PHI has launched an issue brief series called Learning Through Evaluation examining the unique role evaluation plays in supporting PHI’s training and organizational development and policy work.
“Evaluation is an important tool to advance our learning and improve our work with providers of eldercare and disability services,” says Marcia Mayfield, PHI’s director of evaluation.
First Brief Now Available
The first issue brief in the evaluation series — Plan, Implement, Study, Act (pdf) — focuses on PHI’s work with the Northern New England LEADS Institute, an initiative aimed at improving job quality for direct-care workers in Vermont, New Hampshire, and Maine.
Thursday, September 24, 2009
Wednesday, September 23, 2009
Much More in the article……
As Baby Boomers retire, companies as varied as GE, Philips, and Nintendo are working on technology that helps seniors stay at home and remain independent
Slate's interactive guide to the Senate Finance committee markup on health reform. - By Timothy Noah and Chris Wilson - Slate Magazine
Are you REALLY into the health care reform debate?
The health reform bill (text, summary) introduced last week by Sen. Max Baucus, D- Mont., chairman of the Senate finance committee, is kind of a dog. The product of many months of negotiation among a bipartisan seven-member "coalition of the willing" (reduced to six after the defection of Sen. Orrin Hatch, R-Utah), it includes so many concessions to the GOP that at least three Democrats (Sen. Jay Rockefeller of West Virginia, Sen. Ron Wyden of Oregon, and Sen. Maria Cantwell of Washington) are threatening not to vote for it. Yet the bill has not won the support of a single Republican.Slate's Chris Wilson, who sees opportunity where others see an ungainly data dump, assembled all these amendments into a single spreadsheet that can be sorted according to sponsor, party, budgetary offset, and whether the amendment in question addresses insurance coverage, reform of "delivery systems" (i.e., doctors and hospitals), or financing (taxes). (Some readers may need to log in to Gmail to view the sortable version. A low-fi version is available here.)
Tuesday, September 22, 2009
This is huge news! This past Friday, New York Senator Schumer introduced the Community First Choice amendment to the Senate Finance Committee’s health care reform!
This is the closest we’ve ever been to getting the language of the Community Choice Act into federal law. It’s not the “whole enchilada,” because it wouldn’t make it the law of the land, but it would give every state a financial incentive to try community first, consumer directed services and supports based on functional need, not age or diagnosis. This is a very big deal!
The next step is to urge the Senate Finance Committee to pass the amendment. We need every Senator on the Committee to hear from constituents in their state, urging them to support the Community First Choice Amendment…..
Monday, September 21, 2009
Celebrations of last year's landmark mental health parity legislation ending insurance and business discrimination were premature. What once seemed a turning point now seems less certain if the federal guidelines for implementation of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act are delayed beyond the Oct. 3 deadline. Such a delay could spell disaster for the 46 percent of the population whose treatment will be halted or never started, with lives lost, livelihoods delayed, but the status quo intact.
We should recall that parity was hotly debated before two bills (HR 1424 in the House, S 558 in the Senate) and were folded into last year's stimulus package. It was an initiative supported by a unique collaboration between advocates in the mental health community and those in the addiction community, with coverage extending to the self-insured and to those in Medicaid managed care. The House initiative, led by Reps. Patrick Kennedy and Jim Ramstad, wanted to base treatment criteria on the American Psychiatric Association's Diagnostic and Statistical Manual. Insurance and business were able to determine that the Senate's bill allow them to define "medical need."
This provision, allowing the insurance companies to manage medical conditions, mandated there be no discrimination against mental illnesses or addictive disorders. Yet, many companies are attempting to reduce what they are calling "medical necessity" and in this way are encouraging the Departments of Health and Human Services, Labor and Treasury to undermine the fact and the spirit of parity………
Classical conditioning in the vegetative and minimally conscious state : Abstract : Nature Neuroscience
Pavlovian trace conditioning depends on the temporal gap between the conditioned and unconditioned stimuli. It requires, in mammals, functional medial temporal lobe structures and, in humans, explicit knowledge of the temporal contingency. It is therefore considered to be a plausible objective test to assess awareness without relying on explicit reports. We found that individuals with disorders of consciousness (DOCs), despite being unable to report awareness explicitly, were able to learn this procedure. Learning was specific and showed an anticipatory electromyographic response to the aversive conditioning stimulus, which was substantially stronger than to the control stimulus and was augmented as the aversive stimulus approached. The amount of learning correlated with the degree of cortical atrophy and was a good indicator of recovery. None of these effects were observed in control subjects under the effect of anesthesia (propofol). Our results suggest that individuals with DOCs might have partially preserved conscious processing, which cannot be mediated by explicit reports and is not detected by behavioral assessment.
Saturday, September 19, 2009
Text of S.1256 as Introduced in Senate: Home and Community Balanced Incentives Act of 2009 - U.S. Congress - OpenCongress
A bill to amend title XIX of the Social Security Act to establish financial incentives for States to expand the provision of long-term services and supports to Medicaid beneficiaries who do not reside in an institution, and for other purposes.
Medicare won’t pay for conditions “that could reasonably have been prevented.”
These preventable conditions, sometimes dubbed “never events,” i.e. events that should never have happened, may include:
• Bedsores or pressure ulcers not present on admission.
• Injuries caused by falls
• Infections caused by catheters left in blood vessels or bladders
• Sponges or other objects left in patients during surgery
• Incompatible blood transfusions
• Death from other blood products
• Misuse or malfunction of medical devices
• Wrong site surgeries.
• Restraint strangulation.
• Deaths from medications.
• Deaths from childbirth.
The National Center for Health Statistics' website is a rich source of information about America's health... More
Tuesday, September 15, 2009
Citing changing demands on families and the need to recognize diversity, the Office of Personnel Management proposed regulations on Monday opening up the long-term care insurance program and certain leave programs to the same-sex partners of gay and lesbian federal employees.
"With America's changing demographics and socioeconomic trends, employees have increasing personal needs and family care obligations," Jerome Mikowicz, deputy associate director at OPM's Center for Pay and Leave Administration, wrote in the draft leave regulation. "OPM believes it is important to address the needs of a more diverse workforce. By ensuring consistent policies within the federal government we set an example as the model employer of a diverse workforce."
Friday, September 11, 2009
Not Dead Yet News & Commentary: It's Suicide Prevention Week - Except for Old, Ill and Physically Disabled People
I'm not sure how many people are aware of this, but we are nearing the end of National Suicide Prevention Week (Sept. 6-12). In fact, today - September 10 - is World Suicide Prevention Day.Specifically, there is an appalling lack of voiced concern over the promotion of suicide in the populations of old, ill and physically disabled people. For the first few months of this year, there was nationwide coverage of the Final Exit Network - an organization that supports and facilitates the suicides of people with nonterminal disabilities and chronic conditions. Over the course of many months, stories appearing in countless outlets included the URL for the Final Exit Network in their stories. The website provided information on obtaining suicide instructional materials and how to get involved with the Final Exit Network. Most of the articles treated the Network and its "work" sympathetically.
Thursday, September 3, 2009
The elderly who suffer from dementia aren't able to say when something hurts or is sore. They may demonstrate their pain through behaviours like rocking or striking out, and we often dismiss these actions as symptoms of the dementia instead of pain, which is usually from a different problem. Arthritis, diabetic neuropathy, fractures, muscular contractures, bruises, abdominal pain and mouth ulcers are among the list of common ailments that go undetected. It is important for those who live or work with persons with dementia to know how to identify when an elderly person is experiencing pain - and receive treatment sooner rather than later.
The University of Alberta's Cary Brown, PhD, has a new tool to help. She has developed an online workshop and toolkit for caregivers, health-care providers, family members and friends of people with dementia.
The researcher from the Faculty of Rehabilitation Medicine created an evidence-based website with a narrated presentation on pain and dementia, a downloadable resource pack for family members, a downloadable pain log and a facilitator's toolkit with background material, a planning guide, promotional material and supplemental information for organizations who wish to put on a workshop.
The online workshop and toolkit are available at: http://www.painanddementia.ualberta.ca