|Home > Newsletters > Caregiving PolicyDigest > Volum XI, Number 5, March , 2011
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|A Newsletter of FCA's National Center on Caregiving|
March 16, 2011
Volume XI, Number 5
| IN THIS ISSUE|
State Legislation, Policy & Reports
- Utah: Alzheimer's Task Force Created More...
- California: Bills Introduced To Improve Paid Family Leave More...
- NY: Medicaid Recommendations Move Forward, Including Wage Parity More...
- California: Campaign To Protect Adult Day Health Care More...
- 13 States Receive Additional Funding For Money Follows The Person More...
- Firing Of Long-Term Care Ombudsman In Florida Will Be Investigated By AOA More...
Federal Legislation, Policy & Reports
- "Family Caregiving 2010: Year In Review" Released More...
- Elder Abuse Highlighted Through Reports And Hearings More...
- Report By Congressional Research Service On CLASS Act More...
- Lifespan Respite Care Program Reauthorization Input Requested More...
- Canada: Debate On GPS Tracking Devices For Wandering Elderly More...
- New Zealand: 2011 Chart Book On Health Of Older Maori Released More...
- Report: Hospitals In Wales Provide "Shamefully Inadequate" Care To Elders More...
Research Reports & Journal Articles
- Elderly Drivers Drive Slower And Are Less Likely To Notice Pedestrians More...
- Cancer Patients And Caregivers Perceive Caregiving Differently More...
- ASCO Focuses On Palliative Care And Planning For Advanced Cancer Care More...
Conferences & Trainings
- Webinar: "Caregiving: Work With Your Siblings To Keep Your Life, Family and Sanity Intact" More...
- Webinar: "Doing the Best We Can: An Overview of Online and Clinical Resources for Care Providers of Families Struggling with Dementia" More...
- Webinar: Forensic Markers Of Elder Abuse More...
- Conference: 2011 Aging in America April 26-30, 2011 More...
Funding, Media & Miscellaneous
- Brain Injury Documentary Airs On PBS Stations In March More...
- Article Discusses Starting "The Talk" With Mom And Dad More...
- New Guide Explains How To Serve As Medical Decision Maker In Florida More...
- AARP Sues HUD Over Reverse Mortgages More...
- If you are interested in having your research study listed in PolicyDigest, please send an email to firstname.lastname@example.org.
Utah: Alzheimer's Task Force Created
A bill (SB 48) was enacted in Utah on March 10 that will create a task force to address Alzheimer's disease and other dementia in Utah. The task force will include 20 members, including somebody experiencing early-stages of dementia as well as a caregiver for a person with dementia. The task force is charged with assessing the current and future impact of Alzheimer's disease in Utah and developing recommendations for a November 2011 report. Utah joins 25 states that are currently developing Alzheimer's state plans, according to the Alzheimer's Association. For more information, visit:
The Salt Lake Tribune: "Alzheimer's task force created"
Utah State Legislature Website
Alzheimer's Association: State Legislation
California: Bills Introduced To Improve Paid Family Leave
Three bills were recently introduced in California to improve supports for family caregivers who take time off to care for a loved one. AB 59 will expand the definition of family under current law to include seriously ill adult children, siblings, grandparents, grandchildren, and parents-in-law. AB 804 would allow employees to receive a partial wage replacement when they must miss work to care for a seriously ill sibling, grandparent, grandchildren, or parent-in-law. SB 299, if passed, will ensure that employer-provided health care coverage is continued for women who take pregnancy leave under the pregnancy disability leave law. A recent report by Human Rights Watch found that the U.S. (other than New Jersey, California, and six cities) lags behind 178 other developed countries that have national laws guaranteeing paid maternity leave for mothers, while 50 countries also provide paid leave for new fathers. The U.S., Papua New Guinea, and Swaziland offer no legal guarantee of paid maternity leave, and only 11% of U.S. companies have opted to provide paid leave. While the Paid Family Leave Act does mandate the provision of unpaid, job-protected leave, it is only for eligible employees who have worked at least a year, have worked 1,250 hours, and who work for employers with 50 or more employees. For more information, visit:California Legislature
Human Rights Watch: "Failing Its Families: Lack of Paid Leave and Work-Family Supports in the U.S."
NY: Medicaid Recommendations Move Forward, Including Wage Parity
The New York Medicaid Redesign Team selected 79 recommendations that were accepted by Governor Cuomo and are now included in the executive budget 30 day amendments. The proposed recommendations include transitioning Medicaid patients to managed care programs. According to PHI, this move could have led to home health care aides taking an effective pay cut of $2 in order to remain with the clients they serve. However, wage parity was included, meaning that if the Governor's proposal is accepted by the legislature, then businesses employing direct care workers (including certified home health agencies, Long Term Home Health Care programs, and managed long term care plans) will need to pay a living wage in geographic areas that have a living wage law. For more information, visit:
PHI National: "Worker Parity Included in Proposal to Reform New York Medicaid"
CA: Campaign To Protect Adult Day Health Care
In his proposed FY 2011-2012 state budget, Governor Jerry Brown suggested eliminating the Adult Day Health Care (ADHC) program, and an analysis of a similar plan by Governor Schwarzenegger found eliminating ADHC would cost (not save) the state $51.6 million in 2010-11 with that cost rising to over $412 million by 2040-2041.However, under the most recent budget conference committee, state senators and representatives decided to eliminate Medi-Cal coverage of ADHC and propose creating an alternative, narrowly defined plan under a federal waiver. The California Senior Partnership started a campaign to stop the elimination of ADHC, including using a campaign commercial against the proposed cuts. For more information, visit:
Lewin Group: "Projected Economic Impact of Eliminating California's Medi-Cal Adult Day Health Care Program"
California Budget Project: "Back to the Future: How Do The Budget Plans Compare?"
California Senior Partnership: "Senior Partnership Launches Statewide Ad Campaign Aimed at Reversing Proposed Elimination of Vital Senior Program"
13 States Receive Additional Funding For Money Follows The Person
The Department of Health and Human Services recently announced that 13 states would receive more than $45 million in Money Follows the Person (MFP) grants to start the programs in their states with an additional $621 million committed through 2016. This additional funding is projected to help states transition 13,000 people out of institutions and into the community. In announcing the grants, HHS also highlighted the Community First Choice Option, another option for states to receive increased funding (six percent increase in FMAP) for providing additional community based options for Medicaid beneficiaries. For more information, visit:
HHS: "Affordable Care Act Supports States in Strengthening Community Living"
Firing Of Long-Term Care Ombudsman In Florida Will Be Investigated By AOA
Florida's Governor Rick Scott forced the resignation of the state's Long-Term Care Ombudsman in February and the Administration on Aging is now investigating the circumstances surrounding the forced resignation. Brian Lee was the head of the state's long-term care ombudsman program and had recently asked Florida nursing home operators to provide information about their ownership, a move which many speculated prompted his firing. Depending on the outcome of the investigation, the Administration on Aging could refer the case to the Inspector General or the U.S. Department of Justice, could provide technical assistance to the state, or could withhold money appropriated under the Older American's Act. The Orlando Sentinel reports that two bills have been recently introduced in the Florida legislature to water down the power of the Long-Term Care Ombudsman. For more information, visit:
Orlando Sentinel: "Feds to probe ouster of Florida's nursing-home watchdog"
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"Family Caregiving 2010: Year In Review" Released
In honor of the upcoming one-year anniversary of the Affordable Care Act, Family Caregiver Alliance National Center on Caregiving releases "Family Caregiving 2010: A Year in Review." The guide highlights some of the most important developments in 2010 affecting family caregivers, including legislative and policy changes; research focused on caregivers; and media coverage of family caregiving. In conjunction with this guide, Family Caregiver Alliance also announces the recipients of its "Best of 2010" Awards that focus on nine noteworthy family caregiving individuals, organizations, and pieces of legislation. For more information, visit:
FCA: "Best of Awards for 2010"
FCA: "Family Caregiving 2010: A Year in Review"
Elder Abuse Highlighted Through Reports And Hearings
A recent Senate Committee hearing focused on elder abuse, which the GAO estimates happened to an estimated 14 percent of noninstitutionalized older adults in the past year. In a survey of state Adult Protective Services, the GAO found that on average, 5,335 cases (median of 1,982) of elder and at-risk adult abuse cases were substantiated in each state in 2009. Recommendations from the GAO include implementing a nationwide APS system, establishing a national resource center on APS, and requiring a periodic national study of elder abuse. A recent AARP analysis found that despite increased demand for APS (especially for financial exploitation) by almost half the states, funding for APS in most states remained flat for FY 2010 and 2011. The Administration on Aging manages the National Center on Elder Abuse that serves as resource center with statistics, resources, and information for practitioners, policymakers, and families. For more information, visit:
U.S. Senate Special Committee on Aging: "Hearing on Elder Abuse"
GAO: "Elder Justice: Stronger Federal Leadership Could Enhance National Response to Elder Abuse"
GAO: "Survey of Adult Protective Services Program Administrators"
AARP: "Adult Protective Services: Increased Demand and Decreased Funds"
AOA National Center on Elder Abuse
Report By Congressional Research Service On CLASS Act
The Congressional Research Service wrote a report in January about the CLASS Act, a voluntary long-term care insurance program that was included as part of the Affordable Care Act. The report is available on the Kaiser HealthReform Website and includes analysis on how the CLASS program would interact with other government long-term care programs, including Medicaid. For example, for CLASS beneficiaries who are also receiving institutional care funded by Medicaid, the beneficiary would retain 5% of the benefit while the remainder of the benefit is applied to the cost of providing care. For CLASS beneficiaries receiving Medicaid home and community based services or All-Inclusive Care for the Elder (PACE), the beneficiary may retain 50% of the CLASS benefit while the remainder is applied to the cost of their services. President Obama's FY 2012 budget includes $120 million for the implementation of CLASS and the Subcommittee on Health has a hearing about CLASS scheduled for this Thursday, March 17 at 9:30am. For more information, visit:
Congressional Research Service CLASS Report
US House of Representatives, Committee on Energy and Commerce, Subcommittee on Health Hearing on CLASS
Lifespan Respite Care Program Reauthorization Input Requested
The Administration on Aging is seeking input concerning the reauthorization of the Lifespan Respite Care Program (LRCP) that is expected to be reauthorized in 2011, effective for FY 2012. While legislation creating the program was passed in 2006 with appropriations of $289 million for FY 2007 through FY 2011, Congress did not fund the program for FY 2007 or 2008, and funding for FY 2009 and FY 2010 was $2.5 million each year. Input is due by March 31st, 2011, and Family Caregiver Alliance strongly encourages family caregivers to provide input on how their lives have been affected by the Lifespan Respite Care Program. For more information, or to provide input, visit:
Administration on Aging: Lifespan Respite Care Program Reauthorization Page
Arch National Respite Network and Resource Center "Legislative Alerts"
Canada: Debate On GPS Tracking Devices For Wandering Elderly
Earlier this year, the Montreal Police Department shelved a program to give GPS bracelet devices to elderly who are prone to wandering. The bracelets allow family members to track the whereabouts of a loved one using GPS technology. While the proposal was shelved, the police department is now reconsidering after two elderly citizens went wandering in February, leading to extensive searches. In addition to this government program, the author also discusses a smart phone application that allows family members to log onto a website to see the most recent locations of the phone's owner. In order for all of these technologies to function properly, the wanderer must keep the device with them when they wander. For more information, visit:
Montreal Gazette: New cellphone app lets 'watchers' track 'wanderers'
FCA Blog: "Baby Boomer Caregiver Use of Technologies and Social Media Increasing" (scroll down)
New Zealand: 2011 Chart Book On Health Of Older Maori Released
The New Zealand Ministry of Health recently released the 2011 chart book with statistics on the health of older Maori in New Zealand. The Maori are the indigenous population of New Zealand and the authors explain that they provide statistics for Maori aged 50 and older because of shorter life outcomes (as compared to non-Maori). The population of Maori will grow to almost ten percent of the overall population of people who are 50 years or older by 2026, and the government will need to adapt its health care system, especially since this population has a higher burden of chronic illnesses. For more information, visit:
New Zealand Ministry of Health: Tatau Kura Tangata: Health of Older Māori Chart Book 2011
Report: Hospitals In Wales Provide "Shamefully Inadequate" Care To Elders
The Older People's Commissioner for Wales released a report on March 14 and the Commissioner suggested that hospitals have considerable room for improvement in the care provided to elders, who represent 47% of inpatient admissions in 2009 and 2010. According to the report, avoidable incontinence happens regularly due to a lack of prompt response for calls for toileting assistance, a failure to prioritize toileting needs in care routines, and an over reliance on pads. Discussions of patient care are not always held in private, and care for patients with dementia can also be improved. Some patients also report positive experiences with doctors and ward leaders. The Commissioner's 12 recommendations include improving toileting, the discharge process, dementia care, and training for hospital staff. The Commissioner also recommends a pro-active approach to receiving patient and caregiver feedback, instead of only relying on complaints. For more information, visit:
Older People's Commissioner for Wales "Dignified Care?: The Experiences of Older People in hospital in Wales"
BBC: "'Shameful' care of older patients in Wales, says report"
Elderly Drivers Drive Slower And Are Less Likely To Notice Pedestrians
A study by Israeli researchers tested the reaction times of elderly and non-elderly drivers and found that elderly drivers noticed pedestrians half as often as younger drivers. Elderly drivers were also slower to respond to hazardous situations including pedestrians and researchers concluded that elderly drivers reduce their speeds by about 20 percent to allow for greater time to process and respond to driving hazards. Another study, conducted at the University of Granda, found that drivers aged over 60 have higher crash rates than drivers of other age groups except drivers aged 20 or younger. According to the authors, approximately 25% of drivers aged 74 and older keep driving, an activity that has been linked to greater life satisfaction. For more information, visit:
Ben-Gurion University: "New BGU Research shows that Elderly Drivers Notice Pedestrians Half as Much as Younger, Experienced Drivers"
EurekAlert: "Elderly drivers have higher crash rates in non problematic environments than other drivers"
New York Times: "Should Doctors Stop Patients From Driving?"
FCA Fact Sheet: "Dementia and Driving"
Cancer Patients And Caregivers Perceive Caregiving Differently
A recent study surveyed 100 cancer patients and 100 caregivers for patients with cancer and found that the patients perceive the challenges of caregiving differently than caregivers. Caregivers were more likely than patients to report difficulty with the psychosocial aspects of caregiving and were also more likely (than patients) to report helping with logistical needs. The length of time since diagnosis, race, and age were associated with patients' expressed needs, while number of hours providing care was associated with the caregivers reporting needs. For more information, visit:
Supportive Care in Cancer: "Psychosocial aspects of caregiving: perceptions of cancer patients and family caregivers"
ASCO Focuses On Palliative Care And Planning For Advanced Cancer Care
The American Society of Clinical Oncology (ASCO) released a new policy statement in January, encouraging doctors to initiate discussions about the "full range of palliative care and treatment options soon after patients' diagnosis with advanced cancer." At a recent policy forum, the CEO of ASCO, Allen S. Lichter, MD, explained the need for oncologists to start conversations about palliative care, especially since a recent poll found that doctors and providers are the most trusted source of information. In an article about the new policy statement, a nurse at a West Palm Beach hospital, who serves as a oncology patient navigator, explains that "People need to know not to be afraid of talking about it. I have never, ever, ever had a family say to me that we did this too soon. I have had families say I wish we did this sooner." ASCO has released a guide for patients and intends to release more detailed guidelines for doctors later this year. For more information, visit:
ASCO: "Advanced Cancer Care Planning"
The Palm Beach Post: "New guidelines urge doctors to start end-of-life discussions sooner."
National Journal and Regence Foundation Policy Forum Recording: Living Well at the End of Life
Webinar: "Caregiving: Work With Your Siblings To Keep Your Life, Family and Sanity Intact"|
Family Caregiving Alliance is sponsoring a webinar with author and caregiver Francine Russo on working with your siblings to balance the load while caring for parents. Through the webinar, participants will be able to: recognize family dynamics that are affected by caregiving challenges; navigate conflict, guilt and angst from both siblings and parents; and utilize tools and strategies that will help your family find common ground as your parents age. Francine Russo wrote on baby boomer and aging issues for nearly a decade for Time magazine. Her personal family caregiving experience prompted her to write the book, "They're Your Parent's Too! How Siblings Can Survive Their Parents Aging Without Driving Each Other Crazy!" The webinar is on Thursday, April 28th from 12:00 to 1:15pm, Pacific Daylight Time. For more information, or to register, visit:
FCA: "Caregiving: Work with your siblings to keep your life, family and sanity intact!"
Webinar: "Doing the Best We Can: An Overview Of Online And Clinical Resources For Care Providers Of Families Struggling With Dementia"
The American Psychological Association and Dr. Joseph Gaugler from the University of Minnesota are presenting a webinar that will explore helpful online and clinical resources for providers of care to families grappling with the challenges of dementia. Activities on the Webinar include an evidence-based synthesis of effective interventions for family caregivers of persons with dementia; a review of online resources for care providers (including APA's Caregivers Briefcase); and an overview of other helpful clinical and online resources for care providers and families with dementia. The webinar is eligible for 1.5 hours of continuing education credits and costs $25. For more information or to register, visit:
American Psychological Association and University of Minnesota
Webinar: Forensic Markers Of Elder Abuse
A Webinar on March 22, sponsored by the Government Innovators Network, will focus on the forensic and physical markers of elder abuse. Andy Mao is Senior Counsel for Health Care Fraud and Elder Abuse at the Department of Justice and will serve as moderator for the Webinar. Speakers include Lisa M. Gibbs, MD, Associate Medical Director, Family Medicine at the School of Medicine at the University of California, Irvine; Cherie Hill, Detective with the Anaheim Police Department; and Richard Harruff, MD, PhD, the Chief Medical Examiner for Seattle-King County, Washington. For more information, or to register, visit:
Government Innovators Network: "Elder Abuse Series: Forensic Markers"
Conference: 2011 Aging In America April 26-30, 2011
The Annual Conference of the American Society on Aging (ASA) is being held in San Francisco, California April 26-30, 2011. The conference attracts professionals from diverse disciplines and provides an opportunity for attendees to learn about current trends within the field of aging. The National Center on Caregiving at Family Caregiver Alliance (FCA) will be presenting or facilitating at the following sessions:
FCA's National Center on Caregiving will also be hosting a reception to honor the four recipients of the 2010 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards.
- National Technical Assistance Centers for Caregiving and Respite: Creating Learning Communities on April 27th,
- Caregivers are Partners in Care: Shifting the Paradigm Towards Consumer and Family Centered Care on April 27th, and
- Hear from the 2010 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awardees on April 28th.
American Society on Aging
Family Caregiver Alliance National Center on Caregiving
Brain Injury Documentary Airs On PBS Stations In March
Brain Injury Dialogues, a documentary about brain injuries, is airing on PBS stations around the nation during the month of March. The film's creators intend to bring greater awareness about brain injures and the support available to brain injury survivors and their families. For more information, visit:
Brain Injury Dialogues
FCA Fact Sheet: Traumatic Brain Injury
Article Discusses Starting "The Talk" With Mom And Dad
A recent article in the Wall Street Journal discussed the difficult conversations for adult children and their parents in making decisions around health and living situations. A daughter profiled in the article explains that her parents were hesitant to move out of their home until she designed a strategic plan that allowed everyone to discuss the pros and cons of the current situation. For example, while the parent's desire to care for each other was listed as a "pro," the ten trips that the daughter had to make in 2009 from Dallas to her parent's home in Memphis to assist with health problems was listed as a "con." After creating the plan and thinking about it for a few weeks, her parents agreed to move to a senior-living community in Memphis. A chairman of a business that provides in-home caregivers suggests using the "40-70" rule: if the children are age 40 or if the parents are age 70, then it's time to start the discussion. Staff at the National Center on Caregiving at Family Caregiving Alliance speak with family caregivers every day, and encourage creating plans similar to the one described in this article. For example, what are the pros and cons of the current situation, what sort of events might "trigger" a move (i.e. a decline in health, a fall, etc), and what are financial implications of the current situation and making changes? For more information, visit:
Wall Street Journal "Having 'The Talk' With Mom and Dad"
FCA Fact Sheet: Community Care Options
New Guide Explains How To Serve As Medical Decision Maker In Florida
A professor at Florida State University's College of Medicine recently published a guide for people who have been designated the medical decision-maker for another person. The author, Marshall Kapp, is the director of the Center for Innovative Collaboration in Medicine and Law, and is also a professor of geriatrics in the medical school. The 20-page guide, designed for consumers, uses plain language to explain the responsibilities of this role. The booklet stresses communication between the patient and decision maker and includes a two-page quiz that allows patients and their decision makers to compare notes and see if they have a similar understanding of the patient's preferences. For more information, visit:
FSU Center for Innovative Collaboration in Medicine and Law "Making Medical Decisions for Someone Else: A Florida Handbook"
FCA Fact Sheet: "Durable Powers of Attorney"
AARP Sues HUD Over Reverse Mortgages
On March 8, AARP announced a lawsuit against the U.S. Department of Housing and Urban Development (HUD) over a policy that AARP says HUD changed in 2008. Reverse mortgages can be used by homeowners who are 62 or older in order to extract the equity in their homes. Instead of paying a mortgage, the homeowner receives either monthly payments or a lump sum and the loan is paid off (with interest) when the homeowner moves out or passes away and the home is sold. In 2008, HUD issued what it calls a "clarification" but AARP is calling a policy change. Under this new clarification/policy change, if one spouse took out a reverse mortgage and passed away and their surviving spouse is not on the reverse mortgage, then the surviving spouse must pay off the balance of the loan quickly if he or she wants to keep the home, otherwise the bank can foreclose. Because of the housing meltdown, home values have fallen, and this could lead to a surviving spouse or heirs having to pay off a larger loan than the actual value of the house if they want to remain in the home. AARP is suing on behalf of three surviving spouses who are facing foreclosure and argues that the 2008 change/clarification contradicts existing HUD rules as well as mortgage contracts and also suggests that the insurance required with reverse mortgages (HECM) exists so that a surviving spouse or heir would never have to pay more than the current value of the home. In addition, AARP argues that heirs/surviving spouse will have difficulty securing financing that exceeds the value of a property. For more information, visit:
AARP: "HUD Targeted in Suit for Illegal Reverse Mortgage Foreclosure Actions"
New York Times: "A Red Flag on Reverse Mortgages"
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?2011 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 Policy_Digest@caregiver.org or visit the Family Caregiver Alliance website at www.caregiver.org.
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