Michigan Disability Resistance

The push to move consumers needing long-term services and supports (LTSS) out of residential placements and into community settings continues. Part of the push is that there are currently 59 lawsuits related to Olmstead open across the country, which require states to find ways to support care individuals in the community (see Olmstead Litigation in the 12 U.S. Circuit Courts of Appeals). And there are the cost issues. The majority of the services—both institutional and community-based—required to support these consumers are covered by Medicaid. Generally, the community-based options are less expensive than residential care options (see For I/DD, The Question Isn’t Managed Care Or Not-It’s Residential Care Or Not). But while there are an estimated 6.2 million people with I/DD who are on the Medicaid roles, only 689,144 (11.2%) are receiving HCBS services. An estimated 200,000 are on state HCBS waiver waiting list for those services (see How Many Consumers With I/DD Are Served By Medicaid HCBS Waivers & How Many Consumers Are On A Wait List?: An OPEN MINDS Market Intelligence Report).

The raises the question, what’s the hold up? A recent congressional briefing identified four major challenges to HCBS availability for consumers with I/DD (see Congressional Briefing Identifies Waiting Lists, Workforce, Caregivers & Housing As Key Challenges To Medicaid HCBS For I/DD). These challenges include lack of state funding causing waiting lists, high staff turnover rates and overall lack of adequate numbers of direct support professionals, state reliance on unevenly skilled family caregivers, and limited housing opportunities. Without addressing these issues, the numbers of consumer with I/DD with the option of living in the community will continue to lag.

This is what happens when you choose short term savings over long term costs...

https://thebea.st/2LarmEh

The death rate from liver cancer in the U.S. skyrocketed for American adults between 2000 and 2016, according to a new report, because more people are developing the deadly disease than at any time on record. The figures, which come from a report released Tuesday by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics, are at odds with a decrease in mortality for all cancers combined. Liver-cancer death rates increased for both men and women 25 and older, as well as white, black, and Hispanic people—only Asians and Pacific Islanders saw a decrease in mortality from the disease. “I think the main reason for the increase in liver cancer incidence and death rate in the U.S. is the increase in the prevalence of excess body weight and hepatitis C virus infection in baby boomers,” said Farhad Islami, scientific director of cancer-surveillance research at the American Cancer Society. Throughout the 16 years analyzed, the death rate of liver among men was two to 2.5 times higher than it was for women, according to the report.

"I think the main reason for the increase in liver cancer incidence and death rate in the US is the increase in the prevalence of excess body weight and hepatitis C virus infection in baby boomers," said Islami, who authored a study on liver cancer occurrence between 1990 and 2014.

http://bit.ly/2L8KdiP

Many people who had Marketplace coverage and then qualified for Medicare made a costly mistake. They kept their Marketplace coverage and did not enroll in Medicare because they mistakenly believed that their Marketplace subsidies would continue. 

As a result they now face Medicare Part B late enrollment penalties and, for many, gaps in coverage. 

CMS has launched an initiative to provide these individuals with equitable relief including a Special Enrollment Period to sign up for Part B and, importantly, relief from Part B late enrollment penalties. Last year CMS extended its original deadline for equitable relief to September 30, 2018. 

That September deadline is fast approaching and, because the best way to apply is through an in-person visit to a Social Security office, your clients should not wait until the last minute. The deadline for applications is September 30, 2018 Please share this opportunity broadly!

2nd edition of a great book....

https://amzn.to/2L5VjVN

In this new edition of his classic book, Peter Block offers an alternative to the increasing economic, relational, and ideological divides in our culture. To achieve a deeper sense of connection and belonging, we need to change the narrative from one of deficiencies and entitlement to one of possibility and generosity.

This is how community is created, and Block shows how it's done with examples from neighborhoods, towns, and cities around the United States. To bring transformation into everyday life, Community outlines six conversations that create shared accountability and shows how to design systems that foster this sense of belonging. 

The basic standard is that the disability has to prevent all competitive employment in the US no matter what it is. The mushier the disability, the harder it is to actually succeed in meeting this standard even if you do meet it...

http://bit.ly/2JyQRcm

The SSA recognized the potentially unfair obstacles for people with fibromyalgia and issued new guidelines for fibromyalgia disability claims in 2012. 

Getting access to Medicare benefits due to disability for fibromyalgia isn’t easy, but it can be done. Here’s what you should know so you have the best chance of getting approved.

Understanding fibromyalgia and “medically determinable impairment”

The first hurdle in getting a disability claim approved is proving a “medically determinable impairment,” or MDI, with Social Security. The SSA defines an MDI like this: “an impairment that results from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques.” 

In plain language, it means that your impairment, or disability, must be backed up with objective medical tests and evidence. It’s not enough to just have subjective statements that you have a disease or condition—the SSA needs proof. 

That’s where things get difficult for people with fibromyalgia. Unlike other conditions such as rheumatoid arthritis or disc disease which can be seen on x-rays and other imaging studies or lab work, there’s no definitive test that proves fibromyalgia. Diagnosis usually depends on self-reported symptoms of pain, dizziness, “fibro fog,” and other classic signs of fibromyalgia.