Florida Association of Homes and Services for the Aging
September 4, 2008 Vol 15, Issue 37
Hands  FAHSA LINK
 
Welcome to this week's edition of the FAHSA Link.
 
Florida Supreme Court Removes Amendment 5 Off the Ballot -- Within hours of hearing arguments from opponents and proponents of Amendment 5 on Wednesday, the Florida Supreme Court ruled unanimously in favor of upholding the Circuit Court's decision to remove Amendment 5 from the November general election ballot.  Supreme Court Justices also indicated that they would not entertain a request for a rehearing.  To watch the oral argument testimonies from an archived webcast, click here, then click on the Department of State of Florida vs. Beverly Slough, download the video player and the webcast will begin automatically. 
 
FAHSA has been an outspoken opponent of Amendment 5 since it was first proposed by a member of the Taxation and Budget Reform Commission.  If Amendment 5 made it to the ballot and voters approved it, the Florida Legislature would have been forced to replace more than $9.6 billion in lost revenues. The end result would have been a higher sales tax, a possible service tax, and cutbacks in services. This is a big victory not only for FAHSA and the Florida Life Care Residents Association (FLiCRA), but for all citizens.
 
Retirees Warn of "Catastrophe" from Amendment 5 Service Cuts, New Taxes -- On Tuesday, members and staff from the Florida Association of Homes and Services for the Aging (FAHSA) and the Florida Life Care Residents Association (FLiCRA) spoke out during a press conference held in Tallahassee warning citizens that if Amendment 5 is placed and passed on the November ballot, it could have "catastrophic" effects for Florida's seniors.  
 
Amendment5Photo
 
Speaking on behalf of FAHSA and FLiCRA, Dr. Benjamin Colmery, Westminster Oaks resident; Gladys Davis, Georgia Belle Apartments resident; Bennett Napier, CEO, FLiCRA; and Janegale Boyd, President/CEO, FAHSA, charged that Amendment 5 could be a "Category 5 disaster" for Florida elders by creating new taxes on sales and services that would raise the cost of services that retirees rely on, including: monthly community maintenance fees, community entrance fees, meal plans, home health and nursing care and laundry.
 
"If Amendment 5 passes, tens of thousands of retired Floridians, on fixed incomes, would have to pay far more in living costs than they had planned," said Bennett Napier, Executive Director of the Florida Life Care Residents Association. "Such unexpected new costs could have potentially catastrophic effects on the budgets of retirement communities and of residents, pushing them to the tipping point of eventually running out of money."
 
Concerns about the long-term financial security of Florida's seniors have grown as alarming new economic data has emerged showing an increase in bankruptcies among older Floridians. According to a new analysis from the Consumer Bankruptcy Project, the rate per thousand of bankruptcy filings for seniors aged 75 to 84 increased 433 percent from 1991 to 2007. For the same period, bankruptcy rates for seniors aged 65 to 74 increased 125 percent. 
 
A new report, published in July by Ernst & Young, paints a dispiriting picture of the long-term solvency of retired Floridians' savings. Floridians near retirement today have a 75 percent chance of outliving their assets, according to the report, and newly retired Floridians have a 61 percent chance of someday running out of money.
 
"If unexpected new services tax costs imposed by Amendment 5 push retired Floridians into insolvency, thousands who worked hard to finance privately their own long-term care needs could be forced into Medicaid and other taxpayer-funded services," said Dr. Ben Colmery. "In these difficult economic times, the last thing we need to do is raise taxes on our seniors."
 
The groups further argued that with sales tax revenues continuing to decline, the Florida Legislature is expected again to make deep cuts to state-funded elder services - raising questions about the financial wisdom of forcing the state into deeper dependence on the sales tax.
"The simple fact is that greater reliance on the sales tax is not good public policy, and that's only one reason why Amendment 5 would be a Category 5 disaster for Florida seniors," said Janegale Boyd, President and CEO of the Florida Association for Homes and Services for the Aging. "In one stroke, this misguided, misleading Amendment would create new taxes, harm public education, burden seniors on fixed incomes, and devastate critical public services upon which seniors and all Floridians rely."
 
Gladys Davis also argued that Amendment 5 would punish Floridians who rent their homes and thus would not receive property tax cuts to offset higher sales taxes.  "I am convinced that new taxes on sales and services that would likely result from Amendment 5 would make my struggle to keep up with rising costs even more difficult," Davis said. "Like many Floridians with modest incomes, I do not own a home. I would not benefit one iota from Amendment 5. Instead, I would lose by paying more everyday in higher costs and higher taxes."  
 
Amendments 7 and 9 Removed from Ballot, Too - In addition to striking Amendment 5 from the ballot, the Court also struck Amendments 7 and 9, reversing a lower court decision that ruled these amendments proper.  Amendment 7 would have removed the constitutional ban on using public funds for religious-based institutions. Amendment 9 would have authorized school vouchers by allowing the use of public money for tuition assistance at private schools and simultaneously required school districts to spend at least 65 percent of their funding in the classroom (a proposal known as the "65 percent solution").  The argument raised by the challenges to Amendment 7 and 9 was that they were outside the scope of the Taxation and Budget Reform Commission's authority for proposing constitutional amendments, which it was argued is limited to issues concerning taxation and the "state budgetary process" by the constitution (Art. XI, Sec. 6(e)). In reversing the lower court decision and striking these amendments, the Court also ordered that no reconsideration would be entertained and indicated that a full opinion explaining the issues is forthcoming.
Source: TaxWatch E-communique, September 3, 2008
In This Issue
Education News
General News
Home and Community-Based Services News
Housing News
Nursing Home News
Preferred Business Associates News
Job-Mart
FAHSA Quick Links
Education News
Contact Hours to be Uploaded to CE Broker Next Week - If you have recently attended one of FAHSA's workshops, the annual convention, or taken any tests from FAHSA's regulatory videos, the contact hours will be uploaded to CE Broker next week.  To give participants adequate time to review their certificate of attendance forms, FAHSA has been making changes and is in the process of preparing files to upload.  If you have any questions about your hours, please contact the FAHSA office as soon as possible.
 
AAHSA Annual Meeting and Exposition - AAHSA's annual meeting, One Voice, is scheduled for October 12-15, 2008 in Philadelphia, PA.  There's still time to register by clicking on AAHSA's Web site.  More than 500 exhibitors, 250 educational programs, and an evening with the Queen, Aretha Franklin are some of the featured highlights.
 
Upcoming Educational Events:
September 15 - FAHSA's Home and Community-Based Workshop, Hyatt Regency Jacksonville Riverfront, Jacksonville
September 15 - Administrator and Boards of Directors Training for HUD Communities, Hyatt Regency Jacksonville Riverfront, Jacksonville
September 16 & 17 - FAHSA's 25th Annual HUD and Service Coordinator Workshop, Hyatt Regency Jacksonville Riverfront, Jacksonville
September 23 - FAHSA's Regional Meeting - by Webinar, TBA
September 26 - IMAX TRACs Audio Call featuring Bonnie Wilpon
October 13-16 - AAHSA's Annual Meeting and Exposition, Pennsylvania Conference Center, Philadelphia, PA
October 21 - Webinar:  Risk Management, NeverEvents featuring Susan Bugg and Jan Ferguson
October 29 & 30 - FAHSA's Board of Trustees Meeting, The Tradewinds, St. Petersburg
November 13 - Webinar:  Bridging the Gap:  Understanding New Wireless Technology 
  
 

  
FAHSA Calendar of Events
General News

New Dental Health Campaign Launched -- The Florida Dental Association (FDA) launched a new campaign in Tallahassee this week, "Dentistry: Gateway to Good Health".  The campaign highlighted the importance of dental care to overall well-being. A press conference held on Tuesday kicked off the event, along with a life-size, portable billboard, targets both children and seniors in an effort to stress the importance of early dental habits to lifelong health. 
 
Janegale Boyd, President/CEO made the following remarks during the press conference. "Good dental hygiene is important to elders, especially those with serious cognitive and physical impairments who rely on others for mouth care. Preventive dental care affects one's quality of life, nutritional intake and overall health. Without healthy teeth or properly fitting dentures, it's difficult to enjoy food and the social benefits that accompany the dining experience. Dentures that do not fit, a common problem with frail elders, or decayed teeth can result in loss of appetite and serious weight loss. The challenge of ensuring good dental care is particularly great for elders with Alzheimer's disease and other forms of dementia that need help with simple tasks like brushing their teeth.  We are proud to participate in the Florida Dental Association campaign to educate the public about the importance of lifelong dental care. The attention that this campaign brings to the importance of good oral hygiene will benefit Floridians of all ages."  FAHSA, along with more than 12 organizations, supported the campaign.
 
City and County Budgets Could Include Hidden Taxes - Speak Out If They Do - Around the state, local officials are in the process of developing their budgets for the coming year. This will be the first budget cycle that we will see the effects of recent tax reforms enacted by voters and the Florida Legislature.  Although property values have fallen and the public has spoken with the passage of Amendment 1 last January, not all local governments are planning to scale back their expenditures. Even if property taxes go down in your area, local governments have the option of increasing revenues through special assessments and user fees. Increases in the use and amount of special assessments and user fees can cause serious operational problems for FAHSA member organizations.
 
Please be sure to check your local newspaper for the dates and times of public hearings on the budget. It is important for you to attend these meetings to understand how the budget will affect your organization and the residents you serve. The hearings also provide an opportunity for you and your resident leaders to express your opinion to your county council or city commission and to ask for special consideration, particularly if you operate an affordable housing community.
 
Medicare Enhances Consumer Information on Hospital Care -- The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS), recently announced important additions to the Hospital Compare Consumer Web site that will give consumers even better insight into the quality of care provided by their local hospitals.  The improvements include the addition of a mortality measure for pneumonia and, for the first time on Hospital Compare, publicly reported measures for hospital care of children.  
 
CMS Broadcast on Innovative Employer Caregiving Programs -- The next Caregiving broadcast sponsored by the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services New Freedom Initiative Subcommittee (NFI) is scheduled for September 17, 2008, from 1:00 p.m.-2:00 p.m. (Eastern Time).
 
The broadcast will focus on Innovative Employer Caregiving Programs and include presentations from employers and other organizations that have developed and conducted successful programs for employed care givers.  Presenters will discuss their experience with these programs and how they can be replicated by others to help employed caregivers.
 
If you are an Employer looking to expand or create services and programs to support your employed caregivers, a Caregiver working full or part-time and caring for a loved one, an Organization that provides caregiver services, or any one else with an interest in Caregiving, please make plans to listen on September 17th.
 
To learn more about the broadcast or to register as an individual viewer or as a host viewing site, please click here.
 
Salary and Benefits Reports Available for Nursing Homes, CCRCs, and Assisted Living -- The Hospital and Healthcare Compensation Service has published the annual salary survey for all categories of staff in these three long-term care provider groups. To order your copy, click here
 

 

Home and Community-Based Services News
FAHSA's 2nd Annual Home and Community-Based Workshop Scheduled - This year, plan to attend FAHSA's HCBS Workshop on Monday, September 15, from 1:00 p.m. to 5:00 p.m. at the Hyatt Regency Jacksonville Riverfront Hotel in downtown Jacksonville.  Peter Notarstefano, AAHSA's Director of HCBS, Mike Bell, The Hospice Foundation of the Florida Suncoast, Shannon Martin, MSW, CMC, Aging Wisely, and Anne Menard, Agency for Health Care Administration, will present topics such as Implementing a Comprehensive Aging in Place Strategy for Independent Residents, Pushing the Limits of Support Services:  When Does it Become Too Much of a Good Thing?, AHCA Issues New Rules Affecting HCBS/Home Health Providers, and Operational Issues and Challenges for HCBS Providers. Online registration and a brochure are posted on the Calendar Page of the FAHSA Web site
 
Housing News
 
AHCA Responds to FAHSA Member Concerns about Recent HHA Memo
- Recently, one of FAHSA's affordable housing members raised questions about home health agencies not being able to offer free blood pressure checks in his community because of a recently passed state law to address fraud.  Home health agency staff will often visit communities a few times a year to take blood pressure checks of residents or hold health fairs.  According to a couple of affordable housing members, these services have resulted in rushed transportation to emergency rooms and prevented major catastrophes.
 
According to a June memo, issued by the Agency for Health Care Administration (AHCA), and related to legislation passed in 2008, AHCA can deny, revoke or suspend the license and impose fines to any home health agency for providing free or below fair market value remuneration for staffing services.  In an effort to comply with the memo, home health agencies refused to continue performing free blood pressure checks in affordable housing communities and said that the service would have to be discontinued. 
 
Mary Ellen Early, FAHSA's Senior Vice President of Public Policy, asked Anne Menard, Supervisor, Home Health Programs Unit, AHCA, for clarification and referenced a rule from the Federal Register pertaining to gifts and free services to Medicare and Medicaid beneficiaries. "The Federal Register specifically allows for gifts and services to beneficiaries provided that they do not exceed $10 per service per individual or $50 over the year for an individual. The dollar value of blood-pressure checks or health fairs would be tied to be salary of the nurse and the time spent that your community."
 
AHCA responded that the service was not a violation of state law since the housing described is not an assisted living facility nor are preventive blood pressure checks or health-related education programs considered free home health agency services.  Their general counsel also referenced the federal law that prohibits providing free services to beneficiaries exceeding $10 per item and $50 annually per beneficiary by an individual home health agency that might serve as inducements to signing up for services from that home health agency.  To read the bulletin, click HERE, and then look for the U.S. Department of Health and Human Services Office of Inspector General Advisory Bulletin on the Social Security Act Sec. 1128A(a)(5) (gifts to beneficiaries) dated 8/30/2002 (see page 55856).
 
In the near future, AHCA will be hosting a Q&A related to the new home health agency law on its Web site. The question about the legality of providing free services to residents of affordable housing communities will be included. In the meantime, please share this article with home health agencies that have reservations about continuing to provide blood pressure checks and health fairs in your community. If they still have doubts, please ask them to call Gail Matillo or Mary Ellen Early, and we will put them in touch with the appropriate AHCA staff. 
Nursing Home News

Medicare Payments Could Be Reduced if You Owe Taxes -- The Taxpayer Relief Act of 1997, Section 1024, authorizes the IRS to reduce certain federal payments, including Medicare payments, to allow collection of overdue taxes. Should you owe such taxes and your payments are reduced, your remittance advice will reflect a provider level adjustment code (PLB) of "WU" in the PLB03-1 data field.  For more information, please see MLN Matters Article #MM6125.
 
Other Nursing Home News:
 
1. AMDA Guideline Revisions
2. Combating Allegations of Fraud and Abuse
3. Board of Nursing Revised Exemptions for Background Screening
4. Reduction of Medicare Payments to Collect Overdue Taxes
5. MED ALERT: Mobile Oxygen Storage Tank
6. SNF/LTC Open Door Forum
7. AHCA's Response to LSC Questions
8. On-Line Guide to Medicare Information
9. CMS Broadcast on Innovative Employer Caregiving Programs
 


FAHSA Nursing Home Alert Page

Preferred Business Associates News
Newest Preferred Business Associate -- The Provider/Shared Services Committee recently approved LarsonAllen LLP as a Preferred Business Associate (PBA).  

LarsonAllen LLP -- a nationally recognized professional service firm with expertise in a variety of industries, provides assurance, accounting, tax, consulting, and advisory services to companies and individuals managing business ventures and finance.  Health care represents our largest profession. We offer a team that devotes 100 percent of its time to serving health care providers.  Approximately 150 people, including more than 50 principals, exclusively serve health care organizations. Our practice is organized around the needs of our hospital, health system, medical group, senior living, home care, and physician clients.  Please contact Denny Schleper at (813) 286-2477 or e-mail him at dschleper@larsonallen.com. For more information about LarsonAllen LLP please go to their Web site at www.larsonallen.com.

CoupleWithDollarFAHSA's Preferred Business Associates Program (PBAs) -- A list of PBAs can be found by on the FAHSA Web site www.fahsa.org and selecting Preferred Business Associates from the left side menu bar or clicking on the FAHSA Preferred Business Associates Page hyperlink. FAHSA members can also use the on-line directory to search for PBAs by specialty.
 
Job-Mart
 FAHSA is pleased to provide an opportunity for you to advertise your "position wanted" or "position available" through the FAHSA Link newsletter and on our Web Page.

FAHSA members may use the Job Mart services at no charge. A nominal fee of $25 will be charged to nonmembers.

Your Job Mart advertisement will be displayed on our Web site for approximately three months. The FAHSA Link is published weekly and distributed to our membership which is comprised of nursing homes, CCRCs, HUD housing, assisted living facilities, independent living facilities and companies/firms.

To reserve advertisement space in our Job Mart program, please complete the application and fax it to FAHSA at (850) 671-3790 or E-mail Erin Steele at esteele@fahsa.org

Copyright 2008 -- Publication of the Florida Association of Homes and Services for the Aging (FAHSA).

  • FAHSA Chair: Alma Ballard
  • FAHSA President/CEO: Janegale Boyd
  • Managing Editor: Gail Matillo
Copyright Information: Copies of the articles and other information in this publication may be noncommercially reproduced for the purpose of educational or scientific advancement. Otherwise, no part of this publication may be reproduced or utilized in any form or by any means, mechanical or electronic, including photocopying, microfilm and recording, or by any information storage and retrieval system, without the written permission of the editor.

Correspondence: Should be addressed to: Editor, 1812 Riggins Road, Tallahassee, FL 32308. For telephone inquiries, call (850) 671-3700. Or E-mail FAHSA at info@fahsa.org. © 2008 FAHSA. All rights reserved.

Disclaimer: The information contained in this correspondence is not intended as a substitute for legal advice. Please discuss any information gathered from this or any other FAHSA publications with your legal counsel in the context of your particular situation before implementing any new policies or procedures.

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