Justice in Aging is a national organization that uses the power of law to fight senior poverty by securing access to affordable health care, economic security, and the courts for older adults with limited resources.
President Trump’s proposed FY 2019 Budget is yet another attack on the health and economic security of older adults and people with disabilities. After using the latest tax bill to give away trillions of dollars in tax cuts to America’s wealthiest, the Administration is attempting to pay for those tax cuts by slashing critical programs that keep older adults in their homes, allow them to visit their doctors, and ensure they can meet their basic needs.
This budget would take us backwards by increasing poverty and making it harder for people to get the health care they need. It goes against what Congress wants and what the public wants. In its 2018 budget, Congress recently increased spending for important and popular programs. Those gains would disappear in 2019 under this budget.
The American people do not want cuts to Medicaid or the repeal of the ACA, yet this budget renews calls for slashing Medicaid by more than $1.4 trillion over the next decade through block grants and per capita caps, as well as repealing and replacing the Affordable Care Act (ACA). As we have explained, such cuts would be devastating to low-income older adults who rely on Medicaid to support their health care needs and ability to stay in their homes, leave millions without coverage, and weaken consumer protections.
The President promised the American people he wouldn’t touch Medicare, yet his proposed budget for the next ten years calls for over $490 billion in cuts to a program that every American will need.
The budget also would make it harder for older adults to pay rent, put food on the table, and meet their basic needs. The budget proposes significant cuts of over $83 billion to Social Security, primarily through cuts to Social Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs. These programs are there for people who have no or little income and are the difference between home and a life on the streets for many.
Additionally, the budget proposes dramatic cuts to nutrition assistance, eliminates funding for home heating and cooling assistance for about 6 million low-income households, and calls for the complete elimination of the Legal Services Corporation, which provides vital legal help for low-income older adults and their families.
This budget is a true window into the misplaced priorities of this President and his Administration. On the heels of a massive tax cut that will increase income inequality, this budget proposes to make life even more difficult for America’s poor older adults and people with disabilities.
By joining together we have fought back successfully against previous attempts to cut the programs older adults and their families rely on, and we will continue to fight for justice for us all as we age.
(February 5, 2018) A new report released today by the Government Accountability Office (GAO) reveals that lax federal oversight over Medicaid-funded assisted living services threatens the health and safety of the over 330,000 people relying on these services across the country.
The report shows that “critical incidents”, such as unexplained deaths, assault, abuse, neglect, financial exploitation, and other serious situations are not tracked and reported adequately or consistently. Additionally, there is no way for prospective residents and their families to evaluate the quality of various assisted living facilities because this information is not readily available.
Though 48 states provide Medicaid coverage for assisted living at a cost of more than $10 billion annually, more than half (26 states) could not report the number of critical incidents occurring in assisted living facilities.
“The GAO report only scratches the surface,” said Eric Carlson, a directing attorney at the non-profit Justice in Aging. “Despite the significant federal Medicaid expenditures, the federal government generally defers to state assisted living licensing laws, and some of those state laws are grossly inadequate to protect the health and safety of the high-need residents that receive Medicaid funded assisted living care.”
Assisted living residents need significant assistance. In most cases, Medicaid funding for assisted living is only available for persons whose care needs would qualify them for admission to a nursing home. As found by the GAO, 94% of the programs cover assisted living services for persons who need extensive assistance to dress, bathe, eat, or use the toilet.
Contrary to what would be expected for such high need residents, many states do not require any nurse staffing in assisted living facilities. The care is provided primarily by direct care workers whose caregiving education may consist solely of an initial training of 15 to 30 hours, and continuing education of 10 or so hours annually, leaving thousands of residents at risk.
The GAO’s findings are consistent with what Justice in Aging attorneys have seen across the country in working with older Americans and their advocates. Federal legislation is needed to ensure that low-income people reliant on Medicaid receive the care and assistance that they need. Congress should set meaningful care standards, with penalties adequate to ensure compliance and to protect the rights of older Americans who rely on assisted living.
Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center, since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency. Through targeted advocacy, litigation, and the trainings and resources we provide to local advocates, we ensure access to the social safety net programs that poor seniors depend on, including Medicare, Medicaid, Social Security, and Supplemental Security Income (SSI). For more information, visit our website at www.justiceinaging.org.
Are you passionate about social justice? Would you like to contribute to a national effort fighting poverty among older Americans—particularly women, people of color, LGBTQ individuals, and people with limited English proficiency? Justice in Aging is looking for a talented Communications Associate to join our team in our Oakland, CA office.
Your contributions will help ensure that the growing number of Americans aging into poverty are able to pay their rent, buy nutritious food, see their doctors, receive the help they need at home to live safely, and get the legal help they need.
Justice in Aging is a national nonprofit legal advocacy organization that fights senior poverty through law. Since 1972 we’ve worked to secure access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBTQ individuals, and people with limited English proficiency. We provide trainings to thousands of direct service advocates a year, file impact litigation, and advocate at the local, state, and national level for policies to improve the lives of the more than 7.1 million older adults living in poverty.
This is a new position on the Communications Team to increase our impact and grow our profile. The successful candidate will be an integral part of implementing our communications strategy over multiple platforms, and will report to the Communications Director.
Work with the Communications Director to implement robust social media and earned media strategies.
Assist with digital communications efforts to maximize press coverage, drive media outreach, and build relationships with partners and grassroots advocates online.
Assist in conducting proactive, strategic media outreach that will elevate the stories of low-income older Americans and prime the environment for social change.
Work with the Digital Media Manager to design attorney-created publications, and create compelling visuals for use on social media and other channels.
Ensure digital communications strategies are data-driven by tracking and reporting out on performance metrics.
Maintain an up-to-date reporter database and assist the Communications Director in building relationships with individual reporters.
Desired Skills & Qualifications:
Strong written communication skills
Visual design skills
Experience using dominant social media channels strategically for advocacy
Attention to detail and commitment to the highest quality work product
Ability and desire to work collaboratively as well as independently
The position is full time, exempt with a competitive salary and benefits package including health, dental, and life insurance; flexible reimbursement plan; 403(b) retirement savings plan; personal days; and generous vacation policy. Salary range is $45,000-$55,000 depending on skills and experience. We maintain a respectful, collegial work environment in which we strive to hear and elevate all voices within the organization.
Justice in Aging is an Equal Opportunity Employer. We are committed to maintaining a diverse staff and we particularly encourage applications from members of racial and ethnic minority groups, women, the LGBTQ community, and others whose background may contribute to more effective representation of low-income people and underserved communities.
To apply: Send cover letter, resume, a PDF of a short document you have designed, preferably using InDesign or comparable program, and three professional references to Katrina Cohens at firstname.lastname@example.org by February 20, 2018. In your cover letter, please address the following in order for your application to be considered:
To promote social justice and best achieve our mission, Justice in Aging is committed to maintaining a diverse staff and creating an inclusive and respectful workplace in which differences are acknowledged and valued.
How do you think your personal or professional experience or background has prepared you to contribute to a work environment with a strong commitment to diversity and inclusion?
When: Thursday, February 22 at 11:00 a.m. PT / 2:00 p.m. ET.
Supplemental Security Income (SSI) is a critical safety net program administered by the Social Security Administration that provides a very basic income to older adults and people with disabilities with no or very limited other income and resources. This webinar is designed for legal services and other advocates who are just getting started in the field and others who want to learn more about the essentials of the program.
This webinar describes the SSI program, discusses the basic rules of eligibility and how benefits are calculated, and offers useful resources for obtaining additional information.
As of January 1, 2018, dental benefits were fully restored to adult Medi-Cal recipients. Restoration means that older adults will again have access to gum treatment, root canals on back teeth, and partial dentures. This is a big win for older adults and their overall health. This webinar, Oral Health Coverage for Low-Income Older Adults, will provide an overview of the restoration of benefits and Denti-Cal coverage more broadly. The webinar will also cover other dental coverage options available to older adults, how different coverage options work together, and barriers older adults face in accessing dental care.
The webinar will cover:
Denti-Cal coverage – including newly restored benefits
Other dental coverage options – Medicare Advantage, MediGap, Cal
Barriers to care
Who should participate:
Aging and legal advocates, community-based providers, and others wanting to learn more about California’s oral health coverage for older adults.
Amber Christ, Justice in Aging
The webinar will take place on Thursday, February 15, 2018 11:00 a.m. PT/ 2:00 p.m. ET.
(January 12, 2018) Yesterday, the Centers for Medicare & Medicaid (CMS) issued guidance to states that would allow them to condition Medicaid eligibility on fulfilling work and “community engagement” requirements. This represents an unprecedented change to Medicaid eligibility that threatens healthcare for millions of low-income persons, including older adults who are not yet eligible for Medicare, people with disabilities and chronic health conditions, and family caregivers.
Not only have punitive work requirements been proven ineffective at lifting people out of poverty or improving health outcomes, they are also extremely burdensome for beneficiaries to navigate and for states to administer. Requiring people to verify that they are either working or exempt from the requirement will inevitably lead to Medicaid-eligible people falling through the cracks simply because the process is too complicated, onerous or doesn’t work correctly.
CMS intends to allow states broad leeway in determining who would be subject to work requirements and what activities would satisfy those requirements. For example, while CMS recognizes that Medicaid beneficiaries may be caregiving for elderly family members, there are no required protections for caregivers. As a result, depending on how the state defines “work,” family caregivers, who are more likely to be women, risk losing their health coverage. Similarly, many people with chronic health conditions and disabilities that limit their ability to work could be excluded from coverage or face onerous verification processes to be exempted from a work requirement.
We strongly oppose this change in longstanding policy as defying the objectives of the Medicaid program and endangering the lives and well-being of those who rely on it. We urge CMS to reconsider this policy and call on states to maintain the purpose of Medicaid, protect the health of their residents, and not impose work requirements.
Governor Brown released his proposed budget for fiscal year 2018-2019 earlier this week. Despite the governor’s recognition of growing levels of poverty across California, his proposal prioritizes increasing California’s reserves without including any new investments or initiatives to increase the health care and economic security of older adults in California. With a Rainy Day Fund now totaling $13.5 billion, California is in a financial position to restore and strengthen programs that lift seniors and people with disabilities out of poverty while also maintaining sufficient reserves to protect against future federal threats and economic uncertainties. For low-income seniors aging into homelessness and struggling on fixed incomes, we can and must do more.
Most critically, the budget proposal does not restore benefits for elderly Californians and people with disabilities who rely on Supplemental Security Income (SSI) to meet basic needs. Specifically, the proposal fails to increase the State Supplementary Payment (SSP), which is the state-funded addition to the federal SSI benefit, or to provide a Cost-of-Living Adjustment (COLA) to the SSP. SSI/SSP helps ensure stability for seniors and people with disabilities at the very lowest income levels. However, as a result of recession-era cuts to the SSP, the benefit for an individual fell from 100.5% of the federal poverty level in 2009 to 90.5% of the federal poverty level in 2018, leaving individuals with a total SSI/SSP monthly individual benefit of just $910. As a part of the Californians for SSI coalition, Justice in Aging will continue pushing for full restoration of the SSP and annual COLA so that we can lift all seniors in California out of poverty.
Summary of Other Key Budget Proposals for Low-Income Older Adults:
Funding for Medi-Cal Dental Benefits and the State Oral Health Program
Last year, the Legislature and Governor implemented legislation to fully restore dental benefits to adult Medi-Cal recipients starting January 1, 2018, including root canals on the back teeth, gum treatment, and partial dentures. This year’s budget proposal includes $212.2 million to fund the restoration. This is a huge win for the overall health of older adults. For more information on the newly restored benefits, take a look at these Dental Factsheets we developed in collaboration with our partners at CPEHN and Asian Americans Advancing Justice.
This year’s budget proposal will also continue funding to California’s Oral Health Program within the Department of Public Health. This year the program will receive $30 million in funding to improve the oral health of all Californians at the local level through prevention, education, and community organizing.
Minimum Wage Increase and Provider Paid Sick Leave for IHSS Providers
This year’s budget proposal allocates $119.4 million to implement the state’s minimum wage increase for In-Home Supportive Services (IHSS) workers. The proposal also includes $29.9 million to fund the eight hours of paid sick leave IHSS workers are entitled to starting July 1, 2018.
Provider Rate Increases and Supplemental Payments
The budget proposal includes $649.9 million to fund provider rate increases and supplemental provider payments for both physician and dental services. The goal of these increases is to improve access to Medi-Cal services.
As costs continue to rise for housing, food, medical care, and other essentials, older adults and people with disabilities will struggle to live independently in the community without robust investment in and improvements to existing programs. In the coming months, as the budget process moves forward in the state legislature, we will continue to fight for increased economic security and access to affordable health care for seniors and to keep you informed about any changes to the programs that impact older Californians living in or near poverty.
December 20, 2017-Today, the House and Senate passed their destructive tax bill on a purely partisan basis. The tax bill provides an enormous tax break to wealthy individuals and big corporations at the expense of the well-being of millions of others, including older adults. The Joint Committee on Taxation estimates that the bill’s tax breaks for the wealthy will slash federal revenue by over $1 trillion, directly undermining critical programs that older adults rely on, such as Medicare, Medicaid, Supplemental Security Income, and Supplemental Nutrition Assistance Program (SNAP).
This bill threatens the health and economic security of older adults and their families in other ways as well. By repealing the Affordable Care Act’s individual mandate, the tax bill will leave 13 million Americans without health care, including older adults, people with disabilities and 5 million Medicaid-eligible individuals. The tax cuts will not provide financial relief to most older adults. The Institute on Taxation and Economic Policy finds that by 2027 the bottom three-fifths of Americans will see their tax bills rise, as temporary tax cuts for individuals expire and corporate tax cuts remain permanent. Further, under sequestration, the bill also triggers automatic cuts to certain federal programs, including $25 billion from Medicare in 2018 alone.
The fight is not over. Now that Congress has passed the tax bill, we must hold them accountable, and let them know that they can’t pay for tax cuts for the wealthy by slashing Medicare, Medicaid, Supplemental Security Income, SNAP, and many other programs that older adults depend on.
We will be here in the New Year ready to fight back and provide you with the information you need to do your jobs. Thank you for everything you do. Together we will protect older adults, people with disabilities, and their families from harm, and work to strengthen the programs they rely on.
Flawed Plan Will Put Health Care for Older Adults & People with Disabilities at Risk
Washington, DC — Over 50 organizations concerned about access to affordable, high-quality health care and long-term services and supports for older adults, people with disabilities, and their families, sent letters to Congressional leaders in both the House and the Senate today in opposition to the tax bill that is likely to be voted on next week. The letters reiterate the organizations’ strong opposition to any tax bill that would put at risk both health care and long-term care for older adults and people with disabilities.
The reported effects of the tax bill would be to explode the national deficit by at least $1 trillion, and potentially much more. This tremendous revenue shortfall will inevitably put Medicaid, Medicare, Social Security and other programs at risk for massive cuts. These are programs that millions of older adults, people with disabilities, and their families rely on. For example, more than 57 million older adults and people with disabilities rely on Medicare, including 11 million low-income beneficiaries who have both Medicare and Medicaid.
As currently reported, the tax bill would also repeal the Affordable Care Act’s (ACA) individual mandate, leading to an additional 13 million Americans uninsured. Such a repeal will increase insurance premiums for people with preexisting and chronic conditions, disproportionately affecting the 3.3 million adults over 55 who obtain insurance through the ACA marketplaces, and hurting their ability to afford health care.
The letters urge Congress to return to the drawing board. A bipartisan, transparent process for tax reform must take these issues into consideration and must include public hearings, open comments, multi-stakeholder meetings, and sufficient time for the Congressional Budget Office (CBO) and the general public to analyze and understand the bill.
Read the letters and see the list of signatories here: Senate, House.
Justice in Aging (www.justiceinaging.org) is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center, since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency.
The Medicare Rights Center (www.medicarerights.org) is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.
The Center for Medicare Advocacy (www.medicareadvocacy.org) is a national, nonprofit, non-partisan law organization that works to advance access to comprehensive Medicare coverage and quality health care for older people and people with disabilities through legal analysis, education, and advocacy.
On October 2, 2017, the Centers for Medicare and Medicaid Services (CMS) initiated changes in the Provider Remittance Advice and the Medicare Summary Notice (MSN) to show more clearly that Qualified Medicare Beneficiaries (QMBs) may not be charged for Medicare deductibles and co-insurance. Unfortunately, CMS will be temporarily suspending these system changes as of December 8 because of significant unforeseen issues affecting provider payments. CMS is working to address the problem and reinstate the new systems sometime in 2018.
The temporary suspension of the system improvements does not affect the rights of QMBs. QMBs do not owe deductibles and co-insurance for any Medicare Part A or Part B services.
The suspension also does not affect another change, instituted in November, that enables providers to confirm QMB eligibility before serving individuals, using the same systems through which they check other insurance coverage.