ElderWeb

The Florida Agency for Health Care Administration announced that they have published a new guidebook online, called Understanding Prescription Drug Costs. The guide contains information for everyone who needs prescription drugs - whether or not they have health insurance to cover those costs. The purpose of this brochure is to help consumers know what cost-saving options there are and what questions to ask. They point out that the best sources of information to help save money on prescription drugs are physicians, pharmacists, and the customer service or employee benefits office of your health insurance plan. The brochure is a new addition to the extensive information about drugs available on FloridaHealthStat.com, the official source of consumer healthcare information from Florida government health and human service agencies.

The Florida Legislature is considering budget changes for Medicaid long term care programs. Among the changes requested by the Agency for Health Care Administration is a new program incorporating competitive bidding or capitation into the program used to reimburse nursing homes for Medicaid services, which is projected to provide $23 million in savings. Other reductions in spending include the elimination of the "Intermediate" category of nursing home service and the transfer of residents in this program to assisted living facilities, and an additional $23 million to buy more community services to allow elder Floridians to stay in their own homes.

To reduce the spiraling cost of the Medicaid budget, eligibility for Medicaid for people age 65 or older would be limited to those with incomes of no more than 87.5% of the Federal Poverty Guidelines, down from the current cap at 100% of the poverty level. The state would also no longer pay the Medicare Part B deductibles and coinsurance for people who are eligible for both Medicare and Medicaid, and they plan to create a restricted drug formulary to limit the prescription medications which would be covered by Medicaid.

Insure.com reports that 15 Palm Beach County, Fla., residents went to court on Jan. 22, 2001, charging Prudential Insurance Co. with fraud and racketeering and seeking $1 billion in damages. They are charging Prudential with questionable sales tactics targeted at elderly residents, including a "vanishing premium" scheme, in which an agent claims a life insurance policy's cash value will perform so well that the buyer can stop paying premiums within a certain number of years, and avoiding the term "insurance" to sell cash value life insurance policies as "personal pension plans." The plaintiffs in the case all opted out of a class action lawsuit against Prudential that the company settled in 1996 for more than $2 billion.

In a November 1st memorandum to Florida Lt. Governor Brogan's task force, Northeast Florida Area Agency on Aging Executive Director Annette Kjeer said that in Jacksonville, eight of the largest of 37 participating ALFs were withdrawing from the Assisted Living Waiver program, and the remaining ALFs in the program are too small to handle what is approximately one-third of the total client population.

The Assisted Living Waiver program helps lower-income elderly in need of daily assistance to live in an assisted living facility, a less expensive alternative to state-funded nursing home care, and for the elderly person, a much less restrictive residential setting. For a facility to participate in the waiver program it must hold extended congregate care (ECC) or limited nursing services (LNS) licenses. Insurers are telling ALFs they will no longer cover facilities holding these licenses because of the greater potential for lawsuits, so many are dropping their ECC and LNS licenses so they can continue to stay open. Unlike nursing homes, Florida law requires ALFs to carry liability insurance as a condition of licensure.

The Florida Health Care Association, an organization of facility operators, warned that the insurance crisis jeopardizes the assisted living program. They said that some elderly clients may have no other option than state-funded nursing home care, the very thing the Assisted Living Waiver program was intended to prevent. They also report that Florida long term care facilities are three times more likely to be sued than a non-Florida facility because of the unique Florida law that provides incentives to sue nursing homes and assisted living facilities. As a consequence, Florida has the highest liability insurance rates in the nation. A recent Department of Insurance report confirms liability insurers fleeing Florida.

Lt. Governor Frank Brogan heads up a task force created to investigate the availability and affordability of long-term care, including the liability insurance crisis faced by long term care providers in the state of Florida.

Governor Jeb Bush of Florida has proposed a series of initiatives designed to make Florida an "Elder-Friendly" state. Among other things, the governor proposes dedicating $46 million in new funding to improve the quality of nursing home care, $52.4 million to expand community-based options in long-term care for elders, $2.5 million to increase Medicaid fees for home health agencies, and $30 million to fund a new program to assist low-income elders in obtaining needed prescription drugs.

He also is encouraging communities and businesses to attain an "Elder-Ready" brand from the state which will greatly improve the livability of a community for elders. An elder-ready community has: easy access to drug stores, reliable transportation to medical care, pedestrian-friendly traffic lights and walkways, adequate lighting in public places, call boxes to enhance safety, zoning for elder-friendly housing, adequate health providers with gerontological training and much more.

In addition, Governor Bush indicated he is in favor of addressing the cost of litigation of long term care facilities, and noted that 30 assisted living facilities have been notified that they are at risk of losing their licenses because they do not carry liability coverage due to the cost or lack of availability of such insurance.

National HealthCare announced that it will cease operation of 12 owned or leased long-term health care centers and three assisted living centers in Florida. The divestiture, which will take place by October 1, 2000, will be done because NHC cannot obtain liability insurance for its Florida properties. The Florida centers are being leased to non-NHC affiliated companies. Negotiations are underway to replace liability insurance in other states with NHC properties. NHC operates 108 long-term healthcare centers, 35 homecare programs, 445 retirement apartments, 774 assisted living units, and two managed centers.

FloridaHealthStat.com, a new website created by the Agency for Health Care Administration this year, has officially been designated by the Governor's Office as the state's health care electronic portal. All four major health care agencies (AHCA, Dept. of Health, Dept. of Children & Families, and Dept. of Elder Affairs) will all be linked together on the one website. Consumers will then be able to retrieve all types of health care information from this one site. Information will include physician profiles, hospital and nursing home evaluations and a host of other information.

The Florida Department of Elder Affairs has prepared two disaster preparedness guides for older Floridians. They are "2000 Disaster Preparedness Guide for Elders" and the "What Should You Do If A Hurricane Threatens Your Community?" brochure. These guides are designed to help consumers plan for the possibility of a hurricane in the impending hurricane season, and deal with things like developing an escape plan, making a decision to evacuate, and what to do with the family pet.

The Miami Herald reports that the waiting list for services to help the elderly remain independent and in their homes is growing. Lat year the state used money from the Lawton Chiles Tobacco Endowment Fund to nearly eliminate the waiting list for community care for the elderly. The money represented a hefty increase for the programs, which many felt were underfunded for years. But the lists for community care and home care for the elderly are growing again, and more than 1,600 seniors in Broward and more than 1,900 in Miami-Dade await services today and some South Florida seniors have been waiting nearly a year for help.

Although the aid these seniors seek, such as house-cleaning or assistance with bathing, could mean the difference between living independently or moving to an assisted living facility or nursing home. In the past, elder advocates have tracked the waiting list as an indicator of unmet needs among the state's seniors. In the coming months, the state's Department of Elder Affairs plans to replace the traditional wait list with a new list that state officials say will eliminate redundancies and rank people according to need.

But the bulk of the funding increases is for Medicaid waiver programs, which focus on lower-income seniors. The division helps about 2,500 people a year. To take care of the current waiting list, Stephen Ferrante, interim director of the division, estimates he'd need $2 million more a year from the state.