Director's Message

Largest expansion of Medicare ever

We are witnessing the largest expansion of Medicare in the program's history, thanks to the Medicare Modernization Act, which creates a voluntary Medicare drug benefit, effective next year.

For Oregonians, this will bring a number of changes and will help provide drug benefits to those who don't have any. Consider the following:

• Implementation will impact approximately 500,000 Oregon Medicare beneficiaries.
  
• Drug coverage will be provided to approximately 129,000 Oregonians who currently have no coverage, including  many who lost coverage with the elimination of the medically needy program.
  
• Enrollment into the new drug plans will begin this November, with benefits beginning January 1, 2006.

While the Medicare Modernization Act will offer the opportunity for medication to be paid for many Oregonians, there are concerns nationally about how it will be implemented, and notably, how it will impact the frail elderly or those in long-term care situations who may not have strong advocates to help them understand the changes.

What will change

For those who are eligible for Medicare and Medicaid, the act will result in random auto-enrollment in available drug plans. This is being done to ensure that they continue their coverage.

The issue for many will be determining whether the plan they are assigned to is appropriate and if their formulary supports the medications they currently are taking. If it doesn't, they'll have to take some action -- switching plans or potentially switching medications.

Some Medicare beneficiaries may have difficulty understanding the written materials that will be sent to them from the federal government about the change. They could also have problems navigating the Internet-based or toll-free phone-based enrollment process.

Finally, these decisions will have to be made during an initial enrollment period, a compressed time frame of about six months, when beneficiaries must make some choices.

Changes for DHS

Our agency is in the process of determining what we can do to try to make this transition easier for the thousands of Oregonians we serve.

Recently, our medical director for Seniors and People with Disabilities, Dr. Tina Kitchin, testified before the Senate Special Committee on Aging in Washington, D.C., offering suggestions on how to improve the transition in order to minimize the negative impacts, including disruption of service. However, no changes have been announced yet.

We are taking steps here to plan for the changes that cut across many parts of our department and multiple programs. Implementation will require that we change such things as our computer systems, federal reporting, training, and information sharing. This is all occurring at a time when the department faces serious budget restrictions and staffing issues.

We need to work together as an agency, across our clusters and programs, and with our partners to make sure we are clearly communicating to those impacted what they need to do and by when -- to navigate this new process. By finding new ways to work together, we will help ensure the safe and healthy transition of this vulnerable population to this new benefit.

Finding a place to live

If you are a person with special needs, finding a place to live is more than just looking for a residence in a nice location, in an area where you afford it.

People with developmental disabilities, chronic mental illness, victims of domestic violence, individuals who are homeless, and others with special needs face ongoing struggles in finding safe, available and affordable housing options.

The department works with a number of partners all over the state -- including the Oregon Housing and Community Services agency and many others -- to help put together housing opportunities for those facing these issues. We spend a lot of energy at the local level building the groundwork, ensuring neighborhoods and local officials are involved and supportive of the help that is being provided for those with no where else to go.

More than a roof over their heads

One example is a recent project -- spearheaded by the Oregon Housing and Community Services agency -- in the Medford area that will help people with disabilities, victims of domestic violence, and people who are homeless. The families impacted face extreme poverty; many also have mental illness or are recovering from substance abuse problems.

The project and others like it, which we are involved with across the state, help provide supportive services to these individuals, allowing them to correct issues in their lives that have inhibited them from accessing safe, affordable housing on their own.

While initially the practical issue of finding a place to live is key to those with special needs, our involvement goes beyond that. We work across programs and clusters to help those impacted become as independent and self-sufficient as possible.

Our hope is -- at least for some of these individuals -- that one day they may not need our help at all.

Food for thought

"True individual freedom cannot exist without economic security and independence."

-- Franklin D. Roosevelt

This message is intended for all department employees. Please read it electronically, if possible. Managers and supervisors are asked to share the message each week with employees who do not have email access.

If you have a disability and need this message to be provided to you in another format, please send an email to dhs.forms@state.or.us, or call (503) 947-5107. You can also fax your request to (503) 373-7690, or call (503) 947-5080 for TTY service. If you know of others who need this accommodation, please let them know it is available.