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| Home > Newsletters > Caregiving PolicyDigest > Volume IX, Number 13, June 24, 2009
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| A newsletter of FCA's National Center on Caregiving |
June 24, 2009
Volume IX, Number 13
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IN THIS ISSUE
State Legislation, Policy & Reports
- California: Legislature's Budget Conference Committee Tackles Deficit More...
- Delaware: Public May Gain Access to Database on Adult Care Abuse More...
- West Virginia: State Will Study Four Medical Home Models More...
Federal Legislation, Policy & Reports
- RE-Aligning Care Act Introduced in Senate and House More...
- Congress Considers Healthy Families Act More...
- Project 2020 Legislation Promises HCBS Results from Aging Network Investment More...
- Empowered at Home Act of 2009 Would Boost HCBS. More...
International News
- Ireland: Mediation Service Launched for Families of Elders with Dementia. More...
- Japan: Nursing Home Caregivers Will Provide Some Medical Services More...
- Taiwan: Awareness Grows as Number with Dementia Rises More...
- United Kingdom: "Prepared to Care" Shows Social Care Workforce Not Ready More...
Research Reports & Journal Articles
- New Report Examines Place of Long-Term Care in Health Reform More...
- "A Medicare Buy-in Program" Scans Pros, Cons and Design Issues More...
- Data Show Long-Term Care Costs Exceed Yearly Income for Many Older Californians More...
Conferences & Trainings
- Alzheimer's Dementia Summit, July 8 More...
- 2009 Florida Conference on Aging, August 24 -26 More...
- Housing and Registration Now Open for APHA Annual Meeting, November 7-11 More...
Funding, Media & Miscellaneous
- A Walk on the Dark Side: New York Times Covers Adult NIGHT Care More...
- Two New Guides Are Available through Next Step in Care More...
- Article Alerts Seniors to Changes Likely with Health Reform. More...
- Imperial Valley News Highlights Health Bills Reviewed by Veterans Subcommittee More...
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California: Legislature's Budget Conference Committee Tackles Deficit
After 17 days of public testimony and hearings to close the state's $24 billion deficit for the 2009-2010 fiscal year, which begins July 1, the Budget Conference Committee took action on all budget proposals, voting to create a budget that includes both cuts and new revenues. The committee rejected the Governor's proposals to eliminate all 11 Caregiver Resource Centers, the Multipurpose Senior Services Program and Adult Day Health Care, approving about 30 percent in cuts to the CRCs and MSSP and about 16 percent to ADHC. The committee also adopted a compromise proposal restricting in-home supportive services. Revenues proposed include adding cigarette and oil extraction taxes, rescinding corporate tax breaks and taxing Internet and mail-order sales. The budget goes next to final negotiations and vote in the legislature and then to the Governor for signature. The Governor has authority to take out or further reduce any of these programs. For more information, visit:
California Senate
BudgetBlog
California Healthline
Delaware: Public May Gain Access to Database on Adult Care AbuseLegislation (H.B. 145) permitting the Delaware Department of Health and Social Services to provide online access to the names and nature of the conduct of individuals actively listed on the Adult Abuse Registry has passed the Delaware House and is under consideration by the Senate. Sponsored by Rep. Valerie Longhurst (D-Bear) and Sen. Patricia Blevins (D-Elsmere), this bill will make the search for a safe caregiver less difficult, writes Laura Dignan in DelMarvaNow, since family members will be able to see the names of those who have abused, mistreated, neglected or financially exploited the elderly or disabled. For more information, visit: Delaware General Assembly
DelMarvaNow
West Virginia: State Will Study Four Medical Home Models
On the last day of May, Governor Joe Manchin III signed into law legislation (S.B. 414) that authorizes demonstrations of four different patient-centered medical home models. As defined by the new law, a medical home is a "health care setting that facilitates partnerships between individual patients and their personal physicians and, when appropriate, the patients' families and communities." The four models are a chronic care medical home for small medical practices, an individual medical home for larger practices, a community-centered medical home to link primary care practices with community health teams and a medical home for uninsured persons that focuses on providing primary and preventive care. For more information, visit:
West Virginia Legislature
American Academy of Family Physicians
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RE-Aligning Care Act Introduced in Senate and House
Elder care experts praised a bill introduced in May in both houses of Congress that is geared to provide high-quality, cost-effective care to older adults with multiple chronic conditions. Senator Blanche Lincoln (D-AR) and Representative Gene Green (D-TX) sponsored the "RE-Aligning Care Act (S. 1004/H.R. 2307) to amend Title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services. Cheryl Phillips, MD, American Geriatrics Society president and chief medical officer for On Lok, a long-term care innovator in San Francisco, calls this act "an absolutely essential piece of health care reform legislation." Robert J. Egge, vice president for public policy and advocacy for the Alzheimer's Association, explained that the legislation will improve care coordination for the growing aging population, including those with Alzheimer's disease and other dementias who also suffer from multiple chronic health conditions such as heart disease and diabetes. Dr. Phillips believes it "will fill a significant gap in Medicare, improve care for the most vulnerable and costly Medicare patients and help rein in Medicare spending," writes Stephen Baetge in Senior Spectrum. For more information, visit:
Thomas
Senior Spectrum
Congress Considers Healthy Families Act
Senator Edward Kennedy (D-MA) and Representative Rosa DeLauro (D-CT) introduced a bill in late May (S. 1152/H.R. 2460) that would allow Americans to earn paid sick time so that they can address their own health needs and the health needs of their families. The Healthy Families Act would provide workers up to seven paid sick days a year to recover from their own illness, to care for a sick family member, or to seek diagnostic and preventative care. According to a story in PHI's Quality Care through Quality Jobs blog, millions of workers receive no paid sick days, including large percentages of direct-care workers. For them, "taking a day off from work can be a hard decision as it directly affects their income." Several states and cities, including Milwaukee and San Francisco, have introduced similar bills. The National Partnership for Women & Families has released "A Health Impact Assessment of the Healthy Families Act of 2009" which finds that the legislation "would have a profoundly positive effect on public and individual health." For more information, visit:
Thomas
PHI
National Partnership
Project 2020 Legislation Promises HCBS Results from Aging Network Investment
Legislation introduced in the Senate on June 11 (S. 1257) by Senators Maria Cantwell (D-WA) and Debbie Stabenow (D-MI) and in the House on June 12 (H.R. 2852) by Representatives Bruce Braley (D-IA) and John Sarbanes (D-MD) would amend the Social Security Act to make a significant investment in the aging network and community-based long-term care services. Project 2020: Building on the Promise of Home and Community-Based Services supports single-entry point systems, evidence-based disease prevention and health promotion programs, and enhanced nursing home diversion programs. The National Association of Area Agencies on Aging (n4a) and the National Association of State Units on Aging crafted the legislation, which is expected to save Medicaid and Medicare $1.1 billion over 10 years by reducing the need for more expensive institutional care. For more information, visit:
Thomas
n4a
Empowered at Home Act of 2009 Would Boost HCBS
The Empowered at Home Act of 2009 was introduced in the Senate (S. 424) by Senators John Kerry (D-MA) and Chuck Grassley (R-IA) in February, with Senator Susan Collins (R-ME) signing on recently as a co-sponsor, and in the House (H.R. 2688) by Representatives Frank Pallone (D-NJ) and Diana DeGette (D-CO) in June. The two bills include similar provisions that would give states more flexibility in determining eligibility and services and provide grants to states for evidence-based health promotion and disease prevention programs. According to AARP, which has endorsed this proposed legislation, "Many Americans who want to be cared for at home can't because of a costly institutional bias in Medicaid, which pays for nearly two-thirds of the country's nursing home residents. While state Medicaid programs are required to provide nursing home care, home and community-based services that are often less expensive are optional, leaving them first in line to be cut in a poor economy." For more information, visit:
Thomas
AARP
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Ireland: Mediation Service Launched for Families of Elders with Dementia
An article by Carol Coulter in the June 8 Irish Times reports that Aine Brady, Minister of State for Older People, launched a pilot project in Dublin in June, coinciding with an international symposium on elderly mediation. The new project, a collaboration between the Alzheimer Society of Ireland and the Northside Community Law Foundation, will help families "make difficult decisions regarding the care of the sufferer, and deal with any family disputes." Specially trained volunteer mediators will work with people with dementia and their families, with community and where necessary with service providers in the Dublin region. For more information, visit:
Irish Times
Japan: Nursing Home Caregivers Will Provide Some Medical Services
After completing nationwide trials this year, the Health, Labor and Welfare Ministry will allow caregivers working at nursing homes to provide some types of medical care to residents, the Yomiuri Shimbun reported on June 7. Due to a shortage of nurses at such facilities (only 2 percent have regular night nurses), many caregivers are believed to be administering medical procedures illegally now. The government will compile guidelines aimed at ensuring safety and envisions state-certified nursing care workers with special training will be able to use, monitor and clean equipment involved in tube feeding and other procedures. For more information, visit:
Yomiuri Shimbun
Taiwan: Awareness Grows as Number with Dementia Rises
The Taiwan Alzheimer's Disease Association is urging the government to adopt a more active and pragmatic approach toward care of dementia sufferers, according to Taiwan News on June 9. Taiwan has about 2.4 million people age 65 or older now, and the population with dementia is estimated at 120,000. Dementia patients are expected to grow at a rate of 10,000 per year, reaching 620,000 by 2056. Huang Pi-hsia, director of the Department of Social Affairs under the Ministry of the Interior, suggested that future services for dementia sufferers "should focus on local communities, such as setting up special areas, day care services and group homes." For more information, visit:
Taiwan News
United Kingdom: "Prepared to Care" Shows Social Care Workforce Not Ready
"Prepared to Care," a report released in June, reveals results from a four-month inquiry by the All Party Parliamentary Group on Dementia into the dementia care skills of staff supporting people with dementia living in their own homes or in care homes. The APPG, created to build support for dementia as a health and social care priority, found that less than half the people who visit individuals with dementia in their homes to help with such tasks as washing and dressing have received any training in skills needed to handle the condition. Other findings in the report include high turnover of staff (20-23% per year), which hinders workforce development, and lack of regulations regarding training for dementia workers. For more information and to download the report, visit:
Alzheimer's Society
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New Report Examines Place of Long-Term Care in Health Reform
On June 15 the Urban Institute's Urban-Brookings Tax Policy Center published "The Future of Long-Term Care: What Is Its Place in the Health Reform Debate?" by Howard Gleckman, senior research associate at UI and author of Caring for Our Parents (St. Martin's Press, 2009). In this report Mr. Gleckman provides background and analyzes several federal legislative proposals to restructure the delivery and financing of long-term care services, for which demand and cost are escalating. "In contrast to acute medical care, long-term care is aimed at assisting those with chronic illnesses manage their daily lives in relative comfort and security," he says. About 60 percent of those requiring care are over age 65 and 80 percent of care is provided at home, mostly by family members. For more information and to download the report, visit:
Urban Institute
"A Medicare Buy-in Program" Scans Pros, Cons and Design Issues
A research report, published in June in AARP Public Policy Institute's Insight on the Issues series, reviews the pros and cons of allowing adults in their 50s and early 60s to buy into Medicare as a way to expand their coverage options. Authors Gerry Smolka and Sarah Thomas discuss common challenges for this age group in buying coverage and examine some recent Medicare buy-in proposals. They also explore central design questions, including eligibility criteria and financing of the program (which affects program cost and reach); the adequacy of Medicare coverage; having a national premium; outreach and enrollment; and the interaction with other, private coverage. For more information and to download the full report or a synopsis, visit:
AARP
Data Show Long-Term Care Costs Exceed Yearly Income for Many Older Californians
UCLA Center for Health Policy Research and the Insight Center for Community Economic Development released data on June 18 showing the annual cost of in-home care services for seniors living alone in Los Angeles County is now $319 more than their median income. Statewide tables provide cost comparisons by county for different levels of home and community long-term care as well as for those estimates combined with basic living expenses. "In all 58 counties, long-term care paired with basic living expenses exceeds median income," said Jenny Chung, attorney and program manager at the Insight Center. "Seniors can't afford care as it is. How are they going to cope with cuts?" For more information, visit:
UCLA Center for Health Policy Research
EurekAlert!
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Alzheimer's Dementia Summit, July 8
San Francisco Mayor Gavin Newsom will speak at the first Alzheimer's /Dementia Summit and Caregiver Workshops, Wednesday, July 8, at San Francisco City Hall. The meeting, sponsored by Family Caregiver Alliance, is free with advanced registration. Lunch will be available that day for a requested $5 donation. Register free online at FCA. For more information, visit:
FCA
Examiner
2009 Florida Conference on Aging, August 24 -26
The Florida Conference on Aging, "Better Together, Meeting the Challenges," will take place August 24-26 at TradeWinds Island Grand, St. Pete Beach. The Florida Council on Aging invites aging network staff/board members, administrators/policy planners, all health care professionals, civic/community groups, social workers, attorneys, students, researchers/teachers and older Americans/private citizens to participate. Registration deadline is July 23. For more information and to register online, visit:
FCOA
Housing and Registration Now Open for APHA Annual Meeting, November 7-11
The 137th Annual Meeting & Exposition of the American Public Health Association is set for November 7 through 11 in Philadelphia. This meeting is the oldest and largest gathering of public health professionals in the world, attracting more than 13,000 each year. With the world of public health in continual motion, this conference provides a way to stay abreast of the research and learn about emerging issues. For more information, visit:
APHA
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A Walk on the Dark Side: New York Times Covers Adult NIGHT Care
In the June 14 New York Times, Cara Buckley and James Estrin recount their adventure inside the Hebrew Home at Riverdale's all-night care program for people with dementia who have a thirst to be active after dark. Said to be the only such program in the nation, ElderServe at Night operates from 7 p.m. to 7 a.m., picks up and drops off its participants and features activities that mirror those done at most adult day programs: arts, crafts, exercise, meditation and pet therapy. One family caregiver, referring to the first night her mother participated in ElderServe, remarked, "It was like when your baby first sleeps through the night." For more information, visit:
New York Times
Two New Guides Are Available through Next Step in Care
In June, Next Step in Care, the United Hospital Fund campaign to build strong partnerships between family caregivers and health care professionals, especially during transitions between care settings, unveiled two resources. "Hospital Admissions: How to Plan and What to Expect During the Stay" is written for family caregivers and also will help healthcare professionals prepare patients and families for hospital admissions. This guide is available in Spanish as well as English. "How to Get the Most from the Next Step in Care Website" helps family caregivers and health care professionals find what they need and includes Frequently Asked Questions. For more information, visit:
Next Step in Care
Article Alerts Seniors to Changes Likely with Health Reform
Philip Moeller's article in the June 19 U.S. News and World Report, "Health Reform Bill Includes Major Changes for Seniors," says that when a health reform bill finally lands on President Obama's desk "it will contain far-reaching changes of major interest to older consumers." He points out and discusses several areas to watch: coverage for Boomers ages 45 to 54, pre-existing conditions, age rating, Medicare, preventive health services, the Part D "doughnut hole," biologic drugs, and long-term services and support. For more information, visit:
U.S. News and World Report
Imperial Valley News Highlights Health Bills Reviewed by Veterans Subcommittee
On June 19, Imperial Valley News reported that the House Veterans Affairs Subcommittee on Health, chaired by Representative Michael Michaud (D-ME) had held a hearing to review legislation relating to the health of veterans, including the needs of their family caregivers. "VA often relies on caregivers to deliver essential health care services and, therefore, should be appropriately trained and supported," said Representative Bob Filner (D-CA), Chair of the House Committee on Veterans' Affairs. "These caregivers provide necessary physical and emotional support to injured and sick veterans as they work towards recovery." The article summarizes nine bills (H.R. 2770, 1293, 1197, 1302, 1335, 1546, 2734, 2738 and 2898) and reports the Subcommittee also discussed draft legislation not yet introduced that would require the VA to collect annual data on the number of family caregivers of veterans. For more information, visit:
Imperial Valley News
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?2009 Family Caregiver Alliance. All rights reserved.
The National Center on Caregiving at Family Caregiver Alliance works to advance the development of high-quality and cost-effective policies and programs for caregivers in every state in the country. The National Center is a central source of information and technical assistance on family caregiving for policymakers, health and service providers, program developers, funders, media and families. For questions or further information about the National Center on Caregiving, contact PolicyDigest@caregiver.org or visit the Family Caregiver Alliance website at www.caregiver.org.
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