HOMEPAGE

 

PURPOSE OF THIS WEB SITE

Individuals and agencies regularly ask about aging and mental health:

    * How and where do I obtain a service?
    * How do services differ?
    * How do I know if someone needs help?
    * What can I do to stay healthy?
    * Who are providers and how do I know what they do?

It became clear that information about elder mental health and appropriate services is not accessible to everyone.



The Greater Lowell Elder Mental Health Collaborative decided to develop an elder mental health resource. It made sense to place this information at an accessible location. We also wanted to make changes easily in order to keep them current. Therefore we decided to develop an elder mental health resource guide on a web site.

The information in this guide is available to anyone.
The section on agencies and their services is about the Lowell area. The other sections are applicable no matter where you live or work. It is our hope that this guide will help you to make referrals or to obtain services more easily. It will not help you to make diagnoses or assessments for yourself or for others.


We encourage your participation in this guide. If you have suggestions about information or what could be added to any section please let us know
.
Click for the Mission Statement

For More Information

For information about the organization, please send email to info@ eldermentalhealth.org 

For information about this site, please send email to webmaster@ eldermentalhealth.org.




A recording of an interview with Frank E. Baskin

on WUML (UMass Lowell radio) about Elder Mental Health.

 
DIRECTORY (click here)

................................


News Flash
May 3, 2010
House Passes 2011 Budget

On 4/30 the House passed a budget with reduced or level funded services. There were no new revenues. 
Elder Affairs(EOEA) did not receive  new funding.  As a result, if the Senate passes the same funding for EOEA the home care wait list will continue. 
The PNA and leaves of absences for nursing and rest homes were preserved.
Adult dental services will be reduced(details later).
UPDATE ON HOUSE BUDGET PROPOSAL
April 16
Services for elders were mostly set at the same levels as this current fiscal year(level funding).
If passed it means that the wait list for home care will continue into the new fiscal year.


2011 BUDGET DEBATE HOUSE  PROPOSAL
APRIL 14

The Ways & Means Committee announced its budget. There are many cuts(Medicaid, Local Aide, Judiciary, Higher Ed) and no new revenues. 
Details later. Amendents will be accepted on 4/15-16.
Floor debate take place the week of April 26.


 

March 8, 2010

Over use of Psycho-tropic Medications in Mass Nursing Homes
 
An article in the 3/8/10 edition of the Boston Globe discusses a study of psycho-tropic use of medications for nursing home residents.
There is ,evidently, a greater use in Mass facilities than in other States.
Go to:
www.boston.com for the full article.
 

MASS 2011 BUDGET DEBATE
 
 MARCH, 2010
 
The House Ways and Means Committee is expected to announce its budget proposal for 2011 in mid April followed by a floor debate the last week of April.
If revenue projections are low( as predicted by the House and Senate Ways and Means Comm chairs) then funding for services may decrease.
They are indicating that Cities and Towns should expect lower funding. If so, then Senior Centers will receive less monies.
 
FEBRUARY,
2010
 
The House and Senate leadership indicated that revenues are expected to come in at a lower rate and therefore there will probably be reductions in the 2011 budget(compared to 2010).Level funding is not likely.
The House is likely to release its proposed budget in April.


Governor Patrick announced his proposed budget today(1/27/10).

Most items for elders were level funded. 
The PNA was restored at $ 72.80 and the leaves of absences were set at ten
days.
Prescription Advantage will be reduced

MASS 2010  BUDGET UPDATE

Funding for the elder mental health line item has been eliminated.

Please contact your Mass State Rep and Senator to advocate for this funding.
 
December, 2009

December 14

The reductions announced below have been reversed and include:

  • Maintain rates for adult foster care and group adult foster care(used for assisted living)
  • Adult dental and podiatry services returned
  • No additional co-payments for dental, medications and other services.

Elder Mental Health remains unfunded.

The home care waiting list has grown to over 2,300.




 
December 6
 
The Governor announced that spending cuts for the homeless have been reversed. He also said that potential additional cuts for human services will not happen. The State will use some unexpected monies to pay for these services.
 
The waiting list for home care has now reached 2,000 people.
 
December 4
 
Other impacts on elders in the Mass State budget include:
 
  • Elder Mental Health - Funding for this line was eliminated.
  • PNA - Reduced for both rest and nursing home residents to a level set around 1990(this has not yet been implemented as Medicaid has not yet required it and so facilities should still use the $ 72.80 rate).
  • Adult Foster Care  - Rates will be reduced.
  • Group Adult Foster Care(GAFC - pays for assisted living)- Rates will be reduced.
  • Personal Care Attendants(PCA) - Some clients will be removed from the program(if they require less than 14 hours of a PCA per week) but may be able to enter a SCO.
  • Protective Services - Reduction of funding(about 6 %).
  • Senior Centers - Reduction in funding.
  • Medicaid - Co-payments will rise for office visits and medications. There will be restrictions of podiatry and dental services.
  • Home Care - The waiting list(for regular home care and ECOP) was expected to grow to about 2,000 by the end of this fiscal year(June 30, 2010). It is already there. It may instead be about 5 - 6,000 by then. If revenues do not increase during the year the waiting list will continue into the next fiscal year and can be expected to increase further.
 

November, 2009

The Governor announced that there will be cuts in benefits fot those on MassHealth. No one will be dropped from services but many will either not receive a service or will have to pay more for it.

For example. the co-payment for psycho-tropic medications will rise and dental services for adults will be more restricted.

Week of October 26

Governor Patrick clarified with more specifics about his 9-C cuts announced last week(see below).

Cities and towns will not see any reductions in revenue from the State.

1. Senior Centers will experience $ 500,000 reduction.

2. Protective Services will see a one million dollar cut.

3. The Department of Mental Health will see smaller reductions in revenue than expected(and most of that at managerial levels).

4. Home Care was spared any further reductions.


Week of October 12

Governor Deval Patrick announced that there will be further cuts  in the 2010 budget.
This will include:

  • Cuts to Cities and Towns(which means that Senior Centers may be impacted).
  • Cuts to staff at all State agencies(which will include Elder Affairs, DMH, and DPH).
The  details of these cuts will be clear later and there may still be further cuts.

 
As of September 8 a state-wide waiting list for home care clients has begun. 

The reduction in funding for 2010 by the State has resulted in this limitation of services for frail elders. Unless there is additional funding it is unclear if this wait list can end prior to the end of the fiscal year.

There will a priority given for those who are:
  •  abused, 
  •  being discharged from hospitals and nursing homes, 
  •  in hospice.

This wait list will be managed by the Executive Office of Elder Affairs(EOEA)

and not by the individual ASAPs. When services are available for individual clients who do not meet the above priorities EOEA will decide who shall receive services based on a priority system in place at EOEA.

ACTION STEP

You should use this information when you contact your state senator and representative about restoring monies for elder services(including home care, wages for CNA, elder mental health, PNA).


SUPPLEMENTAL 2010 BUDGET AND THE PNA

 
Governor Patrick recently vetoed the PNA which reduced it from  $ 72.80 to
$ 60 per month. The legislature passed a supplemental budget for 2010 which, among other things, included the PNA at $ 69.68 per month.
The Governor can veto this budget or any part of it. That could place the PNA in danger.
 
ACTION STEP:
Please call the Governor at 617-727-3666 and ask him to retain the PNA as it is in the Supplemental budget.
 
ELDER MENTAL HEALTH LINE ITEM
 
All funding for this line item was removed. Whille it seem unlikely that any monies will be restored soon the Massaging and Mental Health Coalition will continue its efforts to educate others about this issue. (see Massaging and Mental Health Coalition).
 
 
 




FEDERAL HEALTH CARE LEGISLATION
 
March 25, 2010
 
More Details about the Health Care Law:
 
The CLASS Act
 
This provision adds insurance for long term care. It will be voluntary and will include a monthly premium. Beneficiaries will receive money(prehaps
$ 50 - 75 per day). Those funds can be used for home and community based care, assisted living , or nursing home care.
 
Medicaid
 
States will be reimbursed at 100 % for the additional costs for new beneficiaries.
 
Elder Justice
 
This provision provides greater protections around elder abuse , neglect and exploitation. It will enhance adult protective service and ombudsperson programs.
 
 
 
March 23, 2010
 
The President signed the Health Care Law today.
 
March 22, 2010
 
On Sunday March 21, the House of Representatives passed a Universal Health Care Bill which will be signed by the President. The House also passed a companion bill to amend the previously passed Senate bill which will require a Senate vote(by a simple majority).
 
Details are not all available but the following is known:
 
General
 
  • Require all Americans to have health care insurance
  • Individuals receive insurance thru exchanges within each State
  • Expand Medicaid
  • Subsidies for those individuals/families who do not qualify for Medicaid
  • Small businesses receive tax credits to provide insurance to their employees.
 
About elders:
 
  • Gradually eliminate the Medicare D donut hole ending it by 2020.
  • Add free preventive services under Medicare
  • Reduce subsidies for Medicare Advantage 
 
Revenue:
 
  • Payroll tax will apply to  those whose income is over $ 200,000.
  • Tax on unearned income over $ 200.000
 
March, 2010
 
The President has revised his version of the bill and has come to agreement with House and Senate leadership.
It will now be submitted to the House for a vote on the bill. This will involve a vote for the already passed Senate version plus votes on changes to the bills.
The vote may take place on March 21st.
 
February,2010
 
There has been no action on the passed House and Senate bills.

 February 25, 2010

 
The President met with House and Senate leadership from each party at the Blair House to discuss the Health Care bills.
They all expressed their preferences and essentially agreed to disagree.

February 22, 2010
 
The President announced his version of a Health Care bill. It is similar to the House and Senate bills.It  includes the CLASS provisions which allows for an optional long term care benefit(from home and community based care to nursing home care). There is no age or income requrement.
Much of his proposal is similiar to the bills already passed(tho more like the Senate version) along with some additions which came out of the Blair House session last week).
 


December, 2009

 
WEEK OF DECEMBER 20
 
December 24, 2009

The Senate this AM passed its version of a universal health care bill.
 
Start Date - 2014 except for some protections which start sooner.

Payment - Taxes on higher cost(cadillac)health care plans;fees on medical device makers
and indoor tanning;higher medicare payroll taxes on high income people.

Aid/subsidizes for low and middle income people.

Pre-existing conditions(and other insurance company exclusions)eliminated.

Medicaid - Expanded.

Children covered up to age 25.

Public option - Not included but the Federal Office of Personnel Management
will coordinate nation-wide plans which must include at least
 one non-profit. People will choose among plans.

***
An amended proposal is expected to be placed
on the floor of the Senate for a vote by Dec 24,
What we know presently is the following:

  •  Most Americans will be required to have health insurance.
  • There will not be a government option.
  • There will be insurance exchanges where consumers may choose among insurance plans.
  • Some plans will be national non-profits.
  • A federal government agency will oversee the exchanges.
  • Earlier limits on the insurance companies(ex.- eliminating the presence of a pre-existing
  • condition as a reason to deny insurance) will remain.
  • There will be subsidies for middle income families who have income ofup to $ 88,000.
  • The tax on plastic surgery was taken out. It is unclear what other was substituted. The tax on high value or luxury plans remains.
 
We'll add more as we receive additional
information.

Week of December 14
 
* During this week opposition to the expansion of Medicare grew
and its inclusion in the bill became unlikely.
Majority Leader Reid and other Senators continue to negotiate
in order to find 60 votes to pass the bill.

* Medicare was added to the bill to replace the government options.
It would require the individual to pay a premium and would be open
to those who are 55 or older. They would receive the same benefits
as other Medicare beneficiaries. With this alternative a current
government plan is expanded instead of creating a new plan.
Medicare was added to the bill to replace the government options.


Week of December 7


On Dec 8 ten senators developed an alternative way to pay for care without the government option. Details are thin.
However, it seems to include an expansion of Medicare to cover those who are 55 or older and an expansion of Medicaid to include more people.
The Congressional Budget(CBO) will estimate the cost prior to a more open explanation of tis proposal.



Long term care is a benefit in the House bill and, at this point, in the Senate. It will cover home and community based care along with assisted living and nursing home care.
Individuals will elect to pay a premium for this benefit. Currently, it will be about $ 50/day. This will cover much of community care, and contribute to assisted living and nursing home care.
If it is intact when the Senate is done the conference committee will only have to address the differences




November, 2009

Week of November 30
 
The amendment submitted by Senator McCain(see below for an explanation) was defeated on 12/3.
 
 
Senator McCain submitted an amendment to the Health Care bill about the Medicare provisions in the Bill.
 
The bill as currently written would curb reimbursements to Medicare Advantage plans(which are private plans which Medicare subsidizes).
This raises the cost to Medicare, threaten its sustainability, and raise the costs for all subscribers. These costs also contibute to Medicare's deficit.

Senator McCain would continue these reimbursements.
 
The bill, as currently written, will reduce the cost for Medicare subscribers when they enter the donut hole(for their prescriptions).

The McCain amendment will see Medicare subscribers continuing to pay the full cost of medications when they are in the donut hole.

The Senate is beginning to debate the bill this week and to consider amendments.
This process is expected to take at least several weeks and possibly to the end of December.
 
Week of Nov 23
 
The Senate has submitted a bill which will be debated and likely amended during the next few weeks.
 
It includes the following:
 


       * Government option which allows individual States to opt  out.
   
    *  All Americans would be required to have coverage.
   
      * Government aid for middle income families to help pay for insurance

More people will be eligible for Medicaid.
   
      * Prohibitions on the private insurance industry to set conditions of insurance such as pre-existing conditions, annual and lifetime benefit limits, higher premiums for people who are disabled, women, etc.

Those with "luxury' health plans will be taxed and there will also be taxes on some medical procedures.


 
 
Week of Nov 9

The Senate may submit its bill in the next few weeks. Senate leadership will probably wait until they have 60 votes before asking for a vote.

Week of Nov 2

Health Care Passed in House(11/7)

The House passed its version of a universal health care insurance plan for most Americans. It includes the following:

  

    *       A requirement that all Americans are insured.
    *        A government option which will compete with private plans
    *       Federal monies for low and middle income people so they can access insurance.
    *       Private insurers will not be able to exclude people due to pre-existing conditions or to set life time limits on coverage.
    *       The Medicare donut hole will be eliminated
    *       Medicaid will cover more people.

  
  There will be 5.4 % tax on the Adjusted Gross Income of those individuals over  $500,000 and for joint payers over one million.

Next:
as the next week or two) and vote later on its version of the bill.  
    *       A conference committee will negotiate the differences and develop a sin

    *       The Senate will begin debate soon(perhaps as early gle bill. 
    *       Each house will vote on the same bill.  
    *       Then the president signs or vetoes it.
    * All this could take until the end of this year or the beginning of the new year.

 
 Nov 5, 2009
 
The house may have its debate on the Health Care Bill followed by a vote possibly as early as this week.
This version includes:



    *    A government option in all states
    *       Makes coverage more affordable for all Americans
    *       Covers more people than the Senate bill.(see also below)


ACTION STEP:
Contact your congressional representative to support and vote for this bill. It is important to have a strong majority.

October, 2009

Week of Oct 26

The Speaker introduced a proposal which combines the three House bills. It includes a government option and a tax on the nation's earners(those couples who earn over 1 million/year). A single bill may  be debated on the House floor in November.
 



The Senate Majority Leader introduced a proposal which combines the two Senate bills. It includes a government option. Individual States will have the choice of opting out if they do not want to have a government option in their State. The cost of this bill will be determined by the Congressional Budget Office.

Week of Oct 19

Last week the Senate Finance Comm approved a health care bill. It does not include a government option(see below Oct 5).

This week about 30 senators sent a letter to the Majority leader indicating their interest in a bill which includes a government option.


Week of Oct. 5


The Senate Finance Comm should complete its work this week or next. It will:

    * not include a government option
    *  will tax those with expensive health insurance plans.


Other plans do include a government option and will tax the wealthiest Americans.
When they are done the House and Senate versions are likely to differ in those and other ways.

However, there may be general agreement on the following:
 
* Most will continue to be covered by their employers.    Self employed people and those working for an employee who does not offer health insurance will be able to buy insurance through exchanges(which may or may not include a government option).  



* There are likely to be tax credits.

    * Private health insurers will have to cover everyone(regardless of pre-existing conditions) and may be limited what they can charge those who are old or sick.
    * Medicare may have to coordinate care for seniors - especially those with chronic conditions - in order to maintain people in the community and decrease or prevent hospital and nursing home care.
    * Medicaid will be expanded to cover more people including childless adults.


 Mental Health Services for Nursing Home Residents:

Clinical social workers cannot bill Medicare B directly for psychotherapy services when an individual is in a Medicare A bed.
Amendment D3 by Senator Blanche Lincoln(D - ARK. in health reform legislation would rectify this problem.
Please contact your federal senator to support Amendment D 3.



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