State Legislation, Policy & Reports 

1. CT: "Insurance Capital Of The World" Drops Managed Care In Medicaid  More...
2. CT: Advocates Sue State Over Medicaid Application Delays  More...
3. ME: Governor's Proposed Budget Eliminates Medicaid Funding For Assisted Living  More...
4. CA:  Governor's Proposed Budget Eliminates Caregiver Resource Centers  More...
5. NJ: Law Implementing POLST Enacted  More...
6. WI: Budget Cap On Family Care Lifted, Possibly Due To Federal Pressure  More...

Federal Legislation, Policy & Reports 

1. HHS Announces Quality Measures For Medicaid-Eligible Adults  More...
2. NASUAD Survey On AAA's Using Participant Experience Surveys  More...
3. Senator Sanders Will Introduce Reauthorization Of Older Americans Act  More...
4. National Plan To Address Alzheimer's Disease Draft Framework Released  More...
5. Comment Period Open For Ending The Companionship Exemption  More...

1. Q&A About UK's Long-Term Care System And Proposals To Fix It  More...

Research Reports & Journal Articles

1. Report Released On The Aging Services Network  More...
2. 2010 Census: Largest Increase In People Aged 65; More Older Males Than Females  More...
3. Evidence Of Effectiveness Of Quality Improvement Interventions For End Of Life Care  More...
4. Study: Heart Attack Risk Increase 21% After Losing A Loved One  More...
5. Report: Medicaid And The Elderly  More...

Conferences & Trainings

1. Aging in America Conference 2012 Conference  More...
2. Webinar: The Role Of Geriatric Social Workers: Jan 25, 1:00-2:30PM (EST)  More...
3. Webinar: Building Partnerships To Promote Activity And Engagement For Older Adults, Jan 26, 1:30-2:30pm (EST)  More...
4. Webinar: Top Ten Scams Impacting Older Adults, How To Avoid Being A Victim, Jan 12, 1:30-2:30PM (EST)  More...
5. $10,000 Award For Senior Transportation Services More...

Funding, Media & Miscellaneous 

1. Article Addresses "In Sickness And In Health" As A Caregiver More...
2. Blog Questions Politics Of America's Fragmented Long-Term Care System  More...
3. Hospitals Help Nurses With Compassion Fatigue  More...
4. Blog: Do Doctors Chose Differently For Their Own End-Of-Life Care Choices?  More...
5. New Guide Helps LGBT Elders Navigate Long-Term Care Options in California  More... 
6. Brochure: 10 Things You Should Know About Aging With Dignity And Independence  More... 

Research Registry  

1. Clinical Trial Recruiting Stroke Patients  More...
2. University Of Washington Study: (LIFT) Life Improvement Following Traumatic Brain Injury  More...
3. Lewey Body Dementia Association Survey  More...

If you are interested in having your registry listed, please contact info@caregiver.org 

Kaiser Health News reports that as of January 1, the state of Connecticut is bucking a national trend of Medicaid managed care and is dropping private health plans from its Medicaid program.  Oklahoma made a similar move in 2005 and according to the state Medicaid director, quality and member satisfaction are high while cost per member has grown at an average annual rate of 1.2% for the past five years.  Health advocates in Connecticut applauded the decision, citing low spending on health care, access issues, and a 2009 report that the state overpaid insurers by $50 million a year.  Doctors interviewed in the story cited difficulty with multiple rules in different plans, payment delays, and problems with specialist referrals.  While base reimbursements will stay the same, doctors will be eligible for bonuses of up to $25,000 a year for improving quality and coordination of care.  For more information, visit:

 

 
HHS Announces Quality Measures For Medicaid-Eligible Adults

HHS announced earlier this month that it has identified 24 core quality measures for Medicaid-eligible adults.  The Affordable Care Act directed HHS to identify the measures and HHS partnered with AHRQ to examine 1,000 measures and ultimately publish 51 measures for public comment, and this list was then reduced to 24 measures.  Public commentary raised questions about if the measures would be applied to managed care and fee-for-service, and HHS explained that the core set would be used across all systems, with additional guidance provided.  Comments also focused on the need for measures that "address a range of disabilities present among Medicaid beneficiaries and those receiving home and community-based services."  In its response, HHS explained that the subcommittee did not indentify existing measures that also met scientific soundness criteria, but that new measure development will be prioritized as part of the Medicaid Adult Quality Measures Program.  For more information, visit:

Federal Register: "Medicaid Program: Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults" 

FCA Blog: "Formalizing 'Person and Family-Centered' Care in Healthcare" 

Commonwealth Fund: "Measures Aim to Boost Quality of Care for Adults in Medicaid" 

 
NASUAD Survey On AAA's Using Participant Experience Surveys

NASUAD recently released results from an ongoing survey of state agencies on aging and whether or not they conduct participant experience surveys.  The introduction notes that measuring quality in HCBS for the elderly and disabled is difficult and that AHRQ has only identified one measurement (readmission or admission to the hospital).  The current report includes responses from 22 states as well as copies of survey instruments.  The report will be updated as more responses are received.  For more information, visit:

NASUAD: "Participant Experience Survey" (Note: Large file may be slow to load) 

 
Senator Sanders Will Introduce Reauthorization Of Older Americans Act

Senator Bernie Sanders (I-VT), Chairman of the Senate Subcommittee on Primary Health and Aging, announced that he will introduce legislation reauthorizing the Older Americans Act later this month.  A press release noted the importance of programs providing meals, home-care, coordinating of long-term care, job training and legal services when one in five older Americans survives on an average income of $7,500 a year. The proposed legislation would change how the cost-of-living is calculated for the elderly, strengthen the meals programs with a 50% increase in funding, and make changes to job training and the long-term care ombudsman program.  For more information, visit the links below, and see the December report on the Aging Services Network featured in the "Research Section" of this issue.

Press Release: "Chairman Sanders to Introduce Older Americans Act Reauthorization" 

Leadership Council of Aging Organizations: "Consensus Recommendations for OAA Reauthorization"  

 
National Plan To Address Alzheimer's Disease Draft Framework Released

The draft framework includes five goals in order to prevent and effectively treat Alzheimer's by 2025.  The plan calls for a summit in May 2012 sponsored by the National Institute on Aging that will provide expert input and identify milestones in slowing progression, delaying onset, and preventing Alzheimer's, and the proceedings will be open to the public.  Goal 3 of the plan calls for better training for caregivers, better identification and support of caregivers, and more assistance with planning for long-term care before it is actually needed as well as maintaining the dignity, safety, and rights of people with Alzheimer's.  The Alzheimer's Association has created a website for people to provide feedback on the plan to HHS.  For more information, visit:    

HHS: "Draft Framework for the National Plan to Address Alzheimer's Disease" 

Alzheimer's Association: "Your Input"  

 
Comment Period Open For Ending The Companionship Exemption

The Department of Labor announced a notice of proposed rule making in December that would end the companionship exemption for home care workers.  The policy change has been somewhat controversial, with some home care agencies concerned about the move while advocates for direct care workers applaud the move.  Perspectives from both sides are provided below.  The Department of Labor is now accepting comments until February 27, 2012.  For more information, or to submit a comment, visit:

"Application of the Fair Labor Standards Act to Domestic Service" 

PHI President Steven Dawson Addresses Business Owners' Concerns About the DOL's Proposed Rule on the Companionship Exemption 

President Obama supports labor law change threatening America's seniors  

 

Report Released On The Aging Services Network    

In December, the National Health Policy Forum released an update to a background paper that was originally published in 2008.  The authors note in the introduction that the aging services network's ability to sustain current capacity and possibly expand depend on the ability to attract and retain additional resources, a challenging proposition given budget constraints at all levels of government.  The network consists of 56 state agencies on aging, 629 area agencies on aging, 246 Indian Tribal and Native Hawaiian organizations, nearly 20,000 service provider organizations, and thousands of volunteers.  The Older Americans Act, which created the foundation for the aging services network, includes seven titles, with Title III comprising the largest component and representing 70% of the Act's FY 2011 appropriation.  The authors note that while there is not much evaluation information available for the National Family Caregiver Support Program, the Administration on Aging is currently completing a national evaluation. For more information, visit:

NHPF: "The Aging Services Network: Serving A Vulnerable and Growing Elderly Population in Tough Economic Times" 

FCA Blog: "The Aging Services Network: Ready to Assist Family Caregivers" 

2010 Census: Largest Increase In People Aged 65; More Older Males Than Females

  
A Census brief released in November provides data on the growth of the number of Americans aged 65 and older.  The authors note that the 2010 Census found more people aged 65 years and older than in any previous census.  The population of people aged 65 and older increased from 2000 to 2010 at a rate of 15.1%, which is larger than the total U.S. population growth of 9.7%.  Males had a more rapid growth in the older population than females, and the largest growth rate was for males aged 85-94 years old (46.5%).  Females in the same age group increased 22.9%.  The largest growth for women was for females aged 65 to 69 years old at 28.2%.  For more information, visit:

U.S. Census: The Older Population: 2010   

Evidence Of Effectiveness Of Quality Improvement Interventions For End Of Life Care

AHRQ is accepting comments on a draft paper (until January 24, 2012) that reviews the evidence on the effectiveness of quality improvement interventions for end-of-life care.  The authors examine 93 studies and find that "Of the 22 studies targeting continuity, coordination of care, and transitions, 33% evaluating quality of life as an outcome, 67% evaluating patient satisfaction, and 46% evaluating healthcare utilization found a statistically significant improvement with the intervention."  "For communication and decision making, only 22% of studies addressing patient or family satisfaction found a statistically significant improvement, compared to 73% for healthcare utilizations."  The authors note there is room for improvement and that future research should improve recruitment and retention to ensure a sufficient sample size, better development and description of interventions, and better selection and standardization of outcome measures and tools.  For more information or to submit comments, visit:

AHRQ  

Study: Heart Attack Risk Increase 21% After Losing A Loved One

A study published in Circulation interviewed 1,985 patients who had suffered heart attacks during a five-year period (1989-1994).  Patients were asked about possible trigger events, and 13.6% had experienced the loss of a significant person in the prior six months.  The incidence rate of heart attacks was elevated 21.1% within 24 hours of the death of a significant person and declined steadily each subsequent day.  The authors conclude that people with already high cardiovascular risk may be specially vulnerable.  For more information, visit:     

Circulation: "Risk of Acute Myocardial Infarction after Death of a Significant Person in One's Life: The Determinants of MI Onset Study" (Abstract is free- Study may be free ) 

EurekAlert: "Heart attack risk rises after loss of loved one" 

Report: Medicaid And The Elderly

A working paper from the National Bureau of Economic Research provides an overview of the eligibility channels for people over the age of 65 to qualify for Medicaid.  The authors compare the categorically needy (described as mostly life-long poor individuals) vs. the medically needy (people who might have earned substantial amounts but have become impoverished).  The report includes charts for the 50 states on State SSI supplements, 2009 income and asset limits, estate recovery percentages, and eligibility criteria for Medicaid waivers.   The report is free for subscribers, corporate associates of the NBER, journalists, employees of the U.S. federal government with a ".gov" domain name or to residents of "nearly any developing country or transition economy," for all others, it is $5 to download. For more information, visit:  

NBER: "Medicaid and the Elderly" 

Article Addresses "In Sickness And In Health" As A Caregiver

A recent profile in the Washington Post Magazine of a caregiver, Page Melton, whose husband, Robert Melton, suffered brain damage after a stroke, addresses how Page Melton addressed the "In Sickness and Health" vows of their marriage.  Robert Melton suffered a brain injury after a heart attack and collapse in September 2003.  While he came home for some time, experts suggested a routine would be helpful for Robert and Page eventually chose for Robert to live at an assisted living facility in 2004.  Page became an advocate and testified to the Virginia legislature about the need for a brain-injury waiver in Medicaid that would enable more people to remain in their homes.  In 2008, Page reconnected with an old classmate, Allan D. Ivie IV, at a college reunion, and eventually a romance began to develop.  In June of 2010, Ivie proposed to Page, who struggled with the idea of a new marriage and moving her family from Richmond to St. Louis.  To read the rest of the story, visit:

Washington Post: "A family learns the true meaning of the vow 'in sickness and in health'"

Blog Questions Politics Of America's Fragmented Long-Term Care System      

A recent posting on the Nieman Foundation for Journalism blog (Harvard University) suggests that America's fragmented long-term care services and supports are in part due to broader political movements to privatize services like Medicaid, Medicare, and assisted living.  Larry Polivka, a Scholar in Residence at the Claude Pepper Foundation at FSU, explains: "This initiative is designed to diminish the public sector and privatize as many traditional government functions as possible at the federal, state, and local levels -- contracting out these functions to private, usually proprietary firms, including many very large corporations. (General Electric, for instance, bought out a nursing home chain with 186 facilities for $1.5 billion dollars in 2006.)"  Polivka suggests that the increased numbers of caregivers will mean more people will be affected by the caregiving experience, and "come to understand the existential meaning of caregiver loneliness and the fundamental vulnerability of everyone. More of us are also likely to perceive the injustice of caregiver abandonment, which has already become all too common."  For more information, visit:

Nieman Watchdog Blog: "The long-term care challenge isn't just a fiscal problem, it's a test of our nation's character"

Clinical Trial Recruiting Stroke Patients

This clinical research study is testing the safety and therapeutic potential of a new stem cell therapy. In animal studies, measurable improvements in use of limbs were shown. Study patients will undergo periodic exams for two years. Study-related costs will be covered. You may be eligible if you:   

• suffered an ischemic stroke within the past six months to three years;  
  have arm or leg weakness;   
• are 18-75 years old;   
• have no history of seizures;   
• had only one stroke.   

Trial locations: Palo Alto, CA and Pittsburgh, PA.  For more information, visit:   

www.strokeclinicaltrial.org

University Of Washington Study: (LIFT) Life Improvement Following Traumatic Brain Injury  

www.LIFTstudy.net