Health and Disability

"The nation's nursing homes are perilously close to laying off workers, cutting services - possibly even closing - because of a perfect storm wallop from the recession and deep federal and state government spending cuts, industry experts say," The Associated Press reports. "A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at week's end by the federal Centers for Medicare and Medicaid Services." This move came in addition to state-level reductions or flat-funding "that already had the industry reeling. And Congress is debating slashing billions more in Medicare funding as part of health care reform."……

Original Article

……The Wall Street Journal article "Making Suburbia More Livable" offers several examples of communities that are redesigning suburbs so that boomers can age in place.

These communities are:
Making new street grids to reduce traffic and improve walkability.
Building town homes and condominiums.
Adding greenways and parks to promote social interaction.
Adding social spaces, shops, transportation options, and recreation and entertainment facilities to help address the needs of people as they grow older…….

Original Article

The state of Florida has agreed to spend up to $27 million to settle a class action lawsuit brought by Medicaid recipients who argue they were forced into nursing homes.

The lawsuit was filed in early 2008 on behalf of approximately 8,500 elderly and disabled Medicaid recipients who allege that Florida’s Medicaid program made it prohibitively difficult to obtain funding for home- and community-based care. By doing so, they argued, Medicaid essentially coerced them into nursing homes…..

BuzzNet Tags: HCBS,lawsuit settlement

Floridians Forced Into Nursing Homes Earn Settlement at PHInational.org

PHI has launched an issue brief series called Learning Through Evaluation examining the unique role evaluation plays in supporting PHI’s training and organizational development and policy work.

“Evaluation is an important tool to advance our learning and improve our work with providers of eldercare and disability services,” says Marcia Mayfield, PHI’s director of evaluation.

First Brief Now Available

The first issue brief in the evaluation series — Plan, Implement, Study, Act (pdf) — focuses on PHI’s work with the Northern New England LEADS Institute, an initiative aimed at improving job quality for direct-care workers in Vermont, New Hampshire, and Maine.

Briefs Examine Role of Evaluation for LTC Providers at PHInational.org

Much More in the article……

As Baby Boomers retire, companies as varied as GE, Philips, and Nintendo are working on technology that helps seniors stay at home and remain independent

Technology That Helps Seniors Stay at Home - BusinessWeek

Are you REALLY into the health care reform debate?

The health reform bill (text, summary) introduced last week by Sen. Max Baucus, D- Mont., chairman of the Senate finance committee, is kind of a dog. The product of many months of negotiation among a bipartisan seven-member "coalition of the willing" (reduced to six after the defection of Sen. Orrin Hatch, R-Utah), it includes so many concessions to the GOP that at least three Democrats (Sen. Jay Rockefeller of West Virginia, Sen. Ron Wyden of Oregon, and Sen. Maria Cantwell of Washington) are threatening not to vote for it. Yet the bill has not won the support of a single Republican.Slate's Chris Wilson, who sees opportunity where others see an ungainly data dump, assembled all these amendments into a single spreadsheet that can be sorted according to sponsor, party, budgetary offset, and whether the amendment in question addresses insurance coverage, reform of "delivery systems" (i.e., doctors and hospitals), or financing (taxes). (Some readers may need to log in to Gmail to view the sortable version. A low-fi version is available here.)

Slate's interactive guide to the Senate Finance committee markup on health reform. - By Timothy Noah and Chris Wilson - Slate Magazine

This is huge news!  This past Friday, New York Senator Schumer introduced the Community First Choice amendment to the Senate Finance Committee’s health care reform!

This is the closest we’ve ever been to getting the language of the Community Choice Act into federal law.  It’s not the “whole enchilada,” because it wouldn’t make it the law of the land, but it would give every state a financial incentive to try community first, consumer directed services and supports based on functional need, not age or diagnosis. This is a very big deal!

The next step is to urge the Senate Finance Committee to pass the amendment.  We need every Senator on the Committee to hear from constituents in their state, urging them to support the Community First Choice Amendment…..

BuzzNet Tags: LTC,community choice

PASS THE COMMUNITY FIRST CHOICE AMENDMENT! : Center for Disability Rights : Free Our People

Celebrations of last year's landmark mental health parity legislation ending insurance and business discrimination were premature. What once seemed a turning point now seems less certain if the federal guidelines for implementation of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act are delayed beyond the Oct. 3 deadline. Such a delay could spell disaster for the 46 percent of the population whose treatment will be halted or never started, with lives lost, livelihoods delayed, but the status quo intact.

We should recall that parity was hotly debated before two bills (HR 1424 in the House, S 558 in the Senate) and were folded into last year's stimulus package. It was an initiative supported by a unique collaboration between advocates in the mental health community and those in the addiction community, with coverage extending to the self-insured and to those in Medicaid managed care. The House initiative, led by Reps. Patrick Kennedy and Jim Ramstad, wanted to base treatment criteria on the American Psychiatric Association's Diagnostic and Statistical Manual. Insurance and business were able to determine that the Senate's bill allow them to define "medical need."

This provision, allowing the insurance companies to manage medical conditions, mandated there be no discrimination against mental illnesses or addictive disorders. Yet, many companies are attempting to reduce what they are calling "medical necessity" and in this way are encouraging the Departments of Health and Human Services, Labor and Treasury to undermine the fact and the spirit of parity………

BuzzNet Tags: recovery,parity

MIWatch - Thought parity was a done deal?

Pavlovian trace conditioning depends on the temporal gap between the conditioned and unconditioned stimuli. It requires, in mammals, functional medial temporal lobe structures and, in humans, explicit knowledge of the temporal contingency. It is therefore considered to be a plausible objective test to assess awareness without relying on explicit reports. We found that individuals with disorders of consciousness (DOCs), despite being unable to report awareness explicitly, were able to learn this procedure. Learning was specific and showed an anticipatory electromyographic response to the aversive conditioning stimulus, which was substantially stronger than to the control stimulus and was augmented as the aversive stimulus approached. The amount of learning correlated with the degree of cortical atrophy and was a good indicator of recovery. None of these effects were observed in control subjects under the effect of anesthesia (propofol). Our results suggest that individuals with DOCs might have partially preserved conscious processing, which cannot be mediated by explicit reports and is not detected by behavioral assessment.

Classical conditioning in the vegetative and minimally conscious state : Abstract : Nature Neuroscience

A bill to amend title XIX of the Social Security Act to establish financial incentives for States to expand the provision of long-term services and supports to Medicaid beneficiaries who do not reside in an institution, and for other purposes.

Text of S.1256 as Introduced in Senate: Home and Community Balanced Incentives Act of 2009 - U.S. Congress - OpenCongress