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Long-Term Care Proposals Within Health Care Reform |
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It is impossible to listen to TV news commentators or read a news service without hearing about health care reform. There is an important component to health care reform, however, that does not seem to be getting much press: long term care. Did you know…for the first time since 1965, when Medicaid began…a national long-term care insurance program is under serious consideration by both the House and Senate?
Taking on the long-term care system is a tremendous initiative. When the Clinton administration attempted health care reform in the early 1990’s, experts to the administration advised them to avoid any discussion about long-term care. Health care reform today is different. For example, on October 13, 2009, the Senate Finance Committee approved America’s Healthy Future Act of 2009. Next, the bill will go to the full Senate for debate. A commentator on N.P.R. said on October 16, 2009, that when the health care reform bill goes to the Senate floor, it will be combined with another Senate bill. [That’s all that was said: “another Senate bill.” And then the commentator moved on to the next story or commercial break.] What is this other Senate bill? It is the Community Living Assistance Services and Supports (C.L.A.S.S.) Act. The bill number is S.697, and the equivalent bill in the House of Representatives is H.R.1721.
The C.L.A.S.S. Act is intended to help people with disabilities gain access to supports and services they need to live independently, so they can have more choices and opportunities to live and participate in their communities. It would establish a national insurance program to provide benefits to adults who become severely functionally impaired.
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The C.L.A.S.S. Act is intended to help people with disabilities gain access to supports and services they need to live independently.
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As the bill is currently proposed, here are the highlights:
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All working adults will be automatically enrolled in the program, unless they choose to opt out of the program.
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Voluntary premium payments ($30/month, regardless of age) will be collected through payroll withholding and placed in an “Independence Fund” managed by the Department of Health & Human Services who will work with third-party administrators as needed.
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To qualify for benefits, individuals must be 18 years old and have contributed to the program at least 5 years.
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State disability determination centers will determine persons eligible to receive benefits as: (1) individuals who are unable to perform two or more activities of daily living (ADL) e.g. eating, bathing, dressing, or (2) individuals who have an equivalent cognitive disability that requires supervision or hands-on assistance to perform those activities (e.g. traumatic brain injury, Alzheimer’s disease, multiple sclerosis, mental retardation).
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The bill provides for two different tiers of cash benefits:
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Unable to perform 2 or more ADLs or have the equivalent cognitive impairment – Tier 1 benefits – $50/day in cash (adjusted annually for cost-of-living), plus advocacy services and counseling.
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Unable to perform 4 or more ADLs or have the equivalent cognitive impairment – Tier 1 benefits – $100/day (adjusted annually) in cash, plus advocacy services and counseling.
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The C.L.A.S.S. Act has the support of the White House as well as almost 100 groups representing the disabled, the elderly, and America’s workers.
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As currently proposed, the bill would have the cash benefit posted monthly to a debit account or a “Choice Account”. Individuals who do not use the full monthly amount may roll it over from month to month, but not year to year.
C.L.A.S.S. Act benefits will be independent of Social Security retirement or disability benefits, independent of Medicare, and independent of Medicaid. In other words, any C.L.A.S.S. Act benefits would simply be added to any benefits a person otherwise receives from other government programs. C.L.A.S.S. Act benefits can also be an addition to any long-term care insurance benefits paid by a private carrier.
The C.L.A.S.S. Act has the support of the White House as well as almost 100 groups representing the disabled, the elderly, and America’s workers, including the Alzheimer’s Association, the American Association of Homes and Services for the Aging, the National Academy of Elder Law Attorneys (NAELA), Easter Seals, and many faith-based coalitions and associations. In late September, the White House reaffirmed its support for the C.L.A.S.S. during a town-hall style meeting hosted by Vice President Biden and Health and Human Services Secretary Kathleen Sebelius.
The program appears to have mixed support by the insurance companies that sell long term insurance contracts, who argue that the program would place even more barriers to people buying LTCI. A positive alternative, however, is that perhaps the debate about the program will bring the need to plan for long term care into the forefront.
If you wish to follow the progress of S.697 and H.R.1721, one source is The Library of Congress.
Source: Press Release dated March 25, 2009 from offices of Sen. Kennedy, Rep. Pallone, and Rep. Dingell
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“Family Business” |
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The entire Hurley Elder Care Law family (and extended family) participated in annual Memory Walk sponsored by the Alzheimer’s Association. Despite the chilly temperature, a good time was had by all.
Sandi took a few days off to visit her daughter in California. She had a great trip reconnecting with old friends and spending time with the grandkids (one of whom is more than 6 ft tall and driving!).
The next time you see Dawn please wish her a happy birthday – it’s one of the big ones!
Our oldest son, Peter, landed a part in the middle school play titled “15 Reasons not to be in a Play”. We are looking forward to attending a school event that doesn’t involve a referee and a ball. Last but not least – Louise and Dawn are going on vacation together! Stay tuned for details.
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 Miles Hurley
Miles Hurley is the founding partner of Hurley Elder Care Law, which was created to provide comprehensive legal solutions for families with age- related events.
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Continue reading » |
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Miles Hurley Presents:
10/22/09 – 11:30 a.m.-1:00 p.m.
Lunch n’ Learn
UniHealth Post-Acute Care Brookhaven
10/23/09 – 12:30-3:45 p.m.
NASW GA Chapter Annual Conference
10/27/09 – 5:00-7:45 p.m.
CEU event, Provino's
10/29/09 – 12:00-1:00 p.m.
CEU event, Piedmont Hospital
11/05/09 – 5:30-7:30 p.m.
ADRC Fall Research Update, Mills Senior Center
11/06/09 – 9:40 a.m.
Presbyterian Village
11/12/09 – 1:30-2:30 p.m.
CEU event, Emory Hospital
11/14/09 – 10:00 a.m.
Manor Care of Marietta
11/17/09 – 8:30 a.m.-2:45 p.m.
CEU event, Sunrise of Decatur
11/20/09
Presbyterian Village
12/05/09 – 10:00 a.m.
Manor Care of Marietta
01/30/10 – 10:00 a.m.
Manor Care of Marietta
02/27/10 – 10:00 a.m.
Manor Care of Marietta
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For event details and more information, click here. |
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