NORC Gazette
February 7, 2003
National Long Term Care
Ombudsman Resource Center
National Citizens’ Coalition
for Nursing Home Reform
Table
of Contents
Ombudsman Program Updates
1. Indiana Ombudsman
Program works to increase PNA
2. Hawaii
volunteer ombudsman program highlighted in Honolulu
Star Bulletin
3. WI ombudsmen develop family councils in
troubled homes
Ombudsman Calendar of Events
Home and Community-Based Care/Olmstead
4. IN seniors, advocates rally for
long-term care reform
5. 2003 Systems Change conference to be held
Nursing Home News
6. OK bill would improve oral health of nursing home residents
7. Nursing home tax enacted in Massachusetts
8. AAHSA study targets pressure sores
Assisted Living
9. NJ study to look at why
residents leave assisted living
10. WI group hopes to provide
assisted living for its county residents
11. DCA hires first executive director
Medicare
12. Advocates urge Congress to extend QI-1
13. Medicare to stop outreach, educational activities
14. The end of
Medicaid as we know it?
15. In-depth guidebook on Medicaid now
available
Medicaid Cuts
16. Oregon nursing home
residents facing eviction under Medicaid cuts
DC Doins’
17. Comment online!
18. Elder Justice Coalition forming
19. Bill would focus on
insurers to reduce malpractice premiums
20. Senate Aging Committee to hold hearing on
guardianship issues
Other News
21. Renowned advocate for older
minority Americans dies
Ombudsman Program Updates
1. Indiana Ombudsman Program works to increase PNA
The Indiana Ombudsman Program, in conjunction with other advocacy groups, is trying to get legislation passed that would increase the personal needs allowance (PNA) for nursing home residents to $78. Currently, the PNA is $52. The bill would also annually adjust the amount for inflation instead of relying on legislators to periodically increase it. State Ombudsman Arlene Franklin testified in support of the bill at a hearing held in late January. Local ombudsmen contacted nursing homes to get staff and residents to contact members of the Ways and Means Committee or to send petitions supporting this increase. The bill passed out of committee, but faces opposition from the governor’s office which states that the legislation would increase state spending on Medicaid. Source: Indianapolis Star, 1/22/03
2. Hawaii volunteer ombudsman
program highlighted in Honolulu Star
Bulletin
An article in the Honolulu Star Bulletin describes the development and growth of the volunteer ombudsman program under the leadership of State Ombudsman John G. McDermott. McDermott, volunteer coordinator Bobbie Kucera, clerical assistant Mika Arikawa and others have spent several years setting up Hawaii’s program. Since January 2002, 23 "certified" volunteers on Oahu have been trained, and McDermott hopes to have volunteers on all the Neighbor Islands by the end of this year. The long-term statewide goal is to have 700 volunteers visiting the 8,400 residents in all 46 nursing homes, 5 assisted living facilities and 560 adult residential care homes. McDermott notes that the program needs more volunteers. “We have so many people who don’t have anybody visiting, who can’t defend themselves, who have no access to a private phone. Who are they going to complain to?” Source: Honolulu Star Bulletin, 1/30/03
3. WI ombudsmen develop family councils in
troubled homes
For approximately the past two years, Wisconsin ombudsmen have worked with families to create councils as a way to assist in turning around problem nursing homes. According to Claudia Stine, director of ombudsman program services in the Wisconsin Board on Aging and Long Term Care, whenever the program identifies a facility that may be in line for closure due to poor care, the local ombudsman meets with families in the facility. The purpose of the meetings is to: help families understand the problems in the facility based on survey reports; discuss what individual family members can do to keep their loved one safe; and inform families about the role they can play in improving conditions in the home. Stine notes that the idea is to show families that they are powerful as a group and can make a difference. The turnaround in care at The Oshkosh Medical and Rehabilitation Center is a case in point. The facility had been on track for decertification. With the help of local ombudsman, Carol Kriemelmeyer, a family council was started at the facility. An article in the Oshkosh Northwestern reports that families believe that this council, along with new management, are resulting in “substantial improvements in residents’ lives.” For more information about this initiative, contact Claudia Stine at (608) 246-7010 or claudia.stine@ltc.state.wi.us Source: Interview with Claudia Stine, 1/24/03; Oshkosh Northwestern, 1/23/03
Ombudsman Calendar of Events
February 10, 2003: Conference call for "new" state
ombudsman (open to all state ombudsmen) on effective communication with local
ombudsman programs. For more
information contact Julie Meashey at 202-332-2275.
February 21, 2003: Conference call sponsored by the Citizens' Advocacy Center and NORC on Pain Management for local and state ombudsmen., 3:00 p.m. EST. RSVP to John Kafka at jkafka@nccnhr.org or 202-332-2275 by Feb. 7th. Limited to 75 people.
February 26-28, 2003: Region IV Ombudsman Conference, Louisville, KY. Open to long-term care ombudsmen in Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Registration ended Jan. 30th. For more information contact Julie Meashey at jmeashey@nccnhr.org or 202-332-2275.
March 13 - 16, 2003: Joint Conference sponsored by American Society on Aging and National Council on Aging, Chicago, Illinois; Sheraton Hotel and Towers. http://www.agingconference.org/jc03/index.cfm
April 12, 2003 (morning): New State Ombudsman Training, Chicago, IL. Contact Alice Hedt for details, ahedt@nccnhr.org
April 12 - 15, 2003: State Ombudsman Spring Conference, Chicago, Illinois. Note: dates are tentative. For details contact Mark Miller at mmiller@nasua.org
October 5 - 11, 2003: Residents' Rights Week - Start planning now. Send your ideas to Julie Meashey at jmeashey@nccnhr.org
October 15-18, 2003: NALC Conference, Arlington, VA; details forthcoming.
October 18 - 21, 2003: NCCNHR Annual Meeting, Arlington, VA; Have ideas for sessions that would be useful for ombudsmen? Contact Alice Hedt at ahedt@nccnhr.org
Home and Community-Based Care/Olmstead
4. IN seniors, advocates rally for long-term care reform
Approximately 600 seniors and advocates, many with signs stating “There’s no place like home,” rallied at the Indiana Statehouse on January 29 to support changes in Indiana’s long-term care system. Participants at the rally urged legislators to pass Senate Bill 493 which would require the state to develop a home - and community-based long-term care service program that makes home and community care as available as nursing home care. It would also raise the income eligibility for Medicaid. The bill is patterned after a similar program in Washington State, which has a comparable population of senior citizens, but spends far more than Indiana on home health care. Source: South Bend Tribune, 1/30/03; Louisville Courier Journal, 1/22/03
5. 2003 Systems Change conference to be held
An upcoming conference sponsored by the Centers for Medicare & Medicaid Services (CMS) is being held to highlight and support work that is being done across the country as part of the federal government’s New Freedom Initiative. Entitled “Living and Working in the Community 2003,” the conference is designed to assist the efforts of current Systems Change and Ticket to Work grantees, showcase New Freedom Initiative activities across Departments, inform advocates, showcase important CMS initiatives and introduce new CMS funding emphases. For more information about the conference, which will be held March 4-5, 2003 in Baltimore, Maryland visit:
www.nashp.org/cmsconference2003/
Source: Home and Community Based Resource Network website, www.hcbs.org/new.htm
Nursing Home News
6. OK bill would improve oral health of nursing home residents
Oklahoma lawmakers are considering a bill that would boost long-term care residents’ access to oral health services. House Bill 1445 would allow licensed dental hygienists to provide services under the supervision of a dentist in nursing homes, public health facilities, group homes or residential care facilities, penal institutions, schools, colleges and even a patient’s private residence. Current law allows hygiene services only in dental offices or in hospitals. Former Governor Frank Keating vetoed a similar measure last year because it did not mandate a dentist’s supervision. Source: SNALF.com, 1/29/03
7. Nursing home tax enacted in Massachusetts
To boost Medicaid funding for its nursing homes, the state of Massachusetts has enacted a nursing home user fee. The tax, about $9.60 per day or $3,504 per year, will be levied on the estimated 8,000 nursing home patients who pay for their own care, and it will generate an estimated $145 million per year. The state will use $130 million from the tax for its share of increased Medicaid reimbursements to nursing homes, with an equal amount coming from federal matching payments. The tax was created at the request of the nursing home industry. Opponents of the tax contend it penalizes people who have purchased long-term care insurance or who are using savings to pay for nursing home care. The federal government has yet to approve the tax. However, Massachusetts officials are not anticipating problems with approval since nearly 20 other states have a similar tax. Many of the state’s nursing homes have already begun collecting the tax. Source: Kaiser Daily Health Report, 1/28/03
8. AAHSA study targets pressure sores
The research arm of the American Association of Homes and Services for the Aging (AAHSA) is launching a project designed to reduce the incidence of pressure sores in long-term care facilities. The Institute for the Future of Aging Services (IFAS) is undertaking the study along with the Institute for Clinical Outcomes Research in Salt Lake City. The project is one in a series of “Partnerships for Quality” initiatives funded by the federal Agency for Healthcare Research and Quality. According to Dr. Robyn Stone, IFAS executive director, “Selected AAHSA members will become test sites, and the results will feed into the national quality improvement efforts currently underway through quality improvement organizations across the country.” Source: SNALF.com, 1/29/03
Assisted Living
9. NJ study to look at why residents leave assisted living
The
Rutgers Center for State Health Policy in New Jersey is conducting a study to
identify the factors that increase the likelihood that residents will move out
of assisted living. The Center will
interview assisted living residents on the state’s Medicaid Waiver program and
survey the assisted living facilities serving the individuals to determine
facility characteristics. Interviews
will include questions such as, “Is the individual still in assisted living? Was there a move to another setting? Has the individual died? If a transition
occurred, what factors prompted the move?
What factors such as client characteristics, hospital admissions,
facility characteristics impact the individual’s ability to remain in the
assisted living setting?” The analysis
will focus on client characteristics and particular facility characteristics
related to aging in place. In addition,
departures from assisted living in New Jersey will be compared with a national
study of assisted living residents by Phillips, Hawes, Spry and Rose
(2000). Source: National Center for
Assisted Living (NCAL) Assisted Living News, January 2003
10. WI group hopes to provide assisted living for its
county residents
A group of concerned individuals in Burlington, Wisconsin plans to build an assisted living home for Racine County residents who are currently being sent to facilities outside the county due to the closing of at least two community long-term care homes. Two facilities that had previously provided shelter for needy, dependent residents with subsidies from Social Security and state and county subsidies have closed, leaving a void of 95 beds. The group, called the Burlington Supportive Living Group, aims to replace at least a fifth of those beds by building a new facility funded by a foundation the group hopes to start. The group has said that separating many lifetime members of the community from loved ones and systems of support is “unacceptable.” Source: Journal Times, 1/30/03
Staffing
11. DCA hires first executive director
The Direct Care Alliance (DCA) has
hired Patsy Teal to become its first executive director. Teal has more than 12 years of experience in
management, consulting, and programming and has participated in economic and workforce
development initiatives in the Austin, Texas area. The DCA is a national coalition of long-term care consumers,
direct-care workers, and concerned health care providers working for
broad-based reforms, within both public policy and industry practice, to ensure
a stable, valued, and well-trained direct-care workforce. For more information, go to http://click.topica.com/maaaNzDaaVz9sbbWbsCb/
Source: National Clearinghouse on the Direct Care Workforce, 1/27/03
Medicare
12. Advocates urge Congress to extend QI-1
The Medicare Savings Program QI-1 (Qualifying Individual-1) will expire on March 12, 2003 without immediate Congressional action. More than 120,000 low-income seniors and disabled Americans are currently enrolled in the program. QIP is one of three programs designed to help low-income seniors pay their Medicare and Medicaid premiums. The QI-1 program pays for the $58.70 monthly Part B premium and would save enrollees over $700 in health care costs in 2003. “Unless Congress acts now, over 100,000 more elderly Americans will be choosing between medicine and food come March,” said Medicare Rights Center President Robert Hayes. U.S. Senator Jeff Bingaman (D-NM) is seeking to introduce an amendment to an appropriations bill to extend QI-1. Source: MRC Flash, 1/24/03; SNFinfo Connection, 1/27/03
13. Medicare to stop outreach, educational activities
Because of budget concerns, Medicare contractors have been ordered by officials at the Centers for Medicare & Medicaid Services (CMS) to end educational services to Medicare beneficiaries. Education services include informing beneficiaries of new benefits and advising them on issues such as appealing a denied claim, selecting a nursing home, obtaining prescription drug discounts, reporting Medicare fraud and addressing overcharging by a physician or hospital. Such services are usually provided through newsletters and in-person visits to health fairs, hospitals and senior centers. Contractors will continue to answer telephone calls and written inquiries from beneficiaries. Source: Kaiser Daily Health Report, 1/27/03
Medicaid
14. The end of Medicaid as we
know it?
The Bush administration has proposed fundamental changes in Medicaid
that would give states vast new power to reduce, eliminate or increase benefits
for millions of low-income people, including many who are elderly or
disabled. The proposal would do away
with federal rules that now apply to one-third of all Medicaid recipients and
two-thirds of all Medicaid spending.
Tommy G. Thompson, the Secretary of the U.S. Department of Health and
Human services, said states would have “carte blanche” to alter Medicaid
coverage for these recipients. The
administration proposal would preserve comprehensive Medicaid benefits for
welfare recipients, poor children and certain other groups who are
automatically eligible for Medicaid under current law. But Thompson said that states could alter
Medicaid benefits for other recipients.
For example, states could charge higher co-payments to some
beneficiaries, cut benefits in some counties and set different eligibility
criteria in various parts of a state.
Democratic members of Congress and advocates for the poor denounced the
proposal, which is subject to approval by Congress. For the full New York Times news story and the Washington Post
story, go to http://www.tcsg.org/newslsd.htm
(see February 1 note). The Committee on
Energy and Commerce has scheduled a hearing for Thursday, February 6, 2003 to
focus on some of the challenges facing the Medicaid Program. Source: ABA Elderbar listserve, 2/1/03; NORC
email, 1/31/03
15. In-depth guidebook on
Medicaid now available
The Kaiser Commission on Medicaid and the Uninsured has released a
new reference book describing the eligibility, benefits, financing, and
administration of the Medicaid program.
The book also includes a legislative history of the Medicaid program and
a listing of Internet resources. The
guide can be accessed by going to: http://www.kff.org/content/2003/2236
and through the Ombudsman Resource Center website at http://www.ltcombudsman.org/ombpublic/49_265_3081.CFM
Medicaid Cuts
16. Oregon nursing home residents facing eviction under Medicaid cuts
The state of Oregon is implementing deep cuts in its Medicaid program that will affect thousands of Oregonians, including residents of long-term care facilities. The state is eliminating long-term care services for 9,000 older adults and people with disabilities, a quarter of the total who are served. For 2,573 people living in adult care homes, assisted living or nursing homes, the cuts mean they also lose the roofs over the heads. The federal government must sign off on some Medicaid-related cuts, but state officials said they chose reductions that would require the least federal approval. Federal officials still are examining Oregon’s cuts, but a spokeswoman for the Center for Medicare & Medicaid Services said that “Oregon’s proposals to actually remove people from nursing homes and long-term care centers is the most severe we’ve received so far.” The effect on nursing home residents will be compounded by cuts to the Medicaid rate paid to nursing homes. Both industry leaders and state officials acknowledge that the twin impact of client and rate cuts will force many centers to close. Source: The Oregonian, 1/31/03
17. Comment online!
The federal government has launched a new online rulemaking website where you can find, review, and submit comments on federal documents that are open for comment and published in the Federal Register. The “E-Rulemaking” initiative is designed to make the federal rulemaking process more accessible to the public. The site is http://www.regulations.gov. Source: AHA News, 1/24/03
18. Elder Justice Coalition forming - Hearing - Feb.
10th
An Elder Justice Coalition is being created to promote the Elder Justice Act that will be reintroduced in Congress this month. The Coalition consists of national, state and local organizations as well as individuals. Both the National Citizens’ Coalition for Nursing Home Reform (NCCNHR) and the National Association of State Long-Term Care Ombudsman Programs (NASOP) have signed on as Coalition members. Coalition activities will include: expanding the list of the bill’s co-sponsors; identifying and approaching a House sponsor; and working for expedited action on the bill in the Senate Finance Committee. For more information, contact Amy Hooper in the office of the National Committee for the Prevention of Elder Abuse at 202-682-4140 or by email at ncpea@erols.com. Source: NORC email, 1/31/03
19. Bill would focus on insurers to reduce malpractice
premiums
U.S. Senators Patrick Leahy (D-VT), Richard Durbin (D-IL), Edward Kennedy (D-MA), and John Edwards (D-NC) are sponsoring legislation that would eliminate insurers’ exemption from federal antitrust laws. The Medical Malpractice Insurance Antitrust Act of 2003 seeks to prevent medical malpractice insurers from driving up doctors’ premiums by engaging in price fixing, bid rigging or market allocations. In a letter to colleagues, the senators wrote that the antitrust exemption allows insurers to “collude to set rates, resulting in higher premiums than true competition would achieve - and because of the exemption, enforcement officials cannot investigate any such collusion.” The measure differs from other recent proposals that have attempted to address malpractice issues by limiting lawsuits and damage awards. Source: SNALF.com, 1/27/03
20. Senate Aging Committee to hold hearing
on guardianship issues
The U.S. Senate Special Committee on Aging will hold an
investigative hearing on the misuse of guardianships/conservatorships over the
elderly on February 11, 2003. The
hearing will enhance general public awareness and educate seniors on the potential
misuses of guardianship as a means of asserting undue control over the
decision-making autonomy of the elderly, and subsequent abuses once the
guardianship is imposed. The hearing
will impress upon seniors the necessity of prior planning for incapacity and
outline the alternatives to guardianship.
The featured testimony will be the Plaintiff and her Attorney in the
Mollie Orshansky case. A number of
other witnesses with expertise in the area will also testify. Source: ABA Elderbar listserve, 1/27/03
21. Renowned advocate for older minority Americans dies
Advocates around the country are mourning the loss of Sam Simmons, the president of the National Caucus and Center on Black Aged, Inc. who died on January 12th. Mr. Simmons was a passionate and strong advocate for many issues that impacted older Blacks and other minorities and endlessly championed for employment, housing, and affordable quality health care for the most vulnerable in our society. Until his death, Mr. Simmons remained actively engaged in handling agency business and issuing the “Call For Action” to address critical issues that eliminate disparities and improve the quality of life for older Americans, especially low-income elderly Blacks. Source: ABA Elderbar listserve, 1/24/03
This publication of the National Ombudsman
Resource Center (NORC), at the National Citizens' Coalition for Nursing Home
Reform, updates State and Local LTC Ombudsmen on the latest information,
resources, ideas, and practices in the full range of long-term health care.
The Gazette is organized for your easy reading. Information is grouped by
topics (Ombudsman Program Updates,
Nursing Home News, Assisted Living, Staffing, etc) and numbered.
You can quickly see if any articles are of interest and immediately go to
those articles.
In order to get this info to you ASAP, there is little to no additional
verification work or search of resources.
The information comes from a number of sources including the Washington Post,
the New York Times, and two daily listservices. (one from the Kaiser Family
Foundation and the American Hospital Association) and other sources happened
upon by NORC staff and consultants. To start a subscription to AHA News
Now, send a message from your subscribing e-mail address listserv@ahals.aha.org
and write in the message area: subscribe ahanewsnow. Please submit suggestions
for improvement or information to Robyn Grant, NORC consultant, at robyngrant@comcast.net.
The National Long Term Care Ombudsman Resource
Center provides technical assistance and support to state and local long term
care ombudsman programs. This summary was supported, in part, by a grant,
No. 90AM2139, from the Administration on Aging, Department of Health and Human
Services. Grantees undertaking projects under government sponsorship are
encouraged to express freely their findings and conclusions. Points of
view or opinions do not, therefore, necessarily represent official
Administration on Aging policy.
For more information contact the National Long
Term Care Ombudsman Resource Center, at (202) 332-2275 or ombudcenter@nccnhr.org