The Stimulus Package Will Help Older Americans

One-time $250 "senior payment" helps people on a limited income—and they’ll spend it
By: Michael Zielenziger | Source: AARP Bulletin Today | February 16, 2009

Older Americans, Medicaid recipients, workers and the unemployed will gain big benefits from the sweeping $787 billion stimulus bill President Obama signs into law tomorrow—marking his first legislative victory in his efforts to turn around a faltering economy.

Workers earning $75,000 or less will get a $400 payroll tax credit—a signature pledge of Obama’s electoral campaign. Millions of Americans receiving unemployment benefits will see a $25 bump in their weekly checks. Unemployment benefits will last longer—as much as 59 weeks in states hardest-hit by job losses. Some $87 billion will be sent to the states to offset potential cuts in Medicaid benefits. The package also provides an extra $20 billion for food stamps over several years. The average family of three will see a 19 percent increase this year, or an extra $63 per month.

Senior payment

Unlike last year’s $152 billion tax rebate plan under the Bush administration, the estimated 51 million Americans who now receive Social Security benefits will automatically get an additional $250 check from the federal government without having to file any extra paperwork. The payment will be sent in late May or early June.

The $14 billion in total payments to older Americans “will help stimulate growth, because those on limited incomes will be spending money for sure,” said Chad Stone, chief economist for the Center on Budget and Policy Priorities in Washington. “This direct payment cuts out the middleman.”

The $250 “senior payment” was never included in the House-written draft of the stimulus package approved in late January, but the payment wound up in the Senate bill after being proposed by Max Baucus, D-Mont., chairman of the powerful Senate Finance Committee.

The provision also was strongly promoted by Sen. Sheldon Whitehouse, D-R.I., who discovered that nearly 10 percent of his state’s estimated 194,000 Social Security recipients didn’t receive last year’s stimulus check, mostly because they were unaware of the need to file a federal tax return or were intimidated by the extra paperwork. “The idea is to make sure Social Security recipients are able to get their rightful stimulus payments without having to jump through the same sort of hoops” as last year, Whitehouse spokeswoman Alex Swartsel said in an interview.

The one-time payment not only recognizes the economic hardship faced by many retirees but also helps boost wider economic growth, “since seniors are more likely to spend the money than any other age group,” noted David Certner, director of legislative policy for AARP, which pushed for the measure early on.

More for Medicaid

A big chunk of the stimulus bill—$87 billion—is going toward an expansion of federal funding for Medicaid, which will allow some states to scale back planned cutbacks in medical services to the indigent. The bill also gives the highest payment boosts to the states hardest-hit by unemployment, such as Ohio, Michigan, Pennsylvania, New York and California. The logic is simple: As growing numbers of workers lose their jobs, a state’s income tax revenues dwindle, while the number of residents qualifying for Medicaid grows.

For example, in California a budget plan offered by Gov. Arnold Schwarzenegger, R, would cut $183.6 million from the state’s Medi-Cal system and exclude from eligibility those whose income exceeds 70 percent of the federal poverty level, which is $632 a month for an individual and $850 for a couple. The current limit is 100 percent of the federal poverty level—about $900 for an individual, $1,214 for a couple.

The stimulus plan should help: It could net the state an additional $11 billion in Medi-Cal funding over the next two years. “We haven’t seen the final numbers yet,” said Tony Cava, a spokesman for California’s Department of Health Services, “but it’s possible we’ll be able to roll back some proposed cuts.”
Is it enough?

Other important spending provisions in the stimulus plan include $19 billion targeted to help hospitals and physicians computerize their medical records; $1.1 billion for “comparative effectiveness” research, which compares treatments, procedures and drugs; $8.5 billion for National Institutes of Health research into Alzheimer’s disease, Parkinson’s disease, cancer and heart disease; and funds for high-speed rail, roads, bridges and energy efficiency.

Although economists like Barry Eichengreen of the University of California, Berkeley believe the stimulus package could have been larger still, most believe the Obama plan will add at least 2 million jobs to the economy over the next 18 months. “Overall, I think the package is too small,” said Eichengreen, who studies economic crashes around the globe. The “small government ideology” of many Republicans got in the way of economic logic, he said. “Three trillion dollars of demand has disappeared, and the stimulus is only a quarter of that size.”

The Obama administration acknowledges that the stimulus alone won’t stop the economic slide. This week the White House will announce new proposals to stem the massive tide of home foreclosures, while the stock markets await more details of a Treasury plan to clean up the enormous pile of bad debt in the nation’s commercial banks.

Michael Zielenziger is based in Oakland, Calif., and writes on business and the economy.

LoJacks for People With Alzheimer’s

LoJack for People Posted Wednesday, February 11, 2009 9:28 AM | By William Saletan

The companies that brought you tracking devices for stolen cars and lost animals have found a new market: tracking human beings.
Radio tracking devices, as Philip Shishkin notes in the Wall Street Journal, were initially placed on endangered animals. More recently, LoJack has installed them in more than 7 million vehicles to foil theft. Some 2,000 to 3,000 police departments have receivers to pick up signals from the devices. Why not extend that network to track people?

In fact, two companies have already put radio monitors on 18,000 people with Alzheimer's or brain injuries. Now LoJack is joining the market in a big way. Yesterday, the company announced a "diversification strategy" to "track and rescue people at risk of wandering, including those with Alzheimer's, autism, Down syndrome and dementia."

The Alzheimer's market looks pretty lucrative. LoJack anticipates up to 16 million Alzheimer's patients by 2050, most of whom wander away at some point. But the company also notes that "autism, which is the fastest growing developmental disability that now afflicts one in every 150 babies born, can also cause children to wander." In fact, LoJack aims to address the whole range of potential wanderers. According to CEO Ronald Waters, "This offering is a natural extension of LoJack's family of products and services and takes our solutions beyond ‘getting the bad guys' off the streets to now protecting those afflicted with cognitive disorders."

Who's going to have the receivers to track all these people? "Law enforcement/public safety agencies," says Lojack. And who's going to buy the devices and put them on the people who will wear them? You can't expect a cognitively disordered person to take that kind of initiative herself. As an Illinois sheriff points out to Shishkin, "The people who need the technology are often too embarrassed to ask for it."

There's no question that these devices save lives. Without them, some people will wander off, get lost, and die. And if your family can't track you, they might resort to keeping you indoors so you don't wander. But "cognitive disorders" can also become an expanding rationale for putting more and more people under constant police surveillance. In the spirit of mutual tracking, let's keep an eye on it.

Choosing an Agency for In-Home Care

The AARP provides the following checklist of questions for identifying good home health care agencies . I find the list to be very helpful.

Services Choose an agency that will provide all the services you need for your parent or loved one. If you need help identifying these, speak with a doctor, care manager, or hospital discharge planner if the person just left the hospital. These people can refer you to agencies. Once you make your list of agencies, start by calling them. Here are some questions to ask:

Is this agency licensed by the state?
What services does it provide?
Are services available 24 hours, 7 days a week?
Would services begin immediately?
If not, how long a wait?
How does the agency decide what services are needed or not over time?

Know the Staff The people providing services will have direct contact with your parent or loved one, so you’ll want to know as much as possible about their qualifications.

What kind of different staff does the agency have available: registered nurse, physical therapist, speech therapist, occupational therapist, nutritionist, social worker, homemaker/home health aide?
How many years of experience does the person have, and how long have they been with the agency?
Does the agency conduct background checks on all staff?
Who supervises the staff?
Are the staff bonded (insured against theft or loss to a home) through the agency?
Do the same staff members attend to a client, or do they rotate among different clients?
What is the procedure if a staff person doesn't show up?
Can you request a different staff person to provide care if you are unhappy with the worker the agency sent?

Costs There are several ways to pay for home-care services:
• Out of your own pocket;
• Through Medicare, Medicaid, or some other public programs;
• Through Medigap, long-term care insurance, or other commercial policies.
Outside assistance with paying for home care-services is generally limited and usually covers only short-term home health care needs. Eligibility for Medicare or Medicaid payment requires an agency to meet certain federal standards and provide skilled nursing services. That means these programs don’t pay for personal care or homemaker services. Persons eligible for coverage under the programs must be homebound and under a doctor’s care.

Here’s what you need to know regarding cost:

Is the agency certified to be paid by Medicare and Medicaid?
Are there deposits, fees, or any extra costs besides those charged for each service?
Are all cost and payment expectations in writing?
Does the agency reduce fees for people who can’t pay for all of their care themselves?
When did the agency last increase its costs and by how much? How often does the agency bill for costs? Does it bill Medicare or the insurance company directly
Is there a contract you can review before making a decision?

Make sure you understand everything on the contract. Question any parts that are unclear or contradict information you’ve been told.

Quality You know it when you see it, but it can still be hard to measure. Here are some questions to help you gauge the quality of an agency and the care it provides:

Does the agency have references or satisfaction reports for itself and staff?
Is the agency inspected by an outside organization?
When was the last inspection?
Are inspection reports available?
Does staff receive ongoing training?
Does the agency provide written job descriptions so clients know what duties to expect from the staff?
Does the agency have quality of care standards and a plan or program to maintain and improve quality? How often does staff communicate with family members and by what means (written report, phone call, etc.)?
What kind of system is there for receiving client problems or complaints and resolving them?
Is there a written plan of care for each client? Are clients and family members involved in creating and reviewing it?
How long has the agency been in business?
Who owns and operates it?