Carmelo Gonzalez News Page 06

New National Support Program For Abused Elders and Adults with Disabilities

(Glendale, WI ¬ July 20, 2005) -- Recognizing the devastation that can stem from being an elder or adult with disabilities who has been abused, neglected, exploited, or self-neglected, the American Society of Adult Abuse Professionals and Survivors (ASAAPS) has launched a new, free, public email Listserve to provide support to victims and their family members and friends. Being the victim of abuse, neglect, fraud, or exploitation can be devastating emotionally, financially, physically, and spiritually. Victims often feel as though their world, their family, their sense of safety, and even their faith in life itself have been permanently broken. ASAAPS¹ Survivors listserve provides a place where people can write about what happened, begin to explore their options, and provide support to others by sharing what they have learned. Topics discussed on the listserve include:
Emotional responses people have to being abused or witnessing the abuse of someone close to you.
Techniques and resources survivors have found useful in coping with what has happened.
Experiences listserve participants have had in working with various services and professionals.
Actions people have taken (or can take) to turn their experiences into positive personal growth and/or community betterment.
How to think through the possible implications of available courses of action.
Whatever else a survivor needs to talk about to feel not as alone in what you have experienced.

Although some protective services, counseling, and other professionals may participate in listserve discussions, the ASAAPS¹ Survivors listserve is designed purely to provide peer-to-peer emotional support, and cannot substitute
for professional legal advice, counseling, or criminal justice services that may be needed to address ongoing or past incidents of abuse, neglect, or exploitation.

To participate in the ASAAPS Survivors¹ listserve, you need to have an email address and access to a computer where you can check for incoming email. Librarians at most public libraries can help you obtain both for free. To find
out more about the listserve or to sign up for it, go to the webpage http://www.ASAAPS.org/aboutus/listserves_sub.php
(http://www.asaaps.org/aboutus/listserves_sub.php) and fill out the form or send an email saying you want to
sign up for the Survivors listserve to listserves@ASAAPS.org

The American Society of Adult Abuse Professionals and Survivors (ASAAPS) networks, supports, and educates people concerned about abuse of elders and adults with disabilities; advocates for the continued improvement of
systems serving adult victims of abuse, neglect, exploitation, and self-neglect; and develops and expands leadership in the field. We make many resources available to the general public as well as to our members; see our website at
http://www.asaaps.org/ for more information or to join.

To print out a flyer on the ASAAPS¹ Survivors listserve that you may give to other victims or distribute to possible referral sources, go to http://www.asaaps.org/docs/survivors_list_flier.pdf

Medicare waiting period leaves over 1.2 million seriously disabled without secure health insurance, USA

17 Jul 2005 - http://www.medicalnewstoday.com/medicalnews.php?newsid=27539#

Over 1.2 million seriously disabled Americans under age 65--including as many as 400,000 without health insurance--are currently in the two-year waiting period for Medicare coverage, according to a new report from The Commonwealth Fund. Eliminating this two-year waiting period would provide stable health insurance to a vulnerable group of adults who are unable to work. Some disabled adults in the waiting period qualify for state Medicaid programs. The report finds that dropping the two-year Medicare wait would save cash-strapped states an estimated $1.8 billion a year in Medicaid costs.

"At a time when Congress is considering major reforms to Medicare they should not forget some of the most vulnerable of all potential beneficiaries--seriously disabled adults who are unable to work," said Karen Davis, president of The Commonwealth Fund. "Individuals in the waiting period for Medicare suffer from a broad range of debilitating diseases and are in urgent need of appropriate medical care to manage their conditions. Eliminating the two-year wait would ensure access to care for those already on the way to Medicare."

Currently, 1.26 million seriously disabled Americans are in the waiting period for Medicare coverage, and as many as one-third of them (400,000) have no health insurance, according to the report, Expanding Health Coverage for Seriously Disabled Adults by Eliminating Medicare's Two-Year Waiting Period, by Stacy Berg Dale and James M. Verdier of Mathematica Policy Research, Inc. These disabled adults under age 65 must first qualify for Social Security Disability benefits by satisfying the work history requirements and proving that they are too disabled to work, wait five months for these benefits to begin, and then wait an additional two years for Medicare. Adults under 65 who qualify for Medicare based on disability suffer from a range of chronic illnesses: more than nine of 10 have one or more chronic diseases including arthritis, heart conditions, lung disease, cancer, and severe mental illness. All are unable to work. By the time they reach Medicare, most (77%) are poor or nearly poor.

Based on reports from several states, the authors estimate that 40 percent of those in the waiting period are enrolled in Medicaid programs, having qualified as disabled and poor. Eliminating the two-year waiting period for Medicare would benefit states by reducing their costs for Medicare-covered services. The report finds that states would save an estimated $1.8 billion per year if the Medicare waiting period were eliminated. Federal Medicaid expenditures for the disabled would also be reduced, by $2.5 billion, offsetting some of the $8.7 billion increase in federal Medicare expenses that would result from the change.

"At a time when states are considering steep cuts in essential services, eliminating this hurdle to Medicare could make a real difference in states' ability to maintain insurance coverage," said Verdier. "Our analysis illustrates that savings could help states maintain Medicaid coverage for children and families or the safety net for elderly and disabled for services not covered by Medicare. If Medicare included prescription drugs, state Medicaid savings could potentially be even greater."

In addition to insuring as many as 400,000 uninsured disabled adults, eliminating Medicare's waiting period would improve the financial security of disabled adults paying high premiums to maintain private coverage after losing jobs due to disability. The report notes that, to the extent that disabled adults rely on coverage through their prior employer or their spouse's employer, eliminating the waiting period would also produce savings to employers who provide this coverage.

Albany Legislative Roundup

Bing Calls on Governor to Sign Emergency Contraception Legislation

Summer Senior Center Tour Begins

Albany Legislative Roundup

In the June update, I discussed the five bills I authored that passed the Assembly this year, including three pieces of legislation that passed both houses of the State Legislature and were on their way to the Governor for his signature. In this issue, I will discuss other important bills that I sponsored that have been signed into law.

I am proud to have been one of the original sponsors last December of Assemblyman Scott Stringer's Assembly rules reform legislation. Many of Assemblyman Stringer's recommendations were adopted by the Assembly, and these changes set the groundwork for significant improvement in the way the legislature functioned this year. As you may be aware, the Legislature passed its first on-time budget in 21 years and a number of significant government reform bills to be discussed below. This is only a beginning, however, and I and my colleagues will continue to work to change the way Albany does business and ensure that the successes we achieved during the 2005 legislative session do not go to waste.

All of the following initiatives passed both houses of the Legislature and have been or are expected to be signed by the Governor:

Elimination of NYC Sales Tax on Clothing:    ends the 4 percent New York City sales tax on clothing under $110 as of September 1, 2005

Expansion of the SCRIE program:    increases income eligibility of the Senior Citizen Rent Increase Exemption program for rent-regulated housing from $24,000 to $29,000 over a five-year period, and allows certain persons with disabilities to qualify for the SCRIE program

Procurement lobbying reform:    expands the definition of lobbying to include any effort to influence the action of public officials regarding procurement of commodities, services or construction

Public authorities reform:    reins in mismanagement of public authorities such as the MTA by creating an inspector general and authority budget office and improving standards for independent audits of authority spending

Ethics reform:    closes loophole that allowed state employees to avoid ethics investigations by resigning their positions

Elections reform:    allows New York State to receive federal money to modernize voting machines, while requiring a voter-verified paper ballot

Identity theft prevention:    requires state agencies, companies or other persons doing business in New York to disclose any security breach of private information to New York State residents

Drug pricing availability:    creates a website that lists drug prices in your local area for easy access and comparison shopping

Hospital infection rates:    requires hospitals to report infection rates and the Health Department to make this information public

Televised coverage of legislature:     implements televising of legislative sessions statewide (currently available only over the Internet)

Bing Calls on Governor to Sign Emergency Contraception Legislation

        On July 22, I participated in a rally held by NOW-NYC in front of Governor Pataki's Manhattan office to call on him to sign the Unintended Pregnancies Act (A. 116) once it reaches his desk. I am a proud sponsor of this legislation because it will give women more control over their reproductive decisions. Under this legislation, a physician would be able to designate certain medical professionals, such as nurses and pharmacists, to dispense emergency contraception over the counter. It is estimated that increased access to emergency contraception could prevent up to half of the unintended pregnancies that occur every year. EC is equivalent to a double dose of a birth control pill, is medically safe, and should be available to women who may need access to it when obtaining an appointment with a doctor is not possible.

Summer Senior Center Tour Begins

        I recently began my yearly tour of the senior centers and residential facilities in my district. I have been a strong advocate for seniors throughout my Assembly career, including sponsoring the SCRIE and drug pricing bills discussed above. I have also authored legislation to develop a statewide funding mechanism for palliative care; exempt social security income from the SCRIE calculation; require HMOs to allow seniors to designate a third party for notification purposes; allow seniors to exempt the first $250,000 of real and personal property from the determination of eligibility for long-term residential care; and require emergency lighting in senior residential facilities.

        During this tour, I will visit St. Peter's Senior Center, James Lenox House, the Stanley Isaacs Community Center, Brown Gardens, and Carnegie East.

For further information, please visit www.Bing2006.com!

Medicaid Hearings

The House Energy and Commerce Subcommittee on Health (June 22) and the Senate Finance Committee (June 28) hearings examined Medicaid drug spending, an area that appears to be a target for legislation. In the Senate hearing, Chairman Charles Grassley (R-IA) estimated that $4 billion could be saved by greater use of generic drugs and changes in the current average wholesale price (AWP) system. He suggested that basing payment on the average sales price (ASP) might be preferable. A U.S. Department of Justice official testified that Medicaid's current pricing mechanisms for prescription drugs are "problematic and subject to manipulation."

The Senate Aging Committee on June 28 looked at "optional" beneficiaries and benefits, people and benefits that states may, but are not required to cover under the Medicaid Act. Diane Rowland, Kaiser Family Foundation, testified that optional populations, most of whom are elderly or people with disabilities, account for 42 percent of all Medicaid spending, of which "70 percent is for 'mandatory' services and 30 percent is for 'optional' services." Patient advocates suggested that many optional services," like prescription drugs, should be considered "mandatory" because they are critical to good health care. On July 20, the Aging Committee held a hearing on "saving money in Medicaid." For the testimony, go to http://aging.senate.gov/public/ and click on "Hearings."

The hearings are in preparation for so called "budget reconciliation" bills, legislation to change the authorizing law to meet an arbitrary spending target. The target in this year's budget will require $10 billion in health care program cuts over five years. It is anticipated that most of that money will come from the Medicaid program, although Medicare could also be looked to for some of the required savings. Authorizing committees are to report this legislation by September 16.

Community-Based LTC - A Comparison, Information Bulletin # 89 (7/05)

For the first time, the FY 2004 Medicaid expenditures compare community based long-term care ("LTC") expenditures by State and by category. What follows is a breakdown and comparison by State.

LTC expenditures are made up of two categories - institutional versus community MA expenditures. For each, there are also two separate subcategories: (1) the MR/DD institutional services include ICF/MR, and the MR/DD community services are MA waivers; (2) for the physically disabled/aged disabled ("PD/AD"), the institutional services are nursing
facilities, and their community based services include waivers, personal care option and home health services.

The organized MR/DD community efforts began years before the PD/AD efforts. As a result, in the same States, the MR/DD category has much higher percentages of MA LTC funds expended in the community than for PD/AD. But the differences are quite stark and offer a great opportunity to equalize the expenditures.

Obviously, the higher the percentages in the community, the more integrated the services. While the MR/DD community deserves loud kudos, the PD/AD communities should ask their Governors to increase the PD/AD percentages in the community to provide equal opportunity to reside in the community.

It is very important to remember that whatever the percentage is for the community-based expenditure, your State is spending the remainder (up to 100%) on institutional services.

What is striking is that only seven states spend more than 50% of their TOTAL LTC (i.e., both MR/DD and PD/AD) on community-based services as opposed to institutional services. However, when one examines only the MR/DD community-based services, then 36 states spend more than 50% of their MR/DD funds in the community; when one examines only AD/PD only 3 States spend more than 50% of their PD/AD community-based services and 47 States spend more to institutionalize persons with PD/AD than they spend to serve these people in the communities.
To find out how well your State is doing overall with regard to community-based expenditures go to http://www.stevegoldada.com/, then click on Medical Assistance/Medicaid. The title at the top of the page is the article you want to link - Community-Based LTC - A Comparison Between PD/MR, #89

WHAT YOU SHOULD DO?
1. Isn't it about time that the PD/AD community organized itself at least to equal the MR/DD percent of MA LTC expenditures in the community?
2. Even though many States have made progress in the last five years to more equalize the community versus institutional MA LTC expenditures, we still have a ways to go. When does your State expect to be above 50% in Chart # 1? Has your State even discussed this as a goal? This is a potential strategy for the PD/AG AND MR/DD groups to work together.
3. As your States continue threatening to and actually reducing MA expenditures, PD/AD advocates should compare Chart #3 with In Informational Bulletin # 88, FY 04 - Medicaid Expenditures Institutional (Nursing Homes) vs. Community-based expenditures - State by State (May, 05), see http://www.stevegoldada.com/ and click on searchable archives. This will give you the dollar amounts behind the percentages. It will also give you ammunition to organize against proposed MA cutbacks.

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