A new report by AARP's Public Policy Institute (PPI) identifies effective practices for monitoring court-appointed adult guardians, reducing the chances for abuses that occur when oversight is lax.
Conducted with the American Bar Association (ABA) Commission on Law and Aging, the report follows a 2006 AARP survey showing that a large number of state courts around the country fail to assign a monitor to visit vulnerable individuals under guardianship, leaving many Americans open to physical neglect and financial abuse. The 2006 survey also found that, in many jurisdictions, no one verifies the information in guardianship reports.
Monday, December 31, 2007
Coalition Proposes More Training for Home Caregivers
Olympia, WA – A group of advocates for Washington seniors and disabled citizens soon will ask the State Legislature to increase the amount of training that in-home caregivers receive. They say the current training standards are inadequate, and they also want training to be available to family members.
Friday, December 28, 2007
Crap In = Crap Out
"Medication errors are among the most common medical errors, harming at least 1.5 million people every year, says a new report from the Institute of Medicine of the National Academies. The extra medical costs of treating drug-related injuries occurring in hospitals alone conservatively amount to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs, the report says."
Wow.
3.5 billion dollars a year? I bet it's way more than that.
Studies indicate that 400,000 preventable drug-related injuries occur each year in hospitals. Another 800,000 occur in long-term care settings, and roughly 530,000 occur just among Medicare recipients in outpatient clinics. The committee noted that these are likely underestimates.
Amazing. Almost 2 million a year.
I agree that the numbers likely represent gross underestimates. The problem, as I see it, is not preventable, nor fixable in the current fragmented environment of health care delivery. Breaking down the problem reveals so many in congruent variables that the current delivery of health care is wide open to errors.Dehydration in the Elderly
I lost this link, so you'll have to trust me on this one:
As people age, the part of their brain that tells whether there is enough water intake begins to malfunction. The brain underestimates the amount of water intake required to prevent dehydration. Thus, the person is always close to dehydration.
The only practical answer is to double the intake of water during the day from the amount that seems right.
As people age, the part of their brain that tells whether there is enough water intake begins to malfunction. The brain underestimates the amount of water intake required to prevent dehydration. Thus, the person is always close to dehydration.
The only practical answer is to double the intake of water during the day from the amount that seems right.
Thursday, December 27, 2007
Nursing Homes Get Funds To Prevent Pressure Ulcers
ALBANY—The New York State Department of Health has awarded $800,000 to 16 nursing homes to support implementation of an evidence-based best practice shown to significantly reduce pressure ulcers.
Known as “On-Time Quality Improvement for Long Term Care,” the approach to preventing pressure ulcers was developed by the federal Agency for Healthcare Research and Quality (AHRQ).
A pressure ulcer (also called a bedsore) is an area of skin that breaks down when a person stays in one position for too long, putting pressure on the same spot without shifting weight. They occur most often in people who are bedridden or in wheelchairs, even for a short time after surgery or an injury.
“The State Health Department is pleased to work with AHRQ and nursing homes across New York on this important effort to improve the health and well-being of nursing home residents in the state,” said State Health Commissioner Richard F. Daines, M.D. “In addition to creating pain and suffering, pressure ulcers can become infected, causing fever, confusion, weakness and even death. They are also very preventable, and costly to treat.”
Nursing home residents at highest risk for pressure ulcers are those in a coma and others who can’t move around or change position on their own. Among this high-risk population the incidence of pressure ulcers is 14 percent in the state (the U.S. average is 12 percent). Among low-risk patients in New York, the incidence is 2 percent (the same as the national average).
The “On-Time” program uses health information technology (HIT) to collect, analyze and promptly report back to staff the information they need to identify which nursing home residents are at risk for pressure ulcers and to track the results of their efforts to reduce risk. It has been implemented, tested and refined in more than 35 nursing homes across the nation and produced an average decrease of 33 percent in prevalence rates in the nursing homes that implemented the model.
Few Cancer Services Provided To Nursing Home Residents
Elderly nursing home residents receive relatively few cancer care services, including screening, surgical treatment, or hospice care.
Few studies have examined cancer treatment and care among elderly patients residing in nursing homes. Yet as the U.S. population ages, more people will move into nursing homes, many of whom will later be diagnosed with cancer. Cancer risk increases as people age.
Cathy Bradley, Ph.D., of the Virginia Commonwealth University Massey Cancer Center in Richmond and colleagues assessed the cancer care received by elderly nursing home residents who were insured by Medicaid. Using data from the Michigan Tumor Registry and Medicare records, they identified 1,907 nursing home residents diagnosed with cancer. They analyzed the patient data by cancer stage at diagnosis, type of cancer, survival time, and whether the patient received surgery or hospice care, as well as other variables.
Sixty-two percent of the nursing home residents with cancer had late or unstaged disease when they were diagnosed, and almost half died within three months of diagnosis. Among patients with late stage cancer, only 28 percent received hospice care. Patients aged 71 to 75 were three times more likely to have surgery than patients aged 86 and older.
Few studies have examined cancer treatment and care among elderly patients residing in nursing homes. Yet as the U.S. population ages, more people will move into nursing homes, many of whom will later be diagnosed with cancer. Cancer risk increases as people age.
Cathy Bradley, Ph.D., of the Virginia Commonwealth University Massey Cancer Center in Richmond and colleagues assessed the cancer care received by elderly nursing home residents who were insured by Medicaid. Using data from the Michigan Tumor Registry and Medicare records, they identified 1,907 nursing home residents diagnosed with cancer. They analyzed the patient data by cancer stage at diagnosis, type of cancer, survival time, and whether the patient received surgery or hospice care, as well as other variables.
Sixty-two percent of the nursing home residents with cancer had late or unstaged disease when they were diagnosed, and almost half died within three months of diagnosis. Among patients with late stage cancer, only 28 percent received hospice care. Patients aged 71 to 75 were three times more likely to have surgery than patients aged 86 and older.
Tuesday, December 25, 2007
Congress Approves Extension of Mental Health Parity Act
Dec 24, 2007
Congress Wednesday passed legislation extending the Mental Health Parity Act of 1996 until the end of 2008. Included in the Heroes Earnings Assistance and Relief Tax Act of 2007 (H.R. 3997), the extension will prohibit group health plans that provide medical, surgical care and mental health care from imposing coverage limits on mental health coverage that don’t apply to other types of medical treatment, and imposes a $100 fine per day for violations.
The extension does not eliminate a loophole in the 1996 law that allows group health plans to impose higher co-payments, deductibles and coinsurance payments for mental health services. The AHA has long advocated parity for hospital days, outpatient visits, co-pays, deductibles and maximum out-of-pocket costs for in-network services.
Source: AHA News Press Release
Friday, December 21, 2007
Alzheimer's Society Comment On Rights, Risks And Restraints,
Anyone reading this report will draw a sharp intake of breath at some of the appalling examples of restraint, in many cases involving people with dementia.
It is devastating to hear of vulnerable people not being treated with the dignity and respect they deserve.
CSCI's report is right to acknowledge that often there isn't simply one place to lay blame for this abuse, as it is partly a result of an overstretched and under resourced system.
It's all too easy to think that restraint is about belts and shackles. In fact restraint goes far wider: from the thousands of people with dementia being sedated by the inappropriate use of anti psychotic drugs to people being denied access to outdoor space because of a lack of staff in care homes.
Many of the horrendous stories of abuse in the report occurred because of care staff's lack of understanding and training in dementia care. Alzheimer's Society's recent Home from Home report echoed these experiences and we believe mandatory dementia training for staff in all care settings would begin to tackle the huge variation in dementia care.
This report makes tough reading for any involved in or using older people's care services. It should provide a wake up call that we can no longer leave people in the front line of care to cope alone without adequate resources; proper inspection and regulation; and specialist dementia training.
Notes
- The All Party Group in Dementia has announced an inquiry into the overuse of anti psychotic drug treatments in care homes.
- Alzheimer's Society spokespeople are available for comment.
- 700,000 people in the UK have a form of dementia, more than half have Alzheimer's disease. In less than 20 years nearly a million people will be living with dementia. This will soar to 1.7 million people by 2051. 1 in 6 people over 80 have dementia.
- The Alzheimer's Society is the leading care and research charity for people with all forms dementia and their carers. It provides information and education, support for carers, and quality day and home care. It funds medical and scientific research and campaigns for improved health and social services and greater public understanding of dementia.
- The Alzheimer's Society provides a national help line on 0845 3000 336 and website http://www.alzheimers.org.uk
It is devastating to hear of vulnerable people not being treated with the dignity and respect they deserve.
CSCI's report is right to acknowledge that often there isn't simply one place to lay blame for this abuse, as it is partly a result of an overstretched and under resourced system.
It's all too easy to think that restraint is about belts and shackles. In fact restraint goes far wider: from the thousands of people with dementia being sedated by the inappropriate use of anti psychotic drugs to people being denied access to outdoor space because of a lack of staff in care homes.
Many of the horrendous stories of abuse in the report occurred because of care staff's lack of understanding and training in dementia care. Alzheimer's Society's recent Home from Home report echoed these experiences and we believe mandatory dementia training for staff in all care settings would begin to tackle the huge variation in dementia care.
This report makes tough reading for any involved in or using older people's care services. It should provide a wake up call that we can no longer leave people in the front line of care to cope alone without adequate resources; proper inspection and regulation; and specialist dementia training.
Notes
- The All Party Group in Dementia has announced an inquiry into the overuse of anti psychotic drug treatments in care homes.
- Alzheimer's Society spokespeople are available for comment.
- 700,000 people in the UK have a form of dementia, more than half have Alzheimer's disease. In less than 20 years nearly a million people will be living with dementia. This will soar to 1.7 million people by 2051. 1 in 6 people over 80 have dementia.
- The Alzheimer's Society is the leading care and research charity for people with all forms dementia and their carers. It provides information and education, support for carers, and quality day and home care. It funds medical and scientific research and campaigns for improved health and social services and greater public understanding of dementia.
- The Alzheimer's Society provides a national help line on 0845 3000 336 and website http://www.alzheimers.org.uk
BenefitsCheckUp Has Served Two Million Seniors
BenefitsCheckUp(R), the nation's most comprehensive online benefits screening service for seniors with limited income and resources, served its two millionth senior as of this month.
Historically, no more than half of older Americans who are eligible for these needed programs ever apply for them. For example, 70 percent of those qualified for food stamps have not enrolled in the program and nearly half of those who qualify for supplemental security income (SSI) have not applied. Similarly, there are still as many as 4.2 million who have not enrolled in the extra help available through Medicare prescription drug coverage.
Developed and maintained by The National Council on Aging (NCOA), BenefitsCheckUp® enables seniors with limited income and resources as well as those who care for or serve them to screen for and in some cases apply for federal, state and local benefits programs.
BenefitsCheckUp® includes more than 1,550 public and private benefits programs from all 50 states and the District of Columbia. These programs include health care, prescription drug assistance, heating and energy assistance, legal services, housing assistance, property tax programs and nutrition programs, as well as volunteer and training opportunities and education programs.
Since its inception in 2001, BenefitsCheckUp® has helped two million seniors determine eligibility for these programs and has identified over $5.8 billion in public benefits...
See http://www.ncoa.org/content.cfm?sectionID=305
Historically, no more than half of older Americans who are eligible for these needed programs ever apply for them. For example, 70 percent of those qualified for food stamps have not enrolled in the program and nearly half of those who qualify for supplemental security income (SSI) have not applied. Similarly, there are still as many as 4.2 million who have not enrolled in the extra help available through Medicare prescription drug coverage.
Developed and maintained by The National Council on Aging (NCOA), BenefitsCheckUp® enables seniors with limited income and resources as well as those who care for or serve them to screen for and in some cases apply for federal, state and local benefits programs.
BenefitsCheckUp® includes more than 1,550 public and private benefits programs from all 50 states and the District of Columbia. These programs include health care, prescription drug assistance, heating and energy assistance, legal services, housing assistance, property tax programs and nutrition programs, as well as volunteer and training opportunities and education programs.
Since its inception in 2001, BenefitsCheckUp® has helped two million seniors determine eligibility for these programs and has identified over $5.8 billion in public benefits...
See http://www.ncoa.org/content.cfm?sectionID=305
Thursday, December 20, 2007
Serious Nursing Home Citations Increased By 22% Over Six Years, According To Analysis
The number of nursing homes nationwide that were cited for placing residents in "immediate jeopardy" increased by 22% from 2000 to 2006, according to a USA Today analysis of CMS records. The citations are the most serious reprimand inspectors can issue and often follow cases in which residents have been physically or sexually abused or did not receive their medications, USA Today reports. Nursing homes that are cited for immediate jeopardy may be fined or prohibited from accepting new Medicaid beneficiaries, "a major source of their income," USA Today reports.
The analysis found that inspectors in 2006 identified nearly 2,000 violations that jeopardized residents at about 850 of the 16,000 nursing homes across the U.S. Those violations account for about 6% of total violations found in nursing homes. CMS records for 2007, which are incomplete, show that more than 1,300 immediate jeopardy citations have been issued.
The analysis found that inspectors in 2006 identified nearly 2,000 violations that jeopardized residents at about 850 of the 16,000 nursing homes across the U.S. Those violations account for about 6% of total violations found in nursing homes. CMS records for 2007, which are incomplete, show that more than 1,300 immediate jeopardy citations have been issued.
Monday, December 17, 2007
Hillary and Harkin Introduce Bill to Force Disclosure of Names of Worst Nursing Homes
As someone with a parent in a nursing home, I am very glad to learn that Hillary Clinton and Tom Harkin (D-IA) have introduced a bill "that would force a federal agency to make public its list of the nation's worst nursing homes."
The U.S. Centers for Medicare and Medicaid Services has compiled a list of 128 nursing homes that have repeatedly fallen in and out of compliance with government health and safety regulations and caused harm to their residents. Those so-called "special-focus facilities" are now subject to more frequent government inspections.
Two weeks ago, the agency released an abbreviated, public version of the list that identified only 52 of the facilities. The agency refused to release the full list of 128 homes, even though it had already provided the full list to nursing home association lobbyists at the American Health Care Association.
Home-Centered Health Care
ike Magee is author of eight books, including Health Politics: Power, Populism and Health. He directs healthcommentary.org, and serves as a member of the National Commission for Quality Long Term Care. We discuss his latest book, Home-Centered Health Care, which argues that the quality of health care can be dramatically improved, and costs contained, by re-building health management around electronic patient records and home-based electronic medical monitoring.
Maryland Appeals Court Ruling Could Broaden Medicaid Eligibility Standards For Elder Care
The Maryland Court of Special Appeals last month ruled that some Medicaid eligibility standards used by the Department of Health and Mental Hygiene were stricter than federal laws allow, and advocates hope the broad standards outlined in the case will be applied universally, the Baltimore Sun reports. The lawsuit was filed by Diane Byus on behalf of her mother, Ida Brown, after Brown was diagnosed with Alzheimer's disease and was unable to receive assistance through the Older Adults Waiver Program, a Medicaid program designed to provide services such as nursing and adult day care.
Maryland limits eligibility in the program to residents older than age 50 who have incomes less than $1,869 a month and require daily care from licensed health care professionals. Although Brown, who also has several chronic conditions, requires daily monitoring, she does not require constant care from a physician or nurse, the Sun reports. Attorneys from the Legal Aid Bureau and AARP argued in the case that state and federal laws limit eligibility to residents who regularly require "health-related care and services," such as those that could be provided in a nursing home, but not necessarily daily by a skilled nurse.
Maryland limits eligibility in the program to residents older than age 50 who have incomes less than $1,869 a month and require daily care from licensed health care professionals. Although Brown, who also has several chronic conditions, requires daily monitoring, she does not require constant care from a physician or nurse, the Sun reports. Attorneys from the Legal Aid Bureau and AARP argued in the case that state and federal laws limit eligibility to residents who regularly require "health-related care and services," such as those that could be provided in a nursing home, but not necessarily daily by a skilled nurse.
Saturday, December 15, 2007
NCQLTC Releases Final Report
By bringing together government and academic leaders, consumer advocates and experts from the front lines, we’re working to lay out real solutions to the pressing questions shaping how an aging generation will live:
Friday, December 14, 2007
Elder care plan defied on 2 fronts
New Hampshire's 10 counties are waiting for a judge to decide if they must follow a new state law that requires them to take over the state's share of long-term care services for poor, frail elders.
The lawsuit won't be heard until mid-winter, but some House members have already crafted an insurance plan - legislation that would remove the counties from the nursing home business, leaving the state with the bill.
The move is the latest development in a complicated debate that's spanned nearly a decade. At issue is how New Hampshire should subsidize elder care for the thousands of poor seniors living in nursing homes or receiving health care services in their communities.
Report on the 2006 AARP National Survey of Reverse Mortgage Shoppers
Results of the first nationally representative survey of reverse mortgage shoppers—older homeowners who have gone through reverse mortgage counseling and either taken out a loan or decided not to do so—are presented in this AARP Public Policy Institute (PPI) Research Report by Donald L. Redfoot of PPI, Ken Scholen of the AARP Foundation, and S. Kathi Brown of AARP Knowledge Management. This survey provides the first detailed look at consumer interest in reverse mortgages, consumer experiences with lenders and counselors, why some consumers decide against these loans, how borrowers use the loan proceeds, and how well reverse mortgages address borrower needs.
Wednesday, December 12, 2007
The Democratic “Invisible Army of Caregivers”
Senator Hillary Clinton released her awaited ”Long-Term Care Agenda” this past week, joining her fellow lead democratic candidates Barack Obama and John Edwards with a plan for how to deal with the rising needs of seniors and caregivers around the country.
Caregiver Education and Support Programs Provide Positive Impact
White Paper Abstract: According to statistics by the Family Caregiver Alliance, approximately 52 million informal and family caregivers provide care to an adult that is ill or disabled in the United States. The majority of caregivers are 35 to 64 years old, and an estimated 60 percent are also working outside the home. A proactive approach to this growing dilemma through caregiver education and support programs allows employers to provide an invaluable benefit, while increasing employee loyalty and productivity.
Please fill out the registration form below to receive "Caregiver Education and Support Programs Provide Positive Impact" [Note: Incomplete and invalid forms will not be processed.]
Top Holiday gifts for those with Dementia
I'm sure if you have a loved-one with Alzheimers, what to get them as a gift can be difficult. Here are some excellent suggestions.
Top Holiday Gifts For Those With Dementia
By Susan Berg
Over 5 million Americans are living with Alzheimer's disease or a related dementia. Buying a gift for them for the holidays is not difficult if you keep a few things in mind.
First you should know the persons likes and dislikes. Also important is knowing their strengths and weaknesses. In addition consider, when purchasing a gift for someone with dementia, keeping their mind and body active. Also think about a gift that will keep on giving long after Christmas, Chanukah, Kwanza or other celebrated holidays are gone Keep in mind, also, that gift selections should change as Alzheimer's disease or another dementia, progress
Gifts that keep dementia persons' mind active
S.1577 - Patient Safety and Abuse Prevention Act of 2007
A bill to amend titles XVIII and XIX of the Social Security Act to require screening, including national criminal history background checks, of direct patient access employees of skilled nursing facilities, nursing facilities, and other long-term care facilities and providers, and to provide for nationwide expansion of the pilot program for national and State background checks on direct patient access employees of long-term care facilities or providers.
Monday, December 10, 2007
SenseCam Aids Patients with Memory Problems
"A small digital camera developed by Microsoft Research could boost memory in people with dementia and possibly mild forms of Alzheimer's disease. SenseCam is worn around the neck and automatically takes a wide-angle, low-resolution photograph every 30 seconds. It contains an accelerometer to stabilize the image and reduce blurriness, and it can be configured to take pictures in response to changes in movement, temperature, or lighting. An entire day's events can be captured and downloaded onto a PC where software converts the pictures into a short movie displaying the images at up to 10 frames per second, to allow patients to view a day's events in a few minutes to jolt their memory. "Not only does SenseCam allow people to recall memories while they are looking at the images, which in itself is wonderful, but after an initial period of consolidation, it appears to lead to long-term retention of memories over many months, without the need to view the images repeatedly," says neuropsychologist Emma Berry."
Caregiver Candidates
According to an article from AARP, and number of the current political candidates are caregivers themselves.
For example, Hillary Clinton’s mother lives with her in her Washington, DC home, and, Elizabeth Edwards, wife of American Democratic presidential hopeful, John Edwards has aging parents in long term care.
I have no idea how that fact may or may not shape their policies, but, I like seeing how they are real people who face some of the same things we do. Even though they may have more resources than we regular folks have, there is a universal emotional and time impact that caring for an aging parent enacts.
Friday, December 7, 2007
Grassley Seeks Probe On Antipsychotic Use In Nursing Homes
Sen. Chuck Grassley (R-Iowa) in a letter on Tuesday asked HHS Inspector General Daniel Levinson to examine the use of antipsychotics in nursing homes, the possibility of payments to physicians who prescribe the medications and the drugs' cost to Medicare and Medicaid, the Wall Street Journal reports. According to a Journal article published on Tuesday, which Grassley cited in the letter, antipsychotics have become the most expensive class of medications for Medicaid. Nursing homes often administer the medications to dementia patients to quiet their symptoms.
In 2005, Medicaid spent $5.4 billion on atypical antipsychotics, not including rebates that the federal government might receive. Grassley also asked CMS for information about how the agency responds to nursing homes that misuse antipsychotics, a practice he called "disturbing and alarming."
In 2005, Medicaid spent $5.4 billion on atypical antipsychotics, not including rebates that the federal government might receive. Grassley also asked CMS for information about how the agency responds to nursing homes that misuse antipsychotics, a practice he called "disturbing and alarming."
Update on Medicare Therapy Caps and ADA Restoration Act
MS Exceptions Set to Expire on Medicare Therapy Caps
Rehabilitation therapy under Medicare might no longer be affordable for some people living with multiple sclerosis and other conditions. The exceptions process to Medicare's arbitrary reimbursement limits, or therapy caps, on rehabilitation services is set to expire on December 31, 2007.
MS activists have long been determined to eliminate Medicare therapy caps altogether on reimbursement for physical therapy (PT), speech language pathology, and occupational therapy (OT) services. In 2008, the therapy cap reimbursement level is scheduled to be $1,810 for PT and speech therapy, and a separate cap of $1,810 will apply to OT services.
Rehabilitation therapy under Medicare might no longer be affordable for some people living with multiple sclerosis and other conditions. The exceptions process to Medicare's arbitrary reimbursement limits, or therapy caps, on rehabilitation services is set to expire on December 31, 2007.
MS activists have long been determined to eliminate Medicare therapy caps altogether on reimbursement for physical therapy (PT), speech language pathology, and occupational therapy (OT) services. In 2008, the therapy cap reimbursement level is scheduled to be $1,810 for PT and speech therapy, and a separate cap of $1,810 will apply to OT services.
Wednesday, December 5, 2007
Nursing Homes Often Medicate Residents Without Psychosis
"In recent years, Medicaid has spent more money on antipsychotic drugs for Americans than on any other class of pharmaceuticals," largely because nursing homes are "giving these drugs to elderly patients to quiet symptoms of Alzheimer's disease and other forms of dementia" -- conditions for which the drugs are not approved by FDA, the Wall Street Journal reports. According to CMS, 21% of nursing home residents who do not have a diagnosis of psychosis are prescribed antipsychotic drugs. "The growing off-label use of antipsychotic medicines in the elderly is coming under fire from regulators, academics, patient advocates and even some in the nursing home industry," the Journal reports.
Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging -- a not-for-profit industry group -- said, "You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they're out of it, and that is unacceptable." According to Teigland, her research shows about one-third of dementia patients in nursing homes in New York state are receiving antipsychotics, with some facilities dispensing the drugs at rates as high as 60% to 70% of patients.
Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging -- a not-for-profit industry group -- said, "You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they're out of it, and that is unacceptable." According to Teigland, her research shows about one-third of dementia patients in nursing homes in New York state are receiving antipsychotics, with some facilities dispensing the drugs at rates as high as 60% to 70% of patients.
Aging is a Business and Economic Issue
Like other CEOs, I’m concerned about stemming “brain drain” amid a mass retirement and experience exodus in Minnesota.But a more immediate economic and competitiveness issue is how to deliver and pay for senior care to assist our current employees who are dealing with their aging parents. Absent innovation, the human and financial costs of a much larger, longer-living senior society will weaken other investments designed to enhance Minnesota’s competitiveness and make this state livable for a lifetime.
If my 86-year-old mother-in-law suffered a significant medical event that required care, I would have the luxury of being able to call upon any number of experts within Ecumen for guidance on what to do next, so she could live as fully and independently as possible.
Tuesday, December 4, 2007
Kerrey Joins Gingrich On Plan for Elderly Care
WASHINGTON — The Democratic head of the New School and a Republican former House speaker are urging presidential candidates to take up the issue of long-term care for elderly Americans, a problem that they warn will worsen with the retirement of the baby boom generation in the coming decades.
Bob Kerrey, the university president and a former Nebraska senator, joined with Newt Gingrich yesterday to release a 94-page report calling for a federal overhaul of the long-term care system that would be financed with a combination of public and private dollars.
Monday, December 3, 2007
Laguna Honda Settlement Creates Community Services
FOR IMMEDIATE RELEASE
Contact:Barbara Duncan
Director of Communications
Protection & Advocacy, Inc. (CA) c/o NDR
Phone: (510) 267-1256
E-Mail: Barbara.Duncan@pai-ca.org
November 28, 2007
Settlement of San Francisco lawsuit to create new community services for
seniors and adults with disabilities
SAN FRANCISCO, CA-Mitch Katz, San Francisco's director of public health,
announced today that a preliminary settlement has been reached in the civil
rights class action regarding expanded community-based living options for
seniors and people with disabilities in San Francisco (Chambers et al. v.
the City and County of San Francisco). The results will be improved
coordination of care and greatly increased housing options and other
services.
The new program, called "Success at Home" will provide people with "a single
door to independent living," said Katz. "We are very pleased to be taking
this innovative next step."
Mark Chambers, a plaintiff in the lawsuit, who has lived in Laguna Honda
Hospital and Rehabilitation Center since receiving a head injury in 1999,
was delighted to hear that he is about to be given the opportunity "to live
in the world." He hopes to be first in line to qualify for one of the 500
units of accessible housing to be found or modified in San Francisco over
the next five years and made affordable by subsidy from the new program.
Elissa Gershon, lead attorney from the Oakland office of Protection &
Advocacy, Inc., counsel in the lawsuit, said that "San Francisco now stands
to regain its progressive edge in disability rights implementation."
Success at Home
Anne Hinton, director of San Francisco's Department of Aging and Adult
Services, which will jointly manage the program with the San Francisco
Department of Public Health said that "Success at Home puts San Francisco in
the forefront of independent living services." The program enables San
Franciscans with disabilities to receive community-based housing and
services to live in the most integrated setting appropriate instead of in an
institution. Eligible individuals will be assessed for, referred to, and
provided with federally subsidized medical services, subsidized housing,
attendant and nursing care, case management, vocational rehabilitation,
substance abuse treatment, mental health services and assistance with meals.
Hinton said "This new single point of entry will also mean community
transition services will be tailored to individual needs and preferences."
Transition services will be coordinated by an individualized Community
Living Plan. Medi-Cal qualified residents of Laguna Honda Hospital and
Rehabilitation Center, those who have been discharged in the last two years
or are on a waiting list for the facility, and patients at San Francisco
General Hospital will be assessed for services.
Herb Levine, director of the San Francisco Independent Living Resource
Center, the organizational plaintiff in the case, commented that he is
"looking forward to the new collaboration between the City and community
service organizations to achieve independence and community living for
hundreds of seniors and people with disabilities." The settlement sets out a
five year timeline for implementation of the new services.
New directions
Paralleling the introduction of new community services, the Laguna Honda
facility will begin to emphasize short-term rehabilitation as one of its
goals. In addition, several hundred Medi-Cal Home and Community-Based waiver
slots, which will allow people to receive long-term health care in their
homes, will be made available to those who qualify, which should bring
millions of dollars in federal and state Medicaid funding to San Francisco.
Summary
The preliminary settlement of the case is awaiting approval by the Board of
Supervisors, the Health Commission, and the Court. Individual plaintiffs are
six residents of Laguna Honda; organizational plaintiff is the Independent
Living Resource Center of San Francisco. Co-counsel on the case are
Protection & Advocacy, Inc., Disability Rights Education and Defense Fund,
AARP Foundation Litigation, the Bazelon Center for Mental Health Law, and
the law firm of Howrey LLP, pro bono.
###
NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List
http://www.adapt.org
Contact:Barbara Duncan
Director of Communications
Protection & Advocacy, Inc. (CA) c/o NDR
Phone: (510) 267-1256
E-Mail: Barbara.Duncan@pai-ca.org
November 28, 2007
Settlement of San Francisco lawsuit to create new community services for
seniors and adults with disabilities
SAN FRANCISCO, CA-Mitch Katz, San Francisco's director of public health,
announced today that a preliminary settlement has been reached in the civil
rights class action regarding expanded community-based living options for
seniors and people with disabilities in San Francisco (Chambers et al. v.
the City and County of San Francisco). The results will be improved
coordination of care and greatly increased housing options and other
services.
The new program, called "Success at Home" will provide people with "a single
door to independent living," said Katz. "We are very pleased to be taking
this innovative next step."
Mark Chambers, a plaintiff in the lawsuit, who has lived in Laguna Honda
Hospital and Rehabilitation Center since receiving a head injury in 1999,
was delighted to hear that he is about to be given the opportunity "to live
in the world." He hopes to be first in line to qualify for one of the 500
units of accessible housing to be found or modified in San Francisco over
the next five years and made affordable by subsidy from the new program.
Elissa Gershon, lead attorney from the Oakland office of Protection &
Advocacy, Inc., counsel in the lawsuit, said that "San Francisco now stands
to regain its progressive edge in disability rights implementation."
Success at Home
Anne Hinton, director of San Francisco's Department of Aging and Adult
Services, which will jointly manage the program with the San Francisco
Department of Public Health said that "Success at Home puts San Francisco in
the forefront of independent living services." The program enables San
Franciscans with disabilities to receive community-based housing and
services to live in the most integrated setting appropriate instead of in an
institution. Eligible individuals will be assessed for, referred to, and
provided with federally subsidized medical services, subsidized housing,
attendant and nursing care, case management, vocational rehabilitation,
substance abuse treatment, mental health services and assistance with meals.
Hinton said "This new single point of entry will also mean community
transition services will be tailored to individual needs and preferences."
Transition services will be coordinated by an individualized Community
Living Plan. Medi-Cal qualified residents of Laguna Honda Hospital and
Rehabilitation Center, those who have been discharged in the last two years
or are on a waiting list for the facility, and patients at San Francisco
General Hospital will be assessed for services.
Herb Levine, director of the San Francisco Independent Living Resource
Center, the organizational plaintiff in the case, commented that he is
"looking forward to the new collaboration between the City and community
service organizations to achieve independence and community living for
hundreds of seniors and people with disabilities." The settlement sets out a
five year timeline for implementation of the new services.
New directions
Paralleling the introduction of new community services, the Laguna Honda
facility will begin to emphasize short-term rehabilitation as one of its
goals. In addition, several hundred Medi-Cal Home and Community-Based waiver
slots, which will allow people to receive long-term health care in their
homes, will be made available to those who qualify, which should bring
millions of dollars in federal and state Medicaid funding to San Francisco.
Summary
The preliminary settlement of the case is awaiting approval by the Board of
Supervisors, the Health Commission, and the Court. Individual plaintiffs are
six residents of Laguna Honda; organizational plaintiff is the Independent
Living Resource Center of San Francisco. Co-counsel on the case are
Protection & Advocacy, Inc., Disability Rights Education and Defense Fund,
AARP Foundation Litigation, the Bazelon Center for Mental Health Law, and
the law firm of Howrey LLP, pro bono.
###
NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List
http://www.adapt.org
Upstairs Solutions
Welcome to Upstairs Solutions LTC, your all-in-one resource for comprehensive on-line training and compliance for senior care professionals.
As a provider-owner company, we understand the obstacles that you face and the many staffing needs that you encounter every day. That’s why we’ve developed:
Sunday, December 2, 2007
Candidates as Caregivers
As the presidential candidates crisscrossed the early-primary states in recent months, Americans facing the challenges of long-term care might have wondered about the contenders' own experiences with their parents. And more important, how have those experiences helped shape the candidates' policies on the way families provide and receive long-term care?
Universally, the candidates have made the best of the varied situations they've been dealt. And from these encounters have emerged a variety of proposals that range from neighborhood networks to many ways government should or shouldn't help.
Hospitalizations and Deaths Caused by Methicillin-Resistant Staphylococcus aureus, United States, 1999-2005
Hospitalizations related to methicillin-resistant Staphylococcus aureus (MRSA) infections more than doubled, from 127,000 to nearly 280,000, between 1999 and 2005, according to a new study in the December issue of the journal Emerging Infectious Diseases. During that same period, hospitalizations of patients with general staph infections increased 62 percent across the country.
Assisted Living Facilities In-service Curriculum offered Online
I’ve just discoverdd an organization called Care2Learn that offers online in-service training - for assisted living facilities nationwide that was developed for the purpose of educating, training, testing, reporting and tracking continuing education for employees in post-acute healthcare.
Their new assisted living curricula offers 87 in-services....Friday, November 30, 2007
AMA adopts new policies on disabled patient care
AMA supports reforms for disabled patients: The AMA passed new policy supporting Medicaid reforms that would provide disabled patients with equal access to home and community-based services so that they can live as independently as possible. The AMA supports passage of congressional legislation, the Community Choice Act of 2007, that would achieve these goals. This policy was recommended to the AMA by the American Academy of Physical Medicine and Rehabilitation and the American Association of Neuromuscular and Electrodiagnostic Medicine.
“People with disabilities who rely on Medicaid should not have to choose between the important care they need and the ability to live independently,” said AMA Board Member Rebecca J. Patchin, MD. “We support Medicaid reforms so that disabled patients, together with their physicians, can decide where the best place is to receive medical care and support based on patients’ individual needs.”
Thursday, November 29, 2007
WSJ Examines Increasing Efforts To Assist Care Providers
The Wall Street Journal on Wednesday examined efforts to provide assistance to an estimated 45 million adults in the U.S. who care for a family member with a severe or long-term illness. According to the Journal, "care giving responsibilities can exact a drastic emotional, physical and financial toll" on people who look after an ill or aging relative, which can lead to "high rates of depression, stress and other physical and mental health problems."
However, the Journal notes that increasing evidence has shown that caregivers can better handle their responsibilities and the accompanying stress when they are provided with counseling and support group opportunities, in-home skills training and additional help. Some advocacy groups currently are lobbying for increased federal funding for caregiver assistance programs, and some experts are calling for formal evaluation programs that health care groups can use to determine what kind of support caregivers might need, according to the Journal. In addition, more hospitals are offering caregiver services and social worker assistance to family members when their relatives are discharged. Experienced caregivers also are "being tapped to help others new to the role," the Journal reports (Landro, Wall Street Journal, 11/28).
However, the Journal notes that increasing evidence has shown that caregivers can better handle their responsibilities and the accompanying stress when they are provided with counseling and support group opportunities, in-home skills training and additional help. Some advocacy groups currently are lobbying for increased federal funding for caregiver assistance programs, and some experts are calling for formal evaluation programs that health care groups can use to determine what kind of support caregivers might need, according to the Journal. In addition, more hospitals are offering caregiver services and social worker assistance to family members when their relatives are discharged. Experienced caregivers also are "being tapped to help others new to the role," the Journal reports (Landro, Wall Street Journal, 11/28).
Long-Term Service and Supports: The Future Role and Challenges for Medicaid
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This report examines the structure and impact of Medicaid’s role in long-term care. Based on a roundtable discussion of policy makers and experts and drawn from a body of health services research, the report highlights policy challenges facing the Medicaid program today and identifies issues in providing long-term care going forward. By gathering evidence to address key policy issues, such as integrating services, benefit design, quality monitoring and financing, the report can serve as a foundation for the current and ongoing policy debate regarding Medicaid’s future role as a provider of long-term care services and supports for low-income elderly and disabled Americans.
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Wednesday, November 28, 2007
http://www.stickershockmusic.com/2007/11/27/startups-hoping-to-reach-maturity/
A year ago, I couldn’t turn around at startup events without bumping into someone launching a social-networking business.
They knew it was the next big thing and a great opportunity to connect with a young demographic sought by advertisers. Now it seems the market is maturing. Literally.
As in, everywhere I go lately, I meet someone starting a company targeting the older population.
This isn’t about more gadgets for grandma and grandpa.
The new thing is services, online and off, aimed at people entering the senior phase of life and seeking help, advice and tools to navigate the transition.
These entrepreneurs see opportunity to reduce friction and complexity in this market, just as others have done with online travel and retail, using tools and processes honed by tech companies.
Tuesday, November 20, 2007
Managing The Chronic Care Of Patients Is Not Being Captured In Today's Reimbursement System
Full time physicians spend an average of one full day a week providing services for patients that are not reimbursed by Medicare, according to a new study conducted by Jeffrey Farber, MD, Assistant Professor of Geriatrics at The Mount Sinai Medical Center, and published in the journal Annals of Internal Medicine.
The study results could potentially prod insurance companies and Medicare to catch up to physicians' current levels of productivity by reimbursing them for the care that is increasingly taking place outside of formal office visits.
"These services that are going un reimbursed are not unusual or luxury services," explained Dr. Farber. "These are basic elements of good patient care and include such things as talking with adult children, managing pain over the telephone, calling pharmacies, coordinating home care services like physical therapy and visiting nurses, and ordering equipment like canes and wheelchairs."...
The study results could potentially prod insurance companies and Medicare to catch up to physicians' current levels of productivity by reimbursing them for the care that is increasingly taking place outside of formal office visits.
"These services that are going un reimbursed are not unusual or luxury services," explained Dr. Farber. "These are basic elements of good patient care and include such things as talking with adult children, managing pain over the telephone, calling pharmacies, coordinating home care services like physical therapy and visiting nurses, and ordering equipment like canes and wheelchairs."...
Monday, November 19, 2007
AARP: CMS Publication of Poor Performing Nursing Homes a Good First Step
WASHINGTON— AARP Legislative Counsel David Certner made the following statement today in response to the Centers for Medicare and Medicaid (CMS) announcement regarding poor performing nursing homes in the Special Focus Facility (SFF) program:
“Residents in the poorest performing nursing homes and their families have a right to know that the care they receive may be sub-standard. Earlier this year AARP called on CMS to release this information, and we are pleased CMS has agreed. People in need of 24-hour care should not have to be concerned that their nursing home is a potentially harmful environment. This information will also be helpful to individuals and their families who are looking to choose a quality facility.
AHCA Questions for the Candidates
The entire long term care profession is concerned with the way in which long term care will be legislated and regulated in the coming years and is eager to hear how the candidates will address the care needs of an Aging America. AHCA/NCAL encourages the candidates to discuss the long term care needs of our nation and to consider the following questions.
Questions for Presidential Candidates:
- The Medicare and Medicaid systems have come under increasing pressure at a time when the population is aging. Do you believe the U.S. can afford to cut these safety net programs as a means of balancing state and federal budgets?
- Most Americans do not understand that health insurance and Medicare do not cover the cost of long term care services. Presently, nearly two-thirds of the residents in America's nursing homes rely on Medicaid. Do you believe that we need to encourage personal responsibility with the purchase of long term care insurance to take the pressure off the Medicaid program? If yes, how do we achieve this?
- We all know that there are 77 million aging baby boomers rapidly nearing retirement – they have changed every aspect of our culture during their lives, and it is clear that they will also have a significant impact on our long term care system. What should the nation's long term care system look like in order to meet this population's clinical health care needs and very specific preferences?
- With the recent trend to move the frail and elderly out of nursing facilities and into home- and community-based care, what sort of oversight system should be in place to ensure that those vulnerable populations are receiving the care and services they require--and that those services are of a high quality? Do you believe that all individuals who are frail and elderly can receive the around-the-clock care that they may require in the home or community?
- In cases where individuals who are frail and elderly outlive their savings and are too sick to manage on their own, what do you see as the most practical way to pay for their care? Where should they be housed?....
Apathy and Insubordination in Long-Term Care Facilities
The causes of apathy and insubordination in long-term care facilities are numerous. The following article approaches some of these causes with the understanding that the medical care of the residents in these facilities is at stake, and apathy and insubordination undermines efforts to provide medical attention to these individuals. Many long-term care facilities in America today do not staff by acuity of resident needs, and this is one of the leading causes of such apathy and insubordination among staff members. Nurses and Nursing Assistants are left to work with large numbers of residents and a minimum of fellow medical staff, resulting in lack of patient/resident medical treatment.
Another issue is the ever increasing amount of paperwork...AARP Reinvents Its Member Newsletters
ecently AARP began making over its member newsletters, which are customized and distributed in each of the fifty states, along with Washington, D.C., the Virgin Islands, and Puerto Rico. We’ve been editing and producing these newsletters for the past year and a half, and have learned our share of lessons about what works and what falls short.
The goal of the cover story, says Pete Wiley, manager for AARP state member communications, “should be to draw an uninterested member” into a newsletter “in a few seconds.”
Based on AARP’s revamped model, here are guidelines that will help any organization craft a sharper, more sophisticated publication.
- Focus on hard news, not staff picnics. Readers are eager to learn about the ways in which often complex legislation affects them. The redesigned newsletter presents concise stories with digestible facts on long-term care legislation, tax breaks, and various programs for low- and moderate-income residents. Most important, the stories conclude with calls-to-action, including Web links, e-mail addresses, and phone numbers that members can use to learn more.
- Use quotes, and conduct interviews with third-party experts—not internal staff. If Republican and Democratic legislators have cooperated on a bill to improve long-term care,.....
Bill Would Allow Tax-Exempt Long-Term Care Insurance Premium Payments
A bipartisan group of senators last Tuesday introduced a bill that would allow employees to pay long-term care insurance premiums with pre-tax dollars, CQ HealthBeat reports. Under the Long-Term Care Affordability and Security Act -- sponsored by Sens. Chuck Grassley (R-Iowa), Blanche Lincoln (D-Ark.), Olympia Snowe (R-Maine), Debbie Stabenow (D-Mich.) and Gordon Smith (R-Ore.) -- employers could offer long-term care insurance under so-called cafeteria plans, which allow employees to select from a number of tax-exempt benefits, as well as flexible spending accounts.
Transforming Hospitals: Designing for Safety and Quality
Transforming Hospitals: Designing for Safety and Quality, a DVD from the Agency for Healthcare Research and Quality (AHRQ), reviews the case for evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, and employee retention, and results in a positive return on investment.
This summary discusses evidence-based design, patient safety and satisfaction, quality outcomes, staff satisfaction and retention, and cost effectiveness.
Select to order the DVD.
Caring for an elder exacts financial toll
The out-of-pocket cost of caring for an aging parent, spouse or loved one averages about $5,500 a year, according to the nation’s first in-depth study of such expenses, a sum that is more than double previous estimates and more than the average American household spends annually on health care and entertainment combined.
Family members responsible for ailing loved ones provide not only “hands-on” care but often reach into their own pockets to pay for many other expenses of care recipients, including groceries, household goods, drugs, medical co-payments and transportation. That nudges the average cost of providing long-distance care to $8,728 a year.
Sunday, November 18, 2007
Poll Shows Long-Term Care An Issue In Presidential Election
More than eight out of 10 people want long term care included in the agenda of presidential candidates, according to a poll by Public Opinion Strategies and the Mellman Group.
It also showed that nearly 70 percent of respondents have not prepared for the long-term care of their family or themselves. However, half of the polltakers indicated that they have known someone who has needed such care.
The poll results also suggested that Americans are willing to aid in long-term care programs at the state and national levels. More than half of the respondents agreed that payroll deductions for such programs would be allowable.
Friday, November 16, 2007
Washington Scrutinizes Nursing Homes
WASHINGTON, Nov. 15 — Lawmakers in two hearings on Thursday proposed ways to force nursing homes to provide more details about ownership and to hold those owners more accountable when problems emerge.
The hearings were prompted in part by concerns that quality at nursing homes was declining as large chains were acquired by private investment groups.
Members of the House Ways and Means Health Subcommittee and the Senate Special Committee on Aging proposed measures to require nursing homes to disclose ownership and to require regulators to release information about poorly managed homes.
Kerry N. Weems, the acting administrator of the Centers for Medicare and Medicaid Services, which regulates nursing homes, offered several initiatives to improve oversight. His suggestions included releasing the so-called special focus facility list, which identifies homes that regulators consider among the nation’s worst. That list, which will be released Dec. 1, has not been public.Info Long-Term Care
This is a blog developed by a librarian about LTC information. Some interesting articles.
Creating The Most Comprehensive Long-Term Care Database
More than 1.4 million Americans live in nursing homes today. By 2020, an estimated 12 million will need long-term care, whether in a nursing home, assisted living facility, chronic care hospital or from an at-home health service provider.
At this time of skyrocketing demand for long-term care, the National Institute on Aging has awarded Brown University a major grant to create the first research database aimed at improving the nation's long-term care system -- and the lives of the elderly who rely on that system to eat, take medications and carry out other tasks of daily living.
Vincent Mor, chairman of the Department of Community Health at Brown and a member of the University's Center for Gerontology and Health Care Research, is principal investigator on the five-year, $10-million grant. Mor and his team will take existing federal data on Medicare reimbursement claims, patient hospitalization rates and other data and combine it with new information the team will collect on the health status of residents, reimbursement rates for long-term care services, the organization of those services, and other topics from a random sample of 2,600 nursing homes across the country. The group will also collect information on relevant policies from all 50 states.
At this time of skyrocketing demand for long-term care, the National Institute on Aging has awarded Brown University a major grant to create the first research database aimed at improving the nation's long-term care system -- and the lives of the elderly who rely on that system to eat, take medications and carry out other tasks of daily living.
Vincent Mor, chairman of the Department of Community Health at Brown and a member of the University's Center for Gerontology and Health Care Research, is principal investigator on the five-year, $10-million grant. Mor and his team will take existing federal data on Medicare reimbursement claims, patient hospitalization rates and other data and combine it with new information the team will collect on the health status of residents, reimbursement rates for long-term care services, the organization of those services, and other topics from a random sample of 2,600 nursing homes across the country. The group will also collect information on relevant policies from all 50 states.
Thursday, November 15, 2007
FDA Seeks To Include Those Most Affected By Alzheimer's Disease In The Drug Review Process
The U.S. Food and Drug Administration (FDA) has expanded its Patient Consultant and Patient Representative programs to include individuals in the early stages of Alzheimer's disease and their caregivers. The FDA made the change in response to a request by the Alzheimer's Association encouraging the agency to give people directly affected by Alzheimer's a more active role in the review and approval of new Alzheimer drugs.
"People who are living with this terrible disease have much to offer to the pharmaceutical industry, researchers and government regulators, and their voices must be heard," said Harry Johns, president and CEO of the Alzheimer's Association. "We are pleased that the FDA understands the value of involving Alzheimer families in regulatory decisions that affect them and appreciate that the agency was so responsive in expanding their patient consultant program."
"People who are living with this terrible disease have much to offer to the pharmaceutical industry, researchers and government regulators, and their voices must be heard," said Harry Johns, president and CEO of the Alzheimer's Association. "We are pleased that the FDA understands the value of involving Alzheimer families in regulatory decisions that affect them and appreciate that the agency was so responsive in expanding their patient consultant program."
Stark Announces Hearing on Trends in Nursing Home Ownership and Quality
House Ways and Means Health Subcommittee Chairman Pete Stark (D-CA) announced today that the Subcommittee will hold a hearing to examine the effect of nursing home ownership trends on nursing home quality and accountability. The hearing will take place at 10:00 a.m. on Thursday, November 15, 2007, in Room 1100, Longworth House Office Building.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Subcommittee and for inclusion in the printed record of the hearing.
Wednesday, November 14, 2007
AMA Adopts New Policies On Disabled Patient Care
AMA supports reforms for disabled patients: The AMA passed new policy supporting Medicaid reforms that would provide disabled patients with equal access to home and community-based services so that they can live as independently as possible. The AMA supports passage of congressional legislation, the Community Choice Act of 2007, that would achieve these goals. This policy was recommended to the AMA by the American Academy of Physical Medicine and Rehabilitation and the American Association of Neuromuscular and Electrodiagnostic Medicine.
"People with disabilities who rely on Medicaid should not have to choose between the important care they need and the ability to live independently," said AMA Board Member Rebecca J. Patchin, MD. "We support Medicaid reforms so that disabled patients, together with their physicians, can decide where the best place is to receive medical care and support based on patients' individual needs."
"People with disabilities who rely on Medicaid should not have to choose between the important care they need and the ability to live independently," said AMA Board Member Rebecca J. Patchin, MD. "We support Medicaid reforms so that disabled patients, together with their physicians, can decide where the best place is to receive medical care and support based on patients' individual needs."
Choice Cuts Costs in Medicaid Programs
States are finding choice is one way to cut costs as America ages.
Policymakers are learning citizens want choice when it comes to long-term care of the graying population.
Marc Gold, director of the Promoting Independence Initiative in the Texas Department of Aging and Disability Services, said the cost of nursing home care is about twice the cost of similar services in community-based care.
“Community care is not only about human choice, not only about individual choice, not only about quality of life, or quality of care,” he said. “Not only is it the preferred model. It’s about saving money.”
Tuesday, November 13, 2007
Dirty Dealings
With that brief background of Antitrust law in mind, what do you folks think about this little deal between Omnicare and Manor Care?
Omnicare and Manor Care formed a partnership on February 16, 1994, called Heartland Healthcare Services. The partnership is still in place, and is operated through a management committee consisting of three Manor Care Executives and three Omnicare Executives (Manor Care 2006 10K).
In its short history, Heartland has established an institutional pharmacy in Toledo, Ohio supporting Ohio and Michigan HCR facilities and two institutional pharmacies in Florida serving HCR and other long-term facilities.
This cozy partnership also includes the Heartland Repack Services, which they recently shut down after a fire, a massive recall (119 pages of recalled drug NDCs), and a damning FDA Warning Letter. - Related Article: Repackager's Recall Could Lead to FDA Visit.
Omnicare contracted with Cardinal to handle Heartland's Repackaging.
Earlier this year, Manor Care agreed to be acquired by private-equity giant Carlyle Group in a $6.3 billion deal (Manor Care Finds a Buyer). In this deal Manor Care will be absorbed by a Carlyle Group entity, ManorCare Health Services, Inc. ("MCHS") (Special Meeting Demand).
But now,what seemed to be a done deal, is coming under increased scrutiny - Florida lawmakers and a union are questioning a private equity firm's pending purchase of the nation's largest nursing home chain.
We learned recently that UnitedHealth received a Subpoena regarding Omnicare patient steering. You don't suppose that subpoena has anything to do with the Heartland partnership?
Do you suppose this Heartland partnership violates anti-trust laws? Do you think that the Long term Care Facilities which make up this partnership might be more than happy to pay inflated prices for drugs which are provided through this little off-the-books joint venture?
Omnicare and Manor Care formed a partnership on February 16, 1994, called Heartland Healthcare Services. The partnership is still in place, and is operated through a management committee consisting of three Manor Care Executives and three Omnicare Executives (Manor Care 2006 10K).
In its short history, Heartland has established an institutional pharmacy in Toledo, Ohio supporting Ohio and Michigan HCR facilities and two institutional pharmacies in Florida serving HCR and other long-term facilities.
This cozy partnership also includes the Heartland Repack Services, which they recently shut down after a fire, a massive recall (119 pages of recalled drug NDCs), and a damning FDA Warning Letter. - Related Article: Repackager's Recall Could Lead to FDA Visit.
Omnicare contracted with Cardinal to handle Heartland's Repackaging.
Earlier this year, Manor Care agreed to be acquired by private-equity giant Carlyle Group in a $6.3 billion deal (Manor Care Finds a Buyer). In this deal Manor Care will be absorbed by a Carlyle Group entity, ManorCare Health Services, Inc. ("MCHS") (Special Meeting Demand).
But now,what seemed to be a done deal, is coming under increased scrutiny - Florida lawmakers and a union are questioning a private equity firm's pending purchase of the nation's largest nursing home chain.
We learned recently that UnitedHealth received a Subpoena regarding Omnicare patient steering. You don't suppose that subpoena has anything to do with the Heartland partnership?
Do you suppose this Heartland partnership violates anti-trust laws? Do you think that the Long term Care Facilities which make up this partnership might be more than happy to pay inflated prices for drugs which are provided through this little off-the-books joint venture?
American Association For Homecare Disputes Validity Of Internet Power Wheelchair Prices
The American Association for Homecare vigorously disputed the validity of using Internet prices for power wheelchairs as a basis for setting reimbursement rates for power wheelchairs provided to seniors and disabled beneficiaries in Medicare.
The Association outlined its concerns in letters sent to Daniel Levinson, Inspector General for the U.S. Department of Health and Human Services Office of Inspector General (OIG), and to Congressman Pete Stark (D-Calif.), who chairs the House Ways and Means Subcommittee on Health.
On October 30, the OIG issued a report titled, "A Comparison of Medicare Program and Consumer Internet Prices for Power Wheelchairs," which concluded that, "Medicare and its beneficiaries could have achieved savings during the first quarter of 2007 had Medicare reimbursements more closely resembled prices available to consumers over the Internet." AAHomecare strongly questions the appropriateness of the OIG comparison and its policy implications for Medicare reimbursement rates.
Tyler J. Wilson, president of the American Association for Homecare, commented, "This study and the inappropriate comparison of Medicare and Internet pricing will be used by some members of Congress to justify further cuts to power wheelchair Medicare reimbursement rates and defend the new competitive bidding program. We urge Congress to evaluate Medicare reimbursement for power wheelchairs in the correct context."
In today's letters to both Inspector General Levinson and Congressman Stark, the Association made several points:....
The Association outlined its concerns in letters sent to Daniel Levinson, Inspector General for the U.S. Department of Health and Human Services Office of Inspector General (OIG), and to Congressman Pete Stark (D-Calif.), who chairs the House Ways and Means Subcommittee on Health.
On October 30, the OIG issued a report titled, "A Comparison of Medicare Program and Consumer Internet Prices for Power Wheelchairs," which concluded that, "Medicare and its beneficiaries could have achieved savings during the first quarter of 2007 had Medicare reimbursements more closely resembled prices available to consumers over the Internet." AAHomecare strongly questions the appropriateness of the OIG comparison and its policy implications for Medicare reimbursement rates.
Tyler J. Wilson, president of the American Association for Homecare, commented, "This study and the inappropriate comparison of Medicare and Internet pricing will be used by some members of Congress to justify further cuts to power wheelchair Medicare reimbursement rates and defend the new competitive bidding program. We urge Congress to evaluate Medicare reimbursement for power wheelchairs in the correct context."
In today's letters to both Inspector General Levinson and Congressman Stark, the Association made several points:....
LTC reform bill introduced in House
The level of discourse about improving the quality of long-term care rose to a new level Tuesday, when three members of the U.S. House introduced the Long Term Care Quality & Modernization Act of 2007 (H.R. 4082). Although there are no illusions in the provider community about quick passage for the sweeping reform measure, its unveiling had been anxiously anticipated since a companion bill was unveiled in the Senate in early August.
Nursing Home Residents Who Receive Eyeglasses For Correcting Poor Vision Experience Less Depression
A nursing home resident who gets eyeglasses for uncorrected refractive error is less likely to suffer from depression than one with refractive error who did not receive eyeglasses, according to an article in Archives of Ophthalmology (JAMA/Archives), November edition.
Refractive error results in blurred vision - the back of the eye does not get the right amount of light.
The authors explain "Nursing home residents in the United States and other industrialized countries have high rates of vision impairment, with estimates ranging from three to 15 times higher than corresponding rates for community-dwelling older adults. Studies suggest that vision impairment in about one-third of nursing home residents could largely be reversed by treatment of uncorrected refractive error (myopia [nearsightedness], hyperopia [farsightedness], presbyopia [loss of focus])."
Cynthia Owsley, Ph.D., M.S.P.H., University of Alabama at Birmingham, and team carried out a trial involving 142 nursing home residents, aged 55 or more. 78 residents were randomly assigned to a group that would get eyeglasses one week after check-up, while 64 received eyeglasses two months after check up (at follow-up). At two months vision-related quality of life and depressive symptoms were measured at baseline.
At baseline the two groups had similar demographic and medical characteristics - they also had similar visual acuteness and refractive error uncorrected by eyeglasses. Two months later, distance and near visual acuity for both left and right eyes improved in the group that had been given eyeglasses, while the other group had no improvement in visual acuity.
During the two-month follow-up, the eyeglass group had better scores for general vision, reading, activities/hobbies and social interaction - they also displayed fewer depressive symptoms.
Refractive error results in blurred vision - the back of the eye does not get the right amount of light.
The authors explain "Nursing home residents in the United States and other industrialized countries have high rates of vision impairment, with estimates ranging from three to 15 times higher than corresponding rates for community-dwelling older adults. Studies suggest that vision impairment in about one-third of nursing home residents could largely be reversed by treatment of uncorrected refractive error (myopia [nearsightedness], hyperopia [farsightedness], presbyopia [loss of focus])."
Cynthia Owsley, Ph.D., M.S.P.H., University of Alabama at Birmingham, and team carried out a trial involving 142 nursing home residents, aged 55 or more. 78 residents were randomly assigned to a group that would get eyeglasses one week after check-up, while 64 received eyeglasses two months after check up (at follow-up). At two months vision-related quality of life and depressive symptoms were measured at baseline.
At baseline the two groups had similar demographic and medical characteristics - they also had similar visual acuteness and refractive error uncorrected by eyeglasses. Two months later, distance and near visual acuity for both left and right eyes improved in the group that had been given eyeglasses, while the other group had no improvement in visual acuity.
During the two-month follow-up, the eyeglass group had better scores for general vision, reading, activities/hobbies and social interaction - they also displayed fewer depressive symptoms.
Future LTC Costs of the War
The link goes to a pdf file from Physicians for Social Responsibility. It focuses on the LTC costs of TBI and PTSD in soldiers returning from Iraq.
Monday, November 12, 2007
no succor for vets once they're out of the suck
..[A]fter a string of damning reports and stinging congressional hearings, there is a rush to help these wounded warriors. A massive mobilization across the Defense and Veterans Affairs departments – with crucial assistance from veteran advocacy groups and nonprofit organizations – is under way to help veterans transition from combat to civilian life.
The result is a cornucopia of services that remains extraordinarily difficult to navigate, even with perseverance and the help of others who know how to work the system.
..
Better medical technology, improved treatment techniques and beefed-up armament means soldiers survive wounds that would have killed them in past wars. Using a narrow definition, the Defense Department reports that more than 28,000 troops have been wounded in Iraq, while just over 3,100 died from combat wounds.
For good order, the DoD numbers are bullshit. According to a Harvard study (pdf), as of January 2007, 152,669 servicemen had applied for disability benefits - far more than the DoD's 28,000 wounded figure, even if half of the applicants were pure PTSD claims (which they're not: "Some 20% have suffered brain trauma, spinal injuries or amputations; another 20% have suffered other major injuries such as amputations, blindness, partial blindness or deafness, and serious burns.").
The result is a cornucopia of services that remains extraordinarily difficult to navigate, even with perseverance and the help of others who know how to work the system.
..
Better medical technology, improved treatment techniques and beefed-up armament means soldiers survive wounds that would have killed them in past wars. Using a narrow definition, the Defense Department reports that more than 28,000 troops have been wounded in Iraq, while just over 3,100 died from combat wounds.
For good order, the DoD numbers are bullshit. According to a Harvard study (pdf), as of January 2007, 152,669 servicemen had applied for disability benefits - far more than the DoD's 28,000 wounded figure, even if half of the applicants were pure PTSD claims (which they're not: "Some 20% have suffered brain trauma, spinal injuries or amputations; another 20% have suffered other major injuries such as amputations, blindness, partial blindness or deafness, and serious burns.").
Sunday, November 11, 2007
Elder Caregiving Site Wins WebAward for Outstanding Online Community
The ShirleyBOARD website, has been recognized by the Web Marketing Association (WMA) for Outstanding Achievement in Website Development by being honored with the Online Community Standard of Excellence WebAward Designation.
ShirleyBOARD is a free online community with tools and features to help those caring for aging loved ones stay organized and communicate with one another. The site allows caregivers to centrally store important information, keep a log of daily activities for family and friends to view, and network with other caregivers for support and inspiration.
Some of the tools include: Online Journal to keep a record of caregiving activities; Photo Keeper for sharing photos; The PillBox to record prescription information, including names of medicines, dose sizes, etc; Document Keeper for uploading wills, power of attorney forms and other documents that you need to keep track of; and, Be a Peer/Find a Peer for users to search for fellow caregivers to get assistance or just connect to ask questions and share tips and stories.
Boomers Not Planning for Parents’ Care
Nov. 8, 2007 -- Baby boomer women are concerned about how to care for their aging parents, but few are planning for it, according to a survey released Thursday by AARP.
The telephone survey included 629 women aged 45 and older with at least one living parent. It was conducted in October 2007.
Almost seven in 10 women surveyed by AARP said they were somewhat concerned or very concerned about their parents' ability to live independently as they age. But just four in 10 said they or their parents had begun to plan living arrangements, whether that means living at home, in a new place, or in a care facility.
"These are difficult conversations, but they are very important conversations," Elinda Ginzler, AARP's director of livable communities, told reporters.
Friday, November 9, 2007
Union, lawmakers challenge sale of Manor Care nursing homes
TALLAHASSEE, Fla. (AP) -- Some Florida lawmakers and a union are questioning a private equity firm's pending purchase of the nation's largest nursing home chain, demanding answers about how it will affect the 3,000-plus residents in the chain's 29 homes in this state.
The lawmakers and the Service Employees International Union are asking that state regulators closely examine Carlyle Group's plan to take over Manor Care Inc. The $4.9 billion buyout, which has already been approved by Manor Care shareholders, is also being examined by officials and lawmakers in other states.
New Survey Finds One In Four Baby Boomers Erroneously Believe They Have Coverage For Long-Term Care Expenses
One in four Baby Boomers erroneously believe they have coverage for long-term care expenses, according to new survey data released by America's Health Insurance Plans (AHIP). The survey found that many Baby Boomers have misconceptions about who pays for long-term care services and have not thought about long-term care insurance.
"This should be a wake-up call to Baby Boomers. They aren't factoring expenses for long-term care into their retirement planning and are missing an opportunity to protect themselves," said Karen Ignagni, President and CEO of AHIP.
"This should be a wake-up call to Baby Boomers. They aren't factoring expenses for long-term care into their retirement planning and are missing an opportunity to protect themselves," said Karen Ignagni, President and CEO of AHIP.
Creating an Ethical Workplace
AAHSA members have moral responsibilities as caregivers, employers and members of the community. More specifically,
the AAHSA mission, vision and ideals suggest that its members have at least a tri-fold responsibility to provide
high-quality services to those in need, meaningful work and an ethical workplace for employees. These expectations
spring from AAHSA’s central value of respect for all persons; therefore, it is appropriate that the Association and the
Commission pay considerable attention to workforce issues. The increasing number, diversity and significance of issues
related to our workforce underscores workplace ethics as a compelling priority.
Issues related to our staff have moral significance. The term “workforce” considers all talent within our housing, care
and service system—encompassing direct-care workers, service coordinators, housekeeping staff, geriatricians, nurses,
pharmacists, therapists and administrators. We believe that all staff members are truly the heart and soul of homes and
services for the aging.
We begin our exploration of.....
the AAHSA mission, vision and ideals suggest that its members have at least a tri-fold responsibility to provide
high-quality services to those in need, meaningful work and an ethical workplace for employees. These expectations
spring from AAHSA’s central value of respect for all persons; therefore, it is appropriate that the Association and the
Commission pay considerable attention to workforce issues. The increasing number, diversity and significance of issues
related to our workforce underscores workplace ethics as a compelling priority.
Issues related to our staff have moral significance. The term “workforce” considers all talent within our housing, care
and service system—encompassing direct-care workers, service coordinators, housekeeping staff, geriatricians, nurses,
pharmacists, therapists and administrators. We believe that all staff members are truly the heart and soul of homes and
services for the aging.
We begin our exploration of.....
H.R. 3582 The Fair Home Health Care Act: An Analysis
H.R. 3582 offers Congress an historic opportunity to send three important economic and
social signals:
1. Homecare workers should be on an equal footing with respect to all other low‐wage
occupations.
2. Within long‐term care, the homecare labor market should not have second‐class status
with respect to compensation and, therefore, with respect to its ability to attract and
retain workers.
3. Federal lawmakers can work together to coordinate, rather than send conflicting
messages about, the direction of our nation’s long‐term care policy.
social signals:
1. Homecare workers should be on an equal footing with respect to all other low‐wage
occupations.
2. Within long‐term care, the homecare labor market should not have second‐class status
with respect to compensation and, therefore, with respect to its ability to attract and
retain workers.
3. Federal lawmakers can work together to coordinate, rather than send conflicting
messages about, the direction of our nation’s long‐term care policy.
Thursday, November 8, 2007
Employer Support For Long Term Care Insurance Grows
More than 90 percent of employers offering long term care insurance at the workplace are willing to help pay for the benefit, Unum (NYSE: UNM) reveals in its second annual Landscape of Long Term Care. This is a dramatic shift from the 100-percent employee-paid coverage that represented most of the market in earlier years.
"The increasing awareness and need for long term care services is propelling the sales momentum in the workplace," says John Noble, director of long term care products for Unum, the leading provider of this benefit. "Unum's sales premium is up 26 percent in the first half of the year. Even more dramatic is that we saw a 54 percent increase in new enrollees."
Costco, Unum's largest group long term care customer, was a pioneer in recognizing the value of employer-sponsored long term care insurance. Costco added the coverage eight years ago and currently enrolls 23,000 employees in the plan.
"The increasing awareness and need for long term care services is propelling the sales momentum in the workplace," says John Noble, director of long term care products for Unum, the leading provider of this benefit. "Unum's sales premium is up 26 percent in the first half of the year. Even more dramatic is that we saw a 54 percent increase in new enrollees."
Costco, Unum's largest group long term care customer, was a pioneer in recognizing the value of employer-sponsored long term care insurance. Costco added the coverage eight years ago and currently enrolls 23,000 employees in the plan.
Wednesday, November 7, 2007
Independent Consumer Group Launches Free Interactive Resource To Help Older And Disabled South Carolina Residents Navigate Medicare
Medicare Interactive Counselor, an online educational tool now includes health information and resources specific to South Carolina. This web-based resource provides easy-to-understand answers to questions posed by the millions of older adults and people with disabilities who rely on Medicare for health insurance. For the first time, older adults and people with disabilities across the state, as well as caregivers and professionals, can access expert, unbiased guidance that is tailored to residents of South Carolina at no charge.
Medicare Interactive Counselor is designed to help people with Medicare navigate the health coverage maze. A service of the Medicare Rights Center-a nonprofit organization that is the largest independent source of health care information and assistance in the United States for people with Medicare-Medicare Interactive Counselor draws from the experience and best practices of real-life counselors.
http://www.medicarerights.org/help.html
Medicare Interactive Counselor is designed to help people with Medicare navigate the health coverage maze. A service of the Medicare Rights Center-a nonprofit organization that is the largest independent source of health care information and assistance in the United States for people with Medicare-Medicare Interactive Counselor draws from the experience and best practices of real-life counselors.
http://www.medicarerights.org/help.html
Tuesday, November 6, 2007
Congress Called On To Replace 'Devastating' Cuts In Medicare Reimbursements
The American College of Physicians (ACP) renewed its call on Congress to replace the 10.1 percent devastating cuts in Medicare reimbursements set to take effect Jan. 1 with at least two years of positive updates that are paid for in a way that does not make the problem worse in future years. The organization of 124,000 internal medicine physicians, related subspecialists and medical students reacted to the final physician fee schedule published late last Thurs. by the Centers for Medicare & Medicaid Services (CMS).
"The cuts will accelerate the collapse of primary care, create access problems and manufacture obstacles to fundamental reform of physician policies," emphasized ACP President David C. Dale, MD, FACP. "It is essential that lawmakers agree on an immediate fix that will provide positive and stable updates, support patient-centered care coordinated by a personal physician, and create the building blocks for long-term reform of a flawed payment system."
"The cuts will accelerate the collapse of primary care, create access problems and manufacture obstacles to fundamental reform of physician policies," emphasized ACP President David C. Dale, MD, FACP. "It is essential that lawmakers agree on an immediate fix that will provide positive and stable updates, support patient-centered care coordinated by a personal physician, and create the building blocks for long-term reform of a flawed payment system."
Monday, November 5, 2007
House Hearing Focuses On Bush Administration Cuts To Medicaid
A House Oversight and Government Reform Committee hearing on Thursday examined six rules proposed by HHS that would affect matching funds for state Medicaid programs, CQ HealthBeat reports. According to committee Chair Henry Waxman (D-Calif.), the six proposals would restrict coverage of rehabilitation services for those who have disabilities and are eligible for Medicaid; eliminate the ability of schools to help enroll eligible children in Medicaid; eliminate Medicaid funding for schools that provide Medicaid services to severely disabled children; limit the services states can cover under Medicaid outpatient programs; eliminate Medicaid payments for graduate medical education; and limit how states can raise money to pay their portion of Medicaid costs.
Waxman said the rules are part of a "thinly disguised assault of the health care safety net," also calling them "lawless regulation, not anchored in statute" (Reichard, CQ HealthBeat, 11/1). Bush administration officials say the regulations are needed to keep the states from overbilling the federal government. Congress has passed a one-year moratorium on one of the regulations, and legislation proposed by Rep. Eliot Engel (D-N.Y.) would extend the moratorium. Witnesses at the hearing urged Congress to work to prevent the rules from being implemented (CongressDaily, 11/1). Comments
Dennis Parella, chair of the National Association of State Medicaid Directors, said a "retrenchment by Medicaid will only make ... struggles more difficult for millions of Americans at a time when no comprehensive health care system is even on the horizon," adding that "it is surprising that this philosophy" of fiscal conservatism "should come when most experts in the field would say that the nation's health care system is in a state of crisis." Many local officials testified about the impact the rules would have (CQ HealthBeat, 11/1).
Waxman said the rules are part of a "thinly disguised assault of the health care safety net," also calling them "lawless regulation, not anchored in statute" (Reichard, CQ HealthBeat, 11/1). Bush administration officials say the regulations are needed to keep the states from overbilling the federal government. Congress has passed a one-year moratorium on one of the regulations, and legislation proposed by Rep. Eliot Engel (D-N.Y.) would extend the moratorium. Witnesses at the hearing urged Congress to work to prevent the rules from being implemented (CongressDaily, 11/1). Comments
Dennis Parella, chair of the National Association of State Medicaid Directors, said a "retrenchment by Medicaid will only make ... struggles more difficult for millions of Americans at a time when no comprehensive health care system is even on the horizon," adding that "it is surprising that this philosophy" of fiscal conservatism "should come when most experts in the field would say that the nation's health care system is in a state of crisis." Many local officials testified about the impact the rules would have (CQ HealthBeat, 11/1).
Caring For Aging Parents: 10 Things To Know For An Emergency
Aging parents may not be able to provide vital information to health care providers caring for them during a medical emergency. Mayoclinic.com provides caregivers with a helpful list of 10 things they need to know about caring for aging parents' health, and discusses some signs that warn of a health problem in aging parents.
"Sometimes a parent isn't able to give medical information when an emergency arises, so emergency medical personnel must rely on the adult children or a spouse for that information," says Paul Takahashi, M.D., a specialist in geriatrics at Mayo Clinic in Rochester. "These are things you should know. Just as you fill out those emergency cards for your kids in school, you should have similar information available about your parents or for whomever you are the caregiver."
MayoClinic.com also provides a downloadable emergency medical information form to use for unexpected emergencies, and the Senior Health Center on MayoClinic.com provides a host of other information on wellness, lifestyle, and health.
"Sometimes a parent isn't able to give medical information when an emergency arises, so emergency medical personnel must rely on the adult children or a spouse for that information," says Paul Takahashi, M.D., a specialist in geriatrics at Mayo Clinic in Rochester. "These are things you should know. Just as you fill out those emergency cards for your kids in school, you should have similar information available about your parents or for whomever you are the caregiver."
MayoClinic.com also provides a downloadable emergency medical information form to use for unexpected emergencies, and the Senior Health Center on MayoClinic.com provides a host of other information on wellness, lifestyle, and health.
Info on Employer based LTC insurance
IMPACT5 OF BENEFIT PORTING ON LTC COSTS
For an employer self-funding long-term care (LTC) employee benefits, cost is typically the biggest concern. There are several cost-saving features that can be implemented such as waiting and vesting periods, cost sharing and underwriting, to name a few. However, there is another implicit element that could have a large impact on program costs.
In a program where the employer is paying for the benefit and employees have a choice of continuing to participate in the program upon termination,(what we refer to as "porting" coverage), the porting rate has a critical impact on plan costs. If all departing employees decide to port the benefits upon termination, this is significantly more expensive for the employer than if no one ports the coverage.
If employees are paying for the program, we would expect porting rates (and therefore cost) to be high among participants, although participation rates would most likely be lower.
What is a Porting Rate?
Porting rates represent the probability that an individual will choose to continue to participate in the LTC coverage upon employment termination. This also implies that the employee will be financially responsible for part or all of the premium from then on. This is the main reason why porting rates are generally very low for employer-paid coverage.
Why Port?
The following issues may impact employees' decision on whether to port their LTC coverage upon termination:
* employee education on the subject of long-term care,
* cost of the coverage for separating employees,
* convenience of making the transition to ported coverage, and
* health status and age at the time of departure.
At termination, an employee in an employer-paid LTC program has to make a decision on whether to drop or pay for LTC coverage. For employees not porting their LTC coverage, obtaining new coverage on the market would be priced based on the older age at which the coverage is now sought. Note also that full underwriting would be required, resulting in some applicants being denied coverage. Waiting until the need is imminent will generally result in coverage becoming unavailable as applicants can not pass underwriting. Despite this, due to the lack of financial commitment to the benefit, many employees drop the coverage.
The Never Ending Tradeoff
Porting rates tend to increase with employment longevity and age due to the greater value of the benefit priced at younger ages, as well as greater awareness of the importance of long-term care coverage. Additionally, an increase in porting rates indicates that the benefit will have greater value to the employees. Porting rates represent the most sensitive assumption in estimating the financial needs of an employer sponsored LTC program, and is the most critical distinguishing element between a voluntary product and an employer-paid benefit. Correctly reflecting low levels of future benefit porting can reduce plan costs significantly as compared to pricing that does not account for this. Incorrectly reflecting higher levels of porting, however, is a risk in setting the contribution rates. Careful monitoring of this experience is critical.
Since there is a fine balance between providing meaningful benefits and paying a reasonable cost, one compromise is for employers who self-fund to explore ways to encourage longer-term employees to port the coverage more than shorter-term employees. "Concentrating" the benefits this way can keep the costs down some, but still encourage the most valued employees to make the best use of the benefit since this coverage becomes truly useful after retirement age.
Note! For an essential perspective about true group long-term care, please refer to the book True Group Long-Term Care by Milliman's consulting actuaries Jon Shreve and Jill Van Den Bos (published by the International Foundation of Employee Benefit Plans). We also provide a variety of resources for true group long-term care, such as informative white papers and articles, on our website at www.milliman.com/denver.
For an employer self-funding long-term care (LTC) employee benefits, cost is typically the biggest concern. There are several cost-saving features that can be implemented such as waiting and vesting periods, cost sharing and underwriting, to name a few. However, there is another implicit element that could have a large impact on program costs.
In a program where the employer is paying for the benefit and employees have a choice of continuing to participate in the program upon termination,(what we refer to as "porting" coverage), the porting rate has a critical impact on plan costs. If all departing employees decide to port the benefits upon termination, this is significantly more expensive for the employer than if no one ports the coverage.
If employees are paying for the program, we would expect porting rates (and therefore cost) to be high among participants, although participation rates would most likely be lower.
What is a Porting Rate?
Porting rates represent the probability that an individual will choose to continue to participate in the LTC coverage upon employment termination. This also implies that the employee will be financially responsible for part or all of the premium from then on. This is the main reason why porting rates are generally very low for employer-paid coverage.
Why Port?
The following issues may impact employees' decision on whether to port their LTC coverage upon termination:
* employee education on the subject of long-term care,
* cost of the coverage for separating employees,
* convenience of making the transition to ported coverage, and
* health status and age at the time of departure.
At termination, an employee in an employer-paid LTC program has to make a decision on whether to drop or pay for LTC coverage. For employees not porting their LTC coverage, obtaining new coverage on the market would be priced based on the older age at which the coverage is now sought. Note also that full underwriting would be required, resulting in some applicants being denied coverage. Waiting until the need is imminent will generally result in coverage becoming unavailable as applicants can not pass underwriting. Despite this, due to the lack of financial commitment to the benefit, many employees drop the coverage.
The Never Ending Tradeoff
Porting rates tend to increase with employment longevity and age due to the greater value of the benefit priced at younger ages, as well as greater awareness of the importance of long-term care coverage. Additionally, an increase in porting rates indicates that the benefit will have greater value to the employees. Porting rates represent the most sensitive assumption in estimating the financial needs of an employer sponsored LTC program, and is the most critical distinguishing element between a voluntary product and an employer-paid benefit. Correctly reflecting low levels of future benefit porting can reduce plan costs significantly as compared to pricing that does not account for this. Incorrectly reflecting higher levels of porting, however, is a risk in setting the contribution rates. Careful monitoring of this experience is critical.
Since there is a fine balance between providing meaningful benefits and paying a reasonable cost, one compromise is for employers who self-fund to explore ways to encourage longer-term employees to port the coverage more than shorter-term employees. "Concentrating" the benefits this way can keep the costs down some, but still encourage the most valued employees to make the best use of the benefit since this coverage becomes truly useful after retirement age.
Note! For an essential perspective about true group long-term care, please refer to the book True Group Long-Term Care by Milliman's consulting actuaries Jon Shreve and Jill Van Den Bos (published by the International Foundation of Employee Benefit Plans). We also provide a variety of resources for true group long-term care, such as informative white papers and articles, on our website at www.milliman.com/denver.
Sunday, November 4, 2007
Medicare Bidding For Durable Medical Equipment Will Harm Small Businesses And Seniors' Access To Care
The Medicare bidding program for durable medical equipment will hurt small providers and "undermine the nation's homecare infrastructure" unless Congress modifies the program. This is the key message that will be presented to a congressional subcommittee today by the American Association for Homecare. The Association believes the bidding program will "jeopardize patients' standard of care, choice of provider, and access to the medical equipment and services they need."
Georgie Blackburn, vice president at Blackburn's, a homecare provider in Pittsburgh, Pa. and a board director at the American Association for Homecare, will testify on behalf of the Association on October 31 before the U.S. House Small Business Subcommittee on Investigations and Oversight.
Blackburn will testify that under the bidding program, "Those who are not selected as winning bidders will not be able to provide competitively bid equipment or services to Medicare beneficiaries. Since Medicare payments typically comprise 35 to 50 percent of a small provider's revenue, losing the ability to provide competitively bid items for a three-year contract period is essentially a death knell."
Georgie Blackburn, vice president at Blackburn's, a homecare provider in Pittsburgh, Pa. and a board director at the American Association for Homecare, will testify on behalf of the Association on October 31 before the U.S. House Small Business Subcommittee on Investigations and Oversight.
Blackburn will testify that under the bidding program, "Those who are not selected as winning bidders will not be able to provide competitively bid equipment or services to Medicare beneficiaries. Since Medicare payments typically comprise 35 to 50 percent of a small provider's revenue, losing the ability to provide competitively bid items for a three-year contract period is essentially a death knell."
Wednesday, October 31, 2007
Number Of Americans Living With Dementia Growing At An Epidemic Rate
ne in seven Americans over the age of 70 suffers from dementia, according to the first known nationally representative, population-based study to include men and women from all regions of the country.
About 3.4 million people, or 13.9 percent of the population age 71 and older, have some form of dementia, the study found. As expected, the prevalence of dementia increased dramatically with age, from five percent of those aged 71 to 79 to 37.4 percent of those age 90 and older.
About 2.4 million of those with dementia, or 9.7 percent of the population age 71 and older, were found to have Alzheimer's disease, the most common cause of dementia, according to the study.
About 3.4 million people, or 13.9 percent of the population age 71 and older, have some form of dementia, the study found. As expected, the prevalence of dementia increased dramatically with age, from five percent of those aged 71 to 79 to 37.4 percent of those age 90 and older.
About 2.4 million of those with dementia, or 9.7 percent of the population age 71 and older, were found to have Alzheimer's disease, the most common cause of dementia, according to the study.
Comparing Long-Term Care in Germany and the United States: What Can We Learn from Each Other?
Though one nation's policies rarely serve to answer another's problems, comparing experiences can help stimulate evidence-based debate and discussion. This AARP Public Policy Institute Issue Paper by Mary Jo Gibson and Donald L. Redfoot examines developments in the long-term care (LTC) systems in Germany and the United States to understand their impact on financing and coverage, consumer options and choice, family caregivers, the LTC workforce, and the quality of services. It also provides a brief overview of LTC reform proposals in both countries.
Friday, October 26, 2007
Caregivers Increasingly File Lawsuits Against Employers Alleging Discrimination
The number of lawsuits stemming from "family responsibilities discrimination," or discrimination against employees who have family care-giving responsibilities at home, has increased by 400% in the last 10 years, according to the Center for WorkLife Law at the University of California, USA Today reports. The U.S. Equal Employment Opportunity Commission also has reported an "upsurge" in cases, many of which result in awards to plaintiffs, and recently has issued its first guidance for employers about the issue.
According to USA Today, the lawsuits -- which usually involve workers who care for a child, elderly parent or spouse with a disability -- "generally fall under three areas":
According to USA Today, the lawsuits -- which usually involve workers who care for a child, elderly parent or spouse with a disability -- "generally fall under three areas":
- Employees claiming an employer denied leave or retaliated against a worker for taking time off to care for a child, which is covered by the federal Family and Medical Leave Act;
- Employees who allege employers violated the federal Americans with Disabilities Act by denying workers accommodations to care for a relative with a disability; and
- Employees who allege gender discrimination, such as women with young children who claim they are not given the same treatment as new fathers.
California Fires Trigger Steps To Safeguard More Than 20,000 Homecare Patients
Homecare providers throughout Southern California have been scrambling to respond to the unprecedented fires sweeping through the region. About 20,000 patients served by Apria Healthcare alone have been displaced or face extreme smoke conditions, triggering implementation of their emergency response plans.
"The entire team in Southern California is working on our emergency response in some capacity, either by staffing the disaster shelters, conducting patient inquiry calls, or delivering oxygen and medical equipment directly to homes," said Steve Foreman, Apria's regional VP of operations for Southern California.
The company first contacted critical care patients in the region - for example those on ventilators or pediatric patients who require oxygen. "We reviewed the evacuation shelter list and equipment needs with them, such as assessing the status of their back-up batteries and portable suction units. Then we contacted or attempted to reach all respiratory patients to make sure that they had adequate supplies until we could get to them," said Foreman.
"The entire team in Southern California is working on our emergency response in some capacity, either by staffing the disaster shelters, conducting patient inquiry calls, or delivering oxygen and medical equipment directly to homes," said Steve Foreman, Apria's regional VP of operations for Southern California.
The company first contacted critical care patients in the region - for example those on ventilators or pediatric patients who require oxygen. "We reviewed the evacuation shelter list and equipment needs with them, such as assessing the status of their back-up batteries and portable suction units. Then we contacted or attempted to reach all respiratory patients to make sure that they had adequate supplies until we could get to them," said Foreman.
Homecare Stakeholders Present Recommendations To CMS Administrator Kerry Weems, USA
Senator Arlen Specter (R-Pa.), the American Association for Homecare, other homecare stakeholders held a meeting with Centers for Medicare and Medicaid Services (CMS) Acting Administrator Kerry Weems. The meeting focused on Medicare program integrity, power mobility issues, the new competitive acquisition program, and home oxygen therapy.
Tyler J. Wilson, president of the American Association for Homecare, commented after the meeting, "We talked about our frustration that CMS has not taken more measures to strengthen program integrity in Medicare and to stem fraud at the front-end. We told the Administrator that we want to collaborate to prevent fraud from happening in the first place."
Tyler J. Wilson, president of the American Association for Homecare, commented after the meeting, "We talked about our frustration that CMS has not taken more measures to strengthen program integrity in Medicare and to stem fraud at the front-end. We told the Administrator that we want to collaborate to prevent fraud from happening in the first place."
Evercare Unveils Details Of Nation's First Alzheimer's Disease Special Needs Plan In Phoenix
Evercare, one of the nation's, and Arizona's, largest health care coordination programs, today unveiled the details of the first-ever Medicare Advantage Special Needs Plan designed exclusively for people with Alzheimer's disease and chronic dementia. Residents of Maricopa County, Ariz. will be the first in the country to have access to this innovative health plan with tailored benefits and services, including special prescription drug coverage and the Alzheimer's Association Safe Return® program. Evercare Care Managers will collaborate with memory disorder specialists from the prestigious Phoenix-based Banner Alzheimer's Institute, with the goal of enhancing Evercare's innovative model of care.
Wednesday, October 24, 2007
30+ Resources For US Politics On The Web
The United States election for President is over a year away (November 3rd, 2008), but from the fervor in the press, one might think it’s tomorrow. With the primaries still looming, now is the time to start looking in to the information out there on the web, and we’ve gathered 30+ tools to help you do just that!
Bed Sores Can Be Stopped With Proper Care In Nursing Homes Medicare Project Shows
A diligent and sustained focus on preventing serious bed sores in nursing home residents was remarkably effective according to the results of a project sponsored by the Centers for Medicare & Medicaid Services.
Results of the project have just been published in the Journal of the American Geriatrics Society.
"Reducing pressure ulcers-the clinical term for bed sores-is a priority for CMS and quality improvement organizations (QIOs) nationwide," said Kerry Weems, acting administrator of CMS. "It is also one of the most important goals of the voluntary Advancing Excellence in America's Nursing Homes campaign, of which CMS is a founding member.
The nationwide project stopped more than two-thirds of the residents' serious bed sores - a dreaded complication of frailty and disability in old age - in the thirty-five nursing homes that reported data from the project, the paper reports.
Results of the project have just been published in the Journal of the American Geriatrics Society.
"Reducing pressure ulcers-the clinical term for bed sores-is a priority for CMS and quality improvement organizations (QIOs) nationwide," said Kerry Weems, acting administrator of CMS. "It is also one of the most important goals of the voluntary Advancing Excellence in America's Nursing Homes campaign, of which CMS is a founding member.
The nationwide project stopped more than two-thirds of the residents' serious bed sores - a dreaded complication of frailty and disability in old age - in the thirty-five nursing homes that reported data from the project, the paper reports.
Tuesday, October 23, 2007
Nursing home advocates demonstrate outside Carlyle's headquarters -- again
Washington Business Journal - by Neil Adler Staff Reporter
A national caravan of caregivers and advocates for seniors arrived in D.C. to hold a demonstration on Monday outside the headquarters of private equity giant The Carlyle Group, which is taking over nursing home chain Manor Care Inc. for $6.3 billion.
A large health care workers union, SEIU Healthcare, is organizing the demonstration. The union, which held a similar demonstration outside Carlyle's headquarters about a month ago, is concerned about the buyout's effect on seniors, taxpayers and nursing-home workers.
At Monday's demonstration, nursing-home workers, family members of patients and seniors advocates spoke about the need for safe staffing levels and improved care. On Tuesday, they plan to visit Capitol Hill and lobby Congress to hold hearings on private equity ownership of nursing homes.
Toledo, Ohio-based Manor Care (NYSE: HCR) runs about a dozen nursing homes in the Washington area and hundreds more nationwide. The acquisition is expected to close by the end of November, Carlyle said in a statement.
The protesters want Carlyle executives discuss their specific plans for Manor Care. Officials with SEIU Healthcare say they are worried about the fate of nursing-home workers and are afraid that care may deteriorate.
They also say Carlyle's purchase will result in a windfall of millions of dollars for top Manor Care executives, and Carlyle stands to reap fees on the deal that could total hundreds of millions of dollars.
On Monday, Carlyle pledged a commitment to quality care at Manor Care. The pledge emphasizes education and training of caregivers, staffing levels that ensure proper clinical care is given, appropriate capital investment to maintain facilities and technology, and abiding by federal and state requirements.
"Meeting the care needs of Manor Care's patients and residents is our top priority," said Karen Bechtel, a Carlyle managing director and head of its health care team, in the firm's statement. "Manor Care is poised to become an even stronger health care provider under Carlyle's ownership."
SEIU Healthcare leaders say the pledge is a public relations tactic designed to help the private equity firm get the deal wrapped up.
"SEIU caregivers, senior advocates, and community leaders will continue to work to hold the Carlyle Group accountable for improving care and staffing at Manor Care," said Gerry Hudson, executive vice president of SEIU Healthcare, in a statement released by the union.
Monday, October 22, 2007
Nursing homes take in mentally ill
CLEVELAND (AP) -- Some northeastern Ohio nursing homes use a Medicaid loophole to accept hundreds of mentally ill patients discharged from hospital psychiatric wards, spending millions of taxpayer dollars to house patients who often do not qualify for nursing-home care, a state investigation found.
Mentally ill patients are eligible for nursing home care paid for by Medicaid if they need 24-hour supervision or hands-on assistance, but an investigation by the Ohio Department of Mental Health found that 60 percent of the psychiatric patients admitted into Cuyahoga County nursing homes don't need such intensive care, The Plain Dealer reported.
Medicaid pays about $148 a day to house such patients, about three times what it would cost to care for the patient in a group home.
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Sunday, October 21, 2007
S.1233 - Veterans Traumatic Brain Injury and Health Programs Improvement Act of 2007
A bill to provide and enhance intervention, rehabilitative treatment, and services to veterans with traumatic brain injury, and for other purposes.
H.R.1783 - Elder Justice Act
To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes.
H.R.1809 - Medicare Independent Living Act of 2007
To amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs.
Friday, October 19, 2007
The Effects Of Caregiving Examined By USC Study
new study from the USC Davis School of Gerontology found that caregivers of different ethnicities showed few negative mental or physical health effects as a result of tending to a family member with dementia.
The findings, which appeared the journal Aging & Mental Health, analyzed mental health and physical health differences between African-American and white caregivers.
The findings, which appeared the journal Aging & Mental Health, analyzed mental health and physical health differences between African-American and white caregivers.
U.S. Senate Finance Committee Takes New Steps To Hold Carlyle Accountable
FOR IMMEDIATE RELEASE
CONTACT: Andrew McDonald - 202-730-7338
Andrew.mcdonald@seiu.org
October 18, 2007
SEIU Applauds Bipartisan Leadership of Sen. Finance Committee in Push for Greater Oversight of Private Equity Takeovers of Nursing Homes
On the day after Manor Care shareholders approve $6.3B Carlyle Group buyout, top oversight committee asks Carlyle, other buyout firms, for info on nursing home ownership, management
WASHINGTON, DC – The nation’s largest healthcare workers union applauded the bipartisan leadership of the Senate Finance Committee today as it took new steps to hold private equity firms accountable for the care, staffing, and conditions at nursing homes they own.
“On the eve of the largest nursing home takeover in history, increased efforts by Congress to hold buyout firms accountable are timely and necessary,” said Gerry Hudson, Executive Vice President of SEIU Healthcare, the nation’s largest healthcare workers union. Yesterday, shareholders of the nation’s largest nursing home chain, HCR Manor Care voted to approve a $6.3 billion buyout by the Carlyle Group, in what will be the largest-ever private equity takeover of a nursing home chain. For more info, visit http://carlylefixmanorcarenow.org/behind-the-buyout/
Hudson continued, “Medicare and Medicaid resources that are intended to support vulnerable Americans are being diverted to the private benefit of wealthy executives and investors. CEO profits cannot come at the price of patient safety and care. The Senate Finance Committee is right to exercise bipartisan leadership to hold the Carlyle Group and other private equity firms accountable for the impact of their actions on people’s lives.”
Today the Chairman and Ranking Member of the Senate Finance Committee – the committee with oversight over Medicare, nursing homes, and private equity-related issues -- sent letters to the Carlyle Group and other four other private equity firms asking for information related to their ownership and management of nursing homes. Sens. Baucus (D-Mont.) and Grassley (R-Iowa) also sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking the federal agency responsible for overseeing nursing home inspections to account for a report of higher health and safety violations in nursing homes that have been bought by private equity investors.
In their letters, the committee cited a recent front page exposé by the New York Times detailing how cuts to staffing and operations at nursing homes bought by private equity firms across the country have enriched top executives and buyout firms but left nursing home residents worse off. Read the article here.
On October 2, 2007, SEIU sent letters to the Senate Finance Committee and three Committees in the House of Representatives calling on Congress to take action to improve the quality of care and hold private equity firms accountable for their ownership of nursing homes. The SEIU letters requested that each committee hold hearings, exercise oversight authority, and consider new legislative reforms related to private equity ownership of nursing homes. Copies of the letters are available at www.CarlyleFixManorCareNow.org
Pending Carlyle Takeover of HCR Manor Care Largest-Ever
With more than 37,000 resident beds, HCR Manor Care is the largest nursing home provider in the country. The $6.3 billion Carlyle takeover deal will result in a windfall of as much as $250 million for top Manor Care executives and directors, including as much as $186 million for Manor Care CEO Paul Ormond. Carlyle stands to reap fees on the deal that could total hundreds of millions of dollars. Much of the money going to fees and executive compensation is from taxpayers: Manor Care receives approximately two-thirds of its revenue in taxpayer funded payments, such as Medicare and Medicaid.
In recent years, large private investment groups have agreed to buy 6 of the nation’s 10 largest nursing home chains, containing over 141,000 beds, or 9 percent of the nation’s total. Private investment groups own at least another 60,000 beds at smaller chains and are expected to acquire many more companies as firms come under shareholder pressure to sell, according to the New York Times article by Charles Duhigg, “At Many Homes, More Profits and Less Nursing,” published September 23, 2007.
www.CarlyleFixManorCareNow.org
CONTACT: Andrew McDonald - 202-730-7338
Andrew.mcdonald@seiu.org
October 18, 2007
SEIU Applauds Bipartisan Leadership of Sen. Finance Committee in Push for Greater Oversight of Private Equity Takeovers of Nursing Homes
On the day after Manor Care shareholders approve $6.3B Carlyle Group buyout, top oversight committee asks Carlyle, other buyout firms, for info on nursing home ownership, management
WASHINGTON, DC – The nation’s largest healthcare workers union applauded the bipartisan leadership of the Senate Finance Committee today as it took new steps to hold private equity firms accountable for the care, staffing, and conditions at nursing homes they own.
“On the eve of the largest nursing home takeover in history, increased efforts by Congress to hold buyout firms accountable are timely and necessary,” said Gerry Hudson, Executive Vice President of SEIU Healthcare, the nation’s largest healthcare workers union. Yesterday, shareholders of the nation’s largest nursing home chain, HCR Manor Care voted to approve a $6.3 billion buyout by the Carlyle Group, in what will be the largest-ever private equity takeover of a nursing home chain. For more info, visit http://carlylefixmanorcarenow
Hudson continued, “Medicare and Medicaid resources that are intended to support vulnerable Americans are being diverted to the private benefit of wealthy executives and investors. CEO profits cannot come at the price of patient safety and care. The Senate Finance Committee is right to exercise bipartisan leadership to hold the Carlyle Group and other private equity firms accountable for the impact of their actions on people’s lives.”
Today the Chairman and Ranking Member of the Senate Finance Committee – the committee with oversight over Medicare, nursing homes, and private equity-related issues -- sent letters to the Carlyle Group and other four other private equity firms asking for information related to their ownership and management of nursing homes. Sens. Baucus (D-Mont.) and Grassley (R-Iowa) also sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking the federal agency responsible for overseeing nursing home inspections to account for a report of higher health and safety violations in nursing homes that have been bought by private equity investors.
In their letters, the committee cited a recent front page exposé by the New York Times detailing how cuts to staffing and operations at nursing homes bought by private equity firms across the country have enriched top executives and buyout firms but left nursing home residents worse off. Read the article here.
On October 2, 2007, SEIU sent letters to the Senate Finance Committee and three Committees in the House of Representatives calling on Congress to take action to improve the quality of care and hold private equity firms accountable for their ownership of nursing homes. The SEIU letters requested that each committee hold hearings, exercise oversight authority, and consider new legislative reforms related to private equity ownership of nursing homes. Copies of the letters are available at www.CarlyleFixManorCareNow.org
Pending Carlyle Takeover of HCR Manor Care Largest-Ever
With more than 37,000 resident beds, HCR Manor Care is the largest nursing home provider in the country. The $6.3 billion Carlyle takeover deal will result in a windfall of as much as $250 million for top Manor Care executives and directors, including as much as $186 million for Manor Care CEO Paul Ormond. Carlyle stands to reap fees on the deal that could total hundreds of millions of dollars. Much of the money going to fees and executive compensation is from taxpayers: Manor Care receives approximately two-thirds of its revenue in taxpayer funded payments, such as Medicare and Medicaid.
In recent years, large private investment groups have agreed to buy 6 of the nation’s 10 largest nursing home chains, containing over 141,000 beds, or 9 percent of the nation’s total. Private investment groups own at least another 60,000 beds at smaller chains and are expected to acquire many more companies as firms come under shareholder pressure to sell, according to the New York Times article by Charles Duhigg, “At Many Homes, More Profits and Less Nursing,” published September 23, 2007.
www.CarlyleFixManorCareNow.org
Kaiser Family Foundation Offers New Tool For Examining Presidential Candidates' Health Care Proposals
2008 Presidential Candidate Health Care Proposals: Side-by-Side Summary, Kaiser Family Foundation: The Foundation has released an interactive tool that compares the health care proposals of presidential candidates by summarizing positions in four overall categories: access to health care coverage, cost containment, improving the quality of care and financing. Users can create customized side-by-side comparisons of up to four candidates, as well as all Democrat or all Republican candidates' health care proposals. The new tool is part of health08.org, a website operated by the Foundation providing analysis of health policy issues, regular public opinion surveys, and news and video coverage from the campaign trail (Kaiser Family Foundation release, 10/16).
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