Health and Disability

A group of Michigan providers convened to address their state’s looming care gap and formed the Kent County Health Field Collaborative (HFC). Its first project: a cooperative, flexible, and resourceful program that would directly address the barriers to sustained employment per the individual staffer.
John Oberlin

In 2004, a number of Michigan providers convened to address their state’s looming care gap and formed the Kent County Health Field Collaborative (HFC). Its first project: a cooperative, flexible, and resourceful program that would directly address the barriers to sustained employment per the individual staffer.

The Opportunity Partnership & Empowerment Network (OPEN) program has been a success and continues to expand its role and coverage area outside of Kent County. During a two-year pilot program, more than 80% of employees utilizing the program maintained their employment. All of these employees were considered at risk of losing their jobs because of inabilities to successfully manage personal challenges and work expectations. Also, two of the five participating employers cut turnover rates in half, while another company reported a drop from an average of 36% to 22%. Among the employers who initially made up the HFC, turnover rates ran as high as 58% before the program.

The program's collaborative structure keeps costs low. Collectively, the provider members, who all share the same problem of staff turnover, pay for one case worker’s salary and any expenses such as supplies and additional project work. Because the HFC is made up of long-term care, acute care, and rehab providers, payments are calculated through a utilization formula.

House leaders should “act quickly and approve” the Indian Health Care Improvement Act reauthorization bill “so that we can send this bill to the president and provide the quality health care that [American Indians] in California and around the nation need and deserve,” Sen. Barbara Boxer (D-Calif.) writes in a Eureka Times-Standard opinion piece (Boxer, Eureka Times-Standard, 4/2). The Senate in February approved the bill (S 1200), which would authorize $35 billion over the next decade for the Indian Health Service to expand health coverage and services for about 1.8 million American Indians and Alaska Natives (Kaiser Health Disparities Report, 2/27).

Under the bill, “For the first time, Indian tribes would be able to use federal funds to provide long-term care, including hospice, home-based and community-based care for elderly and vulnerable members in their communities,” she writes.

just caught this on KELO TV. Reporter Jon Wilson has a story about a Vietnam veteran who came close to dying on April 20th, 38 years ago. Gene Murphy now calls that day his Come Alive Day. Paralyzed from his injuries, Murphy has been advocating for better health care for veterans ever since that day. He has a few criticisms of the current health care system for veterans.

After serving a tour in Vietnam, Murphy has a new enemy these days…the American Health Care System, especially when it comes to long-term care for disabled American veterans.

Murphy says, “I guess I didn’t think we would have to fight this hard for adequate budgets…especially for health care in the 38 years since I returned.”

From heads of state to politicians, even Presidents both present and former, Murphy has been a strong voice in Washington on behalf of disabled vets and says the toughest fight of all seems to be securing benefits that were promised to them by their government.

Murphy says, “And I’ve heard different administrators say I don’t know if we can afford it right now. And I said wait a minute, you had all kinds of money when we sent these young sons and daughters to wars, so we should have all kinds of money now.”

Amen to that Mr Murphy!

Aerotel Medical Systems, one of the world's leading manufacturers of advanced telemedicine and remote monitoring solutions, announced today that Vodafone Spain in conjunction with Medicronic Salud have used Aerotel's e-CliniQ™ Wireless Home Monitoring System with successful results.

The e-CliniQ™ Wireless Home Monitoring System enables patients to keep track of their health, 24 hours a day, 365 days a year. Using Bluetooth technology, Aerotel's Tele-Modem™ Homecare Hub remotely monitors the patient's vital signs from various homecare sensors, transmitting the data to Medicronic's central receiving station via the Vodafone cellular network, where it is stored and analyzed by Aerotel's Medical Parameters Monitoring (MPM™) software.

The seamless technology is being used successfully by MEDICRONIC-VODAFONE SPAIN, a joint venture between Medicronic Salud and Vodaphone, to monitor, for example, patients' blood pressure and other vital signs. Easy to use, the e-CliniQ™ system is activated at the touch of a button. Blood pressure readings are encrypted and sent via a Bluetooth-enabled mobile phone to the receiving center where the patient or doctor can directly access the information via the internet, using Aerotel's MPM-Net™ technology. The system allows doctors to check that patients are adhering to their pharmaceutical treatments.

"Flexibility and adaptation to patient needs has been key to e-CliniQ's success," commented David Rubin, Aerotel Medical Systems President & CEO. "In the modern age of wireless telecommunications and anywhere connectivity via cellular and internet networks, there is no reason why we cannot provide our patients with full remote and non-intrusive monitoring care, saving time and money in unnecessary visits to doctors and hospitals."

Dr. José Antonio Amérigo, Medical Director of MEDICRONIC-VODAFONE SPAIN, says that new cell phone technology, allows to control and follow up of Chronic Illness patients in many different ways, giving them full mobility and using e-CliniQ's to check instantly their vital parameters no matter the time or the place they are.

The Medicare Payment Advisory Committee is proposing changes to Medicare reimbursement to skilled nursing facilities that could lower payments to those facilities performing a high-volume of therapy related services.

The report recommends lower payments made by medicare based upon the efficiencies of scale that the Council has stated that any high volume provide should have achieved by technology and standardization processes. Is the council recommending punishing quality providers by reducing their payments? This could be a big blow to long term care for those who need to use these facilities.

The report criticizes that the current medicare system does not provide the best delivery and the use of private sector physicians and facilities is necessary to cope with the growing needs of the system. The council should recognize that private physicians are not government employees or programs and have every right to run their business as they see fit from an operational and financial perspective. The good news for those in private practice is that the proposal could be years from enactment and is contradictory to previous statements that it believes that highly efficient facilities are better for the long-term health of the medicare program (yeah, but if you cut their margins….). Additionally, Congress has routinely ignored the suggestions of this PAC.

Dementia currently affects 700,000 people in the UK - and it is estimated that 150,000 of these live alone. Many people with dementia live in their own home but rely on support from an older carer, who may have their own health concerns. Consequently, as the effects of dementia progress, there has been little alternative to residential care.

However, innovative models of support are being developed which promote independence - allowing people to stay in their homes for as long as possible. Telecare plays a key role in facilitating the shift from traditional models of residential care, to supporting people with dementia at home.

A range of sensors can be installed in the home, to support existing social care services, by managing environmental risks. These sensors include a natural gas detector, carbon monoxide detector, flood detector, temperature extremes sensor, bed occupancy sensor and property exit sensor. Should a sensor be activated, an alert is sent either to a monitoring centre or a nominated carer. Telecare supports both safety in the home and security outside the home - where 60% of people with dementia experience the risk of 'wandering' dangers.

Dementia is often very distressing for carers, as it places them under immense pressure to provide round the clock support. Telecare can help relieve some of this pressure - enabling carers to take a well-earned break, secure in the knowledge that they will be contacted immediately if needed.

Good intentions only get baby boomers so far in trying to care for their aging parents. No matter how hard one tries to get the best care possible for a loved one, it's still easy to get overwhelmed, frustrated, angry and disappointed in the process.
One Minnesota baby boomer seemed to have an ideal combination of resources to care for her aging mother — 10 siblings as caretakers; a doctor, a lawyer and a geriatric social worker in the family; and multiple housing options from which to choose.

Even with these resources and a carefully considered plan, this was not enough. Her mother experienced three broken hips (including two in one week), staffing issues that added to medical problems, continual shifts in housing to address changing care needs, medication complications, and sudden memory problems. The greatest frustrations and struggles though, have resulted from the bureaucracy of the elder care system, which culminated in a letter sent from the government telling the family members their mother was dead (she wasn't).

Julie Groshens wondered how families get through the maze of elder care options without a social-worker sibling to guide them. Nearly every day, she heard similar stories from colleagues, friends and family. So Groshens decided to form Elder Care Expos, LLC, a Minnesota-based company that produces elder-care resource events for the public.

A new UK study has found that anti-psychotic drugs, such as (Melleril), chlorpromazine (Largactil), haloperidol (Serenace), trifluoperazine (Stelazine) and risperidone (Risperdal), are bad for patients with Alzheimer's disease - the drugs were found to make their condition worse.

The researchers, from Kings College London and the Universities of Oxford and Newcastle, found that neuroleptics undermined Alzheimer's patients' verbal skills, and offered most patients with mild symptoms of disturbed behavior no long-term benefit. In fact, they found that a deterioration in verbal skills happened within six months of taking the medications. Neuroleptics are drugs used for treating schizophrenia as well as some other serious mental illnesses.

In this study, researchers looked at 165 Alzheimer's patients from four different nursing homes in Oxfordshire, Newcastle, Edinburgh and London. Approximately 60% of UK Alzheimer's patients are given medications to control their often aggressive behavior. There are indications that neuroleptics may also up the death rates of Alzheimer's patients.

You can read about this study in the Public Library of Science Medicine

housands of Medicaid beneficiaries who were previously limited to receiving care in an institutional setting may now be given the option to receive that care in their homes and communities, under a proposed rule published by the Centers for Medicare & Medicaid Services (CMS).

The Deficit Reduction Act of 2005 (DRA) gave states a new option to provide home-and-community based services (HCBS) to Medicaid beneficiaries without applying for a demonstration waiver. The proposed rule provides guidance to states on how to implement this provision of the DRA.

Under this option, states will now be able to set their own eligibility or needs-based criteria for providing HCBS. Previously, to qualify for assistance with personal care, home health care or other services in the home or community setting, beneficiaries were required to be at imminent risk of institutionalization. The DRA provision eliminates this requirement and allows states to cover Medicaid recipients who have incomes no greater than 150 percent of the federal poverty level, or $15,600 per individual in 2008, and who satisfy the needs-based criteria.

"Thousands more Medicaid beneficiaries may now be able to opt for needed long-term support services in their homes rather than institutions," said CMS Acting Administrator Kerry Weems. "Breaking the historic link between long-term care and institutions will level the playing field and give beneficiaries new choices for how they receive care."

The proposed rule emphasizes "person centered" care, giving individuals an active role in developing their care plans, and the "self-direction" option in which states can allow individuals to take charge of their own services. The services states may make available under this benefit include case management, homemaker, home health aide, personal care, adult day health, habilitation, and respite care. The DRA also allows states to provide special services to individuals with chronic mental illness, including day treatment or other partial hospitalization, psychosocial rehabilitation, and clinic services.

Tender Tidings, Inc. announced today the launch of a new Internet based solution for caregivers of the elderly. Caregivers will be able to visually monitor their aged loved ones via streaming video from any computer with a high speed Internet connection.

Whether at work, at home, or traveling, caregivers now have the ability to check on their senior loved ones through a convenient, affordable, easy to install wireless camera that can be placed in any room of the senior's home.

Besides the high-quality wireless camera, TenderTidingsSeniors.com offers a collaborative, on-line calendar so family members can keep up with important appointments and events. They also have access to convenient notepads and reminder tools for communicating with in-home caregivers.

TenderTidingsSeniors.com was created by a mother/daughter team: Elaine Osteen, whose mother-in-law with the early stages of dementia lives right around the corner, and Amy Howell, who lives two hours away from her grandmother.

Because so many caregivers share that responsibility with siblings or other family members, the whole family can share one subscription. The main caregiver, or the Guardian, can issue passwords to other trusted friends or family members and each can access the video of their elderly loved whenever it's convenient for them.