By JODIE WAGNER, Palm Beach Post Staff Writer

Mindy Stein gave up a long career in social work 14 years ago to enroll in law school. Then 41, the mother of three stood out among her classmates.

“It’s something I always wanted to do,” Stein, who has a master’s in social work from Columbia University, said of attending law school. “It was immersion therapy. It was very good for me. It was three years of having to study.” Stein, a native of Pittsfield, Mass., who moved to Boca Raton in 1994, graduated from Nova Southeastern University Law School in 1999.

She waited six years, though, to take the Florida Bar Exam, choosing instead to work for an investment banker and as a paralegal. ”I wasn’t sure what I wanted to do,” she said.

After she took the Bar exam, Stein, now 55, began her law career with a large firm. She grew disenchanted, however, after two years. ”They saw my MSW as a liability,” said Stein, who had hoped to incorporate her background in social work into her new career. “So I decided I was going to learn elder law. I started studying it. I went to lots of conferences, and I read a lot.”

Stein left her firm to join another attorney specializing in elder law, and then opened her own practice in Boca Raton a year later.

She works exclusively in elder law and special-needs law and also does probate work and estate planning. ”I love it,” she said of her work. “It’s a lot of family work and family dynamics.”

For more information, read the rest of the article at http://www.palmbeachpost.com/news/boca-lawyer-brings-background-in-social-work-to-1585660.html

Chapters Health System is using a nationwide model to provide assistance.

By ROBIN WILLIAMS ADAMS, THE LEDGER

LAKELAND | Frail, older and chronically ill or disabled Polk County residents can expect a new option for coordinated medical care next year from the parent company of locally based Good Shepherd Hospice.

Chapters Health System is creating a Program of All-Inclusive Care for the Elderly, following a model in use nationwide.

This is a Medicare/Medicaid funded program to coordinate and provide all needed health care for that high-risk group. At least 75 PACE organizations are operating nationally, in locations that include Florida’s Pinellas, Lee, Charlotte and Miami-Dade counties.

Preventive care, primary care, other medical care, hospitalization and, if necessary, long-term care are covered, although the goal is to keep these patients — who have medical conditions that qualify them for nursing homes — living in the community.

“This is very much prevention-based, focused on keeping people out of the hospital,” said Andy Lutton, chief operating officer of Chapters, formerly HPC Healthcare.

Florida lawmakers, after taking six years to allow PACE programs in Florida, are more responsive as they see its potential to reduce the cost of care by delaying or preventing nursing home admissions, said Samira K. Beckwith, president of Hope HealthCare Services and president of a Florida PACE Association.

For details please click on http://www.theledger.com/article/20110703/NEWS/110709822?Title=Elderly-Disabled-to-Get-Medical-Care-Option-

TALLAHASSEE — Caregivers in 40 nursing homes in Florida announced they delivered signatures from 3,000 workers to nursing home administrators urging them to keep bedside staffing levels in place and ignore a roll-back required under a law passed by the Legislature.
The roll-back, which the group dubbed a serious threat to the health and safety of elderly and disabled nursing home residents, became effective when the state’s 2011-2012 budget took effect July 1.

“We are taking matters into our own hands because we are extremely concerned about the serious consequences that rolling back staffing levels will have for our residents,” Sharon Small, a 30-year certified nursing assistant, said in a statement announcing the move.

Small, who has worked at Lake Mary Health and Rehabilitation Center in Seminole County for 10 years, said lawmakers who voted for this roll-back “may not care about holding the bar high, but we do. We want our employers to join us in doing whatever it takes to make sure nursing home residents receive quality care,”

For more on this matter visit http://www.sfltimes.com/index.php?option=com_content&task=view&id=7503&Itemid=210

By: Barbara Peters Smith

When Susan Jackewicz’s father fell ill, she rushed from Boston to her parents’ Palmer Ranch home to help her mother cope. She planned to be in Sarasota for six months. She wound up tending to her parents for the next 12 years.

While the availability of residential care for the elderly in Southwest Florida has remained level for the last decade, the number of people 85 and older living in their homes has exploded — creating a burden carried mostly by their spouses and children.

The AARP Public Policy Institute has estimated that the total economic value of family caregiving was $350 billion in 2006 — $17.3 billion in Florida alone. Without relatives pitching in, the institute said, taxpayers would be on the hook for that assistance, largely through nursing homes.

Now, local agencies that serve caregivers are seeking to coordinate their support for this unpaid and untrained workforce. Organizations including the Area Agency on Aging for Southwest Florida, the Senior Friendship Centers and the Pines Education Institute will meet Tuesday to discuss forming an “umbrella group” to offer information and referral services for caregivers.

To read this article in its entirety go to http://www.heraldtribune.com/article/20110523/ARTICLE/110529781/-1/news?Title=More-help-for-at-home-caregivers

By Dr. Madelyn E. Butler, special to the Times

As a practicing OB-GYN in Tampa and Florida Medical Association president, I was dismayed to read the recent St. Petersburg Times editorial, “Devaluing the lives of poor, elderly.” The FMA finds the editorial’s references to medical liability reform passed during the 2011 legislative session to be misleading.

The FMA, which represents more 20,000 physicians, across the state, worked hard this session to pass medical liability reform, including a provision addressing expert witness testimony — a measure we’ve been working to pass for over a decade. We’ve prioritized the passage of these reforms to increase access to care for all patients and ensure that there are enough physicians to treat them.

Unfortunately, the Times‘ editorial specifically targets HB 479, saying it forces “additional state regulation on medical expert witnesses. … The goal is to make it harder for personal injury lawyers to bring cases by intimidating and harassing the pool of medical professionals willing to testify.”

To read more go to http://www.tampabay.com/opinion/columns/bill-aims-to-make-florida-a-friendlier-place-to-practice-medicine/1170370

Reductions less severe at nursing homes

By Gary Pinnell

SEBRING – Hospitals plan to absorb a 12 percent Medicaid reimbursement cut without reducing health care services or laying off nurses and caregivers.

To reconcile a $4.6 billion revenue shortfall in the state budget, the Legislature agreed to reduce $510 million in Medicaid payments to hospitals.

“The Medicaid cuts include both state and federal funds,” said State Rep. Denise Grimsley, R-Sebring.

Nursing homes lost 6.5 percent of their Medicaid dollars. As a result, each nursing home resident is expected to receive 3.6 hours of care from nursing assistants and nurses, down from 3.9 percent, the Florida Health Care Association estimated.

“However, we also provided for staffing relief, which was worth about 2.5 percent of the 6.5 percent, bringing the total reduction closer to only 4 percent,” said Grimsley, who is also a registered nurse at Florida Hospital Heartland.

To read more about these reductions, visit

http://www2.highlandstoday.com/content/2011/may/15/hospitals-12-medicaid-cut-wont-cause-layoffs/

By: Liz Freeman

NAPLES — Some seniors are caught between their past and their futures.

Legislation passed by Florida lawmakers during the recent session could offer some remedy.

The legislation addresses continuing care retirement communities and would allow these retirement communities to offer “memberships” to seniors for various services while they still live in their private residences.

State Rep. Kathleen Passidomo, R-Naples, was one of the House sponsors.

“This gives the (continuing care retirement community) the ability to provide services to people who want to live off-campus,” she said. “A lot of people can’t sell their home and they are stuck.”

The legislation enables seniors to become part of a retirement community before they have the need to move on the campus, she said. The membership can involve such services as use of wellness programs, the dining room and at-home health care, she said.

For more information about this new law visit http://www.naplesnews.com/news/2011/may/14/continuing-care-retirement-community-florida-law/

By Michael Peltier

(Reuters) – Florida lawmakers passed a sweeping Medicaid reform package that places most recipients into managed care in a closely watched debate over how to curb costs and provide health benefits to the poor.

Following hours of debate and back-room negotiations over the past several weeks, the Republican-dominated Legislature late on Friday sent a package to Governor Rick Scott that backers say will save the state $1.1 billion next year.

Savings would be realized by shifting Medicaid from a traditional fee for service program to one that caps payments to providers and more closely mirrors private sector health insurance plans.

The bill would split the state into 11 regions and allow managed care companies to compete for business within those geographic boundaries

For more information go to

http://www.reuters.com/article/2011/05/07/us-medicaid-florida-idUSTRE7461IU20110507

Republicans have partisan control of both chambers of the Legislature and a shared intention to move Medicaid patients to managed care plans, yet the state Senate and House of Representatives have significant differences over how to implement those strategies.

Medicaid is expected to cost $22 billion next year (as part of a state budget near $68 billion), a huge sum. The program will cover about 3 million Floridians, so that many lives and more will be affected by the Legislature’s decisions concerning Medicaid.

Despite Medicaid’s notoriously low provider reimbursement rates, many corporate managed care plans and health maintenance organizations see opportunities for expanding market share — thus the substantial private-sector support for moving Medicaid patients to managed care from the traditional fee-for-service payment model.

Medicaid provides insurance for among the following Floridians with low family incomes or few financial assets: children who need basic dental care and medical services; adults with chronic ailments, such as diabetes, that often require hospitalization; people of all ages with developmental disabilities; nursing-home residents with long-term ailments such as dementia.

Funding and providing care to such a wide range of patients are, at best, complex tasks that don’t lend themselves to one-size-fits-all measures.

For more information go to http://www.heraldtribune.com/article/20110420/OPINION/110419426/-1/sports?Title=Medicaid-reform-s-huge-stakes

By Jim Saunders
04/15/11 © Health News Florida

The Senate Budget Committee approved a massive Medicaid overhaul Thursday that would try to slam the brakes on health-care spending.

The bill includes a controversial proposal that would cap the amount of money the state spends each year on Medicaid and force mid-year cuts if costs go up. The proposal could be a key issue as House and Senate negotiators work out differences in the coming weeks.

Senate Health and Human Services Appropriations Chairman Joe Negron, R-Stuart, has made the cap a priority and says it would offer “budget predictability.” In recent years, the state has faced steadily increasing costs as the bad economy has pushed more people into Medicaid.

“We as a legislature will decide, ‘This is how much we’re going to spend on Medicaid,’ ” Negron said before the Senate Budget Committee voted 17-4 to approve the overhaul bill and send it to the full Senate.

For the full article go to http://www.healthnewsflorida.org/top_story/read/sen._medicaid_bill_headed_to_floor