LEGISLATION AFFECTING OLDER ADULTS & THEIR CAREGIVERS
Federal aging legislation, policy and initiatives:
S192 Older Americans Act Reauthorization
The Older Americans Act (OAA) Reauthorization Act, S.192, has officially passed the Senate again unanimously and was signed into law by President Obama on April 19, 2016!
FY2016 funding Bill provides a number of increases for aging programs:
- OAA Title IIIC, Congregate and Home-Delivered Meals, received an increase of $20 million, bringing these programs to a total of $835 million
- OAA Title IIIE, National Family Caregivers Support Program, was increased by $5 million, and now totals $150 million
- OAA Title VI Native American Nutrition Program was increased by $5 million, its first increase in years, and now totals $31 million
- OAA Title VI Native American Caregiver Program was increased by $1.5 million, and now totals $7.5 million
- Elder Justice Initiative was doubled from $4 million to $8 million, and will be used for the Adult Protective Services national database
- Community Services Block Grant was increased from $675 million to $714 million
Other programs received "flat funding," the same funding levels as FY2015, including:
- OAA Title II Aging Network Support Activities (such as the Eldercare Locator and Aging and Disability Resources Centers)
- OAA Title IIIB, Home and Community-Based Supportive Services
- OAA Title IIID, Preventive Health
- OAA Title V, SCSEP, avoiding proposed cuts of $30 million
- OAA Title VII Ombudsman Program
- OAA Title VII Elder Rights Support Activities
- State Health Insurance Assistance Programs (SHIPs), avoiding proposed cuts of $22 million
- Social Services Block Grant
- Senior Medicare Patrol
- LIHEAP (Low-Income Home Energy Assistance Program)
No Older Americans Act programs received cuts this year.
S.1719 Recognize, assist, include, support, and engage family caregivers act of 2015 or the raise family caregivers act (raise)—Sponsor: Susan collins (R) maine:
Introduced—July 8, 2015
Congressional Action—Passed by unanimous consent by the Senate on 12/8/2015
This bill directs the Department of Health and Human Services (HHS) to develop, maintain, and periodically update a National Family Caregiving Strategy.
S. 2425: patient access and medicare protection act—Sponsor: Robert Portman (R) Ohio:
Introduced—December 18, 2015
Enacted —December 28, 2015
This bill amends the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments; establishes Medicare administrative contractor error reduction incentives; strengthens penalties for the illegal distribution of Medicare, Medicaid, or CHIP identification.
Ohio legislation, Policy and Initiatives:
Healthy ohio program legislation included in the FY2016—2017 biennium budget bill signed by Gov. Kasich on June 30, 2015, if approved by CMS, will change how the state's Medicaid program works for non-disabled adults receiving Medicaid. The Healthy Aging Ohio Program would include a requirement for certain individuals receiving Medicaid to contribute 2% of their family income or $1 per month, whichever is greater, to a health saving account called a "Buckeye Account." Additional elements of health Ohio include as outlined by the Ohio Hospital Association (10/15) includes rules that:
- Require each county office of the Department of Job and Family Services to refer each Healthy Ohio Program participant who is unemployed or underemployed to a workforce development agency.
- Terminates for at least 12 months the participation of a non-pregnant participant if a monthly payment to a Buckeye account is 60 days late or if a participant fails to timely submit documentation needed for a Medicaid eligibility redetermination' permits a participant to resume participation once the participant pays the full amount of the monthly installment or submits the documentation needed for the redetermination instead of making the individual wait at least 12 months.
- Requires that a participant who exhausts the annual ($300,000) or lifetime ($1 million) payout limits be transferred to the fee-for-service component of Medicaid or the care management system.
- Additional information:
Streamline Medicaid Disability Eligibility and Eliminate Spend Down—Under the Medicaid program Ohio will transition from what is known as a 209(B) State under Title XIX of the federal Social Security Act (SSA) to what is known as a 1634 state under Title XVI of the SSA.
What's the difference?
- Ohio maintains separate systems for Medicaid and SSI
- Individuals granted SSI by the OOD (Opportunities for Ohioans with Disabilities, a state agency that make determinations on Social Security disability) must complete a separate Medicaid and disability determination process
- Ohio must operate a spend down program
- State accepts SSA decision of SSI (in Ohio, OOD determines SSI eligibility)
- SSI beneficiaries are automatically enrolled on Medicaid
- Ohio is not required to operate spend down
What is the impact?
- Eligibility income for the aged, blind and disabled population Medicaid group increases from 64% of the FPL to 75% of the FPL.
- Ohioans who are currently on SSI (but not yet enrolled in Medicaid) will be automatically enrolled in Medicaid.
- Higher income individuals including those in institutions and receiving HCBS waivers services will need to put their income in a Miller Trust to continue to qualify for Medicaid. The Special Income Limit in 2015 is $2,200 per month.
- 22,000 or more community Medicaid Spend Down beneficiaries will no longer qualify for Medicaid because their income is too high. In 2015, this amount is $733 per month.
- Ohio Medicaid will seek a state plan amendment from CMS to create a special benefit program for adults with severe and persistent mental illness. These individuals must meet diagnostic and needs assessment criteria established by the state and validated by a third party entity.
To add your support to these legislative, policy and program initiatives, follow the above links to get more information and contact your legislators. Need help? Follow the link to getting tips for writing letters, calling and visiting your legislator.