Access Alaska: Keep your eye on this one Archives

IMPORTANT - Temporary moratorium on some Medicaid applications and enrollment

Temporary Moratorium on Application and Enrollment in Home and Community-Based Medicaid Waivers and Personal Care Assistance Services

This is why it is critical to call Senator Murkowski's office and ask her to co-sign the Community Choice Act. With the strike of an anonymous bureaucrats pen Home and Community Based services in Alaska have been cut. Call the state today and find out how they intend to keep us in our homes and out of nursing homes.

For Immediate Release July 1, 2009

Contact: Cathy Stadem, 269-3495, catherine.stadem@alaska.gov, Sarana Schell, 269-8041, sarana.schell@alaska.gov

State Senior and Disabilities Services responds to federal review

Temporary moratorium on some Medicaid applications and enrollment

(Anchorage, AK) —The state Division of Senior and Disabilities Services is working this summer in coordination with the Centers for Medicare & Medicaid Services (CMS) to improve its compliance with federal standards in the areas of Home and Community Based Medicaid Waivers and Personal Care Services (Personal Care Assistance).

“We greatly appreciate the thorough and helpful review that CMS recently completed and we are eager to work hand-in-hand with them in any way that will better serve Alaskans who use and need our services,” said Rebecca Hilgendorf, Director of Senior and Disabilities Services.

The CMS review cited several areas in need of improvement to assure that the state’s oversight of the Waivers and Personal Care Services is consistent with federal and state regulations.

While the improvements are ongoing, the state cannot accept new applications for the Home and Community Based Services Waivers or Personal Care Services at the direction of CMS. The department is evaluating other programs available to provide interim services to the persons who are affected by the CMS-imposed moratorium.

“This is only a temporary moratorium while we catch up with a backlog of assessments and implement systems designed to ensure the health, safety and welfare of Alaskans,” Hilgendorf explained.

The division will also assure that its staff and managers responsible for the Home and Community Based Services and Personal Care Services programs attend Web-based waiver training, which is sponsored by CMS. Following the training sessions, the division will develop a work plan and timeline to implement a quality-improvement strategy and end the moratorium.

“After our plan is developed, we will submit it to CMS for approval,” Hilgendorf said. “Our goal is to quickly resolve the areas of concern while strengthening Alaska’s long-term care system for now and the future.”

Providers and Medicaid recipients with questions may contact Angela Salerno at 465-4874, or angela.salerno@alaska.gov.

More information here.
Download memo from DSS

Tags: Olmstead, HCBS, Healthcare, Long Term Care, Nursing Homes, Independence

New Rule Enacted by Bush Administration Impedes Cases Against Nursing Homes

By Cindy Skrzycki
Tuesday, February 24, 2009; D02

The Bush administration shut off a source of information last fall about abuse and neglect in long-term care facilities that people suing nursing homes consider crucial to their cases.

The change, which affects the $144 billion nursing-home industry, was enacted with no public notice or attention.

"This is pretty stunning," said Mark Kosieradzki, a plaintiff attorney in Plymouth, Minn. "Nobody was told. It was just done."

The rule designates state inspectors and Medicare and Medicaid contractors as federal employees, a group usually shielded from providing evidence for either side in private litigation.

The restrictions affect about 16,000 nursing facilities and 3 million residents in the United States. The practical effect is to force litigants to go to greater lengths, including seeking court orders, to get inspection reports or depositions for cases they are pursuing or defending.

"This change hurts nursing-home residents and their families by allowing bad practices to be kept in secret by nursing homes and inspectors," said Eric M. Carlson, an attorney with the National Senior Citizens Law Center in Los Angeles. "Government inspectors have the right to go into nursing homes and investigate, and they learn things that residents and families otherwise could never find out."

The new rule, which was issued in September, generally prohibits state health departments and contractors from participating in private lawsuits involving facilities that are in the federal assistance program without approval by the head of the Department of Health and Human Services.

The rule was justified as being necessary to accommodate the hiring of new contractors to make Medicare payments to providers, perform audit and fraud reviews, and do survey, certification and enforcement work for the program.

Requests for these employees to participate in private cases "divert employees from their federal survey, certification and enforcement responsibilities," the Bush administration said in a supporting document. "The cumulative effect of these requests can impede these activities."

The effect of the directives has started to play out in the nation's courtrooms. Requests for information, once fairly routine, now are stalled between state and federal officials.

Anne Marie Regan, an attorney with the Kentucky Equal Justice Center, a nonprofit poverty legal advocacy and research center, said the change has slowed a case she is pursuing on behalf of an 85-year-old man who was evicted from a nursing home in 2007.

Priscilla Shoemaker, legal counsel for the American Health Care Association in Washington, said nursing homes "are in the same boat" because they also have difficulty getting information on how state inspectors determine penalties, citations and orders to shut down homes.

From the Washington Post.

Update - State assumes control of nursing home

February 12, 2009 - From the Public Information Officer at the Alaska Department of Health and Social Services Division of Public Health

All the entities concerned with the operation, ownership, and management of Mary Conrad Center, including the SOA, are continuing discussions with potential new owners. Should the need arise; the provisional license will be considered for extension.

December 24, 2008 - State grants Mary Conrad home temporary license

The owner of the embattled Mary Conrad Center has agreed to sell the home within 60 days, state health officials said Wednesday.

The health department seized control of the nursing home last Thursday after a five-day investigation, revoking its license and saying it posed an "immediate danger to the health, safety or welfare" of its roughly 90 residents.

The state found medication errors, unclean kitchens and residents with unattended injuries, among other problems, said Public Health Director Beverly Wooley.

December 19, 2008 - State assumes control of nursing home

More here

State health officials said today they are taking over a long-term care center in Anchorage due to the alleged "immediate danger to the health, safety or welfare" of its residents.

he 78-unit Mary Conrad Center was sold this year to RainDance Healthcare Corp. Inc., a Seattle company owned by a controversial former nursing home executive who had stints involving corporate lawsuits and bankruptcy.

State officials said they served a notice today of immediate license revocation to RainDance following the results of a recent inspection at the nursing home. They said revoking a license is a "rare step."

The inspection last week "revealed conditions which the state believed to present an immediate danger to the health, safety or welfare of individuals receiving services at the center," the state said. It provided no details of its inspection.

The state Department of Health and Social Services said it has brought extra staff to the center to manage it. RainDance will be able to appeal the license revocation.

Last year, the Cook Inlet Housing Authority decided to sell the center after it and Providence Health and Services could not agree on terms for renewal of Providence's lease agreement to run the center.

The proposed sale generated concern among some families who said they "Googled" the owner of RainDance, Andrew Turner, after the proposed sale was announced and worried about his past business history.

When Turner visited the center after the proposed sale was announced, he told residents and families that he planned no changes in staffing levels, employee benefits and services to residents.

Follow the story on ADN.

Co-Payments Soar for Drugs With High Prices

From the New York Times: Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases... The system means that the burden of expensive health care can now affect insured people, too. Pay here.

Health Insurer To Be Charged With Teen's Murder

The family of a California teenager who died awaiting a liver transplant say they will sue the insurer who they blame for their daughter's death.

Nataline Sarkisyan, a 17-year-old from Glendale, Calif., died Thursday just a few hours after her insurer, CIGNA HealthCare, approved a procedure it had previously described as "too experimental."

Bill Introduced to Increase Access to Community-Based Services

On March 7, 2007, Senators Tom Harkin (D-IA) and Arlen Specter (R-PA) introduced the Community Choices Act (S. 799) which would give individuals who are eligible for nursing home services or other institutional care equal access to community-based services and supports. The bill would provide an increase in federal funds to help states develop their long-term care infrastructure and to enhance their ability to provide home and community-based services. The bill would also create a demonstration project to evaluate service coordination and cost sharing approaches for those eligible for both Medicaid and Medicare. For more information, visit: thomas.loc.gov.

The bill does not appear to be online yet.

Anchorage attorney battles drug giant

From the Anchorage Daily News

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.

Alaska Medicaid report offers recommendations for cost savings

Tribal health care reform may be a key to controlling the mounting costs of Alaska's Medicaid program, according to a report commissioned by the Alaska Legislature.
The report, penned by the Pacific Health Policy Group and presented to House and Senate committees on Tuesday, offers recommendations that its authors say could save the state between $80 million to a $100 million a year while improving health care services to Alaska Natives and others.

State explores Medicaid changes to hold down costs

"A report commissioned by the Legislature has warned the state that the health care costs for Alaska’s neediest populations will continue to rise significantly during the next 10 years unless reforms are adopted to the Medicaid system. "

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