Flu Clinic Finder

The Carolinas Center for Medical Excellence has created a Flu Clinic Finder that will help you find nearby places to obtain your flu shot. Just click on http://www.thecarolinascenter.org/fcf/ and fill in your zip code and the miles you are willing to drive and you will obtain a list of sites.

Please call any flu clinic listed in the Flu Clinic Finder BEFORE going to receive your shot to make sure the clinic still has flu shots available!

If you are enrolled in a Medicare Advantage plan, check with your plan to find out if you need to get your shot from a certain provider.

The Carolinas Center for Medical Excellence reports:

October 1st is just around the corner, and CCME's Flu Clinic Finder is already up and running! Please visit http://www.thecarolinascenter.org/fcf/

WE NEED YOUR HELP!

1--Please promote this tool to community partners to help consumers--especially older adults--find clinics in their area. (If you have a newsletter, I'd be happy to send you an article to use!)
2--Please also urge immunization providers to advertise their clinics in the Flu Clinic Finder (instructions are on the site).
3--For those of you who have web sites, please consider using the attached button to link to the Flu Clinic Finder.

Sadly, the flu still hospitalizes and kills thousands of older adults each year. Let's do what we can to turn that statistic around!

The South Carolina Respite Coalition will host a conference to discuss successful respite models and the faith community's role in family caregiving. Faith Community leaders, members, and caregivers are especially encouraged to attend, October 18th (details), Lextington, South Carolina.

conference information...

A Call for Transparency

To: The South Carolina Senior Community
From: Curtis M. Loftis, Jr.

NOTE:  Lt. Governor André Bauer is committed to transparent and accountable government, not only within this office, but across South Carolina. He is also committed to targeted, well-managed privatization of certain governmental functions. Privatization that is not prudent, transparent, and accountable to the people of South Carolina is unwise, as examples of such activity in Texas, Indiana, Missouri, Wisconsin, Pennsylvania, and other states have shown us. Simply turning the fate of our ill, frail, elderly and disabled over to private enterprise without proper government oversight cannot stand.

Lt. Governor’s Office on Aging report on the
Medicaid Transportation Advisory Committee

I am distressed to report that the Medicaid Transportation Advisory Committee has, in my opinion, been made ineffectual by the actions of the Department of Health and Human Services. The appalling lack of transparency by HHS has rendered impossible the committee’s efforts to follow the mandate given by state law.

What began as our attempt to advocate for seniors and adults with disabilities by understanding the new brokerage system and assisting in its implementation has disintegrated into a “turf battle” where the committee's right to public information has been thwarted at every opportunity by HHS.

The committee has met only once, and at that meeting no meaningful information pertaining to our mission was made accessible by HHS staff. Not one complaint was presented for review, and information requested by various committee members was not distributed during the meeting. Members of the committee asked that specific information be forwarded after the session, and the self appointed “leader” of the committee Ms. Felicity Myers of HHS, assured us that the information would be forthcoming within one week. What is most distressing is that much of the information should have been readily available and could have been emailed to the committee within minutes, or hours, certainly within a week, of our request.  Nearly a month has gone by and only one piece of information has been received.

I bring this troubling information to you, our partners, as I know that many of you have come to trust the Lt. Governor’s Office on Aging in these matters. I have been prompt in pointing out our successes and therefore I think it only honorable for the LGOA to advise you of this challenge.

Below you will find the unsigned committee report, authored by HHS, on which no vote was taken nor was it ever authorized in a public meeting.  Included in this HHS document are minutes that are neither “true” to the discussion nor inclusive of questions of the committee.  The HHS document does “parrot” the self-serving statements of the brokerage companies themselves. I believe that HHS violated the Freedom of Information act by writing a report in private without notifying the public, and submitting it on our behalf. Nevertheless, the sole saving grace to this distressful event is that several dissenting opinions were placed at the document's end.

An accurate report to the General Assembly would be that, absent information being provided by HHS as requested, the committee is unable to issue a report that reflects its legislative charge to review issues and complaints concerning the Medicaid Transportation Brokerage System and make recommendations for the resolution of these issues and complaints.  This legislative mandate of an external review of this Cabinet agency's handling of this issue was vetoed by the governor and over-ridden by the Legislature. The issue is also currently under review by the Legislative Audit Council.

Following is the HHS report:

Report of the Medicaid Transportation Advisory Committee
First Quarter, SFY 2007-2008

Joint Resolution H. 4178 required the Department of Health and Human Services (DHHS) to establish a Medicaid Transportation Advisory Committee composed of Medicaid service providers, local transportation providers, and Medicaid recipients, who require non-emergency transportation services. The advisory committee was required to have representatives from the South Carolina Emergency Medical Services Association, South Carolina Hospital Association, South Carolina Health Care Association, South Carolina Nursing Home Association, South Carolina Medical Association, Rural Transportation Association, Office on Aging in the Lieutenant Governor's Office, Department of Health and Environmental Control, Public Service Commission, two Medicaid recipients or two family members of Medicaid recipients, and a member of the brokering company operating the Medicaid transportation system.  Per resolution, the advisory committee is to do the following:

1. Meet at least quarterly to review issues and complaints concerning the Medicaid Transportation Brokerage System
2. Make recommendations for the resolution of these issues and complaints
3. Issue a report quarterly to the Governor, Senate, and House of Representatives.

The following report includes information and discussion topics relevant to the committee’s mission and scope as expressed in Joint Resolution H.4178.  In preparing this report, three committee members offered dissenting comments, and their remarks are included at the conclusion of this document.

Meeting Date - Tuesday August 28, 2007 at the DHHS Conference Room.  Committee members in attendance included:

Coretta Bedsole, South Carolina Adult Day Services Association
Elizabeth Burt, South Carolina Hospital Association
Chuck DaZearn, LogistiCare
Dr. Keith Guest, MD, South Carolina Medical Association
Scott Jones, South Carolina Nursing Home Association
Greg Kitchens, South Carolina Department of Health and Environmental Control
Randy Lee, South Carolina Health Care Association
Scott Lesiak, South Carolina EMS Association
Curtis Loftis, Lt. Governor’s Office on Aging
Elaina Macia, Medical Transportation Management, Inc. (MTM)
Barbara Manley, Medicaid Recipient
Lewis Stephens, Medicaid Recipient
Lynn Stockman, Transportation Association of South Carolina
Jonathan Teeter, Office of Regulatory Staff

SCDHHS Staff facilitating the advisory committee meeting:

Felicity Costin-Myers, Chief - Bureau of Rehabilitative and Medical Support Services
Deirdra Singleton, SCDHHS General Counsel

Members of the committee raised the following discussion topics during open forum:

• Is the broker system saving money?
• Is the level of care given to recipients consistent, regardless of provider?
• Are the brokers fulfilling the terms of the contract?
• Are nursing homes still experiencing delays in pick-ups and returns from appointments?
• “Stretcher van” terminology / appropriate use. There is currently no “stretcher van” designation. DHEC is in the process of clarifying this terminology and issues related to “stretcher van” transportation
• Who is to provide for a patient escort and the subsequent reimbursement?
• Clarification on the appropriate use of non-emergency ambulance services
• Need for improved communication of special needs during scheduling (wheelchair, car seat, etc.)

Representatives from each of the transportation brokers provided the following information:

MTM:
• MTM staffs phone lines 24/7
• MTM added a support network to handle same day, next day, out-of-region, and urgent trips. An ambulance company in the local area was awarded this contract.
• MTM set up a discharge line for hospitals (customer service agents can get the nurses off the phone quickly and they use e-mail and faxes to expedite the trips)

LogistiCare:
• LogistiCare staffs phone lines 24/7
• LogistiCare has “facility representatives” dedicated to help providers
• Logisticare has a registered nurse available for consultations
• Logisticare set up preferred providers for facilities upon request

DHHS Staff guided a discussion to develop potential agenda items for future meetings. The intent is to fully inform members and methodically discuss information relevant to the resolution. Committee members responded with these items:

• Discuss a detail summary (report card) of complaints which includes:
   o Complaints broken down by provider type and by region
   o Number of trips by type of transportation
• Review the written description of the brokers’ complaint processes
• Review the description of the level of care determination process utilized by the brokers
• DHEC update on “stretcher vans”
• Review the 216 process by which ambulance trips outside the scope of the non-emergency transportation contracts are deemed necessary.

DHHS staff informed members a “report card” draft of broker data would be sent to the members prior to the next meeting. The report card will contain data from May – July. It will be considered a draft until the committee gives feedback and accepts the format. Members were thanked for their participation.

Proposed dates for future meetings
November 27, 2007
February 26, 2008
May 27, 2008 (tentative)

Dissenting Comments (3)

---------------------
from Curtis Loftis:

Please accept my unequivocal dissent from the proposed "Quarterly Report." I contend that the committee meeting was not in compliance with the spirit or the letter of the law, and that any report pursuant from that meeting is of little or no value.  Despite my constant and vigorous protest, information is not forthcoming in a timely or forthright manner.  There is no effort at transparency; in fact I continue to find that obfuscation is the standard practice of HHS.

Unfortunately, I have participated in the "checks in the mail" game before. And frankly, I refuse to wait by the mailbox day after day, week after week, for information that should have been forthcoming long ago.  Please enter this email, and the letter below, into the record, and into any reports disseminated by this committee.

Curt Loftis, Jr.
Lt. Governor’s Office on Aging

(referenced letter)

Dear Director Forkner,

After careful review of the enabling legislation for the Medicaid Transportation Advisory Committee and after thorough consideration of the events of the last half year, it has become clear to me that the issues surrounding the Medicaid Transportation and Brokerage System are being obfuscated.  The question is why and for what purpose.

The legislation states clearly that the Committee is to "review issues and complaints", "make recommendations for resolution of these issues", and to issue a quarterly report to the Governor, Senate and House of Representatives".

Madam Director, these assigned tasks cannot be fulfilled if Health and Human Services is not forthcoming with information in a transparent and obliging matter.  You personally promised me in our meeting on August 14th that requests for information would be accommodated.  Ms. Felicity Meyers of your agency publicly promised me on August 28th that the information requested by committee members would be received within one week, and now over two weeks has passed and not one shred of information has been disseminated to the committee.

Furthermore, I am dismayed that I now can learn more about the Medicaid Transportation System and HHS's position on these issues by reading your comments in the Greenville newspaper than I can by attending to my official duties as a member of the Advisory Committee.

I request that the Department of Health and Human Services be forthcoming with pertinent information concerning these issues and that committee members and others not be forced to plead for information and that we not be burdened with unreasonable waits or restrictions simply to obtain information that is legally, and morally due to us.

The poor, elderly, ill and frail depend on this transportation system, and this information rightly belongs in the public domain as their care and well being is entrusted to us.  As you know, I believe that HHS is not properly enforcing its contracts with the transportation brokerage companies.  The lack of information from HHS only reaffirms my conclusion.

Perhaps the information requested will allow me to alter my understanding of the system.

Sincerely,
Curtis M. Loftis, Jr.

---------------------
from Randy Lee:

This report does not reflect the questions asked by the members nor does it address the information that we requested.  Having these meetings quarterly and not providing members with the information requested leads me to the conclusion that the agency has no interest in presenting the truth to the committee or the General Assembly.  Why did the committee not get the opportunity to elect a chairman and why is our meeting schedule and agenda controlled by the agency?  This issue is critical now and not two months from now.  I will, if necessary, file my own report with the Governor and the General Assembly.  I am very disappointed in HHS and will not stand back and let this issue be swept under the rug.  If you file this report please note that my organization does not agree with it.

Randy Lee
South Carolina Health Care Association

---------------------
from Dr. Keith Guest:

I will not be able to support the report you provided as submitted. I have not received any of the information I requested at the last meeting and the information provided in the form of a "Broker Report Card" is wholly inadequate for the committee to be able to meet its mandate.  I am requesting that we meet again soon to resolve these and other issues surrounding the general structure of the committee.  No report should be submitted at this time.

Keith A. Guest, MD
South Carolina Medical Association

On September 17, 2007 the joint CMS & SSA "Loss of Deemed Status Letter" (GREY Letter - publication no. 11198) mailing started going out to beneficiaries who automatically qualified (deemed status) for extra help in 2007 that no longer automatically qualify for the subsidy in 2008. The mailing includes an application for extra help with a postage paid envelope to return to SSA.

In early October, CMS will mail a "Change in Extra Help Co-payment Letter" (ORANGE Letter - publication no. 11199) to people who continue to qualify for extra help in 2008 but will have a change in their co-payment level.

The following materials related to these two mailings have been posted to the CMS Limited Income and Resources web page:

· Guide to LIS Mailings for CMS, Social Security and Plans

· Re-deeming Data of Beneficiary Notifications by state, county and zip code

· Notice Sent to Those who No Longer Automatically Qualify for Extra Help in 2008

· Notice Sent to Those with Change in Copayment Level in 2008

· Re-deeming Partner Tip Sheet - Information Partners Can Use on: Changes in
Qualifying for Extra Help in 2008

· Re-deeming Q & A

· Re-deeming Consumer Tip Sheet - What to Do if You No Longer Automatically Qualify for Extra Help (coming soon, currently available here)

· Links to other helpful information, including locating local resources in your area

For Brain Agility, Definitely Use It!

A free presentation in Columbia Tuesday, "Staying Sharp: Maintaining Your Brain As You Age, " typifies a brain-health movement sweeping retirement communities nationwide.

A Washington Post report reprinted in the Knoxville paper notes: “Much as physical fitness buffs hit the gym daily, seniors are doing brain exercises to tone their minds. The theory — so far with little hard science behind it — is that mental stimulation slows memory loss and other cognitive declines associated with aging. Encouraged by research suggesting the brain can sprout new cells and rewire existing ones late in life, senior communities are supplementing their usual lineup of bingo and art classes with new videogames, Sudoku puzzles and computer activities.”

Here in Columbia, national speakers will help people learn how to make changes in your life now that will impact your brain health, help preserve memory, and reduce the risk of stroke and dementia in the years to come.  

The presentation will be held from 10 am until noon, Tuesday, September 18th, in the new  Trinity Center for Missions, located at the corner of Gervais and Marion Streets.   The event is sponsored Still Hopes, Palmetto Health HomeCare, the Lieutenant Governor’s Office on Aging, and AARP South Carolina. 

The Washington Post article included these tips for mental agility:

• Do aerobic exercise: This tops most lists of what scientists recommend for preserving brain cells. Aerobic exercise protects brain neurons by sending more blood to the brain to keep oxygen flowing.

• Lose weight: One scary study found that people who are obese in middle age have twice the risk of developing dementia as those who maintain an ideal weight. Folks who have high blood pressure and high cholesterol also may be at higher risk of dementia, the Alzheimer’s Association reports.

• Eat brain food: Chowing down foods rich in antioxidants helps because they cleanse the brain of so-called free radicals that corrode connections between brain neurons. The foods to choose include leafy vegetables such as spinach, broccoli and cauliflower, and fresh fruit such as strawberries, cranberries and blueberries. Omega-3 fatty acids, found in cold-water fish such as salmon and trout, and in pills sold over the counter, also help fight brain decay.

• Computer exercises and video games.

• Online brain gyms: Web sites include www.happyneuron.com , www.mybraintrainer.com, www.brainbuilder.com, www.eons.com and www.braingle.com.

New Social Sites Cater to People of a Certain Age

A New York Times article indicates recent demographic information has caused many entrepreneurs to shift their attention from teen sites to boomers. Technology entrepreneurs are starting a host of new social networking sites aimed at baby boomers. The new sites provide boomers the opportunity to access issues such as dating, music, cosmetic surgery, diet, and health care .

According to market research results, the number of baby boomer Internet users is relatively equal to the teens.

From the article - The New York Times By Matt Richtel

Older people are sticky.

That is the latest view from Silicon Valley. Technology investors and entrepreneurs, long obsessed with connecting to teenagers and 20-somethings, are starting a host of new social networking sites aimed at baby boomers and graying computer users.

The sites have names like Eons, Rezoom, Multiply, Maya’s Mom, Boomj, and Boomertown. They look like Facebook — with wrinkles.

And they are seeking to capitalize on what investors say may be a profitable characteristic of older Internet users: they are less likely than youngsters to flit from one trendy site to the next.

“Teens are tire kickers — they hang around, cost you money and then leave,” said Paul Kedrosky, a venture capitalist and author of the blog “Infectious Greed.” Where Friendster was once the hot spot, Facebook and MySpace now draw the crowds of young people online.

“The older demographic has a bunch of interesting characteristics,” Mr. Kedrosky added, “not the least of which is that they hang around.”

This prospective and relative stickiness is helping drive a wave of new investment into boomer and older-oriented social networking sites that offer like-minded (and like-aged) individuals discussion and dating forums, photo-sharing, news and commentary, and chatter about diet, fitness and health care.

Read the complete article...

SC Lt. Gov. Bauer: White House hopefuls not addressing issues of Seniors, one third of the vote

Columbia – Lt. Governor André Bauer says seniors, who will provide one-third of the votes in next January’s primaries, have not heard from White House hopefuls about how they will deal with the demographic Baby Boomer tsunami that will shape the next presidency.

“The number of adults aged 65 and older in South Carolina and in the United States is doubling. It is time – in fact it is well past time – for the candidates who are asking for our votes to tell us how they will manage this demographic age wave and its impact on the health, independence, and quality of life of millions of people,” said Bauer in a speech to be delivered to the state’s Silver Haired Legislature on Tuesday.

“In about 120 days the candidates will be asking South Carolina voters to set them on the path to the White House. Do they understand that more than one out of every three votes cast in South Carolina primaries last spring came from seniors? For the record – and the candidates’ contemplation – voters who were 65 and older accounted for 33.9% of the Republican primary ballots last spring and 31.2% of the Democratic ones,” he said.

Bauer laid out a list of issues, and asked specific candidates to respond. He said he would place their responses on his website.

Early Social Security impact: Before our next president takes the oath of office in January 2009, the first of 78 million baby boomers will be turning 62 and applying for early retirement. They will turn 65 before the end of that first term.

Size of Baby Boomers: Bauer said the 78 million baby boomers is an increase of almost 150% in the number of people who received Social Security Administration benefits in 2005.

Alzheimer’s: We now have almost 5 million people 65 and older with Alzheimer’s and other dementias, and 70% live at home, cared for by family and friends. Direct and indirect costs of Alzheimer’s now cost more than $148 billion annually, but in less than a decade the Medicare portion alone is projected to be $189 billion.

Elder Justice Act: Which man or woman asking for our vote here in 2007 can promise us that he or she will stand with seniors in 2009? Who will declare that protection from exploitation, abuse and neglect should be the accepted norm? Who will ensure that those who prey on the frail, ill or elderly will suffer swift punishment? We have bipartisan support for an Elder Justice Act before the Congress of the United States– but we have no White House candidate demanding its immediate passage.

Geriatrician shortfall: One of South Carolina’s most innovative efforts has been to create a geriatric loan forgiveness program which has resulted in 12 board certified geriatricians agreeing to accept forgiveness of medical school loans in return for coming here to treat our seniors. We have increased our state’s number of geriatricians by one third. Still, the American Geriatrics Society says 36,000 more are needed nationally by 2030 to handle the baby boomers. Yet, each year America manages to certify only a little more than 300 geriatricians largely because the massive federal health programs that spend billions of dollars each year on senior medical care do not reward these critical skills.

Caregiving: Aging is the single common experience of our diverse time. It touches us all in ways that we don’t always anticipate. Our youngest baby boomers are building careers, and suddenly find themselves sandwiched between their care giving obligations to their aging parents and to their young children – while still working to establish their own secure future for retirement.

Free Presentation: "Staying Sharp: Maintaining Your Brain As You Age"

Researchers have learned more about the workings of the aging brain in the past 10 years than ever before.  It is possible to take action to improve the function of your brain. 

Learn how to make changes in your life now that will impact your brain health, help preserve memory, and reduce the risk of stroke and dementia in the years to come.  

A presentation by national speakers will be held in Columbia on Tuesday, September 18, from 10 am until noon in the new  Trinity Center for Missions, located at the corner of Gervais and Marion Streets.  

Registration is required for this free event, sponsored by Still Hopes, Palmetto Health HomeCare, the Lieutenant Governor’s Office on Aging, and AARP South Carolina. 

Silver Haired Legislature Meets Sept. 11-13

The Ninth Annual Session of South Carolina’s Silver Haired Legislature begins Tuesday at 1 p.m. in the House of Representatives chambers in the Statehouse.

Lt. Governor André Bauer, who is in charge of the state’s Office on Aging, will deliver a keynote speech to the Silver Haired Legislators at 1:30.

Walhalla Mayor Lamar Bailes serves as Speaker of South Carolina’s Silver Haired Legislature. Other officers include Treasurer Henry Baranoski of Conway, Records Clerk Hannah Timmons of Columbia, Secretary Arlis Hinson of Anderson, and Speaker Pro Tem Eugene Bondurant of Greenville.

South Carolina is one of 31 states that have created a legislative body of senior citizens to bring issues of concern to elected officials. South Carolina’s Silver Haired Legislators serve without compensation, and are chosen in each county in coordination with the state’s 10 Regional Area Agencies on Aging.

The group's legislative issues for 2007 include instituting mandatory criminal background checks for in-home care providers; reforming the "payday loan" industry; increasing state funding for home and community-based services for the elderly; increasing funding to provide emergency shelter for abused elderly victims; and creating a student loan debt forgiveness program to reward nurse practitioners who specialize in geriatric care.

The General Assembly created the SHL in 1999 to identify issues, concerns and possible solutions for problems faced by the citizens of South Carolina with special emphasis on issues related to seniors and to make recommendations to the governor and the Legislature.

The Silver Haired Legislature is divided into six committees that review issues and make recommendations for policy changes. The annual legislative session prioritizes five issues, which are relayed as Legislative Priority Resolutions.

Previous recommendations have been instrumental in helping create South Carolina’s Geriatric Loan Forgiveness program for physicians, the Five Wishes program as an adjunct to advanced planning documents, mandating criminal background checks of service workers, and enhancing the state’s long term care ombudsman program.

2007 Silver Haired Legislature schedule

Tuesday - Sept. 11:
Legislative Session, House Chambers, 1 - 4:30 p.m.

Wednesday - Sept. 12:
Legislative Session, House Chambers, 9 a.m. – noon.

Luncheon, Seawell’s on Rosewood Drive, 1 p.m.

Legislative Session, Seawell’s, 2:30- 4:30 p.m.

Thursday - Sept. 13:
Priorities session, House Chambers, 9 a.m. – noon.

2007 Silver Haired Legislature proposed resolutions