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Threat to senior programs - Federal cuts could leave the elderly out in the cold

A change to a federal health care program has one Brooklyn representative crying foul. Rep. Vito Fossella is calling to block the change to a federal health care program that he said would lock out a significant number of Medicaid beneficiaries from adult day health care programs. Fossella, speaking to a group of senior citizens at the Haym Salomon Home for the Aged in Bensonhurst recently, said a change to the program proposed by the federal government would mean eight states, including New York, could no longer offer the day care as an optional benefit under the Medicaid program. The change, he said, would require states to cover the policy only with a more stringent federal waiver, which could cut coverage for over 5,000 senior citizens in New York State, including hundreds of elderly Brooklynites. “This regulation would force thousands of seniors out of their homes and communities and into institutionalized settings like nursing homes,” said Fossella. “It would deny our most frail seniors and the disabled a critical service that helps them maintain their independence and quality of life.” Fossella contends that the federal government’s overturning of the day care’s status, which has been in effect for 25 years, would eliminate the program for up to 40 percent of the seniors currently eligible under it. Under the waiver that states would have to seek in place of the current program, such programs would only be available to those Medicaid beneficiaries who have stayed in a nursing home within the last 30 days. The federal government denies that this would be the effect of the change. Mary Kahn, a spokesman for the Department of Health and Human Services, denied the congressman’s contention, saying all patients would be phased-in under the new program so long as state’s applied properly. “This will only change the authority under which the patients get their benefit,” said Kahn. “There will be a phase-in. No one’s going to lose their benefit. The states just have to do their paperwork. Craig Donner, a spokesman for Fossella, denied the agency’s claim and pointed to the denial of service to significant numbers of Medicaid beneficiaries who were once eligible in California, which has already made the change. “Between 35 percent and 40 percent in California are losing access,” said Donner, who expects bi-partisan support for legislation that he expected would be put forth in the new session of Congress. Delegations from some of the other states affected by the rule change would likely offer support to a repeal, said Donner. Fossella also pointed out the salutary health effects that can come from an adult day care program, saying that keeping the maximum number of people eligible for the program made sense from a financial perspective as well as a health one. Adult day health care in New York costs an average of $1,703 a month per resident compared with $5,760 per month for the resident of a nursing home. According to a study by the Adult Day Care Health Council, enrollees with five or more chronic conditions have a hospitalization rate 20 percent lower than individuals in the Medicare community as a whole. Several attendees of the Haym Salomon program, speaking in Russian, English and Yiddish, made known their fondness for the adult day care program and their hope that it could be preserved. One elderly man, who said he had been attending the center’s adult day care for ten years, applauded Fossella for his stand and entered into an a cappella rendition of “Let Me Call You Sweetheart” to a round of hearty applause. Fossella took the man’s joie de vivre as a sign of the salutary effects of adult day health care for those who seek it. “Apart from the right thing medically, [blocking the federal change] is the right thing as a human being,” said Fossella. “People can die a number of ways, but the one thing we should not do is to force people to die emotionally or spiritually.”

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