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Provider Perspectives
Medicare Part D: A Disservice to Social Services
Aside from forcing Medicare consumers to navigate complicated legislation, Part D is having dramatic effects on the country's social service industry. Clay Johnson is a Home Services Advocate with the Stone-Hayes Center for Independent Living in Galesburg, Illinois. His major responsibilities include recruiting and referring out personal assistants to people with disabilities. In addition to his expected workload, Johnson has recently undertaken learning and teaching people about the Medicare Part D prescription drug program, holding various trainings for providers and consumers. These are recent responsibilities placed on him due to the extreme rise in informational need. Johnson's role in the Center for Independent Living exhibits not only Part D's consequences for Medicare beneficiaries. His new professional priorities also demonstrate Part D's severe effects on America's social service infrastructure.
Johnson attended his first Medicare Part D training last March, in an ongoing effort to get as much information as possible surrounding the new prescription drug benefit. Struggling to maintain enough information and time for all the confused Medicare consumers calling the Center for Independent Living, he strongly believes that this new legislation requires a specialized point person in all affected nonprofit organizations. Senior providers in the Galesburg area have become overwhelmed with innumerable Part D cases, consequently referring people without disabilities to Johnson. As a Part D expert by default, Clay Johnson has been forced to take on an additional workload, requiring significant expertise.
This added burden of Part D navigation has forced Johnson to reduce the attention needed for his other professional duties. Many Centers for Independent Living in Illinois have been chartered to handle Part D confusion and issues. But not many Centers have received additional funding to provide resources amidst this transition. Johnson makes it clear that his Center has received no funding to provide a comprehensive response to Part D. More time is now taken away from his organizational duties. New individuals, many of whom his Center is not equipped to serve, are coming to him in desperation because they have not been adequately served by the agencies funded to work on Medicare Part D outreach.
Social services that are required to work with Medicare beneficiaries are dealing directly with the consequences of this legislation. People need help choosing plans, communicating, getting information, and applying for various programs or plans. Case workers are directly responsible for maneuvering Part D's complications. Because information is coming out to the public in pieces, and because private drug plans work with each person's specific needs in a different way, there is added stress to the already overworked duties of case managers and social service workers. Johnson says that this transition within social services in America is going anything but smoothly. He states, "I think it's only going to get more complicated… people don't really have a full understanding [of Part D] because they're just getting portions of the full story". Changes in rules, conflicting information, irrelevant facts, and general confusion are getting worse, according to Johnson.
Centers for Independent Living get both federal and state funding. Johnson believes that to address Part D confusion, more funding is necessary to employ a Part D expert in each affected organization. He explains that people want quick solutions to their Medicare problems, particularly because many medications are necessary to stay alive and healthy. For example, if someone is denied their drugs at the pharmacy, they have entered a high-stress situation that requires immediate attention by advocates or providers. To alleviate this high-stress level for social services affected throughout the country, more funding, allowing for more specialized relief and attention on Part D, is necessary. The focus and specialization accompanying Part D experts require recognition and funding from the federal or state governments.
Johnson's remedy for the overworked social service realm in America is simple: funding and collaboration. He firmly believes that senior providers and disability providers must work together. Increased collaboration would decrease the overwhelming feeling resonating in consumer and provider communities, that of "drowning in the issue". Johnson's career, and position in his organization, have been directly affected by Medicare Part D issues. He states, "I think it's just confusion with frustration… The people that have Medicare are frustrated and confused. The people trying to assist them are frustrated and confused". Getting adequate and comprehensive information disseminated to consumers and providers, and giving the social service arena adequate resources on how to assist people, are equally essential in the Part D endeavor — both for individuals, and for the health of the social service industry in the country.
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