Each week the Secretary of Pennsylvania Department of Aging, Brian M. Duke, releases a Friday newsletter with information relevant to activities, issues and events for older Pennsylvanians and persons with disabilities across the Commonwealth.
The Australian Website, The Conversation, featured this interesting infographic showing “how Australia’s health expenditure, access to care and health outcomes compare with seven other Organization for Economic and Cooperative Development (OECD) countries.” It’s interesting for Americans, too.
By Laura Dillon | 21st Century Media
“Nelson and Mary Walter, a couple from Berks County, found love through their involvement with a fitness program called SilverSneakers.
“Their story inspired a nomination for the Richard L. Swanson Award, a national fitness award given through the SilverSneakers program. The couple, now in the Top 10, await the final result of the vote.
“SilverSneakers is a nationwide fitness program for seniors and is owned by a well-being improvement company called Healthways. The program offers free gym access and classes to those who are insured through Medicare.
“Dori Nugent, Group Fitness Director for Valhalla Health and Fitness Studio in Exeter, explained that classes are one hour and consist of cardio and weight training.”
The Centers for Medicare & Medicaid Services Commits to Effective Communication for All Individuals with Disabilities in All of Its Programs
The Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) in the U.S. Department of Health and Human Services have entered into an agreement to ensure that individuals with disabilities can access information provided by CMS and its contractors in CMS programs. The agreement resolves two complaints filed with OCR by a national disability rights advocacy organization, the Disability Rights Education and Defense Fund (DREDF), on behalf of two named complainants participating in the Medicare Program and other Medicare consumers who are blind or have low vision and who need accessible information in Medicare communications. The complaints were filed under Section 504 of the Rehabilitation Act, which prohibits discrimination on the basis of disability in federally assisted and federally conducted programs.
Following an investigation and discussions with CMS about the issues raised in the DREDF complaints and the broader issues of accessibility across CMS programs, OCR and CMS jointly developed an expanded approach to address these issues. These discussions resulted in a comprehensive “Commitment to Action” that resolves the underlying issues raised in DREDF’s complaints about access for individuals who are blind or have low vision in the Medicare program and further encompasses all individuals with disabilities and all CMS programs and CMS contractors. The agreement requires that CMS expeditiously implement a process for responding to all requests for auxiliary aids and services relating to communications between staff and beneficiaries of CMS programs and provide widespread notice of this process. In consultation with OCR, CMS will also engage in a self-evaluation of its compliance with Section 504 and will establish a longer term comprehensive approach to ensuring effective communication with CMS consumers and beneficiaries with disabilities within prescribed timelines. Completion of the action steps in the timeframes specified in the Commitment to Action will ensure that all CMS programs are in compliance with Section 504 with respect to the issues investigated in these complaints as well as proactively address any issues in other CMS communications with other individuals with disabilities. A copy of the signed Commitment to Action can be found at http://www.hhs.gov/ocr/civilrights/activities/agreements/cms.html. OCR will continue to closely work with CMS in implementation of the Commitment to Action.
OCR enforces multiple civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age, sex, and religion by health care and human service providers. When OCR determines that there has been a violation of the law, OCR initially seeks voluntary compliance and provides technical assistance to health care and human service providers. OCR also has the authority to seek remedies as necessary in the event of noncompliance.
To learn more about non-discrimination and health information privacy laws and your civil rights and privacy rights in health care and human service settings, as well as find information on filing a complaint, visit us at http://www.hhs.gov/ocr/office.
The United States Census Bureau has compiled a data filled report on the over 65 population; this report is largely based on 2010 census data and can be very useful for resource providers of this demographic set. Click on the graphic to download the report.
Here are some of the highlights from this study.
- In 2010, Alzheimer’s disease was the fifth leading cause of death among the older population, up from seventh position in 2000. In contrast to declining mortality from most other causes of death, the death rate for Alzheimer’s rose more than 50 percent from 1999 to 2007.
- Over 38 percent of those aged 65 and over had one or more disabilities in 2010, with the most common difficulties being walking, climbing stairs, and doing errands alone.
- The share of the older population residing in skilled nursing facilities declined from 4.5 percent in 2000 to 3.1 percent in 2010. The share in other long-term care facilities, such as assisted living, has been growing.
- Medicaid funds for long-term care have been shifting away from nursing homes with funding for home- and community based services increasing from 13 percent of total funding in 1990 to 43 percent in 2007.
“For me, the charm of this is the simplicity of the device,” Stephen Quake says. “Glaucoma is a substantial issue in human health. It’s critical to catch things before they go off the rails, because once you go off, you can go blind. If patients could monitor themselves frequently, you might see an improvement in treatments.” (Credit: Abe Kleinfeld/Flickr)
“Lowering a patient’s internal eye pressure is currently the only way to treat glaucoma. A tiny eye implant paired with a smart phone could help doctors measure and lower eye pressure.
“For the 2.2 million Americans battling glaucoma, the main course of action for staving off blindness involves weekly visits to eye specialists who monitor—and control—increasing pressure within the eye.
“Now, a tiny eye implant could enable patients to take more frequent readings from the comfort of home. Daily or hourly measurements of eye pressure could help doctors tailor more effective treatment plans.”
Corbett Announces Historic Approval of New Healthy Pennsylvania Program: PA-Specific Plan Will Reform Medicaid, Protect Taxpayers and Increase Access to Private Market Coverage
Harrisburg – Governor Tom Corbett today made an historic announcement that the state has secured agreement with the federal government to implement the portion of his Healthy Pennsylvania plan that will improve and bring financial stability to the state’s Medicaid program so that the state can increase access to quality, affordable health care through the private insurance market.
“From the beginning, I said we needed a plan that was created in Pennsylvania for Pennsylvania − a plan that would allow us to reform a financially unsustainable Medicaid program and increase access to health care for eligible individuals through the private market,” Corbett said.
In order to make the necessary changes to the state’s health care system, the Corbett Administration requested over the past year a waiver and associated state plan amendments from the federal government, which were then modified based on a comprehensive public comment process across the state. Public input included seven public hearings and two webinars statewide with more than 1,000 attendees and 170 live testimonies. The waiver was officially submitted to the U.S. Department of Health and Human Services on Feb. 19.
“Health care is not a one-size-fits-all issue; the governor’s Healthy Pennsylvania plan meets the needs of Pennsylvania,” Pennsylvania Department of Public Welfare (DPW) Secretary Beverly Mackereth said. “Governor Corbett is the first governor to tackle much-needed Medicaid reforms since the program’s creation, with the goal of protecting Pennsylvania taxpayers and looking ahead to maintain a safety net for those who most need public assistance.”
The Healthy Pennsylvania agreement includes two parts: reforming the current Medicaid program and offering the Healthy PA Private Coverage Option (PCO) for eligible Pennsylvanians.
The Healthy Pennsylvania plan focuses on personal responsibility and healthy behaviors; aligning benefits to match health care needs; promoting financial independence through access to job training and employment resources; and increasing access to private, commercial coverage for eligible Pennsylvanians.
Medicaid costs account for 29 percent of the state’s general fund budget and have been growing at an average rate of 3 percent – more than $400 million – each year. Governor Corbett has been clear that he would not expand Medicaid because it is an unsustainable entitlement program. Instead, the Corbett Administration sought common-sense reforms to the Medicaid program.
As part of the approved waiver, the Healthy Pennsylvania PCO will be created to increase access to health care through the private, commercial market for more than 600,000 eligible Pennsylvanians. This will help to reduce bureaucracy by relying on commercial insurance carriers and offer more provider options to recipients. Currently, nine insurers have applied as providers of the Healthy Pennsylvania PCO, offering a minimum of two insurer options in each region of the state. Enrollment is expected to begin Dec. 1.
Healthy PA PCO and Medicaid Reform Innovations
Both components of the plan include these four innovations:
Alignment with Private, Commercial Health Care Benefits:
The current Medicaid program will change from 14 benefit plans into “low risk” and “high risk” benefit packages that include essential health benefits and meet standards for mental health and drug and alcohol coverage uniformity. This change will better tailor health care benefits to the needs of the different populations served in the program.
A new, innovative commercial benefit plan will be offered under the Healthy PA PCO to the more than 600,000 eligible Pennsylvanians.
- Encouraging Employment:
The Encouraging Employment program will assist low-income, able bodied Pennsylvanians to improve overall health and well-being and move out of poverty. Pennsylvania is the first state to advance an incentivized employment program to reduce health care cost sharing.
- Cost Sharing:
To encourage personal responsibility, individuals enrolled in the Healthy PA PCO and Medicaid program will participate in cost sharing:
- Year One: Eligible individuals will pay the same Medicaid copayments that exist today.
- Year Two: Eligible individuals with incomes greater than 100 percent of the Federal Poverty Level (FPL), unless otherwise exempt, will be required to pay 2 percent of their income toward a monthly premium. Current copayments will be eliminated. An $8 copayment for non-emergency use of the emergency room will be introduced. Individuals who do not pay premiums for more than 90 days will be disenrolled, with limited exemptions from premiums for individuals meeting certain criteria.
- Cost-Sharing Reductions:
Individuals in the Healthy PA PCO and Medicaid program will have the opportunity to reduce their cost-sharing obligations by engaging in certain healthy behaviors.
Medicaid participants and Healthy PA PCO enrollees will be able to reduce their health care cost-sharing obligations through job training and work-related activities, with each participant receiving assistance to do so from a Healthy PA Career Coach.
Paying cost-sharing amounts in a timely fashion and having an annual wellness visit in the first year of the program will allow for cost-sharing reductions in the second year. In future years, completion of approved healthy behaviors will continue the cost-sharing reduction and will be reassessed every 6 months.
The Healthy Pennsylvania plan supports independence for all Pennsylvanians, utilizes the private health care market, and increases health care choices for consumers – all without expanding an entitlement program,” Corbett said. “This is truly a Pennsylvania solution.”
The Healthy Pennsylvania Private Coverage Option is contingent upon continued funding from the federal government.
Prioritizing Primary Prevention – Innovative Financing Mechanisms and Successful Community Partnerships
Wednesday, September 3, 1:00 – 2:30 pm Eastern Time
Community-based organizations and anti-drug coalitions promote the wellbeing of their communities. Primary prevention activities are important components of an overall strategy for wellbeing. However, challenges to funding, implementation, and sustainability of primary prevention interventions can be barriers to successful prevention efforts. This webinar is designed for community-based organizations and anti-drug coalitions. The webinar will present the challenges and solutions for funding primary prevention and examples of community organizations that have sustainable programs and partnerships. New opportunities from the Affordable Care Act and some innovative funding from private investors will be highlighted.
Two examples of successful coalitions and community partnerships will be presented. In Maine, the Five Town Communities that Care coalition has diversified its funding and become a major driver of community change. The Mental Health Association in Tulsa has developed a partnership with local schools to promote screening and early intervention. Both models will provide participants with concrete steps to take in their communities to work with other stakeholders to implement mental, emotional, and behavioral (MEB) prevention.
This webinar is aimed at community level stakeholders who are interested in primary prevention, including community-based advocacy organizations, anti-drug and other coalitions, local government (e.g., public health departments, school personnel), and civic and religious groups. The information may also be of interest to researchers, state and federal level stakeholders, and others who are concerned with promoting individual, family, and community wellbeing.
Presenters: Fran Harding, Director, Center for Substance Abuse Prevention; David L. Shern, PhD, Mental Health America; Sarah M. Steverman, PhD, MSW, University of Denver; D. Max Crowley, PhD, Duke University, Center for Child and Family Policy; Dalene Dutton, MS, Five Town Communities that Care, Maine; Michael Brose, MSW, Mental Health Association of Oklahoma
Can’t make it? The recording and slides will be available on the MHA website shortly after the presentation.
This article alerting readers to E-Z PASS scams appeared in The Washington Post on July 9.
Be on guard, two copies of this email (below) were received at this writer’s email account. Be skeptical of any email you concerning your E-Z Pass account.