Study Suggests Medicaid-Sponsored Home Care

A recently released study of Medicaid-financed nursing home use over 18 months in 2001 and 2002 finds that in states such as Oregon that have extensive community based long-term care services, Medicaid-covered nursing home stays were shorter than the national average. The numbers suggest that where seniors have alternatives, their nursing home stays are more likely to be for acute care following a hospitalization or for a shorter period at the end of life.

The study, "Medicaid-Financed Nursing Home Services: Characteristics of People Served and Their Patters of Care, 2001-2002," conducted by Matehematica Policy Research for the Office of Disability, Aging and Long-Term Care Policy for the U.S. Department of Health and Human Services, reports that over half of Medicaid-covered nursing home residents do not become eligible for benefits until after they move to a nursing home, with 29 percent obtaining coverage within six months of moving to the nursing home, 5 percent between six and 12 months, 7 percent between one and two years, and 9 percent after more than two years.

Complex Interventions For Elderly People Can Be Beneficial

According to a meta-analysis published in The Lancet, elderly people can improve physical function and live more independently if provided with complex interventions such as preventive home visits and community-based care after hospital discharge. The study of over 90,000 elderly people also led authors to conclude that well-developed services for the elderly should not be withdrawn.

Elderly people tend to have reduced physical capabilities, which leads to increased dependence on others, a need for hospital and long-term nursing-home care, and premature death. Community-based complex interventions seek to preserve physical function and independence in elderly people. Researchers were interested in assessing the efficacy of interventions such as preventive home visits, care after hospital discharge, fall prevention, and education and counseling in a group setting.

Anna Ortigara on Learning from Direct-Care Workers

“There has been a lot of paternalism about direct-care staff – the notion that they are not really adults,” says Anna Ortigara. “People wonder: Are they really capable of being in a lead role? Can they be trusted to make good decisions? Are they capable of self-direction?”

Instead of these questions, Ortigara believes, we should ask ourselves: “How can we possibly think we are going to improve long term care without involving frontline workers? We need them at the table in order to achieve cultural transformation - and why wouldn’t we want them at the table?”

When Long-Term Care Becomes Wrong-Term Care

The term “long-term care” is revealing. Long-term care is usually about long-term loss: the loss of authority, money, health, and connections to family and community. Our system is based on an expert and medical model of passive consumption and limited choices. And because none of us really want this, we avoid talking about it or planning for it . . .

We need to begin an intergenerational discussion to redefine the issue in radically new - civic - terms . . .

We should talk about how we all age, not just about “the elderly”; about harnessing wisdom and building individual capacity, not just providing more/better services and care. We should talk about health and wellness, not just chronic illness; about taking personal responsibility for our retirement and for the economic health of future generations, not just how we pay the bills for the current troubled system . . .

The Grief Experiences of CNAs

By failing to acknowledge CNAs' grief, nursing homes often make it harder for workers to deal with their feelings, according to a study of how nursing assistants cope with the death that is so much a part of life in nursing homes. CNAs are often left to deal with their emotions on their own, creating a sense of emotional "disenfranchisement." Read more and comment

Tax Credits Could be Worth Thousands to Direct-Care Workers

If you're a direct-care worker or you work with direct-care workers, you might want to help spread the word about the earned income tax credit (EITC). Direct-care workers who file a federal tax return this season could be eligible for thousands of dollars in state and federal credits and refunds, mainly through the federal EITC, which will return up to $4,716 per person to eligible low-income taxpayers. As much as a quarter of all EITC funds go unclaimed each year because so many people don't know they're entitled to them.

Workers who file a federal return may also be eligible for an EITC from their state or for one of the economic stimulus payments being made this year by the federal government. The economic stimulus payments will generally range from $300 to $600 for individuals and from $600 to $1,200 for joint filers, plus $300 for each qualifying child.

The Center on Budget and Policy Priorities website has a useful section on the national EITC. Its online toolkit includes a calculator to estimate how much of a return to expect, tips on how to get taxes prepared free of charge, how to file electronically to get your money back fast, and more.

Another useful website is I-CAN, an online tax filing system that helps low-income taxpayers file their federal forms free of charge and includes information about the EITC. Taxpayers in California, Michigan, Montana, New York, and Pennsylvania can also file their state taxes free through I-CAN.

Economic Study Finds DME Competitive Bidding Program Will Reduce Competition, USA

A new economic study finds that the competitive bidding program for durable medical equipment (DME) being rolled out by the Centers for Medicare and Medicaid Services (CMS) would lead to reduced competition, lower quality of care, and higher costs.

Two Robert Morris University professors, Brian O'Roark, PhD and Stephen Foreman, PhD, conducted the study, which was released this week by the Pennsylvania Association of Medical Suppliers (PAMS).

"The limits on competition that CMS is proposing to implement will have great potential to produce higher prices and lower service quality," Foreman stated. "The franchise bidding process that CMS is implementing is at odds with everything that we know about markets, efficiency and incentives. We should be encouraging added competition in the market, not limiting it. Limits on competition like those proposed by CMS rarely, if ever, make consumers better off."

Innovative Program “OPENS” Doors for MI Health Care Workers, Employers

Michigan’s innovative Kent County Health Field Collaborative (HFC), through its pilot Opportunity Partnership & Empowerment Network (OPEN) program, offers exciting potential to address the “care gap” - Michigan’s rapidly growing number of elders and people with disabilities and ever-shrinking pool of caregivers. The HFC consists of a group of employers working together - along with partners from government, educational institutions, and other not-for-profits - to solve recruitment and retention challenges in health care. Together they identified the challenges employers face now and in the future with growing the workforce.According to a new case study by PHI, a nonprofit organization that supports quality long-term care by improving the quality of direct-care jobs, the OPEN program has achieved impressive results with employee retention. The OPEN program, which the HFC based on a retention model developed by The Source (a coalition of Grand Rapids area manufacturers dedicated to collaborative approaches to employee retention and advancement), saw among its key results significant drops in the overall turnover rates of direct-care workers - those who provide services and supports to elders and people living with disabilities.