WASHINGTON, D.C. – As millions of Americans face significant challenges when it comes to caring for loved ones who needs significant support, Sens. John Kerry (D-Mass.) and Chuck Grassley (R-Iowa) today introduced the “Empowered at Home Act.” The bill seeks to increase access to home and community based services by giving states new tools and incentives to make these services more available to those in need.
“Far too many elderly or disabled Americans can’t get the help they need in their home and community,” said Sen. Kerry. “Home- and community-based services are high-quality, cost-effective, and help many people live independent lives, but Medicaid continues to favor nursing homes. It’s a problem when the nation’s largest purchaser of long-term care services is tilted towards nursing homes rather than home and community based services. This bill will level the playing field and give families real choices to care for their loved ones, and give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable.”
“Being able to live at home greatly improves quality of life because people can be with loved ones and have the dignity that goes with greater independence,” said Sen. Grassley. “This bill encourages states to help make that possible, which is also fiscally smart because institutional care is the most expensive form of long-term care that Medicaid pays for. This bill also empowers individuals to manage the financial burdens that come with caregiving needs.”
The “Empowered at Home Act” has four basic parts:
First, it will improve the Medicaid HCBS State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program, which will create greater options for individuals in need of long-term supports. In return we ask that states no longer cap enrollment and that services be offered throughout the entire state.
Second, the bill ensures that the same spousal impoverishment protections offered for new nursing home beneficiaries will be in place for those opting for home and community based services. In addition, low-income recipients of home and community based services will be able to keep more of their assets when they become eligible for Medicaid, allowing them to stay in their community as long as possible.
Third, the Empowered at Home Act addresses the financial needs of spouses and family members caring for a loved one by offering tax-related provisions to support family caregivers and promote the purchase of meaningful private long-term care insurance.
Finally, the bill seeks to improve the overall quality of home and community based services available by providing grants for states to invest in organizations and systems that can help to ensure a sufficient supply of high quality workers, promote health, and transform home and community based care to be more consumer-centered.
The “Empowered at Home Act” has gained support of numerous health organizations including National Council on Aging, Alzheimer’s Association, American Geriatrics Society, Trust for America’s Health, and SEIU.
Thursday, August 7, 2008
Sunday, August 3, 2008
Neighborhood Hometown
am an avid reader of Globe North to follow local area issues. Reading your article in this Sunday's (8/3/08)
Globe North (slow motion" about the shift in population i can see how this applies to all parts of the Commonwealth. We all realize that the state has a major problem with funding from the Federal Government
if this trend continues.
In the article you point out the movement of population from Lynn to neighboring Peabody (Brooksby Villiage)
which is an assisted living for Seniors mostly affluent long time residents of Lynn looking for a safe and affordable upscale community. I assume Most would rather have rremained in their home and take the next available alternative remaining in the neighboring town in Essex County. We all want to improve our lifestyle.
A followup to your piece on the growing Senior population and their contribution to stability of a city and towns
and what the programs that could be put in place keeping long term residents it their neghborhood and particularly in home environments.
Example Mass Senior Action an advocate group for Seniors have supported with success protecting the rights and needs of elders in Senior and Disabled in subsidized housing. I would like to see them expand to help long time residents not only remain in familiar localities but in the home environment of a familiar neighbor hood.
IN MALDEN:
The Mayor Richard C. Howard, the Malden City Council, The Malden Revelopment Authority, Council on aging after urging from senior groups have plans to opening a new Malden Senior Community Center (Dec 8 2008)
in the downtown Area to improve the economic climate and revitalize Malden Center.
I would suggest their would be much interest to have Globe North do an in depth article of what is happening in Malden to retain our population is a safe and enjoyable city.
I have talked to the Mayor and he is for an outreach program to have a promotion and participation of all non profits in the New Senior Community Center. The concept is to have services to "keep independent living in the neighborhood"
How we can help home caregivers. We need the cooperation of all the non profits who are charged with servicing the Seniors our City Council who represent the citizens throughout the city all the citizens with a Vision For Malden
I would call it a declaration of Independence.
Right now I am trying to get a Focus group to gether for Ideas Interest and comments.
We have a model of several village concepts as guides of what can be done.
As an example:
Beacon Hill Village an all encompassing concierge service created by residents who want to grow old in the homes they have lived in for years.
This could be done on a regional basis or City wide even in a neighborhood.
This is what needs to be determined.
In the service by an organization they can deal with almost any contingency
large of small
without relying on relatives of friends. To preserve their Independence, they
can turn to the village as the non profit association is known
At Beacon Hill they have 320 members find virtually any service, large of small
from 24 hour nursing care to help with a home meal. all at a discounted fee or
from an "entitlement program"
Dan O'Leary Executive director(Mystic Valley Elders ) is on board and has already
had a focus group in Melrose to a standing room only crowd Keven Duffy of Healthy Malden has expressed interest. And Phil Gerioux of Tri Cap is considering his roll. All the city councilors and been briefed. Jim Nestor has all the information and was to contact Chris Depietro Dirtector of Elder Affairs Malden for her input. It would be a help if you and your members would find out from Jim his progress (Jim Nestor) and get a status report
REMEMBER NEW SENIOR COMMUNITY CENTER IS IN WARD 4 VITAL to economic development
of the downtown area.
Any neighbohood resident is asked to participate with membership between 50 and older.
Anyone with a parent needing sercie should be involved.
MaldenSenior
--
Howard McGowan
MaldenSenior
349 Pleasant Street
Malden, Ma 02148
781 324 8076
--
Globe North (slow motion" about the shift in population i can see how this applies to all parts of the Commonwealth. We all realize that the state has a major problem with funding from the Federal Government
if this trend continues.
In the article you point out the movement of population from Lynn to neighboring Peabody (Brooksby Villiage)
which is an assisted living for Seniors mostly affluent long time residents of Lynn looking for a safe and affordable upscale community. I assume Most would rather have rremained in their home and take the next available alternative remaining in the neighboring town in Essex County. We all want to improve our lifestyle.
A followup to your piece on the growing Senior population and their contribution to stability of a city and towns
and what the programs that could be put in place keeping long term residents it their neghborhood and particularly in home environments.
Example Mass Senior Action an advocate group for Seniors have supported with success protecting the rights and needs of elders in Senior and Disabled in subsidized housing. I would like to see them expand to help long time residents not only remain in familiar localities but in the home environment of a familiar neighbor hood.
IN MALDEN:
The Mayor Richard C. Howard, the Malden City Council, The Malden Revelopment Authority, Council on aging after urging from senior groups have plans to opening a new Malden Senior Community Center (Dec 8 2008)
in the downtown Area to improve the economic climate and revitalize Malden Center.
I would suggest their would be much interest to have Globe North do an in depth article of what is happening in Malden to retain our population is a safe and enjoyable city.
I have talked to the Mayor and he is for an outreach program to have a promotion and participation of all non profits in the New Senior Community Center. The concept is to have services to "keep independent living in the neighborhood"
How we can help home caregivers. We need the cooperation of all the non profits who are charged with servicing the Seniors our City Council who represent the citizens throughout the city all the citizens with a Vision For Malden
I would call it a declaration of Independence.
Right now I am trying to get a Focus group to gether for Ideas Interest and comments.
We have a model of several village concepts as guides of what can be done.
As an example:
Beacon Hill Village an all encompassing concierge service created by residents who want to grow old in the homes they have lived in for years.
This could be done on a regional basis or City wide even in a neighborhood.
This is what needs to be determined.
In the service by an organization they can deal with almost any contingency
large of small
without relying on relatives of friends. To preserve their Independence, they
can turn to the village as the non profit association is known
At Beacon Hill they have 320 members find virtually any service, large of small
from 24 hour nursing care to help with a home meal. all at a discounted fee or
from an "entitlement program"
Dan O'Leary Executive director(Mystic Valley Elders ) is on board and has already
had a focus group in Melrose to a standing room only crowd Keven Duffy of Healthy Malden has expressed interest. And Phil Gerioux of Tri Cap is considering his roll. All the city councilors and been briefed. Jim Nestor has all the information and was to contact Chris Depietro Dirtector of Elder Affairs Malden for her input. It would be a help if you and your members would find out from Jim his progress (Jim Nestor) and get a status report
REMEMBER NEW SENIOR COMMUNITY CENTER IS IN WARD 4 VITAL to economic development
of the downtown area.
Any neighbohood resident is asked to participate with membership between 50 and older.
Anyone with a parent needing sercie should be involved.
MaldenSenior
--
Howard McGowan
MaldenSenior
349 Pleasant Street
Malden, Ma 02148
781 324 8076
--
Monday, July 28, 2008
Welcome to Reverse Mortgage Seniors
The Basic Requirements for a Reverse Mortgage
The Basic Requirements Reverse Mortgage The first qualification for a reverse mortgage in America is the borrower has to be at least 62-years-old. Although there are absolutely no credit requirements or minimum income, there are certainly no other requirements and homeowners should ensure they qualify for the loan prior to investing time and money into the entire process. The funds can be used for any purpose for most reverse mortgages. However, the financial borrower must pay off any mortgage which exists with the reverse mortgage proceeds and personal additional funds if necessary. A pending bankruptcy normally slows the whole process.
Applicants must seek free financial counseling from an approved source by HUD (Department of Housing and Urban Development). The financial counseling actually provides a safeguard for the financial borrower and the family. This assures the borrower comprehensively understands the purpose of the reverse mortgage and how it’s obtained. The AARP (American Association of Retired Persons) has proposed a complete plan—which must be approved by the federal US government—for maintaining closing costs low for senior citizens that qualify for reverse mortgages.
Acquiring the Mortgage Program
Homeowners normally learn about reverse mortgages from an advertisement, word-of-mouth, a news article or on the Internet. The owner usually contacts a reverse mortgage lender or even the National Reverse Mortgage Lenders Association for an upfront education. Financial counseling is a requirement for all reverse mortgages as it may be conducted by telephone or face-to-face. By US federal law, a financial counselor must completely review options which are available to the prospective borrower—this includes social services, housing, financial and health alternatives.
The homeowner completes a loan application and chooses a payment plan—whether lump sum payment or fixed monthly payments, line of credit or a combination. Once all pertinent data is received, the lender finalizes parameters of the loan with the homeowner, which can take 4-8 weeks to underwrite the loan package. If the loan package is fully approved, signing of the loan is scheduled.
The homeowner has three business days subsequent to the closing to cancel the loan. The reverse mortgage loan is repaid when the homeowner ceases to be occupant of the principal residence. Of course, the repayment obligation can’t be more than the sale’s price or value of the home.
The Basic Requirements Reverse Mortgage The first qualification for a reverse mortgage in America is the borrower has to be at least 62-years-old. Although there are absolutely no credit requirements or minimum income, there are certainly no other requirements and homeowners should ensure they qualify for the loan prior to investing time and money into the entire process. The funds can be used for any purpose for most reverse mortgages. However, the financial borrower must pay off any mortgage which exists with the reverse mortgage proceeds and personal additional funds if necessary. A pending bankruptcy normally slows the whole process.
Applicants must seek free financial counseling from an approved source by HUD (Department of Housing and Urban Development). The financial counseling actually provides a safeguard for the financial borrower and the family. This assures the borrower comprehensively understands the purpose of the reverse mortgage and how it’s obtained. The AARP (American Association of Retired Persons) has proposed a complete plan—which must be approved by the federal US government—for maintaining closing costs low for senior citizens that qualify for reverse mortgages.
Acquiring the Mortgage Program
Homeowners normally learn about reverse mortgages from an advertisement, word-of-mouth, a news article or on the Internet. The owner usually contacts a reverse mortgage lender or even the National Reverse Mortgage Lenders Association for an upfront education. Financial counseling is a requirement for all reverse mortgages as it may be conducted by telephone or face-to-face. By US federal law, a financial counselor must completely review options which are available to the prospective borrower—this includes social services, housing, financial and health alternatives.
The homeowner completes a loan application and chooses a payment plan—whether lump sum payment or fixed monthly payments, line of credit or a combination. Once all pertinent data is received, the lender finalizes parameters of the loan with the homeowner, which can take 4-8 weeks to underwrite the loan package. If the loan package is fully approved, signing of the loan is scheduled.
The homeowner has three business days subsequent to the closing to cancel the loan. The reverse mortgage loan is repaid when the homeowner ceases to be occupant of the principal residence. Of course, the repayment obligation can’t be more than the sale’s price or value of the home.
Reverse Mortgages for Seniors
Welcome to Reverse Mortgage Seniors
The Basic Requirements for a Reverse Mortgage
The Basic Requirements Reverse Mortgage The first qualification for a reverse mortgage in America is the borrower has to be at least 62-years-old. Although there are absolutely no credit requirements or minimum income, there are certainly no other requirements and homeowners should ensure they qualify for the loan prior to investing time and money into the entire process. The funds can be used for any purpose for most reverse mortgages. However, the financial borrower must pay off any mortgage which exists with the reverse mortgage proceeds and personal additional funds if necessary. A pending bankruptcy normally slows the whole process.
Applicants must seek free financial counseling from an approved source by HUD (Department of Housing and Urban Development). The financial counseling actually provides a safeguard for the financial borrower and the family. This assures the borrower comprehensively understands the purpose of the reverse mortgage and how it’s obtained. The AARP (American Association of Retired Persons) has proposed a complete plan—which must be approved by the federal US government—for maintaining closing costs low for senior citizens that qualify for reverse mortgages.
Acquiring the Mortgage Program
Homeowners normally learn about reverse mortgages from an advertisement, word-of-mouth, a news article or on the Internet. The owner usually contacts a reverse mortgage lender or even the National Reverse Mortgage Lenders Association for an upfront education. Financial counseling is a requirement for all reverse mortgages as it may be conducted by telephone or face-to-face. By US federal law, a financial counselor must completely review options which are available to the prospective borrower—this includes social services, housing, financial and health alternatives.
The homeowner completes a loan application and chooses a payment plan—whether lump sum payment or fixed monthly payments, line of credit or a combination. Once all pertinent data is received, the lender finalizes parameters of the loan with the homeowner, which can take 4-8 weeks to underwrite the loan package. If the loan package is fully approved, signing of the loan is scheduled.
The homeowner has three business days subsequent to the closing to cancel the loan. The reverse mortgage loan is repaid when the homeowner ceases to be occupant of the principal residence. Of course, the repayment obligation can’t be more than the sale’s price or value of the home.
The Basic Requirements for a Reverse Mortgage
The Basic Requirements Reverse Mortgage The first qualification for a reverse mortgage in America is the borrower has to be at least 62-years-old. Although there are absolutely no credit requirements or minimum income, there are certainly no other requirements and homeowners should ensure they qualify for the loan prior to investing time and money into the entire process. The funds can be used for any purpose for most reverse mortgages. However, the financial borrower must pay off any mortgage which exists with the reverse mortgage proceeds and personal additional funds if necessary. A pending bankruptcy normally slows the whole process.
Applicants must seek free financial counseling from an approved source by HUD (Department of Housing and Urban Development). The financial counseling actually provides a safeguard for the financial borrower and the family. This assures the borrower comprehensively understands the purpose of the reverse mortgage and how it’s obtained. The AARP (American Association of Retired Persons) has proposed a complete plan—which must be approved by the federal US government—for maintaining closing costs low for senior citizens that qualify for reverse mortgages.
Acquiring the Mortgage Program
Homeowners normally learn about reverse mortgages from an advertisement, word-of-mouth, a news article or on the Internet. The owner usually contacts a reverse mortgage lender or even the National Reverse Mortgage Lenders Association for an upfront education. Financial counseling is a requirement for all reverse mortgages as it may be conducted by telephone or face-to-face. By US federal law, a financial counselor must completely review options which are available to the prospective borrower—this includes social services, housing, financial and health alternatives.
The homeowner completes a loan application and chooses a payment plan—whether lump sum payment or fixed monthly payments, line of credit or a combination. Once all pertinent data is received, the lender finalizes parameters of the loan with the homeowner, which can take 4-8 weeks to underwrite the loan package. If the loan package is fully approved, signing of the loan is scheduled.
The homeowner has three business days subsequent to the closing to cancel the loan. The reverse mortgage loan is repaid when the homeowner ceases to be occupant of the principal residence. Of course, the repayment obligation can’t be more than the sale’s price or value of the home.
Thursday, July 24, 2008
The Massachusetts Home Care Program
Home Care Program overview
--------------------------------------------------------------------------------
provides support services to elders with daily living needs to remain at home in their communities. The services are designed to encourage independence and to ensure dignity. The program also supports families caring for elders in order to encourage and to relieve the ongoing care giving responsibilities.
The Home Care Program is administered by the Executive Office of Elder Affairs in coordination with local Aging Services Access Points (ASAPs) located in communities throughout the Commonwealth of Massachusetts. Some of the services provided by the program include homemaker, personal care, day care, home deliver meals, transportation, and other community support services to help maintain an elder in his/her home. The ASAPs conduct comprehensive needs assessments to determine eligibly for the Home Care Program and other programs and services as appropriate. An individualized service plan is developed with the elder and his/her family and the ASAP reassesses the elders needs and monitors the services on an ongoing basis.
Eligibility for the Home Care Program is based on age (60 or older), financial status, and ability to carry our daily tasks such as bathing, dressing and meal preparation.
--------------------------------------------------------------------------------
provides support services to elders with daily living needs to remain at home in their communities. The services are designed to encourage independence and to ensure dignity. The program also supports families caring for elders in order to encourage and to relieve the ongoing care giving responsibilities.
The Home Care Program is administered by the Executive Office of Elder Affairs in coordination with local Aging Services Access Points (ASAPs) located in communities throughout the Commonwealth of Massachusetts. Some of the services provided by the program include homemaker, personal care, day care, home deliver meals, transportation, and other community support services to help maintain an elder in his/her home. The ASAPs conduct comprehensive needs assessments to determine eligibly for the Home Care Program and other programs and services as appropriate. An individualized service plan is developed with the elder and his/her family and the ASAP reassesses the elders needs and monitors the services on an ongoing basis.
Eligibility for the Home Care Program is based on age (60 or older), financial status, and ability to carry our daily tasks such as bathing, dressing and meal preparation.
Monday, July 7, 2008
Caring for our Seniors Reform Bill
Senator Boxer California Democrat Susan Collins Maine Repbulican
have created a bill that aims to generate more geriatric specialists and long term care workers and also creates an advisory panel to make recommendations
1. Require health care workers to demonstrate competance in basic geriatric care in order to maintain their liciences and certification.
2. Provide more courses and training in how to care for the elderly in all professional schools and health training programs.
3. Icrease pay for geriatric specialists and direct-care workers
Medicare Should increase is reimbursement reates for services delivered by geriatric specialists and STATES SHOULD ALLOCATE FUNDS TO BE ADDED TO THE MEDICIAD PAYMENTS THAT COVER THE MAJORITY OF SERVICES PROVIDED BY DIRECT CARE WORKERS.
Wednesday, June 25, 2008
We are shifting the way we're delivering health to seniors by bringing care to their communities so people can stay at home longer, surrounded by loved ones and where they are most comfortable,"
1. "Providing rides to appointments and the innovative programs announced today, as well as increased home care and other supports, provides greater access to care for tens of thousands of seniors and at the same time builds stronger communities throughout Massachusetts Local seniors assistance in a variety of areas, including caregiver support and education, supportive housing, transportation and meals, physical activity, wellness and preventive care and reducing isolation.
Programs range from helping elderly homeless men make the transition to permanent housing to helping ensure seniors are released from hospital sooner by providing a home caregiver to assist with medications, groceries and connecting them to community agencies
1. "Providing rides to appointments and the innovative programs announced today, as well as increased home care and other supports, provides greater access to care for tens of thousands of seniors and at the same time builds stronger communities throughout Massachusetts Local seniors assistance in a variety of areas, including caregiver support and education, supportive housing, transportation and meals, physical activity, wellness and preventive care and reducing isolation.
Programs range from helping elderly homeless men make the transition to permanent housing to helping ensure seniors are released from hospital sooner by providing a home caregiver to assist with medications, groceries and connecting them to community agencies
Sunday, May 18, 2008
Independent Living in our own Neighborhood
I would like to see this is a part of a Geratric Service with the cooperation of all the non profits serving the Malden Seniors and their families in assuring good caregiving and promised services not only to our residents in subsidized housing but throughout the City.
WE also need the cooperation of our elected City Council as well as the executive deparrments of the Cities, businesses and the activist citizens in our community.
Declaration of Independents
By: Barbara Basler Source: AARP Bulletin Today Date Posted:
Suzanne Stark, 79, lives in a book-lined apartment in central Boston's lovely Beacon Hill neighborhood. Independent and active, the author and freelance writer nevertheless acknowledges there are times when problems arise and she needs help. Like when her beloved cat Zenobia became suddenly, violently ill, and Stark couldn't get her into a carrier to take her to the veterinarian.
"I tried everything, and then I called Beacon Hill Village," she says. "I said, 'I know this is weird, but can you send someone to help me get this cat in the carrier?' And they did."
Beacon Hill Village is a revolutionary, all-encompassing concierge service created by residents who want to grow old in the homes they have lived in for years.
Now, they can do that, confident that even as they age they can deal with almost any contingency, large or small, without relying on relatives or friends. To preserve their independence, they can turn to the village, as the nonprofit association is known, which helps its 320 members find virtually any service they need—from 24-hour nursing care to help with a wayward cat, often at a discounted fee.
Their innovation is so appealing that a national expert on aging at the Massachusetts Institute of Technology asserts it could well change the way Americans—and the rest of the world—grow old. "The assisted living and the die-with-a-golf-club-in-your-hand communities had better take notice," says Joseph Coughlin, director of the MIT AgeLab, a think tank on aging.
This fresh concept is already attracting attention far beyond the quaint cobblestone walkways of Beacon Hill. In the three years since it started, the village has received more than 200 inquiries—from places as diverse as Manhattan and Las Vegas.
The group's grassroots creators are now writing a how-to manual so others can replicate the village in their own neighborhoods. And MIT is working on a plan of the concept that could be used around the world.
"With Beacon Hill Village you have life, you don't have retirement," Coughlin says. The village not only links members to carefully vetted personal trainers, caterers, house cleaners, plumbers and computer advisers, it also offers them a number of free benefits such as weekly car service to the grocery. Other free benefits include monthly lectures by notable Bostonians, exercise classes and special health clinics—all activities that take place in neighborhood churches, schools and a community center.
The village hasn't yet had a request it couldn't help fill, says Judy Willett, the social worker hired to direct the association and its two other full-time employees. "We even had a member in the hospital call and ask us to find someone to pick up her betting slips at the track. And we did," she says.
"We wanted everything you'd find in a retirement community or assisted living—but we wanted these services in our own homes," explains Susan McWhinney-Morse, 72, the president of Beacon Hill Village, who was one of the 12 residents who helped create it. "We didn't want to leave the neighborhood we love."
Village founder and member J. Atwood "Woody" Ives, 69, says, "Even the places they call active retirement communities tend to be depressing. They're so artificial—everybody there is old."
But, he says, by staying in his own neighborhood, "I see college students, couples, young families, old people. There is a great mix here, and I think that adds to the quality of life."
Any neighborhood resident age 50 or older can join the village. Its members include retirees in their 90s as well as working people in their 50s and 60s.
"The younger ones join because they like the convenience of our services or they need help caring for a parent who lives with them," Willett says. "They want to support Beacon Hill Village, make sure it will be there as they age."
Membership costs $550 a year per person, $750 a year per couple and $100 a year for lower-income residents, who also get a $250 credit toward services. And the village has people who charge as little as $15 an hour for odd jobs.
The woman the village sent to help Suzanne Stark with Zenobia spent all afternoon with them—driving Stark and her cat to the vet, waiting, then driving them to the animal hospital and finally home. "That saved Zenobia's life," Stark says. The cost of the service: $35.
In many cases remaining at home and using the village's à la carte services is much cheaper than assisted living, Willett says. If, however, someone becomes ill enough to need 24-hour care or other expensive services, the total costs probably will equal those of a nursing home, "but with one big difference: You are in your own home."
Village employees not only provide information and referrals, they telephone members to check that each job was completed satisfactorily.
Although members are entitled to highly personalized attention, the tiny staff—operating out of a one-room neighborhood office—has never been overwhelmed because only about a third of the members call the village frequently. Another third use it now and then, while the remainder draw mainly on its social offerings—lectures, weekly lunches in a local restaurant and day trips to places like the Newport Jazz Festival.
"The social aspect is the secret sauce here," says MIT's Coughlin. "Just bringing services to your door doesn't ensure a good life. People, especially older people living alone, need to be engaged, they need reasons to go out, to be a part of a community. And the village works to give them that."
The core group of 12 residents laid the groundwork for the project with meticulous research, drawing up a business plan, vetting and recruiting a number of businesses and health providers, all of them eager to have a reliable stream of customers. Two key concerns joined their effort early and helped anchor it—Harvard Medical School's Massachusetts General Hospital and HouseWorks, a Boston home services company.
The gifted amateur organizers, however, were canny enough to realize they needed help. By donating their own money and raising contributions from others in the neighborhood who believed in the idea, they hired professionals to help market the village concept to residents. They also approached several foundations for money for the subsidized memberships.
The village still relies on foundations and support from board members and the community, but membership is growing by about eight new members a month.
"Membership fees pay for about 50 percent of our expenses, and within a year we think that will rise to 60 percent," Willett says.
The leafy streets of Beacon Hill are lined with 19th-century townhouses where people such as Henry James and Louisa May Alcott once lived. Today's residents live in a dense mix of fine homes, imposing apartment buildings, condos and even subsidized housing for older people, but they still tend to be well heeled and well educated. Can their aging solution really be transplanted to other, very different communities?
Yes, says Coughlin, because innovations "always start at the top, rather than the middle or the bottom. Of all the ideas we've seen here at the AgeLab, this one has got a better chance of going mainstream than many others."
Establishing this city-bred idea in the suburbs and beyond may actually be easier "because the cost of living, the cost of services is much less expensive there than here," says Sue Bridge, 66, one of the founders who, with help from alumni volunteers from Harvard University's School of Business, wrote the village's business plan.
Coughlin points out that "some of the best-knit communities in America are not in the city but in the country, in rural agricultural areas where institutions of faith often organize services and contacts for people."
Transportation in the suburbs or exurban areas could be an issue, but he does not see it as an insurmountable problem. "You have to think creatively," he says. "Missoula, Montana, for example, uses its airport shuttles in the off-peak hours to ferry older residents where they want to go and to take families to visit relatives in nursing homes."
"What we need," Coughlin says, "are folks with the passion to work these things out." Those people may be in a neighborhood association or they may be entrepreneurs "who see an explosion of disposable income and a demand for services that needs to be met."
One of the biggest obstacles to this effort to change the way people age has been the residents themselves. Village research shows that of the 13,000 people in the Beacon Hill area, 14 percent are age 60 or older, and some of these people were the most resistant.
"We couldn't believe all of the people we approached about joining who told us, 'That's a great idea, but I'm not ready yet,' " says board member Ives. "These were people in their 80s and 90s. People just hate to admit they need any kind of help."
Instead, "too many deal with aging by cutting back on where they go and when, what they do, who they see," says Bridge. "Their lives become more and more constricted. When they join the village, suddenly life opens up again."
One resident who initially resisted the village is now a booster. "They treat me like a queen," says Dorothy Weinstein, 97, who recently signed up for a village trip to New Hampshire to see the fall leaves. "They've been a saving grace."
She uses the village grocery service and calls the office when she needs an escort to her clinic appointments. The village even has volunteers who accompany her on neighborhood walks.
A resident of Beacon Hill for 53 years, still living in the house where she and her late husband raised their sons, Weinstein wouldn't think of moving.
"Where would I be as content as I am here?" she asks. "I look out my window at the park. I see people passing. I talk to old neighbors I know. This is the way I want things."
----------
.
Sunday, May 4, 2008
Caregivers can receive aid relief for care of elderly, disabled
Families will soon be able to act as paid caregivers for relatives – including parents – who need intense in-home medical care, under a new MassHealth plan.
The MassHealth Adult Family Care Program matches individuals who need assistance with activities of daily living with host families who provide those services in a home setting. Services can include assistance with activities of daily living such as bathing, dressing, incontinence management and other personal care.
The new Enhanced MassHealth Adult Family Care program will soon be able to meet the needs of individuals requiring a higher level of care by broadening the spectrum of caregivers who are eligible to participate.
Families, or hosts, as they are called in the program, receive about $18,000 to provide care that prevents or delays institutional care.
“People express a clear preference for being cared for in a home setting,” said John O’Neill, executive director of Somerville-Cambridge Elder Services, which provides the program in a number of communities in Greater Boston. “Enhanced Adult Family Care is a wonderful option for MassHealth beneficiaries who would like to receive care from a loved one in a home setting.”
The program allows children to be paid caregivers for their parents. The Enhanced Adult Family Care program will not only allow elders and persons with disabilities to move into a caregiver’s home, but will allow a caregiver to move into the individual’s home. Participants must be 16 years or older and meet MassHealth financial and clinical eligibility standards. Caregivers may be any friend or family member other than a spouse, parent, or legally responsible relative and must meet qualifications specified by the state.
MassHealth pays for Enhanced Adult Family Care if an individual is financially eligible for MassHealth and requires physical assistance with at least three of the following activities: bathing, dressing, toileting, transferring, ambulating, eating; or, physical assistance with two of the activities above and management of behaviors that require caregiver intervention such as wandering, verbally abusive behavioral symptoms, physically abusive behavioral symptoms, socially inappropriate or disruptive behavioral symptoms, or resisting care.
For more information, call the SCES Aging Information Center at 617-628-2601 ext. 3151.
Monday, April 21, 2008
Home Care Site
Published as service in the Malden Observer.
Ross Capobianco is president of Home Instead Senior Care, a provider of home care services to seniors living north of Boston. He can be reached at 781-662-2273 or via e-mail at bostonnorth@homeinstead.com.
Ross Capobianco is president of Home Instead Senior Care, a provider of home care services to seniors living north of Boston. He can be reached at 781-662-2273 or via e-mail at bostonnorth@homeinstead.com.
Sunday, April 13, 2008
Long Term Care Insurance
Baby boomers beware: The safety net you might be relying on to take care of you when you're old and sick is full of holes, a new study warns.
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
Thursday, March 20, 2008
Caregivers Family
Elder Law: Keeping mom at home
By By Ronald Surabian/Elder Law Center
Thu Mar 20, 2008, 02:16 PM EDT
Malden -
Malden - Let’s face it: no one wants to go to a nursing home.
For elders who have supportive families, this is sometimes possible. Today I want to talk about something called Enhanced Group Foster Care. It is a program offered by the Commonwealth that will compensate family members for taking care of their mom or dad. It is aimed at children who either move in with their parent, or have their parent move in with them, instead of going to a nursing home.
The caregiver who accepts this responsibility will receive up to $50 per day, or about $18,000 per year for caring for their parent. As a bonus, this income is non-taxable under section 131 of the Internal Revenue Code, as qualified foster care payments. These payments are for 24-hour care of the senior, but the child can get a break from their caregiver duties for up to 14 days per year under the respite care program.
This would provide a break to the caregiver for a vacation. And, if the senior is willing, there are adult day care programs that provide care at a senior day care facility so that the child can have free time during the week to work, shop or do as they please, knowing that their parent is safe, and being taken care of.
Who Is Eligible
Elders, or disabled adult family members over the age of 16, that need assistance with three Activities of Daily Living (ADL’s), and are financially eligible for MassHealth (Medicaid in Massachusetts) are eligible. Activities of daily living are bathing, dressing, toileting, transferring (this means from bed to wheelchair), ambulating, and eating. Elders who are wandering, verbally or physically abusive, resisting care, or have socially inappropriate or disruptive symptoms only need help with two activities of daily living to qualify. Elders who need less care can also be eligible for this program, however, their caregiver pay is reduced.
Who is Eligible To Be A Caregiver
The program pays family, or non-family caregivers to care for an elder or adult disabled family member over the age of 16. Spouses, and legal guardians are NOT eligible to be paid caregivers under this program. The most common caregivers are children and siblings.
I spoke with Linda Morreale-Steele, a registered nurse and program director for North Region of Caregiver Homes of Massachusetts. Caregiver Homes is an approved Adult Foster Care Program and provides services throughout Massachusetts.
“This program is all about choice,” she said. “It gives elders who could be in a nursing home an option that was previously unavailable.”
Caregiver Homes starts by assessing the elder and developing a care plan and maintaining contact through regular telephone calls and home visits. They also provide continuing education and training to the caregiver to stay current with the changing needs of the seniors.
The elder’s health status is also monitored by daily notes taken by the caregiver and entered into a computer program that connects to Caregiver Homes through the internet. These notes are monitored by an registered nurse and care manager on a daily basis.
When a family member is not available, Caregiver Homes recruits, and trains non-family members to provide care to the senior. For more information, call the placement coordinator for Caregiver Homes at (866) 797-2333.
This article gives general information and not specific advice on individual matters. Persons wanting individualized advice on matters discussed should contact an advisor experienced in those matters. To the extent this article provides information on legal matters, it is based on law in effect in Massachusetts on the date of posting (laws in effect in other states are often quite different).
Ronald H. Surabian is a CPA and attorney who works at the Elder Law Center in Saugus. He also holds Masters in accounting and a master’s degree in tax law. He currently serves on the board of directors of the Massachusetts Chapter of the National Academy of Elder Law Attorneys.
If you have any questions please call me at the Elder Law Center, One Essex Street, Saugus, MA 01906 (781)233-4444. To view this or any prior article, please visit www.elderlawcenter.org
Comments (1)
malden senior
2008-03-20T18:31:53
Report Abuse
On the face of it this sounds great until you realize you must become a pauper (spending down or give away assets) get on Medicaid (with a wait for approval) apply asking for help from a agency (like Mystic Valley Elders) get on a waiting list and hope for a long awaited phone Call
By By Ronald Surabian/Elder Law Center
Thu Mar 20, 2008, 02:16 PM EDT
Malden -
Malden - Let’s face it: no one wants to go to a nursing home.
For elders who have supportive families, this is sometimes possible. Today I want to talk about something called Enhanced Group Foster Care. It is a program offered by the Commonwealth that will compensate family members for taking care of their mom or dad. It is aimed at children who either move in with their parent, or have their parent move in with them, instead of going to a nursing home.
The caregiver who accepts this responsibility will receive up to $50 per day, or about $18,000 per year for caring for their parent. As a bonus, this income is non-taxable under section 131 of the Internal Revenue Code, as qualified foster care payments. These payments are for 24-hour care of the senior, but the child can get a break from their caregiver duties for up to 14 days per year under the respite care program.
This would provide a break to the caregiver for a vacation. And, if the senior is willing, there are adult day care programs that provide care at a senior day care facility so that the child can have free time during the week to work, shop or do as they please, knowing that their parent is safe, and being taken care of.
Who Is Eligible
Elders, or disabled adult family members over the age of 16, that need assistance with three Activities of Daily Living (ADL’s), and are financially eligible for MassHealth (Medicaid in Massachusetts) are eligible. Activities of daily living are bathing, dressing, toileting, transferring (this means from bed to wheelchair), ambulating, and eating. Elders who are wandering, verbally or physically abusive, resisting care, or have socially inappropriate or disruptive symptoms only need help with two activities of daily living to qualify. Elders who need less care can also be eligible for this program, however, their caregiver pay is reduced.
Who is Eligible To Be A Caregiver
The program pays family, or non-family caregivers to care for an elder or adult disabled family member over the age of 16. Spouses, and legal guardians are NOT eligible to be paid caregivers under this program. The most common caregivers are children and siblings.
I spoke with Linda Morreale-Steele, a registered nurse and program director for North Region of Caregiver Homes of Massachusetts. Caregiver Homes is an approved Adult Foster Care Program and provides services throughout Massachusetts.
“This program is all about choice,” she said. “It gives elders who could be in a nursing home an option that was previously unavailable.”
Caregiver Homes starts by assessing the elder and developing a care plan and maintaining contact through regular telephone calls and home visits. They also provide continuing education and training to the caregiver to stay current with the changing needs of the seniors.
The elder’s health status is also monitored by daily notes taken by the caregiver and entered into a computer program that connects to Caregiver Homes through the internet. These notes are monitored by an registered nurse and care manager on a daily basis.
When a family member is not available, Caregiver Homes recruits, and trains non-family members to provide care to the senior. For more information, call the placement coordinator for Caregiver Homes at (866) 797-2333.
This article gives general information and not specific advice on individual matters. Persons wanting individualized advice on matters discussed should contact an advisor experienced in those matters. To the extent this article provides information on legal matters, it is based on law in effect in Massachusetts on the date of posting (laws in effect in other states are often quite different).
Ronald H. Surabian is a CPA and attorney who works at the Elder Law Center in Saugus. He also holds Masters in accounting and a master’s degree in tax law. He currently serves on the board of directors of the Massachusetts Chapter of the National Academy of Elder Law Attorneys.
If you have any questions please call me at the Elder Law Center, One Essex Street, Saugus, MA 01906 (781)233-4444. To view this or any prior article, please visit www.elderlawcenter.org
Comments (1)
malden senior
2008-03-20T18:31:53
Report Abuse
On the face of it this sounds great until you realize you must become a pauper (spending down or give away assets) get on Medicaid (with a wait for approval) apply asking for help from a agency (like Mystic Valley Elders) get on a waiting list and hope for a long awaited phone Call
Friday, March 14, 2008
News Release MVES executive director
Malden - Senior Notes
Locals rally at State House for elder independence
Local seniors and members of organizations that support elder independence converged on the Statehouse on Tuesday, Feb. 26, to tell legislators that elders should have a choice when it comes to long-term care services.
The group of more than 300, including 25 people from the Mystic Valley area, said that the state continues to be overly reliant on nursing home care when most elders want to live independently in their own homes.
“We invest 66 percent of our MassHealth long-term care dollars in nursing homes,” said Mystic Valley Elder Services Executive Director Dan O’Leary. “Yet our official state policy is ‘Community First.’ It’s time to rearrange our budget to reflect what seniors want: care at home. Let the money follow the person back home.”
To emphasize the needed shift in funding, group members waved “Deval Dollars” in support of the governor’s plan to “rebalance” money from nursing homes to community-care programs. Legislators were urged to implement the Equal Choice law, passed in 2006, that guarantees seniors live in the “least restrictive setting” possible.
Silver Legislator Senate President Sally Hoyt also spoke about the importance of independence for elders. The rally took place while lawmakers prepare the Fiscal 2009 budget.
Locals rally at State House for elder independence
Local seniors and members of organizations that support elder independence converged on the Statehouse on Tuesday, Feb. 26, to tell legislators that elders should have a choice when it comes to long-term care services.
The group of more than 300, including 25 people from the Mystic Valley area, said that the state continues to be overly reliant on nursing home care when most elders want to live independently in their own homes.
“We invest 66 percent of our MassHealth long-term care dollars in nursing homes,” said Mystic Valley Elder Services Executive Director Dan O’Leary. “Yet our official state policy is ‘Community First.’ It’s time to rearrange our budget to reflect what seniors want: care at home. Let the money follow the person back home.”
To emphasize the needed shift in funding, group members waved “Deval Dollars” in support of the governor’s plan to “rebalance” money from nursing homes to community-care programs. Legislators were urged to implement the Equal Choice law, passed in 2006, that guarantees seniors live in the “least restrictive setting” possible.
Silver Legislator Senate President Sally Hoyt also spoke about the importance of independence for elders. The rally took place while lawmakers prepare the Fiscal 2009 budget.
Thursday, March 13, 2008
Home Care interest Medicare Beneficiares
i) PROCESSES- The processes described in this clause are the following:
`(I) In developing standards referred to in such subparagraph, the Secretary shall convene a Technical Advisory Group consisting of stakeholders, including individuals and organizations representing the interests of Medicare beneficiaries, the National Association for Home Care & Hospice, and the Visiting Nurse Associations of America, health care academia, and health care professionals, in equal numbers from each and limited to parties without an existing contractual relationship with the Secretary, to advise the Secretary concerning the establishment of such standards in order to distinguish between real changes in case mix and changes in coding or classification of different units of services that do not reflect real changes in case mix. The Technical Advisory Group shall be given the opportunity to review and comment on any proposed rulemaking or final determination by the Secretary on such standards prior to such rulemaking or determination.
`(II) If the Secretary engages an outside contractor to participate in the evaluation of case mix changes described in subclause (I), the Secretary shall only utilize a contractor that has not previously participated in the design and establishment of the case mix adjustment factors under subparagraph (B).
`(III) If the Secretary determines that any increase in case mix relates to changes in the volume or nature of services provided to home health services patients, the Secretary shall evaluate that increase through actual review of claims and services and shall not use any proxy or surrogate for determining whether the change in volume or nature of services is reasonable and necessary.
`(IV) The Secretary shall establish the standards referred to in subclause (I) by regulation.
`(V) With respect to establishment of such standards, the Secretary shall make public all data, reports, and supporting materials, including any comments by the Technical Advisory Group pursuant to subclause (I), regarding the standards at the time of notice of such standards.
`(ii) CRITERIA- The criteria described in this clause are the following:
`(I) The impact of changes in the program under this title that may affect the characteristics of individuals receiving home health services.
`(II) The impact of changes in the provision of health care services by providers of services other than home health agencies.
`(III) Distinctions in the characteristics of individuals initiating home health services from the community and institutional care settings.
`(IV) Whether any changes in coding resulted in a change in expenditures overall annually and disregarding changes in coding that do not have an overall expenditure impact.
`(V) Any other factors determined appropriate by the Secretary in consultation with the Technical Advisory Group under clause (i)(I).'.
(b) Voiding of Proposed Case Mix Adjustment- The Secretary of Health and Human Services shall not take any action to implement or otherwise carry out provisions contained in the final rule published on August 29, 2007, on pages 49762-49945 of volume 72 of the Federal Register, insofar as such provisions propose to make a case mix adjustment to the standardized payment amounts under the prospective payment system for home health services under section 1895 of the Social Security Act (42 U.S.C. 1395fff) to account for changes in coding that were not related to an underlying change in patient health status. The Secretary shall republish any rates specified in such rule to take into account the application of the previous sentence. The Secretary shall only institute an adjustment under subparagraph (B)(iv) of such section in compliance with subparagraph (D) of such section, as added by subsection (a)(2).
`(I) In developing standards referred to in such subparagraph, the Secretary shall convene a Technical Advisory Group consisting of stakeholders, including individuals and organizations representing the interests of Medicare beneficiaries, the National Association for Home Care & Hospice, and the Visiting Nurse Associations of America, health care academia, and health care professionals, in equal numbers from each and limited to parties without an existing contractual relationship with the Secretary, to advise the Secretary concerning the establishment of such standards in order to distinguish between real changes in case mix and changes in coding or classification of different units of services that do not reflect real changes in case mix. The Technical Advisory Group shall be given the opportunity to review and comment on any proposed rulemaking or final determination by the Secretary on such standards prior to such rulemaking or determination.
`(II) If the Secretary engages an outside contractor to participate in the evaluation of case mix changes described in subclause (I), the Secretary shall only utilize a contractor that has not previously participated in the design and establishment of the case mix adjustment factors under subparagraph (B).
`(III) If the Secretary determines that any increase in case mix relates to changes in the volume or nature of services provided to home health services patients, the Secretary shall evaluate that increase through actual review of claims and services and shall not use any proxy or surrogate for determining whether the change in volume or nature of services is reasonable and necessary.
`(IV) The Secretary shall establish the standards referred to in subclause (I) by regulation.
`(V) With respect to establishment of such standards, the Secretary shall make public all data, reports, and supporting materials, including any comments by the Technical Advisory Group pursuant to subclause (I), regarding the standards at the time of notice of such standards.
`(ii) CRITERIA- The criteria described in this clause are the following:
`(I) The impact of changes in the program under this title that may affect the characteristics of individuals receiving home health services.
`(II) The impact of changes in the provision of health care services by providers of services other than home health agencies.
`(III) Distinctions in the characteristics of individuals initiating home health services from the community and institutional care settings.
`(IV) Whether any changes in coding resulted in a change in expenditures overall annually and disregarding changes in coding that do not have an overall expenditure impact.
`(V) Any other factors determined appropriate by the Secretary in consultation with the Technical Advisory Group under clause (i)(I).'.
(b) Voiding of Proposed Case Mix Adjustment- The Secretary of Health and Human Services shall not take any action to implement or otherwise carry out provisions contained in the final rule published on August 29, 2007, on pages 49762-49945 of volume 72 of the Federal Register, insofar as such provisions propose to make a case mix adjustment to the standardized payment amounts under the prospective payment system for home health services under section 1895 of the Social Security Act (42 U.S.C. 1395fff) to account for changes in coding that were not related to an underlying change in patient health status. The Secretary shall republish any rates specified in such rule to take into account the application of the previous sentence. The Secretary shall only institute an adjustment under subparagraph (B)(iv) of such section in compliance with subparagraph (D) of such section, as added by subsection (a)(2).
Tuesday, February 26, 2008
Veterans on Home Care Programs
VA Gives $4.7 Million to Help Caregivers
The Department of Veterans Affairs (VA) will provide nearly $4.7 million for “caregiver assistance pilot programs” to expand and improve health care education and provide needed training and resources for caregivers who assist disabled and aging veterans in their homes. The pilot programs will support eight caregiver projects across the country. Among the key services provided to caregivers are transportation, respite care, case management and service coordination, assistance with personal care (bathing and grooming), social and emotional support, and home safety evaluations.
Education programs teach caregivers how to obtain community resources such as legal assistance, financial support, housing assistance, home delivered meals and spiritual support. In addition, caregivers are taught skills such as time management techniques, medication management, communication skills with the medical staff and the veteran, and ways to take better care of themselves. The VA pilot programs include:
At the Memphis (Tenn.) and Palo Alto (Calif.) VA medical centers, a project will provide education, support and skills-building to help caregivers manage both patient behaviors and their own stress. This intervention will be provided in 14 Home-Based Primary Care (HBPC) programs across the country and also to caregivers in non-HBPC settings at the Palo Alto VAMC.
At the VA medical center in Gainesville, Fla., caregivers will take part in a Transition Assistance Program to provide skills training, education and supportive problem solving using videophone technology.
At the VA Healthcare System of Ohio, headquartered in Cincinnati, caregiver advocates will be available around the clock to coordinate between VA and community services.
At the VA Desert Pacific Network and the VA Sierra Nevada Healthcare System, VA will work with a community coalition to provide education, skills training and resources for caregivers of veterans with traumatic brain injury using computer-based telehealth, including Web, telephone and videoconferencing.
At the VA medical center in Albany, N.Y., a pilot project will convert a three-hour workshop developed by the National Family Caregivers Association called “Communicating Effectively with Health Care Professionals” into a cost-effective multimedia format.
At the Atlanta VA Medical Center, use of computer-based technology will provide instrumental help and emotional support to caregivers who live in remote areas or to those who cannot leave a patient alone.
The Tampa VA Medical Center and the Miami VA Healthcare System are working on a collaborative project. In the Tampa area, the current program will be expanded to provide 24-hour in-home respite care to temporarily relieve caregivers up to 14 days a year. In Miami, the program will coordinate comprehensive community-based care services, including respite, home companions, adult day care and use of emergency response system.
The VA Pacific Islands Health Care System will use the “medical foster home” model of care, in which caregivers in the community take veterans into their homes and provide 24-hour supervision. This program will take place on the islands of Kauai, Hawaii, Maui and rural areas of Oahu.
For more information, visit the Department of Veteran Affairs website.
Comments
takandles
3 days agoSuggest Removal
My father gets Aid in Dependent Care from the VA which is a big financial help. I do not work to take care of him so some of that money is suppose to be to pay me. the down side is that if I want to hire someone for respite care it comes out of my part which I need to support myself. I only get to go to the store when one of my children can come sit with him. I have not gone anyplace else in years. There needs to be more respite care for the caregivers with little or no income such as me. Here in the state of Alabama there isn' much. You have to have no or very little to get help or be rich enough to afford it. What we get from the VA it a big help but not enough.
Temporary relief from the stress and duties of caregiving.
mbsmarttext('Respite Care','bbf852d1-7af3-483e-a7b3-1067f001bd53');
The Department of Veterans Affairs (VA) will provide nearly $4.7 million for “caregiver assistance pilot programs” to expand and improve health care education and provide needed training and resources for caregivers who assist disabled and aging veterans in their homes. The pilot programs will support eight caregiver projects across the country. Among the key services provided to caregivers are transportation, respite care, case management and service coordination, assistance with personal care (bathing and grooming), social and emotional support, and home safety evaluations.
Education programs teach caregivers how to obtain community resources such as legal assistance, financial support, housing assistance, home delivered meals and spiritual support. In addition, caregivers are taught skills such as time management techniques, medication management, communication skills with the medical staff and the veteran, and ways to take better care of themselves. The VA pilot programs include:
At the Memphis (Tenn.) and Palo Alto (Calif.) VA medical centers, a project will provide education, support and skills-building to help caregivers manage both patient behaviors and their own stress. This intervention will be provided in 14 Home-Based Primary Care (HBPC) programs across the country and also to caregivers in non-HBPC settings at the Palo Alto VAMC.
At the VA medical center in Gainesville, Fla., caregivers will take part in a Transition Assistance Program to provide skills training, education and supportive problem solving using videophone technology.
At the VA Healthcare System of Ohio, headquartered in Cincinnati, caregiver advocates will be available around the clock to coordinate between VA and community services.
At the VA Desert Pacific Network and the VA Sierra Nevada Healthcare System, VA will work with a community coalition to provide education, skills training and resources for caregivers of veterans with traumatic brain injury using computer-based telehealth, including Web, telephone and videoconferencing.
At the VA medical center in Albany, N.Y., a pilot project will convert a three-hour workshop developed by the National Family Caregivers Association called “Communicating Effectively with Health Care Professionals” into a cost-effective multimedia format.
At the Atlanta VA Medical Center, use of computer-based technology will provide instrumental help and emotional support to caregivers who live in remote areas or to those who cannot leave a patient alone.
The Tampa VA Medical Center and the Miami VA Healthcare System are working on a collaborative project. In the Tampa area, the current program will be expanded to provide 24-hour in-home respite care to temporarily relieve caregivers up to 14 days a year. In Miami, the program will coordinate comprehensive community-based care services, including respite, home companions, adult day care and use of emergency response system.
The VA Pacific Islands Health Care System will use the “medical foster home” model of care, in which caregivers in the community take veterans into their homes and provide 24-hour supervision. This program will take place on the islands of Kauai, Hawaii, Maui and rural areas of Oahu.
For more information, visit the Department of Veteran Affairs website.
Comments
takandles
3 days agoSuggest Removal
My father gets Aid in Dependent Care from the VA which is a big financial help. I do not work to take care of him so some of that money is suppose to be to pay me. the down side is that if I want to hire someone for respite care it comes out of my part which I need to support myself. I only get to go to the store when one of my children can come sit with him. I have not gone anyplace else in years. There needs to be more respite care for the caregivers with little or no income such as me. Here in the state of Alabama there isn' much. You have to have no or very little to get help or be rich enough to afford it. What we get from the VA it a big help but not enough.
Temporary relief from the stress and duties of caregiving.
mbsmarttext('Respite Care','bbf852d1-7af3-483e-a7b3-1067f001bd53');
Saturday, February 23, 2008
Consumer Nursing Home Data
Massachusetts
The state provides consumer information on nursing homes, including a tool that lets you search for nursing homes by city or facility name to see scores and any deficiencies and enforcement actions from the last three standard surveys. You also can compare and evaluate nursing homes by their performance in five areas—administration, nursing, resident rights, kitchen/food services and environment. You can also see how each facility compares based on a Nursing Home Satisfaction Survey.
For more information, contact the state Department of Public Health's Division of Health Care Quality at (617) 753-8000, or the Massachusetts Long-Term Care Ombudsman or call (617) 727-7750. To find a local ombudsman, call 1-800-AGE-INFO (1-800-243-4636).
The state provides consumer information on nursing homes, including a tool that lets you search for nursing homes by city or facility name to see scores and any deficiencies and enforcement actions from the last three standard surveys. You also can compare and evaluate nursing homes by their performance in five areas—administration, nursing, resident rights, kitchen/food services and environment. You can also see how each facility compares based on a Nursing Home Satisfaction Survey.
For more information, contact the state Department of Public Health's Division of Health Care Quality at (617) 753-8000, or the Massachusetts Long-Term Care Ombudsman or call (617) 727-7750. To find a local ombudsman, call 1-800-AGE-INFO (1-800-243-4636).
Sunday, February 17, 2008
National Resourses for Caregivers
National Resources
Eldercare Locator Operated by the U.S. Administration on Aging, this is a nationwide directory of state and area agencies that deal with services for the aging. There's also a toll-free number -- 1-800-677-1116 -- which operates Monday through Friday, 9:00 a.m. to 8:00 p.m., Eastern time.
BenefitsCheckUp Operated by the National Council on the Aging, this Web-based service identifies federal and state assistance programs for older Americans in each community. You must fill out a short questionnaire which is used only to determine which programs an older person qualifies for.
Children of Aging Parents Establishes support groups, information and referral services and educational outreach for family caregivers.
National Alliance for Caregiving A joint venture of several private and governmental agencies, the alliance Web site provides useful information and links for CareGivers.
National Association of Professional Geriatric Care Managers Care managers are professionals who coordinate caregiving services. They can be helpful when family members are not able to play an active role.
Disease-Specific Information Information about specific diseases and conditions likely to require continuing care.
Eldercare Locator Operated by the U.S. Administration on Aging, this is a nationwide directory of state and area agencies that deal with services for the aging. There's also a toll-free number -- 1-800-677-1116 -- which operates Monday through Friday, 9:00 a.m. to 8:00 p.m., Eastern time.
BenefitsCheckUp Operated by the National Council on the Aging, this Web-based service identifies federal and state assistance programs for older Americans in each community. You must fill out a short questionnaire which is used only to determine which programs an older person qualifies for.
Children of Aging Parents Establishes support groups, information and referral services and educational outreach for family caregivers.
National Alliance for Caregiving A joint venture of several private and governmental agencies, the alliance Web site provides useful information and links for CareGivers.
National Association of Professional Geriatric Care Managers Care managers are professionals who coordinate caregiving services. They can be helpful when family members are not able to play an active role.
Disease-Specific Information Information about specific diseases and conditions likely to require continuing care.
Hospice Care
Hospice Services
Hospice care is dedicated to providing a dignified, pain-free death. In most cases, care is provided in the patient's home with the participation of family members. Support is extended to the patient' s loved ones, as well.
Hospice care is dedicated to providing a dignified, pain-free death. In most cases, care is provided in the patient's home with the participation of family members. Support is extended to the patient' s loved ones, as well.
Monday, February 4, 2008
Assisted Living Program Overview
The Office of Elder Affairs certifies Assisted Living Residences in Massachusetts and offers the Assisted Living Ombudsman Program to provide advocacy, information and complaint resolution to consumers.
One of the most rapidly growing forms of residential long-term care in Massachusetts is Assisted Living. Assisted Living Residences (ALRs) offer a combination of housing, meals and personal care services to adults on a rental basis. Assisted living residences are not the same as licensed nursing facilities; ALRs do not provide medical or nursing services. They are not designed for people who need serious medical care.
Instead, assisted living is intended for adults who may need some help with activities such as housecleaning, meals, bathing, dressing and/or medication reminders and who would like the security of having assistance available on a 24 hour basis in a residential and non-institutional environment. The underlying philosophy of assisted living is based on providing needed services to residents in a way that enhances their autonomy, privacy and individuality. Residents have the right to make choices in all aspects of their lives.
The Office of Elder Affairs certifies Assisted Living Residences in Massachusetts and offers the Assisted Living Ombudsman Program to provide advocacy, information and complaint resolution to consumers.
One of the most rapidly growing forms of residential long-term care in Massachusetts is Assisted Living. Assisted Living Residences (ALRs) offer a combination of housing, meals and personal care services to adults on a rental basis. Assisted living residences are not the same as licensed nursing facilities; ALRs do not provide medical or nursing services. They are not designed for people who need serious medical care.
Instead, assisted living is intended for adults who may need some help with activities such as housecleaning, meals, bathing, dressing and/or medication reminders and who would like the security of having assistance available on a 24 hour basis in a residential and non-institutional environment. The underlying philosophy of assisted living is based on providing needed services to residents in a way that enhances their autonomy, privacy and individuality. Residents have the right to make choices in all aspects of their lives.
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