ElderWeb

The Chicago Tribune reports that Illinois Department of Revenue (IDR) officials have programmed a special toll-free tax hot line for seniors and the disabled, 1-800-624-2459, so that no one can get through to ask questions more than three times a week. The line is used by people who have questions about the complex circuit-breaker program which provides property tax relief and prescription drug discounts for the elderly and disabled. The Tribune reports that officials of the Department of Revenue said they made the decision to ration calls because the agency lacks resources to adequately staff the hot line. The agency first implemented call rationing in 1998 to limit inquiries from people who bombard the hot line several times a day just to ask where their checks are, and noted that one man from Peoria called the hot line 1,520 times in 45 days. According to the Tribune story, the hot line logged nearly 1.3 million attempts to access it in March, but only 26,317 of those calls were routed to live operators. 62,150 calls went into an automated system that gives answers to frequently asked questions, and more than 90% of incoming calls to the hot line got a busy signal. Officials are also trying to encourage people to use their Web site to reduce the call levels.

Illinois Chapter of the American College of Healthcare Administrators is launching a new Web site at http://www.ilchapterachca.org. The American College of Healthcare Administrators (ACHCA) is a professional society of almost 6,000 members across the country, dedicated to the continued professional development of the health care administrators serving the needs of clients in the post-acute (long term care) health care continuum.

The chapter website will be used to communicate information to members, as well as provide information to the public about our activities and organization. They have posted on the website the ACHCA's professional Code of Ethics and Standards of Practice.

The Office of the Inspector General of the Department of Health and Human Services (OIG-HHS) investigated Medicaid payment to skilled nursing facilities in Illinois. A Medicare skilled nursing facility (SNF) claim generally qualifies for reimbursement only if the SNF stay was preceded by an inpatient hospital stay of at least 3 days and the hospital discharge was within 30 days of the SNF admission. This final report estimates, based on a statistical sample, that Medicare inappropriately paid Illinois providers $900,000 for SNF services during calendar year 1996 because the 3-day hospital stay requirement was not met.

This occurred primarily because the fiscal intermediary did not cross check SNF claims against hospital claims. The fiscal intermediaries involved in the sample reviewed the medical records and data for the sampled claims and concurred that the SNF stays were ineligible for Medicare reimbursement and indicated they would request refunds for each incorrect payment identified.

The I-Care Illinois Long Term Care Ombudsman Program has issued a report finding that deficiencies in Illinois nursing homes increased significantly from 1995 to 1999. They found that homes that had one or more deficiencies that indicated that residents had the potential for more than minimal harm increased from 44% to 90% of the homes surveyed and that the percentage of surveys that showed actual harm increased from 6% to 31% of the facilities examined.

They said that many problems within long-term care facilities can either directly or indirectly be attributed to the lack of staff within the facilities, regardless of the fact that some facilities exceed the outdated example defined by Illinois regulation.

"This report is the first of its kind published that presents data from the surveys using the federal certification process which began in 1995," says Brian Lee, Communications Director for the Illinois Retired Teachers Association, who compiled the data for the report.

I CARE stands for Illinois Community Advocates for Residents' Empowerment. I CARE is a long-term care ombudsman program mandated under federal and state law to protect, defend and advocate for residents' rights in long-term care facilities, and provides services to 6,900 residents in 12 Central Illinois counties. It is a volunteer-based program and is sponsored by the Illinois Retired Teachers Association Foundation.

The Chicago Department on Aging has developed a "Red Tape Cutter Program" which allows elderly Chicago residents to fill out an online form to help evaluate programs and services they may be entitled to. Residents can fill out the form online, and a complete printout of the results will be returned to them by mail. The program screens eligibility for Energy Assistance, Circuit Breaker, Sewer Service Charge Exemption, Property Tax Relief, Food Stamps, Medicare: Parts A & B, and Home Weatherization.

Illinois bill SB 1567 changed provisions of the law relating to powers of attorney. Language was added for situations when an agent is acting for a principal who is incapacitated. The new language says that a principal shall be considered incapacitated if that individual is under a legal disability as defined in Section 11a-2 of the Probate Act of 1975, or if a physician has examined the principal and has determined that the principal lacks decision making capacity, and the physician makes a written record of this determination, signs it within 90 days after the examination, and delivers it to the agent. In that event, the agent may rely conclusively on that written record.

In the event that the principal is incapacitated, the agent must provide a record of all receipts, disbursements, and significant actions taken under the authority of the agency when requested to do so: (i) by a representative of a provider agency, acting in the course of an assessment of a complaint of elder abuse or neglect under that Act; or (ii) by a representative of the Office of the State Long Term Care Ombudsman acting in the course of an investigation of a complaint of financial exploitation of a nursing home resident.

Illinois has expanded the Senior Pharmaceutical Assistance Program by increasing the income level for eligibility to $21,218 (1 person household), $28,480 (2 person household) or $35,740 (3+ person household) from the previous $16,000 limitation which applied to households of all sizes. The annual fee was reduced to $5 for persons below the poverty line and $25 for all other persons from the previous fees of $40 and $80, and co-payments were reduced to nothing for persons below the poverty line and $3 for all others from the previous levels of $15 and $25. The maximum benefit was also increased from $800 a year to $2,000 a year. These changes were effective starting July 1, 2000, and the old limitations will apply to drugs purchased prior to that date. The new income levels will also apply to Circuit Breaker property tax relief.

Daniel Kuhn, MSW, Education Director at the Mather Institute on Aging (formerly with the Rush Alzheimer's Center in Chicago) has written an excellent book about working with persons with Alzheimer's disease called "Alzheimer's Early Stages: First steps in caring and treatment". It is online and can be viewed, downloaded and printed for free, or a hard copy can be ordered for $14.95.

In 1997-1998, the State of Illinois paid over $1 million to nursing home providers for residents who were deceased. Although the payments were eventually corrected, there was concern that the providers effectively got an interest-free loan during the time they held the overpayment. The Office of the Inspector General of the Illinois Department of Public Aid (OIG) investigated the cause of these overpayments, to determine whether the providers were not properly notifying the Department, or if the State had not properly processed the notifications. In their report, they identified many problems, attributable both to the state and to the providers.

Files in both the nursing homes and the DHS offices were missing the appropriate death notification form (IDPA 1156). About 20% of the forms were missing from nursing home files, and 73% were completed past the required date. Only about 40% of the forms investigators located in nursing home files could be found in the DHS files, but investigators were unable to prove whether or not the forms had been filed, since Department staff were unable to even find the case file 24% of the time.

Investigators found many other problems. For example, IDPA notified providers in April 1998 that they must notify the Department within 5 days of the death of a resident. The Department provided a mailing address and said a fax machine would be installed to expedite the reporting of the death of a beneficiary, however, the fax machine was not installed for another year, and it was another six months after that before IDPA notified providers of the fax number.

A 52-bed nursing home in Lexington Illinois was closed by the state Department of Health in an emergency action, and the facility's 26 residents have been moved to other homes. The facility had been admitting homeless young people with substance abuse problems from the Chicago area to fill the empty beds, and these younger residents were terrorizing the other residents and facility staff. The drug patients told police they had agreed to go to the home in the quiet town about 100 miles southwest of Chicago after being promised substance abuse treatment, use of a swimming pool and horseback riding, but they found no pool, no drug treatment program, and a horse across the street that hadn't been ridden in years. The Department of Health had received no satisfactory response from the Chicago-area owners, after levying over $100,000 in fines since February.

In a paper published in the Journal of the American Medical Association (JAMA), researchers from Loyola University studied the changes in health and living conditions of Americans age 85 and older, to determine whether the use of health care services, disability and cognitive function, and overall quality of life in the year before death among older adults has changed over time. Among their conclusions for the over-85 group, nursing home stays were down 12%; and cognitive impairments declined about 7%; and the percentage of people who needed assistance in daily activities such as walking, bathing and dressing had dropped 9% for men and 7% for women.

Project Gutenberg was started by Michael Hart at the University of Illinois as an attempt to produce a massive collection of classic literature in an electronic format. Project participants have created e-texts from literature in the public domain, including the works of Shakespeare, Poe, Dante, Sir Arthur Donan Doyle, Lewis Carroll, and hundreds more. To make this information as universally-accessible as possible, all text is created in simple text files. The availability of the text on the Web means that a virtual library of great literature is easily accessible to the homebound. Because of the basic text formatting, the files should also be usable by blind and visually-impaired people dependent on text-readers to interpret Web information. Project Gutenberg is looking for volunteers who are willing to help them convert other books to e-texts, a great project for a computer-savvy older person interested in volunteer work which can be done from home.

The Chicago Tribune reports that the village of Arlington Heights has commissioned a study on senior housing options to identify what options are available for older people, in order to respond for numerous requests from developers who want to build senior housing. Village officials are also discussing emerging problems from condo conversions which leave older tenants who are unable to purchase their units with no place to live.