Act now for more funding

Now’s the time for state budget advocacy on a 6% increase in transportation aids for older and disabled people -- and federal advocacy in support of a 10% increase in Older Americans Act (OAA) funding.

This Thursday morning, May 31, is the deadline for asking state legislators to support the 6% increase, according to Gail Sumi of AARP. The Joint Finance Committee is scheduled to vote on transportation aids that morning.

“Call the Legislative Hotline at 1-800-362-9472 during business hours to leave a message or email them – email addresses available at http://www.legis.state.wi.us/.

“This program is a vital service for the people who would otherwise be stranded in their homes.”

Glenna Schumann of CWAG writes to urge calls to our congressmen to increase Older Americans Act (OAA) funding by 10%.

This act, signed into law by Lyndon Johnson, remains the critical source of funding for aging programs to keep people in their homes and save money through prevention and using the lowest appropriate level of service.

The act created the Administration on Aging, authorized grants to States for community planning and services programs, as well as for research, demonstration and training projects in the field of aging. Later amendments to the Act added grants to Area Agencies on Aging for local needs identification, planning, and funding of services, including but not limited to nutrition programs in the community as well as for those who are homebound; programs which serve Native American elders; services targeted at low-income minority elders; health promotion and disease prevention activities; in-home services for frail elders, and those services which protect the rights of older persons such as the long term care ombudsman program.

Funding has been frozen since 2002, despite increasing costs and needs.

The National Council on Aging (NCOA) writes:

Congress now can fund human service needs that have been sorely underfunded in recent years. . .Chairman David Obey (D-WI) plans to move the Labor-HHS-Education bill--which includes Older Americans Act funding--through his subcommittee in early June. The Senate subcommittee likely will act in late June.

NCOA is providing “a toll-free number for grassroots advocates to use next week to urge Congress to (1) increase funding for all existing OAA programs by at least 10 percent and (2) provide sufficient start-up funding for new program initiatives in the 2006 OAA reauthorization.

“Please urge your members to call 866-OAA-2184 (866-622-2184) next Tuesday, Wednesday and Thursday (June 5, 6, and 7). They will be connected to the Capital Switchboard, where they can then be forwarded to the offices of their Representatives and Senator."

Good news on SeniorCare, Family Care

Great news:

SeniorCare to run through 2009 (JSOnline, May 24, 2007)

Washington - Wisconsin's SeniorCare prescription drug program, set to
expire this year, will get a sudden two-year lease on life under a
provision tucked into the emergency war spending package that Congress
passed Thursday night.

”The program will continue on," Sen. Herb Kohl (D-Wis.) said.
He and the House Appropriations Committee chairman, Rep. Dave Obey
(D-Wis.), inserted the language into the hotly debated spending bill
that President Bush has said he will sign.

However, as James Schmidlkofer, Bureau of Aging and Disability Resources
Office on Aging, reminds us, until the spending bill is passed, nothing is final. Stay tuned!

In the meantime, what do we tell seniors? Schmidlkoffer thinks it’s safe to say that:

1. All current SeniorCare participants should remain in SeniorCare.
2. Seniors who get a SeniorCare renewal form in the mail should
complete the renewal.

Family Care expansion approved by a vote of 15 to 1

Also on May 24, the Joint Finance Committee (JFC) approved a modified version of Governor Doyle's proposed expansion of Family Care. According to a briefing circulated to members of the Make It Work Milwaukee Coalition, “The motion approves the Governor's proposal on funding, retains legislative oversight of expansion, requires consent by a county to participate in Family Care, spells out specifics and decreases the county share of costs, provides ombudsman advocacy services for participants under the age of 60, and increases the funding available for the children's long-term support program.”

Joint Finance also funded Independent Advocates (Yr 1 = 4 FTE and Yr 2 = 6 FTE,) to assist consumers in the Family Care expansion.

Read the approved version of the bill here.

Democracy in action

Monday May 21, Executive Director Amy Ambrose and I had coffee and sweet rolls with some 300 “ordinary people” from Milwaukee County plus a dozen or so of their Wisconsin state legislators.

We were talking about doing good work with limited resources, and the woman sitting next to me said, “the non-profits are doing a great job of holding things together with duct tape and paper clips. But we can’t afford the paper clips anymore.”

The legislative breakfast at State Fair Park Expo Center was sponsored by two “groups of groups.” The People Can’t Wait Coalition includes agencies devoted to “Improving the quality of life for people with disabilities,” while the Make It Work Milwaukee! (MIWM) Coalition works at “Strengthening Milwaukee County through better health and human services.” MIWM includes the disability community as well as groups for the aging, mental health, and children and families.

Constituents and professionals took half a day to come out for the chance to tell their stories about important issues to the people who will vote for the final state budget.

Areas that are being discussed in state budget that affect these populations, and all of us, include:

• Community Aids to fund safety net programs for people with disabilities
• Income Maintenance to eliminate backlogs
• Support for WisconsinCare, BadgerCare Plus, and Family Care expansion
• Transportation, transportation, transportation
• Mental health parity, matching funds for community mental health services
• State funding for Wisconsin Supports Everyone, Recovery Choice
• Emergency assistance and transitional jobs pilot to reform W2
• Wage increase for providers of community-based longterm care
• Affordable housing (support for Housing Trust Fund)
• Increased reimbursement to increase access to dental care

Attitudes, beliefs about race affect us all

One of the interesting “factoids” Jeff Browne of the Public Policy Forum presented at the Milwaukee Aging Consortium member meeting on race relations May 10 was the reluctance of people of color to drive into the more distant—and more white—suburbs. For caregivers, those who place them, and those who need them, that can present big problems.

That reluctance comes from perceptions about dealings with the police and from fear. You can read the report here, but two excerpts follow:

• Police dealings – The biggest single racial gap found on the survey related to dealings with police. Just 1% of whites feel they have ever been stopped by
police because of their race, while half of blacks (including the vast majority of
black males) and a third of Hispanics feel they have.

• Common sense or prejudice? – There is a racial gap in what constitutes prejudice. Most whites view racial profiling by police and avoidance of driving through nonwhite neighborhoods as common sense. Most people of color perceive those decisions as prejudice.

To put some flesh on the bones of the statistics,
consider this story from last week’s Journal Sentinel online:

County park worker sues Tosa
Police seeking black robbery suspect had bias, she says

Dressed in office attire, Alfrieda Durrah was leaving work at a Milwaukee County parks building when she was ordered to the ground at gunpoint by Wauwatosa police, handcuffed and forced to lie face-down on the ground. . .

The lawsuit says that the robber had been described as in her 40s, between 5 feet 8 inches and 5 feet10 inches tall, 180 to 200 pounds with short, straight black hair, brown eyes, medium skin tone, wearing a short-sleeved gray top and blue shorts or pants. . .

Durrah is approximately four to six inches shorter, weighed 20 to 40 pounds less and was six years older than the described assailant, and was wearing completely different clothing, the suit says.

Ms. Durrah’s coworkers were just 3 blocks away, ready to vouch for where she was that day, had anyone asked.

Do you have any experiences in which race played into caregiver relationships? How did the people involved talk about and resolve the problems? If they didn't, what prevented them from doing so? How can we make things better?

It’s not your mother’s retirement. . .

Happy Mother’s Day to those of you who are mothers or who have had mothers! And to anyone who values the nurturing "mother" roles people play throughout their lives.

This is the time of month community newspapers sponsor mother-daughter look-alike contests and publish the winners' photos, and everyone publishes essays on motherhood.

But mothers and daughters aren’t necessarily alike. And neither are their retirements.

According to a InsuranceNet, "Mothers advise their daughters to save more money and not to 'live beyond your means'. . .Daughters, when asked how they would have advised their mothers, say, 'don't forget your dreams' and be 'willing to spend money if it will make you happy.' It will be interesting to see if daughters, as they approach traditional retirement age and are faced with the financial realities of a long life, are more open to their mothers' advice."

The author was referring to a phone survey of some 1,200 mothers and daughters, It’s Not Your Mother’s Retirement: Generational Differences in Retirement Expectations for Women, which found that:

• Daughters will work longer. . . or forever.
• Still, they believe their retirement will be better, more active, and more interesting,
• But they also are more likely to face “financial adjustments."
• Both expect to be able to rely on family and friends to provide support when they need it.
• Married women expect to retire earlier than single women.
• Daughters expect different sources of retirement income than their mothers' sources of income.
• Daughters have more debt and may be derailed by it.
• Home equity will play a role in the retirement of both generations.
• Married women in both groups feel well prepared to take over financial management should they need to.
• Mothers and daughters have different perceptions about how much they talk about anything, including retirement.

The study was undertaken by MetLife Mature Market Institute; WISER, the Women’s Institute for a Secure Retirement; and Mathew Greenwald & Associates.

WisconsinCare prescription drug help--not just for folks with SeniorCare

I'm not sure whether the state's new prescription drug program for seniors and people with disabilities, WisconsinCare, is the SeniorCare "wrap around" program everyone's been talking about.

But it looks like a boon to Wisconsin seniors struggling to pay for medications--or to get insurance that does a good job of it! Thanks for Glenna Schumann of the Coalition of Wisconsin Aging Groups for passing the information along.

“WisconsinCare will provide seniors and people with disabilities access to life-saving prescription drugs at a price they can afford,” Governor Doyle said. “By filling donut holes, using one-page applications,and providing access to affordable prescription drugs, WisconsinCare will protect our seniors – our greatest generation, who ask very little of their government and deserve so much in return.” Governor's office press release, May 9, 2007.

WisconsinCare will begin January 1, 2008. While rolled out to help seniors who must leave the the state's SeniorCare program, it will also be available to all Wisconsin seniors who are on Medicare but not on Medicaid and whose incomes are less than $24,504 (singles)/ $32,856 married couples.

Also eligible for WisconsinCare are:

• All other Wisconsin residents under the age of 65 who are: 1) enrolled in Medicare; 2) have an income of less than $16,336 ($21,904 for a married couple); and 3) are not getting Medicaid.

More information about specific benefits, signing up, and more in the WisconsinCare Fact Sheet.

According to the press release:

WisconsinCare uses a one-page application form similar to the current SeniorCare application; provides seniors with co-payments as low as $2 a prescription drug without any annual enrollment fee; and, by leveraging more federal dollars, serves more people and provides more benefits at a cost that is equal to what the state invests in SeniorCare and without additional state bureaucracy.

Toward fewer surprises in Medicaid estate recovery

Since 1993, every state except Michigan has been legally entitled to recover the costs of long-term care and related Medicaid expenses from the estates of people who received those services. Merely by enrolling, the 55 million low-income Americans presently receiving Medicaid “agreed” that their estates would pay the money back to the extent funds are available.

But they and their families may not realize it, especially as few other federal programs require repayment. According to a recently released AARP report, “Requiring low-income Medicaid beneficiaries to reimburse the government for services received often stuns surviving spouses and family members of deceased Medicaid recipients.”


Protections in Medicaid Estate Recovery: Findings, Promising Practices, and Model Notices, was developed in response to another report in 2005 by the American Bar Association’s Commission on Law and Aging study. The earlier study called for “more rigorous and uniform notice and other procedural protections. . .(to) check misperceptions about estate recovery and ensure the effectiveness of hardship waiver requirements.”

The new 75 page report concentrates on current state practices for clarifying protections, showing “promising practices and model notifications that can be replicated throughout the country for the benefit of both estate recovery programs and the people affected by them.”

SeniorCare saga continues

Added later in the day: It was announced today that Wisconsin has been granted an extension of SeniorCare to December 31, allowing officials to craft a wraparound program for a smooth transition.


The Wisconsin Board on Aging and Long Term Care, issued a news release, SeniorCare, What’s Next?

Some points from the release to keep in mind:

• It’s okay to wait: you don’t need to take action now. SeniorCare and state health officials are working on an alternative program.

• By staying in SeniorCare as long as it lasts, you may continue to save money. You’ll have two months to change after the actual loss of service.

• Call Medigap Helpline if you have problems with health insurance (1-800-242-1060).

For a very different perspective, read Medicare Part D insurers may reap $100 million in revenue in the April 28 Journal Sentinel.

“One of the by-products of providing limited prescription drug coverage for people in the Medicare program, what is known as Medicare Part D, was the creation of a multibillion-dollar business,” Guy Boulton writes.

Twenty-three companies stand to gain the additional revenue from 102,000 customers who, while fighting, will have to switch.

We’re all in this together: health care reform survey

May 1, 2007, the first day of Older American’s Month, seems like an appropriate day for the AARP to release their national healthcare reform survey results.

(Have you noticed that AARP never uses the spelled-out form of its name? My guess is that the "retired persons" part doesn't market test well.)

The report for Wisconsin is here. Consortium member Gail Sumi, AARP State Issues Advocacy Director, helped prepare the report.

In the telephone survey exploring the medical experiences and opinions about health care reform of people ages 18 to 64, Wisconsinites reported believing that “they’re in good health, but that the health care system isn't.”

Even though only those under age 65 were surveyed, their responses show that people in Wisconsin are looking at the bigger picture, not just the one they are in now. And many are ready to support elected officials who will reform the system.

The report concludes that “Clearly, concern over the increasing costs of healthcare and support for universal healthcare are top issues for all Wisconsinites. While exploring ways to ensure that all residents have access to healthcare, Wisconsin should also address the concern residents have over increased healthcare costs.”

Statistical highlights

• 80% of respondents have health care coverage, and 27% say they are in excellent health.

• Almost half of respondents say Wisconsin’s healthcare system has major problems, and 13% say it’s in crisis.

• 76 % say it’s important to reduce the number of residents without healthcare coverage.

• 84% say that it’s important for Wisconsin to make healthcare more affordable for all residents.

• 82 % agree that all Wisconsinites should have access to the same basic healthcare coverage.

• 76% agree that everyone should contribute to the healthcare system to enable all residents access to healthcare.

• 56% would be more likely to vote for a candidate who supported healthcare coverage for all Wisconsin residents.

Budget Matters: changes in the state budget

A couple weeks ago the Joint Finance Committee held meetings around the state to gather input on the governor’s proposed budget. If you want to know what came of those meetings and other deliberations, please read the following message passed along by Barbara Beckert, Milwaukee Jewish Council for Community Relations. It’s long but full of useful information.

(The report was sent to members of the Make It Work Milwaukee! Coalition in which the Milwaukee Aging Consortium participates. The group includes organizations serving older adults, people with disabilities, children and families who want to “strengthen Milwaukee County through better health and human services.”)

From: Michael Blumenfeld

The Co-Chairs of the Joint Finance Committee (Representative Rhoades and Senator Decker) sent the following memo on Friday to committee members. Here is a link to it.

The memo basically does two things:

1) It outlines 48 non-fiscal policy items that will be removed from the budget and considered as separate legislation. These items reference the Legislative Reference Bureau's summary of the Governor's budget proposal that can be found here.

Some items of interest are:

BOARD ON AGING AND LONG-TERM CARE

* CBRF Requirement to Post Contact Information on the Ombudsman Program (Page 63, #9)

EMPLOYMENT RELATIONS COMMISSION

Repeal QEO Provisions (Page 137, #3; Page 138, #4; Page 464, #9)

HEALTH AND FAMILY SERVICES
Medical Assistance - Long-Term Care
* Statewide Licensed Nursing Home Bed Cap and Bed Transfers (Page 290, #7)
* Repeal Nursing Home Bed Bank (Page 291, #8)
* Nursing Home and CBRFs -- Contesting Actions and Receiverships (Page 291, #10)
* Community Relocation Initiative -- Authority to Provide Services to Additional Clients (Page 292, #13)

HEALTH INSURANCE RISK-SHARING PLAN AUTHORITY
* Authority to Designate Insurance Types for Eligibility Purposes (Page 343, #4)
* Eligibility for Premium Subsidies (Page 343, #5)
* Pharmacy and Pharmacist Participation (Page 343, #6)
* Provider Rates (Page 343, #7)
* Fiscal Agent Responsibilities (Page 344, #8)

INSURANCE
* Minimum Coverage Requirements for Treatment of Mental Health and Alcohol and
Other Drug Abuse Problems (Page 362, #16)
* Required Health Insurance Coverage for Autism Spectrum Disorders (Page 363, #17)
* Health Insurance -- Insurer Disclosure of Current Procedural Terminology Code Changes and Explanation of Restriction or Termination of Policy Coverage (Page 363, #18)

2) It also lists what parts of the budget will be using the 2006-07 (current fiscal year) adjusted base as a starting point and what parts will use the Governor's proposal as a starting point.

This is a very important distinction. For items that use the current base as a starting point, the Committee will entertain motions to amend current law or the adjusted base rather than the recommendations of the Governor. Although the Governor's recommendations will be before the Committee, it will take a majority vote for them (or any other proposal) to be adopted.

For items using the Governor's proposal as a starting point, the opposite is the case; it will take a majority vote to remove the Governor's proposal from the
budget. Remember that the Joint Finance Committee is evenly split, 8-8, for
this budget deliberation. The bottom line: base budget items-majority vote
needed to add anything to the base; Governor's proposal items-majority vote
needed to remove a proposal contained in the Governor's budget.

Almost all of the DHFS budget, including Family Care, BadgerCare and other Medical Assistance expansions, will be "Governor's proposal" items, which will require a majority committee vote to remove. Among the "base budget" items is the "Health" section of DHFS. This can be found on pages 304-314 of the Fiscal Bureau summary.

The entire list of base budget items is on page 2 of the memo. For all other agencies, the Governor's budget (known as SB 40) will be the starting point.

In addition, the memo makes these points:

Children and Families. SB 40 recommends that portions of the Departments of Health and Family Services and Workforce Development be transferred to a newly-created Department of Children and Families. The Committee will consider the programs to be transferred within their respective agencies and will separately determine whether the new Department should be created.

Programs Funded with New Revenue Sources. There are a number of programs in a variety of agencies that are funded under SB 40 from new or expanded revenue sources. They include: (1) programs funded from recycling fees; (2) the county aid fund (real estate transfer fee); (3) provisions funded from increased vital records fees; and (4) the health care quality fund (cigarette tax, tobacco products tax, hospital assessment, and injured patients compensation fund). Rather than consider these items under each affected agency, executive sessions will be scheduled for each of these four funding sources. At those meetings, all items related to the use of those funding sources will be considered.

Action begins on SB 40 Thursday, April 26. For agendas and information go here.