In this Issue
- New Online Tool to Get Started Applying For SSI
- Medi-Cal’s Older Adult Expansion
- National Academy of Science Calls for Bold Reform of Nursing Home Care
- CMS Terminates Laguna Honda’s Medicare and Medi-Cal Certification
- State Auditor Blasts California Department of Public Health for Enabling Large-Scale Hospice Fraud, Abuse and Neglect
New Online Tool to Get Started Applying For SSI
The Social Security Administration has released a new online tool for individuals who want to apply for Supplemental Security Income (SSI). Applicants and individuals assisting applicants can now use this online tool to request an appointment to apply for SSI benefits. The request establishes a protective filing date that will be used as the application date, so long as the individual submits an SSI application within 60 days.
After the individual submits the request, the Social Security Administration will schedule an appointment to apply for benefits by phone and send notification of the appointment within 7-14 business days. An individual can also indicate a “priority life circumstance,” such as homelessness, a terminal illness, or recent release from incarceration, that will prompt an SSA employee to attempt to contact the applicant by phone within three business days, to apply for SSI at that time or schedule an appointment to apply. For additional information visit National Center on Law & Elder Rights’ Training on SSI Basics.
Medi-Cal’s Older Adult Expansion
The Health Consumer Alliance (HCA) developed a consumer facing factsheet on the Older Adult Expansion which allows Medi-Cal eligible individuals who are 50 years or older access to full scope Medi-Cal regardless of immigration status. Full-scope benefits include primary care services, IHSS, skilled nursing care, mental health services, vision and hearing aids coverage. Participation in Medi-Cal will not be considered as part of the public charge determination by USCIS. For more information about public charge determination, contact your local CDSS Funded Non-Profit Organization. HCA’s factsheet on the expansion is available in various languages.
National Academy of Science Calls for Bold Reform of Nursing Home Care
On April 6, 2022, the National Academy of Sciences, Engineering and Medicine’s Committee on the Quality of Care in Nursing Homes released a 605 page report – The National Imperative to Improve Nursing Home Quality; Honoring Our Commitment to Residents, Families and Staff – that is meant to be a blueprint for desperately needed reform of nursing home care. The Committee, which began its work in the fall of 2020, considered the daily travesties occurring in nursing homes during the pandemic and the decades of dangerously poor care and staffing that preceded it. Declaring that “as a nation we have made promises for better care in nursing homes, and those promises have not been kept,” it calls for “moral courage” to implement a wide-ranging set of recommendations.
CMS Terminates Laguna Honda’s Medicare and Medi-Cal Certification
On April 14, 2022, the San Francisco Department of Public Health announced that the Centers for Medicare and Medicaid Services (CMS) terminated Laguna Honda’s participation in the Medicare and Medi-Cal programs due to continued violations of federal standards. Nonetheless, the city reported it will keep Laguna Honda open and continue serving the more than 700 residents who live there while it reapplies and seeks to restore its Medicare and Medi-Cal certification. These programs fund more than two-thirds of Laguna Honda’s services. CMS officials advised Laguna Honda that due to the exceedingly large number of residents and unique needs of the population, it is using its discretion to provide transition funding if the facility complies with federal closure requirements. Politicians vowed to prevent Laguna Honda’s closure, including House Speaker Nancy Pelosi, who called on city, state and national officials to work together to protect its life-saving programs for some of the most vulnerable San Franciscans.
Read April 14, 2022 San Francisco Chronicle article: S.F’s Laguna Honda Hospital has 30 days to avoid a shutdown after feds freeze funding
State Auditor Blasts California Department of Public Health for Enabling Large-Scale Hospice Fraud, Abuse and Neglect
A scathing March 29, 2022 report by Michael Tilden, Acting California State Auditor, charged that the California Department of Public Health “essentially enabled hospice agency operators who are possibly fraudulent to continue functioning, putting patients at serious risk of not receiving appropriate care.”
The long-awaited report opens with a letter to the governor and legislative leaders that states: “Indicators strongly suggest that a network or networks of individual perpetrators in Los Angeles County are engaging in a large and organized effort to defraud the Medicare and Medi-Cal hospice programs. Such fraud places at risk the extremely vulnerable population of hospice patients.”