25 STATES FACE TOTAL BUDGET SHORTFALL OF AT LEAST $40 BILLION IN 2009; 6 OTHERS EXPECT BUDGET PROBLEMS

5/7: The following is from an analysis by the Center on Budget & Policy Priorities: At least 25 states plus the District of Columbia, including several of the nation's largest states, faced or are facing an estimated $40 billion in combined shortfalls in their fiscal year 2009 budgets. Another three states also face shortfalls for fiscal year 2009 (which begins July 2008 in most states) but the size of their shortfalls has not been estimated, bringing the total number of states that faced or are facing shortfalls for FY2009 to 28. And three other states expect budget problems in fiscal year 2010, although some of those gaps may occur earlier than expected. In general, states will close these budget gaps through some combination of spending cuts, use of reserves or revenue increases before they adopt a fiscal year 2009 budget. At this point in the year, some states have already adopted those budgets while other states continue to deliberate. In order to present a complete picture of the impact of the current economic downturn on state finances, we report both the gaps that have been closed and those that will be closed in the future. The bursting of the housing bubble has reduced state sales tax revenue collections from sales of furniture, appliances, construction materials, and the like. Weakening consumption of other products has also cut into sales tax revenues. Property tax revenues have also been affected, and local governments will be looking to states to help address the squeeze on local and education budgets. And if the employment situation continues to deteriorate, income tax revenues will weaken and there will be further downward pressure on sales tax revenues as consumers become reluctant or unable to spend. The vast majority of states cannot simply run a deficit or borrow to cover their operating expenditures. As a result, states have three primary actions they can take during a fiscal crisis: they can draw down available reserves, they can cut expenditures, or they can raise taxes. States already have begun drawing down reserves; the remaining reserves are not sufficient to allow states to weather a significant downturn or recession. The other alternatives -- spending cuts and tax increases -- can further slow a state's economy during a downturn and contribute to the further slowing of the national economy, as well. Click above for full analysis.

Medicare chief awaits unhappy anniversary; Still unconfirmed after one year

5/6: The following is from a report in The Hill: Saturday [May 3rd] marks an anniversary of sorts for Kerry Weems, the acting administrator of the Centers for Medicare and Medicaid Services (CMS). On May 3, 2007, President Bush delivered Weems's nomination for the job to the Senate. But little has happened since, leaving Weems with neither the seal of approval nor the sense of full authority brought by confirmation. It also hampers CMS, which has been without a confirmed administrator since Mark McClellan resigned in October 2006. Former CMS officials say having only the acting title handicaps the administrator's authority -- but it doesn't lessen the burdens and responsibilities of running the agency and its nearly $600 billion budget. "In general, it's not good to go this long without a confirmed appointee," said Gail Wilensky, who ran the agency from 1990 to 1992. "There are decisions that come up from time to time when having that imprimatur of a confirmed appointment allows someone to take more decisive actions," said Wilensky, now a senior fellow at the Project HOPE educational foundation. The Weems nomination has become collateral damage in the fight between the Democratic Congress and Bush. The absence of a confirmed administrator certainly has not prevented the Bush administration from putting in place controversial policies regarding Medicare, Medicaid and the State Children's Health Insurance Program (SCHIP). Those actions, however, make it more difficult for Weems to earn confirmation, a Senate aide said. "Mr. Weems has encountered opposition among senators who hold him responsible for the actions of the CMS, particularly in the regulations that CMS has issued. We have heard these objections from Senate offices and are continuing our committee's deliberate consideration of his nomination," an aide to Finance Committee Chairman Max Baucus (D-Mont.) wrote in an e-mail. CMS did not respond to a request for comment by press time. The Finance Committee's consideration of Weems has indeed been "deliberate." The panel's only action so far on the nomination was to hold a confirmation hearing last July. The panel has not returned to Weems's nomination, even though he has testified before the panel several times since on CMS issues. Though Weems came to CMS after more than two decades as a civil servant at the Department of Health and Human Services (HHS), where he never held a political appointment, his tenure at CMS has been beset with the political tension always connected to Medicare and other CMS programs. CMS also has been aggressive in implementing policies opposed by the congressional majority, something typical of a large agency facing the end of a president's term. Click above for full story.

On Economy, Unlikely Allies Forge Winning Strategy; Housing Bill to Test Treasury Chief, Democrat's Ties

5/6: The following is from a May 5th Washington Post report: One is a free-market Republican from Wall Street with roots in the rural Midwest and a passion for bird-watching. The other is a rumpled, union-hall Democrat from Bayonne, N.J., who once famously described himself as "a left-handed, gay Jew." About the only thing Treasury Secretary Henry M. Paulson Jr. and Massachusetts Rep. Barney Frank have in common is a Harvard degree. Yet the two have forged a remarkably productive relationship in the waning days of the Bush administration, steering complicated bills to overhaul two federal agencies through the Democratic House and shaping Washington's response to the nation's credit crisis. Now that relationship is about to be tested. Frank, along with Senate Banking Committee Chairman Christopher J. Dodd (D-Conn.), is championing Washington's most aggressive response to the rising tide of foreclosures that has dragged down the nation's economy -- a $300 billion plan to help thousands of distressed homeowners. The White House has declared its opposition to the bill. But Frank plans to tie it to some of the administration's top housing priorities in hope that Paulson will help him push the package across the president's desk. To access the full story, click above.

States Look to Rein In Private Medicare Plans

5/5: The following is from a May 5th NY Times article: State officials say they will soon ask Congress for more power to regulate the marketing of private Medicare insurance plans to older Americans because they are still receiving complaints of high-pressure sales tactics that have led some beneficiaries to sign up for unsuitable policies. The proposal would be a profound change, but state officials say it is needed to protect consumers and reduce confusion. Of the 44 million Medicare beneficiaries, 25 million are now enrolled in some type of private plan -- either a Medicare Advantage plan, which provides a wide range of health services, or a free-standing prescription drug plan, which covers just medicines. In the draft of a report prepared by the National Association of Insurance Commissioners, state officials say they have received large numbers of complaints but, in most cases, cannot provide direct assistance to beneficiaries or hold insurers accountable. In the report, the state officials propose setting common standards for marketing the private plans, which could then be enforced by states that adopt them. "The current federal regulatory framework does not adequately protect consumers from marketing and sales abuses," and consumers are often left to fend for themselves in "a bifurcated regulatory system," the draft report says. States can regulate the activities of insurance agents and brokers who sell private Medicare plans, but they generally cannot regulate the insurance companies that offer such plans. Under the 2003 Medicare law, which added a drug benefit to Medicare, the federal government sets standards for private Medicare plans, and these standards supersede state laws and regulations except in two areas, the licensing and solvency of insurers. This division of labor -- between states and the federal Centers for Medicare and Medicaid Services -- often confuses consumers, the report says. Click above for full article.

For the Elderly, Being Heard About Life’s End

5/5: According to a May 5th NY Times article: Edie Gieg, 85, strides ahead of people half her age and plays a fast-paced game of tennis. But when it comes to health care, she is a champion of "slow medicine," an approach that encourages less aggressive -- and less costly -- care at the end of life. Grounded in research at the Dartmouth Medical School, slow medicine encourages physicians to put on the brakes when considering care that may have high risks and limited rewards for the elderly, and it educates patients and families how to push back against emergency room trips and hospitalizations designed for those with treatable illnesses, not the inevitable erosion of advanced age. Slow medicine, which shares with hospice care the goal of comfort rather than cure, is increasingly available in nursing homes, but for those living at home or in assisted living, a medical scare usually prompts a call to 911, with little opportunity to choose otherwise. Click above for full article.

Presentation: Smoke-Free Affordable Multi-Unit Housing Is Coming - Now!

4/30: On April 23rd in Detroit, a national conference was held titled Promising Practices From the Field: Tobacco Control Strategies for Priority Populations. The conference was hosted by the Health Education Council, the National Network on Tobacco Prevention & Poverty (NNTPP), and the National African American Tobacco Education Network (NAATEN). Jim Bergman, TCSG Co-Director, presented a session on smoke-free policies in affordable housing, i.e., housing for low and moderate income persons. The session was was titled Smoke-Free Affordable Multi-Unit Housing Is Coming - Now! and included a 66-slide PowerPoint presentation. The presentation included slides with national, socio-economic demographic information about the millions of people living in renter-occupied dwellings. The slides also demonstrated that the market for smoke-free housing is substantial among all socio-economic groups. The presentation showed how the inertia in the multi-unit housing market has now begun to change dramatically, and smoke-free policies are now clearly a hot new amenity that many apartment companies and housing authorities are adopting, including in public and private affordable housing. The major reasons for adopting smoke-free policies are also discussed. Included in the presentation are slides which have the company logo and photos of buildings of large and small apartment companies in Michigan which have adopted smoke-free policies for some or all their buildings, including many which are affordable housing. These slides demonstrate graphically that smoke-free multi-unit housing truly has come of age and that it's happening among large and small apartment owners and housing authorities. Included is a slide of Parkside Commons, a new market-rate apartment building just outside Boston, Massachusetts, and a slide from the Sault Ste. Marie, Michigan, Housing Commission, both of which prominently list smoke-free as an amenity, demonstrating that they believe smoke-free policies are a significant marketing advantage. You can access the 66-slide PowerPoint presentation directly by clicking above. If you simply want to view the presentation in pdf format, with 6 slides per page, you can access the pdf directly by clicking here.

Lincoln Housing Authority adopts smoke-free policy for elderly housing; Fourth Nebraska housing authority to adopt smoke-free policy

4/30: On January 10, 2008 the Lincoln Housing Authority adopted a smoke-free policy for two of its senior high rise apartment buildings, one with 120 units and the other with 91 units. Effective January 11, 2008, the smoke-free policy went into effect for all new residents of both these buildings; on June 1, 2008, the smoke-free policy is in effect for all residents of these two buildings, so they will be totally smoke-free at that time. There is also no smoking within 25 feet of entrances. Nebraska now has 4 housing authorities with smoke-free policies for some or all their buildings: Kearney, Blair, Fremont, and Lincoln. Kearney was the first housing authority in the nation to adopt a smoke-free policy, as far as we know, doing it in 1996, the same year Fort Pearce, Florida, did so for their housing authority. By our count, there are now at least 73 housing authorities in the nation that have adopted smoke-free policies for some or all their buildings. A growing number of these have not grandfathered current residents who are smokers for as long as they live in their unit; instead, they are setting specific limits on how long current residents who are smokers will be allowed to smoke inside before they also have to smoke outside the building. For an updated listing of housing authorities in the U.S. that have adopted smoke-free policies for some or all their buildings, click above.

Supreme Court Upholds Voter Identification Law in Indiana; Elderly Among Those Alleged to be Hurt by Law

4/29: The following is from a NY Times report: The Supreme Court on Monday [April 28th] upheld Indiana's voter-identification law, declaring that a requirement to produce photo identification is not unconstitutional and that the state has a "valid interest" in improving election procedures as well as deterring fraud. In a 6-to-3 ruling in one of the most eagerly awaited election-law cases in years, the court rejected arguments that Indiana's law, probably the strictest in the country, imposes unjustified burdens on people who are old, poor or members of minority groups and less likely to have driver's licenses or other acceptable forms of identification. The ruling, coming just eight days before the Indiana primary and at the height of a presidential election campaign, upheld rulings by a federal district court and the United States Court of Appeals for the Seventh Circuit, which had thrown out challenges to the 2005 law. Justice John Paul Stevens, who announced the judgment of the court and wrote an opinion in which Chief John G. Roberts Jr. and Anthony M. Kennedy joined, alluded to -- and brushed aside -- complaints that the law benefits Republicans and works against Democrats, whose ranks are more likely to include poor people or those in minority groups. The justifications for the law "should not be disregarded simply because partisan interests may have provided one motivation for the votes of individual legislators," Justice Stevens wrote. Justice Stevens and the two court members who joined him found that the Democrats and civil rights groups who attacked the law, seeking a declaration that it was unconstitutional on its face, had failed to meet the heavy burden required for such a "facial challenge" to prevail. Perhaps, they suggested, the outcome could be different in another voter-rights case, one in which a plaintiff could show that his or her rights had been violated. Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. concurred in the judgment of the court, but went further in rejecting the plaintiffs' challenge. In an opinion by Justice Scalia, the three justices said, "The law should be upheld because its overall burden is minimal and justified." Justices David H. Souter, Ruth Bader Ginsburg and Stephen G. Breyer dissented. Justice Souter, in an opinion joined by Justice Ginsburg, said the Indiana law "threatens to impose nontrivial burdens on the voting rights of tens of thousands of the state's citizens." ... Lawyers who challenged the case cited the experience of one would-be Indiana voter, Valerie Williams, who was turned away from the polling place in November 2006 by officials who told her that a telephone bill, a Social Security letter with her address and an expired driver's license were no longer sufficient. "Of course, I threw a fit," she said in a January interview with The New York Times, recalling how she cast a provisional ballot which was never counted. Ms. Williams is black -- and is a Republican. Click above for full article.

The Short End of the Longer Life; Ever Rising Longevity Is Not a Given for All Americans Anymore, Especially Women

4/28: The following is from an April 27th article in The Week in Review section of the NY Times: Throughout the 20th century, it was an American birthright that each generation would live longer than the last. Year after year, almost without exception, the anticipated life span of the average American rose inexorably, to 78 years in 2005 from 61 years in 1933, when comprehensive data first became available. But new research shows that those reassuring nationwide gains mask a darker and more complex reality. A pair of reports out this month affirm that the rising tide of American health is not lifting all boats, and that there are widening gaps in life expectancy based on the interwoven variables of income, race, sex, education and geography. The new research adds weight to the political construct popularized by former Senator John Edwards of North Carolina, that there are two Americas (if not more), measured not only by wealth but also by health, and that the poles are growing farther apart. The most startling evidence came last week in a government-sponsored study by Harvard researchers who found that life expectancy actually declined in a substantial number of counties from 1983 to 1999, particularly for women. Most of the counties with declines are in the Deep South, along the Mississippi River, and in Appalachia, as well as in the southern Plains and Texas. The study, published in the journal PLoS Medicine, concluded that the progress made in reducing deaths from cardiovascular disease, thanks to new drugs, procedures and prevention, began to level off in those years. Those gains, as they shrank, were outpaced by rising mortality from lung cancer, chronic obstructive pulmonary disease and diabetes. Smoking, which peaked for women later than for men, is thought to be a major contributor, along with obesity and hypertension. "Some people are actually sinking," said Majid Ezzati, one of the report's authors. "The line of excuse that we can live with inequality as long as no one is getting worse is just no longer there." The researchers found statistically significant declines for women in 180 of the 3,141 counties in the United States and in 11 counties for men. In an additional 783 counties for women and 48 for men, there were declines that did not reach the threshold of statistical significance. Of particular concern is that the gap in life expectancy between top and bottom counties expanded by two years for men and by about 10 months for women. In the worst-performing counties, all in southwestern Virginia, the drop in life expectancy over the 16-year period was nearly six years for women and two and a half years for men. In the counties showing the greatest improvement, many in the desert West, life expectancy rose nearly five years for women, and nearly seven years for men. The first of the two reports, released two weeks ago by the Congressional Budget Office, declared that the life expectancy gap is growing between rich and poor and between those with the highest and lowest educational attainment, even as it is narrowing between men and women and between blacks and whites. Pointing to the effects of smoking, obesity and chronic disease, the budget analysts wrote that "in recent decades, socioeconomic status has become an even more important indicator of life expectancy, whether measured at birth or at age 65." Among the implications, they wrote, is that Social Security payroll taxes will become less progressive as the wealthy increase their longevity advantage over the poor. Peter R. Orszag, the budget office's director, said that the decline in life expectancy among some Americans was "remarkable in an advanced industrial nation" and that he believed the growing gap related to income inequality. "We've had sluggish income growth at the bottom and rapid income growth at the top for the last three decades," he said. Click above for full story.

Appellate Argument: An Artist’s View

4/23: The following is from an April 22nd column in the NY Times: For three days last week, Chief Justice John G. Roberts Jr. heard arguments in a real court in Washington. Then he came to New York to preside over a fake one -- the finals of the moot court competition at Columbia Law School. Though he looked a little weary, Chief Justice Roberts's questions were deft, and his wit was dry. A few of his remarks, during and after the argument, lit up a large lecture hall like summer lightning. He talked a bit about the art of appellate argument, of which he is an acknowledged master, and he gave some hints about his judicial philosophy, which he presented as cautious and practical. ... Chief Justice Roberts spoke more generally, drawing on his experiences on the other side of the bench. He argued 39 Supreme Court cases in private practice and as one of the elite lawyers who represents the government in the Supreme Court in the solicitor general's office. The chief justice seems to get a kick out of judging moot courts, which is surely a busman's holiday. That is probably because he is a connoisseur of the art of oral argument. "Quite often the judges are debating among themselves and just using the lawyers as a backboard," Chief Justice Roberts explained to the students afterward, referring to appellate arguments in his court and others. "One of the real challenges for lawyers is to get involved in that debate." Click above for full column.

States Look to Tobacco Tax for Budget Holes

4/22: The following is from an April 21st NY Times report: To keep the state's landmark universal health coverage plan afloat, Massachusetts lawmakers are looking to tap an increasingly popular source of financing for health-related initiatives: tobacco taxes. If the state raises its tax by as much as $1 a pack, it will join New York -- and possibly a number of other states -- in enacting significant increases this year. The speaker of the Massachusetts House, Salvatore F. DiMasi, a Democrat, pushed the increase, to $2.51, through the chamber this month, and the State Senate president, Therese Murray, and Gov. Deval Patrick, also Democrats, have signaled support. The $175 million in projected revenue would be used to shore up the state's year-old mandatory health insurance plan. State officials say the plan, which is the first to require that individuals have coverage, is over budget because enrollment has been higher than expected for state-subsidized insurance policies offered to low- and middle-income workers. ... Governors and legislators in other states are making similar pushes. Bills to raise tobacco taxes have been active in 22 state legislatures in 2008, according to the Tobacco Merchants Association, a trade group. That follows a year in which 11 states enacted increases, according to the National Conference of State Legislatures. Supporters emphasize that in addition to providing revenue, increases in tobacco taxes are proven to drive down smoking rates, particularly among youths who may find that they cannot afford to start. In the year after a $1-a-pack increase took effect in Iowa in March 2007, the state's cigarette sales dropped by 36 percent, according to state revenue figures. For full article, click above.

Bush Announces HUD Pick

4/21: The following is from an April 18th Associated Press story: President Bush has chosen SBA Administrator Steve Preston to take over as head of the government's housing agency at a time of deep crisis in the industry, administration officials said Friday. If confirmed by the Senate, Preston would replace HUD Secretary Alphonso Jackson, who announced his resignation last month amid allegations of political favoritism and a criminal investigation. Jackson's last day on the job was to be Friday [April 18th]. Bush was to name Preston's nomination at midday before going to Camp David. Jackson leaves behind the wreckage of a national housing crisis and a trail of unanswered questions about whether he tilted the Housing and Urban Development Department toward Republican contractors and cronies. Preston will take over the agency at a time of chaos in the housing market. Foreclosures have surged to record highs as rising interest rates and the collapse of the once high-flying housing market have made it impossible for some to afford their monthly mortgage payments or sell their homes. ... Preston was sworn in as head of the Small Business Administration in July 2006, after his nomination was unanimously confirmed by the Senate. Bush was expected to praise him as an effective manager and problem-solver who can take on complex challenges, officials said. Preston's selection was first reported by National Journal's CongressDaily. Preston has a background of 25 years in financial and operational leadership positions. Before joining SBA, he was executive vice president of The ServiceMaster Co., where he also served as chief financial officer. Before that, he was a senior vice president and treasurer of First Data Corp. and an investment banker at Lehman Brothers. Click above for full news story.

Mikulski Secures $30 Million for Foreclosure Counseling; Additional Funding for LSC Removed Due to Technicality

4/21: According to a note from the Legal Services Corporation: On April 10, the U.S. Senate passed a housing reform bill (H.R. 3221) that includes $30 million in grant funds for organizations providing counseling services to homeowners facing foreclosure-related legal problems. The Neighborhood Reinvestment Corporation, or NeighborWorks America, a federally-funded non-profit dedicated to supporting community revitalization efforts, will administer the funds. The measure was attached to the bill as an amendment by Senator Barbara Mikulski, D-Md., Chair of the appropriations subcommittee responsible for funding LSC. Her amendment originally included an additional $37.5 million specifically for LSC-funded programs, but a technicality of parliamentary procedure forced her to remove it. She highlighted the importance of legal aid for families facing foreclosure in a statement released after the bill's passage. "The mortgage companies have expensive lawyers on their side. Borrowers and homeowners are by themselves trying to do what’s right, but they do not understand the legal lingo. Legal advice can make all the difference. They do not need a bail-out, but they do need a helping hand." According to Mikulski's press release, the House is working on a similar piece of legislation, expected to be considered in the coming weeks. Click above for Senator Mikulski's press release.

New PowerPoint: Smoke-Free Multi-Unit Housing Has Come of Age

4/21: On April 15 & 16th, TCSG's Jim Bergman was fortunate to be able to do hour-long presentations for the membership of the Property Management Association of Western Michigan (PMAWM), of which TCSG is a member. The presentation was titled Smoke-Free Multi-Unit Housing Has Come of Age and included a 59-slide PowerPoint presentation. The presentation was intended to provide information to multi-unit housing owners/managers demonstrating that it's legal to adopt smoke-free policies and that it makes economic sense, as well as discussing how to transition to smoke-free buildings and why enforcement is not a problem. Included are slides with demographic information showing that the market for smoke-free housing is substantial among all socio-economic groups. The presentation also showed how the inertia in the multi-unit housing market has now begun to change dramatically, and smoke-free policies are now clearly a hot new amenity that many apartment companies are adopting. Included in the beginning of the presentation are 20 slides which each have the company logo and photos of buildings of large and small apartment companies in Michigan which have adopted smoke-free policies for some or all their buildings. These slides demonstrated graphically that smoke-free multi-unit housing truly has come of age and that it's happening among large and small apartment owners and that it's happening all over the state. The slides also show that public housing commissions/authorities are adopting smoke-free policies, as are other affordable housing companies. The 4th to the last slide is also a great one because it's a slide from the web site for Parkside Commons, a new apartment building just outside Boston, Massachusetts, and this web page is touting the apartment building being a 100% smoke-free environment, showing that they see this as a major amenity and selling point for the residents they want to attract -- young, healthy and wealthy. You can access the 59-slide PowerPoint presentation directly by clicking above. If you simply want to view the presentation in pdf format, with 6 slides per page, you can access the pdf directly by clicking here. Feel free to download either of these and use and adapt them as you see fit. You can also be able to access the PowerPoint and pdf on the SFELP Apartments site by clicking here and on the PowerPoint Presentations site by clicking here.

WHERE DO OUR FEDERAL TAX DOLLARS GO?

4/18: The following is from an April 14th analysis by the Center on Budget & Policy Priorities: Over the next several years, policymakers will face important choices about the level of government revenues. Since the government collects taxes in order to finance public services, it is useful to examine where tax dollars go when thinking about these crucial tax-policy decisions. All told, the federal government spent a bit more than $2.7 trillion in fiscal year 2007, representing about one-fifth of the nation's Gross Domestic Product (GDP) or slightly less than the historical average for the last three decades. Of that $2.7 trillion in expenditures, more than $2.5 trillion was financed by federal tax revenues. The remaining $162 billion was financed by borrowing and, hence, will ultimately be paid for by future taxpayers. As shown in Figure 1, about three-fifths of federal expenditures went to three areas, each of which comprised about one-fifth of the budget: 1) Defense and security: In 2007, some 22 percent of the budget, or $590 billion, went to pay for defense, homeland security, and security-related international activities. While roughly $125 billion went to support operations in Iraq and Afghanistan, the bulk of the spending in this category reflects the underlying costs of the Department of Defense and other security-related activities. 2) Social Security: Another 21 percent of the budget, or $586 billion, went to Social Security, which provided retirement benefits averaging $997 per month to 34 million retired workers (and dependents of retirees) in fiscal year 2007. Social Security also provided survivors' benefits to 6.5 million surviving children and spouses of deceased workers and disability benefits to 8.7 million disabled workers. 3) Medicare, Medicaid, and SCHIP: Three health insurance programs -- Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP) -- together accounted for 21 percent of the budget in 2007, or $572 billion. Nearly two-thirds of this amount, or $375 billion, went to Medicare, which provides health coverage to more than 40 million people who are over the age of 65 or have disabilities. The remainder of this category funds Medicaid and SCHIP, which provide health care or long-term care to more than 45 million low-income children, parents, elderly people, and people with disabilities in a typical month. Click above for the full analysis.

ENHANCING AFFORDABLE HOUSING OPPORTUNITIES: REFORMING THE HOUSING VOUCHER PROGRAM: Subcommittee on Housing, Transportation and Community Development; Senate Committee on Banking, Housing, and Urban Affairs

4/18: The following is the April 16th testimony of Barbara Sard, Director of Housing Policy for the Center on Budget and Policy Priorities: The Center is an independent, nonprofit policy institute that conducts research and analysis on a range of federal and state policy issues, with particular emphasis on fiscal policies and policies affecting low and moderate-income families. We receive no government grants or contracts and are funded by foundations and individual donors. My testimony today first will briefly review why the Section 8 Voucher Reform Act (SEVRA) enjoys unusually broad support, and then will address why it is important for the Banking Committee to approve S. 2684 promptly so that final legislation may be enacted this year. Click above to access the full-text PDF of this testimony.

Presumptive GOP Presidential Nominee McCain Proposes Means Testing for Medicare Prescription Drug Benefit

4/17: The following is from an April 16th Kaiser Network Daily Update: Presumptive Republican nominee Sen. John McCain (Ariz.) on Tuesday during a speech at Carnegie Mellon University announced, as part of an economic package, a proposal that would require higher-income Medicare beneficiaries to pay higher monthly premiums for the prescription drug benefit, the Wall Street Journal reports. Higher-income Medicare beneficiaries currently pay higher premiums for Part B, which covers physician visits and outpatient hospital care, but all beneficiaries pay the same premiums for the prescription drug benefit. Under the proposal, individual Medicare beneficiaries with annual incomes that exceed $82,000 and couples with annual incomes that exceed $164,000 would pay higher premiums. The proposal would affect about 5% of Medicare beneficiaries and save an estimated $2 billion a year, according to the McCain campaign (Cooper, New York Times, 4/16). According to McClatchy/Seattle Times, the proposal "brings up the specter of means testing for federal benefit programs, anathema to the politically powerful seniors lobby". McCain said, "People like Bill Gates and Warren Buffett don't need their prescriptions underwritten by taxpayers". He added, "Those who can afford to buy their own prescriptions should be expected to do so. This reform alone will save billions of dollars that could be returned to the taxpayers or put to better use." In addition, McCain said, "As president, I will propose and relentlessly advocate changes that will bring down health care costs, make health care more affordable and accessible, help individuals and families buy their health insurance with generous tax credits and enable you to keep your insurance when you change jobs" (CQ HealthBeat, 4/15). To access the Kaiser news note, with links to the articles, click above.

Co-Payments Soar for Drugs With High Prices

4/15: According to an April 14th NY Times report: Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases. With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month. The system means that the burden of expensive health care can now affect insured people, too. No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without. For full article, click above.

LSC Testifies Before Congress on Need for Funding Increase

4/14: On April 2, leaders from the Legal Services Corporation testified before a House panel on the critical need for increased funding to provide crucial legal assistance to the millions of low-income Americans forced to confront serious civil legal problems without the help of an attorney. LSC Board Chairman Frank B. Strickland and President Helaine M. Barnett appeared before the House Appropriations Subcommittee on Commerce, Justice, Science and Related Agencies to present the case for LSC's FY 2009 budget request for $471 million, an increase of $121 million over current funding levels. The subcommittee is led by Chairman Alan B. Mollohan, D-W. Va., and Ranking Member Rodney P. Frelinghuysen, R-N.J. For the full LSC press release on this, click above.

Ohio adds free legal aid to foreclosure prevention effort

4/14: According to a Columbus Business First article: State officials have added more muscle to an effort aimed at curbing Ohio's foreclosure crisis: free legal aid for troubled homeowners. Gov. Ted Strickland, Ohio Supreme Court Chief Justice Thomas J. Moyer and several other state officials gathered Tuesday [April 1st] to announce it has added the legal component to its Save the Dream initiative, an effort created last month that helps homeowners connect with counselors and nearby assistance. The new Save the Dream component helps those who need foreclosure assistance but can't afford a lawyer. Tuesday's development allows homeowners facing foreclosure to call the Save the Dream hotline at 888-404-4674 and see if they meet income and other eligibility requirements to be connected with an attorney working pro bono. The basic income eligibility requirement has been set at a $54,000 annual income or less for a family of four. State officials last month sent letters to more than 34,000 registered Ohio attorneys requesting they help provide free legal aid. As of Tuesday, more than 1,100 attorneys have registered. About 350 of those attorneys have received foreclosure training from the Ohio State Bar Association, while more training sessions are scheduled, officials said. Bar Association President Rob Ware said in a release that the attorneys that have signed on are being assigned to local legal service offices to be matched with qualified clients. "These pro bono attorneys will supplement the resources available in the legal services community which alone are inadequate to address the current need," Ware said. That need is fueled by pre-foreclosure and foreclosure filings in Ohio that rank among the highest in the nation. Irvine, Calif.-based foreclosure tracker RealtyTrac Inc. reported that Ohio logged 153,196 default notices, auction sale notices and bank repossessions on 89,979 properties last year. That translates to one Ohio property in a stage of foreclosure for every 56 households in the state, the sixth-highest level in the nation. For the state's courts, that meant 83,000 new foreclosure filings in the state last year, a record high, according to Supreme Court data. The state's Save the Dream initiative involves 16 agencies and organizations, including the Department of Development, Coalition on Homelessness and Housing in Ohio and the Ohio Housing Finance Agency. Click above to access the news story.

Walla Walla Housing Authority adopts smoke-free policy for all its 300+ units; Washington state now has 5 housing authorities with SF policies

4/10: The Walla Walla Housing Authority on March 17th adopted a smoke-free policy for all its 300+ units of public and affordable housing for elderly, disabled, and families. The policy grandfathers existing residents who are smokers for about 6 months or until lease renewal. As a result, all the units will be smoke-free by around fall of 2008. We’re very pleased to have been able to share information last June on the adoption of smoke-free policies in public housing with the folks at the Walla Walla Housing Authority, as well as with another eastern Washington housing authority, where they are planning to also adopt a smoke-free policy in the not too distant future. To the best of our knowledge, as of the end of March, 2008, at least 72 local housing authorities had adopted smoke-free policies for some or all of their apartment buildings, with about 58 being adopted in the last 39 months; an average of 1.5 per month. States with such policies include Michigan (25), Maine (14), Minnesota (11), Washington (5), California (4 - 5), Nebraska (3), New Hampshire (3), Wisconsin, Oregon, Florida, Idaho, Montana, Indiana and New Jersey. These policies have been adopted because of the serious health threat posed by secondhand smoke that seeps into adjoining units and for fire safety reasons, as well as to reduce maintenance costs caused by cigarette smoke and burns. Like many private landlords, many housing authorities now view smoke-free policies as amenities which are a positive marketing tool. To access our listing of all the housing authorities we know of with smoke-free policies, in pdf format, click above.

Government Raises Payments to Health Insurers; Advocates Argue Against Excessive Payments

4/9: The following is from an April 7th Associated Press report: The government on Monday [April 7th] said it would raise payments next year to insurers that provide health care coverage to seniors by 3.6 percent, a slight increase from last year's boost. The increase applies to companies in the Medicare Advantage program, the privately run wing of the government health care plan for seniors. Officials from the Centers for Medicare and Medicaid Services said the increase is slightly lower than the estimated 3.7 percent expected growth increase for Medicare in 2009. Last year the agency increased payments on average by 3.5 percent. About 22 percent of the 44 million seniors in Medicare receive their benefits from private companies. The government pays insurers a set fee for each enrollee, which varies by the county they live in. Wall Street was still analyzing the payment increase Monday evening, though it appeared to be lower than some analyst projections. The 2009 payment rate will serve mainly as a benchmark against which companies offer services, rather than a final payment amount. Companies typically offer to provide Medicare benefits for less than the benchmark because they can use the remaining money to offer additional benefits, including dental and vision care. Those extras can help attract new enrollees. UnitedHealth is the largest provider of Medicare Advantage with 14 percent of the market and 1.4 million seniors enrolled. Humana has more than 1.25 million seniors in its plans and accounts for about 13 percent of the total market. Other companies with significant investment in Medicare include HealthSpring Inc., Health Net Inc. and Wellcare Health Plans Inc. ... On Thursday, unions AFL-CIO, AFSCME and several consumer groups sent a letter to congressional leadership calling on it to curb "excessive corporate subsidies" to private insurers. "It is fiscally irresponsible for Congress to allow this waste of taxpayer dollars to continue unabated, when money is needed to shore up Medicare's finances," states the letter, which was also signed by Families USA and the Medicare Rights Center. Despite such prodding by labor and consumer advocates, analysts do not expect another effort to cut payments to the companies. President Bush has vowed to veto any effort by Congress to trim payments to insurers. Click above to access the full article.

CDC Urges Older Adults to Improve Health, Increase Longevity, through Smoking Cessation

4/8: The Centers for Disease Control & Prevention has just issued a media backgrounder on older Americans and smoking. This is the first such backgrounder about older smokers that CDC has issued, we believe. It provides data on smoking among older persons, the reasons for quitting smoking, the dangers of secondhand smoke, smoking cessation options, and more. The CDC backgrounder is now on the website of the National Association of Chronic Disease Directors. Click above to access the backgrounder, in pdf format.

Medicare Finds How Hard It Is to Save Money

4/7: The following is from an April 7th NY Times article: An ambitious three-year experiment to see whether the Medicare system could prevent expensive hospital visits for people with chronic conditions like congestive heart failure and diabetes has suggested that such an approach may cost more than it saves. The test borrowed a practice long available through private health plans. Nurses periodically place phone calls to patients to check whether they are taking their drugs and seeing the right doctors. The idea is that keeping people healthier can help patients avoid costly complications. After paying eight outside companies about $360 million since mid-2005 to try to improve such patients' health, Medicare is still trying to figure out whether the companies were able to keep people healthier. But the preliminary data indicate that the government is unlikely to save money. The experiment, meanwhile, is proving something else: how difficult it can be, politically and practically, to make fundamental changes in the sprawling $400 billion federal Medicare program, which now covers some 44 million Americans. With health costs soaring, few would dispute that the government needs to find better ways to spend its Medicare dollars. But because the system relies heavily on private industry and is subject to Congressional oversight, few changes come easily, and even experimental programs can take on lives of their own. Several of the companies, including two that specialize in disease management, Healthways and Health Dialog, are pressing Medicare to continue the project in some fashion beyond the end of this year, saying the government mishandled the experiment. The senators from the home states of those two companies, including John Kerry, Democrat of Massachusetts, and Lamar Alexander, Republican of Tennessee, have taken up their cause, demanding that Medicare rethink ending the experiment. "Stopping this program," the senators wrote in a letter to Medicare last month, "creates serious health risks for the Medicare beneficiaries already enrolled and heavily reliant" on the services provided by the experiment. Medicare, for its part, says the experiment so far has not reduced medical bills enough to offset the fees the companies are charging the government -- as much as $2,000 a year for each patient. A final accounting of the experiment is likely to come no sooner than next year. About 160,000 people have taken part in the test, known as the Medicare Health Support program, and some 70,000 are still receiving calls from nurses employed by the companies. Experts say that Medicare and the companies alike were too optimistic about how easy it would be to prevent costly complications and hospital visits by patients who are very sick. Click above for full article.

Researchers Find Huge Variations in End-of-Life Treatment

4/7: The following is from an April 7th NY Times report: New research shows huge, unexplained variations in the amount, intensity and cost of care provided to Medicare patients with chronic illnesses at the nation’s top academic medical centers, raising the possibility that the government could save large amounts of money. In a report being issued on Monday, Dartmouth researchers say that total Medicare spending in the last two years of life ranges from an average of $93,842 for patients who receive most of their care at U.C.L.A. Medical Center to $53,432 at the Mayo Clinic's main teaching hospital in Rochester, Minn. Other top-ranked hospitals fell in between. Medicare spending averaged $85,729 for those who used Johns Hopkins Hospital in Baltimore, $78,666 at Massachusetts General and $55,333 at the Cleveland Clinic. Differences in the last six months of life were even more striking. Medicare spent an average of $52,911 for U.C.L.A. patients and $28,763 for those who used the Mayo hospital, St. Marys. The numbers, from the 2008 edition of The Dartmouth Atlas of Health Care, have caught the eye of federal officials, who say Medicare could save billions of dollars a year if doctors and hospitals in high-spending regions were as efficient as those in low-spending regions. "How can the best medical care in the world cost twice as much as the best medical care in the world?" asked Peter R. Orszag, director of the Congressional Budget Office, referring to the top-ranked hospitals. Click above for full article.

For 50 Years This Has Been the Symbol Of Peace. Far Out.

4/4: The following is from an April 4th Washington Post article: The peace symbol -- three simple lines within a circle -- turns 50 today. It's had a colorful and often turbulent life, which is odd considering that it's supposed to symbolize, you know, peace. Unveiled at a British ban-the-bomb rally on April 4, 1958, the peace symbol's peak of potency was in the 1960s, when it was the emblem of the anti-Vietnam War movement and all things groovily counterculture. (Said its late creator, British graphic designer Gerald Holtom: "I drew myself . . . a man in despair . . . put a circle around it to represent the world.") The symbol has marched in service of many causes over the years: civil rights, women's rights, environmentalism, gay rights, anti-apartheid, the nuclear-freeze movement and the latter-day antiwar crowd. Conservatives once denounced it as a lefty tool ("footprint of the American chicken," etc.), but not all the peace symbol's politics have been so easily classified. During the Soviet era, it was a ubiquitous totem of resistance in such cities as Prague and Berlin. ... The peace symbol became a hieroglyphic superstar because of its simplicity and adaptability, says Ken Kolsbun, co-author of the new book "Peace: The Biography of a Symbol." The symbol can be rendered in a few strokes, even by the least artistically gifted, he points out. What's more, the symbol has never been trademarked (although a shoe company once tried), which means that anyone who wants a piece of peace can have at it. Peace never goes out of style, but at the half-century mark, Holtom's creation has grown so recognizable, so often replicated and so drearily commercialized that it raises the kind of question they used to ask all the time in the '60s: Has the peace symbol sold out, or is it indeed still "relevant," man? To access the full article, click above.

New Synthesis Reveals Trends in Medicare Prescription Drug Plans Since 2006

4/4: The following is from an April 3rd Kaiser Network Daily Update: "Medicare Prescription Drug Plans in 2008 and Key Changes Since 2006: Summary of Findings," Kaiser Family Foundation: The report provides a synthesis of key findings from an analysis presented in a series of eight Medicare Part D 2008 Data Spotlights describing key features of stand-alone prescription drug plans offered in 2008, as well as trends since 2006. The synthesis covers a range of topics including premiums, the so-called "doughnut hole" coverage gap, benefit design, cost sharing, specialty tiers, formularies, utilization management, the top 10 brand-name drugs and the availability of low-income subsidy plans. To access the study, click above.

Real estate companies making it tougher for smokers in their homes

4/4: The following is from a March 30th New York Daily News story: They banned smoking in the bars and restaurants - and now they're coming into New Yorkers' homes. City real estate companies are jumping on the anti-tobacco bandwagon with new policies that prohibit tenants from lighting up behind their own doors. It's the latest anti-smoking trend to hit the city since Mayor Bloomberg banned lighting up in bars and restaurants five years ago Sunday. Clare Walsh just moved into a loft rental at 270 Park Ave. South. Its owner, Pan Am Equities, doesn't allow smoking anywhere in its buildings - including inside the apartments of tenants with new leases. "It has my full support," said Walsh, 52. "Smoking is a particularly unhealthy, unattractive activity." City health officials do not have specific data on how many residential buildings have official smoking bans, but real estate experts say a national movement has sprung up around creating smoke-free homes. "We're going with the times, with the city doing the bans with bars," said David Iwanier, Pan Am Equities' vice president. "We are considerate of everybody's needs, as well as [the need to] to compete with the marketplace." Manhattan real estate manager Jeff Lamb said most of the roughly 30 co-ops and condos he handles have banned smoking or are in the process of adopting no-smoking house rules. That means the co-op boards can deny new applicants if they're smokers, or require existing owners who smoke to ventilate their apartments or plug holes to protect their neighbors. The trend began shortly after a Manhattan Civil Court judge ruled in 2006 that secondhand smoke exposure violates residents' warrant of habitability, Lamb said. The same year, the U.S. surgeon general reported on health effects from secondhand smoke. "I would think it's going to become more commonplace," said Lamb, president of J&C Lamb Management. Still, he said, "In one case, the smoking person, being sensitive to these new guidelines, decided to sell her apartment." Neither federal nor state laws prevent residential buildings from adopting smoke-free policies, said Jim Bergman of the Smoke-Free Environments Law Project. Click above for full story. For a related column, click here.

LONG-TERM SOCIAL SECURITY SHORTFALL SMALLER THAN COST OF EXTENDING TAX CUTS FOR TOP 1 PERCENT

4/3: The following is from a March 31st Center on Budget & Policy Priorities analysis: The Social Security trustees' report issued this week estimates that Social Security faces a total shortfall over the next 75 years of 0.56 percent of Gross Domestic Product (GDP). This is slightly less than the estimated cost over that same period of extending the 2001 and 2003 tax cuts just for the top 1 percent of households: 0.6 percent of GDP. (Currently, households in the top 1 percent make more than $450,000 per year.) This striking fact should serve as a much-needed "reality check" in discussions over entitlement programs and the nation's long-term fiscal future. Too often, such discussions assume that Social Security faces a titanic shortfall that will require radical restructuring of the program, while paying little or no attention to the enormous fiscal damage that would result from extending the tax cuts without paying for them. Extending all of the tax cuts (not just those for the top 1 percent) would cost 1.95 percent of GDP over the next 75 years, if their cost is not offset through spending cuts or other revenue increases. That is three and one-half times the size of the Social Security shortfall over that period. These comparisons are not meant to imply that allowing some of the tax cuts to expire in 2010 would free up funds that could be used to bolster Social Security; official budget projections already assume that the tax cuts will expire as scheduled under current law. Nor do they mean that Social Security does not face significant long-term challenges; hard choices will be needed regarding both the program's revenues and its benefits to make Social Security solvent over the long term. Moreover, the Medicare trustees reported at the same time that Medicare's Hospital Insurance (Part A) trust fund faces a 75-year shortfall that is almost triple the shortfall in Social Security. Medicare's financing problems are much more difficult to solve because they largely reflect the sharp increase projected in health care costs throughout the U.S. health care system as a whole. Broader health care reform will therefore be an essential part of addressing the nation’s long-term fiscal problems. But as policymakers consider how to reform Social Security and to address the expiring 2001 and 2003 tax cuts, they should not overstate the problems facing the former or understate the cost of extending the latter. Click above to access the analysis.

Insurers Faulted as Overloading Social Security

4/2: The following is from an April 1st NY Times article: The Social Security system is choking on paperwork and spending millions of dollars a year screening dubious applications for disability benefits, according to lawsuits filed by whistle-blowers. Insurance companies are the source of the problem, the lawsuits say. The insurers are forcing many people who file disability claims with them to also apply to Social Security -- even people who clearly do not qualify for the government program. The Social Security Administration defines "disabled" much more stringently than the insurers generally do, so it rejects most of the applications, at least initially. Often, the insurers then tell their claimants to appeal, the lawsuits say, raising the cost. The insurers say that requiring a Social Security assessment is a standard practice and that there is nothing wrong with it. The policies they sell allow them to coordinate their benefit payments with others to make sure no one is paid twice. Thus, if a disabled person can get benefits from somewhere else -- like workers' compensation, a disability pension or Social Security -- the insurance company can reduce the benefit check by that amount. The flood of referrals, however, is making it hard for Social Security to respond to people who are truly disabled, said Kenneth D. Nibali, the former top administrator of the Social Security disability program. "Anybody who is forced to come into this system, and who doesn't need to be there, is affecting someone else," said Mr. Nibali, who retired in 2002 and is serving as an expert witness for the plaintiffs. "They're holding up cases for the people who have been waiting for months and years, who in many cases are much worse off." Already, the disability program is in much worse shape financially than the old-age portion of Social Security. It is projected to run out of money in 2026, 16 years ahead of the old-age trust fund. The disability caseload is also expected to grow as the work force ages, since recovery time increases with age. The number of people waiting for hearings on their claims by an administrative law judge has more than doubled since 2000, and the average wait has grown to 512 days in that time, from 258 days. The Social Security Administration is not an active participant in the lawsuits and declined to comment on them. A spokesman, Mark Lassiter, said Social Security does not keep track of how many of its roughly 2.5 million annual applicants for disability are referred by insurance companies. But he cited academic research showing that 18 percent acknowledged privately that they were unqualified, because they could still work. "It is probable that many of these claimants were required to apply," Mr. Lassiter said. Click above for full article.

OMB Watch Launches Regulatory Resource Center

4/2: OMB Watch has launched a web-based Regulatory Resource Center at www.ombwatch.org/regresources. The Resource Center provides tips for advocates who want to get involved in regulatory decision making and educational resources for anyone interested in how the federal regulatory process works. The first part of the Regulatory Resource Center is the Advocacy Center. The Advocacy Center shows users how to comment on federal regulations and provides instructions for using Regulations.gov, the government's portal for public comments. The Advocacy Center also has instructions for filing a petition for rulemaking and tips on how to find rules in the Federal Register. The second part of the Resource Center is the Policy Library. The Policy Library contains a flowchart showing how rules move through the regulatory pipeline; a list and brief description of rulemaking agencies; background information describing how the regulatory process works from beginning to end; and a glossary of common terms relating to regulation. The Policy Library also has a reference section, which provides links to legislation, executive orders, and government reports on regulatory policy. To access the Regulatory Resource Center, click above.

States Are Hit Hard by Economic Downturn; Many Cutbacks Felt by Most Needy

4/1: The following is from a March 31st Washington Post report: In Illinois' Cook County, women in poor neighborhoods no longer have access to free mammograms from two mobile vans testing for breast cancer. In Michigan, hikers will find about 20 campgrounds closed, and scientists are ending their studies of fish populations in the Great Lakes. In New Jersey, state workers are being laid off, and at least one town is canceling its traditional Fourth of July fireworks. And in California's San Fernando Valley, Everardo Orozco, 53, who has AIDS, exhausted his medical benefits and can no longer afford the drugs that are keeping him alive. ... State budgets have been hit hard by a worsening national economy, including rising costs for energy and health care. In addition, fallout from the subprime mortgage crisis -- declining home sales, deflated property values and mounting foreclosures -- has caused a slide in states' anticipated tax receipts. Revenue from property taxes, sales taxes and real estate transfer taxes is affected. At least half of the nation's states are facing budget shortfalls, some of them severe, and policymakers in most of the states affected are proposing and passing often-painful measures to trim costs and close the gaps. Spending on schools is being slashed, after-school programs are being curtailed and teachers are being notified of potential layoffs. Health-care assistance is being cut for the elderly, the disabled and the poor. Some government offices, such as motor vehicle department locations, will start closing on weekends, and some state workers are receiving pink slips. Some analysts worry that the impact is being felt disproportionately by the most needy. "It's disappointing, the extent they tend to focus their cuts on the most vulnerable," said Iris J. Lav, deputy director of the Washington-based Center on Budget and Policy Priorities, a liberal think tank that monitors state budget issues. "It does appear to disproportionately affect low-income people." Unlike the federal government, which can run deficits, almost all states are required by their own laws and constitutions to balance their budgets. Many states are just now hammering out their budgets, so some targeted programs could still be saved in last-minute negotiations. In most states, talk of raising taxes has become politically perilous, particularly with residents already hurting from falling housing values and a worsening economy. Only half a dozen states have approved, or are considering, tax increases, including Maryland and Michigan, both of which raised taxes in 2007. In New Jersey, which has a $3 billion deficit, Gov. Jon S. Corzine (D) has proposed eliminating or reducing most property tax rebates. In New York, facing a $5 billion shortfall, an idea in the General Assembly for a new income tax for people making more than $1 million per year died last week after the Republican-controlled Senate, and Gov. David A. Paterson (D), strongly opposed it. Instead of raising taxes, most states with shortfalls are curtailing services, and the effects are already being felt nationwide. Some of the most dramatic cuts are being made in California, Maine and Rhode Island, according to budget experts, with New Jersey not far behind. A recent 50-state survey by the Associated Press showed that hundreds of thousands of poor children, the disabled and the elderly stand to have their health coverage eliminated as a result of budget cuts, and more than 10 million people would lose access to dental care, specialists and name-brand prescription drugs. Budget experts said they see a repeat of the pattern that happened during the recession of 2001: States generally cut health services and medical benefits first, because these costs are often rising more rapidly than others, and the savings tend to be immediate.Click above for full article.

HUD Secretary Jackson Announces Resignation

4/1: According to a March 31st Washington Post report: Housing and Urban Development Secretary Alphonso Jackson announced his resignation today, citing "personal and family matters." He has come under pressure from Congress for his refusal to answer questions about a federal lawsuit and whether he tried to steer land to a business friend. In a letter to President Bush, Jackson, 62, said he is stepping down effective April 18 and would "fully assist in the orderly transition of the leadership at HUD." He added: "There are times when one must attend more diligently to personal and family matters. Now is such a time for me." He made no mention of the controversies that have cast a pall over his agency at a time of crisis in the nation's housing industry. According to two government sources who work on housing issues, Jackson was called last Monday to the White House, where top Bush administration aides discussed his ability to continue to lead the agency. The sources requested anonymity because of the sensitivity of the subject. That meeting came three days after two senior Senate Democrats called on Bush to oust Jackson. Sens. Patty Murray (Wash.) and Christopher J. Dodd (Conn.) advised the president that his secretary's refusal to answer lawmakers' questions made him unable to lead the $35 billion agency. A White House spokesman replied that Bush continued to have confidence in Jackson. Earlier this month, Dodd, Murray and other senators questioned Jackson closely about a federal lawsuit that accused him of using his public office to punish the Philadelphia Housing Authority after it refused to transfer a valuable property to one of the secretary's business friends. Jackson refused in two Senate hearings to discuss his role in the matter. Click above for full article.

Court Looks at Legal Role for Mentally Ill

3/28: The following is from a March 27th NY Times analysis: A landmark Supreme Court decision 33 years ago gave criminal defendants the right to represent themselves at trial. The right to proceed without a lawyer, the court said then, was a logical corollary to the Sixth Amendment right to the assistance of counsel. If the Constitution gave people the right to a lawyer, the justices reasoned, then it necessarily gave them to right to dispense with one, as well. But what about a defendant who is mentally ill and who, although technically competent to stand trial, has come to the perhaps delusional conclusion that he is better off without a lawyer? That was the question for the court during an argument on Wednesday. The court's precedents suggest that the standards for competence to stand trial and competence to represent oneself are one and the same. But at least some justices appeared convinced that the issue required a fresh look. The case is an appeal by the State of Indiana from a ruling by its State Supreme Court that a judge violated a defendant’s right to self-representation by refusing to let him proceed without a lawyer. ... The standard for competence to stand trial, formulated in a 1960 Supreme Court decision, Dusky v. United States, is fairly basic. It requires that a defendant have "sufficient present ability to consult with lawyer with a reasonable degree of rational understanding" and a "rational as well as a factual understanding of the proceedings against him." Mr. Fisher, the Indiana solicitor general, said the standard for competency to represent oneself should require more, "that it is within the state's authority to override this right where the defendant cannot communicate coherently with the court or the jury." To that, Justice Scalia responded: "Cannot communicate coherently? I sometimes think that the lawyers cannot communicate coherently." Click above for the full analysis.

Oxnard, California, City Council approves smoke-free policy for two senior citizen public housing buildings

3/28: On March 25th, the Oxnard City Council in California approved a no smoking policy for their two senior citizens apartment buildings operated by the Oxnard Housing Authority. The two buildings have 150 units; Plaza Vista has 50 units, and Palm Vista has 100 units. Elderly residents of these buildings sought the smoke-free policy to protect themselves from the health dangers of secondhand smoke. The smoke-free policy applies to all residents. Current residents who are smokers will be able to smoke outside, but must be at least 30 feet from the buildings and must be in a designated smoking area. To access a copy of the policy, click above and scroll down to item L in the City Council agenda.

Nursing Homes Cut Back on Restraints

3/27: The following is from a March 26th Associated Press report: The use of physical restraints on nursing home patients declined nearly 40 percent nationally in recent years as the federal government, states and the nursing home industry placed greater emphasis on eliminating what once was a common practice. Overall, about 5.9 percent of 1.5 million long-term patients were physically restrained repeatedly in 2006. That's a drop from 9.7 percent in 2002. Physical restraints, such as bed rails, were once regarded as necessary to improve safety, to keep patients from falling or wandering off, but that mind-set has changed during the past two decades. States where physical restraints for nursing home patients were most frequently used in 2006 were: California, 13.4 percent; Arkansas, 13.2 percent; and Oklahoma, 11.5 percent. States where restraints were least frequently used were Nebraska, 1.3 percent; and Iowa, Kansas and Maine, 2 percent. The nursing home data was part of an Agency for Healthcare Research and Quality report that compares states on numerous health issues. Mary Jean Koren, assistant vice president at The Commonwealth Fund, a research group, said that changes to federal law in 1987 made it illegal for nursing homes to use restraints to discipline residents or as a matter of convenience. The restraints can only be used for medical reasons, such as to prevent a resident from tearing out an IV. Until the change in law, restraints were standard procedure in many homes. ''We didn't know better,'' Koren said. ''We didn't understand what it did to people both physically and psychologically.'' Click above for full article.

Outlook Remains Bleak for 2 Programs: Social Security and Medicare

3/27: According to a March 26th NY Times report: The Bush administration issued a grim report on Tuesday on the financial outlook for Medicare and Social Security, but said the condition of the programs had not significantly deteriorated since last spring. The new report, like the one issued last April, said Medicare's hospital insurance trust fund would be exhausted in 2019, while Social Security's reserves would be depleted in 2041. "Medicare poses a far greater financial challenge," said Treasury Secretary Henry M. Paulson Jr., the managing trustee of Medicare and Social Security. The report may put pressure on the presidential candidates to say what they would do to rein in health costs and to shore up the programs, which serve more than 50 million people. The candidates have largely avoided these questions, but the next president will not be able to escape them. The trustees said Medicare's hospital insurance trust fund would pay out more in benefits than it receives in taxes and other dedicated revenues this year. Social Security costs will exceed tax revenues starting in 2017, they said. The government will then have to draw on assets of the Social Security trust fund -- special government bonds -- to meet its obligations to retirees. For full story, click above.

Its Appeal Slipping, the Senior Center Steps Livelier

3/27: The following is from a March 25th NY Times article: This is a time of ferment for the United States' 15,000 senior centers, many vestiges of the 1960s and '70s when federally financed meals for the elderly were a pillar of the Great Society. Under the Older Americans Act of 1965, centers are subsidized according to how many hot midday meals they serve. Nutrition and companionship remain worthy goals for them but are no longer the draw they once were. A handful of studies show that those younger than 65 say they are too busy to use senior centers. But the main reason for staying away is the stigma associated with aging. In New York City, with a network of 329 centers, almost half are underused, according to Deputy Mayor Linda I. Gibbs. A plan by the administration of Mayor Michael R. Bloomberg to make the city more user-friendly to the elderly includes modernizing the nation's largest system of senior centers, and including cafes, according to the mayor's office and the Department for the Aging. The 40-year-old model is not "serving the seniors of today or attracting the seniors of tomorrow," Ms. Gibbs said. Tomorrow is a far bigger worry. Experts predict that baby boomers will not walk in the door of outdated centers, which are often in church basements, reminiscent of high school cafeterias before the advent of food courts, with few activities besides bingo and transportation to the mall. "If they don't innovate," said John A. Krout, director of the gerontology institute at Ithaca College, "they will die." Fierce competition for the older-American market has inspired a search for new models and an emerging consensus about the elements the senior center of the 21st century should include. Among them are fitness activities, chronic-disease management, fall prevention and other aspects of healthy aging; continuing education both practical and intellectual; volunteer and work opportunities for those not ready for retirement; a handsome environment that accommodates the physical limits of age without looking institutional; and some programs aimed to the "young old," those from 55 to 65, to begin changing their negative view of senior centers. Click above for full article.

Supreme Court allows retiree benefit cuts; Employers may coordinate with Medicare on healthcare provisions for seniors. An AARP legal challenge is turned away.

3/26: The following is from a March 25th Los Angeles Times report: The Supreme Court on Monday gave employers a green light to reduce health benefits for millions of retirees who turn 65 and become eligible for Medicare. The justices turned away a legal challenge from AARP, the nation's leading senior citizens lobby, which had contended these lower benefits for older retirees violated the federal law against age discrimination. The court's action upholds, in effect, a rule adopted last year by federal regulators that says the "coordination of retiree health benefits with Medicare" is exempt from the anti-age-bias law. Advocates for companies and labor unions openly disagreed with AARP and applauded the outcome. They said this compromise rule will encourage employers to maintain health coverage for their retirees. Otherwise, employers might drop all benefits for their former employees, they said. They said it will prove especially helpful to those younger retirees who were offered continued healthcare when they left full-time work. In 2004, a survey cited by AARP found 49% of retirees age 55 to 64 had health insurance coverage from a former employer. Benefits experts for private employers say the proportion is lower. A survey in 2005 found only 13% of those who retired from private companies were promised continued healthcare. Click above for full article.

Social Security Trustees to Give Update

3/26: According to a March 25th Washington Post article: The trustees of Social Security and Medicare are certain to kick off a fierce round of debate when they release their annual assessment of the fiscal health of the government's two biggest benefit programs. The battle will be waged not only between the Democratic-controlled Congress and President Bush but also in this year's presidential campaign, where the issue is expected to attract a lot of attention in light of the looming retirement of 78 million baby boomers. All sides will try to use Tuesday's report to score political points, but that is probably as far as the debate will go -- at least until a new president takes office next year. Bush, who had vowed to make overhauling Social Security a top priority of his second term, will almost certainly leave office with that goal unfulfilled given that Treasury Secretary Henry Paulson, his point person on the issue, has not made any headway with Democrats in Congress in finding a compromise to resolve the pension program's fiscal problems. Democrats contend that Bush lost valuable time after his 2004 re-election pushing a plan to allow younger workers to direct their payroll tax contributions into private accounts, an idea that went nowhere in Congress. The new report is expected to make only small changes in the estimates made last year for when both trust funds will be depleted. Last year's report put the date for when Social Security would exhaust its trust fund resources at 2041 with the same date for Medicare put much sooner at 2019. Medicare is facing much more imminent problems because of soaring health care costs. Click above to access the article.

FACING DEFICITS, MANY STATES ARE IMPOSING CUTS THAT HURT VULNERABLE RESIDENTS, INCLUDING THE ELDERLY AND DISABLED

3/25: The following is from a March 13th analysis by the Center on Budget & Policy Priorities: To date, at least 17 states facing deficits have made or proposed budget cuts that threaten vital services for many residents, including some of the state's most vulnerable residents. Examples include: Public health programs: At least ten states have implemented or are considering cuts that will affect low-income children's or families' eligibility for health insurance or reduce their access to health care services. For example, Rhode Island's governor has proposed eliminating health coverage for nearly 7,400 low-income parents; New Jersey's governor has proposed cutting funds for charity care in hospitals by 15 percent; and California's governor has proposed requiring many families to pay more for their children’s health care. Programs for the elderly and disabled: At least four states are cutting or proposing to cut medical, rehabilitative, home care, or other services needed by low-income people who are elderly or have disabilities, or significantly increasing the cost of these services. For example, Tennessee has cut community-based services for the mentally retarded; Maine's governor has ordered cuts that will remove 7,000 mentally ill and poor adults from Medicaid; and Rhode Island is requiring low-income elderly people to pay more for adult daycare. To access the full analysis, click above.

Legal Aid of West Virginia: Medicaid makes rules hard to find

3/24: The following is from a March 19th Charleston Daily Mail article: West Virginia's Medicaid program files its regulations in such a confusing way that it's hard for people to know if they qualify for any of its health care benefits, according to Legal Aid of West Virginia. The group has filed a petition with the state Supreme Court charging that the rules aren't numbered or indexed, making it nearly impossible to determine which regulations are in effect at any time. Legal Aid says the program is violating a state law that standardizes procedures for filing new regulations with the secretary of state. "You wind up having to play a game of treasure hunt,'' Legal Aid lawyer Bruce Perrone said. "It's a problem, particularly, for anyone dealing with an eligibility question.'' The state's Medicaid program is under the umbrella of the Department of Health and Human Resources. That agency doesn't comment on pending legal matters, said spokesman John Law. Legal Aid's petition asks the Supreme Court to order the Medicaid program to file its rules in "standard size, format, numbering and lettering.'' It also asks that the court order the secretary of state's office not to accept any new rules from Medicaid that don't comply. About 300,000 disabled and low-income West Virginians receive health care through Medicaid, a program funded by the state and federal governments and administered by the state. To access the news story, click above.

Supreme Court Inc.

3/21: The following is from a comprehensive article by Jeffrey Rosen in the March 16th NY Times Magazine: The headquarters of the U.S. Chamber of Commerce, located across from Lafayette Park in Washington, is a limestone structure that looks almost as majestic as the Supreme Court. The similarity is no coincidence: both buildings were designed by the same architect, Cass Gilbert. Lately, however, the affinities between the court and the chamber, a lavishly financed business-advocacy organization, seem to be more than just architectural. The Supreme Court term that ended last June was, by all measures, exceptionally good for American business. The chamber’s litigation center filed briefs in 15 cases and its side won in 13 of them -- the highest percentage of victories in the center’s 30-year history. The current term, which ends this summer, has also been shaping up nicely for business interests. I visited the chamber recently to talk with Robin Conrad, who heads the litigation effort, about her recent triumphs. ... Conrad was in an understandably cheerful mood. Though the current Supreme Court has a well-earned reputation for divisiveness, it has been surprisingly united in cases affecting business interests. Of the 30 business cases last term, 22 were decided unanimously, or with only one or two dissenting votes. Conrad said she was especially pleased that several of the most important decisions were written by liberal justices, speaking for liberal and conservative colleagues alike. ... Examples like these point to an ideological sea change on the Supreme Court. A generation ago, progressive and consumer groups petitioning the court could count on favorable majority opinions written by justices who viewed big business with skepticism -- or even outright prejudice. An economic populist like William O. Douglas, the former New Deal crusader who served on the court from 1939 to 1975, once unapologetically announced that he was "ready to bend the law in favor of the environment and against the corporations." Today, however, there are no economic populists on the court, even on the liberal wing. And ever since John Roberts was appointed chief justice in 2005, the court has seemed only more receptive to business concerns. Forty percent of the cases the court heard last term involved business interests, up from around 30 percent in recent years. While the Rehnquist Court heard less than one antitrust decision a year, on average, between 1988 and 2003, the Roberts Court has heard seven in its first two terms -- and all of them were decided in favor of the corporate defendants. To access the full article, click above.

National Multi-Housing Council memorandum on no-smoking policies in apartments

3/20: A February 1, 2008 memorandum from the National Multi-Housing Council to its member multi-unit housing companies makes clear that it is legal to adopt a smoke-free policy for apartment buildings. The memo also explains why it makes business sense to adopt such policies. It goes on to provide suggestions on how to go about adopting and implementing smoke-free policies. To access a copy of the memorandum, in pdf format, click above. The memo can also be accessed by clicking here and scrolling down to the Overview Materials section of the site.

Middleville Housing Commission adopts smoke-free policy; Michigan has 25 housing commissions with smoke-free policies covering over 3,425 units

3/20: On November 18, 2008, the Middleville Housing Commission adopted a smoke-free policy for its 50 units of elderly/disabled housing at Lincoln Meadow. The policy went into effect January 1, 2008 for all new residents, all guests and staff, and all current residents. Thus, as of January 1st, the entire building was smoke-free. We're very pleased to have been able to work with Lillian Stehr, the Executive Director of the Middleview Housing Commission on the adoption of this policy. Middleville is located in west-central Michigan in Barry County, somewhat southeast of Grand Rapids. Michigan now has 25 local housing commissions which have adopted smoke-free policies. The policies cover about 46 apartment buildings/developments, with over 3,425 apartment units. The 25 local Michigan housing commissions which have now adopted smoke-free policies, in order of adoption, are: Cadillac, Plymouth, East Jordan, Elk Rapids, Melvindale, Livonia, Allen Park, Alma, Sault Ste. Marie, Traverse City, Ishpeming, Belding, Marysville, Paw Paw, Bessemer, Bedford Township, Marquette, Bangor, Eastpointe, South Haven, Grand Rapids, Evart, Negaunee, Middleville, and Escanaba. These housing commissions are located in all regions of the state and range from small to large in the number of apartment units they manage. All 25 of these local Michigan housing commission smoke-free policies have been adopted since July, 2005. To the best of our knowledge, there are now at least 67 local housing authorities/commissions in the U.S. that have adopted smoke-free policies. About 54 of these have been adopted since January, 2005. Michigan has 132 local housing commissions, and now about 19% of them have adopted smoke-free policies. In the 24 months of 2006-2007, 24 housing commissions in Michigan adopted a smoke-free policy for some or all their apartment buildings. Michigan also has well over 5,000 other units of smoke-free “affordable” housing, largely for elderly and/or disabled persons. These private apartment buildings either are already totally smoke-free or are transitioning to smoke-free status as current smokers move out and are replaced with residents who must abide by the smoke-free policies. In addition, tens of thousands of units of market-rate housing are now smoke-free in Michigan, and this number grows weekly. Visit our MISmokeFreeApartment.org online listing of smoke-free rental units located throughout Michigan; the listing page also now features the online apartment locator service RentLinx which allows you to find smoke-free apartments all over the state. The online listing can be accessed by clicking above. For a copy of our list of 67 housing authorities that have adopted smoke-free policies, click here.

Harvard Law, Hoping Students Will Consider Public Service, Offers Tuition Break

3/19: The following is from a March 18th NY Times article: Concerned by the low numbers of law students choosing careers in public service, Harvard Law School plans to waive tuition for third-year students who pledge to spend five years working either for nonprofit organizations or the government. The program, to be announced Tuesday, would save students more than $40,000 in tuition and follows by scant months the announcement of a sharp increase in financial aid to Harvard's undergraduates. The law school, which already has a loan forgiveness program for students choosing public service, said it knew of no other law school offering such a tuition incentive. "We know that debt is a big issue," said Elena Kagan, dean of the law school. "We have tried to address that over the years with a very generous loan forgiveness program, but we started to think that we could do better." For years, prosecutors, public defenders and lawyers in traditionally low-paying areas of the law have argued that financial pressures were pushing graduates toward corporate law and away from the kind of careers that they would pursue in the absence of tens of thousands of dollars in student loans. "The debt loads that people are coming out of law schools with are now in six figures," said Joshua Marquis, the district attorney in Clatsop County, Ore., and vice president of the National District Attorneys Association. "When the debt load is that great, I have had a lot of applicants who've said, 'I'd like to take the job, but I really can't afford it.'" Perhaps worse, Mr. Marquis said, some indebted young lawyers who choose to try to survive on a low salary as a junior prosecutor may decide to leave to earn more just as they gain enough experience to handle more important cases. For that reason, he added, Harvard's program sounded like a "great idea." Harvard's third-year-free program is expected to cost the law school an average of $3 million annually over the next five years, Ms. Kagan said, but that number is just an estimate because it is unclear how many students will take advantage of the offer. The law school's share of the university’s endowment of $34.9 billion is more than $1.7 billion. From 2003 to 2006, as many as 67 and as few as 54 of the 550 students graduating from Harvard Law went to work for a nonprofit organization or the government. That translates to 9.8 to 12.1 percent of the graduating class. A vast majority of students have chosen to join law firms, where they can earn well over $100,000 a year immediately after getting their degree. To access the full article, click above.

Latest statistics on aging population available from AoA

3/19: The Administration on Aging (AoA) has published its brochure, "A Profile of Older Americans: 2007," which is a summary of the latest statistics on the older population of the United States. The publication covers 16 topical areas including population, living arrangements, health, income and poverty, and more. A special section on retirement resources of near retirees aged 55-64 is also included. To access the 19-page brochure, click above.

National Multi-Housing Council memorandum on no-smoking policies in apartments

3/19: A February 1, 2008 memorandum from the National Multi-Housing Council to its member multi-unit housing companies makes clear that it is legal to adopt a smoke-free policy for apartment buildings. The memo also explains why it makes business sense to adopt such policies. It goes on to provide suggestions on how to go about adopting and implementing smoke-free policies. To access a copy of the memorandum, in pdf format, click above. The memo can also be accessed by clicking here and scrolling down to the Overview Materials section of the site.

As the Economy Falters, So Do State Budgets

3/18: The following is from a March 17th NY Times article: Programs for the elderly are being slashed in Maine. Government jobs are being eliminated in New Jersey. Prison construction has been put off in Virginia. Some schools in California will end their music programs. About half of the state legislatures nationwide are scrambling to plug gaps in their budgets, shot through by rapid declines in corporate and sales tax revenue, distressed housing markets and a national economy on the verge of a recession. Many states are reporting their largest budget shortfalls since the recessions of 2001 and 1991-2. In some states where tax increases are generally anathema, including Maryland and Kentucky, governors are looking to raise some levies. "It is not just the standard downturn where unemployment rises for a while, income tax and sales tax revenues are weak, and ultimately the economy recovers," said Iris Lav, the deputy director of the Center on Budget and Policy Priorities, a liberal research group in Washington that tracks state budgets. Ms. Lav pointed to a confluence of factors -- including weak consumer spending, high energy prices, dropping housing values and growing foreclosure rates -- that suggest states will face a protracted struggle to keep their budgets afloat. "This all will make it harder to recover," she said. As of last week, at least 25 states were expecting budget shortfalls for the 2009 fiscal year, according to the budget center, findings that are consistent with other state roundups and an informal phone survey by The New York Times. It is the largest number since 2002, when in the aftermath of the 2001 recession 37 states were forced to cut their budgets. To access the full article, click above.

Bush FY'09 budget proposals roundly criticized by Leadership Council of Aging Organizations

3/17: The Leadership Council of Aging Organizations, which is a coalition of 56 national not-for-profit organizations concerned with the well-being of Americans aged 50 and over, issued, on February 21st, a detailed analysis of the Bush administration's FY'09 budget proposals as they effect older persons. The analysis is a comprehensive criticism of virtually all of the Bush proposals, from Medicare, to Medicaid, to the Older Americans Act, to housing for the elderly, and more. The analysis also criticizes the Bush proposal to extend tax cuts for the wealthy beyond their 2011 expiration date. To access the analysis, in pdf format, click above.

House and Senate Pass Budget Plans

3/14: The following is from a March 14th NY Times article: The House passed a $3 trillion Democratic spending plan Thursday, and the Senate followed suit early Friday as Congress engaged in a day of budget theater that had as much to do with the political bottom line as federal fiscal policy. With three presidential candidates on hand, the Senate gave final party-line approval to its budget after easily dismissing a politically charged plan to ban spending for one year on pet projects sought by lawmakers. The final vote was 51 to 44. Both parties seized on the annual debate over the spending blueprint as a way to shape the 2008 campaign dialogue and try to force the White House contenders into embarrassing votes or to build opposition to their policy ideas. ... The House voted 212 to 207 to approve the plan developed by Democrats, which would increase spending on domestic programs like education, health care, veterans benefits and new energy technology while allowing some tax cuts pushed by President Bush to expire in two years. ... The House defeated a Republican alternative that would have slowed spending on Medicare and other entitlement programs, permanently extended the tax cuts, invested more in military spending and put a one-year freeze on the Congressional pet projects known as earmarks. ... The two budgets, which have to be reconciled for a final vote later this spring, are nonbinding and represent no formal action on either spending or taxes. But a final budget serves as the framework for later spending and tax decisions and as a policy manifesto for the majority party. Click above for full article.

Power shutoff settlement in Michigan could help the needy, elderly

3/13: The following is from a March 12th Kalamazoo Gazette report: Hundreds of needy families and elderly people could benefit from a pending settlement between the state of Michigan and the power company that shut off the electricity to the home of a 90-year-old Vicksburg woman, who died of hypothermia in December. Indiana Michigan Power has agreed to pay $127,250, to be split equally between the South County Community Services and the local Area Agency on Aging, under a proposed settlement before the Michigan Public Service Commission. The social service agencies will use the money to help needy residents with basic living expenses, including their energy bills. "I am never speechless, and I am speechless," Mary Howard, director of South County Community Services, said of the settlement Tuesday. The nonprofit group's budget for utility and housing assistance last year was $13,000. It provided relief to 331 households, she said. "Now, I would know what it's like to win the lottery," Howard said. The power company is offering to pay the money rather face a fine of $11,100, company spokesman David Mayne said. Asked why the company agreed to pay so much more money to the social-service organizations, Mayne pointed to the settlement agreement, which says, "These agencies are best equipped to make sure that assistance is there when it is needed, and that money will go to a better use than would payment of a fine." The sum represents $1 per customer, according to the agreement, which was filed Friday with the commission. The settlement also states that it is not an admission of liability by the company. The three-member commission is not expected to rule on the settlement until next month, Mayne said. But, he added, "I guess you could say that's a formality." Commission spokeswoman Judy Palnau said the payment was "an innovative and unique way" of handling the situation. The company had acknowledged it failed to properly contact Phyllis Willett before shutting off her power Dec. 13. She was found by a social worker four days later and died of hypothermia on Dec. 21. Click above to access the news story.

Republican Lawmakers Join Push for Additional Medicare Advantage Plan Marketing Regulations

3/13: The following is from a March 11th Kaiser Network Daily Update: House Ways and Means Committee ranking member Jim McCrery (R-La.) and Health Subcommittee ranking member Dave Camp (R-Mich.) have begun to collect signatures from committee Republicans for a letter to CMS to request increased regulations on marketing of private Medicare Advantage plans, CongressDaily reports. According to CongressDaily, the letter, which "comes on the heels of reports" of improper marketing of MA plans, "completes the square of agreement" among House Ways and Means Committee and Senate Finance Committee leaders about the need for increased regulations. The letter includes some of the same requests made last week to the Senate Finance Committee by America's Health Insurance Plans, such as a prohibition on the use of cold calls to market MA plans and offers of prizes or other incentives for beneficiaries who enroll. In addition, the letter asked CMS to consider regulations that would allow Medicare beneficiaries to decide to disenroll from MA plans within 10 days of enrollment. The letter also asked CMS to consider the establishment of a public database that contains information about MA plans and sales agents who agency officials have sanctioned for improper marketing practices. According to Republican aides, the letter seeks to determine whether legislative action is needed to address improper marketing of MA plans. Most Senate Finance Committee members believe that legislative action is needed, CongressDaily reports. House and Senate lawmakers likely will include increased regulations on marketing of MA plans in broader Medicare legislation expected in June. To access the full Kaiser news note, click above.

Mediating Elder-Care Disputes

3/12: The following is from a March 2nd article from the Wall Street Journal online edition: It's hard enough for families to navigate the complicated and emotionally charged decisions related to elder care when everyone gets along. Throw in a family with tensions or outright hostility and it's no wonder that disagreements sometimes end up in court, an expensive proposition that can easily magnify divisions. Another way to handle these problems is growing in popularity: mediation. A mediator is sometimes brought in at the order of a judge seeking to settle a dispute without taking it to a jury. But elder-care practitioners are urging more families to take the step voluntarily, especially in disputes over how to handle guardianship for family members who can no longer care for themselves. ... The basic idea behind mediation is that a dispute is resolved through an agreement among the parties, instead of a resolution mandated by a judge or negotiated by attorneys. The role of the mediator -- usually an attorney or someone with a background in social work -- is to facilitate communication and informed decision making. The cost of mediation varies around the country. In big metropolitan areas, it can easily cost $300 to $500 an hour, although it's possible to find dispute resolution centers that are significantly less expensive. Robert Rhudy, a former legal-aid attorney turned mediator, has championed the use of the practice to resolve elder-care disputes in Maryland. "In mediation, everybody who is affected by the situation has an opportunity, in a neutral and confidential setting, to tell their story," he says. Whenever possible, that includes the elderly family member. ... The mediation process for elder-care decisions can -- and most say, should -- bring in experts such as social workers, estate-planning specialists and health-care professionals who would typically be called upon as part of a court case. "The courts will recognize the same issues....It's just that you avoid the expense" of litigation, says Joseph Mahon, an estate-planning attorney in New Jersey (who isn't also a mediator). One challenge facing families looking for mediation help is that there is no formal licensing or credentialing for elder-care mediators, notes James Bergman, a co-director at the Center for Social Gerontology, an Ann Arbor, Mich., nonprofit group that has been a longtime advocate of elder mediation. "Anyone can hang a shingle out and say they're an elder mediator," he says. But there are plenty of experienced mediators, so it's largely a matter of tracking down those with experience in the area and, importantly, a mediator the parties feel comfortable with. To access the full article, click above.

Around the U.S., High Courts Follow California's Lead

3/12: The following is from a March 11th column by Adam Liptak in the NY Times: The California Supreme Court is the most influential state court in the nation. That's not just talk. The numbers back it up. A new study counted up the number of times the decisions of state high courts were followed in other states -- in other words, how often one state's decision played a direct role in shaping a decision elsewhere. That sort of citation analysis is a common measure of influence, and there is a cottage industry of rankings for judges, law professors, law reviews, law faculties and the like. According to the study, published in December in the University of California, Davis, Law Review, the California Supreme Court won by a landslide. In the 65 years ending in 2005, more than 24,000 state high court cases have been followed at least once. California leads with 1,260 decisions. Washington is next, with 942, and Colorado is third, with 848. New York comes in 10th and is only about half as influential as California, with 627 followed cases. The Kentucky Supreme Court is the least influential high court in the nation, with 177 cases. The median was 453. California also leads nationally if only cases followed three or more times are counted. The same goes for cases followed five or more times. In each category, California beats New York handily, by 160 to 39 for three or more followed cases and by 45 to 6 for five or more. The race has tightened a little, though, in the last 20 years. ... But the study's methodology seems smart and hard to quarrel with. The authors of the study did not merely add up the raw number of citations, given that the mere citation of a decision says nothing about whether the citing judge found it to be well reasoned or persuasive. Sometimes courts cite decisions in order to criticize them. Sometimes they mention cases in passing. But, as all litigation associates know from late nights and bitter experience, a service called Shepard's characterizes citations. Decisions may be, for instance, "overruled," "criticized," "questioned," "limited" or "explained." (Woe be to the associate who fails to discover that a partner's brief is premised on a decision that has been overruled.) The study counted only citations designated "followed" by Shepard's. The designation is used relatively rarely and only for "controlling or persuasive authority," meaning that the cited decision played a substantial role in shaping the later decision. A manual Shepard's provides to the lawyers who work for it says that the "followed" designation should be used only if the citing decision "contains language beyond a 'mere going-along' with the cited case." California's victory thus seems authentic. What drove it? Judge Michael A. Wolff of the Missouri Supreme Court said the nature of the California Supreme Court's jurisprudence and the state's legal culture might have played a role in the study's findings. Click above for the full column.

Bill Would Give Federal Retirees Partial Pay for Unused Sick Leave

3/11: The following is from a March 11th Washington Post article: A majority of federal employees would be able to cash out part of their unused sick leave at retirement under a bill introduced yesterday by Rep. James P. Moran Jr. (D-Va.). The employees are covered by the Federal Employees Retirement System, which has a use-it-or-lose it requirement for sick leave -- a policy, Moran said, that encourages people to call in sick in the months before they retire. The abuse is probably costing taxpayers $68 million a year, Moran said, citing an estimate from the Office of Personnel Management. Congress created FERS, as the system is known, to restructure federal retirement benefits. It covers those hired since 1983, now about three-quarters of the workforce. Most of the remaining employees are in the older Civil Service Retirement System, which is being phased out. Employees covered by the older system can convert unused sick leave at retirement into credits that increase their pension. FERS does not include a sick-leave benefit. When FERS was created, Congress sought to make it roughly equal in value to the old system in other ways. For example, though FERS does not offer a sick-leave credit, it does provide matching contributions to the Thrift Savings Plan, a 401(k)-type program. But the differences in the retirement systems seem to encourage FERS employees to use more sick leave. FERS employees eligible to retire used nearly 35 percent more sick leave than comparable employees in the older system, according to a study released last year by the Congressional Research Service. To access the full article, click above.

HUD BUDGET CONTAINS MAJOR FUNDING SHORTFALLS: Congress Needs to Add $6.5 Billion to Administration’s Request to Avoid Cuts In Assistance for Low-Income Families

3/10: The following is from a March 5th Center on Budget and Policy Priorities analysis: Last year, Congress rejected deep cuts the Administration proposed in affordable housing and community development programs and funded the Department of Housing and Urban Development at $2.1 billion above the Administration's budget request for 2008. For 2009, Congress will have to provide a substantially larger increase -- totaling $6.5 billion above the Administration’s request -- to avoid cuts in core programs that help millions of low-income families secure decent housing at affordable rents. There are two primary reasons why. First, Congress can no longer rely on large recaptures of unspent funds from the "Section 8" programs to finance HUD programs. For most of the past decade, Congress and the Administration have used roughly $2 billion per year in unspent balances in Section 8 program accounts to help finance the current costs of HUD programs, thereby reducing the amount of new funding required. Such large recaptures will not be available in 2009 (and probably not in subsequent years, either). As a result, Congress will have to provide an increase of $2 billion in budget authority in 2009 simply to maintain funding for HUD programs at the nominal (pre-inflation) 2008 levels. Second, the President's budget fails to provide funding increases in HUD's three main rental assistance programs needed to prevent cuts in assistance to low-income families now being served. To access the full analysis, click above.

Legal Needs of Older Floridians: A 2006 Survey

3/7: This 2007 AARP publication, prepared by Erica L. Dinger, AARP Knowledge Management, reports results from the 2006 Florida legal needs study. The 62-page report provides data on the legal needs and concerns of older Floridians that include healthcare coverage, housing issues, hurricane repair, and consumer issues. Conducted in October through December 2006, surveys were mailed to 13,000 Floridians. Persons age 60 and older with incomes below $30,000 a year were targeted, and an over-sample of Hispanic Floridians was drawn. The response rate was 29%, with over 3,750 surveys returned. A demographic profile of respondents is included in the report, and annotated questionnaires for the entire sample and for the Hispanic respondents are included as appendices. We have now placed a link to the survey on the TCSG web site. To access a copy of this report in pdf, please click above.

New Generation Gap as Older Addicts Seek Help

3/6: The following is from a March 6th NY Times report: All is peaceful and orderly on the older adult unit at Hanley Center [in West Palm Beach, Florida], where substance abusers over the age of 55 are spared the noisy swagger of addicts half their age across the campus. In their separate oasis, alcoholics and prescription drug abusers of a certain age do not curse at one another, raise their voices in anger or blast music at midnight. They don't brag about their macho pasts or stage drama-queen breakups on the communal pay phone. They show up on time for therapy groups. "We have different health issues, different emotional issues, different grief issues," said Patrick Gallagher, 66, who was treated here for a dual addiction to pain medication and alcohol. "We need more peace and quiet and a different pace." Across the country, substance abuse centers are reaching out to older addicts whose numbers are growing and who have historically been ignored. There are now residential and outpatient clinics dedicated to those over 50, special counselors just for them at clinics that serve all ages, and screenings at centers for older Americans and physicians' offices to identify older people unaware of their risk. Addiction specialists and organizations for the elderly anticipate a tidal wave of baby boomers needing help for addictions, often for different substances and with different attitudes toward treatment than the generation that came before them. Federal data shows the shifting demographics: In 2005, 184,400 Americans who were admitted to drug treatment programs -- roughly 10 percent of the total -- were over 50, up from 143,000, or 8 percent of the total, in 2001. The same report, by the Substance Abuse and Mental Health Services Administration, foresees 4.4 million older substance abusers by 2020, compared with 1.7 million in 2001 -- numbers that are "likely to swamp the current system," said Deborah Trunzo, who coordinates research for the agency. ... Alcohol remains the dominant problem for both groups, although that is changing quickly. Among patients over 65, 76 percent abuse alcohol; many have allowed social drinking to get out of hand after the isolation of retirement or loss of a spouse. In the 50-to-54 age group, by contrast, 55 percent cite alcohol, followed by opiates, cocaine, marijuana and methamphetamines. Prescription drug abuse is climbing in both groups, led by anti-anxiety drugs like Xanax and pain-killers like Oxycontin. Ms. Colleran said prescription drug abuse among the "old old" was usually accidental. They have faith that anything a doctor prescribes must be safe, she said. In the younger group, these medications are knowingly abused, experts said, by buying them online or borrowing from friends. For the full article, click above.

Tapping Into Homes Can Be Pitfall for the Elderly

3/3: The following is from a March 2nd NY Times article: Erika Baker was 67 years old, divorced and worried about her job when a saleswoman showed up at her door in late 2006. A reverse mortgage, the saleswoman explained, would give Ms. Baker instant access to hundreds of thousands of dollars tied up in the value of her home. Such a loan, typically available only to homeowners in their 60s and older, would not have to be repaid until Ms. Baker moved out, the saleswoman said. And if she never moved, the loan would be settled by selling her house after she died. "Your Home Pays You Cash!" read a brochure the saleswoman left behind. Ms. Baker, who lives just outside San Diego, jumped at the offer, borrowing a little more than $200,000 through a company called Senior American Funding. Then the problems began. The saleswoman pressured her to put the proceeds of the loan into complex investments that put her money out of reach, Ms. Baker said. She received only about $33,000 in cash, far less than she needed for her final years. "I thought this was a safe way to make sure I'd never run out of money," Ms. Baker said. "Then everything became so confusing. No matter where I turned for help, it seemed like things got worse." As the United States has become an older nation, reverse mortgages have grown into a $20-billion-a-year industry, with elderly homeowners taking out more than 132,000 such loans in 2007, an increase of more than 270 percent from two years earlier. In surveys, many borrowers say reverse mortgages have improved their lives and provided money they needed for retirement. But hundreds of people who have sought reverse mortgages -- in lawsuits, surveys and conversations with elder-care advocates -- have complained about high-pressure or unethical sales tactics they say steered them toward loans with very high fees. Some say they were tricked into putting proceeds of their loans into unprofitable investments, while sales agents pocketed rich commissions. "Every scam artist is getting into this business," said Prescott Cole, an elder-care advocate who has worked with numerous reverse mortgage borrowers. "Because reverse mortgages are so complicated and give you money up front, years can pass before a senior realizes they've lost everything." Reverse mortgage lenders and brokers dispute those accusations, noting that the loans are heavily regulated and have helped hundreds of thousands of people. ... A survey released last year by AARP, formerly known as the American Association of Retired Persons, of more than 1,500 reverse mortgage borrowers found that almost one in 10 were urged to buy other financial products, like annuities. Click above for full article.

New York attorneys & Governor Spitzer clash over control of state IOLA legal services fund

3/3: The following is from a Feb. 19th Poughkeepsie Jounral report: A bitter dispute about who should control a $25 million state fund that helps to pay for legal representation of poor people has broken out, with the board that now controls the fund fighting Gov. Eliot Spitzer's proposal that he hold the reins. On Tuesday [Feb. 19th], several people prominent in the legal community sent a letter to Spitzer, the legislative leaders and Chief Judge Judith Kaye asking Spitzer to drop his plan. As part of the new state budget, Spitzer has proposed that he be given the power to appoint the staff of what is known as IOLA (Interest on Legal Accounts), a 25-year-old state entity that uses interest on such accounts to help pay for legal aid for the poor. The money is earned on accounts too small or banked for too short a time to generate interest for clients. The cash is meant to subsidize payments from taxpayers for legal services for the poor. The decision on how to divvy up the money rests with the board, which now also has the power to hire and fire staff members. Spitzer's plan would give himself power over the staff. "The bill is a direct threat to the independence of IOLA and, indirectly, to the independence of its grantees who are providing legal services to low-income New Yorkers," the letter said. The letter was signed by eight people who are well known in the legal community, including Evan Davis, counsel to former Gov. Mario Cuomo, Justin Vigdor, a Rochester attorney who was the first chairman of the IOLA board in 1983, and Victor Kovner, chairman of the Committee for Modern Courts, a reform group. "The letter signed by the three past chairs of the IOLA Board and other bar leaders points out the clear conflict of interest and chilling effect which will be created if the Governor controls the grants going to agencies which often engage in litigation against the governor," said William Nojay, a Rochester attorney who was the IOLA chairman until last summer, when Spitzer named Edwin Lopez-Soto of Rochester, who was a legal-aid attorney for 22 years, as his replacement. (The board positions are unpaid.) "When IOLA was established, it was set up so no political or governmental interests had control over it – it's a balanced board," said Nojay, a Republican who was named to the board by then-Gov. George Pataki. "It has been as close as you can get in Albany to being a non-political governmental body. But what the governor has been trying to do since last spring is take control of the organization." There was no immediate explanation from Spitzer Tuesday on why he wants the additional power. Spokesman Errol Cockfield said late Tuesday that the governor had not yet received the letter from the lawyers. No current board members signed the letter, but Lopez-Soto said Tuesday all of the people now on the board feel the same way. "The goal of the board to keep the independence of the organization," he said. "We'd like the governor to withdraw his proposal. The board is unanimous on that." Click above to access the full news story.

Rep. Obey Says Congress Will Wait for Next Administration if Bush Officials Refuse To