CBS/AP) Some veterans are being placed in foster homes where they can receive medical care while maintaining their independence.
The Department of Veterans Affairs' Medical Foster Home Program is designed to provide disabled or chronically-ill veterans of all ages with long-term care outside of traditional nursing homes or hospitals.
Program coordinator Kristin Maxwell says about 30 veterans in South Florida will be placed in foster homes in the next year……
Tuesday, March 31, 2009
CBS/AP) Some veterans are being placed in foster homes where they can receive medical care while maintaining their independence.
Info Long-Term Care: The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand
From the OECD (Organisation for Economic Co-operation and Development), March 2009, this paper serves as a background document to commmittee work on the performance of long-term care systems, in particular to the issue of the LTC workforce and reviews country responses to a growing demand for LTC workers….
To read the full report, go to:
Representatives Christopher Murphy (D-CT) and Judy Biggert (R-IL) have
reintroduced the Frank Melville Supportive Housing Investment Act (H.R.
5772). The bill, which passed the House last year but never found
traction in the Senate, would reform the Department of Housing and Urban
Development’s (HUD’s) Section 811 Supportive Housing Program for Persons
with Disabilities. Section 811 provides housing for people with physical
or developmental disabilities or people with chronic mental illness who
are 18 years of age or older and have very low incomes (at or below 50
percent of the area median income). Section 811 participants may live
in supportive housing units developed and owned by non-profit
organizations, or they may receive tenant-based rental assistance that
helps them rent decent, accessible and safe housing in the private
rental market. Tenants pay 30 percent of their adjusted income
(approximately $200 per month) for rent which ensures affordability for
those receiving SSI benefits.
For years, HUD has treated the Mainstream Voucher program as traditional
Section 8 vouchers, administered by Public Housing Agencies (PHAs) for
many different low income populations on their waiting lists. Even
though these vouchers were supposed to go to persons with significant
disabilities who needed supportive housing, HUD did not put a tracking
mechanism into place to ensure that this occurred until 2005.
Disability housing advocates believe that many non-disabled people and
persons with non-significant disabilities (who could use traditional
Section 8 vouchers) were receiving Mainstream vouchers. This created
fiscal burdens for the small 811 program because renewal of the
Mainstream Vouchers must come off the top of the 811 budget every year.
For example, the FY 2009 budget requires that over $87 million be used
for renewal of Mainstream Vouchers. This would leave only $150 million
for the production of new units.
The bill will shift fiscal responsibility for the Mainstream Housing
Choice Voucher Program to the Section 8 budget where it belongs.
Although funded and renewed from 811 appropriations, these Mainstream
Housing Choice Vouchers have never created new permanent supportive
housing units and are not targeted to people with the most serious and
long-term disabilities. By shifting the Mainstream voucher funding to
the traditional Section 8 program, all Section 811 funds currently used
for Mainstream voucher renewal will be freed up for production of new
units via the Project-Based Contracts (PRAC) Demonstration.
Currently, only Section 811 funds can be used to construct housing units
for non elderly people with disabilities. The new bill would re-write
the law to allow for other funds to be combined with Section 811
funding, thereby increasing the number of units built. The PRAC
Demonstration program will “fast-track” and sustain the creation of
thousands of new permanent supportive housing units every year by
leveraging new set-asides of supportive housing units in federal Low
Income Housing Tax Credit (LIHTC) properties. The PRAC program will also
provide a rental subsidy to reduce rents to affordable levels for people
receiving Supplemental Security Income (SSI) in a small but significant
percentage of the hundreds of thousands of units that are routinely
created every year through the LIHTC program administered by states and
FMI: To read the bill or track its progress, go to
and search for bill number HR 1675.
Gilbert Guide, a senior care website announces the online introduction of a collection of videos covering supportive home care, advanced directives, clinical trials, coping with loss, cancer treatments, and more aimed at educating today's seniors and their families and friends. The videos also discuss vital senior care issues such as coming home from the hospital, performing exercises while bedridden, managing fatigue, and dealing with bowel and bladder issues…..
Monday, March 30, 2009
Two Senate Bills Would Change Tax Code for Long Term Care and Self Employed. | Health Plan Innovation Blog
Two bills were introduced this week in Congress that would change the tax code affecting health insurance,
The Long-Term Care Affordability and Security Act of 2009 (S.702) sponsored by Senator Chuck Grassley (R-IA) would amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. The bill is cosponsored by Collins (R-ME), Ensign (R-NV), Graham (R-SC), Johnson (D-SD), Klobuchar (D-MN), Lincoln (D-AR), Snowe (R-ME).
A second bill (S.725) introduced by Senator Jeff Bingaman (D-NM) is called the Equity for Our Nation’s Self Employed Act of 2009 and it would amend the Internal Revenue Code of 1986 to allow self-employed individuals to deduct health insurance costs in computing self-employment taxes. It is cosponsored by Senator Orrin Hatch.
This is the year of change! President Obama won the presidential campaign, and we are anticipating major changes in health-care reform. I have been a nurse for 34 years, a nurse practitioner for 12. As I enter the realm of "baby boomer,'' I propose adding community-based, long-term care services to the Medicare program.
Medicare has existed since 1965, an automatic federal enrollment for those age 65 and older. The philosophy behind Medicare is to allow seniors to have access to health care without sending them into poverty. Yet long-term care is not covered under optional Part B of the plan; this omission shifts responsibility of such care for the approximately 10 million Americans to families…..
Ask the House Therapist announces the debut of its Web site, AsktheHouseTherapist.com, which provides information about how to get started on home accessibility design to address changing and diverging needs.
Seniors, families and individuals with special needs who are looking for adaptable, universal house plans can access the expertise of universal design specialists at AsktheHouseTherapist.com. The newly launched site provides information about sustainable and adaptable living design…..
Sunday, March 29, 2009
The Coalition to End the Two-Year Wait for Medicare, over 120 organizations who work to ensure access to health care for people with disabilities, enthusiastically supports the introduction of Ending the Medicare Disability Waiting Period Act of 2009, S.700 and H.R.1708, which would eliminate the unjustifiable two-year delay in coverage for people with severe disabilities who are waiting to become eligible for Medicare coverage.
"Nearly 40 percent of people with disabilities are without health insurance coverage at some point during their wait for Medicare; 24 percent have no health insurance during this entire period. Many cannot afford to pay COBRA premiums to maintain coverage from their former employer, and private coverage on the individual market is unavailable or too expensive for this high-cost population," the Coalition wrote to Senator Jeff Bingaman (D-NM) and Representative Gene Green (D-TX)…..
Saturday, March 28, 2009
A new report, LIVING LONGER ON LESS IN MASSACHUSETTS: The New Economic (In)Security of Seniors, issued by the Institute on Assets and Social Policy (IASP) at Brandeis University finds that Massachusetts seniors face widespread financial insecurity. Almost 7 in 10 senior households in Massachusetts lack sufficient resources for long-term economic security, according to the study. Economic risk is especially pronounced for single senior households - with 82 percent among them facing financial insecurity….
Friday, March 27, 2009
Thanks and a Hat Tip to Nelson Grit
Here is a link to a video of Lieutenant Governor Cherry and Secretary of State Land promoting the Living In Michigan Income tax checkoff. Please feel free to share it with your friends and contacts.
If we raise $100,000 each year for three years, the option will remain. Experience suggests that each dollar draws down an additional $11, meaning that the $100,000 will add $1.1 million dollars in investment in affordable housing and community development.
Wisconsin was one of four states chosen to participate in a national project designed to improve care and quality of life for residents of nursing homes while reducing Medicare costs, the state Department of Health Services said Thursday.
The Medicare Nursing Home Value Based Purchasing Demonstration, run by the Center for Medicare and Medicaid Services, is designed to include 100 state nursing homes that will participate on a volunteer basis……
Nineteen national Jewish organizations and nearly 90 local ones have signed a letter to the U.S. Congress that urges “fiscal discipline” in crafting the FY2010 budget and singles out long-term care as one of the areas most in need of attention in the push for comprehensive health care reform.
The letter points out the Jewish community’s longstanding commitment to ending poverty and applauds “President Obama’s pledge to fix our broken healthcare system and his commitment to safeguarding funding for the most vulnerable members of our society during these unprecedented economic times”…..
Thursday, March 26, 2009
Somerset dementia patients are amongst the first in country to benefit from a new personal tracking device which makes use of up-to-the-minute Global Positioning System (GPS) technology to avoid people with dementia wandering or becoming lost.
The tracker is carried by the patient, or fastened to their clothes, and allows their location to be monitored by their carers on a map via a secure website……
Primary Care Shortage In US: Workforce Solutions Proposed To House Health Subcommittee By President Of American College Of Physicians
"The United States is experiencing a primary care shortage the likes of which we have not seen," Jeffrey P. Harris, MD, FACP, president of the American College of Physicians (ACP), told the House of Representatives Energy & Commerce Health Subcommittee. "The demand for primary care in the U.S. will grow exponentially as the nation's supply of primary care dwindles."
The reasons behind the decline in the supply of primary care physicians are multi-faceted and complex, Dr. Harris added. They include the rapid rise in medical education debt, decreased income potential for primary care physicians, failed payment policies, and increased burdens associated with the practice of primary care……
When both spouses of a married couple need nursing home care, the most immediate result is a catastrophic bill of $12,000.00 per month or more. Without the advice of an elder law attorney, the couple will continue to spend down assets until their assets reach just $4,000.00 in cash. Substantially better results can be achieved with some planning, but understanding how to proceed in these circumstances is a delicate matter. The rules are counter-intuitive.
Michigan’s Program Eligibility Manual (which is used by the Department of Human Services to determine eligibility for Medicaid) does not have any clear policies on point to help families facing this situation. The rules allowing a healthy spouse to shelter assets above $2,000.00 do not apply because both spouses are in the nursing home. There is therefore no community spouse….
….Reform should offer more alternatives to Medicaid in order to divert people from needing Medicaid in the first place and Medicaid itself must be rebalanced. In this respect, Vermont provides a model for serious consideration. Patrick Flood, Deputy Secretary of the Vermont Agency of Human Services, has described how Vermont has abandoned the out-dated Medicaid structure of long-term care, and leveled the playing field between institutional and home care with the option of self-direction:
In 2005, Vermont received approval from CMS for an 1115 Waiver to re-design our Medicaid long term care system. The goals for the Waiver were to:
- Provide equal access to either a nursing home or home based care services
- Serve more people
- Manage the overall costs of long term care.
Three years later, it is clear that the Waiver has succeeded beyond what Vermont hoped for. We are serving many more people than we could have under the old system. The number of new persons we can admit each year to our home based alternative programs has grown 2-3 times over what we could in the old system. Nursing home use continues to decline gradually. Overall costs of the system have remained manageable.…..
To authorize the Secretary of Health and Human Services to make grants to promote professional retrofit installation of fire alarm detection systems and other fire detection and prevention technologies in nursing homes, hospice facilities, and other appropriate facilities.
A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes.
This is Tom Harkin’s Senate version of the CCA. Debbie Stabenow is a co-sponsor!!
Wednesday, March 25, 2009
Sens. Herb Kohl (D-WI) and Susan Collins (R-ME) have reintroduced a bill to establish a nationwide system of background checks to prevent people with criminal histories from working in long-term care settings.
Use link to learn more.
To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes.This is the Open Congress page for Danny Davis’ introduction of the CCA. There are 25 House Co-sponsors (NONE from Michigan). They haven’t posted the introduction by Sen. Harkin yet.
Tuesday, March 24, 2009
A new AARP Public Policy Institute survey of chronically ill patients and their caregivers finds health care poses significant challenges for the 70 million Americans 50 and older who have at least one chronic condition. The survey is part of a larger report, "Chronic Care: A Call to Action for Health Reform," which details the state of chronic care and offers recommendations for improving care for the chronically ill as part of comprehensive health reform……
Thanks and a hat tip to Dan Berland < dberland@NASDDDS.ORG >
Representative Lloyd Doggett (D-TX) has reintroduced legislation to
eliminate Medicare Part D co-payments for low-income residents of
assisted living and residential care facilities and others receiving
home and community-based services (HCBS) under Medicaid. The Medicare
Part D Home and Community Services Copayment Equity Act of 2009 (H.R.
1407) would extend the same protection from Part D co-pays afforded to
dual eligibles living in institutions to those residing in the
community. Ben Nelson (D-NE) has introduced a companion bill in the
Senate (S. 534).
Congress exempted dual eligibles living in long term care facilities
such as ICFs/MR and nursing homes from any cost-sharing for Part D
prescription drugs in the original Part D legislation. Passage of this
legislation would eliminate Part D co-payments for about 1 million dual
eligible beneficiaries, including residents of assisted living and
residential care as well as other licensed facilities such as group
homes for people with mental retardation and developmental disabilities,
psychiatric health facilities and mental health rehabilitation centers.
Dual eligibles receiving services under home and community-based waivers
in a home setting would also be relieved of Part D co-payments under the
FMI: To read the bill or track its progress, go to
US Senators Reintroduce Bill Requiring Long-Term Care Workers to Undergo Criminal Background Checks :: Chicago Nursing Home Abuse Lawyer Blog
In the US Senate, Senator Susan Collins (R-Maine) and Senator Herb Kohl (D-Wis) have reintroduced a bill mandating that all long-term care employee applicants who would work directly with patients undergo national criminal background checks. The bill is the Patient Safety and Abuse Prevention Act of 2009. Senator Kohl is the chairman of the Special Committee on Aging.
The measure provides a federal component that would mandate that all long-term care employee applicants be screened against the FBI’s national database. This will hopefully decrease the number of nursing home abuse and neglect incidents, which unfortunately seems to be a regular occurrence in a number of US nursing homes and private residences where professional caregivers are sometimes brought in to care for a sick or frail person…..
Monday, March 23, 2009
While most respondents to this January 2009 survey of adults ages 18 and older said that moving in with a friend or family member was unlikely, among those who thought it was a possibility, one-third said that such a move would be due to a loss in income, while one-fifth said it would be due to a change in job status or a change in health status.
Notably, comfort in living with additional friends or family members was high, with more than four in ten respondents saying they would be comfortable with such an arrangement if it became necessary.
+ Full Report (PDF; 383 KB)
Health care reformers have long advocated providing more care to patients in their own homes or communities instead of treating them in costly institutions like hospitals and nursing homes. So it is disturbing to learn that charges have risen well above reasonable levels in one segment of the home health care market — short-term care provided to Medicare beneficiaries after, or sometimes instead of, hospitalization. The problem is compounded by fraud…..
CHICAGO (AP) — Ivory Jackson had Alzheimer's, but that wasn't what killed him. At 77, he was smashed in the face with a clock radio as he lay in his nursing home bed.
Jackson's roommate — a mentally ill man nearly 30 years younger — was arrested and charged with the killing. Police found him sitting next to the nurse's station, blood on his hands, clothes and shoes. Inside their room, the ceiling was spattered with blood.
"Why didn't they do what they needed to do to protect my dad?" wondered Jackson's stepson, Russell Smith….
Image via Wikipedia
Thanks and a hat tip to Steve Gold:
Two recent studies/reports document the many ways Medicaid's
Community-Based Long Term Care Services are cost-effective as compared to
expensive institutional nursing facilities:
1. "Do Non-Institutional Long-Term Care Services Reduce Medicaid
Spending?" written by H.S Kaye, M. LaPlante, and C. Harrington. It is in
the journal Health Affairs, vol 28, no 1 (Jan/Feb 2009).
2. "Taking the Long View: Investing in Medicaid Home and
Community-Based Services Is Cost-Effective" written by R. Mollica, E.
Kasser, L. Walker, and A. Houser. It is in the publication entitled
INSIGHT on the Issues, vol I26 (March 2009), a publication of the AARP
Public Policy Institute. www.aarp.org/ppi
Do your legislatures really want to save Medicaid funds?
As your legislatures discuss/threaten reducing Medicaid expenditures and
as they do not discuss "rebalancing" institutional versus community-based
expenditures but want to keep people unnecessarily institutionalized,
these two reports from nationally recognized and extremely well-respected
organizations support your arguments.
Are your newspapers and editorial boards aware of the overwhelming data
that exists? Are legislators and their staff aware? Probably not. Meet
with them and share these reports with them.
Do you Congressional representatives and U.S. Senators, who still do not
support the Community Choice Act, know that the CCA will be cost
effective? Again, probably not.
Advocates - use the above two reports!
Steve Gold, The Disability Odyssey continues
Sunday, March 22, 2009
Facility's residents live independently under constant watch.
By Stacey Burling
Inquirer Staff Writer
Charles Marriott, who is 73 and has emphysema, says he wound up in a nursing home after a drug problem got the better of the relative who was caring for him.
He hated the 15 months he spent there and gladly grabbed a chance to move into an apartment of his own.
So it doesn't bother him a bit that the place he's lived in since Jan. 14, New Courtland Square in Germantown, uses machines to monitor practically every move he makes - all in the interest of making sure he's safe….
Saturday, March 21, 2009
Thanks and a hat Tip to Patti Elaine Kefalas Dudek
It's not just about the "nanny tax." When using a home health caregiver, it's crucial to know whether you are the caregiver's employer or someone else to avoid tax and legal snags.
With more baby boomers seeking help for aging parents, the in-home care industry is booming with a wide range of service providers, from geriatric-care managers to home-care agencies. Contractual arrangements and employment policies vary just as widely. So it's wise for consumers to ask questions up front about tax obligations and insurance coverage.
"Families need to be aware of all the ramifications," says Bernard A. Krooks, a certified elder-law attorney and founding partner of Littman Krooks LLP, a New York law firm.
Here’s a rundown of some of the bigger ones to keep an eye on in coming weeks and months, and what they mean to you, the long-term care provider....
Norman DeLisle, MDRC
"With Liberty and Access for All!"
Google Voice: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Thursday, March 19, 2009
In a follow up to yesterday’s guest post about end of life care and the engagement of health care providers comes this. The March 9 issue of Archives of Internal Medicine reports that patients with advanced cancer who discuss end-of-life care with their physicians appear to have lower health care costs in the final week of life than those who do not....
I am not saying that physicians and health care staff should sustain relationships with their patients after all hope is exhausted because it might imply lower health care costs. They should stay engaged because it is the right thing to do. That said some of the end of life decisions should be made by all of us well before we get sick. That requires having a living will and assigning durable medical power of attorney....
Source: AARP Policy & Research
The current fiscal crisis is causing most states to make deep budget cuts. In this climate, many state policymakers are targeting Medicaid home and community-based services (HCBS) because they are optional Medicaid benefits. However, this approach may be shortsighted. Recent evidence indicates that expanding HCBS can be cost-effective in the long run when combined with efforts that reduce reliance on nursing home care. Moreover, states that shift their mode of service delivery away from institutional services and toward HCBS can serve more beneficiaries with available dollars. With declining revenues, states should take the opportunity to focus on longer-term and more cost-effective reform options for their long-term care (LTC) systems, such as promoting HCBS over institutional care. Doing so has the dual benefit of not only slowing the growth in Medicaid LTC spending but also improving consumer choices....
+ Full Report (PDF; 127 KB)
WASHINGTON, D.C. – Senator Herb Kohl (D-WI), Chairman of the Senate Special Committee on Aging, and Senator Susan Collins (R-ME) were pleased to introduce today the Patient Safety and Abuse Prevention Act to prevent those with criminal histories from working within long-term care settings by creating a comprehensive nationwide system of background checks. The legislation would expand a highly successful three-year pilot program, spearheaded by Kohl and authorized under the 2003 Medicare Modernization Act, which prevented more than 7,000 applicants with a history of substantiated abuse or a violent criminal record from working with and preying upon frail elders and individuals with disabilities in long-term care settings. Congressman Joe Sestak (D-PA) is expected to introduce a companion bill in the U.S. House of Representatives...
Wednesday, March 18, 2009
As we enter 2009, some significant trends are impacting the long-term care insurance industry.
Heightened consumer awareness, younger buyers, reformulated products and the intensification of multi-life sales — have led to a steady growth of long-term care insurance policies. Despite some adverse factors — in particular, the weakened economy — we anticipate that sales for the just-ended year will be in the 385,000 policy (and group certificate) range, with premiums up several percent over the prior year. For 2009, our predictions all point to continued growth in the number of Americans who are purchasing this form of protection....
Tuesday, March 17, 2009
Study: Case-mix Medicaid reimbursement systems contain disincentives for nursing home quality improvement
The Long-Term Care Community Coalition (LTCCC) conducted a one-year study of 35 states that use a case-mix Medicaid reimbursement system—a system that reimburses nursing homes based both on quality performance and facility costs. The system has a few built-in disincentives for quality improvement, the study finds. Because residents who require a high level of care bring in more Medicaid money, those who don't may be passed over for care. Also, when heavy care patients improve, they are downgraded to a lower reimbursement category.
The coalition makes a few recommendations for nursing homes and states to improve the use of Medicaid reimbursements. By encouraging spending in direct care and by shifting the focus of reimbursements away from facility costs and toward quality measures, overall quality of care could improve. Also, identifying specific patient needs, setting goals for reimbursement incentives and mandating program and outcome requirements for residents may help improve access for both heavy-care and lighter-care residents.
The report focuses specifically on New York state and its reimbursement system, but takes into account 34 other states with similar systems. The full report can be found online at www.nursinghome411.org.
Since 2006, CAST Commissioner Kathy Bakkenist and members of the CAST Policy Committee she chairs have been touting the benefits of aging services technology to any federal legislator who will listen to them.
“I can’t tell you how many doors we knocked on and how many conversations we had,” says Bakkenist, who is the chief operating officer and senior vice president of strategy and operations at the Minnesota-based Ecumen. “But we were lucky. We had a compelling story to tell about the nation’s shifting demographics and the significant need to change how services are delivered to an aging population. It wasn’t a story of doom and gloom. It was a story of opportunity and solutions. Aging services technologies represent hope and a different way of thinking about how to support independence, choice and aging in place. To me, that was the power of our message.”....
Monday, March 16, 2009
Statehealthfacts.org Provides New Data On CHIP Enrollment, Federal Allocations Under ARRA, Dual Eligibles
New data, statehealthfacts.org: The Kaiser Family Foundation's statehealthfacts.org Web site recently added new data on Medicaid, CHIP and Medicare....
...Statehealthfacts.org also added new data from HHS and the Government Accountability Office about temporary federal Medicaid relief provided by the federal economic stimulus plan to states from October 2008 through March 2009, along with the total estimated federal stimulus allocations to each state through December 2010. The Web site also added new data from an analysis by the Urban Institute and the Foundation's Commission on Medicaid and the Uninsured of 2005 CMS data on dual eligibles. The new data include Medicaid spending for dual eligibles by service, Medicaid spending per dual eligible, dual eligibles as a percent of total Medicare and Medicaid beneficiaries and the distribution of dual eligible enrollment (Kaiser Family Foundation release, 3/11)...
The Centers for Medicare & Medicaid Services has completed a guide for providers who want to employ dining assistants in their facilities. After a drawn out battle, CMS agreed five years ago to allow the use of paid feeding assistants––provided they achieve a certain level of training and have the approval of the state.
Yet despite what was seen as a big victory for providers – because they would no longer have to use higher paid nursing staff to assist with many feeding tasks -- they have been relatively slow to train or use the assistants, federal regulators say...
Saturday, March 14, 2009
This is the second story in a two-part series about the unique relationship shared between a young man and his young caregiver (go to part one).
NOTE: Nathan/Dylan slideshow at bottom.
Nathan has never walked and cannot use his arms. He must be bathed, fed, and lifted from couch to chair to bed. In his own words, the overall physical effect of his disease is that “movement basically dies off.” When asked to describe his body to someone who can’t meet him or see him, Nathan says, “I would say it’s a brain and a jaw. The rest is just useless, there to support my brain.”
But he says that growing up in a small town and going to public school where you knew everybody made him feel less different. He doesn’t identify with others who share his disabilities and doesn’t feel terribly sorry for himself.
“I was born this way and it’s just this subtle thing I’ve dealt with my whole life. It’s hard, but I guess there’s a lot worse things to be afflicted with,” he says. “At least I can still speak and communicate with the world.”
Just as Nathan doesn’t like to be identified as disabled or as an inspiration to others for living beyond his doctors’ predictions, his caregiver doesn’t like to be told that he’s making a huge difference in the world with his job...
Friday, March 13, 2009
Long-term care helps the elderly perform key day-to-day tasks such as eating, personal care and medication. Today, such care is overwhelmingly manual. However, the cost of manual care is unsustainable in the face of demographic trends. Without dramatic breakthroughs in the cost of care, over half of all elders are expected to be without adequate care within a generation.
This talk describes a series of studies performed at Intel (in collaboration with several major partner organizations including the University of Washington) over the past six years towards understanding how technology may substantially reduce the manual burden of care...
Thursday, March 12, 2009
Person-Centred Care Reduces Agitation In People With Dementia And Should Be Considered As Standard Practice In Care Homes
Both person-centred care and dementia-care mapping* reduce agitation in people with dementia in residential care. In addition, person-centred approaches can be taught quickly and should be introduced as standard practice in residential care homes. These are the conclusions of an Article to be published Online First and in the April edition of The Lancet Neurology...
After 20 years of working in long term care facilities as a Certified Activity Director, I have become disenchanted and frustrated with the lack of respect for the democratic resident rights of our ill and aging senior citizens. Where I once believed that it was possible to meet the needs of our aging population by developing high quality long term care facilities, I am no longer inclined to believe that is the norm in most of our nursing facilities. Instead, from my own personal observations and work with seniors and institutions, I believe we have a collusion that has developed between Medicare providers and long term care providers....
A fierce debate has erupted over how best to use the $87 billion in Medicaid money included in the recently passed economic stimulus bill, according to news analyses.
On one side of the issue are providers and patient advocacy goups, who would like to see the new money used to expand services, broaden eligibility requirements and increase reimbursements for providers, The Washington Post notes. Some in state governments, however, want to use the money to even out state budgets as a whole and prevent layoffs and cutbacks in areas other than just healthcare...
Tuesday, March 10, 2009
As the health care reform debate intensifies across the country, AARP today released three new reports on major issues to health care reform. The AARP reports analyze health plan designs, cost shifting for expensive "specialty" drugs, and the access to coverage for Americans age 50-64....
Thanks and a Hat tip to Rob
Health care reform is a vital and engaging concern for America - and for Americans.
But you would not know it from Thursday's White House Forum on Health Reform, which was so narrowly focused and uninspiring that it almost made Hillary Clinton's bumbling efforts of the 1990s look good...
Monday, March 9, 2009
Federal healthcare regulators on Thursday announced a sweeping round of delays for an updated tool to enhance the nursing home payment system. The rollout of MDS 3.0 is now targeted for October 2010 and other intermediary steps are being pushed back, officials with the Centers for Medicare & Medicaid Services said....
Summaries of recent developments related to long-term care issues in Congress appear below.
* Arbitration: Rep. Linda Sanchez (D-Calif.) has introduced the Fairness in Nursing Home Arbitration Act (HR 1237), which would make arbitration prior to court disputes between long-term care facilities and residents invalid and unenforceable, CQ HealthBeat reports. According to Sanchez's office, the bill would not prohibit arbitration, but would give people the option to choose whether they arbitrate conflicts. Sanchez in a statement said, "Arbitration agreements are often buried in overly complicated contracts, and many consumers do not realize they are waiving their legal options." The American Health Care Association and the National Center for Assisted Living oppose the legislation, saying that pre-disputed agreements foster timely, easier settlements, curb rising lawsuit costs and allow staff to focus on patient care (Kim, CQ HealthBeat, 3/3).
* Home and community-based spending: Of the $113 billion Medicaid spent on long-term care in 2007, 53% went to nursing homes and 47% went to care in home and community-based programs, according to testimony given by Thomas Hamilton, director of the survey and certification group at the Center for Medicaid and State Operations of CMS, at a Senate Special Committee on Aging hearing on Wednesday, CQ HealthBeat reports. Hamilton said the almost even split "reflects the progress of the rebalancing efforts in the growing community-based initiatives." The ratio of institutional to community-based spending has been as high as 80 to 20, according to Hamilton. He also said that home and community-based services "actually contained institutional costs and helped states moderate the growth of Medicaid spending overall" (Reichard, CQ HealthBeat, 3/3)....
Friday, March 6, 2009
ALFA Commends Senator Bill Nelson's Commitment To Co-Pay Equity For Home And Community Based Seniors
The Assisted Living Federation of America (ALFA) today praised Senator Bill Nelson (D-FL) and his leading bipartisan co-sponsors Sen. Jeff Bingaman (D-NM) and Sen. Susan Collins (R-ME) for their introduction of the Home and Community Services Co-payment Equity Act of 2009. This legislation will provide nearly one million dually eligible individuals (those receiving Medicare and Medicaid services) across the nation living in home and community based settings, such as assisted living communities, with the same prescription drug benefits under the Medicare Part D Prescription Drug Program (Part D) as those living in institutional settings such as nursing homes...
Sign Up now to Participate in Ruby’s Bequest:
Unprecedented Online Experience Focused on Care Giving
You've been hearing about Ruby's Bequest for a few weeks now; very soon the adventure begins. If you have not yet signed up or told others in your community to do so, we hope you visit Ruby's Bequest today.
A quick reminder about Ruby: Ruby's Bequest is a unique immersive experience in which thousands of people will work together online to imagine—and create—the future of caring and care giving in the United States. We need you to help change the realities of care giving by sharing your story or your perspectives through participation in Ruby's Bequest and by encouraging others you know to get involved as well. Given your mission and commitment to care giving and people with disabilities, we imagine you would be very interested in being a part of this unprecedented experience to develop new ideas and approaches.
Quick Pitch: The only company that builds and manages branded online communities specifically for long-term care (LTC) organizations.
Genius Idea: There are dozens of solutions for private label social networks, in addition to create-your-own socnet services like Ning. That said, there are still underserved niches within the social networking space, and CareNetworks looks to fill one of them by providing online community building services to long-term care organizations, aka, nursing homes and retirement communities...
Realtime results for #CCA
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- NickDupree: RT @NationalADAPT: ADAPT met with NY Senator Gillibrand's office. Late this afternoon she agreed to support #CCA.
- NickDupree: RT @NationalADAPT: at Baucus' office today, ADAPT got the Senate Finance staff to meet with us on March 24 about the #CCA!
- businessksh: RT @NickDupreeRT @NationalADAPT: both Kohl of Wisconsin & Mel Martinez spoke in support of community based supports in long term care. #CCA
- NickDupree: RT @NationalADAPT: both Kohl of Wisconsin and Mel Martinez spoke in support of community based supports in long term care. #CCA
The newest additions to PHI’s National Clearinghouse on the Direct Care Workforce:
Who are direct-care workers? (Updated version)
This is the first story in a two-part series about the unique relationship shared between a young man and his young caregiver.
Nathan and Dylan could be any two dudes in their early 20s, hanging out beneath band posters in their hoodie jackets and ironic T-shirts, chatting away their afternoons about music, video games, and cult-classic films.
They certainly don’t look like the future of caregiving in America — but that’s exactly what they could be...
Thursday, March 5, 2009
A large-scale study conducted at Columbia University's Mailman School of Public Health has identified the type and frequency of hazardous conditions found in the home healthcare (HHC) setting. An anonymous survey of over 700 home healthcare RNs employed in New York City provided the most complete assessment of homecare hazardous household conditions to date. The most common hazardous conditions found in households were environmental and physical hazards, including animal hair, cigarette smoke, excessive dust, and mold/dampness. Physical hazards, such as loose rugs, were also common. The paper, "Household-Related Hazardous Conditions with Implications for Patient Safety in the Home Health Care Sector," was published in the December 2008 issue of the Journal of Patient Safety...
Today U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) held a hearing to call for the inclusion of improvements to long-term care services and supports as part of emerging blueprints for national health reform. A member of the Obama Administration from the Department of Health and Human Services (HHS) offered testimony as the Committee considers how to improve the country's current scattered system of long-term care services and supports, while also working to ensure that they are cost-effective. In recent years, Medicaid payments have shifted from primarily funding nursing home care, to funding more home and community-based care for older and disabled Americans. Witnesses called for targeted changes to Medicare and Medicaid, as well as broader changes in the context of national health care reform discussions....
I don't even know where to begin. I am upset that a well know psychiatrist would publicly diagnose Joaquin with a mental disorder without ever meeting him. I mean ethically, this doctor should have his license removed. From what I have read, no doctor can diagnose a patient with schizophrenia unless he/she has exhibited symptoms (from a criteria) for at least six months. It's bad enough that this doctor would attempt to convince the public that Joaquin is suffering from a mental disorder but the worst part, he has succeeded in fueling stigma. If you haven't already heard about this story, Paul Dobransky — a relationships expert and author of The Secret Psychology of How We Fall in Love (maybe he's trying to sell more books) — told the Los Angeles Times:
Wednesday, March 4, 2009
The Securities and Exchange Commission has filed a fraud complaint against Sunwest Management Inc., which runs one of the largest chains of retirement homes in the country.
In documents filed Monday in U.S. District Court in Eugene, the commission claims that Sunwest lied to investors about its operations, concealed risks from them and exposed them to massive losses when the recession triggered Sunwest's collapse...
A handful of states are now spending more of their Medicaid funding on home- and community-based services than on nursing home care, according to a new report from AARP. The study also found that nursing home occupancy rates have remained static over the last five years, while HCBS funding has soared...
The Senate Special Committee on Aging will convene tomorrow to discuss the inclusion of improvements to long-term care as part of overarching national healthcare reform.
Representatives from the Centers for Medicare & Medicaid Services and various state healthcare agencies will talk about possible changes to the Medicare and Medicaid programs. Panelists also will consider ways to better organize the country's scattered system of long-term care services, according to a statement from Sen. Herb Kohl (D-WI), chairman of the Special Committee on Aging. Thomas Hamilton, director of CMS's survey and certification group, and Karen Timberlake, Secretary of the Wisconsin Department of Health Services, are among the hearing's scheduled witnesses....
Nursing home operators are praising President Obama's proposed 2010 budget for provisions that would help educate and train nurses. But they fear that other parts, including those that call for “bundling” of some Medicare funding for post-acute care, will be harmful. Obama said the goal of bundled payments is to lower hospital readmission rates....