Legislation Would Create Medicare Pilot Program To Expand At-Home Services For Some Beneficiaries With Chronic Conditions

from Medical News Today: 


Sen. Ron Wyden (D-Ore.) and Rep. Edward Markey (D-Mass.) have introduced legislation (S 3613, HR 7114) that would create a three-year Medicare demonstration project in 26 states that aims to expand at-home services for some beneficiaries with multiple chronic health conditions, CQ HealthBeatreports. Eligible beneficiaries would include those who have functional impairments, two or more chronic illnesses and recent use of other health services.

Under the bill, participating physicians or nurse practitioners would collaborate with beneficiaries to develop a comprehensive care plan. The legislation also includes minimum performance standards for health outcomes and would measure the satisfaction level of beneficiaries, caregivers and providers. The bill would require providers to demonstrate savings of at least 5% annually compared to the cost of serving non-participating Medicare beneficiaries with chronic health problems. Providers would be able to keep 80% of the savings as an incentive for participation.


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

Community-Based Participatory Research in Disability and Long-Term Care Policy: A Case Study

From 1997 to 2003, Illinois was spending approximately 80% of its long-term care budget on nursing homes and institutional care and was facing significant challenges to its long-term care delivery and the need to rebalance toward community-based supports for people with disabilities. A case-based program evaluation was done to analyze Moving Out of the Nursing Home to the Community, a community- based participatory research (CBPR) project. The Chicago-based project documented the experiences and concerns of 200 disabled people attempting to transition out of nursing homes to least restrictive community living, actively involving participants in an empowerment and systems and policy change program. The authors describe the partnership between the University of Illinois at Chicago and two centers for independent living; the project's research, policy-related goals, and activities; and the outcomes realized. Barriers and facilitating factors to long-term care systems change are described, as are implications for other CBPR partnerships focused on disability public policy. Keywords: community-based participatory research; disability policy; long- term care policy; community living; nursing homes; community integration; community participation.  More...

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

AARP Solutions Forum Convenes Panel To Examine Medicaid Funding Of Long-Term Care

AARP will release a new report and convene a panel of experts to discuss Medicaid funding for long-term care (LTC) for older adults and adults with physical disabilities. The report analyzes the progress states are making shifting public funds and the people who rely on them from nursing homes to home and community based services.

Approximately 10 million older Americans need assistance with every day activities. Overwhelmingly, people (87 percent) prefer to receive this care in their homes or communities rather than in nursing homes. Few Americans have planned for the cost of LTC and by default Medicaid, which has an institutional bias towards nursing home care, is the primary payer.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Settlement Will Allow People with Brain Injuries to Move out of Nursing Facilities

Landmark Settlement for Individuals with Brain Injuries

SPRINGFIELD, Mass.--(BUSINESS WIRE)--Nearly 2000 individuals with brain injuries will be able to move out of nursing facilities and other institutions under a landmark settlement agreement signed today by state officials and attorneys for the plaintiffs.

The settlement resolves a class action lawsuit, Hutchinson v. Patrick, which was filed in US District Court in Springfield last year on behalf of five individuals, the Brain Injury Association of Massachusetts (BIA-MA) and the Stavros Center for Independent Living. The complaint charges that the Commonwealth is violating the Americans with Disabilities Act for failing to provide adequate community services.

"This is a historic moment for persons with brain injuries in Massachusetts, many of whom have been unnecessarily institutionalized in nursing facilities, often for decades," said Steven J. Schwartz of the Center for Public Representation, lead counsel for the plaintiffs. "As a result of the settlement, close to 2000 persons with brain injuries finally will be able to live in integrated settings, nearer to their families and their home communities."

Approximately 8000 people with brain injuries currently reside in nursing and rehabilitative facilities in Massachusetts. At least a quarter of them could successfully transition to integrated community settings if services were available, according to plaintiffs' co-counsel, Richard Johnston, a partner at Wilmer Hale Cutler Pickering Hale and Dorr.

"Today's agreement is a first in the nation for people with brain injuries and will serve as a model for other states," said Arlene Korab, Executive Director of BIA-MA.

The Centers for Disease Control report that 5.3 million Americans are living with disabilities as a result of traumatic brain injuries (TBI) - head injuries caused by external events, such as falls or accidents. Acquired brain injuries (ABI) - caused by internal medical events such as stroke, disease or poisoning - also are significantly prevalent: more than 700,000 Americans suffer new or recurrent strokes every year.

This case and the settlement agreement apply to Medicaid-eligible residents of nursing and rehabilitation facilities who have either kind of brain injury. It is the first lawsuit in the nation that seeks community services for persons with all forms of brain injuries, regardless of the cause.

Under the settlement agreement, which is still subject to court approval, the Commonwealth will create two new waiver programs designed to transition individuals with brain injuries from nursing facilities and other institutions to community residences. The programs must be approved by the federal government, which will pay half the cost of both programs. The first program, called the ABI waiver, will serve up to 300 individuals with acquired brain injuries who currently are living in nursing and rehabilitation facilities. The second, called the Community First Demonstration Project, will offer transitional services and provide community placements to 1600 persons with brain injuries in nursing facilities. The programs will be implemented over several years, but should result in approximately 200-250 persons a year leaving nursing facilities.

"When I first learned about the issues being resolved, I was so happy, I filled up with tears," Catherine Hutchinson, 55, the lead named plaintiff, wrote in a recent email. A mute quadriplegic as a result of a brain-stem stroke in 1996, she lived for more than a decade at the Middleboro Skilled Care Center. "I think about the residents [with brain injury] ... and I know what their empty lives are like," wrote Hutchinson, who recently moved to The Boston Home, a specialized care facility in Dorchester.

The agreement also requires the Commonwealth to create a new system of community services for persons with brain injuries, including new policies and procedures, a new treatment planning process, a new appeal process for individuals and families, and new quality standards for community services. People in nursing facilities will be offered a choice to receive services in the most integrated setting appropriate to their needs, including their own homes and apartments, or shared living arrangements. In addition, the Commonwealth will establish an education and outreach initiative to inform persons with brain injuries and their families about the new waiver programs as well as the benefits of community living.

Korab applauded the courage of the named plaintiffs who "have opened the door for individuals with brain injury to live independently in the community."

The majority of people with brain injuries spend weeks or months in acute care hospitals and rehabilitative facilities. Once the acute treatment ends, these individuals still need some level of assistance with personal care and activities of daily living rehabilitative care. However, due to the lack of community-based options for continued rehabilitative care, most of them have no choice but to be admitted to nursing and rehabilitative facilities to have their basic needs met.

When the lawsuit was filed May 17, 2007, Hutchinson described her decade-long institutionalization as being "in prison for a crime I didn't commit." In a written statement, she added, "We must find a way to allow people like me to live as independently as possible. I should not have to fight the system when each day I must already fight to communicate, to be understood, make choices and express my feelings."

The settlement agreement will provide transitional and community services to Hutchinson, the other named plaintiffs and all class members. "For them, the promise of the Americans with Disabilities Act will become a reality," said Schwartz.

In addition to Hutchinson, originally from Attleboro, the other named plaintiffs are Raymond Puchalski, 59, a Millers Falls resident who has lived for three years at the Kindred/Goddard Hospital's neurobehavioral unit in Stoughton; Glen Jones, 58, of Haverhill, who has resided at the Worcester Skilled Care Center since 1990; and Nathaniel Wilson, 55, of Springfield, who resides at Wingate of Wilbraham. A fifth named plaintiff, Jason Cates of Westfield, died last fall.

A preliminary hearing on the settlement agreement will be scheduled for mid-June before District Court Judge Michael A. Ponsor in Springfield. Judge Ponsor has been asked to set a final fairness hearing on the agreement for July 25, 2008.

Judy R. Roy
Independent Living Resources of Greater Birmingham
206 13th Street S.
Birmingham, AL 35233-1317
Phone 205.251.2223 ext 102
Email bhamilc1@bellsouth.net
There are only four kinds of people in the world: those who have been caregivers; those who are currently caregivers; those who will be caregivers; those who will need caregivers. - Rosalynn Carter

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

ADAPT's 10 best and worst

For Immediate Release
April 29, 2008

For information contact:
Bob Kafka 512-431-4085
Marsha Katz 406-544-9504
http://www.adapt.org


ADAPT Announces 10 Best and Worst States for Community Services


Washington, D.C.--- In the plaza of the Hall of the States, ADAPT
announced the 2008 Ten Best and Ten Worst States in the delivery of home
and community services to people with disabilities and older Americans.
The Hall of States building is home to the National Governors Association,
an organization that has been very vocal in recent years about the
preference of community services over nursing homes and other
institutions, yet has not been able to inspire its own members to improve
their provision of those services.


Speakers representing states inB both the best and worst categories spoke
at the press conferenceB about the horrors of nursing home life and the
joys of living in the community in those states that provide good
community services. Randy Alexander from Tennessee ADAPT and LaTonya
Reeves from Colorado ADAPT also spoke of the
disability-underground-railroad that assists people in states without
community services to move to states where they can live quality lives in
their own homes with the supports and services they need.


The grouping of states into the top and bottom tenB was based on publicly
available data from highly respected researchers, supplemented by the
results of an informal survey widely distributed across the country by
ADAPT. As has so often been the case over the years, there were few
surprises. Many of the ten states doing the poorest job of providing
services that allow citizens to receive long term care in their own homes
in the community have been on the "worst" list over and over.


The states are listed alphabetically, not ranked numerically;


TEN BEST STATES
Alaska Colorado
Maine Massachusetts Michigan Minnesota
New Hampshire
Oregon
Rhode Island
Vermont


HONORABLE MENTION
Kansas
New York
Washington
Wisconsin
Wyoming

TEN WORST STATES
Arkansas Georgia Florida Illinois Indiana
Louisiana
Mississippi
North Dakota
Tennessee
Texas


DISHONORABLE MENTION
Alabama
District of Columbia
New Jersey
Ohio
Pennsylvania


"No state is ideal, and no state is all bad in how it provides home and
community services," said Bob Kafka, ADAPT National Organizer. "This, as
always, is simply a snapshot based on current information from the Kaiser
Commission, the Research and Training Center on Community Living at the
University of Minnesota, Thomson Healthcare, and our survey. People are
welcome to email me at bob.adapt@sbcglobal.net for more information."

# # #
FOR MORE INFORMATION on ADAPT visit our website at http://www.adapt.org/

Keeping Dementia Sufferers In Their Own Homes For As Long As Possible

APH Ltd is using KNX technology as part of a project which is looking to helping dementia sufferers stay in their own homes for as long as possible - a flat within a Sheltered Housing Scheme in Bristol, England, has been converted into a prototype "Smart Home".

APH is a member of the KNX UK Association and was asked to tailor an intelligent design to suit the requirements of the occupant of the flat. KNX smart technology is employed to monitor the occupant's activity and sounds a warning when it thinks there may be a problem. Special sensors have been fitted into the flat that can tell, for example, if the front door is being opened at night. In this particular flat, wireless light switches, motion detectors, speakers and a voice messaging system have been installed. Coercive messages pre-recorded by the occupant's family are then played when appropriate.

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.

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.