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|A Newsletter of FCA's National Center on Caregiving|
February 9, 2012
Volume XII, Number 3
State Legislation, Policy & Reports
- CA: Report Explains How To Use Flexible Accounting To Promote Aging In Place More...
- VA: $2 billion Settlement Reached In Olmstead Enforcement Case More...
- WA: Pharmacy Repackaged And Resold Prescriptions After Residents Died More...
- FL: Managed Care May Mean Longer Medicaid Waiting Lists More...
- TN: State Will Propose Tighter ADL Test For Nursing Home Coverage More...
- NY: Provider Agencies Can Pay No More Than $199,000 If Contracting With State More...
Federal Legislation, Policy & Reports
- Senator Sanders Introduces Legislation Reauthorizing Older Americans Act More...
- Labor Secretary Solis And First Lady Michelle Obama Announce Proposed Changes To FMLA More...
- House Votes To Repeal CLASS Act More...
- VA Caregiver Support Line Celebrates One Year Anniversary More...
- White House Announces Larger Federal Investment In Alzheimer's Research More...
- Canadian Nursing Home Tailors Services For Chinese Residents More...
- Study: Advanced Care Planning Led To 43% Drop In Unplanned Hospital Admissions More...
- Canada: Ontario Elder Abuse Hotline May Have To Close Due To Lack Of Funding More...
- Ireland: Report Provides Road Map To Develop Dementia Strategy More...
Research Reports & Journal Articles
- Clinician's Corner Focuses On Strain Of Caregiving For Wife Of Cancer Patient More...
- Study: Elderly African Americans Less Likely To Receive Depression Diagnosis And Treatment More...
- Study: Private Health Insurance, Income, Assets Lead To Higher Functioning Later In Life More...
- Study: Low Social Status Linked To Functional Decline And Socioeconomic Distress More...
Conferences & Trainings
- Aging In America Conference 2012 Conference: Early Registration Ends 2/13/12 More...
- Webinar Series: Applying Best Practices To Diverse Older Adults Feb 9 More...
- Webinar: On The Verge: The Transformation Of Long-Term Services And Supports More...
- n4a Accepting Nominations For Aging Innovations and Achievement Awards More...
- NIA Accepting Applications For Summer Institute On Aging Research More...
- Conference: Call For Abstracts For Disability Research Interest Group More...
Funding, Media & Miscellaneous
- Petition Against Caregiver Resource Center Cuts More...
- HHS Sponsors Health IT Challenge For Post-Discharge Follow-Up Appointments More...
- Consumer Voice: Consumers Asked To Participate In Survey About Home Care More...
- Social Media For Small Non-Profits: More Work Or A New Way To Do Work? More...
- Lewey Body Dementia Association Survey More...
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A report by Mildred Consulting provides an overview of how flexible accounting could be used in California to support rebalancing. The authors explain that traditional accounting, defined as creating budgets based on estimates of service needs in the upcoming year, can become a barrier to providing the "right care at the right time, in the right place." As states move to managed care, including for dual eligibles, flexible accounting can reduce the utilization of nursing facilities and provide savings to better support HCBS. The Scan Foundation, which sponsored the flexible spending brief, recently released a brief on nursing facilities in California, including services provided, demographics of residents, and financing mechanisms. For more information, visit:
Mildred Consulting "Flexible Accounting for Long-Term Care Services"
Scan Foundation: "Nursing Facilities in California"
The Washington Post reports that the state of Virginia reached a settlement with the Department of Justice to close four of Virginia's five centers that house about 1,000 developmentally disabled people. The state is expected to spend $340 million on the settlement and will receive $935 million from the federal government. Virginia will offer 4,200 HCBS waivers, provide more support to 1,000 people already receiving community supports, expand crisis services, and create an $800,000 housing assistance fund. For more information, visit: Washington Post: "Virginia to transform system of caring for developmentally disabled"
The Seattle Post Intelligencer reports that federal investigators have raided pharmacies in Seattle and Bellingham after receiving tips that several pharmacies were collecting unused drugs in long-term care facilities and re-packaging and re-selling them. Beyond obvious safety concerns, court papers suggest that this allowed the pharmacies to "double-dip" by charging Medicaid for the same drugs twice. The federal investigation was launched after a former manager tipped off a state inspector and explained that employees would often sort pills in a back room. For more information, visit:
The Tampa Bay Times reports that data in a new report by Florida's Office of Program Policy Analysis and Government Accountability suggests that waiting lists for Medicaid HCBS programs rose by 30% this year. The waivers are operated by both managed care and nonprofit providers, and the cost of managed care was also "significantly higher" than the two nonprofit programs. The article explains that despite the increased cost, Florida is currently petitioning CMS to eliminate the less expensive programs and to allow managed care to administer the programs. Laura Summer, a researcher from the Georgetown University Health Policy Institute, suggested that as waiting lists grow longer, some people won't be able to wait and may be forced into institutional care. Summer presented her research on Florida's attempted transition to managed care during a webinar in January. For more information, visit:
WCYB.Com reports that the state of Tennessee is proposing more restrictive functional eligibility tests for long-term nursing home coverage. Under current rules, needing assistance with one Activity of Daily Living (ADL) is sufficient to qualify, but under the proposed rules, this would increase to four ADLs by next year. A state representative noted that home and community based services would be a possible alternative for people who didn't meet the new four ADL requirements. For more information, visit:
The Post-Standard reports that New York Governor Andrew Cuomo recently signed an executive order that will restrict salaries for non-profit and for-profit agencies that contract with the state. In addition to a salary cap of $199,000, the executive order also requires that at least 75% of every state grant must be spent on care or services rather than administrative costs, and this figure will rise to 85% in 2015. The New York Times reported in December 2011 that an executive director of a Brooklyn non-profit that provides home care was receiving a salary of $400,000 and also hired her daughter to fill a high-ranking position at the company. For more information, visit:
Senator Sanders Introduces Legislation Reauthorizing Older Americans Act
Senator Bernie Sanders (I-VT), introduced legislation on January 26 to reauthorize the Older Americans Act. In a press release, Sanders cited the 10,000 baby boomers who are turning 65 every day and the fact that one in five older Americans is surviving on an average income of $7,500 a year. One of the proposed provisions would require the Bureau of Labor Statistics to revise how it calculates inflation for the elderly to better reflect higher health care costs. The bill would also authorize a 50% increase in funding for meal programs funded the act, and would clarify the legal definition of economic security. Senator Kohl (D-WI) and Senator Mikulski (D-MD) introduced a re-authorization bill in November 2011 that would include a voluntary grant program to assess family caregivers and connect them to supportive services. For more information, visit:
Press Release: "Chairman Sanders Introduces Older Americans Act Reauthorization"
Caregiving PolicyDigest: "Federal Legislation Introduced With Caregiver Assessment Component"
Labor Secretary Solis And First Lady Michelle Obama Announce Proposed Changes To FMLA
First Lady Michelle Obama and Labor Secretary Hilda Solis announced proposed changes to the Family Medical Leave Act (FMLA) that would affect military families and airline flight crew employees. The changes would extend FMLA eligibility to family members of the Regular Armed Forces and would extend the ability to take leave to family members of veterans with serious injuries or illnesses for up to five years. The proposed rule would also change how leave is calculated for airline flight crews. For more information, visit:
US Dept. of Labor: "Notice of Proposed Rulemaking to Implement Statutory Amendments to the Family and Medical Leave Act"
Washington Post: "Michelle Obama, Labor Secretary Hilda Solis propose more job protection for military caregivers"
House Votes To Repeal CLASS Act
The US House of Representatives voted earlier this month to repeal the CLASS Act, the voluntary long-term care insurance program included in the Affordable Care Act. It remains unclear if the repeal would gain any traction in the Senate. Howard Gleckmen provides a summary of a recent panel discussion on how to build on the CLASS experience. Beyond technical changes to CLASS to make is work, suggestions from speakers included increasing public awareness of long-term care insurance needs, stronger regulation of long-term care insurance, a home-care benefit under Medicare, and a suggestion to integrate medical care with personal care. For more information, visit:
Howard Gleckman: "What Happens After CLASS?"
FCA: "Letter Against the Repeal of the CLASS Act"
VA Caregiver Support Line Celebrates One Year Anniversary
The VA's Caregiver Support Line recently celebrated its one year anniversary. The Center received 25,000 calls and emails during its first year. Caregiver Support Coordinators at each of the VA's medical center have responded to over 8,000 referrals through the program. In May 2011, the VA also began accepting applications for a new Caregiver Support program that provides stipends to caregivers of post 9-11 veterans. An article in the Sacramento Bee notes that the VA will be required to report in May 2013 on the feasibility of expanding the caregiver program beyond solely 9-11 veterans, who only comprise about 10% of the veteran population. For more information, visit:
Press Release: VA Caregivers Support Line Celebrates First Anniversary"
FCA Blog: "2011 Marked Milestones in VA's Recognition of Caregivers"
Sacramento Bee: "The Conversation: New help for our wounded warriors"
White House Announces Larger Federal Investment In Alzheimer's Research
The White House announced on Tuesday that the National Institutes of Health is immediately redirecting $50 million of its FY 2012 budget towards Alzheimer's research and that the president would request another $80 million in his proposed FY 2013 budget. The president will also request $26 million in his budget for public education on the disease, outreach to care providers, and expanded support for caregivers. An Oakland Tribune article published the day before the announcement highlights the need for additional education and support. A wife who is a caregiver for her husband with Alzheimer's explained that her husband's doctor told her she was over-reacting and to "get a grip" when she first mentioned the possibility of her husband having Alzheimer's. While the $130 million in additional funding would represent a 25% increase in the current funding level of $450 million, Alzheimer's advocates are concerned that spending on Alzheimer's is still dwarfed by the amount of money invested in research on other diseases. For more information, visit:
Huffington Post: "A Commitment to Alzheimer's" (Written by former caregiver)
Oakland Tribune: "Oakland woman cares for Alzheimer's-stricken husband while educating others about it"
Kaiser Health News Blog: "Alzheimer's Research Gets Funding Boost"
|Canadian Nursing Home Tailors Services For Chinese Residents
The Globe and Mail reports that a nursing home in Mississauga has adapted its approach to providing services to better meet the needs of Chinese seniors, who are one of the fastest growing minority groups in Canada. Some residents have waited five years for the Yee Hong Geriatric Care Center, and the cultural tailoring includes offering Chinese food, a seated adaptation of tai chi, and offering Chinese opera in the karaoke system at the center. According to the organization, the tailored approach has led to lower rates of depression, falls, bed sores, and hospitalizations as compared to residents in "mainstream" homes. For more information, visit:
Globe and Mail: "Ethnic-focused nursing homes put a Canadian face on filial piety"
Study: Advanced Care Planning Led To 43% Drop In Unplanned Hospital Admissions
The Telegraph reports on research in the British Journal of General Practice on Anticipatory Care Plans (ACPs) and their effect on hospitalization and duration of hospital stays. General practitioners in Scotland who asked elderly patients to write ACPs reported unplanned admissions falling by 43%, and the length of hospital duration was 52% lower as compared to patients who had not been asked to write an ACP. The authors explain that the associated costs were also cut in half. For more information, visit:
The Telegraph: "End-of-life plans halve unplanned hospitalizations"
British Journal of General Practice: "Anticipatory care planning and integration: a primary care pilot study aimed at reducing unplanned hospitalization" (article is free)
Canada: Ontario Elder Abuse Hotline May Have To Close Due To Lack Of Funding
The Star.com reports that the Ontario Network for the Prevention of Elder Abuse may be forced to close its Senior Safety Line, a service that assists 13,000 seniors, caregivers, family members, and friends each year. The service is operated 24/7 in 150 languages. The organization has appealed to the government for funding but has been unsuccessful thus far, and the organization leaders suggest that $75,000 would keep the service running for an additional six months. For more information, visit:
The Star.com "Ontario elder abuse hotline in jeopardy"
Ireland: Report Provides Road Map To Develop Dementia Strategy
A new report provides a foundation of data as the Irish government creates a national strategy to address Alzheimer's. The authors calculate that there are over 26,000 people with dementia in Ireland that are living at home, and that an estimated 50,000 family caregivers are caring for a person with at least one of the six specified symptoms of dementia. The authors explain that 48% of the cost of dementia can be attributed to caregiver opportunity cost while 43% can be attributed to the costs of residential long-term care. For more information, visit:
"Creating Excellence in Dementia Care: A Research Review for Ireland's National Dementia Strategy"
Clinician's Corner Focuses On Strain Of Caregiving For Wife Of Cancer Patient
A recent "Clinician's Corner" in the Journal of the American Medical Association focuses on the experience of a 53-year old woman who is the sole caregiver for her husband who is undergoing cancer treatment. The authors note that the caregiver burden is complex and includes multiple, competing priorities which can lead to stress and negative health effects. However, doctors and their interdisciplinary teams are in a prime position to conduct even brief assessments of the caregiver and connect them with resources to mitigate caregiver stress and burdens. For more information, visit:
JAMA: "Caregiving Burden, Stress, and Health Effects Among Family Caregivers of Adult Cancer Patients" (Abstract is free)
Study: Elderly African Americans Less Likely To Receive Depression Diagnosis And Treatment
A study in the February issue of American Journal of Public Health analyzed Medicare data on diagnosis and treatment of depression for community-dwelling elderly. The authors found that diagnosis rates for non-Hispanic Whites were 6.4%, while African Americans were 4.2%, Hispanics were 7.2%, and others were 3.8%. The authors find that African Americans were less likely to receive a depression diagnosis and those who were diagnosed were less likely to receive treatment. In an interview, Dr. Ayse Akincigil, the lead author, explained that if depression remains untreated or under-treated, it can diminish quality of life while also complicating medical conditions including congestive heart failure, diabetes, and arthritis. For more information, visit:
American Journal of Public Health: "Racial and Ethnic Disparities in Depression Care in Community-Dwelling Elderly in the United States" (abstract is free)
Press Release: "Diagnosis, Treatment of Depression Among Elderly Depend on Racial, Cultural Factors"
Study: Private Health Insurance, Income, Assets Lead To Higher Functioning Later In Life
A study in the January issue of Health and Social Care in the Community examines panel data from the Health and Retirement Study to analyze how socio-economic status (SES) affects function (as measured by five basic activities of daily living) in older adults. The authors explain that men had much higher levels of health care coverage, income, assets, and education than women at the baseline. While black adults had lower initial function, white adults had steeper declines than black adults. For men, only a higher level of assets predicted a slower decline in physical functioning, while assets, income, and health care coverage (but not education) were significantly associated with the rate of functional decline. The authors conclude that based on their results linking socio-economic status to functional ability later in life, policymakers should view health disparities with a life course perspective and should especially target their efforts to women. For more information, visit:
Health and Social Care in the Community: "The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States" (article is free)
FCA Blog: "Protecting Caregivers through Social Security"
Study: Low Social Status Linked To Functional Decline And Socioeconomic Distress
A study in the January issue of the Journal of General Internal Medicine uses data from the Health and Retirement Study to analyze the impact of self-reports of social status (SSS) on socioeconomic distress and risk of functional decline. Participants marked a 10-rung ladder to represent where they stand in society (SSS), and functional decline was measured by new difficulty in any of five activities of daily living, mobility decline, or death. SSS was divided into three groups, and during the four years, 50% of the lowest SSS group declined in function, compared to the middle (28%) and highest group (26%). The authors conclude: "These findings suggest that self-report of low subjective social status may give clinicians additional information about which older adults are at high risk for future functional decline." For more information, visit:
Journal of General Internal Medicine: "Subjective Social Status and Functional Decline in Older Adults" (abstract is free)
The 2012 Aging in America conference, sponsored by the American Society on Aging, will take place March 28-April 1, 2012 in Washington, DC, and the event typically attracts 3,000+ attendees. 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:
Family Caregivers: Policy Perspectives and Media Musings
The 2011 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards: A Reception Honoring the Award Recipients
Aging in America 2012
The Stanford Geriatric Education Center, in conjunction with several partners, is sponsoring a series of webinars during 2012. Part I of the series will focus on "Applying Best Practices to Diverse Older Adults," with four webinars. Part II will focus on "Tackling the Tough Topics in Ethnogeriatrics." Registration is free, however, there is a cost if the webinars are taken for continuing education credits. For more information, visit:
Stanford Geriatric Education Center Webinar Series
Webinar: On The Verge: The Transformation Of Long-Term Services And Supports
A new research brief from the AARP Public Policy Institute, NASUAD, and Health Management Associates analyzes a growing trend of states switching to managed care to provide long-term services and supports (LTSS). A webinar on February 14, 2012 at 1pm (EST) will focus on the report's findings. Twelve states have existing managed care programs in their Medicaid LTSS, with an additional 11 states planning implementation. For more information or to register, visit:
"On the Verge: The Transformation of Long Term Services and Supports"
n4a Accepting Nominations For Aging Innovations and Achievement Awards
The National Associate of Area Agencies on Aging is accepting nominations for its Aging Innovations and Achievement Awards. The top three programs will receive cash awards of $1,000, $1,500, and $2,500. As n4a notes in its announcement, "you deserve applause!" for initiatives in care transitions, financial assistance, caregiving, livable communities, technology, volunteerism, and more. The deadline is March 14, 2012, for more information, visit:
N4a "Aging Innovations and Achievement Awards"
NIA Accepting Applications For Summer Institute On Aging Research
The National Institute on Aging is currently accepting applications for the Summer Institute on Aging Research, 2012, which will take place from July 7, 2012 through July 13, 2012. The Institute includes lectures, seminars, and small group discussions on research design related to aging and will include consultation on the development of research interests and advice on preparing and submitting grants applications to NIA. The Institute is intended for 35 emerging researchers, and the application deadline is March 9, 2012. For more information, visit:
Summer Institute on Aging Research, 2012
Conference: Call For Abstracts For Disability Research Interest Group
The Disability Research Interest Group (DRIG) is accepting abstract submissions for the DRIG meeting in Orlando, Florida, on Saturday, June 23, 2012. This year's meeting is focused on issues related to dual eligibility among adults under the age of 65 with disabilities. Abstracts are due by February 15, 2012. For more information, visit:
2012 Disability Research Interest Group Meeting
Petition Against Caregiver Resource Center Cuts
In Governor Brown's proposed budget for FY 2012-13, he eliminates all funding for the 11 California Caregiver Resource Centers. The 11 centers are located throughout the state and assist over 12,000 family caregivers annually. In addition, the state funding allows organizations to "draw down" additional federal matching dollars through Older Americans Act funding. The CRC's are one of the only organizations with a focus on the caregiver, not the care recipient. There are 6 million family caregivers in California. According to population projections, the senior population will double by 2030 to nearly 18% of the state's total population, and according to California's Alzheimer's Action Plan, one in six baby boomers in California is projected to have Alzheimer's disease by 2030. The California Caregiver Resource Centers began an online petition against the cuts to demonstrate to Governor Brown and the California State Legislature the need for organizations that serve California's family caregivers. Family Caregiver Alliance, which produces Caregiving PolicyDigest, is one of the 11 Caregiver Resource Centers. To view the petition, or for more information, please visit:
California Caregiver Resource Center Petition to Restore Funding for FY 2012-13
FCA Blog: "Don't Balance the California Budget on the Backs of Family Caregivers"
HHS Sponsors Health IT Challenge For Post-Discharge Follow-Up Appointments
HHS recently announced a Health IT Challenge focused on post-discharge follow-up appointment scheduling. The Office of the National Coordinator (ONC) for Health Information Technology announcement asks for developers to create an "easy-to-use web-based tool that will make post-discharge follow-up appointment scheduling a more effective and shared process for care providers, patients, and caregivers." Developers are charged with including an easy to navigate user interface, easy to navigate process for downstream accepting providers, information for patient and caregiver convenience and preference. The deadline is April 30, 2012, and winners will be notified by May 23, 2012. For more information, visit:
Discharge Follow-Up Appointment Challenge
Consumer Voice: Consumers Asked To Participate In Survey About Home Care
The Consumer Voice is currently conducting a survey of consumers on their experiences with long-term home care. Participants are asked to either participate in 30 minute phone interview or to participate in an online survey (that can also be printed out and mailed). Participation in the survey will not affect eligibility for long-term care programs. Data from the surveys will be used in a report to policymakers in California, New Mexico, Ohio, Vermont, Virginia, and nationwide. For more information, visit:
Consumer Voice Survey
Social Media For Non-Profits: More Work Or A New Way To Do Work?
A recent blog posting on FCA's blog focuses on FCA's use of social media, primarily Facebook. Social media was described as "free like a puppy" in the Nonprofit Quarterly, yet at the same time, women aged 45 and over are the fastest growing population of Facebook fans, and 50% of active Facebook users log in every day. The posting provides an overview of how FCA has used Facebook to connect with family caregivers and other service providers and also provides strategies for organizations to improve their "Edge Rank" in Facebook. For more information, visit:
FCA Blog: "Social Media and Nonprofits: Extra Work or A New Way to Do Work?"
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
|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|
2012 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 firstname.lastname@example.org or visit the Family Caregiver Alliance website at www.caregiver.org.
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