Independent Social

MAY 16, 1994 VOLUME 1, NUMBER 25

Security Agency

Senate Finance Committee Chairman Daniel Patrick Moynihan is urging Congress to establish Social Security as an independent agency. The New York Democrat argues that such a move would help insulate the program from political attacks and manipulations.

Social Security frequently comes under attack for its perceived contribution to the federal deficit. Moynihan points out that the program actually is “off budget,” meaning that revenues received and benefits paid are separate from federal budget calculations and do not affect the deficit.

Moynihan argues that Social Security would also have a higher public profile than it enjoys as a division of the Department of Health and Human Services. The Social Security Administration employs 63,000 people and pays out more than $350 billion in benefits to 42 million beneficiaries.

Aids and the Elderly

The April, 1994, issue of The Harvard Health Letter points out that even the elderly should be worried about AIDS. Men and women over age 50 account for 10% of all AIDS cases diagnosed each year. While AIDS cases diagnosed among the elderly a decade ago were almost all attributed to transfusions of contaminated blood or homosexual contact, HIV infection through heterosexual contact has been rising since 1986. Today, heterosexual transmission accounts for about 10% of new cases in the over-50 age group.

A recent survey published in The Archives of Internal Medicine reported that older citizens at risk of contracting AIDS were only one-sixth as likely to use condoms as the 20-year-old comparison group. They were only one-fifth as likely to be tested for HIV. The conclusion is obvious–older patients tend to ignore (or do not understand) the risk of AIDS.

The study’s principals, Ron Stall and Joe Catania, are behavioral epidemiologists at the University of California in San Francisco. For purposes of the study, they defined “at risk” older participants to include all those having multiple sex partners, sex partners with known HIV risk, or having received a blood transfusion between 1978 and 1984. Stall and Catania indicate that the results do not surprise them, especially since AIDS prevention messages are aimed almost exclusively at younger people.

Income Cap Trusts


Regular Elder Law Issues readers will recall that the federal government has finally provided some relief for nursing home patients who fail to qualify for ALTCS because they receive “too much” income. Under current eligibility rules, a patient with over $1338 in monthly income will not qualify for ALTCS assistance, even though the cost of care may exceed $2500 or even $3000 per month.

Last August Congress gave patients in the so-called “Utah Gap” the opportunity to assign their income to special trusts. These trusts (variously known as Income Cap Trusts, MillerTrusts or Qualified Income Trusts) had not previously been recognized in Arizona. Since the new legislation was adopted, Arizona officials had been unusually quiet about what specific terms might be deemed acceptable, leading critics to speculate that each trust would face legal challenges.

Now comes word from Phoenix that at least two Income Cap Trusts have been approved by ALTCS. Two more such trusts have been filed in Tucson, and the results are expected within the next few weeks. It may finally be possible to secure nursing home care for the “Utah Gap” patient.

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