Demand the STATE to stop wasting STATE FUNDS to keep seniors in Nursing homes and provide the home care services needed that cost less for them to be home

    For over 20 years, I have been a patient, senior, tenant and community advocate. I am a senior at NYCAS University studying Human Services full time. My concentration was supposed to be "Administration", I decided to concentrate on "Gerontology". I was technically the only student in my class concentrating in Gerontology. There are no classes that can teach you or prepare you enough for the circumstances that seniors are really going through.

    The majority of those who reside in nursing homes are seniors. They start off as rehabilitation patients and then get stuck along the way due to the lack of regulations, assistance, lack of advocates and at times no family to help them. If seniors or patients eventually are released homelessness may be the end result if they reside by themselves. They may become homeless because they lost their homes or apartments while being in rehabilitation. Which is another main reason why so many disabled and seniors are homeless besides the cost of living. Unfortunately, the lack of proper legal assistance and representation they should be entitled to receive and don't, resulting the lose of their homes and apartments or are stuck in nursing homes and eventually pass away as they call it "expire".

    After a 100 days when the insurance stops paying for physical therapy they the facility makes the assumption and determines that the patient will not get any better. The patient then becomes a permanent patient without getting any more physical therapy despite of the doctor's orders that patient needs physical therapy. Idling the patient/senior and keeping them wheelchair bond due to the lack daily physical movement. That will cause the patient to be totally disabled, slowly deteriorating them physically and mentally.
    Nursing homes should be temporary not something permanent. It cost more for people to stay in nursing homes than being in their homes and receiving the care they need. I am not saying that some people don't need to be in a nursing homes but not the way it currently is.
    _________________________________________________

    20 years ago when a neighbor who was senior citizen was being harassed by a property manager. I called APS because the senior was depressed and malnourished. He wouldn't come out of his apartment or eat. Not knowing what was going to happen to him next. When he got better and he was released he was then homeless and it broke my heart. APS never finish advocating for him. I never forgot about him.
    Recently I had another retired senior (Ms. A) who broke her hip in the ending of December 2021 and did not have family to advocate for her properly. It was difficult for me to advocate for her at this specific facility. The social worker would not respond to my calls. The social worker at the rehabilitation facility told her if she doesn't pay a $683 she can't go home. This senior borrowed money from family members and left the facility without any proper discharge plan in March 2022. I then had to do all I could to advocate under the agency that I was interning at and now volunteering for her to get a short term care, and long term care. She resides by herself and she only receives 25 hours a week of home care ( 5 hours, 5 days a week) We tried to more hours during the weekdays when she needs help to go to the doctors and so on. It was impossible she had a recent evaluation who wanted to give her 4 1/2 hours a day for 7 days. When she asked if she can get it Monday through Friday, the evaluator said "NO, take or leave it". They expect a home attendant to work 7 days a for 4 1/2 hours they would need more than two patients to be full time and the patient would be limited to what is needed during the day.

    __________________Why I created this petition______________________

    Julia Rosa (83years old retired HHA worker) who was admitted to the rehabilitation facility since June 29, 2021 after having surgery on a broken femur. Ms. Rosa was supposed be discharged since July 29, 2021 because she wanted to go home. She needed a 24/7 days a week home attendant because she resided by herself and at the moment she needed those many hours. Though doctors wrote the letters requesting for such assistance she was denied by the MLTC, including the internal and NYS disability appeal who sided on behalf of the MLTC due to the lack of legal representation. (see below in back ground for more information regarding this)
    __________________ Current Situation ________________________

    New York Independent Assessment-NYIA aka MAXIMUS

    ***As of May 16, 2022 patients are imposed to having not one but two alleged Independent assessments. One from the nurse (main) and the second the clinical in order to receive any home care services.***

    https://www.health.ny.gov/health_care/medicaid/redesign/nyia/

    _____________________________________________________________

    On June 22, 2022, Ms. Julia Rosa has an assessment (NYIA) via zoom (few hours) with her disabled daughter present. The assessor (Nurse) states "I will put in all the information and I will approve it please look for an MLTC so that she can receive Home are services starting August 1,2022. There should be no reason for her not to be able to go home."
    On Sunday June 26, 2022, Ms. Julia now has the second part (the clinical) by a Physician Assistant via zoom (not in person) for about 15 minutes with her disabled daughter. Who tells the daughter "please wait two weeks for the decision."
    A letter dated June 29, 2022 states that her PCS and HCPS is denied with no sufficient reason keeping her in the nursing home. The letter from NYIA also claimed that a conference can be requested and a fair hearing.
    When I contacted the NYIA asking for explanation of the letter and to request for a conference. Spoke to three different representatives

    First representative said "it was approved." Asked me to contact the NY Medicaid to make sure.
    NY Medicaid representative stated "it was approved to receive MLTC in the nursing home not at home."
    I call back and ask for the conference.
    The third representative stated "There is nothing to conference because it was approved." I asked that she look deeper, she then stated "Oh yes the first one was approved which the main one and the second did state she was not stable enough to go home, that makes no sense. We don't do conferences neither I don't understand why that letter states that!"
    On July 17, 2022 I requested for a conference in writing to NYIA who the letter states that it can be reversed if they made a mistake. Also requesting for another fair hearing from the NYS Office of Administration for the temporary disabled.
    On July 17, 2022, I contacted ICAN (who filed a complaint with the DOH), July 17, 2022 NYLAG (waiting on their response), On July 21, 2022 I contacted NYS Assembly member Jo Anne Simon, and NYS Assembly member Nikki Lucas (waiting for their response)
    On July 25, 2022, I received a call from a clinician manager "NYIA" who claimed she was part of the decision and that our call was the conference if I had any questions however she can't change anything only the fair hearing can.
    Do you think it's fair for anyone to go through this? Do you think if you got hurt and needed home care services and worked your entire life you should stay stuck in a nursing home?
    _________________________Background__________________________

    What led to this mess?

    I did contact an attorney from CIDNY.ORG who filled out the papers (Beginning of August 2021) who couldn't represent her. Which made no sense! I could have filled out the papers myself. Now if I wasn't there advocating on her behalf, would Ms. Rosa be able to have an opportunity to appeal while she was in the rehab? Of course not, who was going to appeal it? Who is going appeal any of the seniors appeal while they are in the rehab especially if they have no family or proper assistance? Some family members may be older or some with medical conditions themselves or may have a language barrier.
    While trying to advocate with the appeals from July 2021 to December 2021 the MLTC-(Health First) was authorizing an alternative level of care. Which meant that Ms. Rosa's would have no financial responsibility to pay for the rehabilitation and the Health First Medicare portion would pay for her stay because it was the MLTC fault that was not approving the home care hours . Ms. Rosa's Social Security check would not to be taken because Ms. Rosa's rent needed to be paid on the outside awaiting on the appeals decisions.
    Moving forward towards the ending of December 2021, I had to contact the Ombudsman for Long term Care because Julia Rosa wasn't receiving any more physical therapy that went against her Orthopedic doctor's order, who wanted her to have continuous physical therapy for to walk again. The rehab/nursing home Social worker stated "Ms. Rosa can't receive anymore therapy because she is now a permanent resident." Ms. Rosa never received a permanent room, she is currently still in a rehabilitation room and they claim she is a permanent resident regardless of requesting for a private room. The Ombudsman's office intervened and she started receiving physical therapy.
    By January 2022, her MLTC was removed and then an application was submitted to CASA- The State to evaluate her which also took about 3 months to process. She was approved for 12 hours/7 days a week by nurse who evaluated her from CASA. Which also takes time to process. After 5 months CASA denied her services because she needed more than 8 hours and asked Ms. Rosa's to contact an MLTC.
    On June 2022 I contacted MAXIMUS aka NYIA ( State evaluation) that approves Long term care if accepted then Ms. Rosa's can apply for a MLTC. During this time and the loops, Ms. Rosa has an apartment and her rent is not being paid because the rehabilitation center took her checks from October 2021 despite of her having alternate level of care approved by the MLTC to cover her.
    When I contacted the rehab via email on March 2022, I was ignored. On May 19, 2022, Ms. Rosa's disabled daughter went to visit her at the rehab and she went to the financial department and I spoke to them and conferenced me on the phone who stated that "Ms. Rosa can't leave unless she pays a balance of a $126" I then questioned "why does she have a bill and why are bills sent to Ms. Rosa's apartment if Ms. Rosa is allegedly residing in the rehab including an alleged $50 allowance that she never is told about?" The financial coordinator stated "she (Ms. Rosa) was suppose to give us the check since August 2021 and the $50 we can keep it and pay it towards her outstanding balance and I am not going to to argue with you this is senseless conversation." Then I said "Okay, I am going to contact Medicare."
    On May 19, 2022, I then contacted the MLTC (Health First) who agreed that Ms. Rosa was not suppose to have any financial responsibility and they trying to fix it. I also contacted Medicare who told me "Ms. Rosa rehabilitation is being charged as if she just entered. She wasn't suppose to have any financial obligations until after 100 days from them billing Medicare in 2022." Which meant that Ms. Rosa would be a rehabilitation patient not a nursing home resident. No Social Security check was suppose to go the facility.
    I then contact the Ombudsman office for the Long term Care who said that they will see what they can do. Then get a response that they are limited as to what to do. Then give me a two referrals to lawyers for elder abuse who do not take cases for seniors in NYC. I then contacted the NYS Governor Kathy Hochul, NYS Attorney General Leticia James and NYC Mayor Eric Adams and explained all this on May 27, 2022. (NO response of yet)
    On June 21, 2022, Ms. Rosa contacts me to let me know that her physical therapy stopped once again because the 100 days of the insurance is up. Though she was making progress and the facility is keeping her checks they stopped her therapy. Once again I had to contact the Ombudsman office to ask what can be done?
    ___________________Lack of transparency to vote _____________________

    I was told that "Seniors in nursing homes do not vote, so politicians are not interested." This is a very disturbing and upsetting statement to know that politicians don't care about patients and have allowed patient and seniors to be caught in a political sham. You pay taxes and vote, then in the long run you are nothing but a bed number and a dollar bill attached to that bed, causing you to lose your home or apartment. A law was passed for these patients and seniors to vote however they claim due to the pandemic it has been paused. No politician goes to these facilities and sees the conditions they are kept in. No one gives them that right to get a absentee ballot to cast their vote. Not everyone knows how to navigate online to get absentee ballots, many seniors don't know how to use a smart phone. They are not being taught how to use a smart phone in the nursing home they are just entertained with some arts and crafts.

    As to the statement that was made about seniors not voting in nursing homes:

    I asked Ms. Rosa (a 83y/o senior who is currently in the rehab/nursing home), "Did anyone come around to tell you about the elections, or having the right to vote while you have been there or asked you if you want to vote?" Ms. Rosa's response, "No one has asked me or told me anything about voting. I haven't voted since I have been in here (It's almost a year) I usually vote on every election."

    Do you think it's fair for seniors and patients in rehabilitation/nursing homes not to have a proper and transparent access to vote? Do you think it's fair for patients including seniors to enter a rehabilitation center to recover end up homeless? Do you think it's fair for a patient or senior to stay stuck in a rehabilitation as a nursing home resident because they have no one who cares? Why aren't agencies really helping these patients especially the seniors when they are in a rehabilitation? You work so hard to retire and God forbid you fall you are stuck living in a Rehabilitation facility as a nursing home resident. Why aren't there any proper legal assistance and representation helping seniors and patients in Long term care in NYC? Why are these patients not given proper and more transparent access to vote?

    I ask myself why is there so much elder abuse not being reported in nursing homes... perhaps no family, the lack assistance and advocacy. If you contact the NYS Department of Health, Division of Nursing homes and nothing is done or complaints go unfounded because not only do they take too long to investigate, but when you have more information to add to the complaint, you are made to loop back to their intake. This is why I am asking you to sign this petition to help the elderly seniors in the rehabilitation and nursing homes. This elder abuse needs to end they should be heard. Your signature is their voice. Thank you.
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