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July 26, 2007
Advocacy CLASS Act Would Provide Cash Payments for LTC Services AAHSA is supporting passage of the Community Living Assistance Services and Supports (CLASS) Act of 2007, which would establish a national insurance program to provide cash benefits to adults who become functionally impaired. The voluntary program would provide benefits of $50 a day to individuals who have two or more ADL or cognitive impairments, and $100 per day for people who have four or more of these impairments. Program participants would pay a monthly premium for their insurance and would choose what services to buy with their cash benefit. Read a statement about the bill from AAHSA President and CEO Larry Minnix. Alzheimer's Disease Study Group Starts Work A new Alzheimer's Disease Study Group, led by former Speaker of the House Newt Gingrich (R–Ga.) and former Sen. Bob Kerrey (D–Neb.) will report next spring on ways to revise current federal policies addressing the disease. According to a recent report in CQ Healthbeat News, the 12–person panel is expected to address the lack of adequate research money to study Alzheimer's, and the disease's impact on caregivers. Read more. Background Checks Weed Out Criminals and Abusers About 5,000 individuals who applied for jobs that involved caring for older people have been rejected after background checks in seven states disclosed the applicants' criminal records or a history of abusing patients. The background checks were conducted as part of a pilot program approved by Congress in 2003, through which seven states–Michigan, Alaska, Idaho, Illinois, Nevada, New Mexico, and Wisconsin–linked state and federal databases to screen out potentially harmful employees. The pilot program's success has spurred Congress to consider passage of the Patient Safety and Abuse Prevention Act of 2007, which would expand the program nationally. Find out more. Home Health Care CDC Launches Home Health Aide Survey The National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) is getting ready to conduct a survey of the nation's home health aides that is expected to provide critical information needed to recruit, retain and develop the paraprofessional long–term care workforce. The National Home Health Aide Survey is the first national survey of home health aides in this country. Six thousand randomly selected home health aides working at about 800 agencies will be interviewed by telephone about their training, supervision, job history, work setting, wages, education, benefits, and family life. Survey participants will each receive $30. For more information visit the CDC Web site or contact Peter Notarstefano, (202) 508–9406. HHS Launches Campaign to Fight Home Health Fraud Home health care providers who operate in the Los Angeles and Houston areas will have to resubmit their applications for status as qualified Medicare Home Health Agencies (HHA) under a new campaign to combat Medicare fraud. Agencies that fail to reapply for HHA certification within 60 days of receiving notice from the Centers for Medicare and Medicaid will have their Medicare billing privileges revoked. The HHA campaign is the second fraud–fighting initiative announced this year by the U.S. Department of Health and Human Services. In May, the agency began investigating fraudulent billing practices by durable medical equipment suppliers in South Florida and Los Angeles. Learn more about the HHA campaign, or read about medical equipment fraud in The Los Angeles Times. Newspaper Warns of Care Gap in Homecare The Dallas Morning News warned recently that the home care industry will soon face a "care gap" because it won't have enough workers to care for a growing aging population. Low wages are a big reason why home health agencies are having trouble attracting and retaining workers. The median annual wage for home care aides was $17,710 in 2005, which the newspaper says is "about what store cashiers and maids make." Some agencies have tried to improve compensation by offering workers bonuses, college scholarships, or catastrophic health care coverage. Read more. Montana Lets Agencies Use Medicaid to Pay Workers' Health Coverage Montana has approved a new way of providing health care coverage to home health care workers. As of January 2009, the state will increase its Medicaid payments to agencies that deliver in–home care so they can purchase health insurance for their direct–care employees. Read more. Hospice Palliative Care Comes to the Hospital About a third of U.S. hospitals now offer some form of palliative care, which resembles hospice care but does not require that patients have a life expectancy of six months or less, or that they end treatment for their medical conditions. Palliative care teams are now seeing patients earlier and are focusing not only on helping patients through the dying process, but also on improving a patient's quality of life. The approach may even be keeping hospital costs down. Read about this trend in "A New Focus on Easing the Pain," published recently in The Washington Post. News from HHS CMS Begins Work to Design Medical Home Demonstration The Centers for Medicare and Medicaid (CMS) will soon begin designing a "Medical Home" Demonstration program that will help up to eight states provide targeted, accessible, continuous and coordinated family–centered care to Medicare beneficiaries with multiple chronic or prolonged illnesses. The demonstration, authorized by the Tax Relief and Health Care Act of 2006, will be implemented in September 2008. For more information about the demonstration, visit the CMS Web site or contact Peter Notarstefano, (202) 508-9406. For more information about the Medical Home model of care, read The Advanced Medical Home: A Patient–Centered, Physician–Guided Model of Health Care, a policy monograph published by the American College of Physicians. AOA Announces Two Grant Programs Two new grant programs, administered by the Administration on Aging (AoA), will increase older persons' access to home and community–based services. August 24 is the deadline for State Units on Aging to apply for the new Nursing Home Diversion Modernization grants, which are designed to help individuals who are not eligible for Medicaid to avoid nursing home placement. State governments have until August 28 to apply for AoA's Alzheimer's Disease Demonstration Grants to the States Program, which is designed to translate existing evidence–based service delivery research into useful programs for persons with Alzheimer's disease and related dementias. Nursing Home Diversion grants will average $400,000. Alzheimer demonstration grants will average $250,000. Read more about both grant programs. AoA Gateway Provides Information about OAA Changes Do you have questions about the changes brought about by the 2006 Amendments to the Older Americans Act? Check out a new Gateway Web site sponsored by the Administration on Aging to offer information about the changes, links to technical assistance materials, and frequently asked questions. Visit the Web site. Hospitals Implement New Discharge Policy for Medicare Patients If your home care patients spend time in the hospital, they should know about their rights regarding hospital discharge. Beginning July 1, hospitals began using a revised discharge notice, which features a clearer explanation of Medicare patients' discharge rights. The notice must be provided to families both after arrival and before departure. If a patient contests a discharge, hospitals have until noon the next day to provide a detailed explanation of why the patient is ready for release and how the patient can continue an appeal. Get more information. Adult Day Services Consumer Guide Outlines Benefits of Adult Day Services Are your prospective clients confused about what adult day services are and how those services can benefit older people and their families? You may want to refer them to an online consumer guide called "Adult Day Care Centers: A Guide to Options and Selecting the Best Center for Your Needs." The guide defines adult day care; examines typical services, benefits and costs; and offers tips on how to find the right center. Check out the guide, which is published by Helpguide, a nonprofit organization created by the Rotary Club of Santa Monica, Calif. Transportation Transportation Web Site Launched The National Center on Senior Transportation (NCST) has launched a new web site that offers resources to help local transportation agencies establish transit options for older adults who wish to live more independently within their communities. The NCST is administered by the Federal Transit Administration (FTA) and the U.S. Administration on Aging. Visit the Web site. Transportation Tool Box Offers Resources for Coordination Fourteen communities–in Virginia, Washington, Minnesota, New York, Maryland, Illinois, Florida, Idaho, Oregon, Indiana, Kansas, and South Carolina–are featured in a new publication that describes innovative efforts to coordinate transportation services for older people. Seniors Benefit from Transportation Coordination Partnerships – A Toolbox, was published by the Administration on Aging and United We Ride, a federal interagency transit initiative. Resources in the toolbox include descriptions of useful practices in transportation coordination, a handbook for creating door through door transportation programs, a template that communities can use to build their own transportation resource guide, a comprehensive resource list for transportation coordination, and a presentation on useful practices. View the report. Film Explores Driving Alternative for Older People "Getting Around: Alternatives for Seniors Who No Longer Drive" is a new documentary that chronicles the challenges that older drivers and their families face in a society that is wedded to the car. Sponsored by the AAA Foundation for Traffic Safety, the film showcases best practice transportation models, including the Portland, Maine–based Independent Transportation Network; the Riverside County, California "friendly volunteer" ride service; a van service operated by the Sheridan Senior Center in rural Wyoming; and a sales tax in Phoenix, Arizona that funds major public transportation improvements and van services. Read more about the film and view other transportation–related resources. Caregiving Unpaid Caregivers Provided $350 Billion in Care in 2006 What is the economic value of family caregiving? According to a recent AARP report, informal caregivers provided a whopping $350 billion worth of care in 2006. How much is $350 billion? The study provides a few eye–opening comparisons. For example, $350 billion is as much as the government spends for the Medicare program ($342 billion in 2005); is more than we spend for Medicaid ($300 billion in 2005); and equals Wal–Mart's total annual sales ($349 billion in 2006). Read the study, entitled "Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving." New Legislation Would Offer Paid Leave to Caregivers The Family Leave Insurance Act of 2007, recently introduced by Senators Christopher Dodd (D–Conn.) and Ted Stevens (R–Ark.) would provide up to eight weeks of paid leave to workers needing time off to care for a relative, including a spouse or parent with a serious illness. Employers would pay employees who took the leave, and then would be reimbursed from an insurance fund established within the Department of Labor. Businesses with 50 or more employees would be required to participate in the program, while participation by small businesses would be optional. For more information, search for S.1681 on the Library of Congress's Thomas Web site. Enlisting Neighbors to Care for Older People Solitude among Japan's older population is fatal, according to a recent column in the Korean newspaper Chosum Ilbo. The suicide rate of Japanese older persons who live alone is "twice or three times as high" as that of older citizens who live with their families, according to the newspaper. To alleviate the loneliness of its elders, the Japanese government now offers allowances to healthy seniors who provide volunteer services to less healthy neighbors. And communities like the Tokiwa–daira housing complex are encouraging residents to look after one another. Tokiwa–daira has a "zero solitary death campaign" that tries to convince its residents that neighborly living guarantees lifelong happiness, as well as happiness in advanced age. Read more. USA Today Explores Caregiving Issues USA Today ran 20 articles in June that featured family caregivers' personal stories and highlighted a range of issues related to caregiving. You can still read all the articles in the series, which is entitled "Role Reversal: Your Aging Parents and You." Focus on the States Illinois Seniors Fight HCBS Budget Cuts AARP and other advocates for older people converged on the Illinois state capitol in June to voice their opposition to the state's "no–growth" budget. The proposed budget would eliminate 400,000 meals delivered to seniors, reduce in–home services, and cut programs that work to prevent elder abuse and neglect. Programs that deliver meals to rural elderly or help seniors manage their medications would not receive any funds at all. An AARP survey found that the overwhelming majority of Illinoisans over the age of 50 don't back the cuts. View the survey or check on the status of the budget bills. Louisiana: Bill Allows State to Automatically Raise HCBS Spending Lawmakers in Louisiana have passed a bill that would allow the state to automatically expand its New Opportunities Waiver (NOW) program, which provides HCBS to Medicaid beneficiaries. According to Senate Bill 98, which has been sent to Louisiana Governor Kathleen Blanco, anytime the state's income projections are revised during the fiscal year, 12 percent of the new unbudgeted dollars could be used to add new slots to the NOW program, up to $50 million a year. Read the bill. Minnesota: Buy LTC Insurance and Keep More Assets Minnesota is initiating a Long Term Care Partnership Program to encourage its residents to buy long–term care insurance. Residents who buy a qualified policy under the new program can preserve more of their assets if policy benefits run out and they need to apply for Medicaid. The program is based on the Partnership for Long–Term Care, a model developed in the 1980s with support from the Robert Wood Johnson Foundation (RWJF). Read more about the Minnesota program. Ohio: Collective Bargaining Rights for In–Home Workers Governor Ted Strickland of Ohio has extended collective–bargaining rights to the 7,000 nurses and other independent workers who contract with the state to provide Medicaid–funded in–home services for older people and people with disabilities. The order does not apply to employees of nursing homes, who already have bargaining rights, or to employees of health–care agencies. Opponents of the executive order worry that the change will mean higher Medicaid costs. Read a news article about the order. North Carolina: Legislators Balk at the Rising Cost of Personal Care Personal care services delivered to North Carolina homes are projected to cost Medicaid more than $315 million during the next budget year. Some state legislators think that's too much. About 53,000 people received Medicaid–funded personal care services in 2006, up from about 9,000 in 1999. Several years ago, the cost of personal care grew so quickly that legislators made it harder for Medicaid beneficiaries to qualify for these services. Lawmakers are now considering adding another level of physician approval before beneficiaries can receive personal care services. Find out more. Resources and Publications Find Useful Data for Your Next Grant Proposal The next time you're looking for health statistics to insert in a grant proposal, check out a new Web site developed by the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention (CDC). The Web site provides up–to–date data on life expectancy and death rates; the prevalence of leading chronic conditions; the use of inpatient, outpatient, nursing home and home health care; and functional status and behavioral risk factors experienced by older people. Find out how to use the database by visiting the CDC Web site and clicking on "Instructions." Uninsured Older People Postpone Care Until Medicare Kicks In A study published in the New England Journal of Medicine reports a surge in use of health care after uninsured adults with chronic illnesses become eligible for Medicare. The surge was most noticeable among previously uninsured people with heart disease or diabetes. When these people became eligible for Medicare, they had 13 percent more doctor visits, 20 percent more hospitalizations, and reported 51 percent greater medical expenditures than those with the same diseases who had insurance all along. Read about the study in The New York Times. AAHSA News Get Your Technology Planning Tool How will technology affect your organization now and in the future? Find out with a new technology planning tool designed by AAHSA's Center for Aging Services Technologies (CAST). The tool features ideas and suggestions for practical action steps you can take today to prepare for the new care paradigms of tomorrow. Contact Rebecca Scritchfield, (202) 508–9416. See the tool. Last Chance to Apply Executive Management Fellowship Can't afford to attend the executive education program of your choice? Apply for the AAHSA–Ziegler Graduate Fellowship in Executive Management by Aug. 10 and you could receive $10,000 to fund your continuing education. Contact: Trish Calamari, (202) 508-9480. Start your application. Upcoming Meetings 2007 Institute for Transportation Coordination: August 20–23 Community teams can learn how to provide cost–effective and customer–focused transportation services during this intensive training and planning forum. The institute takes place August 20–23 in Washington, DC. Get more information. 7th Annual National Aging and Law Conference: Oct. 11–13 "The Safety Net for Older Americans: What Can Be Done to Protect It?" will be the theme when the AARP Foundation National Legal Training Project sponsors this year's aging and law conference. It takes place Oct. 11–13 in Arlington, Virginia. Get more information. AAHSA 2007 Annual Meeting & Exposition: Oct. 21–24 Now's the time to secure your spot at AAHSA's 2007 Annual Meeting & Exposition, which will take place Oct. 21–24, in Orlando. Speakers will include Sidney Portier and Elie Wiesel. Watch your mailboxes for more information. In the meantime, you'll find complete program details and registration information on our Annual Meeting Web site. View past issues of the HCBS Report. AAHSA · 2519 Connecticut Ave. NW · Washington DC 20008 · www.aahsa.org
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