Tag Archives for Medicaid

The Best Of…Former Sen. Moss’ Advocacy Commitment Will Be Missed

Published on February 3, 2003

            Last Wednesday evening, former U.S. Sen. Frank Moss of Utah died.

            After he received his law degree in 1937 from Washington, DC-based George Washington University, Moss briefly worked on the legal staff of the U.S. Securities and Exchange Commission.

           Throughout his legal career, he would sharpen his legal skills by working in a variety of settings.  Initially, clerking at the Utah Supreme Court, he would ultimately win an election putting him on the bench of the Salt Lake City Municipal Court in 1940.

         During the World War II, he would serve on the Judge Advocate General’s staff of the U.S. Armory Corps in England.  After the war, Moss would be elected in 1950, reelected in 1954, to serve as Salt Lake County attorney.

         Two years after his unsuccessful bid for Utah Governor, in 1956, Moss would run for Senate and win, by less than 40 percent of the vote.

         Obituaries in newspapers stated that the liberal three-term Senate Democrat was best known for his environmental work that included the establishment of national parks and recreational areas in Utah.  Moss was also recognized for drafting a series of bill protecting consumers, ranging from mandating labeling on cigarette packages about the health hazards of smoking, banning cigarette advertising on radio and television, to developing minimum safety requirements for automobiles.

           But for me and many of my colleagues in the field of aging, we will always remember Moss as being a true advocate for the nation’s elderly.

           Moss worked closely with President Kennedy, Vice President Lyndon Johnson, who would later become President, Hubert Humphrey and Claude Pepper getting Medicare and Medicaid enacted into law.

          Moreover, Moss will always be remembered for being the driving force behind the establishment of the Senate Special Committee on Aging in 1961.

          He also played a major role in establishing the House Committee on Aging with the late Rep. Claude Pepper.  The two special committees would later put the spotlight on aging policy issues, generating both the public and political will to bring about the needed policy changes.

          Throughout his Senate Career, in addition to authoring legislation that would require federal minimum standards for nursing homes and helping to create  the Medicare and Medicaid home health care benefits. Moss held the first hearing on hospice care and introduced legislation authorizing payment for hospice care.

           More than 40 years ago, the Special Committee on Aging, chaired by Moss, began to hold a series of hearing s on nursing homes.  It became extremely clear to his committee through its hearings, generating 1,300 pages of testimony, that both nursing home standards and enforcement by state regulatory agencies varied drastically.  Moss noted that these hearings helped to shape the Medicare and Medicaid programs, and that they also lead to series of reforms in 1967.

         Ultimately, a series of 30 hearings held between 1969 and 1976 eventually lead to the publication of a 12-volume report, entitled “Nursing Home Care in the United States: Failure in Public Policy.”

        In 1977, Moss, with coauthor Val Halmandaris (who at the time was responsible for research of the Subcommittee of Long-Term Care, but now serves as executive director of the National Association of Home Care) wrote “Too Old, Too Sick, Too Bad: Nursing Homes in America,” detailing the plight of America’s elderly.

       More than 10 years later, in a 1998 speech to the National Council on Aging, Moss expressed his concerns that American’s elderly were losing ground from all the gains they had achieved in the late 1960s and 1970s.  Congress has yet to enact a pharmaceutical drug program to put the brakes on spiraling drug costs.  Elder abuse is still running rampant throughout the nation.  Medicare expenditures are being slashed to nursing homes, home and hospice care.

        It is now time for Congress to get serious about tackling the multitude of problems thrust upon the nation by an aging society.  Moss’ advocacy comment to the nation’s elderly will be sorely missed, and his shoes will be hard to fill.

        Herb Weiss is a Pawtucket-based freelance writer who writes about aging, health care and medical issues.  He can be reached at hweissri@aol.com.

The Best Of…Many Opting to Pre-Plan, Pre-Pay for Funerals

Published on February 1, 2003

             For me, it was stressful attempting to get my elderly father and my mother with dementia to enter into a pre-need agreement funeral arrangement.  After all, my three siblings and I were only trying to give our parents the opportunity to have a say in their minute details of their final arrangements.

            With my confused mother at his side, my father choose their caskets like he was purchasing a new car.  He checked under the lid, throughly examined the lining and the wood.  Ultimately, he would not buy the cheaper model, but he chose a nice one, a little higher on the price list.

            Of course, my father told the funeral director their services would be held at Temple Emanuel  with the family Rabbi presiding.  But what type of music, vocal or instrumental did they want played?  Or did they want a visitation or to name their  pallbearers.  Closed or open casket?  All these decisions might have been made right there on the spot, but in the end my father backed out.

           A little technicality over paper work derailed the process, causing my father to not sign on the dotted line and walking out of the funeral home in a huff.

           My father’s experience was not the norm because most aging baby boomers make it through the most stressful process of pre-planning and pre-paying in advance.

           According to a 1998 AARP survey, two in five people age 50 and older reported that they were contacted about the advance purchase of funerals.

           About one-third of those responding said that they had prepaid, or were in the process of prepaying, for funerals or burials.  Of this group, 86 percent had prepaid for cemetery plots, mausoleums, or niches, 58 percent had paid for other burial goods or services and 40 percent had prepaid for funeral services.

          For those prepaying for funerals, 30 percent had funds in trust and 30 percent had funds in life insurance policies.  Sixty percent held title to a cemetery plot, and 15 percent said they had that money in a life insurance policy.

         Ted Wynne, funeral director of Pawtucket-based Manning-Heffern Funeral Home, sees a transient society where children are living in different states, fueling the demand for pre-planning and prepayment.  “Seniors want to take the pressure off their children who live thousands of miles away from making the burial arrangement,” Wynne says.  “Thus, they pay up front or set aside money for future funeral and burial payments.”

        Bradford Bellows, funeral director of D.W. Bellows & Sons, Pawtucket and Bellows-Falso Funeral Chapel in Lincoln, says the seniors in nursing  homes are also good candidates for prepaying a funeral.

        “The family watches their parents’ funds dwindle to a point where they are forced to go on Medicaid.”  Prior to being eligible for Medicaid, the senior or their children should prepay the funeral costs.  Assets given the funeral home are allowed under Medicaid eligibility guidelines prior to going on Medicaid.

           “Consumers must understand that pre-arranging a funeral is not the same as pre-paying one,” Bellows adds.

            By pre-paying a funeral you are actually paying  for a funeral at today’s prices, not tomorrow’s, Bellow says.  “If the funeral occurs in the future, the funds will earn interest which will be used to pay for the cost of the funeral at the time of the death.”

           Bellows offers these tips when pre-paying your funeral.

           1.  Make sure that your social security number is indicated on your savings account or insurance policy where the monies are placed to prepay your funeral.  If the funeral home ever goes out of business or goes bankrupt, the funds are still yours and are safe, and can be easily be transferred to another funeral home.

          2.  When you enroll in the Medicaid program, all the funds in your prepayment account must be used.  Any excess funds will be returned by the  funeral home to the State of Rhode Island, to defray health costs incurred by the state of Rhode Island’s Medicaid program.

         3.  Once the funeral home opens the account or insurance policy, don’t forget to get a copy of the Irrevocable Funeral Trust Agreement, showing the bank or credit union account or the original insurance policy that was issued.  This will give you proof that your advance payment has been set up for your funeral needs.

          Herb Weiss is a Pawtucket-based freelance writer who covers, aging, health care and medical issues.

Inaction on RIPAE Proposals Would Be a State Tragedy

Published in the Pawtucket Times on May 20, 2002

Lawmakers are rushing to finalize the state’s business, hoping to adjourn as early as the end of May.

With thousands of proposals in the legislative hopper, each representative was directed by House leadership to choose three of their own sponsored bills to push for in the Senate.

All legislative proposals that do not make the “priority” lists are as good as dead for the year.

At press time, one proposal, Pharmaceutical Assistance for the Elderly Program (RIPAE) moves closely to passage.

The House Finance Committee has put the proposal (H 7291) into the state budget article. Susan Sweet, a consultant and aging advocate said she expects full House passage of the state budget article by the end of the week.

Once passed by the House, the state budget article goes to the Senate for their consideration and approval. Sweet told All About Seniors that she believes that the Senate will quickly pass the budget, too.

With passage, the final state budget will be  forwarded to Governor Lincoln Almond.

Under H 7291, the state Department of Human Services would seek a waiver from the federal government, allowing Rhode Island to use Medicaid funding to pay for prescription drugs for low-income seniors with incomes up to $ 17,720 and couples with incomes up to $ 23,880.

The legislative proposal, authored by Lt. Governor Charles Fogarty and sponsored by Rep. Constantino and House Finance Chairman Gordon Fox, would enroll about 90 percent of the 37,000 seniors now enrolled in RIPAE. Because seniors would now qualify for prescription drug coverage under Medicaid all U.S. Food and Drug Administration (FDA) drugs would be covered not just those currently covered by RIPAE.

Seniors would pay a small copayment rather than the 40 percent co-payment currently charged.

With the passage of the state budget article, then “cleanup” begins on all legislative proposals, Sweet noted, adding that the two other RIPAE proposals have not been acted upon yet.

These legislative proposals would make prescription drugs more affordable to seniors and persons with disabilities who are not covered by the Medicaid waiver.

One bill (H 7290) would allow seniors enrolled in the RIPAE program to buy prescription drugs not currently covered by RIPAE at the discounted state price.

The other (H 7524) would allow low-income disabled persons on Social Security Disability Income who are between ages of 55 and 65 to become members of RIPAE and purchase prescription medications at the state discounted rate. Under booth, the state would be able to obtain the manufacturer’s rebate available through RIPAE.

Sweet along with other aging advocate groups, has called on the Rhode Island General Assembly to pass the three RIPAE proposals, which don’t cost the state one penny.

Not acting on them will continue a tragic trend that is well-documented in Rhode Island and nationwide.

That is, the high cost of prescription drugs forces many seniors on fixed incomes into not taking their prescribed medications at all or using only partial doses.

Moreover, noncompliance can lead to unnecessary hospitalization, nursing home admission and premature death.

Even in the shadow of a huge state budget deficit, lawmakers have the opportunity to lower the spiraling out-of-pocket costs of costs of prescription drugs, at no cost to the state.

The Ocean State is now posed to enact sound public policy that will result in no fiscal impact to state coffers.

If Congress is not ready to tackle this aging policy issue through the creation of a Medicare pharmaceutical benefit, then the Rhode Island General Assembly must take the lead and pass the three RIPAE proposals.

Simply put, it is the right thing to do on behalf of older and disabled constituents.