A: Yes. The IRS says it will never email you for more information about your “economic stimulus” rebate check—or anything else. If you filed a federal tax form with the IRS, they will do the rest to handle your refund check.

One scam email on the internet looked remarkably like a real IRS website. It had the IRS blue logo, and said: “After the last annual calculations of your financial activity, we have determined that you are eligible to receive a tax refund of $280.40. Please submit the tax refund request, and allow 3-4 days in order to process it. A refund can be delayed for a variety of reasons.” The form then instructed you to fill in your Social Security number, your debit card number, expiration date, pin number, and your email.

If you submitted this information, a screen came up which told you to “please allow 3-6 business days for processing.” You will receive a confirmation email once you request was processed.” Once you submitted your information, you were linked back to the real IRS webpage.

If you go to the real www.irs.gov/ website, you will find an alert about these phony IRS emails. According to the IRS: “An e-mail claiming to come from the IRS about the 2008 Economic Stimulus Refund tells recipients to click on a link to fill out a form, apparently for direct deposit of the payment into their bank account. This appears to be an identity theft scheme to obtain recipients' personal and financial information so the scammers can clean out their victims' financial accounts. Taxpayers do not have to fill out a separate form to get a stimulus payment or have it directly deposited; all they had to do was  file a tax return and provide direct deposit information on the return.”

Consumers have also received scam phone calls, in which the caller impersonates an IRS employee. The caller asks the taxpayer for their Social Security and bank account numbers, claiming that the IRS needs the information to complete the processing of the taxpayer's payment. Another new scam notifies the recipient by email that his or her tax return will be audited.

Identity thieves use a victim’s personal and financial data to empty the victim’s financial accounts, run up charges on the victim’s existing credit cards, apply for new loans, credit cards, services or benefits in the victim’s name. Most of these scams can be done electronically from a remote location—even overseas. People whose identities have been stolen can spend months or years cleaning up the mess thieves have made of their reputations and credit records. In the meantime, victims may lose job opportunities, may be refused loans, education, housing or cars, or even get arrested for crimes they didn't commit.

The IRS does not gather any information by phone.  Filing a tax return is the only way to apply for a tax refund. You should ignore any unsolicited, tax-account related e-mails or phone calls from the “IRS.”

A: No. But changes are coming that every consumer with a TV will want to understand. Congress has passed a law which requires that as of midnight, February 17, 2009, all full-power television stations have to stop broadcasting in analog format, and broadcast only in digital. All-digital broadcasting means a better picture and sound quality, and will free up frequencies for more wireless services for consumers. But if you currently own an analog TV, you are going to have to purchase a digital tuner box that converts your TV from analog to digital. If you have an analog TV, but you are hooked up to a cable TV or satellite TV service, you don’t need to do anything further.

Because of the new digital TV changes, you have three options:
1. Keep your existing analog TV and purchase a TV converter box, or
2. Use your analog TV, but buy cable, satellite or other pay service, or
3. Buy a new TV with a digital tuner.

The first step is to figure out if your TV is analog. If you receive TV broadcasts using an antenna, such as "rabbit ears" or a rooftop antenna, you are probably analog. If your TV says on it “Digital Tuner,” or “DTV,” “ATSC” or “HDTV,” then you are digital and don’t need a converter box. If you see “analog” or “NTSC” anywhere, you will need a converter. If you can’t tell what kind of TV you’ve got, write down the manufacturer’s name and model number found on the TV, and call a retail electronics store in your area, and ask them if your model has a digital tuner.

If your TV is analog, and you need a converter, the federal government (taxpayers) will provide you with two coupons, worth $40 each, to be used to buy a digital-to-analog converter box. Remember: if you have cable or satellite service, you don’t need a converter. You can order these coupons regardless of your household income, but you have to ask for coupons no later than March 31, 2009. It is expected that TV converter boxes will cost between $50 and $70. After using your two coupons, you will be charged by converter box sellers the remaining balance of between $10 and $30. Converter boxes must meet the standards set by the National Telecommunications and Information Administration (NTIA) in order to qualify for the Coupon Program. There are currently 18 models of converters, be sure to ask if it meets NTIA standards.

One way to get your converter coupons is to call free the 24-hour hotline 1-888-388-2009 and press “1”, (TTY1-877-530-2634.) Or on the internet, go to http://www.dtv2009.gov . You can apply now, while supplies last. If you feel you can’t apply by yourself, another person can apply for you, but they will need to use your home address. All this may seem like one more hassle for TV viewers, but the federal government assures us that digital TV will give us all “an enhanced viewing experience.” It will certainly enhance the bottom line of converter box makers.

A: Yes, but the protections vary by how you heat your home. If you heat with gas or electricity, there are shutoff protections for seniors---year round. Some other low-income households have limited protection during the period November 15 to March 15th. The utility companies call this a “winter moratorium” on shut-offs. But if everyone in your household is over 65, the company cannot terminate your service for failure to pay a past due bill without approval of the Massachusetts Department of Telecommunications and Energy (DTE).

If you can’t pay your bill all at once, you can work out a payment plan with the company. In addition, you have a right to a hearing at the DTE before termination. Utility companies are also required to give written notice of a shut-off to the state’s Executive Office of Elder Affairs.

Elders may believe that their electric or gas heat cannot be shut off. This is technically not true. If the state approves the utility’s request, you can be terminated—even during a “winter moratorium”. But in practice, it is not likely that the state will approve a heating-related shut-off during the winter months.

There is also financial aid to help pay heating bills. Some seniors will be able to take advantage of the Low Income Home Energy Assistance Program (LIHEAP), which can help pay for heating bills---whether you use gas, electricity, coal, oil, wood, or propane. LIHEAP assisted roughly 141,000 households last winter in Massachusetts. The program is managed by regional non-profit organizations. LIHEAP will provide fuel assistance payments for people with annual income of up to $20,420 for a single person, and $27,380 for a two person household. The maximum grant this winter is expected to be around $609.

To sign up for the heating assistance program in your area, call the state “Heatline” at 1-800-632-8175 and enter your zip code. If you feel your gas or electric service has been improperly terminated, call the DTE at 1-800-392-6066. If you owe a company money, call the state Attorney General’s office, at 1-888-514-6277. They will contact your utility or oil company and help you work out a repayment plan. Do it before the snow flies.

A: Yes. The current casino debate in Massachusetts is a reminder that many of the patrons who keep the casinos floating are elderly. Research shows that an estimated 7 million people in the U.S. are problem gamblers. 5% to 10% of elderly gamblers will become addicted, according to Casino Watch, twice as likely as younger gamblers. The elderly are the fastest growing group of gamblers. Those older than 65 who have gambled jumped from 35% in 1975 to 80% in 1998. A study of elderly women revealed that they gambled 249% of their monthly income. The gambling-addicted elderly stop taking medications, steal money, gamble with credit cards, mortgage and utility money, or even skip meals.

You may know an elder who gambles more than they intended, or who feels guilty about the way he or she gambles. They want to stop betting money, but feel like they can’t. They hide betting slips, lottery tickets, gambling money or other signs of betting. They argue over how they are handling money, or they borrow money and don’t repay it.  These are all likely signs of “problem” gambling.

The American Psychiatric Association says that signs of problem gambling include:

• Preoccupation with gambling (reliving past gambling experiences, planning the next venture or thinking of ways in which to gamble)
• Needing to gamble with increasing amounts of money in order to achieve the desired excitement
• Trying to control, cut down or stop gambling unsuccessfully
• Feeling restless or irritable when attempting to cut down or stop gambling
• Using gambling as a way to escape problems or bad moods (helplessness, guilt, anxiety, depression)
• Returning to gamble after losing money gambling
• Lying to conceal the extent of involvement with gambling
• Committing illegal acts, such as forgery, fraud, theft or embezzlement to finance gambling.
• Jeopardizing or losing a significant relationship, job, educational or career opportunity because of gambling.
• Relying on others to get out of debt

. If you have a problem gambler in your family, don’t play the odds. Try playing these numbers instead: 1-800-426-1234. That’s the hotline for the Mass Council on Compulsive Gambling, which provides live, confidential responses 24-hours a day, 7-days a week. The Council offers information for self-help programs, and treatment options, for people experiencing a problem with their own, or a loved one’s, gambling.

Seniors and Sex

A: It’s probably strange not to talk about it. One of many myths about growing old is that you lose your interest in, or need for, sex. Many people in our culture don’t like to connect the two words, “seniors” and “sex,” but its just another form of age discrimination.

We assume that when people get old they’re no longer useful as workers, as lovers, as role models---you name it. In our culture, we have a hard time thinking of older people as people.

A new national survey of 3,005 Americans between the ages of 57 and 85 reveals that seniors want to talk about sex, but have no one to talk to. The study found that more than half to three-quarters of those surveyed said they were still sexually active, and that interest in sex remains high as people get older. The frequency remains “surprisingly stable” among the physically able “who are lucky enough to still have partners.”

"There's a popular perception that older people aren't as interested in sex as younger people," said one of the researchers. "Our study shows that's simply not true. Older people value sexuality as an important part of life." According to the study, elderly men reported more sexual activity than women, but researchers said that was because women live longer than men, giving the surviving men more opportunities to have sex than women, because the woman can’t find partners. (The prevalence of same-sex activity among the elderly does not seem to make the headlines in such studies.)

The fact is, most younger people have no idea about the sexual wants of older people, because they have no clue about their needs in general. "This study paints a portrait of this aspect of older Americans' lives that suggests a previously uncharacterized vitality and interest in sexuality," said the study.

Because of stereotypes, we give older people little credit for still being “real” people. As one researcher said, “Our findings indicate that when it comes to sexual activity, older people are really just younger people later in life. There's no reason to believe they give up the basic human desire for love and intimacy and the kind of pleasure that comes from intimate relationships."

One intriguing part of this new study is the suggestion that sex may make you healthier. "Individuals who remain sexually active gain the benefit of the physical exercise that comes with sex," the researchers found. "It's also possible the hormones -- the endorphins released during sex -- give a general sense of well-being that could be beneficial. The psychological benefits of being loved and cared for may also trickle over to physical health."

The saddest aspect of the study is that many of the people interviewed said they had never had a chance to talk to anyone about these issues--not even with a spouse or their physician. If an older person wants to talk about sex, one reasonable response is simply to say, “Tell me about it.”

Treating Incontinence

Early-Stage Memory Disorder Support Group Open to New Members

Sharon, MA - The monthly Early –Stage support group which meets Thursday afternoons at HESSCO Elder Services has space for new members.  This Early –Stage group is for individuals with a diagnosed, early-stage memory disorder and their care partners.  This support group is actually two separate meetings: one group is for those with the diagnosis to share coping strategies and feelings about the changes they are experiencing and one group to educate and support the care partner.

This support group is free of charge and has limited enrollment; pre-registration is required.  To register call Diane Simoni at HESSCO Elder Services at 781-784-4944, extension 218, or call Bernadette Graycar at EPOCH Senior Healthcare of Sharon at 781-784-6781, extension 132.  Visit www.HESSCO.org for directions to HESSCO Elder Services or information on the support group.

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Q:  Can family members be paid as caregivers?

A:  Yes.  There are several programs in Massachusetts that allow family members- with notable exception of spouses – to be paid as a caregiver for an elderly or disabled relative.  The Personal Care Attendant (PCA) program, which is for people with personal care needs who qualify for MassHealth (Medicaid), has allowed relatives to be hired since last spring, is the largest program.  An individual with a disability can hire their son or daughter to help them eat, bath, dress, etc.  Friends or neighbors can also be Personal Care Attendants.

The newest caregiver program to include family members is the “Enhanced Adult Foster Care” (EAFC) program, which began December 1st.  EAFC services are provided in a home, and include assistance with bathing and dressing, and other supports, such as medication management, food shopping, nursing oversight, and care management.  The new program is for elderly and disabled MassHealth members, and provides personal care services and supports 24 hours a day/seven days a week.

Family caregivers will be paid $1,500 a month, plus a room and board payment of $600 from the elderly or disabled person directly (if they have moved into the caregiver’s home), for a total of $25,200 a year.  If a family member moves into the elder’s home, there is no room and board payment.  The elder or disabled person can attend adult day care 5 days a week, and there is a limited respite care service of 14 days per year.

To qualify for the program, an elderly or disabled adult must need physical assistance with three of the “activities of daily living” (ADLs) such as eating, bathing and dressing.  Or, physical assistance with two ADLs plus “management of behaviors” that require caregiver intervention, such as wandering, or socially inappropriate or disruptive behavior.  A person does not need skilled nursing care to qualify.

Most homes will have one resident and one caregiver – but there can be a second participant if a married couple both are eligible for the program.  The home itself must be adequately maintained, and be clean, adequately heated and maintained.  The home must be accessible to meet the specific needs of a physically disabled client.  Each resident must have a separate bedroom, and they must be provided with personal care as needed.

There is also an “Adult Foster Care” for people who are less disabled.  Although this program pays family caregivers less money, it still provides 24/7 residential care, which is a great service for people who cannot live on their own.

Families looking to take advantage of any of these programs that pay family members, should call 1-800-AGE-INFO, and push “3” to be connected with the nearest Age Info Center.  To find out if you qualify for MassHealth, call 1-800-841-2900.

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Q:  What is the new Pension Protection Act?

A:  The new 900-page “Pension Protection Act” (PPA) is a very complex law, but here are just a few of the ways it could affect you:

• IRA Contribution Limits:  A 2001 law increased the annual contribution limits a worker could make into their Individual Retirement Accounts (IRA) and qualified pension plans, and allowed people age 50 and over to make additional “catch-up” contributions.  These reforms were scheduled to expire in 2010, but the PPA would make them permanent.  IRA contributions will be $4,000 in 2006 and 2007, $5,000 in 2008, and adjusted for inflation after 2008.

• Tax Credits Kept:  Certain workers who make contributions to an IRA get an income tax credit for the first $2,000 of annual contributions.  The credit is 50% of the contribution for people with incomes of $15,000 or less ($30,000 or less for couples).  The credit phases down to $0 for people with incomes of $25,000 or less ($50,000 or less for couples).  This credit would have expired in 2007.

Q:  Has MassHealth restored dental and vision services for older adults?

A:  Yes, effective July 1, 2006, MassHealth has restored a number of services for adults age 21 or older, that had been eliminated.  Here is a list of  eight  services that seniors on MassHealth can now get again – as long as the services are considered “medically necessary:”

*Dental Services:  exams, preventive services, restorations, root canals, and dentures.  Some of these services must be approved in advance by MassHealth.

*Vision Services:  vision exams, eyeglasses, eyeglass parts, eyeglass dispensing, certain contact lenses, and other visual aids, such as magnifying aids.

*Orthotics:  mechanical devices, such as braces, or orthotic shoes, to support or correct weakened body parts.

*Prosthetics:  an artificial extension that replaces a missing part of the body, like an artificial leg or arm.

*24-hour substance abuse treatment services:  MassHealth will cover certain 24-hour post-medical detoxification substance abuse treatment services.

*Acute hospital inpatient administratively necessary days:  MassHealth will cover all administratively necessary inpatient stays, which are days in which a person is in a hospital awaiting relocation to another setting.

*Chiropractor Services:  MassHealth will now cover the services of a chiropractor.

*Smoking Cessation Services:  group or individual counseling to stop smoking, nicotine replacement prescriptions, such as patches, gum and lozenges.  MassHealth will also pay for bupropion, a non-nicotine drug.

Most elders who are on MassHealth are also on Medicare, and many of the restored services listed here are important, because Medicare does not cover them.  For example, Medicare does not cover dental care and dentures, or orthopedic shoes, or routine foot care, routine eye care and most eyeglasses.  Even with this list of restored services, there are still some “gaps” in health care services, which neither Medicare, nor MassHealth will cover, such as hearing aids or hearing exams for the purpose of fitting a hearing aid.

Elders on MassHealth who have any questions about specific services that have been restored as of July 1, 2006, should call the MassHealth Customer Service Center at 1-800-841-2900 (TTY:  1-800-497-4648).  The Customer Service Center hours are weekdays between 8:00 A.M. and 5:00 P.M.  Or call 1-800-Age-Info, then press “3” and ask to speak with an Information Specialist.

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Senior citizens and the disabled who qualify for long term care services under the MassHealth program will have an “equal choice” of care at home, or care in a nursing home, under legislation adopted Monday night on a unanimous 153-0 vote on the floor of the House.

S.2273, the “equal choice” bill, modernizes the MassHealth program from one which has been historically been institutionally oriented, to one which focuses on care “in the least restrictive setting appropriate” to an individual’s needs.

According to Mary Raczka, of HESSCO Elder Services, the bill is “an important civil rights protection that allows consumers to seek care in the most integrated setting.”

The equal choice bill also establishes a more focused “pre-admission counseling” program for people who are being referred to a nursing home, to ensure that they are aware of community alternatives.  Everyone about to enter a nursing home – regardless of whether they are privately paying, or seeking MassHealth support – will have the opportunity to explore options in the community first.

The equal choice bill also requires the state to submit a “waiver” to the federal government which will raise the income and asset levels for the MassHealth long term care program, thus allowing the Commonwealth to capture 50% federal match for some elders who are now fully supported by state funding.

According to the Romney Administration, the equal choice bill will save taxpayers $134 million in the first five years after implementation.  Several recent studies of the state’s long term care system have noted the Commonwealth’s over-reliance on institutional care.  Today, approximately 75 % of the MassHealth funding for long term care goes to nursing homes.  Massachusetts ranks 25th in the nation for the percentage of MassHealth funding spent in the community.

The Senate has already engrossed a similar version of the equal choice bill on a unanimous vote.  The equal choice legislation has been endorsed by the major elderly and disabled rights groups in the state, including Mass Home Care, AARP, the Statewide Independent Living Council, MAOA, Mass Senior Action, Mass Councils on Aging, and the Greater Boston Interfaith Organization.

“The elderly and the disabled want to be cared for at home as a first resort,” explained Raczka.  “This legislation gives them the choice to live independently in the community.  For the first time in 40 years, we set a clear mission for more than $2 billion in state spending.  This bill is a win-win.  It keeps elders living in the community, and it saves tax dollars as well.

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Q:  How can I find a good nursing home?

A:  In Massachusetts, 80% of the people who enter a nursing home come from a hospital first.  If a hospital discharge planner says your Mother must be out in 24 hours, and gives you a list of area nursing homes – you are suddenly under pressure to make a decision.  But the goal in our state is to make nursing home care a last resort, so be sure to ask for home care alternatives as your first resort.  And then:

Extend your hospital stay:  Use your appeal rights under Medicare to extend the hospital stay for two days.  Ask for a “notice of non-coverage.”  This will buy you additional time.

Check out alternatives:  Call 1-800-Age-Info, press “3” to be connected to your local Aging Services Access Point (ASAP).  Ask to speak with a nursing home screener.  If your relative is on MassHealth, inquire about the “community choices” program as an alternative to nursing home care, or the personal care assistance program.

Get the names of local facilities:  Your ASAP can give you a list of nursing homes and put you in touch with your local nursing home ombudsman.  Ask that person about their experiences with area homes – good and bad.

Look for report cards:  The federal government maintains a “Nursing Home Compare” website at www.medicare.gov that will give you info on local homes.  Also go to www.consumerreports.org and look for their “Nursing Home Quality Monitor.”

Check the ownership:  Look first at the independent, non-profit homes, rather than at a for-profit chain.  Non-profits or religious groups usually havea mission to help people, not just their bottom line.  Ask if the home has changed owners multiple times.  If the facility is part of a large chain, you may have a harder time complaining about bad care.

Visit several times:  If you’ve got one or two homes on your list, make unannounced visits.  Stop by after breakfast to see how many people are still in bed.  Visit at dinnertime and taste the food yourself.  If residents are eating in their rooms, that’s not a good sign.  Ask the nurse aides how many residents they each care for.  The smaller the number, the better.

Read the reports:  Ask for the home’s Form 2567.  That’s the state inspection survey.  If you have difficulty obtaining it, that’s not good.  A survey with lots of violations indicates problems.  Ask if the administrator and the director of nursing have worked at a facility for several years, that’s a positive sign.  Frequent turnover of key staff can indicate bad morale or mismanagement.

Talk to the administrator:  What is his or her philosophy of care?  Is this philosophy written down and given to families to read?

Do advance research:  Nursing homes are an expensive investment.  Do some research before a family member needs care.  Ask your ASAP about what alternatives exist in the community for people who might need nursing home care, and learn those options first.

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