Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

In Pa., a struggle to pay for some long-term care

Excerpt from Newsworks: (click for entire article)

This is part of a series on aging in the Delaware Valley called "Gray Matters: New Tools for Growing Older" from the WHYY Health and Science Desk. The six-week series features audio and video stories as well as personal essays.

Last June, Rene Green got the phone call children of aging parents everywhere dread. It was the paramedics, and it was about her mother.

"She had fallen," Green said. "Her neighbor upstairs had found her on the floor."

America Needs Better Solutions and More Options for Long-Term Care

Excerpt from Michigan Elder Law Center: (click for entire article)

This spring, the House of Representatives, in a party-line vote, approved a budget that makes fundamental changes to the delivery of long-term care services and support (LTSS) under the Medicaid program. LTSS includes home health and personal care for persons who remain in the community, plus institutional care such as a nursing home. The changes included in the budget are harmful to older Americans and people with disabilities and fail to address the need for LTSS.

This budget proposal would have an impact on most Americans. Consider these statistics:

•     About 70 percent of people age 65 or older will need LTSS at some point in their lifetime.1
•     It is a common misconception that only seniors require LTSS; in fact, 40 percent of people currently receiving LTSS are adults under age 65.
•     Medicaid is the primary LTSS provider for America’s seniors and persons with disabilities, paying for care for more than 3 million individuals.
•     The median cost of nursing home care is $73,000 per year, and the cost of licensed home-health aide services is $19/hour.

A Life Worth Ending

Excerpt from New York Magazine: (click for entire article)

On the way to visit my mother one recent rainy afternoon, I stopped in, after quite some constant prodding, to see my insurance salesman. He was pressing his efforts to sell me a long-term-care policy with a pitch about how much I’d save if I bought it now, before the rates were set to precipitously rise. For $5,000 per year, I’d receive, when I needed it, a daily sum to cover my future nursing costs. With an annual inflation adjustment of 5 percent, I could get in my dotage (or the people caring for me would get) as much as $900 a day. My mother carries such a policy, and it pays, in 2012 dollars, $180 a day—a fair idea of where heath-care costs are going.

I am, as my insurance man pointed out, a “sweet spot” candidate. Not only do I have the cash (though not enough to self-finance my decline) but a realistic view: Like so many people in our fifties—in my experience almost everybody—I have a parent in an advanced stage of terminal breakdown.

It’s what my peers talk about: our parents’ horror show. From the outside—at the office, restaurants, cocktail parties—we all seem perfectly secure and substantial. But in a room somewhere, hidden from view, we occupy this other, unimaginable life.

Long Term Care: 6 Tips You Need to Know

Excerpt from Examiner.com: (click for entire article)

Father time eventually catches all of us, even the models of healthy living. That means we must plan for our long-term care needs. This is complicated. Where to begin?

First, don’t think you will be the exception who will not need LTC. Today, with 85 and older the fastest growing demographic group in the country, it is likely that at some point most of us will need a nurse, an aide or some other medical care provider. Or we will need to live in a nursing care home or assisted living facility.

The question is not if, but when. So here are the vital things to consider:

How will you pay for long-term care? Most people never give thought to the question until they need medical services and then of course it is way too late. The strongest solutions range from self-insuring (i.e. having lots of money around) to purchasing long-term care insurance. The other that people often believe is that Medicare will take care of them. Wrong. It does not cover LTC. As baby boomers leave their careers behind, long-term care insurance will become very important in their financial strategies. The reasons to get an LTC policy after age 50 are very compelling. Your premium payments buy you access to a large pool of money to cover long-term care costs.

Over 1,000 people will be stuck in Michigan Nursing Facilities Next Year

From the Michigan Disability Rights Coalition: (click for entire article)

The Nursing Home Transition Initiative (NFTI) is part of the MI Choice Medicaid Waiver program.  NFTI is a cutting edge program that has gained national attention for successfully transitioning people in nursing homes who want to leave but face barriers.  Barriers can include losing their home, not having an accessible home, and needing services and supports to stay at home.  Last year, over 1,600 people were transitioned; data suggest that every year about 3,000 people in nursing homes are candidates for NFTI.   

NFTI saves the state money because it targets people on Medicaid who cost an average of $172/day in a nursing home, compared with an average of $60/day in their own home.  It is estimated that $25 million will be needed next year to transition another 1,600 people.

The Governor’s budget allocates $11 million to serve people on the MI Choice waiting list, but only $3.1 million for NFTI, enough to continue the program for only two months.  This would mean over 1,000 people would be forced to remain in nursing homes when they could live in the community at a much lower cost to the state.  An additional $22 million is needed for NFTI in fiscal year 2013.   

Legislators are now crafting the state’s FY 2013 budget, and the final decisions will be made by joint House-Senate Conference Committees.  We need to convince committee members to approve the Governor’s request for $11 million to serve the MI Choice waiting list, and also provide the $25 million in funding necessary to transition 1,600 people from nursing homes next year.

WHAT YOU CAN DO:

Click here to send a letter to your legislators thanking them for their past support of MI Choice and nursing facility transitions, and asking them to approve $11 million for the MI Choice waiting list and $25 million for nursing facility transitions in the MI Choice budget for FY 2013.

Nursing Home Transition Initiative (NFTI) in Jeopardy

Excerpt from Area Agencies on Aging Association of Michigan: (click for entire article)

The Nursing Home Transition Initiative (NFTI) is part of the MI Choice Medicaid Waiver program. NFTI is a cutting edge program that has gained national attention for successfully transitioning people in nursing homes who want to leave but face barriers. Barriers can include losing their home, not having an accessible home, and needing services and supports to stay at home. Last year, over 1,600 people were transitioned; data suggest that every year about 3,000 people in nursing homes are candidates for NFTI.

NFTI saves the state money because it targets people on Medicaid who cost an average of $172/day in a nursing home, compared with an average of $60/day in their own home. It is estimated that $25 million will be needed next year to transition another 1,600 people.  The Governor’s budget allocates $11 million to serve people on the MI Choice waiting list, but only $3.1 million for NFTI, enough to continue the program for only two months. This would mean over 1,000 people would be forced to remain in nursing homes when they could live in the community at a much lower cost to the state. An additional $22 million is needed for NFTI in fiscal year 2013.

Long term care insurance and more

Excerpt from Federal News Radio: (click for entire article)

This week on Your Turn, Federal Times senior writer Stephen Losey joins host Mike Causey to give us an up-to-the-minute status report of what's going on on Capitol Hill.

In the second half of the program, Paul Forte and Mary Lou McGuiness, will answer the 10 questions you were afraid to (or didn't know you should) ask about long term care. They are with Long Term Care Partners which manages the federal program.

Homes away from home not so sweet for long term care patients

Excerpt from The Valley Leader: (click for entire article)

Long-term elderly patients are facing the prospect of moving to another hospital ... sometimes isolating the patient from their loved ones.

That is the result of the Central Regional Health Authority’s Interim Placement program, and it is having an impact on people like Ben Schellenberg.

He suffers from Alzheimer’s and dementia, and he had been at Boundary Trails Health Centre for the last six months.

U.S. Senate Special Committee on Aging Ponders Future of Long Term Care - Part I

Excerpt from Aging in Chicago: (click for entire article)

On April 18, Senator Herb Kohl Chairman of the U.S. Senate Special Commmittee on Aging convened a hearing to consider how best provide and finance long-term care services and supports (LTSS) for millions of Americans. In his opening remarks, Sen. Kohl recited sobering statistics: current cost for LTSS is more than $300 billion a year and Medicaid alone projects $1.9 trillion in costs over the next 10 years with an annual average increase increase of 6.6%. He noted that America is going to have to do more with less: finding more efficient ways to provide care because (Federal and state) money will not be there.

Two themes emerged from  the testimony given by a distinguished panel of experts: innovation is critical to expanding the capacity and efficacy of the LTSS infrastructure, yet encumbered by the Medicaid program's exclusive reliance on skilled nursing care (by design), and secondly, stakeholders are uncertain as to how to encourage Americans to take responsibility for funding their future long term care needs.

Medical home guidelines expand focus to specialty practices

Excerpt from PGIP Matters: (click for entire article)

BCBSM along with provider organization leaders from across Michigan have expanded the PGIP PCMH Interpretive Guidelines to include concepts from the Patient-Centered Medical Home-Neighbor model endorsed by the American College of Physicians.

Patient-centered medical home is an approach in which patients take an active role in their own health care, working closely with their primary care physicians (pediatricians, internists and family practice doctors). Doctors coordinate patients' health status, manage chronic conditions, track all medications, offer extended office hours and practice ongoing health management to keep patients healthy and prevent complications.