the task force, said it grew out of his review of
Government Accountability Office reports and other issues concerning LSC
following his nomination last year to the Board. "Given the
number of issues that have confronted LSC in the recent past, I thought as a
matter of some urgency that I wanted to get a blue-ribbon task force in place
to help us take a hard look at how we conduct fiscal oversight -- how we have
in the past, how we do it currently, and to give us advice on how we might best
do it in the future," Chairman Levi said. The task force's "findings and expertise will be
critically important as the Board works to expand legal assistance to
low-income Americans across the nation," Chairman Levi said. The
task force will seek information and advice from other grant-making
organizations, accounting firms, technology experts, and other business and
academic advisers familiar with institutions similar to LSC, Chairman Levi
said. Current and former LSC employees will not serve on the task force, he
said, "so that we get a completely independent look at our operations and
we can all stand by and feel good about the process that we went through."
Board members Robert J. Grey Jr. and Victor Maddox will lead the task
force, which is scheduled to issue findings and any recommendations by March
31. "The magnitude of our challenge cannot be overstated,"
Chairman Levi said. "Fifty-four million Americans qualify for legal
assistance from LSC programs, and these programs are vital to building stronger
communities across the nation. Legal aid programs help low-income Americans
when they are trying to maintain livelihoods, keep a roof over their heads or
escape domestic violence. The work of legal aid programs helps bring life to our
nation's promise of equal access to justice." Click above to access
the LSC web site for additional information.
Cuts in Home Care Put
Elderly and Disabled at Risk
7/21: The following is from a July 21st NY Times
article: As states face severe budget shortfalls, many have cut
home-care services for the elderly or the disabled, programs that have been
shown to save states money in the long run because they keep people out of
nursing homes. Since the start of the
recession, at least 25 states and the District of Columbia have curtailed
programs that include meal deliveries, housekeeping aid and assistance for
family caregivers, according to the Center on Budget and Policy Priorities, a
research organization. That threatens to reverse a long-term trend of enabling
people to stay in their homes longer. For Afton England, who lives in a
trailer home here, the news came in a letter last week: Oregon, facing a $577
million deficit, was cutting home aides to more than 4,500 low-income
residents, including her. Ms. England, 65, has diabetes, spinal stenosis,
degenerative disc disease, arthritis and other health problems that prevent her
from walking or standing for more than a few minutes at a time. Through a
state program, she has received 45 hours of assistance a month to help her
bathe, prepare meals, clean her house and shop. The program had helped make
Oregon a model for helping older and disabled people remain in their homes. But
state legislators say home care is a service the state can no longer afford.
Cuts affecting an additional 10,500 people are scheduled for Oct. 1. ...
Nursing homes here [Oregon] cost the state an average of $5,900 a month; home
and community-based services cost $1,500 a month. Other states have made
similar cuts: For the full article, click above.
Sault
Tribe Housing Authority offers smoke-free housing
7/20: The following is from a July 20th
SooToday.com news story: The Sault Ste. Marie Tribe of Chippewa
Indians has become the first tribe in Michigan - and fifth in the nation - to
establish smoke-free housing units for tribal members. The Sault Tribe
Housing Authority today celebrated the opening of smoke-free homes for eight
tribal families (four duplex units) in Kincheloe, Michigan. Additional smoke-free housing units will be
established in future years, under a new policy adopted earlier this year by
the Sault Tribe Housing Authority Commission. "Providing a healthy
living environment for tribal members is our main goal," said Sault Tribe
Housing Director Joni Talentino. "We want to give our members the
opportunity to join the nationwide movement toward becoming smoke-free."
All of the smoke-free units are full. Starting in November 2008,
as an initiative of the Sault Tribe Strategic Alliance for Health Project, the
Sault Tribe Tobacco Task Force, the Sault Tribe Housing Authority, the Sault
Tribal Youth Council, the Chippewa County Tobacco-Free Living Coalition, the
Smoke-free Environments Law Project and the Michigan Department of Community
Health worked together to adopt the policy and establish the smoke-free housing
units. Other supporters of the
policy included the Tribal Youth Council and smoke-free environments.
"Many tribal and non-tribal entities worked hard on obtaining this
status," said Donna Norkoli, project coordinator of the Sault Tribe
Strategic Alliance for Health Project. "It truly could not have been done
without these partnerships." The Sault Tribe Housing Authority joins
nine other local housing commissions in the U.P. who have adopted smoke-free
policies. "Of 11 tribal housing authorities in Michigan, the Sault Tribe
has taken the lead in adopting a smoke-free policy," said Jim Bergman of
the Smoke-Free Environments Law Project. "Hopefully, other tribes will
soon follow the Sault Tribe's leadership role." ... The Sault Tribe
Housing Authority manages more than 500 housing units across the Upper
Peninsula. To access the news story, click above.
Obama
bypassing Senate for new Medicare chief
7/7: According to the July 7th Washington Post: Bypassing Republicans eager to grill an
administration official over the new health care law, President Barack Obama is
planning to appoint the head of Medicare and Medicaid without Senate hearings.
Obama intends to use a so-called recess appointment to put Dr. Donald
Berwick in charge of the Centers for Medicare and Medicaid Services, a White
House official said Tuesday night. The appointment was expected Wednesday. The decision means Berwick, an expert on patient
care, can assume the post without being confirmed by the Senate, which is in
recess for the July Fourth holiday. He could serve through next year without
Senate confirmation. Republicans had indicated they were prepared to
oppose him over comments he had made on rationing of medical care and other
matters. Democrats wanted to avoid a nasty confirmation fight that could reopen
the health care debate. Berwick was nominated in April but no confirmation
hearing had been scheduled. Click above for full article.
'Father
of modern gerontology' Robert N. Butler dies at 83
7/7: The following is from the July 7th Washington
Post: Robert N. Butler, 83, a
Pulitzer Prize-winning author, psychiatrist and expert on aging who helped
illuminate the "quiet despair, deprivation, desolation and muted
rage" that he said characterized the act of growing old in America, and
who co-wrote a best-selling sex manual for senior citizens, died July 4 at
Mount Sinai Medical Center in New York. He had leukemia. For more than half a
century, Dr. Butler was a leading advocate in academic and policy circles for
the dignified treatment and care of the elderly. He coined the term
"ageism" to describe systematic discrimination against older people
and challenged lawmakers, scientists and medical students to consider how to
create a health-care system in which Americans could grow old gracefully.
"Bob was certainly the person, more than any other single
individual, who helped create the modern notion that aging is a time of choice,
of opportunity, of growth," said Dan Perry, who leads the Washington-based
Alliance for Aging Research. "He was really the father of modern
gerontology." Dr. Butler
was appointed the first director of the National Institute on Aging, part of
the National Institutes of Health, in the 1970s. Later, he established a
geriatrics department at Mount Sinai, one of the first such comprehensive
departments at an American medical school. At the time of his death, he was
president and chief executive of the International Longevity Center-USA, a New
York-based nonprofit research organization he founded in 1990. ...
Through his work as a clinician and researcher, Dr. Butler saw firsthand how
difficult it was for the elderly to find adequate health care and live with
dignity. They were treated by society as useless, warehoused in nursing homes
staffed by woefully undertrained caregivers and seen by doctors who knew little
about the unique needs of people in the latter stages of life. Dr. Butler
compiled those observations in his 1975 book "Why Survive? Being Old in
America," which won the Pulitzer for general nonfiction in 1976. "We
have shaped a society which is extremely harsh to live in when one is
old," he wrote. "The tragedy of old age is not the fact that each of
us must grow old and die but that the process of doing so has been made unnecessarily
and at times excruciatingly painful, humiliating, debilitating, and isolating
through insensitivity, ignorance, and poverty." Click above for full obituary.
House
Subcommittee Approves $20 Million Increase for LSC
7/1: The following is from a June 30th note from
the Legal Services Corporation: The House Appropriations Subcommittee on
Commerce, Justice, Science and Related Agencies approved a $440 million Fiscal
Year 2011 budget for the Legal Services Corporation (LSC) on June 29.
The funding increase was announced by Rep. Alan B. Mollohan (D-W.Va.),
chairman of the House Appropriations Subcommittee, and represents a nearly 5
percent increase in the LSC budget.
Rep. Frank R. Wolf (R-Va.) is the Subcommittee's ranking member.
"LSC is enormously grateful for the strong support of Chairman
Mollohan, Ranking Member Wolf and all Subcommittee members. The ranks of
low-income Americans are growing and LSC-funded programs report that requests
for legal assistance are increasing. This new funding approved by the
Subcommittee will help legal aid programs to better serve the nation's
poor," LSC President Victor M. Fortuno said. In February, President
Fortuno testified before the Subcommittee, noting that requests by low-income
Americans for help with foreclosure and unemployment problems were increasing.
Fifty-four million Americans, including 18.5 million children, are eligible for
civil legal assistance. The weak economy has placed a great strain on the
resources that support legal aid programs, with some non-federal funding for
legal aid in decline, raising concerns about the ability of legal aid programs
to provide increased services this year and next year. The
Subcommittee bill continues existing restrictions on the use of funds, but
lifts the restriction on the ability of LSC-funded programs to consolidate
related client cases into class-action suits. Chairman Mollohan and Reps. Patrick J. Kennedy (D-R.I.) and Adam B.
Schiff (D-Calif.) urged the Subcommittee to permit class actions. "Lifting
this restriction will allow grantees to more efficiently address systemic
issues such as predatory lending or wrongful eviction," Chairman Mollohan
said in a statement. LSC is the single largest funder of civil legal aid
in the nation, and currently funds 136 independent nonprofit legal aid programs
across the country. Established in 1974, LSC operates as a 501(c)(3) nonprofit
corporation to promote equal access to justice and to provide for high-quality
civil legal assistance to low-income Americans. The annual LSC budget
includes basic field grants that provide for the delivery of civil legal
assistance, technology grants, an education loan repayment program for the
recruitment and retention of lawyers, and grants oversight to ensure compliance
and accountability by legal aid programs. For more info, go to the LSC web site
by clicking above.
Investing in
Prevention: The New National Prevention, Health Promotion and Public Health
Council
7/1: The following is from a June 30th Fact
Sheet from the U.S. Surgeon General's office: Chronic diseases -- such as heart
disease, cancer, stroke, and diabetes -- are responsible for 7 of 10 deaths
among Americans each year and account for 75% of the nation's health spending. Often
due to economic, social, and physical factors, too many Americans engage in
behaviors -- such as tobacco use, poor diet, physical inactivity, and alcohol
abuse -- that lead to poor health. A focus on prevention will offer our
nation the opportunity to not only improve the health of Americans but also
help reduce health care costs and improve quality of care. By concentrating on the underlying drivers of
chronic disease, the Affordable Care Act helps us move from today's sick-care
system to a true "health care" system that encourages health and
well-being. The Affordable Care Act signed into law by President Obama
creates a National Prevention, Health Promotion, and Public Health Council. The
Council, composed of senior government officials, will elevate and coordinate
prevention activities and design a focused National Prevention and Health
Promotion Strategy in conjunction with communities across the country to
promote the nation's health. The Strategy will take a community health approach
to prevention and well-being -- identifying and prioritizing actions across
government and between sectors. On June 10, the President signed an
Executive Order creating the National Prevention Council. Established
within the Department of Health and Human Services, the Council is chaired by
the U.S. Surgeon General. Click above to access the full Fact Sheet.
To access the Council's report in pdf format, click here.
Health
Agency Nominee Faces Confirmation Battle
6/22: The following is from a June 21st NY
Times article: President
Obama's nominee to run Medicare and Medicaid, Dr. Donald M. Berwick, is a man
with a mission, a preacher and teacher who has been showing hospitals how they
can save lives and money by zealously adhering to clinical protocols for the
treatment of patients. Hospital executives who have worked with Dr.
Berwick describe him as a visionary, inspiring leader. But a battle has
erupted over his nomination, suggesting that Dr. Berwick faces a long uphill
struggle to win Senate confirmation. Republicans are using the nomination
to revive their arguments against the new health care law, which they see as a
potent issue in this fall's elections, and Dr. Berwick has given them plenty of
ammunition. In two decades as a professor of health policy and as a prolific
writer, he has spoken of the need to ration health care and cap spending and
has confessed to a love affair with the British health care system. He has made
numerous public appearances to talk about health care and has published a book
of his speeches on the topic. Mr. Obama nominated Dr. Berwick on April 19
to be administrator of the Centers for Medicare and Medicaid Services, the
largest purchaser of health care in the United States. The post has been vacant
since October 2006, and the need to fill it has become more pressing with
passage of the new law. The agency must write and enforce dozens of regulations
to expand Medicaid, trim Medicare and test new ways to deliver care. Click
above for full article.
Should
public housing projects go smoke-free?
6/17: The following is from a June 16th CNN report: Between puffs of his cigarette, Aristo Lizica
explains why he's all for a smoking ban in public housing -- including his own
housing project on the Upper West Side of Manhattan. "When you smoke
indoors, it hurts everybody," the 59-year-old says, leaning against an
iron fence outside his building. "It's better for me to just make myself
sick." Lizica would prefer to avoid making himself sick too, of
course. "I want to quit," he adds. "I know cigarettes are bad
for my health." Yet he remains unable to kick the habit. Federal
housing officials are trying to help people like Lizica -- and his neighbors --
by making public housing smoke-free. Full or partial smoking bans would reduce
secondhand smoke drifting between apartments, prevent cigarette-related fires,
and even help smokers quit, they argue. "We see it as a win-win for both residents and
housing authorities," says Donna White, a spokesperson for the U.S.
Department of Housing and Urban Development, the federal agency that oversees
public housing. In a 2009 memo, the department highlighted the dangers
that indoor smoking poses to the nation's 2.1 million public housing residents,
and "strongly encouraged" local housing authorities to implement
smoking restrictions. But doing so
remains voluntary, and so far only about 4 percent of local authorities have
taken the step. "Change is hard," White says. Public health
experts are hoping to light a fire under the cause. In a paper published
today in the New England Journal of Medicine, a team of researchers and
attorneys from Harvard University argue that the health and safety gains of a
smoking ban in housing projects would far outweigh the losses, which some say
would include the privacy rights of smokers. Yet smokers like Lizica could prove to be the biggest winners,
the authors suggest. "If federal officials and public housing authorities
take this cue, we can expect to have large numbers of people quit
smoking," says the lead author of the article, Jonathan Winickoff, M.D., a
pediatrician and assistant professor at Harvard Medical School, in Boston.
"That could be the single greatest health benefit." Click above for
the full CNN article. To access the full NEJM article, click here.
Medical Marijuana and
Smoke-Free Multi-Unit Housing: An
Analysis
6/11: We at TCSG's Smoke-Free Environments Law Project
(SFELP) are pleased to release a new document by SFELP Consulting Attorney
Cliff Douglas, J.D., titled Restricting the Use of Medical Marijuana
in Multi-Unit Residential Settings: Legal and Practical Considerations. This may be one of the first such analyses
done anywhere in the U.S., and, while it focuses on Michigan's Medical
Marihuana Act, it has great relevance for other states (at least 13 to 15
states have such laws). We have now added a section to the Landlord
Rights page of the
MISmokeFreeApartment web site where you can access the analysis. At that
site, you can also access a copy of the Michigan Medical Marihuana Act and a
copy of a 1999 HUD legal memorandum on this topic. The analysis is 12
pages, but the introduction is just one page, and it summarizes the question
addressed -- Do multi-unit residential property owners have the authority to
prohibit the smoking of marijuana in their properties when the individual marijuana
user is authorized by the state of Michigan to user it? -- and provides answers
to that question for both market-rate properties and for affordable housing,
including public housing. Our conclusion is that owners may prohibit the
smoking of marijuana, including medical marijuana, in their properties. We
addressed this issue because many multi-unit residential property owners,
including housing authorities, who had adopted overall smoke-free policies,
wanted to know how they would deal with individuals who are licensed by the
state to use marijuana for medicinal purposes. We encourage you to go to
the site and download copies of the analysis and the HUD memorandum.
Also, feel free to do a link to the page from your own web sites.
To access the analysis and 1999 HUD memorandum, click above.
Social
Security's defenders wary of deficit reduction commission
6/9: The following is from a June 9th Washington
Post article: One of the oddest
Web posts making the rounds in Washington is a series of blurry videos from
Capitol Hill showing people coming and going from a closed-door meeting of
President Obama's new deficit commission. The mundane scenes have a sinister
cast for activists who say the commission is at work on a secret plan to gut
Social Security. Nancy Altman, whose group, Social Security Works, shot the
footage, says the threat to the nation's primary social safety net is greater
now than at any time in the program's 75-year history. "This is going to affect every single
American if they reach agreement," she said. "People need to know
what's going on." The heated rhetoric is an ominous sign for Obama's
deficit-fighting task force, which is charged with developing a bipartisan plan
to stabilize the soaring national debt. Adjusting Social Security benefits is a
likely point of consensus, commission members say. Now, some of the same
activists who helped derail a 2005 GOP plan to restructure the program are
threatening to rally the public against any proposal to cut benefits.
Their campaign to take Social Security off the commission's agenda has so
far been limited to op-eds, online postings and thousands of postcards to
lawmakers. But AARP, which lobbies on behalf of people over 50, recently
fired a warning shot, urging the commission not to "unfairly target
hard-earned benefits of millions of Americans." And several groups,
including MoveOn.org and the Campaign for America's Future, are threatening to
make Social Security an issue in the midterm elections. "It's likely to be a pretty full court
press," said MoveOn campaign director Daniel Mintz, whose group plans to
ask candidates to sign a pledge opposing Social Security cuts. "We're
going to demand solutions to the deficit that make corporations and the rich
pay their fair share of taxes, rather than cutting benefits and squeezing the
middle class." ... Over the past month, deficit commission members have
begun meeting in small working groups, including one subpanel, chaired by
former Clinton budget director Alice Rivlin and Sen. Judd Gregg (R-N.H.),
dedicated to Social Security. Other panels are focusing on other entitlement
programs, such as Medicare, an even bigger budget problem, as well as discretionary
spending and the tax system. If 14 of
the commission's 18 members reach agreement on a deficit-reduction plan,
congressional leaders have pledged to put it to a vote after the fall
elections. Commission members have declined to say what options they are
considering, repeating the Obama mantra that everything is "on the
table." But options for Social Security are no secret: In addition to
boosting taxes, the lengthy list includes raising the retirement age for people
now in middle age and trimming benefits for the wealthy. Social Security has been self-supporting since 1935,
with taxes paid by current workers financing benefits for current retirees. But
people today retire earlier, live longer and have fewer children. As result,
the number of workers for each retiree is expected to fall from about three to
one now to two to one by 2050. Sometime in the next few years, taxes will no
longer cover benefits. The program's defenders argue that there is no crisis:
If Treasury would repay billions of dollars in surplus Social Security taxes
borrowed over the years, the program could pay full benefits through 2037. But
many budget experts question whether supporting the existing benefit structure
should be a cash-strapped nation's first priority. To access the full
article, click above.
Counting on
Medicaid Money, States Face Shortfalls
6/8: The following is from a June 7th NY
Times article: Having counted on
Washington for money that may not be delivered, at least 30 states will have to
close larger-than-anticipated shortfalls in the coming fiscal year unless
Congress passes a six-month extension of increased federal spending on
Medicaid. Governors and state lawmakers, already facing some of the
toughest budgets since the Great Depression, said the repercussions would
extend far beyond health care, forcing them to make bone-deep cuts to
education, social services and public safety. ... The Medicaid provision, which would extend assistance first
granted in last year's stimulus package, was considered such a sure bet by many
governors and legislative leaders that they prematurely included the money in
their budgeting. But under pressure from conservative Democrats to rein in
deficit spending, House leaders in late May eliminated $24 billion in aid to
states from a tax and jobs bill that was approved and forwarded to the Senate.
The Senate plans to take up the measure this week, and the majority
leader, Harry Reid of Nevada, favors restoring the money, said his spokesman,
Jim Manley. The House speaker, Nancy Pelosi, signaled last week that her
chamber was open to reconsidering the appropriation. But state and Congressional officials said the
evolving politics of an election-year Congress meant the federal aid could no
longer be taken for granted. And if it does not arrive, it will leave gaping
shortages for states that are already slashing services and raising taxes to
balance their recession-wracked budgets. According to the National
Conference of State Legislatures, states are relying on the money to close more
than a fourth of the $89 billion in cumulative budget shortfalls projected for
fiscal 2011, which starts on July 1 in 46 states. Click above to access the
full article.
Secretary of HHS
announces tobacco-free initiative
5/12: On May 11th, HHS Secretary Sebelius announced
a major new initiative to prevent and reduce tobacco use and its effects.
Her web site states: Smoking harms nearly every organ of the body,
causing many diseases and affecting the health of smokers in general. Quitting
smoking has both immediate and long-term benefits for you and your loved ones.
Despite progress in reducing tobacco use, more than 20% of Americans still
smoke and smoking rates that have been falling for decades have now stalled.
The good news is that we know what it will take to get those numbers dropping
again – comprehensive, sustained, and accountable tobacco control efforts
based on evidence-based interventions. We have identified the following
set of actions to accelerate our efforts to prevent and reduce tobacco use.
To go to the web site, click above.
5/6: The following is from a May 5th Detroit
News Article: Trying to entice
employers to keep early retirees on their medical plans, the Obama
administration announced Tuesday it's making $5 billion available until the
safety net of the new health care law is in place. Effective next month,
federal subsidies will allow employers to recoup a big chunk of the cost of
medical claims for retirees ages 55 to 64 not yet eligible for Medicare.
Older baby boomers working for large companies -- and looking to downshift
to less-demanding employment-- could be immediate beneficiaries. However,
in the long run, experts predict that President Barack Obama's health overhaul
will accelerate the decline of employer-sponsored retiree coverage, by making
it easier for people to find and keep affordable coverage on their own, as well
as improving Medicare benefits. Starting in 2014, the health care law
forbids insurers from denying coverage to people with medical problems, limits
what the companies can charge older individuals, and sets up competitive health
insurance markets where consumers can buy a policy, in many cases with direct
government assistance. Early retirees will have options they don't currently
enjoy. Click above to access the full article.
5/5: According to a May 4th press release from
HHS: The U.S. Department of Health and Human Services today issued
regulations establishing the Early Retiree Reinsurance Program in the
Affordable Care Act. This temporary program will make it easier for
employers to provide coverage to early retirees. "Rising costs have
made it hard for employers to provide quality, affordable health insurance for
workers and retirees," said Secretary Sebelius. "As a result,
many Americans who retire before they are eligible for Medicare are worried
about losing health insurance coverage through their former employers, putting
them at risk of losing their life savings due to medical costs. This new
program will provide much-needed relief so that employers can provide more
retirees with quality, affordable insurance, starting this year." The
percentage of large firms providing workers with retiree coverage has dropped
from 66 percent in 1988 to 31 percent in 2008. The Affordable Care Act
includes $5 billion in financial assistance to employers to help them maintain
coverage for early retirees age 55 and older who are not yet eligible for
Medicare. The program will end in 2014, when Americans will be able to
choose from additional coverage options through the health insurance exchanges. Eligible employers can apply for the program
through the Department of Health and Human Services. Applications will be
available by the end of June. Both self-funded and insured plans can
apply, including plans sponsored by private entities, state and local
governments, nonprofits, religious entities, unions, and other employers. You
can find more information about this important new program by clicking above.
4/28: The following is from an April 26th The
Hill story: A liberal lawmaker on the
White House fiscal commission warned its Republican co-chairman against relying
on cuts to seniors' entitlement benefits to craft a plan to rein in the
deficit. Rep. Jan Schakowsky (D-Ill.) said former Sen. Alan Simpson
(R-Wyo.) and other fiscal hawks have focused too much on possible changes to
entitlement programs, especially Social Security, ahead of the White House
fiscal commission's first meeting on Tuesday. "If Alan Simpson is so committed to putting entitlements
on the table... then we better put all entitlements, including tax
entitlements, on the table as well," Schakowsky told The Hill on Monday.
The "tax entitlements" Schakowsky referring to were exemptions
aimed at helping people save for retirement, such as tax breaks on money
invested in 401k and individual retirement accounts (IRAs), according to her
office. The commission's recommendations need the votes of 14 of the 18
members to make it to Congress, so any defector could be a cause for concern.
And if Schakowsky's against the possible changes to entitlement programs than
other Democrats would worry about voting for them because it could be seen as a
vote against seniors. Schakowsky joined liberal groups in pushing back
Monday against Simpson and the fiscal commission's Democratic co-chairman,
former Clinton White House Chief of Staff Erskine Bowles, who have said that
all options for reducing deficits must be considered. "I feel that
part of my job on the commission is to make sure that we have a consensus that
the goal of fiscal policy and budget policy is to make sure that we serve the
needs of the people in our country, in our democratic society, and not just put
out a green eyeshade and start slashing programs," Schakowsky said.
Simpson and Bowles, picked to lead the commission by President Barack Obama,
have made clear that the commission will consider new taxes that could irk
Republicans and cuts in spending and entitlement benefit levels that would be unpopular
with Democrats. Click above for the full article.
Justices Put Curbs on
Payment for Lawyers
4/23: The following is from an April 22nd NY
Times article: The Supreme
Court on Wednesday made it a little harder for civil rights lawyers to be paid
extra for exceptional results. In most American lawsuits, each side pays
for its own lawyers whether they win or lose. But Congress occasionally allows
the winning side to claim its legal fees from its adversaries, notably in cases
involving claims of civil rights violations. The question in the case
decided Wednesday, Perdue v. Kenny A.,
No. 08-970, was how judges should determine how much the losing side has to
pay. The case arose from a successful class-action suit on behalf of
3,000 children in Georgia that helped reform the foster-care system there.
The trial judge awarded the lawyers $6 million using a conventional way
of calculating legal fees -- hours worked times the local hourly market rate
for lawyers of comparable experience and skill. The judge then added $4.5
million for what he said was work of exceptionally high quality. Justice
Samuel A. Alito, writing for five justices, said that some additional payments
may be proper in rare cases but that the judge here had not given good enough
reasons for increasing the basic payment by 75 percent. For the most part, Justice Alito said, it is not possible
to know what role a lawyer played in obtaining a favorable result. ... Justice
Alito, joined by Chief Justice Roberts and Justices Antonin Scalia, Anthony M.
Kennedy and Clarence Thomas, said that the trial judge's "essentially
arbitrary" award in the Georgia case would have caused the lawyers there
to "earn as much as the attorneys at some of the richest law firms in the
country." The legal-fees provision, he wrote, "was enacted to
ensure that civil rights plaintiffs are adequately represented, not to provide
such a windfall." Justice Stephen G. Breyer, joined by Justices John
Paul Stevens, Ruth Bader Gisburg and Sonia Sotomayor, said the Georgia lawyers
had indeed vindicated important civil rights and helped reform an abusive
foster-care system through an exceptionally long, complex and hard-fought
litigation. Justice Breyer added that the trial judge was in the best position
to assess their performance. "If this is not an exceptional
case," Justice Breyer asked, "what is?" Click above for
full article.
Federal Government
Will Pick Up Nearly All Costs of Health Reform's Medicaid Expansion
4/22: The following is from an April 20th Center
on Budget and Policy Priorities
analysis: Health reform's critics argue that states will bear a significant
share of the costs of the new law's Medicaid expansion, placing an unaffordable
financial burden on states. The argument does not withstand scrutiny. In its
first five years, the Medicaid expansion will add just 1.25 percent to what
states were projected to spend on Medicaid over that period in the absence of
health reform, while providing health coverage to 16 million more low-income
adults and children. The health reform law requires all states to expand
Medicaid to all non-elderly individuals with incomes up to 133 percent of the
poverty line, or about $29,000 for a family of four. The Medicaid expansion and
new premium credits for people with incomes too high to qualify for Medicaid
will, together, reduce the number of uninsured people by 32 million by 2019,
according to the Congressional Budget Office (CBO). The Medicaid
expansion in health reform is a good deal for states. 1) The additional cost to the states represents only
a 1.25 percent increase in what states would have spent on Medicaid from 2014
to 2019 in the absence of health reform. 2) The federal government will
assume 96 percent of the costs of the Medicaid expansion over the next ten
years, according to an analysis of CBO estimates. 3) And having more
people covered as a result of the Medicaid expansion and other provisions in
the health reform law will reduce state and local governments' current spending
on other services for the uninsured, such as mental health services. In
sum, the Medicaid expansion will significantly increase coverage at a modest
cost to the states and will help reduce states' costs for providing care to the
uninsured through a variety of state programs outside of Medicaid. Click above for the full analysis.
4/22: We are delighted to report that the Sault
Tribe Housing Authority in the Upper Peninsula of Michigan on April 19th
adopted a smoke-free policy for some of their Tribal Housing homes. The
policy states that "The Housing Authority Board of Commission has declared
that certain Tribal Housing homes, located in the Seven-County service area of
the Sault Ste. Marie Tribe of Chippewa Indians, shall be designated as
smoke-free. Smoking is not permitted in any inside area of the designated
homes." The Housing Authority Board of Commission will, at the May
meeting and at subsequent meetings as needed, approve a resolution for each
individual property that will be designated as smoke-free. We expect that
initially a number of duplexes will be designated as smoke-free, as well as
some triplexes that will be constructed in 2011 for elderly housing. This
is a great achievement by the Sault Tribe Housing Authority and is something
that has been worked on for well over a year. Our congratulations to
their Board, their Executive Director Joni Talentino and her staff, including
Mariea Mongene, who worked tirelessly on this. Congratulations also to
Donna Norkoli of the Sault Tribe Health Center, as well as Lauren Eveleigh of
the Health Center, and Julie Trotter of the Chippewa County Health Department
and to all the other folks who contributed so much to this effort. It has
been our pleasure at TCSG's Smoke-Free Environments Law Project to be a part of
this endeavor. The Sault Tribe Housing Authority is the first tribal
housing authority in Michigan to adopt a smoke-free policy and, as far as we
know, only the fifth in the nation.
There are three tribal housing authorities in Alaska and one in Maine
that also have adopted smoke-free policies. The Sault Tribe Housing
Authority has about 500 units of housing in the 7-county area. To access
the Sault Tribe web site, click above.
Obama
picks Donald Berwick of Harvard to run Medicare and Medicaid
4/21: The following is from an April 20th Washington
Post report: President Obama formally
announced Monday his nominee for administrator of the Centers for Medicare and
Medicaid Services, fulfilling widespread expectations that he would tap Donald
Berwick, a Harvard University professor and leading advocate for improving health-care
quality and efficiency. If confirmed by the Senate, Berwick will play a
pivotal -- and challenging -- role in implementing the recently enacted
health-care overhaul legislation. The agency, which is part of the Department
of Health and Human Services, must oversee a massive expansion of Medicaid, the
federal-state insurance program for the poor, with an estimated 16 million
people expected to join its rolls by 2020. At the same time, Medicare, the
insurance program for the elderly, will need to reduce payments to health-care
providers by about $400 billion over 10 years without impacting the quality of
coverage. Berwick, who specializes in health-care policy and pediatrics,
has never led such a large organization. As head of the Boston-based Institute
for Healthcare Improvement, however, he is known for persuading doctors and
hospitals to adopt innovative methods for reducing medical errors. Click
above to access the story.
After Health
Care Passage, Obama Pushes to Get It Rolling
4/20: The following is from an April 18th NY
Times article: Mindful that the new health care law's ability to slow
rising medical costs will depend to a great extent on how it is put in effect,
President Obama is assembling a high-level team to carry out key elements of
the overhaul and is considering moving faster than the law requires to put them
into action. The president has tapped Pete Rouse, one of his closest
White House advisers, to oversee what one insider described as an
"elaborate implementation plan." And he personally pressed
Nancy-Ann DeParle, who directed the legislative effort and has long experience
in the health sector, to shelve her plans to leave; she will instead manage
construction of the machinery for extending coverage to about 30 million
uninsured Americans while also moving toward the law's long-run goal: cost
containment. Kathleen Sebelius, the secretary of health and human
services and, before that, insurance commissioner and then governor of Kansas,
has assumed a higher-profile role both within the administration and publicly.
Ms. Sebelius has begun work on the first of what will be numerous regulations
for Medicare, Medicaid and private health care providers. Within her
department, she has reorganized the Centers for Medicare and Medicaid Services
to make room for an innovation center intended to test ways of reimbursing
providers that could reduce spending while improving patient care. The secretary can expand successful ideas nationwide
without Congress's permission. ... The law's main provisions, including those
creating state insurance exchanges where uninsured Americans can shop for
competitively priced policies, will not take effect until 2014 -- two years
after the next presidential election. But Mr. Obama has urged advisers
to consider moving sooner to set up an Independent Payment Advisory Board for
controlling Medicare spending. Some administration
officials, however, fear that creating the board much before 2014 could
prematurely make it a target for attacks of the "death panel" sort,
leaving it politically vulnerable before its powers to impose changes take
effect. The board was a top priority for Mr. Obama during the long
legislative battle. He faced down Democratic leaders, who opposed delegating
powers to an unelected board for the government's popular health insurance
programs. Even some skeptics of the health insurance law say that the
board, and the law more generally, could prove more effective at restraining
spending than estimated by the nonpartisan Congressional Budget Office -- if
only because of the nation's bleak fiscal future. ... The president will
nominate the 15 members of the Independent Payment Advisory Board; Senate
confirmation is required for the six-year terms at what are to be full-time
jobs, for better bureaucratic clout. Each year that Medicare spending exceeds
annual targets, as most analysts expect it will, the board must propose ways to
reduce payments to care providers. Unlike an existing Medicare
commission whose recommendations Congress routinely disregards, the board could
put its proposals into effect unless Congress modified or rejected them within
30 days. Even then, the president could veto a disapproval resolution; it would
take a two-thirds vote of both houses of Congress to override the veto. "It's a very promising structure," said
Peter R. Orszag, Mr. Obama's budget director. "But like anything
else in life, it's what you make of it. So whether it realizes its potential
depends on how it's implemented." Click above for the full article.
Smoke-Free
Affordable Housing: Picking on
Poor People or a Case for Social Justice?
4/15: The Non-Smokers' Rights Association in
Canada has just released a new resource for tobacco control and smoke-free
housing advocates entitled "Smoke-Free Affordable Housing: Picking on Poor
People or a Case for Social Justice?" To access this informative
analysis, click above.
California
protest seeks Social Security benefits for gays
4/13: The following is from an April 12th Washington
Post article: Protesters chanting
slogans and carrying signs marched in Hollywood Sunday to demand equal Social
Security benefits for same-sex couples. About 700 peaceful demonstrators
walked more than a mile to rally outside the Hollywood Social Security
Administration office, said Lorri L. Jean, CEO of the Los Angeles Gay &
Lesbian Center. "This was the kickoff for a national campaign to
end discrimination when it comes to Social Security," Jean said. "We
not only have to educate the straight community, but we have to educate our
own. Many don't know how it works until they're older and faced with having
been denied benefits."
Before the march, U.S. Rep. Linda Sanchez told the cheering crowd she
would author legislation that would extend survivor benefits to older gay and
lesbian couples. "We now have quality, affordable health care coming
to all," Sanchez said. "What good is the quality of our health care
in America if Americans are not treated equally under all of our laws?"
U.S. Rep. Judy Chu offered to co-author the bill. U.S. Sen. Barbara Boxer
also spoke. Senior citizen Alice Herman spoke about being denied benefits
after the death of her partner, Sylvia, even though they were legally married.
Had Sylvia been a man, Herman said, she would have been entitled to receive her
spouse's larger Social Security payments. Click above for full article.
Bernanke:
Paying for Medicare, Social Security weighs on economy
4/8: The following is from an April 7th
Washington Post article: The United States needs to take new steps to improve
the financial condition of Medicare and Social Security, Federal Reserve
Chairman Ben S. Bernanke said Wednesday, describing the challenges of paying
for those programs as one of the greatest long-term challenges for the economy.
Bernanke, in an unusual discussion of an area outside his immediate
responsibility, seemed to be using his bully pulpit to try to focus attention
what he views as the top long-run challenge for U.S. economic policy. "To
avoid large and ultimately unsustainable budget deficits, the nation will
ultimately have to choose among higher taxes, modifications to entitlement
programs such as Social Security and Medicare, less spending on everything else
from education to defense, or some combination of the above," Bernanke
said in a speech to the Dallas Regional Chamber. "These choices are
difficult, and it always seems easier to put them off -- until the day they
cannot be put off any more. But unless we as a nation demonstrate a strong
commitment to fiscal responsibility, in the longer run we will have neither
financial stability nor healthy economic growth." Bernanke did make
clear that he does not view immediate steps to reduce the budget deficit as
desirable, given the continued high joblessness. Click above to access
the full article.
4/8: The following is from an April 7th
Buyrlington Free Press report: Burlington Housing Authority's three
high-rise buildings will become smoke-free Nov. 1, but at least one resident of Decker Towers on St.
Paul Street vows a legal challenge to the new policy. "If I can't
find someone to help me, I'll do it myself," said Chris Hersey, who has
lived in the high-rise for six years. "I'll walk into federal court by
myself if I have to. I won't let some city bureaucracy tell me what I can and
can't do. I'm not letting them get away with this." The new
policy will affect the 159 units in Decker Towers, the 65 units in South Square
Apartments on College Street, and the 50 units in Champlain Apartments on North
Champlain Street. The apartments provide housing for income-eligible people
over age 62 and for the disabled.
BHA Executive Director Paul Dettman said the new policy, announced in
late February in a letter to residents, is part of a national trend encouraged
by the U.S. Department of Housing and Urban Development, which provides funding
for the housing. The shift is motivated by concerns about the effects of
second-hand smoke on residents and by safety concerns. He said BHA has
not tested the flow of second-hand smoke in the three Burlington high-rises but
has received "infrequent" complaints about smoke from some tenants.
The letter to residents said, "BHA takes the health, safety and welfare of
our tenants very seriously" and noted that Decker Towers had an apartment
fire Feb. 17 "caused by careless smoking." Water from the building's
sprinkler system caused $100,000 damage, Dettman said. He said the BHA
decision wa s not arbitrary but part of a national movement. The
Smoke-Free Environments Law Project of the Center for Social Gerontology in Ann
Arbor, Mich., is an advocate for smoke-free housing units. Jim Bergman, the
project director and co-director of the gerontology center, said the increase
nationally in smoke-free, market-rate and affordable housing has been dramatic.
... The BHA policy will require resident smokers to leave the property. "Violating this policy," BHA's letter said,
"will result in terminating your tenancy." Bergman and Dettman
said they are unaware of any legal challenge to smoke-free housing policies
such as those being implemented in Burlington. "I'm totally confident a
legal challenge would not prevail," Bergman said. Click above to
access the full article.
School Law Clinics
Face a Backlash
4/7: The following is from an April 4th NY
Times article: Law school
students nationwide are facing growing attacks in the courts and legislatures
as legal clinics at the schools increasingly take on powerful interests that
few other nonprofit groups have the resources to challenge. On Friday, lawmakers here [Annapolis,
Maryland] debated a measure to cut money for the University of Maryland's law
clinic if it does not provide details to the legislature about its clients,
finances and cases. The measure, which is likely to be sent to the
governor this week, comes in response to a suit filed in March by students
accusing one of the state's largest employers, Perdue, of environmental
violations -- the first effort in the state to hold a poultry company
accountable for the environmental impact of its chicken suppliers. Law
clinics at other universities -- from New Jersey to Michigan to Louisiana --
are facing similar challenges. And legal experts say the attacks jeopardize
the work of the clinics, which not only train students with hands-on courtroom
experience at more than 200 law schools but also have taken on more cases
against companies and government agencies in recent years. "We're seeing a very strong pushback from
deep-pocket interests, and that pushback is creating a chilling effect on many
clinics," said Robert R. Kuehn, a law professor at Washington University
in St. Louis, citing a recent survey he conducted that found that more than
a third of faculty members at legal clinics expressed fears about university or
state reaction to their casework and that a sixth said they had turned down
unpopular clients because of these concerns. But critics say law clinics are costly, unaccountable and often
counterproductive to states' interests, especially as they have broadened the
scope of their work. The debate has raised larger questions about academic
freedom at state-financed law schools and the role lawmakers should have over
decisions at those schools. Click above for full article.
Report
on Social Security Delayed Until June 30th
4/6: The following is from an April 5th Associated
Press report: The Obama
administration is delaying release of the annual report on the financial health
of Social Security and Medicare so that the new report can reflect the impact
of the recently passed health care overhaul. An administration official
told The Associated Press that this year's trustees report will be delayed
until June 30, three months later than it usually comes out. The
official, who spoke on condition of anonymity before the formal announcement,
said that the delay will allow the government to determine the impact of the
massive overhaul of health care that President Barack Obama just signed into
law. In January, Richard Fisher, the
chief actuary for Medicare, estimated that the Senate bill which passed on
Christmas eve would extend the life of the Medicare hospital trust fund by 10
years. The legislation that finally passed Congress was the Senate bill but
with revisions approved to win House support. The administration official
said that passage last month of the health care overhaul legislation had made
the trustees report, which usually comes out around April 1, obsolete. This
official said the decision was made to incorporate all of the changes made by the
legislation to better reflect reality now that Congress has passed health care
overhaul. The new health care law seeks to guarantee health insurance
coverage for nearly all Americans while cracking down on insurance industry
abuses. It also promises to reduce federal deficits by an estimated $143
billion over a decade. Click above for the full article.
Seniors
wary of health overhaul impact on Medicare
4/1: The following is from an April 1st Washington
Post article: Seniors aren't
celebrating President Barack Obama's health care overhaul. While
Democrats hail the sweeping legislation as the greatest expansion of the social
safety net since Medicare, they also fear that seniors won't see it that way
for this fall's elections. Indeed, Republicans have portrayed the overhaul as a
raid on Medicare - a bedrock of retirement security - to provide money to pay
for covering younger, uninsured workers and their families. An Associated
Press-GfK survey in March found that 54 percent of seniors opposed the
legislation that was then taking final shape in Congress, compared with 36
percent of people age 18-50. And last week a USA Today/Gallup Poll found that a
majority of seniors said passing the bill was a bad thing - while younger
people were positive about it. There's no doubt that broad cuts in projected
Medicare payments to insurance plans, hospitals, nursing homes and other
service providers will sting. What hasn't sunk in yet is that the new law also
improves the lot of many Medicare beneficiaries. Obama is hoping that most will
eventually conclude the plusses outweigh the minuses. Keenly aware that this is a congressional
election year, Democrats structured the law so virtually all the cuts start
next year and take effect only gradually. For this year, the law provides a
sweetener. More than 3 million seniors who have been falling into a Medicare
prescription coverage gap will get a $250 rebate, a down payment on closing the
"doughnut hole." Nonetheless, seniors are anxious. Click
above for full article.
Obama
Chooses Health Policy Scholar as the Director for Medicare and Medicaid
3/31: The following is from a March 27th New
York Times report: President
Obama will soon name Dr. Donald M. Berwick, an iconoclastic scholar of health
policy, to run Medicare and Medicaid, the programs that serve nearly one-third
of all Americans, administration officials said Saturday. Dr. Berwick, a
pediatrician, is president of the Institute for Healthcare Improvement in
Cambridge, Mass. He has repeatedly challenged doctors and hospitals to provide
better care at a lower cost. He says the government and insurers can increase
the quality and efficiency of care by basing payments on the value of services,
not the volume. Mr. Obama plans to nominate Dr. Berwick to be administrator
of the Centers for Medicare and Medicaid Services, a unit of the Department of
Health and Human Services that has been without a permanent chief since October
2006, when Dr. Mark B. McClellan stepped down. If confirmed by the Senate, Dr. Berwick would
have a huge plate of responsibilities under the new health care law. The
law, signed Tuesday by Mr. Obama, will expand Medicaid to cover 16 million more
people, squeeze nearly a half-trillion dollars out of Medicare in the next 10
years and establish many demonstration projects to test innovative ways of
delivering health care. Dr. Berwick's nomination would be subject to
Senate confirmation. Senators would almost surely use a confirmation hearing as
a forum to debate the merits of the new health care law and to investigate how
the administration plans to carry it out. Steven D. Findlay, a health
policy analyst at Consumers Union, said: "This would be a spectacular
appointment. Don has been an intellectual force in health care for decades. He
helped forge many ideas incorporated in the new health care law."
Click above for full article.
Health
Reform Law Has Options for Affordable Long Term Care Insurance
3/31: The following is from a March 30th New
York Times article: So Ms. Priaulx
has been paying close attention to a little-remarked but potentially
transformational provision of the health care bill President Obama signed last
week. The Class Act, a legacy of Senator Edward M. Kennedy (whose widow and son were on hand for the signing), sets
up the first national government-run long-term care insurance program, which
will be offered primarily through employers. Long-term care means help with the so-called activities of daily
living -- like bathing, dressing, getting in and out of bed and using a toilet
-- for those, old or young, who become disabled. More than 10 million Americans
need long-term care, nearly 60 percent of them 65 or older, Georgetown
University researchers reported in 2007. But few are prepared for the expense.
... The Class Act does not require screening of applicants for health problems,
so people who might not qualify for private long-term care insurance can
enroll. Participants will pay monthly premiums; after a five-year vesting
period, they receive benefits if they need care, whether they are 28-year-olds
hurt in snowboard accidents or 88-year-olds with Parkinson's disease. The
program is not designed to pay the entire cost of long-term care, which can be
staggering, but it could nevertheless provide substantial help with the burden.
And because beneficiaries will receive cash -- the projected minimum average is
$50 a day, depending on how disabled they are -- they can choose the kind of
assistance that best suits their needs: several hours' daily help from a home
care aide (including a family member or a neighbor), participation in an adult
day program, adaptations to their own homes, or a move to assisted living or a
nursing home, though advocates argue that the program will help the disabled
stay in their homes. Ms. Priaulx plans to sign up. Actually, she won't
have to: the new program is a benefit that employees will have to opt out of
if they don't want it. ... The law --
"Class" stands for Community Living Assistance Services and
Supports -- authorizes the secretary of Health and Human Services to establish
such all-important details as the new program's eligibility requirements and
premiums, and to devise mechanisms to include the self-employed and those whose
employers decline to participate. Even the timing appears unclear. Click
above to access the full article.
3/30: The following is from a March 29th Washington
Post article: The Obama
administration announced Monday that it is expanding by $600 million a fund
aimed at helping states tackle the foreclosure crisis with locally tailored
approaches. State housing finance agencies from North Carolina, South
Carolina, Ohio, Oregon and Rhode Island will share $600 million to test new
approaches to helping borrowers save their homes from foreclosure. That is in
addition to $1.5 billion set aside for California, Nevada, Arizona, Michigan
and Florida when the program was initially announced in February. Both
initiatives will be financed through the government's Troubled Assets Relief
Program. While the first round of funding targeted states that had seen
home values decline more than 20 percent, the second round of states were
picked because they had high concentrations of people living in economically
distressed areas, including counties where the unemployment rate exceeded 12
percent in 2009. Click above for full article.
Phoenix
Senior Apartment Complex Goes Smokefree
3/30: According to a March 25th press release
from the Maricopa County Tobacco Use Prevention Program: Manistee Manor
Senior Apartments will go completely smokefree on April 1, 2010, according to
Debi Widahl, property manager. This 75 multi housing unit is following the July
2009 HUD document that "strongly recommended all HUD funded properties go
smokefree or partially smokefree." A celebration will be held at
Manistee Manor located at 7987 N. 53rd Ave. Glendale, AZ at 1 pm on Thursday,
April 1. An award will be presented by the Maricopa County Tobacco Use Prevention
Program. Sue Bergquist, Community Development Specialist in Multi Housing
says, "Manistee Manor has gone above and beyond in setting the standard
for multihousing. Smoke-free multi-housing is a critical frontier that needs to
be promoted to protect the health of non smoking residents. Residents often
experience exposure to secondhand smoke that migrates into their apartments
through common air ducts and walls under which they have no recourse under most
state clean indoor air acts." While considering the decision to become
smokefree, Manistee Manor had a smoking related fire that could have been
disastrous. It occurred on a balcony at 3:00 in the morning. The heat was so
intense it melted the metal railing. Someone adjacent to the building saw the fire
and called the fire department. Luckily it was contained. Smoking is the number
one cause of residential fires. Residents were notified in April 2009
that the property would go smokefree in April 2010. A few residents chose to
move, some quit and some agreed to smoke off the property. Interviewed
residents say they are thrilled and have thanked management for their decision.
Management now has a waiting list for tenants who want a smokefree environment.
... Maricopa County Tobacco Use Prevention Program was instrumental in helping
Manistee go smokefree. It provided a Tobacco 101 presentation to residents,
information regarding the state-funded ASHLine that provides free online or
phone cessation counseling for those that want to quit, and sample document
language for the property owners. Click above for the full press release.
Review
heightens concerns over Medicare billing at nursing homes
3/29: The following is from a March 29th Washington
Post report: More than a decade
ago, Congress set out to squeeze the fraud out of Medicare billing at nursing
homes, requiring more precise justifications for costs. It created new
"ultra-high" billing categories intended to be used for only 5
percent of the patients needing highly specialized care and rehabilitation.
But within a few years, nursing homes flooded the ultra-high categories
with patients, contributing to $542 million a year in potential overpayments,
federal analysts found. Since
then, the numbers in the ultra-high categories have quadrupled, and the amount
of waste and abuse could reach billions of dollars a year, according to nursing
home experts and a Washington Post examination of the program. The billing
program is specifically targeted in President Obama's health-care legislation
passed last week by Congress, changing two rules that experts said have been
exploited by nursing homes to inflate bills. "Facilities have been able
to bill the way they want, and they are billing for more services than they are
providing to people," said Toby S. Edelman, a senior attorney for the
Center for Medicare Advocacy, a watchdog group in Washington. "There's
been a lot of abuse." Federal
analysts assigned to the inspector general's office for the Department of
Health and Human Services are examining the billing program. "There
is a lot of vulnerability in the system, and we are concerned by what we've
seen," said Jodi Nudelman, regional inspector general for the HHS New York
field office, which is conducting the examination. A separate division of
the HHS inspector general's office is investigating North American Health Care,
which operates 35 facilities, most of them in California. Across the chain,
64 percent of NAHC patients are billed in the highest category; the national
average is 9 percent. The category covers the most extensive medical care
combined with the most intensive rehabilitation. The pattern was
discovered last year by the Service Employees International Union, which has
been feuding with NAHC over efforts to organize the homes' employees. The Post
independently analyzed an updated version of the data and confirmed the
pattern. The Post also found that NAHC operated 21 of the top 30 facilities nationally
with the highest percentage of residents billed in the most expensive category.
Click above for the full article.
Social
Security to See Payout Exceed Pay-In This Year
3/26: The following is from a March 25th New
York Times article: The bursting of
the real estate bubble and the ensuing recession have hurt jobs, home prices
and now Social Security. This year, the system will pay out more in benefits
than it receives in payroll taxes, an important threshold it was not expected
to cross until at least 2016, according to the Congressional Budget Office. Stephen C. Goss, chief actuary of the Social
Security Administration, said that while the Congressional projection would
probably be borne out, the change would have no effect on benefits in 2010 and
retirees would keep receiving their checks as usual. The problem, he
said, is that payments have risen more than expected during the downturn,
because jobs disappeared and people applied for benefits sooner than they had
planned. At the same time, the program's revenue has fallen sharply, because
there are fewer paychecks to tax.
Analysts have long tried to predict the year when Social Security would
pay out more than it took in because they view it as a tipping point -- the
first step of a long, slow march to insolvency, unless Congress strengthens the
program's finances. "When the level of the trust fund gets to zero,
you have to cut benefits," Alan Greenspan, architect of the plan to rescue
the Social Security program the last time it got into trouble, in the early
1980s, said on Wednesday. That episode was more dire because the fund
could have fallen to zero in a matter of months. But partly because of steps taken
in those years, and partly because of many years of robust economic growth, the
latest projections show the program will not exhaust its funds until about
2037. Click above for full article.
In Health
Care Bill, Obama Attacks Wealth Inequality
3/25: The following is from a March 24th New
York Times article: For all the
political and economic uncertainties about health reform, at least one thing
seems clear: The bill that President Obama signed on Tuesday is the federal
government's biggest attack on economic inequality since inequality began
rising more than three decades ago.
Over most of that period, government policy and market forces have been
moving in the same direction, both increasing inequality. The pretax incomes
of the wealthy have soared since the late 1970s, while their tax rates have
fallen more than rates for the middle class and poor. Nearly every major
aspect of the health bill pushes in the other direction. This fact helps explain why Mr. Obama was willing to
spend so much political capital on the issue, even though it did not appear to
be his top priority as a presidential candidate. Beyond the health reform's
effect on the medical system, it is the centerpiece of his deliberate effort to
end what historians have called the age of Reagan. Speaking to an ebullient audience of Democratic
legislators and White House aides at the bill-signing ceremony on Tuesday, Mr.
Obama claimed that health reform would "mark a new season in
America." He added, "We have now just enshrined, as soon as I sign
this bill, the core principle that everybody should have some basic security
when it comes to their health care." The bill is the most
sweeping piece of federal legislation since Medicare was passed in 1965. It aims to smooth out one of the roughest edges in
American society -- the inability of many people to afford medical care after
they lose a job or get sick. And it would do so in large measure by taxing the
rich. A big chunk of the money to pay for the bill comes from lifting
payroll taxes on households making more than $250,000. On average, the annual
tax bill for households making more than $1 million a year will rise by $46,000
in 2013, according to the Tax Policy Center, a Washington research group. Another
major piece of financing would cut Medicare subsidies for private insurers,
ultimately affecting their executives and shareholders. The benefits, meanwhile, flow mostly to households
making less than four times the poverty level -- $88,200 for a family of four
people. Those without insurance in this group will become eligible to receive
subsidies or to join Medicaid. (Many of the poor are already covered by
Medicaid.) Insurance costs are also likely to drop for higher-income workers at
small companies. Finally, the bill will also reduce a different kind of
inequality. In the broadest sense, insurance is meant to spread the costs of an
individual's misfortune -- illness, death, fire, flood -- across society. Since
the late 1970s, though, the share of Americans with health insurance has
shrunk. As a result, the gap between the economic well-being of the sick and
the healthy has been growing, at virtually every level of the income
distribution. The health reform bill will reverse that trend. By 2019, 95
percent of people are projected to be covered, up from 85 percent today (and
about 90 percent in the late 1970s). Even affluent families ineligible for
subsidies will benefit if they lose their insurance, by being able to buy a
plan that can no longer charge more for pre-existing conditions. In effect,
healthy families will be picking up most of the bill -- and their insurance
will be somewhat more expensive than it otherwise would have been. Click
above to access the full article.
3/25: The following is from a March 24th New
Haven Register article:
Residents in the city's 465 public housing units soon no longer will be
able to light up in their homes. Spurred in part by a "strong
recommendation" from the U.S. Department of Housing and Urban Development,
the Milford Redevelopment & Housing Partnership banned smoking in all parts
of its buildings in a recent split vote.
"It is a smoke-free facilities policy," Milford Housing Authority
Executive Director Anthony Vasiliou said Tuesday. "It covers 100 percent
of all of the property we own and operate." The last day current
residents can light up inside their MRHP-owned house or apartment is Nov. 1.
The ban takes effect immediately for anyone signing a new lease, and smoking in
common areas already has been banned for more than a decade. Smoking
still will be allowed outside the buildings, but designated areas will be
established if people don't "exhibit common sense" and stay away from
the entrances when they go out for a cigarette, Vasiliou said. Vasiliou
said public housing smoking bans are becoming more prevalent across the
country, but particularly have taken
root in the Northeast. In supporting the ban, MRHP Chairwoman Hilary H.
Holowink cited health concerns over secondhand smoke, safety surrounding
accidental fires and economic reasons concerning smoke damage. "We
voted for the health benefits and the fire safety benefits and to be a good
steward of state and federal money," Holowink said Tuesday. "It takes at least twice as much money to
refurbish a unit after a smoker has been living there." Click above
to access the full article. This brings the total nationally to at least 153
housing authorities. To access a list of all 153, click here.
3/24: The Center on Budget & Policy
Priorities has re-posted its Dec. 4,
2009 analysis of the above title. The following is from that analysis:
Health reform legislation that has passed the House in one form and is
before the Senate in another is facing a series of attacks that, taken
together, suggest the legislation would do little to control health care costs
and would increase budget deficits. Many of these charges are exaggerated or
simply incorrect, based on the Center's careful analysis of the legislation. In
particular, a number of criticisms rest on a mistaken belief that, in recent
years, Congress has repeatedly enacted provisions to achieve savings in
Medicare and then generally blocked these provisions before they could take
effect. Thus, critics say, no one should take seriously the provisions of the
current bills that would produce Medicare savings. In fact, the Center's
analysis of major legislation affecting Medicare that Congress has enacted over
the last two decades shows that Congress has permitted the vast majority of
Medicare savings to take effect. A
number of commentators have leveled at least four distinct, though related,
lines of attack either on the House-passed bill or on both the House bill and
the pending Senate bill. As summarized below and explained in more detail in
subsequent sections of this paper, these attacks do not hold up well under
scrutiny. To access the full analysis, click above.
Obama
to sign health-care bill into law Tuesday; Has Medicare improvements as well as
much more
3/23: The following is from a March 22nd Washington
Post article: President Obama will
sign landmark health-care legislation into law Tuesday without waiting for the
Senate to deal with a package of revisions that was also approved by the House
late Sunday, administration officials said. ... The Senate will begin work on
the House-passed revisions as soon as Obama signs the broader legislation, said
Jim Manley, spokesman for Senate Majority Leader Harry M. Reid (D-Nev.). The
debate will be limited to 20 hours and likely will end early Thursday, Manley
said. Then begins a series of votes on amendments, a process with no time limit
but that allows for just one minute between votes. At the moment,
Democratic Senate leaders are uncertain how long the voting process will last,
although most senators still expect to leave more or less on schedule for a
two-week recess scheduled to begin Saturday. ... The bill will affect virtually
every man, woman and child in the United States in some way, from the
20-somethings who constitute one of the largest uninsured groups to poor,
childless adults who don't qualify for Medicaid in most states to well-paid
professionals who could see their benefits shrink. ... Medicare, the federal
health program for people over 65, will undergo significant changes intended to
deliver care more efficiently and at a lower price, with the aim of using the
nation's largest insurance plan to force doctors, hospitals and other
private-sector players to follow suit. Medicare
Advantage, a form of Medicare provided by private insurance companies to about
11 million seniors, will lose nearly $120 billion over the next decade,
probably forcing providers to drop popular add-on benefits such as gym
memberships. ... For seniors, the bill will immediately expand the Medicare
drug benefit and, effective July 1, provide a 50 percent discount on brand-name
drugs for the low-income elderly. To access the full article, click
above.
3/18: The following is from a March 16th Center
on Budget & Policy Priorities
analysis: The President's $350 million Transforming Rental Assistance
(TRA) initiative, outlined in his fiscal 2011 budget, would enable local
housing agencies and private owners to more easily preserve affordable housing,
in part by giving them more adequate and sustainable funding to operate it. As
a result, TRA would help preserve an estimated 300,000 affordable apartments
(both publicly and privately owned) in its first year and more in later years.
Most of these apartments house low-income elderly people and people with
disabilities, and without TRA many of these units would eventually become
uninhabitable or be lost as affordable housing in other ways. In addition, TRA would make other improvements
to rental assistance programs (including public housing) that would give
families with housing subsidies the choice to rent housing in a wider range of
neighborhoods, which would allow them better access to employment or
educational opportunities. TRA also would streamline administration of these
programs. Public housing preservation: Of the 300,000 apartments that the Department of
Housing and Urban Development (HUD) estimates TRA would reach during its first
year, as many as 280,000 would be in public housing, which now assists 1.2
million units. The federal government has consistently provided less funding
for public housing than agencies need to operate and occasionally renovate it.
As a result, more than 165,000 public housing units have been demolished or
otherwise removed from the available stock in the last 15 years, and the
remaining units have a backlog of unmet renovation needs of at least $20
billion (and possibly considerably more). To address this problem, TRA
would give agencies the option to convert public housing units to a new type of
long-term housing subsidy. That would help preserve the units for the long term
in two main ways: 1) Sustainable funding levels. Of the $350 million that
the President has requested for TRA, $290 million would boost subsidies for
underfunded public housing developments to a level that is adequate to sustain
them in good condition over time. 2) Greater ability to leverage private
investment. The rules governing the new subsidies would allow housing agencies
to more easily borrow private funds to perform needed renovations. HUD estimates
that TRA would enable agencies to obtain $7.5 billion in private financing.
Preservation of private affordable housing: TRA would allow the private owners of units that are
supported through three small rental assistance programs to convert about
20,000 such units to new long-term subsidies that would preserve the units as
affordable housing. Under current law, subsidies for many of these units will
end in the coming years because there currently is no adequate mechanism to
extend their subsidy contracts. Click above for the full analysis.
With
Medicaid Cuts, Doctors and Patients Drop Out
3/16: The following is from a March 16th NY
Times article: It has not taken
long for communities like Flint to feel the downstream effects of a nationwide
torrent of state cuts to Medicaid, the government insurance program for the
poor and disabled. With states squeezing payments to providers even as the
economy fuels explosive growth in enrollment, patients are finding it
increasingly difficult to locate doctors and dentists who will accept their
coverage. Inevitably, many defer care or wind up in hospital emergency rooms,
which are required to take anyone in an urgent condition. ... The inadequacy of Medicaid payments is severe
enough that it has become a rare point of agreement in the health care debate
between President Obama and Congressional Republicans. In a letter to Congress
after their February health care meeting, Mr. Obama wrote that rates might need
to rise if Democrats achieved their goal of extending Medicaid eligibility to
15 million uninsured Americans. In 2008, Medicaid reimbursements averaged
only 72 percent of the rates paid by Medicare, which are themselves typically
well below those of commercial insurers, according to the Urban Institute, a
research group. At 63 percent,
Michigan had the sixth-lowest rate in the country, even before the recent cuts.
In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from
Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of
Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared
with $1,393.31 from Blue Cross. If she takes too many Medicaid patients,
she said, she cannot afford overhead expenses like staff salaries, the office
mortgage and malpractice insurance that will run $42,800 this year. She also
said she feared being sued by Medicaid patients because they might be at higher
risk for problem pregnancies, because of underlying health problems. As a
result, she takes new Medicaid patients only if they are relatives or friends
of existing patients. But her guilt is assuaged somewhat, she said, because her
husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and
throat specialist, is able to take Medicaid. She said he is able to do so
because only a modest share of his patients have it. The states and the federal
government share the cost of Medicaid, which saw a record enrollment increase
of 3.3 million people last year. The program now benefits 47 million people,
primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting
limits on eligibility, benefits and provider payments within broad federal
guidelines. Michigan, like many other states, did just that last year,
packaging the 8 percent reimbursement cut with the elimination of dental, vision,
podiatry, hearing and chiropractic services for adults. Click above to
access the full article.
Changes in
Medicare Tax on High-Income People Represent Sound Additions to Health Reform
3/11: The following is from an analysis of the
above title from a March 4th paper released by the Center on Budget &
Policy Priorities: The President's
health reform plan would raise the Medicare tax rate for single filers with
incomes over $200,000 and married filers with incomes over $250,000 -- a
provision that was included in the Senate-passed health bill -- and also would
extend this tax to the unearned income these affluent households receive such
as income from capital gains, dividends, and royalties. These proposals, which
would help finance the expansion of health coverage to more than 30 million
Americans, would affect only U.S. households at the very top of the income
scale while improving tax equity and economic efficiency. These
provisions would affect only the 2.6 percent of U.S. households with the
highest incomes, according to the Urban Institute-Brookings Institution Tax
Policy Center. The Medicare taxes that the other 97.4 percent of Americans pay
would remain unchanged. Among elderly households, only the top 2.2 percent
would be touched, with the other 97.8 percent remaining unaffected. These proposals would mainly affect people with
incomes exceeding $1 million a year. The Tax Policy Center reports that 74
percent of the increase in Medicare tax contributions would come from people
making over $1 million a year, and 91 percent would come from people with
incomes over $500,000. Among elderly households, 78 percent of the new tax
contributions would come from those with incomes exceeding $1 million, while 93
percent would come from seniors with incomes over $500,000. The proposals
also would improve both tax equity and economic efficiency. Under current law,
people with very high incomes generally pay a smaller share of their income in
Medicare taxes than middle-class and low-income working families do because
they derive much of their income from capital gains and dividends, which are
now exempt from the Medicare tax. The proposal would address this disparity.
Click above for the full analysis.
Senate Panel
to Investigate Deaths at Long-Term Care Facilities
3/10: The following is from a March 8th New
York Times report: The Senate
Finance Committee has opened an investigation into patient deaths and
allegations of substandard treatment at long-term care hospitals, small
specialty medical centers that treat chronically ill patients. The
investigation focuses on the Select Medical Corporation, a for-profit
corporation that runs 89 long-term care hospitals, more than any other company. In a letter sent on Monday to Select's chief
executive, Robert Ortenzio, the committee's top two senators demanded that
Select provide records about staffing levels and quality at its hospitals.
The committee has substantial power over long-term care hospitals because
it oversees Medicare. The federal program spends almost $5 billion annually on
the hospitals, providing about 60 percent of their total revenue. An
article in The New York Times last month detailed poor treatment and patient
deaths at long-term care hospitals, which treat 200,000 seriously ill patients
a year nationwide, but rarely have full-time physicians on staff. In one incident at a Select hospital in Kansas, a
dying patient's heart alarm sounded for 77 minutes before nurses responded.
Select has said that it conducted an appropriate clinical review in the case
and terminated a clinician involved in the patient's care. The article
prompted the investigation, according to the letter, which was sent by Senator
Max Baucus, Democrat of Montana, the committee's chairman, and Senator Charles
E. Grassley of Iowa, the panel's senior Republican. The letter is not a subpoena, but companies usually
respond voluntarily to such requests for information. Select Medical said
that it would cooperate fully with the inquiry. Through a spokeswoman, Carolyn
Curnane, the company referred to the Times article as misleading and inaccurate
and said it looked forward to providing the committee with accurate facts about
the quality of care in its long-term care hospitals. Mr. Baucus and Mr.
Grassley asked Select to disclose its policies for patient monitoring,
emergency situations and staffing, including physician involvement at its
hospitals and staff turnover. Former employees of Select have said that the
company's hospitals are understaffed and rely heavily on temporary nurses. The
letter also requests that Select disclose information about its discharge
policies. Former employees have also said that the company presses to keep
patients for 25 days and then discharge them almost immediately, because
patients are most profitable if they stay exactly 25 days under government
reimbursement rules. At some Select hospitals, the 25th day is called the
"magic day," ex-employees say. Click above for full article.
Obama
to target Medicare and Medicaid fraud
3/10: According to a report in the March 10th Washington
Post: Today President Obama
will embrace tougher new efforts to fight fraud in Medicare and Medicaid as
part of his drive to pass comprehensive changes to the nation's health care
system, the White House announced last night. Officials said the
president will sign a presidential memorandum today that directs all federal
departments and agencies to expand their use of audits that recapture improper
or erroneous payments. They said that
could save the government as much as $2 billion over the next three years.
In a health-care speech in St. Louis, Obama will also offer his explicit
support for bipartisan legislation aimed at expanding the use of so-called
"recapture audits" in government agencies, officials said.
Together, the announcements are intended to show the president's
seriousness on two fronts: the willingness to incorporate Republican ideas into
his overall plans for health reform, and his desire to confront fraud and waste
in government. Click above to access the full news report.
In a Polarized Court,
Getting the Last Word
3/8: The following is from a March 8th New
York Times column: A few times
a year, Supreme Court justices go out of their way to emphasize their
unhappiness by reading a dissent from the bench out loud, supplementing the dry
reason on the page with vivid tones of sarcasm, regret, anger and disdain. The
practice is on the rise, and it is suggestive of an increasingly polarized
court. "Dissenting from the bench," a new study to be published
in Justice System Journal
contends, is a sort of nuclear option that "may indicate that bargaining
and accommodation have broken down irreparably." Yes, a new study.
Academic scrutiny of almost every aspect of the Supreme Court is oppressively
comprehensive, and now three sets of researchers have identified the empirical
analysis of oral dissents as a new frontier. Over the 36 years Warren
E. Burger and William H. Rehnquist served as chief justices, there were on
average three dissents read from the bench each term. In the first four years
of the court under Chief Justice John G. Roberts Jr., the number rose by a
quarter, to 3.75. So far this term,
there has been only one oral dissent, but it was a doozy. For the full
column, click above.
Senate
rejects bonus Social Security payments
3/4: The following is from a March 4th Washington
Post report: The Senate has rejected
President Barack Obama's proposal to give a $250 bonus payment to people on
Social Security. The proposal failed by a 50-47 vote in which Republicans
and Democratic budget hawks opposed the idea for adding $14 billion to the
budget deficit. Independent Vermont Sen. Bernie Sanders said the $250 payment
was needed to make up for the lack of a cost-of-living adjustment this year for
beneficiaries. Disabled people and veterans also would have been eligible for
the payments. Seniors received an identical $250 bonus last year as part
of the economic stimulus bill. But economists say the payments don't do
much to boost the economy since many seniors simply save the money rather than
spend it. Click above to access the news story.
U.S. Plans New
Measure for Poverty
3/3: According to a NY Times report: The federal government announced on
Tuesday [March 2nd] that it would begin producing an experimental measurement
of poverty next year, a step toward the first overhaul of the formula since it
was developed nearly a half-century ago by an obscure civil servant in the Social
Security Administration. While the original definition -- the cash income
collected by a family or individual -- will remain the official statistical
measure for eligibility and distribution of federal assistance for the time
being, "the new supplemental poverty measure will provide an
alternative lens to understand poverty and measure the effects of antipoverty
policies," said Rebecca Blank,
the under secretary of commerce for economic affairs. Advocates for the
poor and technical experts have argued for years that the original standard,
developed in conjunction with the Johnson administration's War on Poverty, was
anachronistic. The civil servant who created it, Mollie Orshansky, based it on
the Agriculture Department's cheapest meal plan, on the assumption that the
average family spent a third of its income on food at the time. Her formula has
largely remained the same except for inflation adjustments. ... The new
supplemental measure will be released for the first time in the fall of next
year. It adapts National Academy of
Sciences recommendations issued in 1995 and later embraced by, among others,
the administration of Mayor Michael R. Bloomberg of New York to formulate
antipoverty policies. Federal officials describe the supplemental measure
as experimental and a work in progress. It establishes a poverty threshold that
depends on the cost of food, shelter, clothing and utilities "plus a
little more" for "a population that is not poor but is somewhat below
the median." Click above to access the article.
LSC Publishes Interim
Final Rule on Attorneys' Fees Regulation
3/2: The Legal Services Corporation published an
interim final rule and request for comments in the Federal Register on February
11 to repeal the Corporation's regulation that prohibits LSC grantees from
claiming, collecting and retaining attorneys fees. The rule, which
becomes effective on March 15, permits LSC grantees to make claims for
attorneys' fees in any case in which the award of fees is permitted by law. LSC
grant recipients also will be permitted to collect and retain attorneys' fees
whenever such fees are awarded to them. The rule notes that LSC has
adopted a policy under which it will exercise its enforcement discretion and
not take enforcement action against any recipient that filed a claim for or
collected and retained attorneys' fees between the period of December 16, 2009,
and March 15, 2010. LSC's action is in keeping with the intent of Congress, which
repealed the statutory prohibition on attorneys' fees in the bill containing
LSC's fiscal year 2010 appropriations bill. President Obama signed the
bill into law on December 16, 2009. To access the interim final rule,
click above. LSC has issued a program letter to LSC grantees containing
additional guidance on the matter; it can be accessed here.
We Keep Hearing
About "Reconciliation" in Congress, But What Is It?
2/26: In the Feb. 25th New York Times, there is a very good article which describes the
so-called "reconciliation" process that Congress can use to pass
legislation in such manner that the legislation can avoid being held captive by
a filibuster in the U.S. Senate in which 60 votes are required to gain passage,
not just a 51 vote majority. The article gives some history of the
"reconciliation" process, and it also describes how it is done.
As you'll see, it isn't a simple process, and it gives credence to the
old saying that "if you like sausage and the law, don't watch either
being made". To access the
article, click above.
Stimulus Funds
Support Smoke-Free Multi-Unit Housing Project in Michigan
2/19:
We're thrilled to announce that the Michigan Department of Community
Health's (MDCH) Tobacco Section has just been awarded a $1.5 million grant for
a 2 year project to greatly expand the smoke-free multi-unit dwellings (SF
MUDS) efforts we have been involved in since 2003. The funding is from the funds the Centers for Disease
Control & Prevention received under the American Recovery &
Reinvestment Act of 2009 (ARRA) aka "stimulus funding". 15 grants were awarded nationwide (to
13 states), and it appears that only 2 dealt with tobacco or secondhand smoke
issues, and Michigan's appears to be the only one that dealt with SF MUDS. The
other awards dealt with reducing obesity, increasing physical activity,
improving nutrition, and decreasing smoking. This project has as its goal to increase smoke-free public
and other affordable housing in Michigan by making 80% to 90% of all public and
other affordable housing smoke-free by the end of 2011, including tribal public
and other affordable housing. This
ambitious project is a partnership of the MDCH Tobacco Section, TCSG's
Smoke-Free Environments Law Project, two tribal organizations (the South
Eastern Michigan Indians, Inc., and the Sault Tribe), and about 10 local health
departments. The project will
involve working closely with local public housing commissions, tribal housing
authorities, other private affordable housing owners/operators, sovereign
tribal entities, and others. The
project starts almost immediately and will go on until February, 2012. You can
access the HHS press release on this by clicking above.
2/19:
TCSG's Smoke-Free Environments Law Project maintains an up-dated listing
of all the public housing authorities/commissions in the U.S. that we know of
which have adopted smoke-free policies for one or more of their apartment
buildings. The listing is done
largely in the order in which the policies have been adopted. As of January, 2010, at least 145 local
housing authorities had adopted smoke-free policies for some or all of their
apartment buildings, with about 130 being adopted since the beginning of
January, 2005; an average of over 2 per month. That constitutes an increase in
the number of housing authorities with smoke-free policies of over 866% in 60
months. The 22 states with such
policies include Michigan (33), Minnesota (29), Maine (19), Colorado (13),
California (7), Nebraska (6), Washington (6), Oregon (5), New Hampshire (4),
Alaska (4), Idaho (3), Utah (3), New Jersey (2), Wisconsin (2), Arkansas (2), Florida,
Montana, Indiana, Kentucky, Pennsylvania, Texas and Massachusetts. To access the listing, in pdf format,
click above.
County Health Rankings Include
Smoking and Obesity Rates, Social & Economic Factors
2/18: On Feb. 17th, the County Health Rankings
-- the first set of reports to rank the overall health of every county in all
50 states -- were released by the University of Wisconsin's Population Health
Institute and the Robert Wood Johnson Foundation at a briefing in Washington,
D.C. The health rankings include the smoking rates, obesity rates,
economic data, and more in each county. To access the rankings web site,
click above.
AoA
Statement on the release of FY 2011 budget request
2/17: The Administration on Aging budget request
for FY 2011 was sent to Capital Hill on February 1st with the overall HHS
budget request. AoA has released a brief statement describing the AoA
budget request, which calls for an increase of $108.4 million above the FY 2010
enacted level. To access the statement, click above.
2/10: The following is from a news note from the
Brennan Center for Justice: On February 1, 2010 President Obama released
his federal budget for Fiscal Year 2011, which includes a proposed total
funding level of $435 million for the Legal Services Corporation, $15 million
more than LSC's current funding level, but the same amount the Administration
included in its FY 2010 budget for LSC. This flat funding recommendation
follows the Administration's announcement that it plans to freeze non-security
related, discretionary spending for the next three fiscal years. LSC
submitted its own budget request to Congress on January 29th, requesting $516.5
million in total funding, 95% of which, or $484.9 million, would be granted to
local programs for the provision of civil legal assistance. In its
request for increased funding, LSC cites the severe drop in IOLTA and other
non-federal funding for legal services and the growing number of requests for
representation by low-income Americans. The President's FY 2011 budget also
calls on Congress to repeal two of the onerous legal services funding
restrictions that have been attached to the Corporation's funding in every
appropriations cycle since 1996:
the restriction that extends federal control to LSC grantees' state,
local, private, and other funds, and the restriction prohibiting LSC grantees
from participating in class action lawsuits. The
Administration urged Congress to repeal these two restrictions in last year's
budget as well, but Congress failed to go that far. Instead, Congress
lifted a third restriction whose repeal the President also urged: the
restriction that had barred LSC grantees from seeking court awarded attorneys'
fees from those who have violated the law. Under no legal obligation to
enact the President's budget as recommended, the House and Senate will now
draft their own appropriations bills for FY 2011. For more info, go to
the LSC web site by clicking above.
LSC Sends FY 2011
Budget Request to Congress
2/3: The following is from a Jan. 29th announcement
from the Legal Services Corporation: The Legal Services Corporation (LSC) today
asked Congress to provide $516.5 million in Fiscal Year 2011 funding, with more
than 95 percent of the budget request going to fund 136 nonprofit legal aid
programs across the nation that provide civil legal assistance to the nation's
poor. The 2008 recession and the rise in unemployment during 2009 created
new stresses for legal aid programs, which are able to serve only half of those
seeking help with pressing civil legal problems. The Corporation's 2009 Justice
Gap Report showed that in one category – foreclosures -- LSC programs are
turning away two people for every client served. Many legal aid programs
are confronting a downturn in non-federal funding at a time when they report
increasing requests for help by low-income Americans. In particular, Interest
on Lawyers' Trust Accounts (IOLTA) -- a major source of funding for legal aid
programs -- has declined significantly because of the drop in short-term
interest rates. In addition to providing $484.9 million for the provision
of civil legal assistance, the Corporation's Fiscal Year 2011 Budget Request
proposes $6.8 million for technology grants that improve access to legal
assistance and self-help guides for the poor, $1 million for student loan
repayment assistance to legal aid lawyers, $19.5 million for management and grants
oversight and $4.35 million for the LSC Office of Inspector General. The
2009 Justice Gap Report found that for every client served by LSC programs,
another person who seeks help is turned away due to a lack of program
resources. The conclusion reaffirmed the findings of the original report on the
justice gap published by LSC in 2005. LSC is the single-largest funder of
civil legal assistance for the poor in the nation. Established by Congress in
1974, LSC operates as a private, nonprofit organization to promote equal access
to justice and to ensure the provision of high-quality legal assistance to
low-income Americans. Download the full budget request by clicking above.
Download a summary of the document in pdf format by clicking here.
2/1: The following is from a January 31st Boston
Herald article: Mayor Thomas M.
Menino is opening a new front in his war against tobacco: the city's
cigarette-riden housing projects, which he vows to make smoke-free in the next
four years. "What we are
trying to do is make a healthier environment for people who work and live in
our city," Menino told the Herald. By this summer, smoking could
be banned in more than 100 new units in Boston Housing Authority public housing, which currently sees rates of smoking 50 percent
higher than the general population. According to a 2006 city survey, 15.5 percent
of nonpublic housing residents smoke, compared to 23 percent of BHA renters.
... The newly built smoke-free units include: 14 at Franklin Hill in
Dorchester that opened in October; up to 100 at Roslindale's Washington-Beech
that will open in August; and 100 at Old Colony by 2012. While those units represent less than 2
percent of the BHA's 12,000 units, it's a start, said Menino. "I
would think in the next three to four years every public housing unit will be a
smoke-free unit," he said.
The ban comes amid a perfect storm of factors, according to BHA
officials: Demand by parents. Children in public housing are more likely to
have asthma and to live with or around cigarette smoke, which triggers asthma
attacks. "People are trying to escape second-hand smoke and so we're
trying to create this option for folks," said BHA director of planning
Kate Bennett. Pressure from the feds. In July, the U.S. Department of
Housing and Urban Development "strongly encouraged" public housing authorities
go smoke-free. Click above for the full article and two related articles.
MEDICAID
PAYMENT FOR ASSISTED LIVING: CURRENT STATE PRACTICES, AND RECOMMENDATIONS FOR
IMPROVEMENT
1/29: The following is from the National Senior Citizens Law Center: State Medicaid programs increasingly are able to pay for assisted living services, but most consumers and advocates know little about how these programs work. In this case, what you don't know can hurt you, as policies differ widely from state to state, and many state Medicaid programs follow rules that disadvantage assisted living residents and their families. NSCLC has prepared an issue brief that examines many of the most important issues in Medicaid payment for assisted living, and makes recommendations for policy changes at the federal and state levels. Among other things, the issue brief recommends that Medicaid-certified facilities be required to accept Medicaid from Medicaid-eligible residents, and not be allowed to demand or solicit "supplemental payments" from residents' family members or friends. The federal government at a minimum should require that Medicaid-certified facilities not discriminate against Medicaid-eligible residents. To access the NSCLC issue brief in pdf format, please click above.
Foreclosure
Resources Available on Legal Services Corporation site
1/29: For those working with elders facing
foreclosure, there are a wealth of resources on the Legal Services Corporation
web site to assist you in working with clients. To access the site, click
above.
States Can Opt Out
of the Costly and Ineffective "Domestic Production Deduction"
Corporate Tax Break
1/20: The following is from a Center on Budget & Policy Priorities analysis: Over the past year, state revenue collections have dropped dramatically, creating large budget gaps for many states. A contributor to this fiscal crisis in many states is a relatively new and rapidly growing corporate tax break -- one that in most states never even received a vote in the state legislature but nonetheless is costing states hundreds of millions of dollars each year. The federal government created this tax break, known as the "domestic production deduction," in 2004. Since most states base their own tax codes on the federal tax code, the tax break was carried over into many states without specific legislative scrutiny or a vote. Now it is costing not only the federal government but also 25 states a large, and growing, amount of money. By 2011, it will cost these states over $500 million per year. The deduction -- enacted as Section 199 of the federal Internal Revenue Code -- allows companies to claim a tax deduction based on profits from "qualified production activities," a sweeping category that goes well beyond manufacturing to include such diverse activities as food production, filmmaking, and utilities -- a substantial share of states' corporate income tax base. The revenue loss to states that still allow the deduction will increase steeply this year because of how the federal credit is designed. Initially, the cost was relatively modest because the deduction was limited to 3 percent of qualifying income. As of January 1, 2007, the percentage rate rose to 6 percent. The final increase to 9 percent takes effect in the 2010 tax year. Federal estimates suggest that allowing this deduction will reduce the revenue yield of corporate taxes by roughly 3.1 percent in 2011 and also reduce individual income taxes somewhat. States are not required to allow this deduction. Since 2008, Connecticut, New York, Wisconsin, and the District of Columbia have joined 18 other states in disallowing the deduction and thereby reducing their current budget shortfalls and benefitting their states' economies. But another 25 states continue to permit it. Click above for full analysis.
1/12: The Utah Tobacco Prevention and Control
Program is holding its annual statewide conference in Salt Lake City on January
12th. The keynote will be given by Greg Connelly of Massachusetts who
will discuss Federal, State & Local Tobacco Control in the 21st Century. Jim Bergman of TCSG will do two presentations
on Smoke-Free Multi-Unit Housing: Blazing Trails – Rapidly. One session will be for housing authority
directors and staff, and the second will be for health and tobacco control professionals.
To access the 57-slide PowerPoint that Bergman will use, click above.
To access a pdf copy of the ppt presentation, click here.
1/11: The following is from a Jan. 8th
Administration on Aging press release: Recognizing the challenges many
older Americans are facing in today's economic climate, HHS Assistant Secretary
for Aging Kathy Greenlee has launched a new Web site for the National Legal
Resource Center (NLRC). The NLRC was created in 2008 by the
Administration on Aging (AoA) to empower legal and aging services advocates
with the resources necessary to provide high quality legal help to seniors who
are facing direct threats to their ability to live independently in their homes
and communities. "It is important that legal and aging service
providers have easy access to the wide range of support resources the NLRC has
to offer," said Assistant Secretary Kathy Greenlee. "The new NLRC Web
site creates a much needed resource portal to critical support tools designed
to help providers serve older consumers facing difficult legal issues impacting
their independence and financial security." The NLRC is a
collaborative project involving five national non-profit organizations known
for their work in legal and aging services support who have teamed up to better
help people in need. The new NLRC Web site provides professionals and advocates
in aging and law with streamlined access to important resource support
including case consultation and training on the most difficult legal issues
facing older persons. State
offices on aging and local community-based aging organizations can also gain
Web site access to technical assistance for efficient, cost-effective and
targeted provision of legal services to older persons in the most social or
economic need. AoA funds over 1,000 legal services providers nationwide,
which provide nearly one million hours of legal assistance per year. Legal
challenges faced by seniors may include the loss of their homes through foreclosure,
consumer scams that destroy nest eggs and steal identities, and difficulties in
accessing public benefits essential to remaining financially secure,
independent, and healthy. The five national non-profit organizations of
the NLRC are: National Senior Citizens Law Center; National Consumer Law
Center; The Center for Social Gerontology; The Center for Elder Rights
Advocacy; and the American Bar Association-Commission on Law and Aging.
The new Web site can be accessed by clicking above.
1/11: The following is from a Dec. 22nd National
Lawyers Guild press release: The National Lawyers Guild (NLG) calls on
President Obama to withdraw the nomination of Sharon Browne to the board of
directors of the Legal Services Corporation (LSC). On December 17, Obama
announced his intention to nominate Ms. Brown, a principal attorney and member
of the senior management at the conservative Pacific Legal Foundation and a
member of the Civil Rights Practice Group of the Federalist Society. The
Legal Services Corporation is the nation's principal funder of civil legal aid
for the poor. Established by Congress in 1974, it operates by providing grants
to -- and overseeing -- independent nonprofit legal aid programs throughout the
US. The LSC operates as a private, nonprofit corporation, with a board of
directors composed of 11 members appointed by the president and confirmed by
the Senate. By law, the board is bipartisan: no more than six members may be
of the same political party.
The Pacific Legal Foundation, in contrast, describes itself as a
"public interest legal organization that fights for limited government,
property rights, individual rights and a balanced approach to environmental
protection." At the PLF, Browne has authored briefs arguing against
race-based school district assignment policies. She and the PLF have also been
ardent supporters of Prop. 209, the 1996 ballot initiative that ended most
affirmative action programs in California. Not only does the PLF
oppose much of what Legal Services stands for, but it has also directly opposed
funding for Legal Services agencies.
The PLF filed an amicus brief seven years ago in support of litigation
challenging the legality of IOLTAs, or Interest on Lawyers Trust Accounts,
which are an essential supplementary funding resource for Legal Services
agencies around the country. While this slot on the LSC Board cannot legally
go to a Democrat and while the minority members are traditionally selected by
the minority party's congressional leadership, there is no legal bar and ample
precedent for naming an independent rather than a member of the opposition
party. At the very least, the
president is obligated to nominate someone who believes in the importance of
ensuring that the poor be afforded the legal services they need. We note, for example, that the recently-deceased former
head of the Legal Services Corporation, William McAlpin, was a Republican who
fought vigorously to strengthen it. [Note: Ms. Browne had been
recommended by U.S. Senate Republican Leader Mitch McConnell.] Click above to
access the full press release.
1/7: The following is from a Jan. 6th CNN
report: November 5, 2009. That's the day the AARP endorsed the House
health care bill. With nearly 40 million members, it's not surprising that the
president quickly came before cameras in the White House to thank the AARP for
its endorsement. That AARP endorsement wasn't universally applauded by
all of the organization's millions of members. The organization admits it has
lost 150,000 members since the endorsement but says that's been offset by more
than 2-million new or renewed memberships. Some, like Robert Tice, feel the AARP is out of touch with its
members by focusing so much on selling insurance. He says he will let his AARP
membership lapse without renewal because he doesn't like what they're up to.
"The letters don't mean American Association of Retired
Persons," he told CNN's Carol Costello. "It just means AARP. It's
just a name. ... The AARP is about insurance. People need to know that. AARP is
not out there to help you." In fact, the AARP brands several
types of insurance, including health policies with United Healthcare. By
endorsing so many insurance policies the organization brought in around $650
million dollars last year in premiums. That's almost three times what it took
in from membership dues. Republicans
say the AARP's endorsement of the House health bill is more about supporting
its insurance business than anything else. They point to the organization's
acquiescence to billions of dollars in cuts to the Medicare Advantage Plans,
which AARP and other insurers offer as private alternatives to Medicare that
often includes extra medical coverage like dental and vision care.
According to the Congressional Budget Office, some suggested cuts in the
program might make it so unattractive that millions of Americans could be
forced out because the plan's benefits would shrink. It is also possible that
some insurance companies would stop offering Medicare Advantage policies
altogether because it would be far less profitable. So, why would the
AARP support cuts to Medicare Advantage? Rep. Phil Gingrey (R-GA) thinks he
knows what the AARP is up to. Gingrey says the organization hopes that millions
of seniors will move from Medicare Advantage to AARP's branded Medigap plan,
which has far higher profit margins. ... Carol Costello asked the AARP if any
of this is true. The AARP's director of legislative policy, David Certner, says
"it's not an issue we have lobbied on at all." Certner says
his organization supported cuts to Medicare Advantage to "trim the
fat" so Medicare itself survives. "We understand there are financial
issues with Medicare, and we need to save money for the Medicare program." Click above for the full report, plus a video.
1/6: The following is from a Dec. 18th Center on
Budget & Policy Priorities analysis: States face a serious fiscal problem
that could force them to institute additional deep budget cuts and tax
increases in 2010, weakening the fragile economic recovery and harming
vulnerable children, seniors, and people with disabilities, among others. The
federal assistance that states received for their Medicaid programs under this
year's economic recovery legislation is scheduled to end with a
"cliff" on December 31, 2010, and the assistance states received for
education and other services also will be largely exhausted by then. Although
that date is more than a year away, the problem is coming to a head now.
That's because states -- which continue to face huge budget shortfalls
that they must close -- are taking steps now to plan their budgets for state
fiscal year 2011, which starts on July 1, 2010 in most states. Governors will
send their budget proposals to their legislatures between next month and
February 2010 in almost all states. The legislatures will have to pass budgets
as early as March or April in some states and by the end of June in almost all
states. If states do not know they will receive additional federal fiscal
relief, they will begin implementing new budget cuts and tax increases by this
summer, at the latest. Presuming they
will get no more fiscal relief, states will have to take steps to eliminate
deficits for state fiscal year 2011 that will likely take nearly a full
percentage point off the Gross Domestic Product. That, in turn, could cost the
economy 900,000 jobs next year. Mark Zandi, Chief Economist of Moody's
Economy.com, recently warned that these state budgetary actions "will be a
serious drag on the economy at just the wrong time." Click above for the
full analysis.
State
budget pictures bleak as lawmakers head back; Aging programs likely to be hard
hit also
1/4/10: According to a January 4th Washington
Post report: If you thought
state budgets were in bad shape last year, just wait: 2010 promises to be
brutal for lawmakers - many facing re-election - as they scramble to find
enough money to keep their states running without raising taxes. Tax
collections continue to sputter. Federal stimulus dollars are about to dry up.
Rainy day funds have been tapped. And demand for services - like Medicaid, food
stamps and unemployment benefits - is soaring. As lawmakers head back to
state capitols this month, budget woes range "from bad to ridiculously
bad," said David Wyss, chief economist at Standard & Poors in New
York. "There are some states, those hit particularly hard by the
recession, that I don't think can cut spending enough. They're running out of
things to cut." Typically, the worst budget years for states are
the two years after a recession ends. Across the nation, budgets are already
lean after several rounds on the chopping block. And unless lawmakers increase
taxes or fees - unpopular moves in an election year - most will need to cut
even more as they grapple with the steepest decline of tax receipts on record.
Services ranging from higher education to programs for the elderly could be in
jeopardy. The crunch could also
mean new tolls to fund road projects, more prisoners being released early to
trim corrections budgets, and the end of welfare programs that don't bring
federal matching dollars. The Center on Budget and Policy Priorities
offers a bleak forecast: State budget shortfalls are likely to reach a whopping
$180 billion for the coming fiscal year, double the size of Texas' annual
budget. "It's going to be the toughest year yet," said Raymond
Scheppach, director of the National Governors Association, who predicts funding
could evaporate for higher education, the arts and economic development. "The
states haven't hit bottom." Mary Ann Neureiter, who runs an adult
day care center in suburban Atlanta, saw her state aid cut in half in 2009. The
Cambridge House Enrichment Center once offered state-subsidized care to 10
low-income clients with disabilities such as Alzheimer's. It's now down to
three, and Neureiter fears the funding could dry up altogether this year.
"It's heartbreaking because I foresee, in the coming year, it's
going to get even worse for services for the elderly," she said. Eckl
predicted that after several years of across-the-board cuts and short-term
fixes designed to ride out the sour economy, states this year will look to make
deeper, more, sustained cuts that could fundamentally change what services
government provides. Whole programs could be eliminated. Layoffs will take the
place of furloughs. Click above for
full article.
Aging
adults in suburbs lose appetite for driving
12/30/09: The following is from a Dec. 29th Washington
Post article: For 60 years,
Mary Schaaf has had a driver's license, and now, at the age of 86, she finds
she's driving more than ever. That's because her friends are not. One by
one they have surrendered their car keys, their independence overtaken by
fading eye sight, slowing reflexes and physical infirmities that make
navigating the fast-paced roads of Montgomery County on their own too risky.
They turn to Schaaf, who drives on undaunted by the years or the "erratic"
younger drivers who share her roads. ... The generation that gave birth to
suburbia and the two-car garage is reaching the age where for many driving no
longer seems like such a swell option. As Americans grow older -- one in five
will be over the age of 65 by 2030 -- many are finding that the world that
lured them away from city life is losing some of its appeal. "The concern is that when they no longer
can drive they will find themselves trapped in their homes in suburban
neighborhoods where there are no sidewalks or, if there are sidewalks, there's
no place to walk to," said Stewart Schwartz, executive director of the
Coalition for Smarter Growth. ... Suburbia is where the population is aging
fastest. At the dawn of the 21st century, 69 percent of people 65 and older
lived in the suburbs. ... And the aging baby boomers want to remain in the
suburbs where they were raised. Eighty-five percent of people over the age
of 50 told the American Association of Retired Persons (AARP) that they plan to
live in their current communities for as long as they can. But for many older people, the AARP said,
driving has lost its attraction. More than half of drivers over the age of
75 say they avoid driving at night or in bad weather, and almost 40 percent of
them stay home when traffic is at its worst, according to recent research. The AARP also found that older adults prefer to
travel by car, either as drivers or passengers, rather than take public
transportation. Click above to access the full article.
Health-Care
Reform 2009: The not-so-sweet side of closing 'doughnut hole'
12/29: The following is from a Dec. 28th Washington
Post article: Six years after
Congress added a prescription drug benefit to Medicare, Democrats in the House
and Senate are poised to make a central change that they and most older
Americans have wanted all along: getting rid of a quirk that forces millions of
elderly patients with especially high expenses for medicine to pay for much of
it on their own. The closing of an unusual gap in Medicare drug coverage -- a
gap that Republicans had, when they controlled Capitol Hill and the White
House, insisted was needed for the government to be able to afford the program
-- would "forever end this indefensible injustice for American's
seniors," Senate Majority Leader Harry M. Reid (D-Nev.) said in announcing
that the Senate would join the House in supporting the change. But
details of the change underscore that, for patients and the federal budget
alike, the implications of the sprawling health-care bills pushed through by
congressional Democrats are more nuanced than lawmakers' talking points. The
Democrats and President Obama have been clear that the "doughnut
hole," as the gap is known, would disappear gradually over the next 10
years. They have not mentioned that Medicare patients would, according to House
figures, face a slightly larger hole in coverage during two of the next three
years than they do today. Proponents
say the government can afford to eliminate the gap because the pharmaceutical
industry would pay for the phaseout. But less than half of the $80 billion that
drugmakers agreed to provide, under a health-care reform agreement over the
summer with Senate Democrats and the White House, would be used to help fill
the gap, according to Senate Democratic aides. Moreover, there are no budget
forecasts far enough into the future to show how much the expanded drug benefit
would cost the government once the gap is fully closed. Despite such
uncertainties, the prospect of filling the hole in drug coverage responds to a
strong desire among older Americans -- a significant constituency that tends to
be wary of changes to the health-care system. The 2003 law that added the drug benefit to Medicare was the largest
expansion since the creation of the federal health insurance system for the
elderly four decades ago. The new coverage became available in 2006. As of last
year, about 32 million people, nearly three-fourths of everyone on Medicare,
had it. Click above for full article.
Smoke-Free Multi-Unit
Housing in Michigan & the Nation: A Decade of Enormous Growth
12/29: The following is from an end-of-the-year
TCSG/SFELP press release: "As the first decade of the 21st century ends,
we find that the growth in Michigan and nationally in smoke-free multi-unit
housing has been enormous -- going from virtually no smoke-free housing in 2000
to many hundreds of thousands of units today," according to Jim Bergman,
Co-Director of The Center for Social Gerontology, Inc. in Ann Arbor, Michigan,
which operates the Smoke-Free Environments Law Project (SFELP). "In
2000, it was virtually impossible to find apartment or condominium buildings
that were smoke-free in all the living units, as well as the common areas. This was true in Michigan and in almost every
state in the nation. By 2005, a number of states, including Michigan,
Maine, Minnesota, and California had begun to develop a growing supply of
smoke-free apartments. By the end of the decade, virtually every state
has smoke-free multi-unit housing available, and many states have thousands, if
not hundreds of thousands, of smoke-free units," said Bergman. ... In public housing, funded by the
federal Department of Housing & Urban Development (HUD) and other federal
and state entities, the growth in smoke-free housing has been equally as great,
if not greater. In 2000, there were only two public housing authorities
in the nation that had smoke-free policies for some or all their buildings (Kearney, NE and Fort Pierce, FL). By the end
of 2003, just eleven housing authorities had smoke-free policies. By
January, 2005, that number had only risen to fifteen. But, then the
growth sky-rocketed. As of December, 2009, at least 136 public housing
authorities in 19 states had adopted smoke-free policies for some or all their
buildings. The growth in the entire decade was 6700%; since December,
2003, the growth was 1136%; and the growth in the past 5 years has been over
800%. In Michigan, the Cadillac
Housing Commission was the first public housing authority to adopt a smoke-free
policy, doing so in July, 2005. Today, thirty-two local Michigan housing
commissions have adopted smoke-free policies, covering about 56 apartment
buildings/developments and over 60 townhouses/scattered site units, with about
4,158 apartment units. That is a 3100% increase in the 48 months since
January, 2006. To access the full press release, click above.
Months to Live;
Hard Choice for a Comfortable Death: Sedation
12/29: The following is from a Dec. 27th New
York Times article: In almost every room people were sleeping, but not
like babies. This was not the carefree sleep that would restore them to rise
and shine for another day. It was the sleep before -- and sometimes until --
death. In some of the rooms in the hospice unit at Franklin Hospital, in
Valley Stream on Long Island, the patients were sleeping because their organs
were shutting down, the natural process of death by disease. But at least one
patient had been rendered unconscious by strong drugs. The patient, Leo
Oltzik, an 88-year-old man with dementia, congestive heart failure and kidney
problems, was brought from home by his wife and son, who were distressed to see
him agitated, jumping out of bed and ripping off his clothes. Now he was
sleeping soundly with his mouth wide open. ... Mr. Oltzik received what some
doctors call palliative sedation and others less euphemistically call terminal
sedation. While the national health
coverage debate has been roiled by questions of whether the government should
be paying for end-of-life counseling, physicians like Dr. Halbridge, in
consultations with patients or their families, are routinely making tough
decisions about the best way to die. Among those choices is terminal
sedation, a treatment that is already widely used, even as it vexes families
and a profession whose paramount rule is to do no harm. Doctors who perform it say it is based on carefully
thought-out ethical principles in which the goal is never to end someone's
life, but only to make the patient more comfortable. But the possibility
that the process might speed death has some experts contending that the
practice is, in the words of one much-debated paper, a form of "slow
euthanasia," and that doctors who say otherwise are fooling themselves and
their patients. There is little information about how many patients are
terminally sedated, and under what circumstances -- estimates have ranged from
2 percent of terminal patients to more than 50 percent. (Doctors are often
reluctant to discuss particular cases out of fear that their intentions will be
misunderstood.) While there are universally accepted protocols for
treating conditions like flu and diabetes, this is not as true for the management
of people's last weeks, days and hours. Indeed, a review of a decade of
medical literature on terminal sedation and interviews with palliative care
doctors suggest that there is less than unanimity on which drugs are
appropriate to use or even on the precise definition of terminal sedation. To access the full article, click above.
Senior-home
hell; Brooklyn facility hit for $19M in neglect suit
12/28: The following is from a Dec. 28th New
York Post article: A Brooklyn nursing
home will have to fork over nearly $19 million in damages to the family of a
76-year-old patient neglected so badly that he left with more than 20 bedsores.
The massive award, handed down by a Brooklyn jury earlier this month,
is the first in the state against a nursing home that includes punitive
damages, lawyers said. "It was
horrible," said Margaret Whitehurst, 55, who pulled her father, John
Danzy, from the Brooklyn Queens Nursing Home after just nine months. "He
walked in on two legs and a cane. He was 237 pounds. When we got him back, he
was 148 pounds and he had holes all over his body." She and her
siblings moved Danzy, a retired truck driver and butcher, to another nursing
home. Six months later, in November 2003, he succumbed to an infection caused
by the bedsores, according to testimony. A Brooklyn jury deliberated two
full days following the four-week trial before finding the Cypress Hills
facility delivered substandard care. The panel awarded $3.75 million
for Danzy's pain and suffering, but tacked on $15 million in punitive damages,
based in part on the allegation that the home had doctored records to try to
cover up the neglect. Lawyer Dennis
Kelly said the first-ever imposition of punitive damages against a nursing home
in New York state was due in part to evidence that the home tried to cover up
the lack of care Danzy was getting. An FBI expert testified that about
100 different skin-check notes showing "G" for "good" had been
penned over to show "B" for "broken" -- an effort by the
home to claim it hadn't missed the horrific sores, Kelly said.
"Someone went back and wrote B's over the G's to cover their tracks,
so they falsified the records, he said. "We believe that once they found
out they were being sued, they went back and said, 'How could we have G's here
when they guy has 20 sores?' " Click above for full article.
Woman,
62, dies in Quincy fire; Blaze sparked by cigarette; oxygen devices fuel flames
12/28: The following is from a Dec. 27th Boston
Globe report: A woman died yesterday
morning in a two-alarm fire sparked by a cigarette, according to fire officials.
Residents of the city-owned high-rise at 95 Martensen St., which houses
elderly, low-income, and disabled residents, said they had warned 62-year-old
Donna Marani not to smoke in her apartment - especially because she regularly
used home oxygen devices. "She was a smoker," said Jenn Fell,
31, who lives in the building with her two young sons. "Several people in
the building have warned her about smoking while on oxygen. Smoking can be very
dangerous, and unfortunately everybody lost a really good friend out of this
tragedy." State, local, and Norfolk County officials determined
yesterday afternoon that a cigarette ignited the fire. "The
investigation revealed the cause to be consistent with a smoking-related
fire," State Fire Marshal Stephen D. Coan told the Globe yesterday.
"And there was home oxygen in the apartment." ... While firefighters
managed to contain the fire to Marani's apartment, significant water and smoke
damage could be seen throughout the building yesterday. Cleanup crews were on
hand all afternoon. Most residents were allowed to return home, but more
than a dozen from units near Marani's apartment were being sheltered at a
Salvation Army facility, fire
officials said. ... Since 1997, 18 people have died and more than 30 others
have been severely burned or suffered serious smoke inhalation in fires across
the state involving people who smoked while using a home oxygen system, Coan
said. Air is about 21 percent
oxygen, but medical tanks are filled with 100 percent oxygen, which can fuel
intense flames. "Fires related to smoking and use of home oxygen
have been a great concern of mine for a long time," Coan said. "We
have a group made up of fire service personnel, members of the medical
community, oxygen manufacturers, the Red Cross, and others focused on a public
education campaign to highlight the dangers." [It should be noted
that a no-smoking policy could have prevented this tragedy.] Click above
to access the full report.
Leadership
Change at Legal Services Corporation
12/22: The following is from a Dec. 18th news
note from the Brennan Center for Justice: The new Administration is bringing
with it new leadership for LSC. On December 17th, LSC president, Helaine
M. Barnett, announced that she will be stepping down as president at year's
end. She has served as LSC chief executive for six years. Barnett's
successor will be chosen by the new sitting LSC Board of Directors once it is
in place. Until then, an interim president will likely lead the
Corporation. The LSC Board of Directors is comprised of 11
individuals who are nominated by the president and confirmed by the Senate.
By law, no more than six board members can be of the same political
party. President Obama has nominated nine members to the board: Lauri I. Mikva was nominated in April and
confirmed by the Senate on June 19th. On August 9th, President Obama nominated
five members to the board: Robert J. Grey, John G. Levi, Martha L. Minow,
Julie A. Reiskin and Gloria Valencia-Weber. December 17th, President
Obama expressed his intent to nominate three more members to the Board: Sharon
L. Browne, Charles Norman Wiltse Keckler, and Victor B. Maddox. Mikva is
the only nominee to have been confirmed by the Senate thus far. Of the
nine nominees, six are Democrats, including Mikva, and 3 are Republicans.
The President has the authority to nominate two additional members.
He is free to choose among Republicans and Independents, since six
Democrats have already been nominated. For more news from the Brennan
Center, click above.
HHS Announces
$27 Million from Recovery Act to Help Older Americans Fight Chronic Disease
12/18: The following is from a Dec. 16th HHS
press release: HHS Secretary Kathleen Sebelius has announced the
availability of $27 million to help older individuals with chronic conditions
to improve their health and reduce their use of costly medical care. These
funds are made possible through the American Recovery and Reinvestment Act,
which has provided up to $650 million to HHS for the Communities Putting
Prevention to Work initiative launched earlier this fall to promote
evidence-based prevention strategies in communities and states across the
country. "This program is about getting money to communities to
help seniors manage chronic conditions that threaten their ability to remain in
their own homes. Through HHS' national aging-services network which reaches
into nearly every community in America, we are helping people living with
chronic conditions and others better manage their own health," Secretary
Sebelius said. Research has
shown that prevention programs can improve the quality of life for older
individuals, including frail seniors with multiple chronic conditions, and also
reduce health care costs. The Recovery Act funds will put the results of HHS'
research investments into practice at more than 1,200 community-based sites
across the country -- reaching tens of thousands of older Americans and their
families. "The American Recovery and Reinvestment Act has been about
helping families in need during challenging economic times," said
Assistant Secretary for Aging Kathy Greenlee. "This innovative program
will give at-risk older people and their caregivers the tools they need to make
their own decisions so they can live longer, healthier and more independent
lives." This competitive initiative gives every state Aging and
Health Department and U.S. territory the opportunity to implement rigorously
tested Chronic Disease Self-Management Programs (CDSMP), one of the most
prominent being the Stanford University model. The CDSMP is a six-week peer-led training program
that covers topics such as healthy eating, exercise, managing fatigue and
depression, and communicating effectively with health care professionals.
While further research is underway, rigorous evaluations have suggested
that the program improves participants' overall health and energy levels and
results in savings to Medicare through fewer hospital stays. CDSMP are
specifically designed to be delivered by non-health professionals in community
settings, such as senior centers, congregate meal programs, faith-based
organizations and senior housing projects. To access the full press
release, click above.
12/17: The following is from a Dec. 16th
analysis by the Center on Budget & Policy Priorities: Some critics charge that the new policies pursued by
President Obama and the 111th Congress generated the huge federal budget
deficits that the nation now faces. In fact, the tax cuts enacted under
President George W. Bush, the wars in Afghanistan and Iraq, and the economic
downturn together explain virtually the entire deficit over the next ten years.
The deficit for fiscal 2009 was $1.4 trillion and, at an estimated 10
percent of Gross Domestic Product (GDP), was the largest deficit relative to
the size of the economy since the end of World War II. Under current policies,
deficits will likely exceed $1 trillion in 2010 and 2011 and remain near that
figure thereafter. The events and policies that have pushed deficits to
astronomical levels in the near term, however, were largely outside the new
Administration's control. If not for the tax cuts enacted during the Presidency
of George W. Bush that Congress did not pay for, the cost of the wars in Iraq
and Afghanistan that began during that period, and the effects of the worst
economic slump since the Great Depression (including the cost of steps
necessary to combat it), we would not be facing these huge deficits in the near
term. For the full analysis, click above.
The
First Lady on Health Insurance Reform & Older Women
12/16: On November 13th, the White House hosted
a meeting on health insurance reform and older women. Among the speakers
was First Lady Michelle Obama. You can view this meeting in a 37 minute
video by clicking above.
For Elderly in Rural
Areas, Times Are Distinctly Harder
12/11: The following is from a Dec. 10th New
York Times article: Growing old has
never been easy. But in isolated, rural spots like this, it is harder still,
especially as the battering ram of recession and budget cuts to programs for
the elderly sweep through many local and state governments. Ms. Clark has
been able to get help since her fall two winters ago because Wyoming, thanks to
its energy boom, continues to finance programs for the elderly. But at least
24 states have cut back on such programs, according to a recent report by the
Center on Budget and Policy Priorities, a Washington research group, and
hundreds of millions of dollars in further cuts are on the table next year. The difficulties are especially pronounced in rural
America because, census data shows, the country's most rapidly aging places are
not the ones that people flock to in retirement, but rather the withering,
remote places many of them flee. Young people, for decades now, have been an
export commodity in towns like Lingle, shipped out for education and jobs, most
never to return. The elderly who remain -- increasingly isolated and stranded
-- face an existence that is distinctively harder by virtue, or curse, of
geography than life in cities and suburbs. Public transportation is almost
unheard of. Medical care is accessible in some places, absent in others, and
cellphone service can be unreliable. Even religion and the Internet are
different here. Churches have consolidated or closed -- a particular hardship
for older people, who tend to be avid churchgoers. And a lack of high-speed
broadband service in many rural areas compounds the sense of separation from
children and grandchildren, as well as the broader world. The distance
between friends is what gnaws most fiercely at George Burgess. Click above for
the full article.
Congressional
Negotiators Back 8% Funding Increase for LSC
12/10: According to a Dec. 9th note from the
Legal Services Corporation: House and Senate negotiators have approved a
consolidated appropriations bill for Fiscal Year 2010 that includes $420
million for the Legal Services Corporation (LSC) to promote equal access to
justice and to provide for civil legal assistance to low-income Americans. The
vast majority of the funding -- $394.4 million -- will be distributed in grants
to 137 independent nonprofit programs across the nation to help low-income
individuals and families who are trying to avert foreclosure or eviction,
trying to escape from domestic violence or who have a pressing civil legal
problem that places their security and safety at risk. Overall, the
appropriations bill increases LSC funding by $30 million from the current
level. It also lifts a restriction on the ability of LSC-funded programs to
pursue the recovery of attorneys' fees when it is permitted or required under
federal or state law. In addition to providing grants for the provision of
civil legal assistance, the appropriations bill provides $17 million for
management and grants oversight, $3.4 million for technology grants that
improve access to legal assistance and self-help guides for the poor, $1
million for student loan repayment assistance to legal aid lawyers, and $4.2
million for the LSC Office of Inspector General. The consolidated
appropriations bill, which combines six annual appropriations bills for the
fiscal year that began October 1, will go to the House and Senate for final
approval and then to the president for his signature. An interim funding
measure expires December 18.
U.S. Will Settle Indian
Lawsuit for $3.4 Billion; Many elders will receive cash payments
12/9: The following is from a Dec. 9th New york
Times story: The federal government announced on Tuesday that it intends
to pay $3.4 billion to settle claims that it has mismanaged the revenue in
American Indian trust funds, potentially ending one of the largest and most
complicated class-action lawsuits ever brought against the United States.
The tentative agreement, reached late Monday, would resolve a 13-year-old
lawsuit over hundreds of thousands of land trust accounts that date to the 19th
century. Specialists in federal tribal law described the lawsuit as one of
the most important in the history of legal disputes involving the government's
treatment of American Indians.
President Obama hailed the agreement as an "important step towards a
sincere reconciliation" between the federal government and American
Indians, many of whom, he said, considered the protracted lawsuit a
"stain" on the nation. As a presidential candidate, Mr. Obama
said, "I pledged my commitment to resolving this issue, and I am proud
that my administration has taken this step today." For the
agreement to become final, Congress must enact legislation and the federal
courts must then sign off on it. Administration officials said they hoped those
two steps would be completed in the next few months. The dispute arises from a system dating to
1887, when Congress divided many tribal lands into parcels -- most from 40 to
160 acres -- and assigned them to individual Indians while selling off
remaining lands. The Interior Department now manages about 56 million
acres of Indian trust land scattered across the country, with the heaviest
concentration in Western states. The government handles leases on the land for mining,
livestock grazing, timber harvesting and drilling for oil and gas. It then
distributes the revenue raised by those leases to the American Indians. In the
2009 fiscal year, it collected about $298 million for more than 384,000
individual Indian accounts. The lawsuit accuses the federal government
of mismanaging that money. As a result, the value of the trusts has been
unclear, and the Indians contend that they are owed far more than what they
have been paid. Under the
settlement, the government would pay $1.4 billion to compensate the Indians for
their claims of historical accounting irregularities and any accusation that
federal officials mismanaged the administration of the land itself over the
years. Each member of the class would receive a check for $1,000, and
the rest of the money would be distributed according to the land owned. In addition, legal fees, to be determined by a judge,
would be paid from that fund. Philip Frickey, a law professor at the
University of California, Berkeley, who specializes in federal Indian law, said
that of all the Indian land claims and other lawsuits over the past generation,
the trust case had been a "blockbuster" because it is national in
scope, involves a large amount of money, and has been long-running. Click
above to accesss the full Times article. To access a related Washington
Post article, click here.
12/8: The following is from Dec. 4th Center
on Budget & Policy Priorities
analysis: Health reform legislation that has passed the House in one form and
is before the Senate in another is facing a series of attacks that, taken
together, suggest the legislation would do little to control health care costs
and would increase budget deficits. Many of these charges are exaggerated or
simply incorrect, based on the Center's careful analysis of the legislation. In
particular, a number of criticisms rest on a mistaken belief that, in recent
years, Congress has repeatedly enacted provisions to achieve savings in
Medicare and then generally blocked these provisions before they could take
effect. Thus, critics say, no one should take seriously the provisions of the
current bills that would produce Medicare savings. In fact, the Center's
analysis of major legislation affecting Medicare that Congress has enacted over
the last two decades shows that Congress has permitted the vast majority of
Medicare savings to take effect. To access the full analysis, click above.
Home Care
Patients Worry Over Possible Cuts
12/7: The following is from a Dec. 4th New
York Times article: As they are
across the nation, Medicare patients and nurses in this town in northern Maine
are anxiously following the Congressional debate because its outcome could
affect Medicare's popular home health benefit in a big way. The legislation
would reduce Medicare spending on home health services, a lifeline for
homebound Medicare beneficiaries, which keeps them out of hospitals and nursing
homes. Under the bills, more
than 30 million Americans would gain health coverage. The cost would be offset
by new taxes and fees and by cutbacks in Medicare payments to health care
providers. Home care shows, in microcosm, a conundrum at the heart of the
health care debate. Lawmakers have decided that most of the money to cover the
uninsured should come from the health care system itself. This raises the
question: Can health care providers reduce costs without slashing services?
Under the legislation, home care would absorb a disproportionate share
of the cuts. It currently accounts for 3.7 percent of the Medicare budget, but
would absorb 10.2 percent of the savings squeezed from Medicare by the House
bill and 9.4 percent of savings in the Senate bill, the Congressional Budget
Office says. The House bill would
slice $55 billion over 10 years from projected Medicare spending on home health
services, while the Senate bill would take $43 billion. Democratic
leaders in the Senate and the House justify the proposed cuts in almost
identical terms. "These payment reductions will not adversely affect
access to care," but will bring payments in line with costs, the House
Ways and Means Committee said. The Senate Finance Committee said the changes
would encourage home care workers to become more productive. Click above for
the full article.
11/12: On Nov. 12th the Washington Post did an interview with AARP's Director of Policy, John
Rother, concerning AARP's endorsement of health care reform legislation.
Seniors have been the least supportive of health care reform legislation
and AARP has taken some heat over their endorsement. In the interview,
Mr. Rother discusses why and how AARP feels such legislation will be a very
positive thing for seniors. To read a transcript of the interview, click above.
AARP
endorses House health-care bill
11/6: According to a Nov. 5th Washington Post report: The AARP, the nation's largest and most
influential association of older Americans, endorsed the House health-care bill
Thursday morning and vowed to lobby House members in advance of Saturday's
historic vote. AARP vice president Nancy A. LeaMond said the House
package, which would spend more than $1 trillion over the next decade to expand
insurance coverage to millions of Americans who lack it, meets the group's
chief goals for reform, including strengthening Medicare, the federal health
program for people over 65. "We can say with confidence that it
meets our priorities for protecting Medicare, providing more affordable health
insurance for 50- to 64-year-olds and reforming our health care system," LeaMond
said in a briefing for reporters.
LeaMond praised House leaders for including a plan to close the coverage
gap in Medicare prescription drug coverage known as the donut hole. Key
Democrats said the endorsement, one of several expected today, could prove
critical to pushing their vote count over the top. To access the full
story, click above.
10/30: The following is from the Center for
Medicare Advocacy web site: The Center for Medicare Advocacy is launching a new
advocacy and education initiative to eliminate the Medicare "Improvement
Standard," which requires that Medicare beneficiaries be able to improve
in order to qualify for coverage. The insistence that people must be able to
get better unfairly restricts access to Medicare coverage and necessary health
care. Although the Improvement Standard conflicts with the law, it has
become deeply ingrained in the system and ardently followed by those who
provide care and those who make coverage determinations throughout the health
care continuum. Beneficiaries are told Medicare coverage is not available if
their underlying condition will not improve, if they have
"plateaued," are not likely to improve, or if they need
"maintenance care only". As
a result it keeps people with debilitating, chronic conditions from receiving
the care they need. This practice persists although the Medicare Act does not
require improvement as a precondition to coverage for illness or injury.
Further, the federal regulations state that "restoration is not to be the
deciding factor" in making Medicare coverage determinations. Everyday
the Improvement Standard blocks access to Medicare and health care for real
people. The people most affected by
this barrier include people with Multiple Sclerosis, Alzheimer's disease, ALS
(Lou Gehrig's disease), spinal cord injuries, diabetes, Parkinson's disease,
hypertension, arthritis, heart disease, and stroke. Further, the erroneous
standard disproportionately affects people who have low-incomes, as well as
African-Americans and Hispanics. With support from The Atlantic
Philanthropies, the Center for Medicare Advocacy will begin a focused,
collaborative effort to eliminate the Improvement Standard in Medicare policy
and practice. This effort will include advocacy with the administration,
litigation if needed, and a multi-faceted education campaign. The Center
for Medicare Advocacy, founded in 1986, is staffed by attorneys, other
professional advocates, and a nurse. The Center's staff assists thousands of
individuals in obtaining Medicare coverage and necessary health care each year.
Armed with this experience, the Center works to obtain systemic change to
eliminate unfair barriers to coverage and care. For decades, the Improvement
Standard has been among the most significant obstacles facing the Center's
clients, as well as the millions of other people with Medicare who have no
legal representation. By removing this obstacle, we will open doors to needed
medical and rehabilitative care for people with long term conditions and
injuries. This is the goal of the proposed project. To learn more,
click above.
Critics:
DEA crackdown denies some patients pain medication
10/29: The following is from a Washington
Post article: Heightened
efforts by the Drug Enforcement Administration to crack down on narcotics abuse
are producing a troubling side effect by denying some hospice and elderly
patients needed pain medication, according to two Senate Democrats and a
coalition of pharmacists and geriatric experts. Tougher enforcement of
the Controlled Substances Act, which tightly restricts the distribution of pain
medicines such as morphine and Percocet, is causing pharmacies to balk and is
leading to delays in pain relief for those patients and seniors in long-term
care facilities, wrote Sens. Herb Kohl (Wis.) and Sheldon
Whitehouse (R.I.). The
lawmakers wrote to Attorney General Eric H. Holder Jr. this month urging that
the Obama administration issue new directives to the DEA and support a possible
legislative fix for the problem, which has bothered nursing home administrators
and geriatric experts for years. The DEA has sought to prevent drug theft and
abuse by staff members in nursing homes, requiring written signatures from
doctors and an extra layer of approvals when drugs such as morphine and
Percocet are ordered for sick patients. The law, however, "fails to
recognize how prescribing practitioners and the nurses who work for long-term
care facilities and hospice programs actually order prescription
medications," Kohl and Whitehouse wrote. They concluded that delays can
lead to "adverse health outcomes and unnecessary rehospitalizations, not
to mention needless suffering." Click above for the full article.
10/28: The following is from an Oct. 27th Washington
Post report: As congressional leaders
haggle over the shape of a proposed government-run "public option" in
health-care reform legislation, a quiet revolt is brewing against a different
public insurance program -- a plan to create government insurance for
long-term care. The proposal is known as the CLASS Act, short for
Community Living Services and Support. The
idea has been around for years, and the late Sen. Edward M. Kennedy
(D-Mass.) pushed to have the measure included in the health-care overhaul
package that passed the Senate health committee in July. A similar measure was
also adopted by voice vote in one of the three House committees handling health
care. The idea is to create long-term care insurance that would be
available to anyone, including those who are already disabled. People would be automatically enrolled, unless they
chose to opt out, and would pay a premium in exchange for the opportunity to
receive cash benefits to cover the cost of home care, adult day programs,
assisted living or nursing homes after they had been enrolled for at least five
years. Premiums and benefit levels would be set by federal health officials,
but advocates predict that the program would provide beneficiaries with a
minimal sum, around $75 a day. The proposal has gained momentum in
recent days as Democrats in both the House and Senate cast about for cash to
help finance a final health package.
Because the program would begin taking in premiums immediately but would not
start paying benefits until 2016, congressional budget analysts have forecast
that it would generate a nearly $60 billion surplus over the next 10 years,
cash that would help the larger measure's balance on paper. To access the
full article, click above.
10/27: The following is from an Oct. 27th Washington
Post report: The nation's preeminent
seniors group, AARP, has put the weight of its 40 million members behind
health-care reform, saying many of the proposals will lower costs and increase
the quality of care for older Americans. But not advertised in this
lobbying campaign have been the group's substantial earnings from insurance
royalties and the potential benefits that could come its way from many of the
reform proposals. The group and its subsidiaries collected more than
$650 million in royalties and other fees last year from the sale of insurance
policies, credit cards and other products that carry the AARP name, accounting
for the majority of its $1.14 billion in revenue, according to federal tax
records. It does not directly sell
insurance policies but lends its name to plans in exchange for a tax-exempt cut
of the premiums. The organization, formerly known as the American
Association of Retired Persons, also heavily markets the policies on its Web
site, in mailings to its members and through ubiquitous advertising targeted at
seniors. The group's dual role as an insurance reformer and a broker
has come under increasing scrutiny in recent weeks from congressional
Republicans, who accuse it of having a conflict of interest in taking sides in
the fierce debate over health insurance.
Three House Republicans sent a letter to AARP on Monday complaining that the
group was putting its "political self-interests" ahead of seniors.
GOP lawmakers point to AARP's thriving business in marketing branded
Medigap policies, which provide supplemental coverage for standard Medicare
plans available to the elderly. Democratic proposals to slash reimbursements
for another program, called Medicare Advantage, are widely expected to drive up
demand for private Medigap policies like the ones offered by AARP, according to
health-care experts, legislative aides and documents. Republicans also question
the high salaries and other perks given to some top AARP executives, who would
not be subject to limits on insurance executives' pay included in the Senate
Finance Committee's health reform package. Former AARP chief executive William
Novelli received more than $1 million in compensation last year. ... Several
top AARP officials also said they have no idea whether the group might gain
insurance business as a result of the proposed reforms. "We wouldn't know
it, and we wouldn't really care," Certner said. "The advocacy is what
drives what we do here, and not the other way around." Click above for the full article.
10/23: On October 20th, the Charlevoix Housing Commission
adopted a smoke-free policy for its 62-unit Pine River Place apartments for the
elderly and disabled. The policy went into effect immediately for all new
residents and current residents who are not smokers, as well as guests and
staff. Current residents who are smokers are exempted from the policy for
as long as they live in their current unit. Under this new policy,
secondhand smoke and other damage caused by smoking or tobacco products will
not be considered ordinary wear and tear, and some or all of the resident's
security deposit may be retained by the housing commission to cover costs of
damage caused by smoking or tobacco products; damage above and beyond the
amount of the security deposit may be billed to the resident. Further, it
is the resident's responsibility to take steps to keep smoking residue from
building up in units, including more frequent cleaning and wall washing, etc.
Annual inspections of units will be utilized to ensure that apartment
residents are following this part of the policy. Charlevoix
becomes the 32nd public housing commission in Michigan to adopt a smoke-free
policy. It has been our
pleasure working with Rob Harrison, the Executive Director of the Charlevoix
Housing Commission on this policy. Charlevoix is a located in northern
Michigan on Lake Michigan, and is known as "Charlevoix the
beautiful". The 32 Michigan housing commissions with smoke-free
policies have about 56 apartment buildings/developments and over 60
townhouses/scattered site units. A total of at least 4,158 apartment
units are covered by the local Michigan housing authority smoke-free policies.
More are in the pipeline. There are now at least 129 housing authorities
in the U.S. with smoke-free policies for some or all their buildings. To
access a copy of the list of 129 housing authorities in the U.S. that have
adopted smoke-free policies for some or all their buildings, click above.
Hidden
Costs of Medicare Advantage; Plans' Free Perks Are Subsidized By Government
10/19: The following is from an Oct. 15th Washington
Post article: Seniors in this Sun
Belt retirement haven and across the country revel in the free perks that
private insurance companies bundle with legally mandated benefits to entice
people 65 and older to forgo traditional Medicare and sign up for private
Medicare Advantage policies. The trouble is, the extra benefits are not
exactly free; they are subsidized by the government. And some of the plans pass
their costs on to seniors, who pay higher co-pays and additional fees to get
care. "It's a wasteful, inefficient program and always has
been," Sen. John D. Rockefeller IV (D-W.Va.) said at a recent hearing. At
its core, Rockefeller added, Medicare Advantage is "stuffing money into
the pockets of private insurers, and it doesn't provide any better benefits to
anybody." President Obama
has proposed cutting more than $100 billion in subsidies over 10 years, a
contentious component of health-care reform that will be fought in earnest as
the bills move through Congress. But unlike some issues that touch off partisan
sparring, Medicare Advantage has an unlikely band of bipartisan defenders who
have already battled to restore $10 billion of the proposed reductions.
In a health-care debate defined by big numbers and confusing details, the
prospect of losing benefits such as a free gym membership through the Silver
Sneakers program is tangible, and it has spooked some seniors, who are the
nation's most reliable voters and have been most skeptical about reform.
Medicare Advantage was established in the 1970s (under a different name)
when private insurers convinced Congress that they could deliver care at lower
costs than Medicare. The program blossomed in the late 1990s when Congress
bolstered it with millions in additional federal subsidies to for-profit HMOs.
It has proven popular among younger, active seniors who had managed-care plans
as workers, and about a quarter of Medicare's 45 million beneficiaries are
enrolled. Many private plans require no additional monthly premiums,
yet the government pays an average of $849.90 in monthly subsidies to insurance
companies for a person on Medicare Advantage, according to the Kaiser Family
Foundation. That is about 14 percent more than the government spends on people
with standard Medicare, according to the nonpartisan Medicare Payment Advisory
Commission. "The promise
of Medicare Advantage and Medicare HMOs was to save the government money, to
save consumers money, all the while providing additional benefits and
coordinating care," said Joseph Baker, president of the Medicare Rights
Center. "That promise has been unfulfilled overall because the plans are
overpaid by the federal government at this point." Click above for
the full article.
10/19: According to an Oct. 14th Washington
Post article: Now they have an enemy.
For months, President Obama and his administration waged their fight for
a health-care overhaul without a clear opponent, even courting the industry
executives and interest groups that helped kill reform efforts 15 years ago.
But attacks on the leading Democratic reform plan this week by the
insurance lobby left little doubt that two of the most powerful institutions
involved in the debate -- the White House and the nation's insurance companies
-- have abandoned any real hope of forging a compromise. What was a tenuous
truce has turned quickly into an all-out battle, with both sides ratcheting up
the hostilities. As the Senate Finance Committee on Tuesday approved a 10-year,
$829 billion bill to remake the health-care system, Obama's top advisers and
the insurers moved into a more intense stage of conflict. "The
insurance industry has decided to lead the charge against health reform, and
everyone recognizes their motives: profits," said White House deputy
communications director Dan Pfeiffer. "We are going to make sure they
can't sink this effort at the last minute." ... The insurers, however,
showed no sign of being chastened. America's Health Insurance Plans, an industry
trade group, opened a fresh line of attack with a multistate advertising
campaign warning that senior citizens enrolled in private Medicare plans could
lose benefits under the legislation.
"Is it right to ask 10 million seniors on Medicare Advantage for
more than their fair share?" the television spot asks. "Congress is
proposing $100 billion in cuts to Medicare Advantage. The nonpartisan
Congressional Budget Office says many seniors will see cuts in benefits."
The Finance Committee's bill would reduce spending on the plans AHIP
cites by $113 billion over the next decade, which could mean reduced insurer
profits, higher co-payments by beneficiaries or fewer extra benefits such as
eyeglasses and gym memberships. "We want to begin to build an
awareness of the potential implications to seniors," said AHIP President
Karen Ignagni. She declined to say how much money would be spent on the
commercials airing in six states, but one advertising analyst said the industry
has enough cash to pose a serious threat. "They can spend whatever they
feel they need to influence this," said Evan Tracey, president of the
Campaign Media Analysis Group. "Seniors are a very important group
politically." The insurance sector and health maintenance organizations
spent more than $116 million on lobbying in the first six months of this year,
according to an analysis by the nonpartisan Center for Responsive Politics. "It's pretty clear now, they intend at the
eleventh hour to launch a very expensive and misleading campaign against
reform," Pfeiffer said. Click above for the full article.
Elder Financial
Abuse Case: Brooke Astor's Son Guilty in Scheme to Defraud Her
10/9: The following is from an Oct. 8th New
York Times report: The son of Brooke
Astor, the legendary New York society matriarch, was convicted on Thursday of
stealing from her as she suffered from Alzheimer's disease in the twilight of
her life. Barring an appeal, the jury's verdict means that Mrs. Astor's
son, Anthony D. Marshall, an 85-year-old war veteran who fought at Iwo Jima,
can be sentenced to anywhere from 1 to 25 years behind bars. Mr.
Marshall was found guilty of 14 of the 16 counts against him, including one of
two first-degree grand larceny charges, the most serious he faced. Jurors
convicted him of giving himself an unauthorized raise of about $1 million for
managing his mother's finances. Prosecutors
contended that Mrs. Astor's Alzheimer's had advanced so far that there was no
way she could have consented to this raise and other financial decisions that
benefited Mr. Marshall. A second defendant in the case, Francis X.
Morrissey Jr., a lawyer who did estate planning for Mrs. Astor, was convicted
of forgery charges. Mr. Marshall
was found not guilty on two counts: the other grand larceny charge, which
stemmed from the sale his mother's Childe Hassam painting, and falsifying
business records. Mrs. Astor, whose fortune was estimated at more than
$180 million when she died two years ago at 105, may have been best known for
channeling large sums toward New York charities and cultural institutions like
the Metropolitan Museum of Art and the Bronx Zoo. The verdict drew the
curtain on a trial that lasted longer than had been expected. The jury of eight
women and four men sat through more than 19 weeks of testimony and arguments in
State Supreme Court in Manhattan, hearing detailed accounts of Mrs. Astor's
luxurious life of summers on an estate in Maine and dinners with diplomats.
They heard testimony from Henry Kissinger, Barbara Walters and Annette de la
Renta, among others. ... The prosecutor, Elizabeth Loewy, asked that bail be
increased to $5 million from $100,000 but the judge, Justice A. Kirke Bartley
Jr., refused. He set sentencing for Dec. 8. Click above to access the
full article.
Waterloo
Region, Ontario adopts smoke-free policy for affordable housing
10/9: Historic news from the Waterloo Region of
Ontario. On October 6th, the Community Services Committee of the Regional
Municipality of Waterloo (which includes the cities/townships of Waterloo,
Kitchener, Cambridge, Wellesley, North Dumfries, Wilmot, and Woolwich) voted to
approve a smoke-free policy for all buildings and property of "regionally
owned community housing" in the Waterloo Region. The policy covers
about 2,700 units of "social housing", also known as "affordable
or low and moderate income housing". The Waterloo Region Housing
manages 2,591 community housing units owned by the Region of Waterloo, many of
which are elderly and disabled housing. These units are located in
Kitchener, Cambridge, Waterloo, Woolwich and Wellesley. The new policy
will receive final approval at the October 14th Regional Council meeting, and
the approval is certain since the Community Services Committee that voted on
October 6th is a committee of the whole of the Regional Council. The
new policy is historic because it is the first such public housing policy in
Ontario and only the second in all of Canada. With over 2,700 units, it
is also constitutes one of the largest impact policies in the country. The policy says that all new leases signed by
residents after April 1, 2010 will include a provision saying that no smoking
will be allowed inside their units or in common areas, and outdoor smoking by
the resident will be restricted to at least 5 meters away from any windows,
entrances or exits to the building. Ontario provincial laws prevent
the smoke-free policy from applying to current residents. Therefore, the
buildings covered will have to transition to being fully smoke-free over time,
as current smokers move out. Notwithstanding the
"grandfathering" of current smokers, this is a very important victory
and will, undoubtedly, serve as a catalyst for other governmental units across
Canada to also adopt smoke-free policies. The push for this policy began
with resident complaints of secondhand smoke intrusions into apartment units.
In the spring of this year,
representatives of the Waterloo Region Housing Division and the Tobacco Program
of the Region of Waterloo Public Health, together with tenants and the legal
department, conducted a detailed study of the matter, met with residents,
conducted resident surveys, and produced a report which was presented to the
Community Services Committee. Among the key players in this process were:
Mary Sehl, Manager of Tobacco Programs for the Region of Waterloo Public
Health; Irwin Peters, Manager of Waterloo Region Housing; and Laurie Nagge,
Public Health Nurse in the Tobacco Program. Many others were also deeply
involved in this victory, including Pippa Beck of the Non-Smokers Rights
Association, and other tobacco control leaders across Ontario and Canada.
Jim Bergman of the Smoke-Free Environments Law Project of The Center for
Social Gerontology, Inc. had the pleasure to have also worked with the Waterloo
Region folks, and he was invited to speak at the October 6th hearing, together
with Brian King of the Roswell Park Cancer Institute in Buffalo, NY. The
agenda for the meeting, with a link to the smoke-free housing report, can be
accessed by clicking above.
Legal
Aid Programs Turn Away One Person for Every Client Served
10/1: The following is from a Sept. 30th Legal
Services Corporation note:
Nearly a million poor people who seek help for civil legal problems, such
as foreclosures and domestic violence, will be turned away this year by the
nation's largest nonprofit legal aid network because of insufficient resources,
the Legal Services Corporation (LSC) projects in a report released today.
The report is the Corporation's second analysis of the "justice
gap" in America -- the difference between the level of civil legal
assistance available and the level that is necessary to meet the legal needs of
low-income individuals and families. For every client served by LSC
programs, another person who seeks help is turned away, the report concludes.
The conclusion reaffirms a 2005 report by LSC that also found 50 percent of
potential clients seeking help from LSC-funded programs were not served because
of a lack of resources. "This nation is built on the promise of
equal justice under law, but there is a justice gap in America. We must do more
to close the justice gap and provide equal access to justice for all Americans,
regardless of their economic status," LSC President Helaine M. Barnett
said. "Many of these Americans in need of legal assistance are the
most vulnerable among us -- they are trying to escape from domestic violence,
trying to avert foreclosure and homelessness, trying to qualify for disability
benefits, trying to recover from natural disasters. Legal aid saves lives and
makes communities stronger," LSC President Barnett said. The
report projects that LSC programs will not be able to meet the legal needs of
about 944,000 poor people seeking assistance in 2009, slightly more than the
programs served in 2008. In one category -- foreclosures -- LSC-funded
programs are projected to turn away two for every person served. Programs also
will take up fewer than half of the requests for help with employment and
family law matters, the report shows. Despite increased appropriations
from the Congress in recent years, state and local government funding and
contributions from charitable donors and foundations declined during the
recession. Funding from Interest on Lawyers' Trust Accounts (IOLTA), in
particular, has dropped significantly in many states. LSC is the single
largest funder of civil legal assistance to low-income individuals and families
across the nation, operating as a federally-funded nonprofit organization that
promotes equal access to justice. The Corporation funds 137 nonprofit civil
legal aid programs with 918 offices to ensure the provision of high-quality
legal assistance to the poor. Click above to download the full report in
pdf format.
When
Medicare is the piggy bank
9/30: The following is from a Sept. 28th Associated
Press report: Medicare is
looking like a big fat piggy bank for health care overhaul. President
Barack Obama and the Democrats want to pay for much of their plan to cover the
uninsured by cutting hundreds of billions from the Medicare budget over the
next 10 years. From its inception, the health plan for seniors has been
kept afloat by taxes out of workers' paychecks. Now, Medicare savings would
count toward helping uninsured working-age children and grandchildren afford
their own coverage. Most seniors are willing to help younger generations.
But having reached that point in life when you have to spend more time in the
doctor's office than you'd prefer to, older Americans worry the cuts will mean
lower quality care. The proposed cuts to hospitals, nursing homes and
other providers are bigger than any Congress has imposed since the late 1990s.
However, in percentage terms, they're far from the largest ever. And Democrats
are also proposing to spend tens of billions to improve Medicare prescription
coverage and preventive care. "Seniors should definitely be paying
attention," said Mark McClellan, who ran Medicare under President George
W. Bush. "There's some redesign, some improvements, but unquestionably
there would be some adverse impacts. It's a mixed bag, but it's not like the
sky is falling." Click above for full article.
HUD's Non-Smoking Policy
Notice for Public Housing Could Stamp Out Tobacco for Good
9/30: The following is from a news note on the
web site of the American Association of Homes & Services for the Aging (AAHSA): Public and Indian housing authorities
are permitted and "strongly" encouraged to implement non-smoking
policies -- including smoking cessation at lease renewal -- the U.S. Department
of Housing and Urban Development (HUD) announced July 17, 2009, signaling that
an agencywide shift toward smoke-free federally assisted housing may be in the
offing. AAHSA views this as an encouraging development given that, as
HUD noted, elderly populations -- which make up 15 percent of the residents
living in public housing -- are especially vulnerable to the adverse effects of
smoking. Even though HUD's notice
only applies to public and Indian housing, it's possible that HUD's multifamily
office could follow suit with similar guidance. Until that time, the PIH
notice provides guidance that can be helpful for providers interested in having
smoke free environments in senior housing. Environmental Tobacco Smoke,
officials said, can migrate between multifamily housing units, causing
respiratory illness, heart disease, cancer and other ill effects. Fire is
another concern. Federal data show that in multifamily buildings, 26 percent of
fire deaths in 2005 were smoking-related -- the leading cause of fire deaths.
"By reducing the public health risks associated with tobacco use,
this notice will enhance the effectiveness of the Department's efforts to
provide increased public health protection for residents of public
housing," HUD said. PHAs have wide latitude to stamp out smoking, as
long as they stay within state and local laws, HUD said. More than 114 PHAs and
housing commissions around the country have gone non-smoking in one or more
apartment buildings so far, according to the Smoke-Free Environments Law
Project at The Center for Social Gerontology, a Michigan-based organization that
keeps a running tally of smoke-free policies in public housing. With
this new notice, there could be a broad proliferation of non-smoking public
housing policies around the country.
Click above to access the AAHSA note.
Editorial: Medicare Scare-Mongering
9/29: The following is from a Sept. 27th New
York Times editorial: It has
been frustrating to watch Republican leaders posture as the vigilant protectors
of Medicare against health care reforms designed to make the system better and
more equitable. This is the same party that in the past tried to pare back
Medicare and has repeatedly denounced the kind of single-payer system that is
at the heart of Medicare and its popularity. For all of the cynicism and
hypocrisy, it seems to be working. The Republicans have scared many older
Americans into believing that their medical treatment will suffer under pending
reform bills. The general
public believes that, too. The latest New York Times/CBS News poll of 1,042
adults found that only 15 percent believe changes under consideration would
make the Medicare program better, while 30 percent think they would make it
worse. That does not mean that Medicare will be untouched under the
Democrats' plans. The Obama administration and Congressional leaders are hoping
to save hundreds of billions of dollars by slowing the growth of spending in
the vast and inefficient Medicare system that serves 45 million older and
disabled Americans. The savings would be used to help offset the costs of
covering tens of millions of uninsured people. But far from harming
elderly Americans, the various reform bills now pending should actually make
Medicare better for most beneficiaries -- by enhancing their drug coverage,
reducing the premiums they pay for drugs and medical care, eliminating
co-payments for preventive services and helping keep Medicare solvent, among
other benefits. The main exception, a
fully justified one, is that some of the 10 million people enrolled in private
plans that participate in Medicare -- the Medicare Advantage program -- might
suffer a dilution or elimination of the extra benefits they get that other
beneficiaries do not. ... We have long championed Medicare. And we believe
elderly Americans, and all Americans, should closely examine the proposed
health care reforms. But the Republicans have done far too good a job at
obscuring and twisting the facts and spreading unwarranted fear. It is time to
call them to account. President Obama and the Democrats in Congress have to
make the case forcefully that health care reform will overwhelmingly benefit
Americans -- including the millions of older Americans who participate in
Medicare. Click above for full editorial.
9/23: According to a Sept. 22nd Reuters article: Health insurers accused the U.S. Medicare
agency on Tuesday of political interference in a battle over whether the
industry can lobby its customers directly over healthcare legislation.
The Centers for Medicare & Medicaid Services (CMS), which oversees the
Medicare program for the elderly and disabled as well as privately run Medicare
alternatives, said on Monday it was investigating a letter Humana Inc sent
enrollees about efforts to overhaul the nation's healthcare system. Humana's
letter, sent in an envelope citing important plan information, told customers
the Democrats' bills could hurt "millions of seniors and disabled
individuals <who> could lose many of the important benefits and services
that make Medicare Advantage health plans so valuable," according to CMS. The agency also warned other insurers against
sending potentially misleading health reform mailings to customers. America's
Health Insurance Plans, the industry lobby group, called the CMS action a
"gag order." ... CMS dismissed the criticism, saying it wanted to
ensure companies do not violate marketing rules or improperly use protected
Medicare mailing lists. "Our goal is to safeguard beneficiaries'
personal information," agency spokesman Peter Ashkenaz told Reuters. Democratic
Senator Max Baucus had urged CMS to get involved and later welcomed the
investigation of what he called "scare tactics" by Humana. Click
above for the full Reuters
article. A Washington Post article stated: The big insurer Humana
triggered the HHS crackdown with a letter to Medicare enrollees claiming that
health reform proposals could hurt "millions of seniors and disabled
individuals" who "could lose many of the important benefits and
services that make Medicare Advantage plans so valuable." The letter was
sent in envelopes marked "important information about your Medicare
Advantage plan -- open today!" HHS wrote to Humana last week
instructing it to stop the mailings, and it wrote to all Medicare Advantage
plans Monday, saying "such communications are potentially contrary to . .
. federal law." The government regulates communications between the health
plans and their members. To access the Post article, click here.
9/16: According to a Sept. 15th The Hill article: Congress has only been back in session for a
week, but Senate Majority Leader Harry Reid is already warning he may cancel
the next break because of a lack of GOP cooperation. Reid (D-Nev.) has
warned Republicans that they need to pick up the legislative pace or he will
cancel the weeklong Columbus Day recess next month. Reid told Senate
Minority Leader Mitch McConnell (R-Ky.) that the Senate will stay in session
straight through October if Republicans slow the floor debate on appropriations
bills and other issues. ... Reid has repeatedly voiced frustration over
Republican efforts to slow floor proceedings. He asked Republicans to cooperate
in passing spending bills funding the departments of Transportation and Housing
and Urban Development. "This will be only our fifth appropriations
bill we will have done," Reid said. "We have many more to do. I
have trouble comprehending people not letting us finish these bills and then
complaining that we have to do a continuing resolution to fund
government." Democratic leaders have hoped to avoid combining
unfinished appropriations bills into a massive omnibus package. It appears
certain, however, that lawmakers will not be able to pass all the bills needed
to fund the federal government by Sept. 30, when the fiscal year ends. Click above for full article.
Boise
City/Ada County Housing Authority becomes 3rd Idaho housing authority to go
smoke-free
9/15: The Boise City/Ada County Housing
Authority (BCACHA) has adopted a smoke-free policy for all of its 3 buildings,
with 214 units of elderly, disabled and family housing. The policy will
be effective on November 1, 2009. Idaho is taking a real lead on smoke-free
multi-unit housing for low-income people. Together with the Nampa Housing
Authority and the Caldwell Housing Authority, I believe they now have their
three biggest housing authorities in Idaho all with smoke-free policies for all
their housing. Nampa was first in the fall of 2007, and Caldwell followed
on January 1, 2009. Congratulations to all the Idaho folks who worked on this.
We're pleased to have been able to play a small part in this. To
access the BCACHA web site click above. To access our listing of
smoke-free housing authorities, click here.
9/15: According to a Sept. 10th analysis by the Center
on Budget & Policy Priorities:
Median household income declined 3.6 percent in 2008 after adjusting for
inflation, the largest single-year decline on record, and reached its lowest
point since 1997. The poverty rate rose to 13.2 percent, its highest
level since 1997. The number of people in poverty hit 39.8 million, the
highest level since 1960. The number of people who are uninsured jumped
by 682,000...and reached 46.3 million. The figures for 2009, a year in
which the economy has weakened further and unemployment has climbed
substantially, will look considerably worse, and the figures will likely worsen
again in 2010 if, as many economic forecasters expect, unemployment continues
to rise in that year. To access the full analysis, click above.
9/14: The following is from a Sept. 13th New
York Times analysis: American politics has been defined by gender gaps, racial
gaps, geographic gaps and the gap between the religious and the secular. Now
comes the geriatric gap. As the population ages and the nation faces intense
battles over rapidly rising health care and retirement costs, American politics
seems increasingly divided along generational lines. The question is how real and defining this gap is
going to be -- whether in 10 or 20 years it will prove as consequential or
intense as, say, the gender divide, particularly as it was played out last year
with the presidential campaign of Hillary Rodham Clinton. As distasteful
as the notion of intergenerational conflict may seem, the fight over health
care -- not to mention the election of health care reform's current chief
proponent, President Obama -- suggests that something is going on. Older
Americans are more likely to oppose Mr. Obama's initiative than any other age
group. The White House views this dynamic as one of the biggest obstacles to
tamping down public concerns about its approach and assembling a legislative
coalition to get a bill passed in Congress. Older voters were one of the few
groups Mr. Obama did not win in the presidential election last year, leaving
him and his party particularly reliant on younger voters, who do not show up at
the polls as reliably as older people do. They have a dimmer view of his
presidency than the rest of the nation. And there is no reason to
think that whatever tensions have been unearthed with this fight are going to
end once it is resolved. Mr. Obama
has signaled his intention to tackle the long-term financial problems of Social
Security, another issue the elderly play an outsize role in, and they tend to
be resistant to change there, too. Click above for full article.
9/11: On September 8th, the Monroe Housing
Commission voted unanimously (5 to 0) to adopt a smoke-free policy for all
their buildings. The policy is to go into effect November 1, 2009 for all
residents, including current residents who are smokers. The housing
commission has a 7-story, 148 unit, high-rise for elderly and disabled (River
Park Plaza), and a 115-unit family housing building (Greenwood), plus 30 single
family houses; a total of 293 units. The policy will allow smoking
outdoors, but only in designated areas, if any. It was a great pleasure
working with Nancy Wain, the Executive Director of the Monroe Housing Authority
on this. Adoption of this policy makes Monroe the 31st housing commission
in Michigan to adopt a smoke-free policy and the 125th in the nation. To
access a copy of the list of 125 housing authorities in the U.S. that have
adopted smoke-free policies for some or all their buildings, click above.
Data Fuel
Regional Fight on Medicare Spending
9/8: The following is from a Sept. 8th New
York Times article: For years,
health policy experts have said health care spending is much higher in New York
City and Boston because doctors and hospitals there provide more services,
practicing medicine in a more intensive way. But new government data show
that Medicare costs per patient in those cities are slightly below the national
average when the numbers are adjusted for the cost of living and other factors.
The new numbers add fuel to a raging debate over what Congress should do
to reduce geographic disparities in Medicare spending. The debate involves a
combustible mix of health policy and money. As part of any bill to revamp
health care, President Obama and Democratic leaders in Congress say they want
to reward doctors and hospitals for providing higher-quality, lower-cost care.
But their efforts have touched off a fight within the Democratic Party, pitting
urban lawmakers against rural lawmakers and creating a major new hurdle for
health legislation. Click above for full article.
IN
WISCONSIN, A PIONEERING PROGRAM:
The Unwitting Birthplace of the 'Death Panel' Myth
9/8: The following is from a Sept. 4th Washington
Post article: This city often shows up
on "best places to live" lists, but residents say it is also a good
place to die -- which is how it landed in the center of a controversy that
almost derailed health-care reform this summer. The town's biggest hospital,
Gundersen Lutheran, has long been a pioneer in ensuring that the care provided
to patients in their final months complies with their wishes. More recently, it
has taken the lead in seeking to have Medicare compensate physicians for
advising patients on end-of-life planning. The hospital got its wish this
spring when House Democrats inserted that provision into their health-care
reform bill -- only to see former Alaska governor Sarah Palin seize on it as
she warned about "death panels" that would deny care to the elderly
and the disabled. Despite widespread debunking, those warnings have led
lawmakers to say they will drop the provision. "It's really
distressing," hospital official Bud Hammes said. "These things need
to be addressed." President Obama's health-care initiative was
nearly consumed by the furor over that provision, and Republicans continue to
argue that the legislation would ration care for the elderly. The debate has
underscored how fraught the discussion is on end-of-life care in a country
where an optimistic ethos places great faith in technology and often precludes
frank contemplations of mortality.
That tendency has a price tag: A quarter of Medicare costs -- totaling $100
billion a year -- are incurred in the final year of patients' lives, and 40
percent of that in the last month. But the controversy has had most
resonance where it arguably took root, in this town of 52,000 where nearly
everyone of a certain age has an advance-care directive. To access the
full article, click above.
Senator Ted
Kennedy was long-time supporter of legal services for elderly
9/4: The Board of Directors and the Co-Directors
and staff of The Center for Social Gerontology, Inc. mourn the loss of
Senator Ted Kennedy as a great leader, especially in support of the elderly and
of legal services for the elderly. Since the early 1970s, Senator Kennedy
held U.S. Senate hearings on the delivery of legal services for the elderly and
strongly supported increased legal services for the elderly. He was a
champion on these issues long before most of his colleagues in Congress, and he
never stopped working on these issues. In the reauthorization of the Older
Americans Act in 2000, it was Senator Kennedy who saved Title IV's section
dealing with legal services for the elderly, when House members tried to
eliminate it. As in so many other areas of public policy, his leadership
will be extremely difficult to replace. For a NY Times obituary, click
above.
LSC on
the Passing of Senator Edward M. Kennedy
9/4: The following is from an Aug. 26th Legal
Services Corporation press release: Sen. Edward M. Kennedy (D-Mass.) will
be remembered at the Legal Services Corporation and at civil legal aid
organizations throughout the nation as a champion for equal access to justice,
LSC President Helaine M. Barnett said today. "Senator Kennedy's
longtime support for LSC was invaluable and consequential for the clients and
communities that are served by LSC-funded legal aid attorneys every day,"
LSC President Barnett said. "In addition to civil legal assistance, his
extraordinary career in public service focused on legislation and issues of
utmost importance to the poor -- employment, health care and education."
For the full LSC press release, click above.
Montana Court to
Rule on Assisted Suicide Case
9/2: According to a September 1st New York
Times story: Robert Baxter was
by all accounts a tough man. Even in the end, last year, as lymphocytic
leukemia was killing him, Mr. Baxter, a 76-year-old retired truck driver from
Billings, Mont., fought on. But by then he was struggling not for life, but
for the right to die with help from his doctor. "He yearned for death," his daughter,
Roberta King, said in a court affidavit describing her father's final agonized
months. Now, in death, Mr. Baxter is at the center of a right-to-die
debate that could make Montana the first state in the country to declare that
medical aid in dying is a protected right under a state constitution. The state's highest court on Wednesday will
take up Mr. Baxter's claim that a doctor's refusal to help him die violated his
rights under Montana's Constitution -- and lawyers on both sides say the
chances are good that he will prevail. Washington and Oregon allow
physicians to help terminally ill people hasten their deaths, but in those
states the laws were approved by voters in statewide referendums, and neither
state's highest court has examined the issue of a constitutional right to die.
In Montana, the question will be decided by the seven-member State
Supreme Court. A lower-court judge ruled in Mr. Baxter's favor last
December -- on the very day Mr. Baxter died -- and the State of Montana
appealed the ruling. The legal foundation for both sides is a
free-spirited, libertarian-tinctured State Constitution written in 1972 at the height
of a privacy-rights movement that swept through this part of the West in the
aftermath of the 1960s. Echoes of a righteous era are reflected in language
about keeping government at bay and maintaining individual autonomy and
dignity. "The dignity of the human being is inviolable," the drafters
declared. Lawyers on both sides say the Montana Supreme Court has a
tradition of interpreting the State Constitution with that sentiment in mind,
with privacy rights and personal liberty often outweighing other concerns. The
court ruled in 1997, for example, that Montana's anti-sodomy laws were
unconstitutional invasions of privacy. Click above to access the full
story.
Smoke-Free Public Housing:
It's Legal, Profitable & HUD Supports It
9/2: On August 26, 2009 at the Texas Housing
Association Annual Conference in Fort Worth, TCSG Co-Director Jim Bergman gave
a presentation of the above title. The presentation focused on smoke-free
policies in public housing, with special attention to the HUD notice issued on
July 17, 2009 in which HUD strongly encouraged public housing authorities
(PHAs) to adopt smoke-free policies for some or all their buildings. Included
in the 56-slide PowerPoint presentation was additional information on ways in
which HUD was now encouraging PHAs to adopt smoke-free policies, including in
their 2009 Healthy Homes Strategic Plan and in their scoring for the award of
HUD stimulus funds to PHAs. Also included in the presentation was
information on the cost savings and fire prevention reasons for adopting
smoke-free policies, as well as demographic and marketing reasons for doing so.
Examples were provided of public housing and other affordable housing
entities that have adopted smoke-free policies, as well as housing industry
trends. To access the 56-slide PowerPoint presentation, click above.
To access a pdf copy of the presentation, with 6-slides per page, click here. To access a copy
of the HUD July 17, 2009 Notice click here.
HUD issues notice strongly
encouraging public housing agencies to adopt smoke-free policies
8/6: On July 17th, the federal Department of
Housing and Urban Development (HUD) issued a Notice (PIH-2009-21 (HA)) titled
"Non-Smoking Policies in Public Housing". The notice stated
that HUD "strongly encourages Public housing Authorities (PHAs) to
implement non-smoking policies in some or all of their public housing
units." The notice goes on to encourage PHAs to adopt smoke-free policies
in their buildings, including in common areas and in individual units.
The HUD notice describes the health problems associated with secondhand
smoke and also points out the additional costs to PHAs of rehabbing units in
which smokers have lived. This is an extremely important statement by HUD
and is likely to encourage many more PHAs to adopt smoke-free policies.
Already about 120 PHAs have adopted smoke-free policies for some or all
their buildings. To access the HUD notice on TCSG's SFELP site, click
above.
7/13: The following is from a July 5th NY
Times article in the Week in Review:
Should the government get in the health insurance business? The question
will be debated fiercely in coming months as President Obama and some
Democratic lawmakers push for the creation of a government-run plan to compete
with private insurance companies for the business of nearly 50 million people
who are without insurance. ... It won't be the first time. The federal
government is already in the health insurance business in a big way, providing
coverage to more than 45 million elderly and disabled people through Medicare.
(Another government plan, Medicaid, is run and financed in combination with the
states to provide health care to about 60 million poor people.) How closely
a new public plan would resemble Medicare is unclear. Still, Medicare's record
offers insights into the benefits and pitfalls of public health care. While it
has driven down costs though its sheer market dominance, Medicare has also been
extremely slow in using its power to encourage or compel more effective health
care. And, of course, providing health care for older Americans has been
expensive. Medicare is expected to represent an estimated 13 percent of next
year's federal budget. Medicare has evolved into the bedrock of health
insurance for America's elderly population since it was created in 1965.
For the full article, click above.
7/13: TCSG's Smoke-Free Environments Law Project
maintains an up-dated listing of all the public housing authorities/commissions
in the U.S. that we know of which have adopted smoke-free policies for one or
more of their apartment buildings. The listing is done largely in the
order in which the policies have been adopted. As of May, 2009, at least
114 local housing authorities had adopted smoke-free policies for some or all
of their apartment buildings, with about 96 being adopted since the beginning
of January, 2005; an average of over 1.8 per month. That constitutes an
increase in the number of housing authorities with smoke-free policies of about
660% in 53 months. The 17 states with such policies include Michigan
(29), Minnesota (19), Maine (18), Colorado (11), California (7), Nebraska (6),
Washington (5), New Hampshire (3), Oregon (3), Alaska (3) New Jersey (2),
Wisconsin (2), Idaho (2), Florida, Montana, Indiana, and Kentucky. To
access the listing, in pdf format, click above.
7/2: The following is from a July 1st NY
Times analysis: Chief Justice
John G. Roberts Jr. emerged as a canny strategist at the Supreme Court this
term, laying the groundwork for bold changes that could take the court to the
right even as the recent elections moved the nation to the left. The
court took mainly incremental steps in major cases concerning voting rights,
employment discrimination, criminal procedure and campaign finance. But the
chief justice's fingerprints were on all of them, and he left clues that the
court is only one decision away from fundamental change in many areas of the
law. Whether he will succeed depends
on Justice Anthony M. Kennedy, the court's swing vote. And there is reason to
think that the chief justice has found a reliable ally when it counts. "In
the important cases, Kennedy ends up on the right," said Thomas C.
Goldstein, a student of the court and the founder of Scotusblog, which has
compiled comprehensive statistics on the current term. The two justices agreed
86 percent of the time. ... Chief Justice Roberts has certainly been
planting seeds in this term's decisions. If his reasoning takes root in future
cases, the law will move in a conservative direction on questions as varied as
what kinds of evidence may be used against criminal defendants and the role the
government may play in combating race discrimination. The two newest justices, Chief Justice Roberts and
Justice Samuel A. Alito Jr., both appointed by President George W. Bush, agreed
92 percent of time, the highest rate for any pair of justices. But Justice
Alito often wrote concurring opinions to underscore or try to extend
conservative rulings, especially in criminal cases. He may well now be the
court's most conservative member. "Alito is staking out some room to
the right of the chief justice," said Pamela Harris, the executive
director of the Supreme Court Institute at Georgetown University Law Center,
"and you would have thought there is no such room." ... The court was
remarkably polarized in the 74 signed decisions it issued this term, dividing
5-to-4 or 6-to-3 in almost half of them, up from roughly a third in the three
previous years. The court reversed lower courts about three-quarters of the
time, up from two-thirds in the last term. Justice Kennedy was in the
majority 92 percent of the time and in all but 5 of the 23 decisions in which
the justices split 5-to-4. Those decisions were, moreover, often divided in the
expected way: in 16, all four members of the court's liberal wing were on one
side and all four of its conservatives were on the other. And in
between them was Justice Kennedy, the most powerful jurist in America. He joined the liberals 5 times and the conservatives
11. That was a significant shift to the right: in the previous term, Justice
Kennedy voted four times each with the liberals and the conservatives in cases
divided along the traditional ideological fault line. Justice Kennedy
swung right in the cases that really mattered. To access the NY Times article, click above. To access a Washington
Post analysis, click here.
7/1: The following is from a June 27th Columbian article: In 1988, they banned it in airplanes. In
1994, in offices. In 2006, the bars. And this month, they finally banned
smoking in Teri Richard's apartment building. "When I grew up, there
was a big ashtray on everybody's table," said Richard, 53, sitting under a
small corner of awning that stretches 25 feet from the nearest door.
Though Richard and a handful of her neighbors are only the latest of
millions of tenants across the country to choose such indignities for the sake
of an addiction, these tenants have an unusual landlord: the Vancouver Housing
Authority. The new decision by Clark County's subsidized housing agency
to ban smoking in some of its properties reflects Washington's successful
crusade to drive down cigarette use. ... After years of debate, the VHA
banned smoking indoors and on the balconies of Richard's building at the start
of June. The company that manages the
property has left notes on apartments but is still working out how the new
rules would be enforced. On Wednesday, Columbia House in the Hough
neighborhood will become the VHA's second smoke-free property. The agency might
roll the ban out to others of its dozens of buildings across the county , VHA
deputy director LaVon Holden said in May. Most public housing agencies
are doing the same, she said. "It
is just a standard of the business," said Holden, a former smoker.
"We are becoming a culture that is less tolerant of secondhand smoke,
because we now know the downside." The decision will save the agency
about $1,900 for every two-bedroom apartment that doesn't have to be scrubbed
and repainted every time a smoker moves out, Holden said. Smokers' habits
had been making life less nice for some of the Esther Short building's
nonsmokers, who are a majority of the tenants. Click above for full article.
6/12:
According to a June 12th note from the Brennan Center for Justice: On
June 4, 2009, the House Appropriations Subcommittee on Commerce, Justice,
Science and Related Agencies (CJS), which has jurisdiction over funding for
LSC, considered its annual appropriations bill. The bill, which was passed out of the Subcommittee the same
day, raised LSC's total funding level to $440 million, up from $390 million in
FY 2009, a 12.8% increase. Authored by the Chair of the CJS Subcommittee,
Representative Alan Mollohan (WV), the bill also removes the restriction that
currently prohibits LSC grantees from using LSC funds to seek attorneys' fee
awards -- a limitation that had been included as a rider to the LSC
appropriation every year since 1996. The bill does not lift any of the other LSC funding
restrictions. The full bill passed the full House Appropriations Committee on
June 9, 2009, with no changes to the LSC provisions, and now awaits passage b y
the full House. The bill's call
for increased funding is a greatly welcomed boost, especially because the
economic downturn has substantially increased legal need while reducing the
availability of other legal services funding. However, the bill does not lift
other LSC restrictions, specifically, it does not lift the restriction on
non-LSC funds, and it does not lift the restriction on class actions. Pres. Obama's detailed budget had
called for removal of these two additional restrictions. In the Senate, the CJS Appropriations
Subcommittee has yet to produce an FY 2010 appropriation bill, but is expected
to turn to this now. The CJS
Subcommittee is free to draft its own bill, and could do so along the lines of
the President's budget. Senator
Barbara Mikulski (MD) chairs the Senate's CJS Subcommittee. Once both the House and Senate have
passed their respective CJS bills, differences between the two versions will
likely be addressed and reconciled by a conference committee. For further info from the Brennan
Center, click above.
6/2:
TCSG's Smoke-Free Environments Law Project maintains this up-dated
listing of all the public housing authorities/commissions in the U.S. that we
know of which have adopted smoke-free policies for one or more of their
apartment buildings. The listing
is done largely in the order in which the policies have been adopted. As of May, 2009, at least 112 local
housing authorities had adopted smoke-free policies for some or all of their
apartment buildings, with about 94 being adopted since the beginning of January,
2005; an average of about 1.8 per month. That constitutes an increase in the
number of housing authorities with smoke-free policies of about 660% in 53
months. The 17 states with such
policies include Michigan (28), Minnesota (19), Maine (18), Colorado (11),
California (7), Nebraska (6), Washington (4), New Hampshire (3), Oregon (3),
Alaska (3) New Jersey (2), Wisconsin (2), Idaho (2), Florida, Montana, Indiana,
and Kentucky. To access the
listing, in pdf format, click above.
Bipartisan
Group of Senators Support $45 Million Increase for LSC
6/1:
According to a May 22nd Legal Services Corporation press release: Fifty-three Senators have signed on to a
letter asking key appropriators to provide at least $435 million for the Legal
Services Corporation in fiscal year 2010-a $45 million increase over current
funding levels and the amount requested by President Obama. Forty-five
Democrats, six Republicans and two Independents signed the letter. Senator Ted Kennedy (D-Mass.) was the
lead sponsor of the letter and has sent similar letters requesting increases
for LSC for at least the last eight years. Senator Kennedy is Chairman of the
Health, Education, Labor and Pensions Committee, which is responsible for
conducting oversight of the Corporation.
The letter notes that the increase for LSC is necessary to meet
"the greater need that exists today because of the economic crisis, which
has increased the number of foreclosures, the numbers of the unemployed, and
the number of individuals and families who now qualify for federally funded
legal aid." The letter also points out that current funding levels are
still far less, in real dollars, than what LSC received nearly 15 years and 30
years ago. "Without continued
increases in federal funding," concludes the letter, "many more of
our most vulnerable citizens will be denied assistance in the future. We urge
you, therefore, to fund the Legal Services Corporation at no less than $435
million for the coming fiscal year to help meet this critical need." Click
above to access the full press release.
President
announces intent to nominate Kathy Greenlee as Assistant Secretary for Aging
5/5: According to a May 4th Administration on Aging
press release: President Obama announces intention to nominate Kathy Greenlee
as U.S. Assistant Secretary for Aging. The Administration on Aging is pleased
to report that on Friday, May 1, 2009, President Obama announced his intent to
nominate Kathy Greenlee, Kansas Secretary of Aging, for Assistant Secretary for
Aging, U.S. Department of Health and Human Services. Kathy Greenlee has served
as Secretary of Aging for the state of Kansas since January 2006. In that
capacity, she has led a cabinet-level agency with 192 full-time staff members
and a total budget of $495 million. Her department oversees the state's Older
Americans Act programs, the distribution of Medicaid long-term care payments
and regulation of nursing home licensure and survey processes. Ms. Greenlee has
served on the board of the National Association of State Units on Aging since
2008. From 2004-2006, Greenlee served as State Long-Term Care Ombudsman in
Kansas, and prior to that, was the state's Assistant Secretary of Aging. From
1999-2002, Greenlee served as general counsel at the Kansas Insurance
Department. During her tenure there, she led the team of regulators who
evaluated the proposed sale of Blue Cross/Blue Shield of Kansas, and oversaw
the Senior Health Insurance Counseling for Kansas program. Greenlee also served
as Chief of Staff and Chief of Operations for then Governor Kathleen Sebelius.
She is a graduate of the University of Kansas with degrees in business
administration and law. Once nominated, Ms. Greenlee must be confirmed by the
U.S. Senate. To access the press release, click above.