The Affordable Care Act
Affordable Care Act (Health Reform) Information
The Affordable Care Act is the first comprehensive law in a generation to improve the care and safety of the elderly and persons with disabilities in nursing homes and other long-term care settings. When they are fully implemented in 2013, its Nursing Home Transparency and Elder Justice provisions in the law will provide:
- Information to guide families in one of the most difficult decisions they ever make: the choice of a nursing home to care for a loved one. The ACA will expand information about the quality of individual nursing homes on the Medicare website, Nursing Home Compare; help consumers avoid homes that provide poor care; and create incentives for Medicare and Medicaid providers to improve staffing, services, and safety in their facilities.
- Public disclosure of nursing home owners and operators that will allow government regulators, as well as consumers, to identify who is responsible for care in facilities.
- More accountability in individual facilities and better oversight of corporations that operate nursing homes in multiple states.
- A stronger consumer complaint system.
- Disincentives for nursing homes to delay compliance by filing meritless appeals.
- Adequate notification and appropriate relocation of residents when facilities decide to close.
- Training of nursing assistants in the care of people with dementia and in preventing abuse.
- Better training for long-term care ombudsmen and state inspectors.
- A program to support national criminal background checks on people who work with vulnerable adults who receive long-term care in institutions or in their own homes.
- Mandatory reporting of the abuse, neglect, or exploitation of anyone in a long-term care facility that receives federal funds.
- Better coordination among agencies that prevent, investigate, and prosecute neglect, exploitation and abuse of the elderly.
The Community Living Assistance Services and Supports (CLASS) Act
What is the CLASS Act?
- The CLASS Act was passed as a part of the Affordable Care Act to address long-term care affordability, and quality of care concerns. The law seeks to allow those receiving long-term care to continue living in the community, or better afford their nursing home care.
How is the CLASS Act funded?
- The CLASS Act is entirely self-funded. Only those who pay in to the CLASS system will receive benefits. No additional taxpayer money will be used for CLASS benefit payouts.
- Willing participants will pay in to a "Life Independence Account" through payroll deductions; or
- Directly contribute to their Life Independence Account if they are self-employed, or otherwise do not have access to employer payroll dedcutions.
- For those who have multiple places of employement, a scheme will be developed to ensure you do not have extra funds taken from your paychecks.
- The average monthly premium cost will be $123 per month.
- Those who do not wish to contribute to CLASS can opt-out of program at any time.
How do I become eligible for CLASS benefits?
- You must:
- Have 2 or more diagnosed physical or cognitive impairments or limitations.
- Pay into a Life Independence Account for 5 years (60 months).
- Maintain employment for 3 of the 5 years required for pay-in.
- There are some exceptions for those with low-income and for full-time students.
What are the benefits offered under The CLASS Act?
- The primary benefit under CLASS is a cash payment for non-medical services. This cash benefit will be no less than $50 per day or $27,000 per year.
- The amount paid out will vary based on degree of disability or impairment.
- Examples of things the CLASS cash benefit can be used for include:
- Respite Care
- Home Health Care
- Home Modifications
- Transportation Services
- Homemaker Services
- Offset cost of assisted living or nursing home facilities
- Also includes Advocacy and Advice/Counseling Services to help participants take charge of their care and receive the best care possible.
- Participants will not begin receiving benefits until 2017.
Please oppose efforts to repeal health care reform and the CLASS Act!
The U.S. House of Representatives voted to repeal the Affordable Care Act. Some states and others have filed lawsuits and taken other steps to keep it from being implemented. If health care reform is repealed, the provisions above will be lost. Please ask your members of Congress and your governor and state legislators to oppose repeal of the Affordable Care Act!
In addition to the vote to repeal the Affordable Care Act, two committees in the House of Representatives have approved legislation that would specifically repeal The CLASS Act. In the near future, these pieces of legislation will receive a full vote in the House. Please contact your Representative and/or Senator and urge them to vote against the repeal of the CLASS Act!
Resources on health care reform, The CLASS Act, seniors and long-term care:
AARP
Center for Medicare Advocacy
Families USA
Kaiser Family Foundation
Leadership Council of Aging Organizations
National Academy of Elder Law Attorneys
National Council on Aging
National Senior Citizens Law Center
PHI
National Consumer Voice for Quality Long-Term Care
Robert Wood Johnson Foundation/Health Affairs
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