Geriatric Mental Health Alliance News - Week of August 24, 2009

Geriatric Mental Health Alliance News

A bi-weekly email to brief you on issues important to geriatric mental health

August 24, 2009 - Vol 3, Issue 08

Status of Older Americans Act Appropriations

On July 24, the House passed the Appropriations Bill (H.R. 3293) for the Departments of Labor, Health and Human Services (HHS) and Education that included funding for Older Americans Act (OAA) programs. The Senate moved its version through the committee process on July 30 with a vote of 29 - 1 in the Labor/HHS/Education Appropriations Subcommittee. Action on the Senate floor is not expected until this fall. As noted in the attached chart and reported in prior e-mails, the House recommended a total of $1,530,881,000 for Older Americans Act (OAA) programs administered by the Administration on Aging (AoA). Increases were recommended for several programs including: $2.6 million for Choices for Independence, $10 million for Title III-B Supportive Services, $13 million for Title III-C-1 Congregate Meals, $6.4 million for Title III-C-2 Home Delivered Meals plus small increases for Title IV Program Innovations, Title VI grants to Native Americans and program administration for a total increase of $37,038,000.

For Title V, the House recommended an increase of $43.5 million from $571,925,000 in the current year to $615,425,000 for FFY 2010.

Here are the component of House Report for the Labor/HHS/Education that pertains to OAA programs for your information and use.

Senate appropriators have proposed a $1,495,038,000 for OAA programs administered by AoA in FFY 2010, an increase of $1,195,000. They recommended a $3.5 million for Title V. Overall, the Senate was much less generous than the House with program increases.

For more information, please visit NYSOFA's website at http://www.aging.ny.gov

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New NYS Law Regarding Powers of Attorney

Starting on September 1, 2009, new requirements regarding powers of attorney go into effect. We are grateful to Martin Petroff, of Martin Petroff & Associates, who has provided GMHA with a short piece regarding these important changes. It is important to note that the power of attorney executed before September 1, 2009 will continue to be valid after that date.

To read the article, click here or click here for the sample power of attorney (Statutory Short Form Durable Power of Attorney).

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Orange County Begins Training Initiative in Geriatric Mental Health

Orange County has initiated a series of presentations regarding geriatric mental health, using the GMHA Speakers' Bureau to make the arrangements. So far two events have taken place. Michael Friedman, Alliance Chair, did Geriatric Mental Health 101. Amy Stern, LCSW from Weill-Cornell Medical College's Department of Geriatric Medicine, did a presentation on how to screen for mental illness and/or substance abuse. Two more presentations are planned, including:

• Practical Strategies for Addressing Medication Safety Issues Among Older Adults
  Date: Tuesday, September 22, 2009
  Time: 10:00am to 12:00pm
  Presenters: Andrew Kolbasovsky, Psy.D. and Arsenio Gonzalez, Pharm.D. of EmblemHealth
  
  
• Understanding the Differences Between Dementia, Alzheimer's Disease, and Depression
  Date: Tuesday, October 27, 2009
  Time: 10:00am to 12:00pm
  Presenter: Gary Kennedy, MD, Montefiore Medical Center

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Upcoming Events

The GMHA is pleased to announce its upcoming educational programming for Fall 2009. Exact dates and location will be announced in early September 2009.

Webinars:

• September 22, 2009 - Geriatric Mental Health 101
  Presenter: Michael Friedman, LMSW, GMHA
  
• October 22, 2009 - Working with LGBT Elders
  Presenter: Bobbi Williams, PhD, Rainbow Access Initiative
  
• November 4, 2009 - Substance Abuse Among Older Adults
  Presenter: Frederic Blow, Ph.D., University of Michigan
  

Best Practices:

• October 2009 - Understanding the Pain/Depression Dyad Among Older Adults
  Presenter: Cary Reid, MD, PhD, Wright Center on Aging/Weill-Cornell Medical College
  
• November 2009 - Identifying Elder Mistreatment
  Presenter: Debra Greenberg, PhD, Montefiore Medical Center
  
• December 2009 - Holocaust Survivors: Stories of Resilience
  Presenters: To Be Announced

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Other Upcoming Events

September 16-17, 2009 - The 16th Annual New York State Adult Abuse Training Institute - Strengthening Alliances: Realizing Solutions within Our Reach Sponsored by The NYS Office of Children and Family Services, the event will be held at the Albany Marriott Hotel and Conference Center, Albany, NY. Click here for details!

This event is held under special contract with Brookdale Center for Health Aging & Longevity of Hunter College/CUNY September 17-18, 2009 - Building A Successful Aging Friendly Community Workshops sponsored by the NYS Coalition for the Aging and the NYS Association for Area Agencies on Aging. The workshop will help answer what is an Aging Friendly Community, what communities in NYS support and encourage fun and successful aging, and discuss successful examples of practices and programs in NYS.

Please click here for more information. There will be a training in Rochester, Latham, Watertown, and Binghamton, NY.

September 23, 2009 - Geriatric Mental Health Coalition Workshop sponsored by the Westchester County Dept. of Senior Programs and Services - "Out of the Shadows: Documenting Elder Abuse Prevalence and Implications for Policy Services" from 8:30am to 11:am at the Crown Plaza Hotel (66 Hale Ave., White Plains, NY).

Click here for the Save-the-Date!

September 29, 2009 - 2nd Annual Health Aging Conference The keynote speaker is Dr. Robert Butler, president and CEO of the International Longevity Center-USA. The conference will take place from 8:00am-3:00pm at The Queensbury Hotel in Glens Falls.

For more information, please click here or please visit www.arhn.org or contact Gail Holstein Danforth at 518-761-0300 ext. 251 or gdanforth@medserv.net.

October 7, 2009 - NYIT Center for Gerontology & Geriatrics's Second Annual Conference on Aging & Society at the Riland Academic Health Care Center on their Old Westbury campus from 8:30am to 4:00pm. This year's theme is Reforming Long Term Care-Back to the Future.

Please visit the conference website for more information.

October 15-17, 2009 - 2009 State Society on Aging of NY Conference: "Caregiving and an Aging Population". The event will be held at The Hyatt Regency, Rochester, NY.

Click here for the preliminary program with registration form.

October 28 & 30, 2009 - Best Practices: Dementia Training SUNY at Albany's Center for Excellence in Aging Services will provide aging network staff with best practices, tools and resources to assist persons with dementia and their caregivers in Batavia and Syracuse, NY. The trainers are Lisa A. Ferretti, LMSW, Director of Operations and Philip McCallion, Ph.D. Professor and Director of the Center for Excellence in Aging Services, School of Social Welfare, University at Albany, State University of New York.

Click here for Training Objectives.

October 29, 2009 - SAVE THE DATE - The Greater New York Chapter of the National Association of Professional Geriatric Care Managers Annual Conference The theme is CAREMANAGING IN AN ECONOMIC DOWNTURN with keynote speaker, Dr. Robert N. Butler, Founder, President and CEO of the International Longevity Center. The conference will take place from 8:30-4:30 at The Roosevelt Hotel, 45th St. & Madison Ave., NYC.

More Information available in the coming months: NY Chapter Website - www.nygcm.org NY GCM Voice Message - 212-222-9163

The Geriatric Mental Health and Emergency Preparedness Program offered by The Consortium of New York Geriatric Education Centers provides an introduction to emergency preparedness for healthcare professionals and others working with older adults, focusing on effective ways your organization can work with first responders and the government, as well as clinical response to disasters. Participants must attend the 3 day course and 2 additional electives to receive 40-hour Geriatric Scholar Certificate. The Mount Sinai School of Medicine designates this educational activity for a maximum of 40 AMA PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity. At American Nurses Credentialing Center, the certification program does accept CME hours for nurses re-certifying. Please see our brochure for details and register online.

Geriatric Mental Health Alliance News - Week of August 10, 2009

Geriatric Mental Health Alliance News

A bi-weekly email to brief you on issues important to geriatric mental health

August 10, 2009 - Vol 3, Issue 07

Governor Paterson To Seek $2.1 Billion In Mid-Year Cuts

Revenue shortfalls related to the poor economy in NYS will result in a deficit for 2009-10. To avert this deficit, Governor Paterson has announced that he will seek $2.1 Billion in spending cuts when the Legislature comes back into session in September. These cuts are likely to affect health, mental health, substance abuse, aging, and children's services as well as education. We will let you know details as we learn them. Please be prepared to write, call, and visit your Assemblyperson and Senator to urge them to protect critical services for older adults with mental and/or substance use problems.

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Permanent Timothy's Law

Governor Paterson signed a bill making NYS's parity act (known as "Timothy's Law) permanent. The original act was scheduled to sunset this year. There was widespread agreement to extend it for one year, but mental health advocates (including The Geriatric Mental Health Alliance) fought successfully to make the law permanent. Kudos to Assemblyman Rivera, Senator Huntley, and Governor Paterson for leading the fight.

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Community Empowerment Grants Announced

New York State Office for the Aging Director Michael Burgess announced that $490,000 in State grants has been awarded to fifteen not-for-profit organizations and local governments to support the creation of communities in which older adults can successfully age in place. The choices reflected increased recognition of the importance of mental health to living well in old age-a very positive development.

Please click here for more information.

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Medicare Optimization Project Making Progress

The Geriatric Mental Health Alliance has been working for a number of years to help providers who respond to the mental health needs of older adults to get all of the funding they are entitled to from Medicare and other funding streams. Most recently, the NYS OMH contracted with GMHA to work with 10 demonstration projects to develop plans for them to become financially self-sustaining and to develop finance models that will make it possible to increase mental health services for older adults. The project is producing some promising results, which will be reported to the NYS Interagency Geriatric Mental Health and Chemical Dependence Planning Council on September 30. That meeting will be webcast.

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End of Life Provisions in the Health Care Reform (H.R. 3200) Legislation

Director Burgess of NYSOFA has recommended a more detailed explanation of the end of life provision in H.R. 3200, American's Affordable Health Choice Act.

ISSUE: Some opponents of health care reform are scaring seniors by reporting that Congress is considering legislation to require Medicare beneficiaries to participate in mandatory consultations on how they want to die. This information is NOT correct.

BACKGROUND: H.R. 3200, America's Affordable Health Choices Act, which is being considered in the House, includes a provision to improve the Medicare program by authorizing reimbursement for one Advance Care Planning Consultation every five years. The consultation is not mandatory. Rather, Medicare would provide reimbursement if beneficiaries voluntarily chose to meet with a health care practitioner for information about advance directives, including living wills and durable powers of attorney; the continuum of end-of-life services and supports available, such as palliative care and hospice; and orders regarding life sustaining treatment. Consultations could be conducted more frequently if there is a significant change in the health condition of an individual.

The purpose of Sec. 1233 of H.R. 3200 is to help people discuss their views regarding end-of-life care with their families and health care providers before the need for such care arises and to learn what they must do to ensure that their wishes are carried out if they become incapacitated. The Advance Care Planning Consultation, which would be paid for by Medicare, is intended to improve the quality of end-of-life care provided to beneficiaries. These meetings between patients and their doctors would be completely voluntary and no one would be required to complete an advance care directive or living will. The requirement in the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) requiring physicians to provide an advance care planning consultation as part of the Welcome to Medicare physical exam is not considered as one of the advance care planning consultations available to beneficiaries every five years.

H.R. 3200 also requires the inclusion of quality measures on end-of-life care in the Physician's Quality Reporting Initiative, and the inclusion of information on advance care planning in the paper and electronic versions of the Medicare & You handbook.

SUPPORT FOR Advance Care Planning Consultations: Supporters of the Advance Care Planning Consultation provision in H.R. 3200, and related legislation that has been introduced in Congress, believe it is very important for people to discuss their views regarding end-of-life care with their families and health care providers before the need for such care arises and to learn what they must do to ensure that their wishes are carried out if they become incapacitated. In addition, it is very helpful for people to know about the wide range of options that are available to them for end-of-life care, from very aggressive treatment to palliative services and hospice care. The purpose of this provision is to help fulfill individual wishes; avoid disputes, such as those that arise among family members when a loved one's wishes are not known; and to improve the quality of end-of-life care.

NYSOFA POSITION:

• The purpose of the Advance Care Planning Consultation provisions in health care reform legislation is to improve the Medicare program for beneficiaries. The consultations are completely voluntary.
• It is important for individuals to make known their wishes about end-of-life care, both for themselves and for their family members and health care providers, so that their wishes can be carried out without dispute if they become incapacitated.
• Having information about the wide range of services available to those with advanced illnesses can help improve the quality of care they receive as they near the end of their lives.

Please share this information with other advocates and seniors!

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Orange County Beings Training Initiative in Geriatric Mental Health

Orange County has initiated a series of presentations regarding geriatric mental health, using the GMHA Speakers' Bureau to make the arrangements. So far two events have taken place. Michael Friedman, Alliance Chair, did Geriatric Mental Health 101. Amy Stern, LCSW from Weill-Cornell Medical College's Department of Geriatric Medicine, did a presentation on how to screen for mental illness and/or substance abuse. Two more presentations are planned, including:

• Practical Strategies for Addressing Medication Safety Issues Among Older Adults
  Date: Tuesday, September 22, 2009
  Time: 10:00am to 12:00pm
  Presenters: Andrew Kolbasovsky, Psy.D. and Arsenio Gonzalez, Pharm.D. of EmblemHealth
  
  
• Understanding the Differences Between Dementia, Alzheimer's Disease, and Depression
  Date: Tuesday, October 27, 2009
  Time: 10:00am to 12:00pm
  Presenter: Gary Kennedy, MD, Montefiore Medical Center

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Upcoming Alliance Events

The GMHA is pleased to announce its upcoming educational programming for Fall 2009. Exact dates and location will be announced in early September 2009.

Webinars:

• September 22, 2009 - Geriatric Mental Health 101
  Presenter: Michael Friedman, LMSW, GMHA
  
• October 22, 2009 - Working with LGBT Elders
  Presenter: Bobbi Williams, PhD, Rainbow Access Initiative
  
• November 4, 2009 - Substance Abuse Among Older Adults
  Presenter: Frederic Blow, Ph.D., University of Michigan
  

Best Practices:

• October 2009 - Understanding the Pain/Depression Dyad Among Older Adults
  Presenter: Cary Reid, MD, PhD, Wright Center on Aging/Weill-Cornell Medical College
  
• November 2009 - Identifying Elder Mistreatment
  Presenter: Debra Greenberg, PhD, Montefiore Medical Center
  
• December 2009 - Holocaust Survivors: Stories of Resilience
  Presenters: To Be Announced

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Other Upcoming Events

August 26 & 27, 2009 - Best Practices: Dementia Training SUNY at Albany's Center for Excellence in Aging Services will provide aging network staff with best practices, tools and resources to assist persons with dementia and their caregivers in Batavia and Syracuse, NY. The trainers are Lisa A. Ferretti, LMSW, Director of Operations and Philip McCallion, Ph.D. Professor and Director of the Center for Excellence in Aging Services, School of Social Welfare, University at Albany, State University of New York.

Click here for Training Objectives.
Click here for the Registration Form.
Click for directions to Batavia (Genesse AAA) and Syracuse (NOPL).

Additional trainings are currently planned for October 28 and 30, 2009. Click here for more information.

September 16-17, 2009 - The 16th Annual New York State Adult Abuse Training Institute - Strengthening Alliances: Realizing Solutions within Our Reach Sponsored by The NYS Office of Children and Family Services, the event will be held at the Albany Marriott Hotel and Conference Center, Albany, NY. Click here for details!

This event is held under special contract with Brookdale Center for Health Aging & Longevity of Hunter College/CUNY

September 29, 2009 - 2nd Annual Health Aging Conference The keynote speaker is Dr. Robert Butler, president and CEO of the International Longevity Center-USA. The conference will take place from 8:00am-3:00pm at The Queensbury Hotel in Glens Falls.

For more information, please click here or please visit www.arhn.org or contact Gail Holstein Danforth at 518-761-0300 ext. 251 or gdanforth@medserv.net.

October 29, 2009 - SAVE THE DATE - The Greater New York Chapter of the National Association of Professional Geriatric Care Managers Annual Conference The theme is CAREMANAGING IN AN ECONOMIC DOWNTURN with keynote speaker, Dr. Robert N. Butler, Founder, President and CEO of the International Longevity Center. The conference will take place from 8:30-4:30 at The Roosevelt Hotel, 45th St. & Madison Ave., NYC.

More Information available in the coming months: NY Chapter Website - www.nygcm.org NY GCM Voice Message - 212-222-9163

The Geriatric Mental Health and Emergency Preparedness Program offered by The Consortium of New York Geriatric Education Centers provides an introduction to emergency preparedness for healthcare professionals and others working with older adults, focusing on effective ways your organization can work with first responders and the government, as well as clinical response to disasters. Participants must attend the 3 day course and 2 additional electives to receive 40-hour Geriatric Scholar Certificate. The Mount Sinai School of Medicine designates this educational activity for a maximum of 40 AMA PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity. At American Nurses Credentialing Center, the certification program does accept CME hours for nurses re-certifying. Please see our brochure for details and register online.

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Combining Physical and Mental Health

Medicaid beneficiaries with chronic physical conditions and serious, persistent mental illness do best when both physical and behavioral care services are integrated, concludes a new report from the United Hospital Fund's Medicaid Institute. Among this chronically ill population, the addition of one behavioral health condition doubles medical expenditures for physical health, the emergency room visit rate, and the hospital admission rate. The report suggests ways New York can reduce avoidable exacerbations of illness that often result in high-cost services. The report also proposes that New York consider two options for this population: fully capitated health plans that integrate physical and behavioral services, and capitated behavioral health organizations that are separate from existing managed care plans. "Providing Behavioral Health Services to Medicaid Managed Care Enrollees" is online at www.uhfnyc.org.

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ASA-MetLife Foundation MindAlert Awards

Deadlines: October 1, 2009

Purpose: The ASA-MetLife Foundation MindAlert Awards were established to recognize innovations in mental fitness programming for older adults. One MindAlert award will be made to a program within each of the following three categories that reflect the focus of the program and the population it serves.

1. Lifelong Learning /Third Age Educational programs
2. Programs specifically focused on enhancing mental fitness for the general population of older adults.
3. Programs designed to enhance mental fitness specifically for early stage cognitively-impaired older adults.

Eligibility:
Programs and products or tools that promote cognitive function in later life that have been in operation or distributed for at least one year are eligible. Submission must come from non-profit organizations located in the United States. Submission must come from a member of ASA (either individual or organizational membership).

Applicants must have completed a recent evaluation of their programs or products. If you have questions about eligibility, please contact Cary Speidell, Project Manager, at mindalert@asaging.org, 415-974-9630

Each of the three programs will receive $1,500.

Please click here for more information.

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Congress Tackles Long-Term Care

Congress Tackles Long-Term Care
The New York Times
By Paula Span
July 22, 2009

Generally overlooked in the debate over health care reform, and of particular interest to New Old Age readers, is the C.L.A.S.S. Act, a bill introduced by Senator Edward M. Kennedy, Democrat of Massachusetts, that would establish a national long-term care insurance program. The idea has circulated for years, but now advocates think there's a real possibility such a plan will be incorporated into whatever health care bill emerges from Congress.

The C.L.A.S.S. Act (short for Community Living Assistance Services and Support, if you're wondering) could transform the way people pay for long-term care. Participants would receive daily benefits - money they could use to pay for home care, adult day programs, assisted living or nursing homes - whether they're elderly or young and disabled.

To date, two of the five Congressional committees working on a health care overhaul have adopted the proposed legislation; the others have yet to vote. Howard Gleckman, a senior researcher at the Urban Institute, pointed out that while some insurance companies oppose the idea, "the biggest problem the C.L.A.S.S. Act has isn't opposition, but indifference - a sense on the Hill that they just don't want to mess with long-term care."

Mr. Gleckman added, "That it's gotten this far is a surprise to lots of people. But Senator Kennedy has been pushing it hard. Given his health and his interest, there may be some sentiment for doing this for him."

Barbara Manard, a health economist with the American Association of Housing and Services for the Aging, worked with Mr. Kennedy's staff to draft the legislation. Here are her answers, edited and condensed, to questions about how the program would work.

Q: What's the basic idea behind the C.L.A.S.S. Act?

To read more, click here.

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CMS Proposes Huge Reduction in Medicare Payments to Physicians

Washington, D.C. -- The Centers for Medicare & Medicaid Services (CMS) is proposing a whopping 21.5% reduction in payment rates for services furnished during calendar year (CY) 2010 by more than 1 million physicians and non-physician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The proposal is expected to prompt significant angst and resistance within the U.S. physician community, especially within the powerful American Medical Association (AMA), the nation's largest organization representing the interests of physicians, according to Aging News Alert, an online, interactive and continuously updated online news service. In previous years when CMS proposed reductions in physician payment rates, the AMA responded with dire warnings of Medicare beneficiaries seeing reduced access to doctors and other healthcare professionals. By law, CMS is required to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate -- or SGR -- that was adopted in the Balanced Budget Act of 1997. This complex formula has yielded negative updates every year since 2002. Even so, CMS took administrative steps to avert a payment rate reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009. Given the level of criticism now being directed at the Democrat-controlled Congress regarding the ever-increasing deficit, it is uncertain whether federal lawmakers will intervene this time to stop the proposed cuts from taking effect.

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Archive of GMHA Newsletters

If you're looking for a previous edition of the Geriatric Mental Health Alliance's Newsletters, please don't hestitate to contact Yusyin at yhsin@mhaofnyc.org.