Medical Assistance Amendment Gives People with Mobility Impairments Greater Access to their Communities
Pennsylvania’s Department of Human Services (DHS) has amended the state’s Medical Assistance plan to cover removable medical equipment for children and adults with mobility impairments. Removable medical equipment is necessary to the health and wellbeing of individuals with disabilities as it can support activities of daily living and help an individual enter or exit their home, facilitating greater engagement with their community.
The new coverage is part of a settlement in a class-action lawsuit filed by Disability Rights Pennsylvania on behalf of a class of children in the state’s Medical Assistance program. The plaintiff class alleged that DHS violated the Social Security Act by denying requests for removable medical equipment. Further, the suit alleged that DHS failed to inform the plaintiff class of the availability of such equipment under Medicaid and even led youth, hospitals, equipment vendors, families, advocates, and others to believe that such devices were not covered. As detailed in the resulting settlement, the state’s Medical Assistance plan has updated the definition of covered home health services to explicitly include wheelchair lifts, ceiling lifts, stair glides, metal accessibility ramps, and other such equipment that can be reused and removed without damage to the item.
The amendments, which are applicable to all Medical Assistance recipients regardless of age, have been approved by the Centers for Medicare and Medicaid Services (CMS) for coverage retroactive to April 1, 2020. Considering this, PHLP encourages individuals who have previously applied for and been denied removable medical equipment to reapply for approval with an updated letter of medical necessity from their physician. For those who denied after April 1, 2020 but have since paid out-of-pocket for removable medical equipment, this amendment may open the door for individuals to submit a claim for reimbursement from the state.
While this update increases access to necessary devices for individuals with mobility impairments, there are still gaps in coverage. Although the update includes coverage for certain elements of the installation process of these devices, the Pennsylvania Medical Assistance program does not cover home modifications outside of waiver services. This means that when a structural change to the home, like electrical updates or demolition of existing structures, is required for proper installation of removable medical equipment the beneficiary will have to pay for that service as separate from the installation.
For more information on the new Medical Assistance coverage and questions about how to apply for removable medical equipment, please call PHLP’s Helpline at 1-800-274-3258 or email us at staff@phlp.org.
For more information about the lawsuit and settlement agreement, contact Disability Rights Pennsylvania by calling 1-800-692-7443, Option 6, or sending an email to equipment@disabilityrightspa.org.
ACL Policy Update: What the Changes in the “Public Charge” Immigration Rule Mean for the Aging and Disability Networks
July 30, 2021
Summary: Earlier this year, the Department of Homeland Security (DHS) rescinded the “public charge” rule implemented in 2019. This means that receiving or applying for most Medicaid benefits, public housing, or nutrition assistance are no longer grounds for denying an individual seeking a visa to come to the United States or to become a lawful permanent resident. Services provided through ACL’s programs, and medical treatment or preventive services for COVID-19, including vaccinations, also will not count against people seeking legal entry to the country.
Background
The “public charge” doctrine allows U.S. immigration officials to bar a person from getting a visa or becoming a lawful permanent resident if they are determined to be likely to become a “public charge,” meaning a person who is likely to primarily rely on the government for assistance. This long-standing policy was put into immigration law in the 1990s. In 1999, Interim Field Guidance clarified that this policy applies only to immigrants likely to become dependent on direct cash assistance, like Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF), or to individuals who rely on Medicaid-financed “long-term institutionalization,” such as a nursing or psychiatric facility.
The Trump administration issued a new public charge rule in 2019 to significantly expand the policy to include anyone who lawfully used virtually any public benefit for more than 12 cumulative months over any 36-month period. For example, enrollment in Medicaid for acute medical care or for home and community-based services (not just institutional care), or receiving housing or nutrition assistance, could all be used to designate a person as a “public charge” and deny them a visa or permanent legal residency.
What Changed
One of the first executive orders issued by President Biden directly addressed immigrant access to public benefits and the public charge rule. Implementation of the order caused a series of actions by DHS and the Department of Justice that ultimately resulted in the 2019 rule being removed from the Code of Federal Regulations, and DHS announced in March that it would revert to 1999 Interim Field Guidance.
In an April letter to interagency partners, the U.S. Citizenship and Immigration Services also stated that “medical treatment or preventive services for COVID-19, including vaccinations, will not be considered for public charge purposes. This policy will help ensure that noncitizens are able to access important government services for which they may be eligible.”
Recently, the Centers for Medicare and Medicaid Services issued an informational bulletin reminding state Medicaid agencies that they may not share information with immigration officials about an person’s Medicaid coverage (or application) for the purposes of a public charge determination.
Looking Ahead
The 2019 Public Charge Rule had a chilling effect on immigrants accessing benefits to which they are legally entitled – research has shown that immigrant families have avoided both programs specified in the 2019 rule and those outside the rule for fear of immigration-related consequences. It created particularly devastating consequences for older adults and people with disabilities, who often rely on Medicaid to stay healthy and to live in their communities. That’s why sharing information about the changes is so critical.
As trusted messengers in your communities, the aging and disability networks have a particularly important role to play in dispelling fear and confusion. Please help spread the word that using public benefits to which people are entitled (with the longstanding exception of cash assistance and Medicaid-funded institutional care) will not adversely affect the immigration status of older adults and people with disabilities.
We will continue to keep you updated about policy changes like this one as they arise.
Grant Opportunity for Agencies Working with Children
Kiwanis Club of Lebanon, PA is currently accepting applications for their Community Grant program. Awards are granted to those that help kids in our community.
Applications are due August 8, 2021
https://files.ctctusercontent.com/49d4573a001/ceb2afbf-0c9f-4ab1-900c-f37e821b9edb.pdf?rdr=true
“3 tips for preventing heat stroke” – The Conversation
“Heat stroke is when a person’s core body temperature rises too high – often more than 104 F (40 C) – because high environmental temperatures and humidity prevent the body from cooling itself through sweating and breathing.”
by Gabriel Neal
“As a primary care physician who often treats patients with heat-related illnesses, I know all too well how heat waves create spikes in hospitalizations and deaths related to ‘severe nonexertional hyperthermia,’ or what most people call ‘heat stroke.’
“Heat stroke is when a person’s core body temperature rises too high – often more than 104 F (40 C) – because high environmental temperatures and humidity prevent the body from cooling itself through sweating and breathing. As heat stroke develops, a patient experiences rapid heart rate, ragged breathing, dizziness, nausea, muscle cramps and confusion. Eventually the patient may lose consciousness entirely.
“Without medical intervention, heat stroke is often fatal. On average, about 658 Americans die each year from heat stroke, according to the Centers for Disease Control and Prevention.
“Victims of heat stroke can be any age, but most often it strikes the elderly –”
Continue reading this article at The Conversation – click here.
“Former addict shares message of hope after college graduation: ‘Stop selling yourself short'” – Today.com
“Virginia Burton spent most of her life in and out of jail. In May, she graduated from the University of Washington after receiving a scholarship in 2020.”
“How about that for motivation? I honestly thought I’d die on a park bench with a needle in my arm or by gunshot to the head. I would’ve never in a million years thought my life would look the way it does today.
“Stop selling yourself short. You don’t know what tomorrow might bring so you might consider starting today.” #wedorecover #dudeicantevenbelieveit
by Rachel Paula Abrahamson
“Virginia “Ginny” Burton was 6 years old when she was introduced to marijuana by her drug-addicted mother. At the age of 12, she was using crystal meth. By 14, Burton, a student in an accelerated learning program, had dropped out of school and was smoking crack.
“’I went from being a really sweet kid to an angry and aggressive one,’ Burton, 48, told TODAY Health. ‘I didn’t want to be in a classroom. I just wanted to get high.’
“Burton found herself bouncing from one juvenile detention facility to the next. By 2012, Burton, a mom of three, was homeless, addicted to heroin and had served multiple prison sentences. Her children were taken away.
“’My kids would grab my ankles when I went into the kitchen because that’s where I smoked crack,’ Burton revealed. ‘My life was a nightmare.’
“But it’s not anymore.”
Click here to read this absolutely fascinating and riveting article in its entirety at today.com.
New name for APPRISE: Pennsylvania Medicare Education and Decision Insight, PA (MEDI)
Effective July 1, 2021, APPRISE is now Pennsylvania Medicare Education and Decision Insight, PA MEDI – Same Program, Same Services for Pennsylvania’s Medicare Beneficiaries, now with a New Name.
Pennsylvania Medicare Education and Decision Insight (PA MEDI) offers free Medicare counseling to older Pennsylvanians. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance.
PA MEDI Counselors do not sell Medicare products but rather offer current, non-biased Medicare education to help you make the most informed choice about the Medicare options available to you.
Read more about the name change here.
“Calming Computer Jitters: Help for Seniors Who Aren’t Tech-Savvy” – Kaiser Health Network
by Judith Graham
“Six months ago, Cindy Sanders, 68, bought a computer so she could learn how to email and have Zoom chats with her great-grandchildren.
“It’s still sitting in a box, unopened.
“’I didn’t know how to set it up or how to get help,’ said Sanders, who lives in Philadelphia and has been extremely careful during the coronavirus pandemic.
“Like Sanders, millions of older adults are newly motivated to get online and participate in digital offerings after being shut inside, hoping to avoid the virus, for more than a year. But many need assistance and aren’t sure where to get it.
“A recent survey from AARP, conducted in September and October, highlights the quandary. It found that older adults boosted technology purchases during the pandemic but more than half (54%) said they needed a better grasp of the devices they’d acquired. Nearly 4 in 10 people (37%) admitted they weren’t confident about using these technologies.”
Continue reading this article at KHN, click here.
Generations on Line’s Katie Burke has presented at Link Service Area 13 cross-training meetings in each of the Service Area’s counties; she’s also facilitated a Link Webinar earlier this year.
Click here to visit the Generations on Line Website for much more about its services.
“Join the Pennsylvania Department of Aging (PDA) and the Department of Military and Veterans Affairs (DMVA) in raising awareness about scams and exploitation involving veteran benefits.”
There are nearly 800,000 veterans in Pennsylvania and over half of them are age 60 and older.
Veterans may be eligible for a wide array of benefits from both the Pennsylvania Department of Military and Veterans Affairs (DMVA) and the U.S. Department of Veterans Affairs (commonly referred to as the VA). One such benefit is a VA pension.
Unfortunately, there are unscrupulous people who are preying on veterans, particularly older veterans, to profit from their desire to apply for the benefits they earned while defending our country and our freedoms.
Free and safe assistance is available to help veterans and their beneficiaries apply for veteran benefits, including VA pension. PDA and DMVA want to team up with you to help raise awareness of this issue in your community. Together we can reduce the likelihood of scams, fraud and exploitation against our veterans and their benefits!
Click here:
What to Know About Veteran Pension Poaching
“What it feels like to live with Parkinson’s? – The New York Times
By Steven Heller and Véronique Vienne. Illustrations by Christoph Niemann.
“Steven Heller, 70, has lived with Parkinson’s for more than 10 years. Véronique Vienne, 79, only recently learned that she had the disease. Both have had long careers as art directors, and the two have been friends for more than three decades. Back in March, the pair exchanged a flurry of emails over a 10-day period, where they explored the “before” and “after” of a Parkinson’s diagnosis. Here is an edited version of their conversation.”
Click here to read this New York Times article in its entirety.
Download this special report | “Building Bridges: Suicide Prevention Dialogue with Consumers and Survivors: From Pain to Promise”
Click here to download this report – The focus of this report is on sharing the concerns and recommendations of people who have direct personal experience with suicide, particularly those who have attempted suicide and those who have lost a loved one to suicide.
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