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NationalSeniorCitizensLawCenter 2NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgLeadershipPerspectiveTheNationalSeniorCitizensLawCentercelebratedits40thanniversarythispastyearandwhatanamazing40yearsithasbeen.Ourearlyhistoryincludedimportanteffortsfromdefendingpensionsinthecourtstoachievingreformofthenationsnursinghomes.Welitigatedsignificantissueswithbroadimpactongovernmentbenefitsprogramsrestoringmillionsofdollarsforseniorsandprotectingfuturebeneficiariesfromillegalpractices.ThechallengeswefacetodaytoSocialSecuritySupplementalSecurityIncomeSSIMedicareandMedicaidremindusthatanorganizationcommittedtoprotectingtherightsofpoorseniorsremainsasimportanttodayasitwasin1972.NSCLCfightstoensurequalityhealthcareeconomicsecurityandaccesstoourjusticesystemonbehalfofmillionsofolderadultswhohavelittleornovoiceinWashingtonorinstateCapitols.Thereisnoothernationalnon-profitthatremainsasdeeplycommittedtoandfocusedontherightsofAmericaslow-incomeolderadultsasNSCLC.In2012therewerenotablesuccessesineachoftheorganizationsprimaryissueareas.HerearesomeexamplesHealthCareNSCLCledabroad-basedmovementtoprotectbenefitsandfightcutstokeyservicesforolderadultsunderMedicareandMedicaid.Italsosteppedupitseffortstoprotectandexpandhomeandcommunity-basedservicestokeeplow-incomeolderadultsoutoflong-termcareinstitutions.NSCLCwhichwasaleadingvoiceinsupportofthehealthreformlawanditsconstitutionalitycelebratedtheSupremeCourtslandmarkdecisionontheAffordableCareAct.EconomicSecurityNSCLCledaneducationalcampaignthatraisedawarenessoftheneedtoupdateSSIprogramtheprimaryincomesupportprogramfortheverypoor.TheresultwillbetheintroductionoflegislationinCongresstoaddresssomeoftheproblemsNSCLCidentified.InJuneafederalcourtorderedtheSocialSecurityAdministrationtoimplementaplantofindandrestorebenefitstoover140000seniorsandpeoplewithdisabilities.TheylostbenefitsbecauseofanillegalpolicythatNSCLCandpartnerssuccessfullychallengedinlitigation.ThisfallNSCLCalsobeganworkonamulti-yeargrant-fundedprojectthatseeksfixestoSSIsbrokennon-disabilityappealsprocess.NSCLCalsocontinuestoofferinformationeducationandcounseltolegalservicesandagingservicesadvocatesfromalloverthecountrythroughitspublicationsfrequentalertsmonthlywebinarscaseconsultationsandfrequentpresentationsatconferencesseminarsandforums.In2012forexamplewetrainedover2000agingadvocatesandprovidedover600caseconsultations.RobertJohnsonChairBoardofDirectors 3NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgWhiledeliveringtheseserviceswealsotookstepstogrowourboardandstaff.OverthepastyeartheboardaddedArnoldandPorterManagingPartnerRichardAlexanderNationalHispanicCouncilonAgingPresidentandCEOYaniraCruzandretiredCareFirstExecutiveVicePresidentJohnPicciottoandwelcomedStaffAttorneysFayGordonandKateLangtotheWashingtonDCstaff.WearegratefulforthecontinuedsupportwereceivefromsomeofAmericasleadingfoundationsandareexcitedtobeaddingmorefoundationandoutsidesupporttooureffortsincludingfirst-timegrantsfromtheOakFoundationtheNationalCommitteetoPreserveSocialSecurityandMedicareandtheGayandLesbianAllianceAgainstDefamation.WeareFoundingExecutiveDirectorPaulNathansonshownherewiththelateactivistandGrayPantherfounderMaggieKuhnservedtheorganizationfrom197280andreturnedtoleaditin2008.WhilehedirectedtheUniversityofNewMexicoUNMInstituteofPublicLawandtaughtatUNMslawschoolintheinterveningyearshealsoservedasaNSCLCboardmember.NathansonisretiringthisyearbutplanstoremainactivelyinvolvedintheworkofNSCLCanditscontinuingstruggletosecureandprotecttherightsoftheelderlypoor.alsoextremelythankfulforthecontributionswereceivefromindividualdonorsandlawfirms.Weappreciatetheirongoinginterestinandcommitmenttolow-incomeolderadults.ThecomingyearwillbringnewchallengesandsignificantchangesatNSCLC.PaulNathansonourExecutiveDirectorhasannouncedthathewillretirein2013.TheBoardofDirectorshasbegunasearchforanewExecutiveDirectortoleadtheorganizationintothefuture.PaulhasbeenafixtureatNSCLCformuchofitshistoryhavingbeenitsfirstExecutiveDirectoralong-servingBoardmemberandatrustedleaderforthepastfiveyears.DuetohisvisionaryleadershipNSCLCsfinancialstatusissoundandNSCLCispoisedtodogreatthings.Heresto40moreyearsThechallengeswefacetodaytoSocialSecuritySupplementalSecurityIncomeSSIMedicareandMedicaidremindusthatanorganizationcommittedtoprotectingtherightsofpoorseniorsremainsasimportanttodayasitwasin1972. 4NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgHealthCareNSCLCseekstoprotectlow-incomeolderadultswithMedicareandMedicaiddualeligiblesasmanystatesproposemovingthemintomanagedcareplansaspartofdemonstrationprojectsencouragedbytheAffordableCareAct.Wealsostrivetoexpandhomeandcommunity-basedservicesforlow-incomeolderadultsandtodecreasehealthdisparitiesimpactingthosewhohavelimitedEnglishproficiencyoraredisadvantagedbecauseoftheirraceorsexualpreference.Toachievetheseobjectivesin2012NSCLCwasTheleadingadvocateforconsumersandaprimaryinformationsourceforadvocatesonthedualeligibledemonstrationprojects.AsstatessubmittedproposalstothefederalCentersforMedicareandMedicaidServicesCMStomovedualeligiblesintomanagedcareplansNSCLCsadministrativeadvocacyNSCLCshealthteamincollaborationwithlocaladvocatesandothernationalandstateorganizationsusesadministrativeadvocacytoprovideinformationtoandpushforpolicychangesfromfederalandstateagenciesonrelevantissues.NSCLCselectivelyuseslitigationtoprotecttherightsofindividualstobenefitsandtotheircontinuedaccesstothecourts.DeputyDirectorKevinPrindivillewhofrequentlytestifiesandpresentsonhealthcareissuesaddressestheNationalHealthPolicyForum.wasinhighgear.NSCLCcreatedawebsiteclearinghouseonthe26stateprojectsthatadvocatesnationwideusetotrackproposalsstayinformedandremaininvolvedintheprocess.NSCLCorganizedanadvocatesworkgroupof130peoplefrom20statesandworkedwithnationalorganizationstogeneratemanycommentsandinfluencefinalproposals.OnefocusofthisnationaladvocacyhasbeenacallforanombudsmanofficeineverydemonstrationstatetohelpbeneficiariesnavigatethenewsystemandCMSlistenedcallingoneachstatetocreatesuchanoffice.Californiasproposalseekstomoveasmanyas700000peopleintoprivateplans.NSCLCco-chairedaworkinggrouponBeneficiaryNoticesandProtectionstestifiedseveraltimesbeforethestatelegislatureandfiledhundredsofpagesofspecificcommentsonproposaldetailsgeneratingacommitmentfromstateandfederalauthoritiesforstrongerprotectionsandoversight.NSCLCalsopointedoutinfrequenttestimonyandincommentsthatthestatesproposalwasontoofastatrack.Asaresultthestatemoveditsproposedimplementationdatebacksothatenrollmenttimeframeswouldbemorerealistic.In2013NSCLCwillcontinuethiskindofadvocacyasCaliforniaandotherstatesreceivefederalapprovalforthedemonstrationsandbeginimplementation. 5NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgAvocaladvocateformorehomeandcommunity-basedservicesasanalternativetonursingfacilitiesforthosewithMedicaid.Manyintheagingandlegalservicesfieldareconcernedbystateproposalstomovehundredsofthousandsoflow-incomeolderadultsneedinglong-termservicesandsupportsintomanagedcareplans.Amajorworryisthatmanyplansareunfamiliarwithhomeandcommunity-basedservicesHCBSandthataccessmaybejeopardizedasaresult.NSCLCissuedreportshostedtheLTSSinaManagedCareEnvironmentwebinarwithover500attendeesandpresentedtoastanding-roomonlyaudienceatanationalHCBSconference.InthefallNSCLCpublishedanAdvocatesGuidetoMedicaidLTSSaprimeronthelawthatimpactsMedicaid-fundedHCBS.InadditionstafftrackedandsharedanalysisofnewregulationsgoverningAffordableCareActprogramssuchastheBalancingIncentivePaymentsProgramandCommunityFirstChoiceprogramsdesignedtoimproveaccesstoHCBS.NSCLCcontinuestomonitorstateplansinthisarenaandtoencourageadvocacythatexpandaccessandprotectsbeneficiaries.LitigationAleadingdefenderoftheAffordableCareActsindividualmandate.Initsamicusbriefontheindividualmandatejoinedby14othernationaldisabilityandconsumeradvocacygroupsNSCLCarguedthatitfellsquarelywithinCongressauthoritytoregulateinterstatecommerce.InadditionNSCLCledanefforttoprepareanamicusbriefbyfiveaginggroupstodescribeprogramsofvitalimportancetoolderadultsthatshouldnotbeaffectedbyaSupremeCourtdecisiononthemandate.TheCourtsubsequentlyruledthatthemandatewasconstitutional.Corazoncameclosetolosingheradultdayhealthcarebenefitsbecauseofaproblemwithmanagedcarerelatedtotheneedforheartsurgery.NSCLCuseditsconnectionstosolvetheproblemandshewasabletokeepherbenefitsandhavehersurgery.NSCLCisagreatresource.ItwaslifeordeathforCorazonsaidheradvocateAsakoOkumaofAmeriCareAdultDayHealthCareinSanMarcosCA.NSCLCplayedaleadingroleindefendingtheAffordableCareActsuchasdraftingfriendofthecourtbriefsfortheSupremeCourt. 6NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgTheyNSCLCstaffhaveapracticalhands-onapproachandtheyunderstandandpickuponthedirectservicecomponent.AileenHarperCenterforHealthCareRightsLosAngelesCAAdefenderoftherightsofolderadultstobetternursinghomecarefullMedicarebenefitsforhospitalcareandensuringthatsettlementwiththestateonCaliforniasadultdayhealthprogramisnotignored.NSCLCusedthecourtstoprotectlow-incomeolderadultsaccesstohealthcareandLTSS.EarlyintheyearNSCLCjoinedwithAARPandsubmittedanamicusbrieftoensureadequatestaffinglevelsin19CalifornianursinghomesthecourtfoundthattheplaintiffscouldenforceminimumlevelsShutsvCovenantHoldcoLLC.InalawsuitbroughtwithleadcounselCenterforMedicareAdvocacyBagnallvSebeliusNSCLCchallengedanillegalpracticethatdeniesMedicarebeneficiariesplacedonobservationstatusaccesstoMedicarePartAhospitalbenefits.Thecasehasbeenwidelypublicizedinthemedia.NSCLCalsomonitoredtheimplementationofthesettlementinthecasethatpreventedthestateofCaliforniafromeliminatingitsadultdayhealthcareprogramforpeoplewithMedi-CalDarlingetalvDouglas.NSCLCjoinedasco-counselonceagaintoblockcutstohomecareinCaliforniaforseniorsandpersonswithdisabilitiesOsterv.Lightbourne.NSCLCwasalsoadrivingforceinacasethatsoughttoprotectaccesstothecourtsbytheelderlypoorDouglasvIndependentLivingCenter.NSCLCstrivestoexpandhomeandcommunity-basedservicesforlow-incomeolderadultsandtodecreasehealthdisparitiesimpactingthosewhohavelimitedEnglishproficiencyoraredisadvantagedbecauseoftheirraceorsexualpreference. 7NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgEconomicSecurityTheincometeamusesadministrativeandlegislativeadvocacyincombinationwiththeeducationandcounselingofadvocatestoimproveincomesecurityprograms.Iteffectivelyuseslitigationtochallengeadministrativepoliciesthathavemadeaccesstobenefitsdifficultforthousandsofelderlypoor.In2012NSCLCLaunchedacampaigntoupdatetheSSIprogram.ThroughouttheyearNSCLCmadeSSImodernizationapriorityraisingawarenessofthefixesneededwithkeyaudiencesincludingadvocatespolicymakersandthemedia.BecauseofthoseeffortsincludingoutreachattheDemocraticconventionaWhiteHousevisiteducationofkeypolicymakersonandoffCapitolHillwebelievecutstoSSIarelesslikelytobepartofanyactiontakentoreducethenationsdeficit.AtyearsendNSCLChadidentifiedachampionintheU.S.HouseofRepresentativeswhowillintroduceabilltoimproveSSIinearly2013.NSCLCstrivestopreservestrengthenexpandandimproveaccesstoprogramssuchasSupplementalSecurityIncomeSSIandSocialSecuritythatprovideincomesecuritytomillionsofolderadultsandpeoplewithdisabilities.Ensuredthatatleast140000peoplemayreceiveatotalof1billioninbackSocialSecuritybenefits.InAprilafederaljudgeissuedafinalorderinClarkvAstrueacaseinwhichNSCLCsuccessfullychallengedtheSocialSecurityAdministrationspolicyofsuspendingordenyingSocialSecurityandSupplementalSecurityIncomeSSIbenefitswheneversomeonehadanoutstandingwarrantforanallegedviolationofprobationorparole.Undertheorder140000classmemberswhosebenefitsweresuspendedordeniedbecauseofthispolicysinceOctober2006mayreceivefullretroactivereinstatementiftheycontinuetootherwisebeeligible.PaymentofbackbenefitshasbegunandwillcontinuethroughMarch2014.PlaintiffsinthecasewererepresentedbyNSCLCtheMentalHealthProjectoftheUrbanJusticeCenterandprobonocounselfromProskauerRoseLLP.InitiatedaspecialprojecttofixthebrokenSSIappealssystemthatcurrentlydeniesdueprocessrightstomanylowincomeolderadults.InDecemberNSCLCaddedastaffattorneytoworkonaspecialprojectrelatedtofixingtheprocessforappealingSSIsuspensionsandreductions.Theprojectfollowsupa2011NSCLCstudywhichidentifiedwidespreadfailurebySSAtoprovideminimumdueprocessrightsintheseappeals.StaffincludingDirectingAttorneyGeraldMcIntyreparticipatedinsome50trainingsorpresentationsin2012. 8NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgEducatedadvocatesaboutthepotentialbenefitforindividualswhowouldqualifyforSocialSecurityspousalorsurvivorbenefitsbasedonsamesexmarriagewereitnotfortheDefenseofMarriageActDOMA.About200advocatesattendedawebinarinwhichtheywereadvisedtohelptheirclientsthatareinasamesexmarriagetoapplyforSocialSecurityspousalandsurvivorRamonGonzalezisamemberoftheplaintiffclassinClarkvAstrue.LeftdisabledafterhewashitbyatruckRamoniseligibleforSocialSecurityDisabilityInsurancebuthasyettogetapenny.HecontactedSandraSusseatCommunityLegalAidinSpringfieldMAforhelpinapplyingforSSIbenefitswhoworkedwithNSCLCtoresolvehisissues.Ididntknowwheretoturn.IfitwasntforherGonzalezsaidIdontknowwhatIdhavedone.RamonwithhiscaregiverandfriendReinaSantana.benefitsnow.Inadditionstaffalsoauthoredarticlesandpresentedatconferencesonthetopic.ApplicationsforspousalorsurvivorbenefitswillbedeniedbutifappealsarefiledandDOMAisruledunconstitutionalbytheU.S.SupremeCourteitherinWindsorvUnitedStatesorasubsequentcasemanycouldgetretroactivebenefitsbasedonthedateoftheirapplication.NSCLCeffectivelyuseslitigationtochallengeadministrativepoliciesthathavemadeaccesstobenefitsdifficultforthousandsofelderlypoor. 9NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgInthefiscalyearthatendedonJune302012NSCLCreceivedrevenueamountingto1865766andincurredexpensesamountingto1935278resultinginananoveralldecreaseofnetassetsamountingto69512.Unrestrictednetassetsincreasedby85771toatotalof262841.Temporarilyrestrictednetassetswhichrepresentgrantfundsreceivedtosupportprogramsinfuturefiscalyearsdecreasedby155283toatotalof1494845.Totalnetassetsattheendoftheyearamountedto1757686.FinancialsPrivatefoundationandgovernmentgrantscontinuedtobetheprincipalsupportforNSCLCsprogramsproviding73oftotalrevenue.Contributionspublicationsalesattorneysfeesandotherincomeprovided27oftotalrevenue.NSCLCsprogramservicescontinuedtobefocusedonissuesaffectingtheelderlypoorprimarilyhealth-relatedissuesandalsoincomesecurityandcourtaccessissues.Programserviceswere83ofNSCLCsexpenditures7wereformanagementandgeneralexpensesand10werefordevelopmentexpenses.FY2012ExpensesByCategoryFY2012RevenuesByCategoryLitigation6DevelopmentExpenses10ManagementGeneralExpenses7HealthPrograms65IncomeSecurityPrograms12GovernmentGrantsContracts13PrivateFoundationGrantsContracts60OtherProgramIncome12Contributions6AttorneysFees9 10NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.orgGrantsIn2012thesefoundationsandorganizationsprovidedsupportforprojectsandprogramsinalphabeticalorderAdministrationonAgingU.S.DepartmentofHealthandHumanServicesAlbertandElaineBorchardCenteronLawandAgingAmericanFederationofStateCountyandMunicipalEmployeesAFSCMEBetTzedekLegalServicesLosAngelesGayandLesbianAdvocatesandDefendersGLADHarryandJeannetteWeinbergFoundationIndependenceFoundationNationalCommitteetoPreserveSocialSecurityandMedicareFoundationRuthArnholdEndowmentFundoftheEastBayCommunityFoundationStateBarofCaliforniaIOLTAProgramandEqualAccessFundTheAdvocacyFundTheAtlanticPhilanthropiesTheCaliforniaWellnessFoundationTheCommonwealthFundTheNathanCummingsFoundationTheOakFoundationDonorsNSCLCsstaffandboardaretrulygratefulforthegenerosityofourindividualdonors.WeareamemberoftheCombinedFederalCampaign12348andalsothankthosethatcontributethroughtheirworkplace.10000andaboveRobertandMarilynJohnson5000andaboveJosephJacquelineKirshbaumMemorialFundoftheLibertyHillFoundationBarryandPaulaLittMungerTollesOlsonLLPNaomiandStuartPaleyRichardM.Alexander2500andaboveDavidH.FryEdwardD.SpurgeonTheLoisandIrvingBlumFoundationMr.andMrs.MatthiasJ.DeVitoStephenR.BruceWilliamandJeanneBarulich1000andaboveDavidJ.CallardHannahandStevenLiebermanJohnA.andDianneC.PrindivilleLouisH.CarpenterMichaelJ.KellyMiddleRoadFoundationRebeccaC.andJackK.MorganRobertAdlerStuartandCarolZimringSueHimmelrichandMichaelSoloffTheHon.FredR.HarrisTheNationalSeniorCitizensLawCenterBoardofDirectorsandStaffexpresstheirsincerethankstothosewhofundourwork.Supporters 11NationalSeniorCitizensLawCenter2012AnnualReportwww.NSCLC.org500andaboveC.DavidAndersonGeorgiaBurkeandDavidLuJohnA.PicciottoKathleenA.SykesMichaelFriedandRuthLeysNeeraTandenPaulS.NathansonPhyllisJ.Holmen250andaboveAaronandJenniferBarulichAlanFriedmanAnonymousCarrollL.EstesDeborahWinstonCallardElizabethK.MoserEmilyJennyandChrisKaufmannEricM.CarlsonandGracielaMartinezJamesandCaroleBarrallJasonD.KoganJeffreyM.andReneeC.EpsteinJohnB.andSusanB.PowellKathleenandLouisKravitzStephenM.KristovichSteveandLindaWeitzTheJewishFoundationofLosAngelesTomFreemanandWendy-SueRosen100andaboveAllanRodgersBrendaWillettBrianW.LindbergBrysonL.CookCarlosA.ArcosLawCorporationConstanceR.CaplanDavidandLucyEisenbergDouglasandEricaRosenthalE.PercilStanfordE.KPenningtonandL.J.LardyEdKathrynLangEdwardF.HowardGeraldineE.ChampionGillDefordHernndez-SternFamilyFundoftheCaliforniaCommunityFoundationJudithR.PachtKarenKaplowitzLawOfficesofDavidJ.HoeyInc.LowellPaulLydiaMissaelidesMichaelandNoraJeanLevinNadiaK.GareebRenReixachRobertA.RussellRonaldandBarbaraGeorgeSelmaHaymanSoniaValdezandCaioArellanoTheFrithLawFirmTheodoreKroeberandShiraShafirUpto100AnneB.andGeorgeGingoldAnneMarieReaganandDouglasM.MageeBettyFinneyCatherineCalleryCharlotteFlynnDonnaAmbrogiElizabethSchneiderEricaWoodJocelynTichenorJonathanRiceMorrisKleinPilarMurraySamHerbertSarahShenaTomFuchsandFeleciaBartow www.NSCLC.org1444EyeSt.NWSuite1100WashingtonDC20005202289-6976202289-7224Fax3701WilshireBlvd.Suite750LosAngelesCA90010213639-0930213368-0774Fax1330BroadwaySuite525OaklandCA94612510663-1055510663-1051FaxADMINISTRATIONPaulNathansonExecutiveDirectorKevinPrindivilleDeputyDirectorScottParkinCommunicationsDirectorTomSmithFinanceandAdministrationDirectorNancyArvaloProgramCommunicationsAssociateKatrinaCohensOfficeManagerCurrentLeadershipSTAFFATTORNEYSAmberCutlerStaffAttorneyGeorgiaBurkeCo-DirectingAttorneyEricCarlsonDirectingAttorneyFayGordonStaffAttorneyKateLangStaffAttorneyGeraldMcIntyreDirectingAttorneyAnnaRichSeniorStaffAttorneyRobertK.JohnsonchairBarrettS.LittvicechairPaulNathansonexofficiosecretaryRichardAlexanderTeresaA.BryceBazemoreYaniraCruzDavidH.FryPhyllisJ.HolmenBOARDOFDIRECTORSMichaelJ.KellyHannahE.M.LiebermanJohnA.PicciottoEdwardD.SpurgeonE.PercilStanfordNeeraTandenStuartD.Zimring