August 2009

 

Please join us at our next statewide meeting on Saturday, August 8, 2009 from 10:30-2:30 at the Library of Michigan Lake Superior Room, 717 West Allegan, Lansing.  And plan on joining us for our next meeting on Saturday, November 14 (same time and place) as well.  We love to welcome new members and see old friends!  If you plan to attend the August meeting, please RSVP to Alison Hirschel at hirschel@umich.edu or 517-324-5754 by August 5, 2009.  We need you to be part of our plans and discussions!  Join us!                                                                             

1.  Campaign accepting nominations for the Nadene Mitcham Courage and Heart Award–-Each year, the Campaign presents awards to individuals who have made a significant difference in the lives of long term care consumers and who have shown both courage and compassion.  Last year, we added the name of Nadene Mitcham, our long time state chairperson, to the name of the award to honor Nadene’s many contributions to our efforts.  Past winners of the Courage and Heart Award include State Ombudsman Sarah Slocum, State Medicaid Director Paul Reinhart, elder law attorney Doug Chalgian, disability rights advocate RoAnne Chaney and a number of others who went far beyond the call of duty to champion long term care consumers’ rights and improve their lives.  You may nominate anyone– a public official, advocate or ombudsman, direct care worker, volunteer, or anyone whose work you think we should recognize and celebrate.  Please include as detailed a description of why you are nominating the person, your contact information, and the name, address, and phone number of the nominee.   We will be accepting nominations until August 7 and selecting the winners at our August 8 meeting.  Please email nominations to Alison Hirschel at hirschel@umich.edu (please put “Courage and Heart nomination” in the subject line) or fax your nomination to Alison at 517-394-4276.                      

           

2.  Nursing home residents on Medicaid continue to face problems obtaining medically necessary power wheelchairs; Campaign fights back! – We reported in previous newsletters that the Campaign and other advocates have worked hard to persuade the Department of Community Health to approve requests for Medicaid payment of customized power wheelchairs for nursing home residents who need them.  In appropriate cases, these wheelchairs, designed to meet individual needs, can help reduce the risk of the resident developing pressure ulcers, improve posture, aid in mobility, reduce pain and discomfort, improve the resident’s ability to swallow, and allow residents the dignity to do some things (like repositioning and self-care) themselves without being entirely dependent on staff for help.  While these chairs were approved more readily for people who lived outside a nursing home, the Department’s policy made it virtually impossible for Medicaid funded nursing home residents to obtain these chairs because the Department insisted nursing home staff was supposed to meet residents’ needs.  Last summer, the Department bowed to pressure from advocates and agreed to rewrite its policy to make the expensive, custom-made chairs available to residents.  Despite these promises, the policy was never issued for public comment. 

          In late May, the Campaign became aware that the Department had developed a new draft policy that continues to create significant barriers for residents to obtain the chairs they need despite the promises made to us last year.  We immediately contacted Steve Fitton, the Acting Medicaid Director. He acknowledged that the policy was controversial and promised that we will have an opportunity to meet with him and his staff and comment extensively on the policy before any final decisions are made.  A number of other advocacy groups, providers, and others are also actively involved in this effort.

          While we continue to press the Department for a policy that meets residents’ needs, some residents’ requests for customized power chairs are being denied.  Alison Hirschel, who serves as counsel for the Campaign, and Mark Cody, a lawyer at Michigan Protection and Advocacy Service, recently filed a petition in Ingham County Circuit Court to challenge one of these denials.  In that case, a very alert and social resident who has had M.S. (Multiple Sclerosis) for more than 50 years is currently using both an ill-fitting scooter and a manual wheelchair that does not meet her needs.  As a result, she is in pain for much of the day, is not able to reposition herself to relieve pain and numbness, has difficulty attending to her personal hygiene, cannot participate in many activities inside and outside her facility, has difficulty swallowing (because her current wheelchairs do not help her maintain normal posture), and is at risk of developing pressure ulcers.  Two doctors, a physical therapist, an Assistive Technology professional, and her daughter all provided substantial and persuasive evidence that the power chair she requested is medically necessary.   However, under the Department’s policy, the chair she needs cannot be provided simply because she resides in a nursing home.  Alison and Mark argue that the state policy violates both federal Medicaid law and the Americans with Disabilities Act.  We will keep you posted on developments in this important case.

 

3.  State budget for FY 2010 still unresolved; State budget

troubles continue- State legislators and the Governor continue to wrestle over the state budget; the final impact on long term care programs is uncertain.  The total budget deficit for FY 2009-2010

is estimated at approximately $1.7 billion.  Earlier this year, the Governor issued an Executive Order in an attempt to balance this year’s budget.  That Order included the elimination of the Single Points of Entry/Long Term Care Connections that provided one

stop shopping for long term care consumers who needed information and assistance as well as Medicaid coverage of adult dental care and many other programs and services discussed in earlier newsletters.  The cuts made this fiscal year as a result of the Executive Order are expected to remain in effect when the new fiscal year begins on October 1, 2009.  So far, to our knowledge, no cuts in the MiChoice Home and Community Based Waiver program or Home Help have been proposed though a number of other services for the elderly and people with disabilities are on the chopping block.  A 4% cut was imposed on nursing homes and other Medicaid providers which advocates feared could have an impact on staffing and services, but we understand these cuts have been ameliorated by other changes in nursing home reimbursement.  The Campaign will continue to monitor budget developments closely and advocate for continued and increased funding of essential long term care programs.

4.  President Obama names former Kansas State Ombudsman and Secretary of Aging to lead federal Administration on Aging -- Kathy Greenlee, a former public interest elder law attorney, state ombudsman, and Secretary of Aging in Kansas has been confirmed by the Senate as the Assistant Secretary for Aging in the Department of Health and Human Services.  She has extensive experience with long term care, elder rights, and elder abuse issues and a practical and passionate approach to addressing them.  In a recent interview with AARP, Ms. Greenlee

emphasized the importance of providing more home and community based care to long term care consumers, noting that non-institutional care is both what most consumers prefer and more cost-effective

 

than nursing home care.  Advocates around the country have hailed Ms. Greenlee’s appointment as a very positive development for aging advocacy.  Ms. Greenlee will be speaking at the NCCNHR Annual Meeting (see #5 below) in October and the Campaign will be sending her a letter congratulating her on her appointment and summarizing our goals and priorities.

 

 

5.   NCCNHR–The National Consumer Voice for Quality Long Term Care offers 34^th Annual Meeting and Conference on October 22-25 in Washington, D.C. –- NCCNHR, the long time national champion of long term care consumers, will be holding another wonderful conference in Washington, D.C. on October 22-25.  As usual, a number of Campaign members and state and local ombudsmen will be attending and presenting at the conference, joining hundreds of other advocates, consumers, and experts from across the country.  For more information on the conference, go to http://nccnhr.org/public/460_2452_19914.cfm or call NCCNHR at 202-332-2275. 

 

6.  The Campaign thanks its generous donors – The following individuals have donated money since our last newsletter: Patricia I. Peterson, Nadene Mitcham (twice!), Lydia Rizzo, Wayne Oakes, Richard Marks, Monika Jackson, Kate Doelker, Lois Hitchcock, Jane Jones, Virginia Nicoll, Ellen Story, Albert Krug, James Gump Family in memory of Mildred Hadley, Carolyn Burns, Skye Hayward, Lori Mosier, Pamela L. Balfour, Patricia Meehan, Dennis H. Cavanaugh, Sara E. Hunt, Barbara J. Fielder, Sarah J. Slocum and Lois Hitchcock.  Each and every donation, big or small, helps us continue our effective advocacy and we are deeply indebted to all our   supporters.  We are also cheered by the encouraging and appreciative messages that accompanied many of the donations.