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| Home > Newsletters > Caregiving PolicyDigest > Policy Digest, Volume XI, Number 23, December 7, 2011
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| A Newsletter of FCA's National Center on Caregiving |
December 7, 2011
Volume XI, Number 23
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State Legislation, Policy & Reports
- CA: LTC Summit Proceedings, And Del Mar Caregiver Resource Center Profiled More...
- WA: Judge: Dept. Of Health And Social Services Owes Caregivers $96 Million More...
- TN: State Considers Eliminating Hospice Counseling Services In TennCare More...
- FL: LTC Ombudsman Expands Lawsuit Against Governor For Firing More...
- WV: State Freezes Enrollment In Medicaid Aged And Disabled Waiver Program More...
- PA: Providers And Consumers Slow To Embrace New Category Of Long-Term Care More...
Federal Legislation, Policy & Reports
- Medicare And Medicaid Data Will Be More Accessible More...
- HUD: $749 Million In Grants To 42 States Will Benefit 4,800 Elderly and Disabled More...
- Poll: Consumer's Favorite Part Of Affordable Care Act? Short Health Plan Summaries More...
- Study Finds 164 Accountable Care Organizations In Existence More...
International News - Australia: Elderly Are Entering Nursing Homes Later, With Greater Care Needs More...
- Canada: Extensive Report On Hospice Care Released More...
- Canada: 23% Of Seniors Take 10 Or More Medications Every Day More...
- Australian Welfare Report 2011: Chapter 7 Focuses On Caregivers More...
Research Reports & Journal Articles
- Study: Caregivers For Loved Ones With MCI Changes Daily Stress Levels More...
- Generations United Report: One In Six Americans Live In Multigenerational Households More...
Conferences & Trainings
- Webinar: Creativity, Communication and Dementia, December 8, 12:00pm (PST) More...
- NASUA Online Course Focuses on Aging Information & Referral/Assistance More...
- Aging in America Conference 2012 More...
- Webinar: CMS Innovation Center, December 8, 1:00PM (EST) More...
- Webinar: State Aging And Disability Advocates In Duals Integration December 9, 2:00PM (EST) More...
Funding, Media & Miscellaneous
- Caregiving: A Perspective From A 87-Year Old Mom On Boomers And Their Parents More...
- AARP PPI Caregiver Forum: Presenter Asks: "Should We Occupy Elder Care?" More...
- Article: Technology Is Good For Patients, Caregivers, And Doctors More...
Research Registry
- Lewey Body Dementia Association Survey More...
If you are interested in having your registry listed, please contact info@caregiver.org
FCA is on Facebook- Click here to visit our page
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The Scan Foundation organized a summit on California's long-term services and supports in September, and proceedings from the conference are now available in a report. While the state budget crunch continues to limit options, speakers at the conference also discussed strategies to make the system more consumer and family-focused. The recent AARP PPI score-card and a survey by the Scan Foundation on long-term care were both part of the event, and the afternoon session polled summit attendees on state priorities for improving long-term care. A policy brief released today by the UCLA Center for Health Policy Research highlights the experiences of 33 older and disabled Californians who are receiving non-institutional long-term services and supports, and one of the policy recommendations in the report is to consolidate California's many long-term care programs and provide a single entry point for participants.
The Del Mar Caregiver Resource center was recently profiled by HealthyCal.org for its work with family caregivers in Monterey, Santa Cruz, and San Benito counties. A daughter who is caring for her father with diabetes and step-mother with late-stage Alzheimer's is assisted by a family consultant who helps her with respite, and navigating long-term care services. The center is part of California's statewide network of 11 Caregiver Resource Centers that are funded by the California Department of Mental Health. For more information, visit:
Scan Foundation Summit Proceedings
UCLA CHPR: Independence at Risk: Older Californians with Disabilities Struggle to Remain at Home as Public Supports Shrink
HealthyCal.org "Del Mar offers caregivers a helping hand in Salinas"
The Seattle Times reports that a county judge in Washington State ruled earlier this month that Washington's Department of Social and Health Services (DSHS) owes 22,000 home-care workers about $96 million in back pay and accrued interest. The lawsuit is based on a 2003 decision by Washington State to pay caregivers 15% less if they lived in the same household as the care recipient (in the state's Medicaid program). While the state plans to appeal the ruling, an attorney for the plaintiffs suggests that interest could cost $30,000 a day if the plaintiffs ultimately prevail. The state reversed the policy after the state Supreme Court ruled against the state in 2007, however, it never reimbursed caregivers for the four years of "lost" payments. The state of Minnesota recently attempted to cut the wages of caregivers for relatives by 20%, though a judge issued a temporary restraining order. A petition to stop the 20% cut in Minnesota was recently started on the Care2 petition website. For more information, visit: Seattle Times: "Judge: DSHS owes $96 million to caregivers"
The Tennessean reports that the state of Tennessee is considering eliminating hospice counseling services in the state's Medicaid program. Governor Bill Haslam asked each state department to make plans for a budget that is reduced by 5%, and the Director of TennCare explained that eliminating grief counseling, reducing provider reimbursement rates, cutting a grant program, and no longer covering prescription-strength allergy medication would achieve the 5% savings. For more information, visit:
The Miami-Herald reports that Brian Lee, the former Long-Term Care Ombudsman for the state of Florida, has expanded his lawsuit against three organizations after he was forced out of his position by Governor Rick Scott. Lee's amended complaint suggests that the Dept. of Elder Affairs and two nursing home trade associations violated a law against interfering with ombudsman activities and Lee also suggests that the FL Heatlh Care Association defamed him. An investigation by the Administration on Aging found that while Governor Scott did not violate the letter of the law, he did violate the spirit of the Older Americans Act. For more information, visit:
The Charleston Daily Mail reports that the state of West Virginia recently announced that it will not allow its Aged and Disabled Waiver Program to grow beyond the current 8,000 Medicaid clients receiving services through the waiver. The program provides eligible Medicaid clients with about $25,000 worth of in-home care annually, including through paying family members to provide care. The program had 4,700 participants in 2007, and has grown to 8,000 in 2011, with an estimated annual cost of $200 million. For more information, visit:
The Pittsburgh Post-Gazette reports that Pennsylvania launched a new category of long-term care this year known as assisted living which is designed to be a "middle ground" between nursing homes and personal care homes. While original projections by former Governor Rendell's administration suggested there would be 150 assisted living centers, there are currently only 10 (with 26 in the pipeline) and providers, including the 1,300 personal care homes, cite the cost of upgrades to residences, more training, higher licensing fees, and more regulation without increased reimbursement as a large obstacle to growth of these residential facilities. Governor Rendell's administration reversed course on seeking federal funding to help cover the cost of care for low-to-moderate income residents, which was also cited as a potential obstacle. One of the new assisted living centers profiled in the article currently charges $4,790 a month and has half of its beds occupied. For more information, visit:
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Medicare And Medicaid Data Will Be More Accessible
The San Francisco Chronicle reports that the Centers for Medicare and Medicaid announced earlier this month that Medicare will begin allowing employers, insurance companies, and consumer groups to begin using Medicare claims data, which was previously unavailable. This data has the potential to improve the quality of care, for example, report cards are set to be released by late 2012, and consumers can use them to choose a doctor. On a related note, CMS announced the launch of Medicaid.gov, a website that features data on each state's Medicaid programs, including pending and approved waivers, Affordable Care Act implementation efforts, and state-specific information. For more information, visit:
San Francisco Chronicle: "Feds to allow use of Medicare data to rate doctors"
Medicaid.gov
HUD: $749 Million In Grants To 42 States Will Benefit 4,800 Elderly and Disabled
The U.S. Department of Housing and Urban Development (HUD) announced in December that 42 states will receive $749 million in housing assistance grants under the Sections 202 ($545 million) and 811 ($137 million) Supportive Housing Programs. The money will support construction or major rehabilitation on more than 189 housing developments in 42 states and Puerto Rico, with an expected outcome of affordable housing for 4,800 households for elderly people and people with disabilities. The Section 202 program will provide $54 million in rental assistance for very-low income elderly person who are 62 years of age or older, while the Section 811 program provides housing for households with one or more very low-income individuals with a disability. Residents who receive assistance under either program generally have annual incomes of $13,500 or less (for a one-person household). For more information, visit:
HUD Press Release (November 16, 2011)
Poll: Consumer's Favorite Part Of Affordable Care Act? Short Health Plan Summaries
The Kaiser Family Foundation conducts a monthly tracking poll, and in the most recent survey, Americans were asked about their favorite and least favorite parts of the Affordable Care Act. The most popular provision (with 60% of respondents giving it a very favorable rating) was a new requirement that health plans provide consumers with a short, easy to understand description of their benefits and coverage. The Obama administration is currently writing the final regulations to implement this provision. Other provisions include the ban on denying coverage for pre-existing conditions (47% very favorable); closing the Medicare doughnut hole (46% very favorable); and tax credits for individuals and small business to pay for coverage (44 and 45% very favorable). The individual mandate, a provision advocated for by insurance companies (among others) during health care reform, was least popular, with only 16% viewing it favorably. For more information, visit:
Kaiser Family Foundation: "The Most Popular Provision in the ACA?"
Study Finds 164 Accountable Care Organizations In Existence
The Kaiser Health News blog recently covered a new report by Leavitt Partners focused on the number of Accountable Care Organizations (ACO's) in the U.S. The authors of the report estimated that there are 164 ACO's, and calculated this number through researching press releases, media reports, and interviews. Organizations were included in the ACO count if they self-identified as an ACO or if they were "adopting the tenets of accountable care." Of the 164 ACO's, 99 were sponsored by hospital systems, 38 by physician groups, and 27 by insurers, however, poor and rural regions showed little ACO growth. For more information, visit:
Kaiser Health News Blog: "ACOs Are Bursting Out All Over"
Report: "Growth and Dispersion of Accountable Care Organizations"
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Australia: Elderly Are Entering Nursing Homes Later, With Greater Care Needs
An article in the Sydney Morning Herald highlighted a trend of elderly Australians entering nursing homes later in life and with greater care needs. The Australian government provides a subsidy for nursing home care for its citizens, and a recent forecast projects that the costs for this subsidy will increase $1.9 billion above the original forecast that was released in May. Robyn Batten oversees a non-profit organization that operates 4,500 nursing home beds and explained that the proportion of low-care patients has fallen in the past three years from 40% to 13%, which has also affected the staff at nursing homes. The median stay in nursing homes is about two years for women and one year for men, and Batten suggests that about 60% of patients also have some level of dementia. For more information, visit:
The Sydney Morning Herald: "Elderly more frail before moving to aged care"
Canada: Extensive Report On Hospice Care Released The Parliamentary Committee on Palliative and Compassionate Care released a report in November that focuses on hospice and palliative care in Canada. The report is focused on four areas, including palliative and end-of-life care, suicide prevention, elder abuse, and a disability perspective on health care and community living. The authors note that only 16-30% of Canadians who need palliative care actually receive it, and also suggest that too many elders from the First Nation communities die in facilities far from their own homes. Family caregivers are recognized in the report for providing 70-80% of long-term care in Canada, at an estimated annual value of $25 billion. For more information, visit: PCPCC: Not to be Forgotten: Care of Vulnerable Canadians
Canada: 23% Of Seniors Take 10 Or More Medications Every Day
A recent article in the Toronto Star highlights a report recently released that focuses on elder Canadians and their health care. The report, Health Care in Canada, 2011: A Focus on Seniors and Aging, addresses current issues challenging the provision of care. While seniors represent 14% of the population, they use 40% of hospital services and account for 45% of all provincial and territorial government health spending. The authors also note that seniors account for 85% of patients who are considered "alternate level of care stays"- meaning they have completed their acute care phase of their treatment, but remain in an acute care bed, with 47% of seniors waiting to be moved to a long-term care facility. Sixty-three percent of senior Canadians took five or more prescription drugs in 2009, with 23% taking ten or more medications. In addition, one out of ten seniors are taking medications from the Beers list, which is an internationally recognized list of drugs that should only be taken by seniors if there are no alternatives. For more information, visit: Toronto Star: "One quarter of seniors taking 10 or more medications" CIHI Report: "Health Care in Canada, 2011: A Focus on Seniors and Aging"
Australian Welfare Report 2011: Chapter 7 Focuses On Caregivers
The tenth annual report from the Australian Institute of Health and Welfare was released last month and is an extensive report on the country's welfare services. Chapter seven focuses on the 2.6 million family caregivers in Australia, of these caregivers, 45% were caring for a spouse. The authors cite data from the Inquiry into Better Support for Carers that found that over 25% of caregivers were "hidden" as defined by not seeking service providers. Thirty-eight percent of primary caregivers wanted an improvement or more support in their situation, with caregivers who had been caregiving for five years or more seeking more help. Financial assistance was the most commonly reported additional support wanted by caregivers. For more information, visit: AIHW: "Australia's welfare 2011"
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Study: Caregivers For Loved Ones With MCI Changes Daily Stress Levels
A recent study of 30 spousal family caregivers for people with mild cognitive impairment (MCI) finds that the day-to-day challenges of caregiving can not only increase the levels of cortisol (stress-related hormone), but also had slower rates of decline of cortisol levels. The researchers called the 30 caregivers every day for a week to inquire about their days, interactions with their spouse and other family members, and about the loved one's behavior during the day. Saliva samples were also gathered on four of the days to measure cortisol levels. Dr. Tina Savla, the lead author, explains "Dealing with the day-to-day issues of living with a person with MCI can allow little time for recovery and may tax one's hypothalamic-pituitary-adrenal (HPA) system. The dysregulation in this system likely contributes to illnesses by further distressing the cardiovascular, metabolic, and immune functions." She adds that helping caregivers to learn effective stress management techniques early on may be especially helpful for the caregiver's physical health and psychological well-being. For more information, visit:
The Journals of Gerontology, Series B: "Effects of Daily Stressors on the Psychological and Biological Well-being of Spouses of Persons With Mild Cognitive Impairment" (abstract is free)
EurekAlert: "Caregivers at risk for health problems"
FCA Fact Sheet: :Mild Cognitive Impairment" (updated 2011)
Generations United Report: One In Six Americans Live In Multigenerational Households
A December report from Generations United finds that an increased number of Americans are living in multigenerational households, due in part to the poor economy and also to an increasing number of elders living with family members who provide care. The authors explain that more than 51.4 million Americans of all ages live in a multigenerational household, a greater than 10% increase since the start of the recession in 2007. The reasons cited include the current economic climate (66%); job loss/change/underemployment (40%); health care costs (20%); and foreclosures or other housing loss (14%). Seventy-two percent of respondents agreed that this type of household arrangement improved the financial situation of at least one family member, while 82% agreed that the arrangement has enhanced bonds or relationships among family members. Seventy-eight percent report that the arrangement can be stressful at times, and 75% agree that it helps make it easier to provide for care needs of a family member (including child care, older adult care, or special medical care). Policy recommendations include changing housing systems to accommodate multigenerational families, increasing funding for the National Family Caregiver Support Program to $250 million, fully funding the Lifespan Respite Care Program, and enacting a federal caregiver tax credit. For more information, visit: Generations United: "Family Matters: Multigenerational Families in a Volatile Economy"
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Family Caregiver Alliance is sponsoring a webinar: Creativity, Communication and Dementia webinar on December 8, 2011 at 12:00 p.m (PST). Two professionals in the aging field, Drs. Anne Basting and Gay Hanna, will discuss (1) the importance of increasing awareness among arts and aging professionals, family caregivers and others about the link between the arts and wellness in older adults; and (2) TimeSlips, a current program which has been effective with individuals with dementia. For more information or to register, visit:
FCA: "Creativity, Communication and Dementia"
The National I&R Support Center at the National Association for States United for Aging and Disabilities is offering a new online training course, "Basic Training for Aging I&R/A Professionals." The course contains four modules designed to assist professionals in enhancing their knowledge and also helps prepare participants to obtain a certification in Certified Information and Referral Specialist-Aging. The course is free, and the center is supported by the U.S. Administration on Aging. For more information, visit:
NASUA National I&R Support Center
Aging in America Conference 2012 Conference The 2012 Aging in America conference, sponsored by the American Society on Aging, will take place March 28-April 1, 2012 in Washington, DC. The event attracts 3,000+ attendees, and early registration (at a reduced rate) ends on December 15. Family Caregiver Alliance will host several sessions, including "Family Caregivers: Policy Perspectives and Media Musings," as well as a reception to honor the 2011 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards. For more information, visit: Aging in America 2012
Webinar: CMS Innovation Center, December 8, 1:00PM (EST) The Administration on Aging is hosting a webinar on December 8, from 1:00-2:00PM (Eastern) with staff from the Innovation Center at the Department of Health and Human Services to focus on the Health Care Innovation Challenge. Through this program, HHS will award up to $1 billion in grants to applicants to deliver better health, improved care, and lower costs for people in Medicare, Medicaid and CHIP, with a focus on people with the highest health care needs. For more information or to register, visit: AOA:The Health Care Innovation Challenge
Webinar: State Aging And Disability Advocates In Duals Integration December 9, 2:00PM (EST) The Friday Morning Collaborative is sponsoring a webinar on December 9, from 2:00-3:30PM (Eastern) focused on the nine million dual eligible Americans and current efforts to better coordinate care and reduce expenses for this population. Speakers include Edo Banach, CMS Medicare-Medicaid Coordination Office; Hilary Dalin, National Council on Aging; Kevin Prindiville, National Senior Citizens Law Center; and Mary Lou Breslin, Disability Rights Education & Defense Fund. For more information, or to register, visit: Involvement of State Aging and Disability Advocates in Duals Integration
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Caregiving: A Perspective From A 87-Year Old Mom On Boomers And Their Parents
A recent column on Slate.com provides a unique view from the care recipient's perspective, in this case, from a mother to her baby boomer daughter. Lilian Rubin, the writer (and mother) explains that her daughter has increased the amount of phone calls she makes to her mom and has reduced her travelling abroad. A friend who reviewed the article highlighted the difficult issue of communication between parents and their adult children: "It would be nice if you'd expand on what you do need. Parents tend not to say what they need, and we children are left to try to figure it out, which leads to problems when we make mistakes." Rubin weighs the feelings and issues for both the adult children and their parents on issues including driving, where to live, and paying for long-term care. Rubin concludes that both parents and their adult children should try to influence health care policy: "At minimum, a change in Medicare policy that would allow for long-term care, whether outside or inside the home, without requiring that the recipient be impoverished - a policy shift that would ease the financial anxieties of both generations and surely assuage some of their psychological anxieties as well." For more information, visit:
Salon.com: "The dilemma of taking care of elderly parents"
AARP PPI Caregiver Forum: Presenter Asks: "Should We Occupy Elder Care?"
AARP's Public Policy Institute hosted a forum earlier this month focused on public policy and caregiving and the majority of the guests had direct experience with caregiving, which kept the conversation grounded in the day-to-day realities of caregiving. Carole Levine explained that the availability of family caregivers does not absolve policymakers of their own responsibility to make sure that their actions assist rather than destroy families. Susan Denzter noted the context of the forum, with the US House of Representatives voting to repeal the CLASS program the day before and considering whether or not to stop funding the Clearinghouse for Long-Term Care. Jonathan Rauch suggested that instead of multiple policy proposals, there needs to be an Occupy Elder Care to create the same social power and movement that pushed through changes in the past during the feminist, gay rights, and civil rights movements. Gail Sheehy joked about the "bouncer" at hospitals (the discharge planner) while Dr. Peter Rabins said that the current discharge process is a "national disgrace." The forum is now archived, for more information or to view it, visit: PPI Solutions Forum: The Challenges of Family Caregiving- What Needs To Be Done? Forbes: Howard Gleckman (Panelist at forum): "Occupy Elder Care: Why Caregivers are Bad Advocates"
Article: Technology Is Good For Patients, Caregivers, And Doctors
A recent article in American Medical News focuses on how technology can enable family caregivers to be more involved in the care of their loved one. A pulmonologist interviewed for the article explains that when a patient brings a family caregiver to an appointment, he begins the conversation by discussing when and how he can share information with the caregiver. A study by the National Alliance for Caregiving published earlier this year found that caregivers think technology can reduce stress, make them more effective, and save time. HIPPA is cited as one obstacle for information sharing between doctors, patients, and their caregivers. For more information, visit: American Medical News: "How technology can connect doctors and caregivers"
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 Lewey Body Dementia Association Survey The Lewey Body Dementia Association (LBDA) is conducting a survey to assess if there are differences in how grief is experienced by caregivers for individuals with Lewy bodies, Alzheimer's disease, Parkinson's disease with and without dementia, and frontotemporal degeneration. The survey will also assess the well-being and quality of life for caregivers of individuals diagnosed with the neurodegenerative diseases. Internet access is required to participate in the study, and LBDA needs 500 caregivers who are currently providing care for each different disease that is being studied. For more information, or to participate, visit:
Neurodegenerative Disease Caregiver Study
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To find caregiver support services in your state, visit FCA's Family Care Navigator http://caregiver.org/caregiver/jsp/fcn_content_node.jsp?nodeid=2083
?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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Caregiving PolicyDigest is a publication of the National Center on Caregiving at Family Caregiver Alliance, 180 Montgomery Street, Suite 900, San Francisco, CA 94104.
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