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The New York City Council is pulling out all the stops to halt the spread of social day care centers that rip off Medicaid. The New York Times is reporting that the Council is looking to implement regulation and enforcement in order to weed out the shady centers that lure in healthy seniors in order to reap a windfall in Medicaid benefits.

In April, we first reported on the proliferation of social day care centers, which exploded from just eight programs citywide to 192 in only two years. The facilities arose in the wake of a new law enacted by Governor Andrew Cuomo, which wished to curb Medicaid costs by steering seniors needing expensive in-house or nursing care to the less-costly, community-friendly centers. The centers are supposed to treat patients with severe disabilities and medical problems but instead, many have been tapping healthy seniors to participate, luring them with cash and free groceries. The Times explains how the managed care plans and social centers profit by this practice:

Under the new system, managed care plans get roughly $3,800 a month for each eligible person they enroll in New York City, regardless of what services are provided. The plans contract with the social adult day care centers to provide services to their members. But advocates for the elderly and for people with disabilities have warned state officials that some plans were “cherry-picking” healthy seniors by using the new day care centers as marketing tools, while shunning the people who needed hours of costlier home care.

Joan Pastore, director of Amico, a city senior center in Dyker Heights, Brooklyn, said members of the center told her that they were not only signed up by new centers with enticements like $100 in cash and $50 for bringing a friend, but “coached on how to lie to qualify for home care.”

Members of the Council expressed anger at the practices of the managed care plans and the social day care centers.

“It is just outrageous that these pop-up centers are threatening the well-being of our seniors while draining Medicaid resources from legitimate programs for older adults. Increased oversight and regulation of these programs is needed immediately,” City Council Speaker Christine Quinn told the Times.

In response, the Council has introduced a bill that would impose minimum requirements on the centers, which as of right now, are unregulated. Centers would be limited to treating seniors with impairments, set minimum safety standards and must register with the city’s Department of Health and Mental Hygiene. The bill would also protect centers that play by the rules and offer robust service to patients with actual disabilities.

Centers that don’t register or ignore the new rules could be fined between $250 to $1,000 a day. Enforcing these new rules won’t be cheap. City officials estimate that it will cost $2 million to police the nearly 200 centers throughout the city.

State Senator Diane Savino is looking to create a statewide bill that is modeled after the Council version.

Source: Blue387 via wikimedia commons

Marty Golden is following through on his promise to bring back the old voting machines by leading the New York State Senate in approving legislation that would allow the machines to be used in upcoming elections, according to a press release.

The legislation, which was sponsored by Golden, allows New York City to use lever machines for all non-federal elections, including the upcoming mayoral primaries, run-offs and general election. Golden praised the passage of the bill as a victory for making voting simpler.

“The lever voting machines had been successfully used in New York for over 100 years. They have proven to be reliable and easy for voters to use. In addition,  using lever voting machines will expedite the canvass of votes cast in the primary election and reduce the number of paper ballots that would need to be hand-counted,” Golden said in the release.

State Senator Simcha Felder believes that the machines will help seniors.

“The new voting machines are confusing to people and very hard to read, especially for seniors,” Felder said.

There have been concerns that the new voting machines, which rely on paper ballots and digital readers, were causing more problems than solving them. Voters, especially seniors, complained about difficult to read and confusing paper ballot instructions, and the Board of Elections has proven unequal to the task of tallying the votes on the new machine in a timely manner.

The bill will now go to the Assembly for a vote.

Source: Jhawk/Flickr

Social day care centers, community facilities that cater to the elderly, are being accused of abusing Medicaid, according to a report in the New York Times.

Under a new law enacted by Governor Andrew Cuomo, managed care, the type of service offered at the centers, became mandatory for people receiving home services. The hope was that New York, which has the largest Medicaid budget in the country at $54 billion, could steer the costs away from expensive long-term home care like nursing homes to less expensive and safer community friendly centers.

The centers, which have ballooned from eight programs to 192 in just two years, are supposed to treat patients with severe disabilities and medical problems. The Times described the scenes at centers meant to cater to the frail:

Scores of elderly Russian immigrants played bingo under the chandeliers of a former funeral parlor in Brooklyn on a recent Monday, with a free dinner and door-to-door transportation from anywhere in the city.

Nearby, older people speaking Chinese filled a supermarket-size storefront with vigorous games of table tennis, billiards and mah-jongg, and ordered free lunch from a takeout menu featuring minced pork, beef and salty fish.In Bensonhurst, Brooklyn, at the new R & G Social Adult Day Care Center, known locally among elderly immigrants for luring clients with cash and grocery vouchers, most people there for lunch did not stay to eat. Instead, many walked briskly toward the subway carrying bags stuffed with takeout containers, and two elderly men rode away on bicycles with the free food.

If something seems out of whack in this picture it’s because the financial rewards for the centers are huge. These new social day care centers are taking in seemingly healthy, active elderly people because, in New York City, Medicaid reimburses these centers per member to the tune of $3,800 each, per session, compared to the statewide average reimbursement of $93 per member.

Right now, there is little oversight or regulation. As a result, there has been an aggressive push by the centers to recruit elderly members no matter how healthy they might be. The Times described how the centers tempt elderly with financial incentives:

At Mr. [Warren] Chan’s Asian Senior Day Care center on 18th Avenue, around the corner from R & G, Liang Mei King, 77, was one of several clients who said they were offered financial inducements to join R & G.

“I went once to see,” she said through an interpreter, interrupting her mah-jongg game. “If you get someone else, they give you $50. And each week, there’s a certain amount of money. One day there’s $5, a $10 grocery coupon, or an unlimited MetroCard. If you don’t want the MetroCard, they offer $125 in cash.”

Mr. Chan said other centers were resorting to the same tactics, and elderly immigrants who did not know better accused him of pocketing benefits himself.

While the redesign of the state’s Medicaid system was enacted to curb costs, the loopholes have costs spinning out of control. Part of the problem is that Medicaid is not overseeing the centers, and instead leaves oversight to the managed care plans that pay out to the centers. That, however, is a shoddy system, since there’s little incentive for managed care plans to crack down on centers, since the managed care plan gets a cut of the payment.

Valerie Bogart, a lawyer for the New York Legal Assistance Group explained the problem to the Times:

“The whole thing is going to end up costing the state much more money. It’s really up to the managed care plans to be the watchdogs now, and it’s like the fox watching the chicken coop, because they have an incentive to make money from these centers, too,” Bogart said.

Source: Jaszek Photography via Flickr

According to the Department of Transportation (DOT), seniors account for 38 percent of pedestrian fatalities, yet represent only 12 percent of the population. The reasons for this discrepancy, they say, are the lack of “complete streets.”

What are complete streets, you ask? Well, according to the National Complete Streets Coalition, “complete streets are designed and operated so they work for all users—pedestrians, bicyclists, motorists and transit riders of all ages and abilities.”

Essentially, they are the sort of streets that are neatly organized with sensible traffic flow, clear traffic signs and wide walking spaces that compliment bike lanes so pedestrians and bikers aren’t getting in each other’s way.

An example of a “complete street.” Source: smartgrowthamerica.org

New Yorkers can sense when they aren’t on a “complete street.” Incomplete streets are the sort of narrow sidewalks that barely accommodate two-way foot traffic, have winding twists and no clear intersections that promote safe crossing. According to the DOT, the lack of complete streets present a real issue for seniors:

A recent report by AARP showed that 40% of adults over 50 reported inadequate sidewalks in their neighborhoods, and 50% reported they cannot cross streets safety. The report also revealed that many people would walk, bicycle or ride the bus if these conditions were improved.  Challenges that frequently affect people’s mobility as they age include declining vision, reduced physical fitness and flexibility, decreased ability to focus attention and increased reaction time.

For the DOT, the need to proliferate the city with “complete streets” will become a pressing issue within the next decade as 2025 the population of older adults will double, likely leading to an increase of pedestrian accidents. Because of this, they are advocating community involvement and awareness in “complete street” policies and planning. Here is some relevant information:

Attend a DOT forum or workshop about transportation or neighborhood planning.  Visit our event calendar or view upcoming events on Facebook. Participate in your community board’s transportation committee. (Find your community board).

Check out resources like the National Complete Streets Coalition, the National Center for Safe Routes to School, the National Highway Transportation Safety Administration and the Rudin Center for Transportation Policy and Management at NYU.

Source: slack12/Flickr

New York 1 has been following a story about a group of elderly residents that have been left stranded in their Brighton Beach building courtesy of a broken elevator that has been out of commission since Superstorm Sandy struck late last October.

The residents, many disabled, have had difficulty scaling the steps of their six-story building.

“I live on the sixth floor and every day I cannot go out,” Alexander Fayn told NY1.

When NY1 originally reported on the story earlier in the month, the Department of Buildings promised that it would get fixed, but three weeks later it remains broken, driving the tenants mad.

“I’m frustrated, I’m upset, I’m furious,” said Michael Royzman to NY1.

NY1′s further inquiry with the Department of Buildings resulted in a promise by the DOB to investigate the matter.

Great…an investigation, why not just fix the elevator!?

Source: Nesnad via Wikimedia Commons

A 78-year-old man was struck by a school bus near Ocean Parkway yesterday morning. The man was taken to Lutheran Medical Center where he died.

The accident occurred at the corner of Ocean Parkway and Kings Highway at about 6:50 a.m. The man, whose name is being withheld until his family is notified, was struck and thrown approximately 20 feet. The man was found to be bleeding from his face and in critical condition.

“The guy was not okay. He was out on the floor…not moving,” witness Danny Mizrachi told DNAinfo. “He did not say anything.”

The bus driver, 60, had no passengers and stayed on the scene. The police suspect no criminality, though their investigation is not yet complete.

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For some people, Hurricane Sandy came and went, barely disrupting their lives or neighborhoods. Others, especially the elderly living in Brighton Beach and Coney Island, were not nearly as lucky. A report in the New York Daily News chronicles the weeks-long nightmare that elderly New York City Housing Authority residents have faced in Sandy’s aftermath.

Virtual prisoners of their own apartments, scores of seniors were shut in their homes without power, heat, hot water, and medical supplies, and had no one coming by to check in on or assist them. New York City Public Advocate Bill de Blasio blames the mayor’s office and NYCHA for failing to do a more extensive door to door check of people’s homes affected by shortages of essential needs.

The city claims to have visited more than 65,000 apartments, with 42,000 of those being NYCHA properties. However, de Blasio told The Daily News that the effort wasn’t enough. “They’re missing whole parts of the city. It’s scattershot. We hear it over and over: ‘No one has knocked on our door.’”

Those the city missed include Irine Lombardo, a 74-year-old Coney Island resident forced to evacuate her flood-damaged apartment to a friend in Brighton Beach. During the storm, she lost her oxygen tanks, and when forced to relocat to a friend’s fifth floor apartment in Brighton Beach, she had no access to electricity, heat, or hot water, leaving her trapped and vulnerable, and without proper medical care.

Irine’s friend, Olga Romanov, told The Daily News that, “Nobody came to us from the city. Nobody came to us from NYCHA.”

Through the combined efforts of de Blasio’s office and volunteers from the Physicians for a National Health Program, Lombardo finally got her oxygen tanks this past Sunday.

The following is a press release from the Mazel Day School:

Source: Manitowoc.uwex.edu

Receive support, knowledge, and insight from caregivers in a supportive environment during a free Caregiver’s Support Group, recommended for adults, at the Kings Bay YM-YWHA (3495 Nostrand Avenue), January 9 from 1:00 p.m. to 2:30 p.m. To learn more, call (718) 648-7703, email info@kingsbayy.org or visit www.kingsbayy.org.

Source: Wycokck (Unified Government of Wyandotte County and Kansas City, Kansas)

After a chorus of disapproval over safety concerns, New York swiftly reinstated vision tests for more than two million drivers who renew licenses each year; at least until a medical advisory board determines the best way to check drivers’ eyesight, according to New York State Department of Motor Vehicles Commissioner Barbara Fiala.

That announcement came less than 48 hours after a statement about a plan to end the tests would have taken effect on October 5, and given individuals the benefit of the doubt when it comes to their vision.

Under that set up, drivers applying for renewal would essentially be permitted to self-certify that their eyes were fine. Regardless of whether or not the exam is abolished, those applying for the first time or for a commercial license must still get their eyes tested.

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