Age-Friendly Communities Conference Coming on March 11th

There’s a nationwide effort to encourage towns and cities to develop initiatives and programs that will make their communities more “age-friendly,” to encourage people to remain a part of the local community as they get on in years. Community initiatives have included outdoor upgrades such as better lighting, more benches, and better crosswalks, as well as expanded senior centers, broader library services, inter-generational local events and ventures, and expanded transportation options. The Grotta Fund for Senior Care and the Taub Foundation are co-sponsoring  the 2020 Age-Friendly Communities Conference for professionals and lay volunteers who are involved with — or want to get involved with — these efforts. The event will take place March 11th in Whippany, NJ. You can read more about it, and register, HERE.  Professional CLE credits will be available.

Click here to learn more about age-friendly initiatives. In fact, it isn’t just going on in the USA — the World health Organization has identified “age friendly” as a major important goal for communities around the world. Take a look.

Aging in place involves a partnership between people and local government, and people and their families or trusted support network. There are a variety of sources people can turn to, for help in assembling the team and making sure that structures are in place to enable them to age in place — geriatric care managers (aging & life care specialists), interior designers and contractors who can make a home more age-friendly, elder law attorneys, financial advisors, and visiting nurse services, to name just a few.

For advice about elder care and senior planning, call us at …… 732-382-6070

Medicaid Stakeholders Attend the Big MAAC

New Jersey FamilyCare’s Medicaid program has many components that serve different population groups of people who are aged, disabled or poor. Did you know that there is a Medical Assistance Advisory Committee (MACC) which meets regularly and is required to hold quarterly public forums? On February 5th, along with other members of New Jersey NAELA, I attended the first MAAC (Medical Assistance Advisory Committee) meeting of the year.  MAAC meets quarterly outside of Trenton to discuss issues related to Medicaid and to take stakeholder input. It was quite a lively meeting.

In the audience there were attorneys, non-profit advocates, members of County Boards of Social Services, representatives of the Medicaid Managed Care Organizations and several Medicaid enrollees.  Here are some of the issues discussed  at the meeting:

— implementation of S499 and how that relates to denials of Medicaid applications for failure to provide certain information;

— Transitioning Medicaid/ MLTSS  recipients from a nursing home to a home in the community and how to assure continuity of care when the person switches from one program to the other;

— reductions in Private Duty Nursing and Personal Care Assistant (home health aide) hours for certain enrollees;

— how enrollees transition from one way of having Medicaid eligibility to another.

— an update on the Coronavirus, and many other topics.

I asked questions and expressed concern about how the State was implementing S499’s provision about giving extensions to applicants to obtain documentation.  I also commented on the importance of planning ahead for Medicare eligibility when a Medicaid recipient is eligible under the ACA.

Stakeholders at the meeting have a chance to ask questions of the state officials who are responsible for the Medicaid program, and they also have a chance to make recommendations for future MAAC meeting presentations.  If you have a concern about the Medicaid program in New Jersey, consider attending these meetings, or bringing them to the attention of your elder law attorney or another organization who can bring the concern to the MAAC.

Call us for advice on medicaid eligibility planning, applications and appeals ……… 732-382-6070

Hearing Monday in Trenton on Social Isolation and Age-Friendly communities

New Jersey is working on efforts to encourage municipalities to become “age-friendly communities.” Age Friendly is spreading across the country, with interesting initiatives in many places. Take a look at South Orange-Maplewood, Chatham, and Elizabeth for starters. Looking for volunteer opportunities? Contact your Mayor — you may be able to get involved with those initiatives or help to jump-start a new process. Age-friendly is an approach to community development that looks at the impact on seniors of a community’s physical space, transportation, recreation opportunities, public building access, access to municipal government and services, housing, etc. etc. and what might be done to improve those systems to make it more feasible for people to “age in place.”

Two new bills will be introduced to the NJ legislature which addressing key issues concerning older adults.  Click here to read the text

https://www.njleg.state.nj.us/2018/Bills/AR/246_I1.PDF

 https://www.njleg.state.nj.us/2018/Bills/A9999/5314_I1.PDF

 A-246 is a Resolution co-sponsored by Assemblyman Herb Conway and Assemblyman Wayne DeAngelo that urges New Jersey counties and municipalities to take the steps necessary to be accepted into the AARP network of age-friendly communities as defined by the World health organization.

A-5314 requires the Commissioner of the Human Senior Services “within 180 days and biennially thereafter” to assess and report to the Legislature on the state of social isolation in New Jersey as if affects individuals who are over 65, have disabilities, are suffering with mental illness, or are otherwise vulnerable. The bill marks a recognition that extreme social isolation is a problem in the State which adversely affects many citizens and might be alleviated if better understood and tackled. The report must also include recommendations for strategies to counter this problem. 

The Committee hearing will take place Monday morning May 19th at 10 am in the Committee Room 11, 4th Floor, State House Annex, Trenton.

If these issues are of interest to you, contact your Legislators, and read more here.

 

Planning for a good old age involves looking at a wide array of issues, and each person’s situation is unique. Call us for individualized elder care legal planning …. 732-382-6070

Will Medicare ever pay for nursing home care?

Consumers of health care in old age likely consider nursing home care to be part of the continuum of health care that a patient may require. Yet health insurance plans do not pay for nursing home care because it isn’t defined as “treatment.”  Instead, it is classified as long-term care rather than “health care,” because the care is maintaining the individual and not really treating-to-improve a chronic or permanent health condition.

The 2017 Long-Term Care trends poll of the Associated Press-NORC Center for Public Affairs Research Survey revealed that more than half of those polled believe that Medicare and health insurance companies should cover some or all of these costs and that the federal government should be doing more to provide financial support to those who are providing the care in the home setting. This was the survey’s finding among those who identified as Republican as well as those who identified as Democrat.

A bill to start addressing an aspect of this issue was introduced in Congress by Sen. Orrin G. Hatch, R-UT, and is S-870.— “Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017.” So far, the bill has been approved/passed by the full Senate. The Act  is designed to give some Medicare providers additional flexibility in the way they care for people with chronic conditions. This could be a first step toward including chronic, non-improving conditions in the category of “health conditions” for which Medicare dollars could be applied.  Co-sponsors include Ron Wyden (D-OR), Johnny Isakson (R-GA) and John Warner (D-VA). Read the legislation.

If this issue is of interest to you, contact your Representatives.

For advice and representation on nursing home care planning and challenges, contact us at …… 732-382-6070

Section 8 housing rules for live-in caregivers

Did you know that if a person with physical or cognitive disabilities resides in section 8 funded HUD housing, the law requires the Public Housing Agency (PHA) to allow a necessary home health aide to reside with the tenant? The concept is that the PHA is required to make a reasonable accommodation for the tenant’s needs pursuant to the Americans with Disabilities Act, to enable the participating tenant to reap full benefit from this federal housing program to enable them to dwell in the community and avoid nursing home placement. The regulation is in surprisingly plain English:

             “24 USC § 982.316 Live-in aide. (a) A family that consists of one or more elderly, near-elderly or disabled persons may request that the PHA approve a live-in aide to reside in the unit and provide necessary supportive services for a family member who is a person with disabilities. The PHA must approve a live-in aide if needed as a reasonable accommodation in accordance with 24 CFR part 8 to make the program accessible to and usable by the family member with a disability. (See § 982.402(b)(6) concerning effect of live-in aide on family unit size.)”

Normally, the income of other occupants of the apartment will be counted in the household income calculation for Section 8. However, if the person resides there because s/he serves as the live-in aide, his/her income is not counted. The criteria for exclusion of that person’s income are in the federal regulations and are basically that (1) the aide’s services are essential to the care and well being of the person(s); (2) the aide is not under a legal obligation to support the person(s) with the disabilities, and (3) the aide would not be living in the unit except to provide the necessary supportive services. The tenant needs to formally request the accommodation by submitting an application to the PHA. The tenant who is applying for this special accommodation would need to provide relevant and necessary medical proofs as to the disability and need for a live-in aide, including physicians’; opinion reports, and evidence concerning the identity of the aide and services to be provided. A sample detailed explanation of the requirements for this application are here, from the Georgia Department of Community Affairs.

The person being proposed as the live-in aide must still be eligible to reside in HUD housing based on other federal criteria, but that is a different topic.

Senior care planning involves looking at the opportunities to enable a person to age in place in his or her preferred environment. There are a wide array of legal questions that are relevant to that planning, including the public benefits that might be available.

Call us for advice about planning for senior care …. 732-382-6070