Welcome to Burrillville, RI - Dept of Elderly Affairs - The Information Memo

Meals on Wheels of RI has expanded the senior nutrition program by including two restaurants that seniors, age 60 years and older, can go to and enjoy a wonderful meal in a pleasant atmosphere. In September 2007, the Congregate Department at Meals on Wheels began the first restaurant program with Chelo’s Hometown Bar & Grille at 505 Silver Spring St. in Providence. The extension of the Ocean State Nutrition Program, funded in part by the RI Department of Elderly Affairs, has recently included IHOP Restaurant at 45 Pleasant Valley Parkway in Providence. With a $5.00 donation to the agency the senior receives a coupon at the Meals on Wheels office, 70 Bath St., Providence which is then presented to one of the restaurants listed. The menus vary with some of the items to include chicken entrees, fish entrees, pot roast, spaghetti and meatballs, chicken pot pie, breakfast items, burgers, and much more.

Many Rhode Island cities and towns offer some type of property tax relief to their older residents who meet age, income and residency requirements. Inquire at your city or town hall. Applications for the Rhode Island Property Tax Relief Program (Form RI1040H) must be filed between January 1 and April 15. Rhode Island resident homeowners and renters with household incomes not exceeding $30,000 may receive up to $300. For more information on the Property Tax Relief program call 574-8829. To request a form, dial 574-8970.

The United Way of Rhode Island supplied 211 with FamilyWise prescription drug discount cards. The card offers a 20% discount on any prescription drug and can be duplicated just like a coupon. For more information, go to www.familywise.org or call United/Way 211.

Programs are produced by senior volunteers and are sponsored by the Department of Elderly Affairs with the support of COX Communications. Programs are aired on Sundays at 5:00 p.m., Mondays at 7:00 p.m., and Tuesdays at 11:30 a.m. over statewide Cox Communications channel 13 and Verizon channel 32.

Only a few days are left for seniors to convert their television signal from the current analog signal to digital broadcasting. On February 17, 2009, all television signals will be switched to a digital broadcast signal. Beginning February 17, 2009, if you have a television set that receives its over-the-air programming with antennas, you will no longer get a picture. These sets will require a conversion box to pick up a television signal. Time is running out for more than 15,000 seniors who have not yet converted their television sets. Television sets that are hooked into a cable or satellite broadcasting system will not need a converter box.

Why the switch? Under a law passed by Congress in 2005, all free local broadcasters are required to turn off their analog channels and broadcast exclusively in the digital format. February 17, 2009 is D-Day.

What is Digital Television (DTV) anyway? DTV is a new type of broadcasting that produces a dramatically clearer picture and sound. DTV can also offer multiple program choices and better service such as significantly enhanced closed captioning. DTV will also enable broadcasters to provide several channels of programs at once (multicasting) and will free up the traditional analog channels to be used for public safety uses by police and fire services.

The Low-income Home Energy Assistance Program (LIHEAP) grants funds to the local Community Action Program (CAP) agencies. The purpose of LIHEAP funds is to assist eligible households in keeping the heat on in their homes and to reduce household energy burdens through weatherization improvements.

Through the summer months, Governor Carcieri joined other Northeast Governors in petitioning the federal government to increase the funding for LIHEAP in anticipation of increased energy costs. Funding has been increased from $20 million to $38 million. “We are happy that our requests were heeded,” said Governor Carcieri, “but we need to keep pressure on Washington to restore the impact that the LIHEAP program once had when it began in 1982. Since that time, its ‘buying power’ has shrunk considerably.”

The Governor’s Office of Energy Resources administers the LIHEAP program in partnership with the CAP agencies. Applications for LIHEAP assistance are accepted at the Community Action Programs and eligibility is based on 60% of the RI median income, or $46,913 for a family of four. As of result of the higher cost of home heating fuels, the Governor has increased the average LIHEAP primary grant from $340 to $480. Due to extra efforts made by the Office of Energy Resources, the LIHEAP funds have been released a month earlier this year than in past years.

“Anticipating the increasing demand for LIHEAP grants this year, we worked diligently with the CAP agencies on the early release for funds,” said Andrew Dzykewicz, Director of the Office on Energy Resources. “With the assistance of the CAP agencies, more Rhode Island families will keep warm this winter.”

In addition, for those households whose utility service has been turned off mid-winter, the Administration has set aside additional LIHEAP funds for “crisis grants” to assist families in making the down payment necessary to get their utility service restored. To apply for a "crisis grant" simply contact the local CAP agency providing LIHEAP services in your city or town. LIHEAP grants are made payable directly to the household’s primary heating vendor.

“Winter comes earlier and harder in the Northeast than it does in most other parts of the country,” said Carcieri. “This winter, Rhode Islanders are facing record energy bills and rising food costs, and no one should ever have to go without either. To help with household costs, we have also instituted a program, called “Heat & Eat” that will increase the amount of Food Stamps for many households.”

“Heat & Eat” is a new program, led by the Office of Energy Resources and the Department of Human Services, which enables those who are receiving LIHEAP funds to receive an increase in Food Stamps. Under the program, individuals and families who receive heating assistance through LIHEAP are eligible to receive the maximum monthly food stamp benefit. LIHEAP issued heating assistance checks to 9,400 individuals and families who live in subsidized housing, who do not traditionally receive heating assistance because heat is included in the rent subsidy. The LIHEAP check automatically triggers an increase in the Food Stamp benefit. The average increase for these individuals and families is $86 per month. That represents more than $800,000 in increased funds coming into the state each month.

In general, Medicare covers only oral surgery, and in extreme circumstances that are potentially life threatening if left untreated. Medicare does not cover routine dental care. Currently, Medicare will pay for dental services that are an integral part either of a covered procedure (e.g. reconstruction of the jaw following accidental injury) or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw. Medicare will also make payment for oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Medicare Part A.

The dental exclusion was included as part of the initial Medicare program. In establishing the dental exclusion, Congress did not limit the exclusion to routine dental services, as it did for routine physical checkups or routine foot care, but instead included a blanket exclusion of dental services.

The Congress has not amended the dental exclusion since 1980, when it made an exception for inpatient hospital services when the dental procedure itself made hospitalization necessary.

According to some sources, 60% of us will need long term care sometime during our lives. It is important for all of us to prepare for that day when we will need to help loved ones with elder care or we will need elder care ourselves.

It’s simply a fact of life to prepare financially for unexpected disasters by covering our homes, automobiles and health with insurance policies and to provide funding for our retirement. But no other life event can be as devastating to our lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal retirement dreams of elderly Americans, which are:

Yet, is our experience that the vast majority of the American public does not plan for the devastating crisis of needing elder care. This lack of planning also has an adverse effect on the older person’s family, with sacrifices made in time, money and emotional health.

The Recovery Economic Stimulus Rebate Credit is a one-time benefit for people who did not receive the full economic stimulus payment last year and whose circumstances may have changed, making them eligible now for some or all of the unpaid portion of the rebate. People who fall into the categories described below may be eligible for the recovery rebate credit this year:

2. Those who received less than the maximum economic stimulus payment in 2008-$600 per taxpayer; $1,200 if married filing jointly-because their qualifying or gross income was either too high or too low.

For the first time in history, the Centers for Medicare and Medicaid Services has released quality ratings for each of the nation’s 15,800 nursing homes that participate in Medicare or Medicaid.

Facilities are assigned star ratings from a low of one star to a high of five stars based on health inspection surveys. staffing information, and the quality of care measures. The ratings are publicly available on the agency’s Nursing Home Compare site at www.medicare.gov.

“Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinction between high and low performing homes,” said CMS Acting Administrator Kerry Weems. “The new information will also help consumers and families identify important questions to ask nursing homes and challenge nursing homes to improve their quality of care.”

The new ratings system also received high marks from Sen. Herb Kohl (D-WI), chairman of the Senate Special Committee on Aging. “With this new ratings system, CMS is improving the ability of consumers to readily obtain critical information which should be used in conjunction with in-person visits to the facility. Transparency is the key when it comes to nursing home quality, said Senator Kohl. “I commend Acting Administrator Weems and appreciate the opportunity to work together to improve our nation’s nursing homes”.

Consulting with a panel of experts from academia, patient advocacy and nursing home groups, CMS developed the rating system based on each nursing home’s performance in three critical areas.

1. Health inspection surveys. Each year, federal and state surveyors conduct about 15,800 on-site, comprehensive assessments of each nursing home’s health care services and compliance with federal/state rules. These surveys are designed to help protect the health and safety of residents, including residents’ rights and general quality of life. Surveyors also conduct about 50,000 complaint investigations each year. Information from the most recent three years of survey findings was used to develop the ratings.

2. Quality measures. The quality rating system uses 10 key quality measures out of the 19 that can be found on the Nursing Home Compare Web site. Area examined include the percent of at-risk residents who have pressure ulcers (bed sores) after their first 90 days in a nursing home, the number of residents whose mobility worsened after admission and whether the residents received proper medical care.

3. Staffing information. There is strong evidence that low staffing levels can compromise the level of patient care in a nursing home and is considered an important indicator of quality. This measure reports the number of hours of nursing and other staff care per patient per day. This measure is adjusted to account for the level of illness and services required by each facility’s residents.

The Web site provides the public with a quality rating for each of the three areas listed, as well as a composite or total score. A five star designation means that the facility ranks “much above average,” a four-star rating indicates “above average,” a three star rating means “about average,” two is “below average,” and ranking with a one indicates that the facility ranks “much below average.” Rankings are dynamic and will be updated monthly.

“Because the quality and conditions within a nursing home can change at any time, this system is not intended to be the only tool families can use in selecting the right nursing facility for a loved one,” Weems noted. “Nursing homes can make dramatic improvements between rating periods, just as a previously high-rated home could see its quality of care deteriorate. And nothing can substitute for visiting a nursing home.

In this first round of quality ratings, about 12 percent of the nation’s nursing homes received a full five star rating while 22 percent scored at the low end with one star. The remaining 66 percent of facilities were distributed evenly among the two, three and four star rankings.

“Choosing a nursing home or community-based care is one of the most difficult and sometimes confusing decisions families have to make,” noted Thomas Hamilton, director of the CMS Survey and Certification Group that helped develop the system. “The new Web site improvements also include links to information for community-based alternatives to nursing homes that may be of great interest to families.”

“Regardless of the type of support a family chooses,” he said. “It is vital that families and caregivers use the web site as just one of the many important sources of information they should consult. Families should also consult with their physician, talk to the state’s nursing home ombudsman or the state’s survey and certification office, and, most importantly, visit the nursing home or community-based program for themselves.”

The addition of a five-star quality rating system is just the latest in a series of improvements to the Nursing Home Compare web site. In November 2007, CMS took another historic step in publishing a list of the nation’s nursing homes with consistently poor performance records. Nursing homes selected as such “Special Focus Facilities (SSF)” are provided with increased oversight, including onsite inspections that occur twice as often as better performing homes. Homes with the SSF designation are clearly marked on the Nursing Home Compare web site.

“Around three million Americans depend on nursing homes at some point during each year to provide life-saving care,” Weems said. “Most of those individuals are enrolled in Medicaid or Medicare and we all bear a special responsibility to protect their health and welfare. Adding this new quality rating system to our web site is a huge step toward giving our beneficiaries and their loved ones meaningful information to compare nursing homes more easily.”

CMS also publishes an updated version of its “Guide to Choosing a Nursing Home” which can help families through the process. The Guide can also be accessed by going to www.medicare.gov. You can also call Medicare at 1-800-Medicare (1-800-633-4227).

Department of Elderly Affairs (DEA), John O. Pastore Center, Hazard Building, 74 West Road, Cranston, RI 02920 publishes the Information Memorandum. Reader’scomments, suggestions, or items of interest are welcome. The DEA also encourages aging network agencies to reprint any articles that appear in the Information Memorandum or The Older Rhode Islander. Permission to reprint this material is not required by DEA. For additional information on DEA publications, call Larry Grimaldi at 462-0509. To send a FAX, dial 462-0503; or e-mail larry@dea.state.ri.us.