In a few days Democrats in the U.S. House of Representatives will introduce a bill which, if enacted, will provide important protections for Medicare recipients. The Children’s Health and Medicare Protection Act started out as a bill designed to expand insurance coverage nationwide for low-income children. Republicans in the Senate Finance Committee voted last week with Democrats to approve that bill which would provide financing for health insurance for all low-income children by raising cigarette taxes.

Democrats have announced that they will attempt to push through an expanded version of the bill, which would reverse the free ride that private Medicare plans currently enjoy at elder tax payers' expense. In 1997, the Republican Congress passed a law allowing seniors to replace traditional Medicare health coverage with enrollment in a fee-for-service health insurance plan. Congress actually pays these private plans - called Medicare Advantage Plans – huge subsidies, paying 19% more on average per senior than for the same services under traditional Medicare. No wonder Medicare is scheduled to go broke!

Not only do these plans get higher reimbursement rates from the government than services provided under traditional Medicare, these Medicare Advantage plans often have much larger co-pays for hospital stays, home health aides, nursing home stays and prescription drug plans than traditional Medicare does. Seniors often don’t realize that there are higher co-pays until they get the hospital or other bill, and by then it is too late. (See Elder Advocacy Blog: "Government Subsidizes Insurance Companies Who Push Private Fee-For-Service Medicare Plans On Unwary Seniors" May 8, 2007).

The bill proposed by Democrats would prohibit private Medicare plans from charging higher co-pays than traditional Medicare, and would give State insurance commissioners power to regulate marketing of these private plans to Medicare recipients. The bill also contains provisions to eliminate the outrageous government subsidies given to these private plans.

To gain the support of physicians, Democrats have shrewdly added provisions that would block cuts in Medicare payments to physicians. That was evidently enough to prompt the American Medical Association to join with AARP in endorsing the bill. Olay!

Bush was quoted as saying that the bill is a step "down the path to government-run health care for every American." All I can say is, "I HOPE SO."

Needless to say, insurance companies are up in arms against the bill. The insurance and tobacco industries are pulling out all stops to block this bill, and they know they can count on President Bush to veto it. These Medicare Advantage plans have received a lot of well-deserved negative publicity, however, and Republicans will be under pressure to vote for the bill.

Do your part, and contact your Representatives in Congress and the Senate and urge them to support the Children’s Health and Medicare Protection Act.

The information in this entry came from a July 23, 2007 front page article of the New York Times. To read the article, click here.

Click here for email addresses and phone numbers for your representatives.


Felicia Curran
www.ElderAdvocacyLaw.com

California is considering legislation prohibiting employment discrimination against individuals with caregiving responsibility for aging parents, children, or ill spouses.

The proposed law is based on evidence that employees with caregiving responsibilities are often passed over for jobs, dinged on performance reviews or blocked from promotions. Some employers assume they would be absent more frequently and won't work as hard or be as committed to their careers as those without caregiving duties.

California law expressly bars job discrimination on the basis of sex and marital status, among other factors, but not caregiving. Federal law requires employers to accommodate the needs of disabled workers and grant employees leave to care for sick or disabled relatives. But no federal statute expressly forbids job discrimination on the basis of an individual's caregiving status.

"Today’s families are under enough pressure,” said Senator Sheila Kuehl, sponsor of the legislation, SB 836. “No one should have to worry about losing their job just because they are taking care of their family.”

Alaska and nine cities and counties, including Atlanta, Chicago and Washington, have passed similar legislation. Lawmakers in Pennsylvania and New York are also considering such measures.

SB 836, would amend the Fair Employment and Housing Act to prohibit employment discrimination based on familial caregiving status, extending that protection to parents and to employees with an ill or disabled parent or spouse. It is scheduled for a vote in the Senate Appropriations Committee today.

To contact your state representatives in support of the bill, go to www.leginfo.ca.gov.

*
Felicia Curran
www.ElderAdvocacyLaw.com

A colleague in our firm recently asked me if I could tell her how she could check the track record of a residential care facility that her father has moved to. The short answer is, “Realistically, you can't.”

California Residential care facilities for the elderly (RCFEs) are licensed by the California Department of Social Services Community Care Licensing Division, Senior Care Program Offices (“DSS” for short). As part of its oversight responsibilities, DSS investigates complaints made on behalf of residents, conducts surprise inspections, generates reports, and issues citations and fines to facilities who are caught violating the licensing regulations. DSS investigates so infrequently, and sometimes so ineffectively, that many bad facilities dodge the bullet and have a clean licensing file. So if DSS has actually cited or fined a facility, or found the facility to be in violation of regulations relating to resident’s rights or resident’s care, that is something you should know about before your loved one goes to live there. Department of Social Services does not post any of this vital information on the web. The only information they post is name, license number, and number of beds. To see their website,

click here

This is a typical entry from the DSS website, for a RCFE in Albany:

Facility No: 015600285 Capacity: 0013
License Status: Licensed
RN3 LOVING CARE HOME
906 CORNELL AVENUE
ALBANY , CA 94706
(510) 526-2533
Contact: CHENG, FANGJUAN
DO: CENTRAL COAST SC/RES (14)
DO Phone: (650) 266-8800

I have no personal information about the RN3 Loving Care Home, and the point is that neither will you, just by looking at the DSS website. But you should. The only way to access the DSS information now is to go to one of the 5 DSS Senior Care Program Offices around the State (Rohnert Park, San Bruno, Woodland Hills, San Diego, and Sacramento). That’s not reasonable access to this vital public information.

Posting of citations, fines, and evaluation reports for each facility would alert unsuspecting family members about that facility, and could actually force a change for the better in how these facilities care for their residents. The New York Times recently had an article about a new website put up by the U.S. Department of Health and Human Services

www.hospitalcompare.hhs.gov.

The website says that it “provides information on how well the hospitals in cities across the country care for all their adult patients with certain medical conditions, on a comparative basis.” The New York Times article described how in the year preceding the launching of this website, several prominent hospitals actually improved their performance in key aspects of their patient care for the reason that the hospitals knew that their ”score cards” would soon be on the web for all to see. The hospitals were candid in admitting that the prospective posting of the data on the website actually spurred them to improve performance.

RCFEs, like the hospitals listed on the www.hospitalcompare.hhs.gov website, would very likely do a better job for their elderly residents if they knew their track record would be there on the web for all to see. There is no excuse for hiding this information from California residents and their families.

Contact Ben Partington, Program Administrator at the DSS Sacramento Office, 744 P Street, MS 10-90 Sacrament, CA 95814, fax (916) 653-9335 and Governor Schwarzenegger (click here) and let them know what you think.


Felicia Curran
www.ElderAdvocacyLaw.com