Fall 2015
Medicare Part D Webinar - November 18th 

Beginning on January 1, 2016, there will be some changes in Medicare Part D, the federal drug benefit that is used by most dual eligibles (persons who have both Medicaid and Medicare) to obtain their prescription medications. 

This webinar is for everyone who wants to know about Medicare Part D for the dual eligibles, including employees of provider agencies serving people with intellectual and developmental disabilities (I/DD), staff from the Division of Developmental Disabilities (DDD), family members, and health care professionals. The webinar will discuss the details of the changes and how they will affect individuals with developmental disabilities who are eligible for both Medicare and Medicaid.

After registering, you will receive a confirmation email containing information about joining the webinar.  

Important Information on the 2016 Medicare Part D Drug Plan Changes for the Dual Eligibles

Each year, starting on January 1st, there may be some changes in the Medicare Part D drug plans. For information on the changes that may affect some individuals with intellectual and developmental disabilities (I/DD) who have both Medicare and Medicaid (the "dual eligibles").   READ MORE

     The Arc of New Jersey's Annual Awards Celebration  
                             November 17, 2015

We are delighted that Jennifer Velez (former Commissioner,  NJ Department of Human Services), 
Stephanie Pratico  (Chair of the NJ Council  on Dev e lopmental Disabilities), and  Evan Spivack, DDS   (Director, Special Care Treatment Center, NJ  Dental School)  will be among  a distinguished group of honorees at  The Arc of New Jersey's Annual Awards Celebration. 

This year's gala event will take place  on  Tuesday evening,  November 17th 
at the Imperia  on Easton Avenue in Somerset.

Planning for the Future:
Special Needs Trusts as Tools to Enhance Quality of Life
Ellen Nalven, Executive Director
Planned Lifetime Assistance Network of NJ (PLAN/NJ)

The future is always a concern for families of individuals with disabilities. How will  they provide a good life for their children even after  they're gone? Good financial planning is a crucial part of a well-designed 'whole person' approach to prov iding for their adequate care, comfort, enjoyment and engagement in life.  Many parents are aware that they must maintain crucial public benefits and ser vices for their children throughout their lifetime, and they wonder how they can still hope to enrich their children's lives while meeting Medicaid criteria. Special Needs Trusts are one answer to this dilemma.  

Crises are a Family Affair

Lucille Esralew, Ph.D.
Clinical Administrator SCCAT & S-COPE, Trinitas Regional Medical Center

In a mental or behavioral health crisis, we all tend to focus on one identified individual.  However, I would like to suggest that this is a limited and not particularly helpful approach because crises affect all members of the family.

For the purpose of our discussion we will follow John, a hypothetical individual, age 24, who receives DDD services and who has an intellectual disability as well as a diagnosis of bipolar disorder. John's mother, Mrs. Smith, is John's primary caregiver and support person. According to our u sual thinking and practice, if John has acted unsafely, resulting in his need for crisis services or hospitalization, all services leading up to, during and following hospitalization would focus on John. For the purpose of our review, all members of John's family are affected by events leading up to crisis, during crisis and in the aftermath of a mental health or behavioral emergency.  

New Jersey Senate Resolution:  A Tribute to 50 Years of Medicaid and Medicare 
Fifty years ago (July 30, 1965) President Lyndon Johnson signed the law that created Medicaid and Medicare.  In recognition of the 50th anniversary of the establishment of Medicare and Medicaid, the New Jersey Senate passed a Resolution, which was introduced by Senate President Stephen Sweeney and Senate Majority Leader Loretta Weinberg.  The Senate Resolution states, in part that "Medicare and Medicaid have significantly enhanced the lives of individuals throughout the United States, including low-income families, pregnant women, people with disabilities and those in need of long-term care." The Resolution further states that "The strength and success of the State of New Jersey, the vitality of our communities, and the effectiveness of our American society depend, in great measure, upon concerned and dedicated social service programs such as Medicare and Medicaid."

Left to right in first row: Marilyn Askin, AARP; Peg Kinsell, Statewide Parent Advocacy Network (SPAN); Beverly Roberts, The Arc of New Jersey; Senator Loretta Weinberg.   Left to right in second row: Dan Keating, Alliance for the Betterment of Citizens with Disabilities (ABCD); India Hayes Larrier, New Jersey Citizen Action; Maura Collingsru, New Jersey Citizen Action; Senate President Stephen Sweeney; and Ray Castro, New Jersey Policy Perspective.

Medicare's Coverage of Diabetes Services and Supplies

The Center for Medicare and Medicaid Services (CMS) published a 32-page guide with detailed information on Medicare's coverage of diabetes services and supplies.  Some of the services and supplies are covered through Medicare  Part B (e.g., blood sugar self-testing equipment and supplies, and foot exams and  treatment);  and some items are covered through Medicare  Part D  (e.g., Insulin and anti-diabetic drugs). 

The Medicare Rights Center has a  TWO-PAGE FLYER, providing helpful and concise information on Medicare coverage of diabetes services and supplies.  

Important information for dual eligibles (persons who have both Medicare and Medicaid) who are using diabetes services and supplies that Medicare covers:

The information in the links above states that Medicare beneficiaries would
pay 20 percent of Medicare's approved amount after paying the deductible.  However, that information pertains to persons who do not have Medicaid.  
Please note: Dual eligibles should not be charged any money for the diabetes services and supplies that Medicare covers, as long as they use 
a Medicare-approved supplier. Furthermore, dual eligibles do not have to pay a Medicare deductible.

To avoid any cost sharing issues, dual eligibles should use a supplier who  accepts both Medicare and their Medicaid HMO. If not  certain which suppliers are in their Medicaid HMO network, check with the dual eligible's Medicaid HMO care manager.
Healthy Times  is a publication of Mainstreaming Medical Care, a program of 
The Arc of New Jersey funded by the New Jersey Division of Developmental Disabilities. 
To view or print copies of current and past issues, please visit us on the internet at:

Thomas Baffuto
Executive Director, The Arc of New Jersey
Robert Hage
President, The Arc of New Jersey
Beverly Roberts
Director, Mainstreaming Medical Care;Editor
Jennifer Lynch
Administrative Assistant, Mainstreaming Medical Care;Graphic Designer

Mainstreaming Medical Care Advisory Board
                              Steven Cook                                                         Leone Murphy, RN, MS, CS, Chair
                              Barbara Coppens                                                John Nevins, DO
                              Kristen Creed                                                        Emily Ott, RN, BSN 
                              Lucille Esralew, PhD                                            Stephanie Pratico 
                             Theodor Feigelman, MD                                       Andrea Quinn, Psy.D. 
                              Carly Heaton, DO                                                  Margaret Springer, RN, MSN, APN
                              Theodore Kastner, MD, MS                                  Deborah Spitalnik, PhD
                              Seth Keller, MD                                                      Evan Spivack, DDS
                              Robert Like, MD, MS                                             Kevin Walsh, PhD
                             Pauline Lisciotto, RN                                              Kellie Woodruff
                                                                                                          Leah Ziskin, MD 

Healthy Times newsletter is intended for informational purposes only, and does not  provide or claim to provide advice regarding diagnosis or treatment for any individual case.