I recently had the chance to take part in an informational forum focusing on federal programs that provide a wide array of services to seniors living in our state and around the country. It was an excellent opportunity to speak about the benefits of community-based care with some of our elected officials who represent us in Washington, D.C.
As Ranking Senator of the legislature’s Aging Committee, I believe it is essential to improve these programs that enable seniors to stay in their homes and receive quality health care. At the event, we were joined by an impressive panel including U.S. Senator Richard Blumenthal, Congressman Joe Courtney, Executive Director Judith Stein of the Center for Medicare Advocacy and Dawn Lambert of the state Department of Social Services among others.
The event focused on current programs and proposed legislation that would assist individuals as they age in place, such as Money Follows the Person, Community Living and Support Services (CLASS), Medicare and energy assistance programs.
First, Congressman Joe Courtney (D-CT) spoke about House Resolution 1543 “Improving Access to Medicare Coverage Act of 2011,” a bill he is co-sponsoring with Rep. Tom Latham (R-IA), to address a recent trend regarding denial of Medicare coverage for payment of post-hospital care in a skilled rehabilitation or nursing home facility.
As an elder law attorney, I am quite familiar with problems with Medicare following a discharge from the hospital. Generally, Medicare provides payment for up to 100 days during each spell of illness. A patient is entitled to full coverage for the first 20 days and partial coverage for the remaining 80 days. The patient will not be eligible for any Medicare coverage unless he or she was admitted to the hospital for at least three days prior to the nursing home admission. However, due to an audit requirement, some hospitals do not admit individuals as “inpatient” status and instead keep patients in “observation.”
As a result, Medicare will not pay for the nursing home stay because the patient was never formally admitted as “inpatient” despite the fact that the patient was in a hospital room and bed for a number of days. Judith Stein, Executive Director of the Connecticut-based Center for Medicare Advocacy, stated that some patients remain in observation for 5 days. Congressman Courtney’s bill would allow Medicare to grant benefits if a patient was in a hospital for three days regardless of whether the stay was as an “inpatient” or “observation.”
Next, U.S. Senator Richard Blumenthal discussed S.B. 2077 “Elder Protection and Abuse Prevention Act of 2011″ which he proposed, together with the Money Follows the Person program that provides incentives for families to care for their loved ones in the community rather than a nursing home. Currently, in order to qualify for Money Follows the Person, an individual would have to enter a nursing home for 90 days before the state would help that individual return to the community. Common sense says that it would be far better, and less expensive, for the individual to remain at home and not go to a nursing home in the first place.
Bonnie Gauthier, president of Hebrew Health Care, ended by asking about the future of the CLASS program. CLASS is a privately funded voluntary program designed to provide long term care services to families. Senator Blumenthal stated that financial analysts warn that the CLASS program would not be solvent in the long term and is likely to face repeal in Congress later this year.
Overall, the forum was an exceptional opportunity to discuss important programs with our elected federal officials and how current legislation in Washington can affect us in Connecticut. Becoming a full committee in 2011, the General Assembly’s Aging Committee serves an important role in crafting laws to support our seniors. As one of the fastest growing aging populations in the nation, Connecticut must focus to make our state more user-friendly for aging in place.