Friday, March 18, 2005
Copyright © Las Vegas Review-Journal

'Train wreck' seen for elderly

Lawmakers skeptical of effects of Medicaid Modernization Act

CARSON CITY -- Nevada lawmakers and welfare advocates are concerned that a new federal act shifting some prescription-drug responsibilities from Medicaid to Medicare will leave seniors waiting in long lines to apply for the benefits.

The Medicaid Modernization Act, which will take effect on Jan. 1, 2006, mandates that Medicare provide prescription drugs for "dual eligibles," people who qualify for both assistance programs.

But the state Welfare Division still will have to help process applications, said Administrator Nancy Ford. That means seniors will have to visit welfare offices to apply, she told a Senate-Assembly budget subcommittee on Thursday.

Assemblywoman Sheila Leslie, D-Reno, said she thinks of her own mother, who is 75 years old, when considering how the changes will affect the elderly.

"I just can't imagine her standing in that line," she said, adding, "I just see a train wreck. I'm just concerned it's going to be very fragmented and very difficult."

Jon Sasser, a legal services advocate for three nonprofits, said he also is concerned about seniors who have never had to deal with the welfare system having to do so beginning in July, when applications will first be accepted.

People can apply online, but Leslie said that's not practical for someone like her mother, who doesn't own a computer.

Assemblywoman Chris Giunchigliani, D-Las Vegas, said the division should consider buying laptops and taking them to senior centers, grocery stores and libraries to make the application process easier on the elderly.

"I think this is a point where we can be creative," Ford said.

Another obstacle in processing applications, Ford said, is the Payment Error Rate Measurement requirement, which is still being formulated. PERM requires Welfare Division staff to sample 2,000 or more cases a year for errors. Each case takes 24 hours to review, so the entire process would require 30 additional staff members.

"I think 30 positions is going to be impossible to swallow," Leslie said. "I think we only gave Medicaid four" additional positions.

Welfare advocates also were worried about the amount families can receive under the Temporary Assistance for Needy Families program. Since 1992, a single mother with two children has been able to receive up to $348 each month on welfare. The average grant is slightly more than $273, and advocates say that doesn't cut it.

"They have to find a way to make ends meet on $273.20 a month," said Jan Gilbert, Northern Nevada coordinator of the Progressive Leadership Alliance of Nevada. "We feel an increase is long overdue. If we're going to have a safety net, then let's be at least compassionate."

TANF's federal funding is $44 million, plus $3.7 million for population growth. But the supplemental grant hasn't increased since 2001, and Nevada is the nation's fastest-growing state, Ford said.