Access Alaska

NOME, Alaska (AP) -- Lance Mackey couldn't shake four-time champion Jeff King and his faster team.

So Mackey pulled off a stunt at the Elim checkpoint -- 123 miles from the Nome finish line -- that proved to be the turning point en route to winning his second consecutive Iditarod Trail Sled Dog Race on Wednesday.

Mush here for more.

Official Iditarod site.
More here.

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NOME, Alaska (AP) -- Lance Mackey couldn't shake four-time champion Jeff King and his faster team.

So Mackey pulled off a stunt at the Elim checkpoint -- 123 miles from the Nome finish line -- that proved to be the turning point en route to winning his second consecutive Iditarod Trail Sled Dog Race on Wednesday.

Mush here for more.

Official Iditarod site.
More here.

See also Alaska, News, Whats Hot

By JULIA O'MALLEY, jomalley@adn.com

Published: June 15, 2007

Lynn Cragholm lived 73 years without walking the street in protest, but her lack of experience didn't show Thursday at the corner of Fireweed Lane and A Street.

Facing traffic, her hair swept into a graceful, gray top-knot, she waved a sign that read: "Work Hard, Pay Taxes, Raise a Family, Get Shafted by Rep. Coghill."

Cragholm joined about 60 seniors who demonstrated on all four corners of the intersection in support of SeniorCare, a program that provides $120 a month to low-income people over 65. SeniorCare is set to end June 30, but supporters hope to pressure the Legislature to extend it in a special session that begins here on June 26.

You can read the full story online at:

http://www.adn.com/news/alaska/anchorage/story/8978567p-8893993c.html

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SeniorCare provides $120 a month to low-income seniors (singles over 65 with annual incomes of less than $16,133 and couples with annual incomes of less than $21,641). Most recipients use the benefit for utilities, food, rent, or medications. Recipients of the assistance program as well as senior advocates are expected to make comments. Legislators have also been invited to attend.

WHAT: Public rally in support of the SeniorCare program
WHERE: Access Alaska Offices, on the corner of “A” and W. Fireweed
WHEN: Thursday, June 14, 2007 from 11:30 am – 1:00 pm
WHO: Seniors and senior advocates

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ANCHORAGE, AK – With the aid of 89,000 members, AARP is calling on U.S. Senators Lisa Murkowski and Ted Stevens to stand with the overwhelming majority of Alaskans and vote to give Medicare the power to negotiate for lower prescription drug prices. Murkowski and Stevens are two of the few remaining Senators yet to publicly state their position on this important issue, and their votes are critical to the bill’s success.

On Wednesday, April 4, AARP members throughout Alaska and across the country will be calling Senators and urging them to support legislation that could help lower Medicare drug prices for Alaska’s Medicare beneficiaries.

According to a recent AARP poll, 85% of Alaska residents want Medicare to leverage the buying power of 43 million Medicare members to negotiate lower prices for prescription drugs. “You would think this would be an easy decision for Senator Murkowski and Senator Stevens. Our polls show that Alaska residents support giving Medicare the power to bargain for lower drug prices,” said Ken Osterkamp, AARP Alaska State Director. “AARP members want – and deserve - to know if Senator Murkowski and Senator Stevens will side with their constituents or with the pharmaceutical industry on this important issue.”

Americans pay more than anyone else in the world for most brand-name drugs. In 2006, on average, brand name prescription drug prices increased 6.2 percent for a sample of 193 brand-name drugs widely used by older Americans. During that same period general inflation was just 3.2 percent. Older Americans are the largest consumers of prescription drugs, with a typical senior taking four prescriptions daily.

Giving Medicare the authority to use its bargaining power to negotiate with drug companies to help achieve even lower drug prices would strengthen the Medicare drug benefit even further.

Earlier this year, the U.S. House of Representatives passed H.R. 4, the “Medicare Prescription Drug Price Negotiation Act of 2007” by a bipartisan vote of 255 – 170. AARP strongly supported H.R. 4 and is now putting its weight behind passing similar legislation in the Senate.

AARP is tracking key votes in the 110th Congress and reporting back to its 38 million members how Congress votes on legislation AARP members are interested in like health care.

“Giving Medicare bargaining power is a key issue for AARP Alaska’s 89,000 members, and we will be letting them know how their elected officials voted on this matter,” said Osterkamp.

Contact info

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(Published: April 2, 2007)

Linda Spencer was trying to focus on her most immediate problem: Her mattress on the floor at Brother Francis Shelter was good for only two more days. Then she had to find another place to sleep.

It was 25 degrees outside and snowing.

For an hour, she'd been meaning to catch the bus to somewhere she could get on the Internet. But the blind man next to her at Bean's Cafe was singing hymns and the sound soothed her, taking her mind out of the humid soup kitchen, away from the shuffle and the smell of bleach. She decided she'd catch the bus later, maybe after lunch.

Her shelter time was almost up, she told the others cupping mugs at the table. They nodded. They knew the drill: Spend 30 days in the shelter, then you have to leave and you can't come back for 30 more. There's an exception for people who are making serious progress getting a place to live. But Linda's time had run out and she wasn't getting more.

Maybe she could sleep outside on layers of cardboard, suggested the blind man.

Or camp out in that van off Muldoon with the bad transmission, someone else advised.

"I just love singin' " said a child-size grandmother in a spotty kuspuk. She smiled, showing her pink gums, and launched into "I'll Fly Away." Linda and the blind man joined in.

Linda, 59, doesn't drink or do drugs. She's never been in trouble with the law. She was married once, has a daughter and worked as a jeweler. But in the '80s, she suffered a head injury and her life began to fray. Like many at the shelter, an overwhelming list of troubles trails behind her.

A few years back, she hurt her Achilles tendon running for the bus and that put her in a wheelchair for a while. Then there was a diagnosis of colon cancer. Then surgery. Was all that before or after the fight with her family, and the mistake with paperwork that made her disability payments quit coming? It's hard to keep the dates straight. While she was in a homeless shelter in Washington state, there was a flood in her house in Alaska. Mold moved in.

In December, she locked her belongings in a storage unit in Eagle River and took a bed at the Rescue Mission. Now life is the bus schedule, the meal schedule, the rules of the shelter and all the lines to stand in; the paperwork for housing, disability payments and health care. Misplaced forms. Faxes that never make it.

"Sometimes I get lost. Sometimes I get sidetracked. It's part of my problem," she said.

Some days she gets desperate and frustrated. She has difficulties with her doctors and her social workers and the women in the shelter who complain about her snoring. She wants to protest or sue. On the day she was trying to catch the People Mover bus, she had government paperwork in her breast pocket along with some toilet paper.

"People say that everybody has choices, but sometimes the choices suck," she said. "Sometimes there are no answers."

Finally, she got the bus, but it was late arriving at the transit center, so she missed her connection. She took a place on a bench to wait for No. 13. A man next to her swayed forward, his eyes glassy.

"Sometimes I think about it, you know?" the stranger said. "I'm a drifter. I haven't really found my place yet."

"You're still looking," Linda assured him.

She was thinking about her daughter who just had a baby in Washington. You can tell a lot about a tree by the fruit it bears, she said. She keeps a neat folder with a copy of her girl's birth certificate. And pictures of her prom. They're 20 years old.

"My daughter. I love her dearly. She's been the greatest joy in my life. Be sure to put that in the paper," she said.

Just then, a black-haired woman breezed in. She was keyed up and chewing gum. Linda had met her at the Rescue Mission. She calls her "The Raven," because she's usually up to mischief.

"Got kicked out of the hostel," The Raven said. She was carrying a garbage bag and a wad of cash. "I owe you a dollar."

"No you don't, you owe me 25 cents," Linda said, adding that she was getting kicked out of the shelter too.

"They said I wasn't making sufficient progress," Linda said.

A woman on a neighboring bench butted in.

"And, you can't go to AWAIC because you're not abused, right?" she said.

"Want me to beat you up?" asked The Raven, half-joking.

"Could you do it where it doesn't hurt?" Linda said.

The bus rolled up. It was too late to get to the Internet place, but Linda got on anyhow. So did The Raven. The bus pulled onto Sixth Avenue. Scenes of Fairview scrolled past the windows: gritty snow, the iron fence around the downtown cemetery, a woman with a case of beer in the parking lot of Carrs on Gambell. The Raven pieced through a stack of pictures someone left. She laughed too loud and snorted.

The bus slowed. Linda stood and took a few steps forward, like a woman walking upriver.

"I love you!" The Raven called, yelling the digits of her phone number.

The doors sighed open and let Linda out into the street.

"I love you, too," she called back, repeating the numbers to herself so she wouldn't forget.

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A permanent increase of $100,000 in State Independent Living funding.

• CILs continue to serve more people each year while funding has remained relatively flat over the past decade. 112% more disabled and senior Alaskans have been served in the past three years – 3,200 persons in 2006 alone.
• Costs to provide these preventive services that keep people out of expensive institutions are rising, stretching and even breaking Alaska’s CIL budgets.
• CILS are only 9% State funded. Alaska’s CILs leverage State dollars, and are extremely resourceful, cost-effective agencies providing necessary services on behalf of the State of Alaska.

A $94,000 increase to support interpreter referral services for Alaskans who are deaf and hard-of-hearing.

• This program allows deaf and hard of hearing Alaskans whose primary language is American Sign Language, to access medical and legal services, the justice system and employment and training.
• The program has been flat-funded for over 17 years, while the deaf population is growing in areas like the Kenai Peninsula, where no interpreter program currently exists.
• Agencies have been subsidizing the operations of this service for years, while serving more people every year.

A twelve percent increase in the state’s reimbursement rate for Personal attendant services.

• This combined federal and state funded program provides in home supports for the frail, elderly and Alaskans who experience disabilities to help them to continue living in their homes rather than having to seek care in nursing and assistive living homes.
• The PCA program reimbursement rate has been flat funded since 1998. A twelve percent increase will help assure that PCA programs can continue to pay for their operating costs.

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Alaska’s Personal Care Program Must Have:

• Integrity
• Accountability
• Sustainability

The Campaign for PCA Reform has been working since 2004 to make these principles a reality at the highest levels in PCA service delivery, in State policy, and in management of the program. Our efforts are discussed in detail in our attached Briefing Paper.

• Legislation To Strengthen State Medicaid Audits, ensuring accountability and fairness, and protecting the State of Alaska from undue Federal fiscal recoveries.
• Legislative Support For Annual Rate Readjustments, so that PCA Providers never go another 10 years without any rate increase to keep up with increasing business and compliance costs. While PCA rates were frozen from 1998 through the present, Alaska Medicaid paid hospitals and nursing homes with automatic and annual index-based rate increases every year since 1999, averaging over 3% per annum.
• One Time Catch Up Adjustment In FY2008 Operating Budget. Medicaid has not allowed a single payment increase in PCA rates since 1998. We are seeking a 2.5% per annum equivalent, with a raise from the 1998 rate of $21 per hour to $26.88 for FY2008.
• To Assure The Legislature That Improvements Have Been And Are Being Made In The Integrity And Quality Of Dh&ss Management Of The Pca Program. We are available at any time to describe the progress that the State and Providers have made.<

Integrity:
In April, 2006 new State regulations governing the PCA program were signed into law. These new regulations, among other changes, implemented a third-party assessor of services across the State. Professionally trained assessors have greatly improved program integrity by replacing the provider agency in its previous dual role as both assessor of eligibility/service level and provider. Third-party assessors also have increased the quality of assessments by ensuring only those individuals truly in need are receiving PCA services, and only at the accurate level of services necessary to maintain safe community living. PCA services are now based on a professionally conducted and objective assessment with no potential for conflict of interest.

Accountability:
With the implementation of SB41, PCA providers were audited for the first time in the history of the program. According to data provided by the Department of Health and Social Services, during audits conducted in FY2005 the billing error rate among PCA services providers was 14.42%. Through efforts of the PCA Provider’s Association and the technical assistance provided by the Division of Senior and Disability Services, in FY2006 the billing error rate dropped significantly to 4.75%. The Departmental goal for FY2008 is to show additional improvement of another 10% or 4.28%. PCA service providers have embraced the concept of accountability and will continue to strive for lower error rates. (Please note that billing “errors” are not necessarily “overpayments,” in fact most of the audited “errors” did not overpay the provider.)

Sustainability:
Ideas about the best way to care for the elderly and people with disabilities have undergone dramatic changes in the past several decades. In Alaska and at the national level, the pendulum has swung towards in-home care and greater control over services by the recipient of care. As our population ages and chooses to remain in Alaska, the need for in-home support services will grow as well. PCA services are often the first line of defense, after familial and community support, for seniors who require hands-on assistance to remain in their own homes. With the assistance of a PCA, seniors are able to meet their basic health needs often preventing the need for more costly medical intervention or out-of-home placement. PCA services have effectively reduced the amount of time an individual may need to spend in very costly nursing homes at the end of his or her life; however, there is a cost to the provision of PCA services as well.

In order to sustain this viable service, PCA Providers must be adequately compensated to meet the rising operational costs. The Department of Health and Social Services has identified sustainability of a qualified provider pool as a key component challenge stating: “In order to provide affordable access to quality health care services to eligible Alaskans, a sufficient supply of providers must be enrolled in Medicaid. A strategy to maintain provider participation is for provider reimbursement rates to keep pace with health care costs. Since provider participation in Medicaid is voluntary, if Medicaid’s rates are too low providers may stop seeing Medicaid clients.”

Legislation To Strengthen State Medicaid Audits
We support the ongoing technical assistance efforts of the Department in assisting PCA Providers in continuously improving their accuracy rates on billing issues. Now that the State has good background data, as a result of SB41, we are seeking legislation to further strengthen Alaska’s system for auditing Medicaid providers, particularly in dealing with collection of “overpayments.” We urge the Legislature to follow the example of many other states, and adopt “safe harbor” audit rates and audit recovery principles:

• 10% or less in overpayment billing errors would incur only the obligation to pay back the difference between the correct billing amount and the overpayments (if any), and to take corrective action to prevent future errors, so long as no intent to defraud or to ignore prior corrective actions is indicated. (No extrapolation assessment.)

• Billing errors, of any rate, that result in underpayment to the provider or that result in neither underpayment nor overpayment shall not be subject to payback to either provider or the State, but shall be subject to corrective action regulations of DH&SS (e.g., requiring proof of improved provider documentation practices).
• When the rate of overpayment errors is more than 10%, only the average amount of overpayment above the correct billing amount may be extrapolated against the rest of the provider’s Medicaid billings for the audit period. (Again, assuming no fraudulent intent or disregard of prior corrective action.)

Legislative Support For Annual Rate Readjustments
The rates for reimbursement for PCA services have been frozen in regulation since 1998. We request regulations setting an annual adjustment to the PCA rate equal to the change in the consumer price index or the CMS nursing facility market basket (a national cost data study). It should be noted that Alaska’s Medicaid payment rates for hospitals and nursing homes are “re-based” every four years, and on the years in between the rates go up automatically by the percent of change in the CMS market basket. We support the Department’s efforts to establish rate-setting methodology that establishes uniformity among provider types of comparable services. This must happen to ensure that PCA providers are adequately compensated for the provision of their services. The cost of providing PCA services, as with all goods and services, continues to rise annually, including workers’ compensation insurance for this high-risk category of workers.

One Time Catch Up Adjustment In FY2008 Operating Budget.
We request a one-time “catch-up” adjustment of the current rate to reflect a 2.5% per annum adjusted rate from November 1998 through June 2008. For FY2008, this would raise the PCA rate to $26.88 an hour. Please note that the Governor’s budget includes funding for an 8% average increase between FY2004 and FY2008 in the Medicaid rates for hospitals and nursing homes, which are “re-based” every four years. PCA rates have not been adjusted since 1998.

Legislative Assurance Of Improvements In Integrity And Quality Of DH&SS Management Of PCA Program.
We support the continued efforts of the Department of Health and Social Services in conducting third-party assessments to determine eligibility and service level needs. PCA service providers are able to focus their attention on the provision of high-quality in-home support services without any potential for conflict of interest. Consumers can choose their service provider based on the quality of care they receive.

For more information, please contact:

Sandra J. Heffern
Chief Executive Officer
Ready Care
800 918-3045
sheffern@jobready-ak.com

Connie J. Sipe
Executive Director
Center for Community
csipe@cfc.org

James Beck
Executive Director
Access Alaska
800-770-4488
jbeck@accessalaska.org

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MS AWARENESS: Seven years ago, Doug Toelle was hauling supplies by snowmachine in the Brooks Range when some of the machines got stuck in overflow at 20 below.

As the group struggled to get the sleds out of the ice, he suddenly found that he was frozen and not because of the cold.

“My body shut down and wouldn’t move,” Toelle said in a recent letter to the Fairbanks City Council. “Tim Woller almost ran over me as I tried to get an uncooperative body to behave and react. I realized something was really, really wrong.”

Not long after that harrowing experience, Toelle was diagnosed with multiple sclerosis, the beginning of a struggle of a different kind.

The council approved a resolution designating this past week as Multiple Sclerosis Awareness Week. According to one estimate, about 200 people in the Fairbanks area have MS, a chronic and disabling disease of the central nervous system.

It strikes people in different ways, with symptoms that range from mild to severe. The disease can “erode a person’s abilities and hopes, halt a career and unravel the fabric of families,” yet there is research that holds promise, the council resolution said.

Some people are homebound with the illness, while others have a tough time getting around. Toelle said he can walk, but “every step requires thought and planning” because the disease inhibits the communication that takes place between his brain and his muscles.

“My primary symptoms are fatigue, lack of balance, limited mobility and pain,” he said.

Toelle, 50, has been a successful entrepreneur and consultant in information technology for two decades. He helped launch the first Internet Service Provider in Fairbanks, Polarnet, and has been involved in numerous other enterprises.

He said that he no longer has the energy it takes to run his own business, but he is grateful for the opportunity to help aging and disabled Alaskans as the new development director for Access Alaska.

The agency provides services to people with MS and other disabilities, with the goal of helping them continue to lead productive lives.

Toelle said that those who want to know more about Access Alaska can go to www.accessalaska.org or drop by the office in what once was the deli section of Foodland at 526 Gaffney.

Those who are dealing with MS are invited to attend the MS Support Group, which meets on the second Wednesday of the month from noon to 1:30 p.m. at Access Alaska.

From the Fairbanks Daily News-Miner

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Anchorage lawyer Jim Gottstein has emerged as a player in a national controversy over the psychiatric medication Zyprexa, which is Eli Lilly's best-selling drug.

An advocate against forced medication in the treatment of mental illness, Gottstein obtained documents about the drug that had been sealed in Outside lawsuits against Eli Lilly and provided them to a New York Times reporter. According to the Times, the records showed a decade-long effort to downplay the drug's health risks in order to protect sales.

Read more.

More on the PsychRights website.

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Read more in the Anchorage Daily News

"I sympathize with how complex Medicaid is for clients, health care providers, program managers, as well as employees. We also find it difficult as legislators to find a legislative fix for most of these problems," Senate President Lyda Green, R-Wasilla said.

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From the Anchorage Daily News

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