Vitamin D Levels in Elders

Vitamin D Levels in Elders: "Most older people had low serum levels, and at least 25% of elders had frank vitamin D deficiency. Two studies in the Journal of Clinical Endocrinology and Metabolism focus on vitamin D in older populations."

We All Need a Little More D. A New Report on The Sunshine Vitamin

We All Need a Little More D. A New Report on The Sunshine Vitamin Click above for a video presentation

Age Page: Hyperthermia: Too Hot for Your Health

Irene is retired, she loves to work in her garden. Because she has always spent hours outside, she thinks the heat and humidity of Midwestern summers don’t bother her. Then last year an unusual heat wave hit her area. Every day the temperature was over 100° F, and the humidity was at least 90%. Five days into the heat wave, her daughter Kim came over because Irene sounded confused on the phone. Kim found her mom passed out on the kitchen floor. The ambulance came quickly when called, but Irene almost died. She had heat stroke, the most serious form of hyperthermia.

Almost every summer there is a deadly heat wave in some part of the country. Too much heat is not safe for anyone. It is even riskier if you are older or if you have health problems. It is important to get relief from the heat quickly. If not, you might begin to feel confused or faint. Your heart could become stressed, and maybe stop beating.

Your body is always working to keep a balance between how much heat it makes and how much it loses. Your brain is the thermostat. It sends and receives signals to and from parts of your body that affect temperature, such as the spinal cord, muscles, blood vessels, skin, and glands that make substances known as hormones. Too much heat causes sweating. When the sweat dries from your skin, the surface of your body cools and your temperature goes down.

Being hot for too long can cause many illnesses, all grouped under the name hyperthermia (hy-per-ther-mee-uh):

• Heat cramps are the painful tightening of muscles in your stomach area, arms, or legs. Cramps can result from hard work or exercise. While your body temperature and pulse usually stay normal during heat cramps, your skin may feel moist and cool. Take these cramps as a sign that you are too hot — find a way to cool your body down. Be sure to drink plenty of fluids, but not those containing alcohol or caffeine.
• Heat edema is a swelling in your ankles and feet when you get hot. Putting your legs up should help. If that doesn’t work fairly quickly, check with your doctor.
• Heat syncope is a sudden dizziness that may come on when you are active in the heat. If you take a form of heart medication known as a beta blocker or are not used to hot weather, you are even more likely to feel faint when in the heat. Putting your legs up and resting in a cool place should make the dizzy feeling go away.
• Heat exhaustion is a warning that your body can no longer keep itself cool. You might feel thirsty, dizzy, weak, uncoordinated, nauseated, and sweat a lot. Your body temperature stays normal, skin feels cold and clammy. Your pulse can be normal or raised. Resting in a cool place, drinking plenty of fluids, and getting medical care should help you feel better soon. If not, this condition can progress to heat stroke.
• Heat stroke is an emergency — it can be life threatening! You need to get medical help right away. Getting to a cool place is very important, but so is treatment by a doctor. Many people die of heat stroke each year. Older people living in homes or apartments without air conditioning or good airflow are at most risk. So are people who don’t drink enough water or those with chronic diseases or alcoholism.

The Signs of Heat Stroke Fainting, possibly the first sign, Body temperature over 104° F, A change in behavior — confusion, being grouchy, acting strangely, or staggering, Dry flushed skin and a strong rapid pulse or a slow weak pulse, Not sweating, despite the heat, acting delirious, or being in a coma.

Who Is at Risk?

Hundresds of people die from hyperthermia each year during very hot weather. Most are over 50 years old. The temperature outside or inside does not have to hit 100° F for you to be at risk for a heat-related illness. Health problems that put you at risk include:

• Heart or blood vessel problems, poorly working sweat glands, or changes in your skin caused by normal aging.
• Heart, lung, or kidney disease, as well as any illness that makes you feel weak all over or causes a fever.
• High blood pressure or other conditions that make it necessary for you to change some of the foods you eat. For example, if you are supposed to avoid salt in your food, your risk of heat-related illness may be higher. Check with your doctor.
• Conditions treated by drugs such as diuretics, sedatives, tranquilizers, and some heart and blood pressure medicines. These may make it harder for your body to cool itself by perspiring.
• Taking several drugs for a variety of health problems. Keep taking your prescriptions, but ask your doctor what to do if the drugs you are taking make you more likely to become overheated.
• Being quite a bit overweight or underweight.
• Drinking alcoholic beverages.

How Can I Lower My Risk?

Things you can do to lower your risk of heat-related illness:

• Drink plenty of liquids — water or fruit and vegetable juices. Every day you should drink at least eight glasses to keep your body working properly. Heat tends to make you lose fluids so it is very important to drink at least that much, if not more, when it is hot. Avoid drinks containing caffeine or alcohol. They make you lose more fluids. If your doctor has told you to limit your liquids, ask him or her what you should do when it is very hot.
• If you live in a home or apartment without fans or air conditioning, be sure to follow these steps to lower your chance of heat problems:
  • open windows at night;
  • create cross-ventilation by opening windows on two sides of the building;
  • cover windows when they are in direct sunlight;
  • keep curtains, shades or blinds drawn during the hottest part of the day;
  • try to spend at least 2 hours a day (if possible during the hottest part of the day) some place air-conditioned — for example, the shopping mall, the movies, the library, a senior center, or a friend’s house if you don’t have air conditioning.
• Check with your local area agency on aging to see if there is a program that provides window air conditioners to seniors who qualify.
• If you think you can’t afford to run your air conditioner in the summer, contact your local area agency on aging. Or, ask at your local senior center. They may know if there are any programs in your community to aid people who need help paying their cooling bills. The Low Income Home Energy Assistance Program (LIHEAP) is one possible source.
• Ask a friend or relative to drive you to a cool place on very hot days if you don’t have a car or no longer drive. Many towns or counties, area agencies, religious groups, and senior citizen centers provide such services. If necessary, take a taxi. Don’t stand outside waiting for a bus.
• Pay attention to the weather reports. You are more at risk as the temperature or humidity rise or when there is an air pollution alert in effect.
• Dress for the weather. Some people find natural fabrics such as cotton to be cooler than synthetic fibers. Light-colored clothes reflect the sun and heat better than dark colors. If you are unsure about what to wear, ask a friend or family member to help you select clothing that will help you stay cool.
• Don’t try to exercise or do a lot of activities when it is hot.
• Avoid crowded places when it’s hot outside. Plan trips during non-rush hour times.

What Should I Remember?

Headache, confusion, dizziness, or nausea when you’re in a hot place or during hot weathercould be a sign of a heat-related illness. Go to the doctor or an emergency room to find out if you need tgreatment. To keep heat-related illnesses from becoming a dangerous heat stroke, remember to:

• Get out of the sun and into a cool place — air-conditioning is best.
• Offer fluids, but avoid alcohol and caffeine. Water and fruit and vegetable juices are best.
• Shower or bathe, or at least sponge off with cool water.
• Lie down and rest, if possible in a cool place.
• Visit your doctor or an emergency room if you don’t cool down quickly.

News in Health, July 2009 - National Institutes of Health (NIH)

You may wonder if you’ve been drinking enough water, especially when it’s hot out. There’s a lot of confusing advice out there about how much you really need. The truth is that most healthy bodies are very good at regulating water. Elderly people, young children and some special cases—like people taking certain medications—need to be a little more careful. Here’s what you need to know.

“Water is involved in all body processes,” says Dr. Jack M. Guralnik of NIH’s National Institute on Aging. “You need the proper amount for all those processes to work correctly.”

The body regulates how much water it keeps so it can maintain levels of the various minerals it needs to work properly. But every time you breathe out, sweat, urinate or have a bowel movement, you lose some fluid. When you lose fluid, your blood can become more concentrated. Healthy people compensate by releasing stores of water, mostly from muscles. And, of course, you get thirsty. That’s your body’s way of telling you it needs more water.

At a certain point, however, if you lose enough water, your body can’t compensate. Eventually, you can become dehydrated, meaning that your body doesn’t have enough fluid to work properly. “Basically, you’re drying out,” Guralnik says.

Any healthy person can become dehydrated on hot days, when you’ve been exercising hard or when you have a disease or condition like diarrhea, in which you can lose a lot of fluid very quickly. But dehydration is generally more of a problem in the elderly, who can have a decreased sensitivity to thirst, and very young children who can’t yet tell their parents when they’re thirsty.

How much water does your body need? Guralnik says you have to consider the circumstances. “If you’re active on a hot day, you need more water than if you’re sitting in an air-conditioned office,” he explains. An average person on an average day needs about 3 quarts of water a day. But if you’re out in the hot sun, you’ll need a lot more than that.

Signs of dehydration in adults are being thirsty, urinating less often than usual, having dark-colored urine, having dry skin, feeling tired or dizziness and fainting. Signs of dehydration in babies and young children include a dry mouth and tongue, crying without tears, no wet diapers for 3 hours or more, a high fever and being unusually sleepy or drowsy.

If you suspect dehydration, drink small amounts of water over a period of time. Taking too much all at once can overload your stomach and make you throw up. For people exercising in the heat and losing a lot of minerals in sweat, sports drinks can be helpful. But avoid any drinks that have caffeine.

Remember: the best way to deal with dehydration is to prevent it. Make sure to drink enough water in situations where you might become dehydrated. For those caring for small children or older people with conditions that can lead to dehydration, Guralnik advises, “You need to prompt the person to drink fluids and remind them often. It’s not just a one-time problem.”

News in Health, July 2009 - National Institutes of Health (NIH)

National Long-Term Care Insurance: How Much Would It Cost?

The Urban Institute released a new publication by Howard Gleckman examining long-term care insurance within the context of healthcare reform. Abstract

About two-thirds of those over 65 will need some long-term care before they die. Howard Gleckman looks at a key question at the heart of the debate over long-term care insurance: how much will premiums cost?

Link

Delaying Generic Drugs

from WSJ.com: Health Blog by Jacob Goldstein

The heat is closing in on the drug indsutry’s practice of paying generic manufacturers to delay competition for branded drugs.

Companies say the practice is legal. But the U.S. Department of Justice took a skeptical view when it weighed in Monday on a pending case brought by CVS and Rite Aid. The drug stores (which make higher margins on generics) challenged a deal in which Bayer paid Barr to delay producing a generic version of the antibiotic Cipro. Here’s more on the case from Dow Jones Newswires.

Hong Kong researchers implicate silent infarcts in glaucoma

TUESDAY, July 7 (HealthDay News) -- A study of people who suffer the mini-strokes called silent cerebral infarcts could help explain the medical mystery of normal-tension glaucoma, Hong Kong ophthalmologists report. Full Article

Census Bureau Annual Social & Economic Supplement

The Census Bureau plans to request clearance for the collection of 
data concerning the Annual Social and Economic Supplement (ASEC) to be 
conducted in conjunction with the February, March, and April Current 
Population Survey (CPS). The Census Bureau has conducted this 
supplement annually for over 50 years. The Census Bureau, the Bureau of 
Labor Statistics, and the Department of Health and Human Services 
sponsor this supplement.

In the ASEC, the Census Bureau collects information on work experience,
personal income, noncash benefits, health insurance coverage, and migration.
The work experience items in the ASEC provide a unique measure of the 
dynamic nature of the labor force as viewed over a one-year period. 
These items produce statistics that show movements in and out of the 
labor force by measuring the number of periods of unemployment 
experienced by people, the number of different employers worked for 
during the year, the principal reasons for unemployment, and part-/
full-time attachment to the labor force. We can make indirect 
measurements of discouraged workers and others with a casual attachment 
to the labor market.

The income data from the ASEC are used by social planners, 
economists, government officials, and market researchers to gauge the 
economic well-being of the country as a whole and selected population 
groups of interest. Government planners and researchers use these data 
to monitor and evaluate the effectiveness of various assistance 
programs. Market researchers use these data to identify and isolate 
potential customers. Social planners use these data to forecast 
economic conditions and to identify special groups that seem to be 
especially sensitive to economic fluctuations. Economists use ASEC 
data to determine the effects of various economic forces, such 
as inflation, recession, recovery, and so on, and their differential
 effects on various population groups.

A prime statistic of interest is the classification of people in 
poverty and how this measurement has changed over time for various 
groups. Researchers evaluate ASEC income data not only to determine 
poverty levels but also to determine whether government programs are 
reaching eligible households.

New questions are proposed for the ASEC, beginning in 2010. The 
questions are related to: 
(1) Medical expenditures; 
(2) presence and cost of a mortgage on property; 
(3) child support payments; and 
(4) amount of child care assistance received. 

These questions will enable analysts and policymakers to obtain
better estimates of family and household income, and to gauge 
poverty status more precisely. To offset respondent burden, 
some questions will be removed from the ASEC. Those removed 
include questions on transportation assistance, child care 
services, and questions on receipt of government assistance 
related to welfare reform.

Full Announcement

Funding Opportunity: Careers in the Arts for Individuals with Disabilities

The Arts Endowment’s support of this project may start on or after January 1, 2010. An initial award period of up to two years is allowed. This project is designed to advance education and career opportunities in the arts for individuals with disabilities. Link to full Announcement

Funding Opportunity: Links between Psychosocial Stress, Aging, the Brain and the Body

This FOA encourages multidisciplinary and interdisciplinary research to elucidate the mechanistic links between psychosocial stress and health in aging, as well as how the aging process and age-related diseases affect the responses to psychosocial stressors. Generally, research should be focused on (1) aging and how neural mechanisms respond to psychosocial stress and affect other body systems, (2) characterizing the behavioral, psychological and social mechanisms and pathways involved in transducing psychosocial stressors into health outcomes, (3) how stressors modulate physiological process underlying life-span, immune mechanisms, and metabolism, and (4) how psychosocial stress contributes to the development or progression of geriatric syndromes, chronic medical conditions, and disabilities in later life. Research is strongly encouraged that aims to identify appropriate targets for intervention, at any level of analysis, from societal to molecular. Research spanning multiple levels of analysis is particularly encouraged. Link to Full Announcement

No Improvement In Survival with Inhospital CPR

No Improvement In Survival with Inhospital CPR Among elderly patients, survival after inhospital cardiopulmonary resuscitation (CPR) hasn't improved over a 15-year period, researchers say. The proportion of hospital deaths among patients who had undergone inhospital CPR has actually increased, while the proportion of survivors discharged home after having the procedure has decreased, William J. Ehlenbach, MD, of the University of Washington, and colleagues, reported in the July 2 issue of the New England Journal of Medicine. The finding is concerning because it comes "during a time of more education and awareness about the limits of CPR in patients with advanced chronic illness and life-threatening acute disease," the researchers said. Shared via AddThis

Hospital system tries letting patients read physicians' notes

Pamela Lewis Dolan in AMnews -

Tom Delbanco, MD, conducted an experiment in the 1970s in which he asked patients to take their own notes during clinical visits and compare them to their physicians' notes.

The experiment didn't last long, he said, because when patients asked other physicians for notes, "doctors thought the patients were crazy," he said. "They literally said, 'I am calling a psychiatrist.' "

Now, more than 30 years later, Dr. Delbanco, an internist at Beth Israel Deaconess Medical Center in Boston and professor of general medicine and primary care at Harvard Medical School, is trying again. He is one of the leaders of an experiment at Beth Israel that allows patients unfettered access to their doctors' notes made in relation to their visits. The idea is to see how granting real-time access to clinical notes will change the dynamic between physicians and patients.

Read Full Article

Health Care Reform Gets Personal

Ronni Bennett in Time Goes By blog - Having misplaced the link and having no luck with Google, I must ask you to trust me: somewhere a week or two ago, there was a news story about elders being the biggest threat to a single-payer system or public option in whatever health care reform bill emerges from Congress.

The thinking of the writer was that since elders have their own single-payer system, Medicare, they don't give a damn about the rest of the country and therefore won't support reform for everyone.

And this morning in The New York Times, a Maine small-business owner echoed that sentiment. People on public programs like Medicaid and Medicare

"...are less likely to speak up [about health care reform]," he said. "'It does not affect them the way it affects us.'"

What hogwash. Elders have children, grandchildren and in some cases great grandchildren and they are acutely aware of their progeny's struggle to pay for health care with and without coverage. Many elders are helping out their families every way they can. Of course (depending on party affiliation and political ideology), they would support affordable health care for their children.

Read her complete post

Safety Net Effective at Fighting Poverty But Has Weakened for the Very Poorest — Center on Budget and Policy Priorities

As mounting job losses threaten to push more Americans into poverty and make poor families still poorer, a new examination of the public benefits system finds that it is more effective in reducing poverty than previously known but has become less effective over the past decade in protecting Americans from deep poverty. Safety Net Effective at Fighting Poverty But Has Weakened for the Very Poorest — Center on Budget and Policy Priorities Shared via AddThis

The Barrier Free Health Care Initiative

The Barrier Free Health Care Initiative

Posted using ShareThis

2010 National Mental Health Services Survey

The Substance Abuse and Mental Health Services Administration's 
(SAMHSA) Center for Mental Health Services (CMHS) will conduct the 2010 
N-MHSS. This national survey will update the previous biennial mental 
health facility survey conducted in 2008--the National Survey of Mental 
Health Treatment Facilities (NSMHTF) under OMB No. 0930-0119. Similar 
in design to the 2008 NSMHTF, the 2010 N-MHSS will survey all mental 
health service locations, instead of surveying each mental health 
organization as a whole. These separate mental health service locations 
(facilities) are in contrast to mental health organizations which may 
include multiple facilities (service locations). This survey will be 
(a) A 100-percent enumeration of all known facilities nationwide that 
specialize in mental health treatment services, (b) more consumer-
oriented in describing services available at each facility location, 
and (c) patterned after SAMHSA's Office of Applied Studies National 
Survey of Substance Abuse Treatment Services (OMB No. 0930-0106).

The 2010 N-MHSS will utilize one questionnaire for all mental 
health facility types including hospitals, residential treatment 
centers, outpatient clinics, and multi-setting facilities. The 
information collected will include: intake telephone numbers for 
services, types of services offered, sources of payment for services, 
facility caseload characteristics, and facility bed counts, if 
applicable. This survey will use a multi-mode approach to data 
collection--mail and Web with telephone follow-up.

The resulting database will be used to provide both State and 
national estimates of facility types and their patient caseloads. 
Information from the 2010 survey will also be used to update SAMHSA's 
online Mental Health Facility Locator for use by consumers. In 
addition, data derived from the survey will be published by CMHS in 
SAMHSA publications such as Mental Health, United States and in 
professional journals such as Psychiatric Services and the American 
Journal of Psychiatry. The publication, Mental Health, United States, 
is used by the general public, State governments, the U.S. Congress, 
university researchers, mental health service providers, and mental 
health care professionals. 

Full Notice

Advisory Council on Employee Welfare and Pension Benefit Plans

The Council will study the following issues:
(1) Approaches for Retirement Security in the United States,
(2) Stable Value Funds and Retirement Security in the Current Economic
Conditions, and
(3) Promoting Retirement Literacy and Security by Streamlining Disclosures 
to Participants and Beneficiaries.

The schedule for testimony and discussion of these issues generally will be
one issue per day in the order noted above. Descriptions of these
topics are available on the Advisory Council page of the EBSA Web site, at 
http://www.dol.gov/ebsa/aboutebsa/erisa_advisory_council.html.
The EBSA update is scheduled for the afternoon of July 23, subject to change.
  
Organizations or members of the public wishing to submit a written 
statement may do so by submitting 30 copies on or before July 14, 2009 
to Larry Good, Executive Secretary, ERISA Advisory Council, U.S. 
Department of Labor, Suite N-5623, 200 Constitution Avenue, NW., 
Washington, DC 20210. Statements may also be submitted electronically 
to good.larry@dol.gov. Relevant statements received on or before July 
14, 2009 will be included in the record of the meeting. Individuals or 
representatives of organizations wishing to address the Advisory 
Council should forward their requests to the Executive Secretary or 
telephone (202) 693-8668. Oral presentations will be limited to ten 
minutes, time permitting, but an extended statement may be submitted 
for the record. Individuals with disabilities who need special 
accommodations should contact Larry Good by July 14 at the address 
indicated.

The "Woodwork" Myth

Steve Gold's Informational Bulletin #286 (6/09) For years, we have heard cries, fears and woes from elected officials about "the woodwork" effect. No, these officials are not talking about cockroaches. Then what do they mean? Under Medicaid, there is a federal statutory entitlement to institutional long-term services - people with disabilities have a statutory right to enter a nursing home or an intermediate care facility. However, these same people with disabilities do not have a federal statutory right to receive the same long-term services in their homes and community. Why an institutional bias? In part, it was a historical accident when Medicaid was enacted in the 1960s. In part, Congress tinkered with addressing it by enacting "Waivers" in the 1980s. But then why doesn't Congress just amend Medicaid and eliminate the institutional bias? One reason is nursing homes and other institutions have fed at the federal troughs for so long, made so much money, and politically contribute so much that they are now a political force. Keeping the status quo suits the nursing home industry just fine. Also, many elected congressional folks probably do not recognize or view discrimination against people with disabilities as a fundamental civil rights issue and violation. But that is not polite or pc to admit. So instead, they invent a "woodwork" myth. Here's how it goes. If people in nursing homes were to have an entitlement to receive services in the community, then they would leave the nursing homes and live in the community. The myth then posits that new people with disabilities - they're the people in the woodwork waiting and waiting - would then enter the nursing homes. So the feds and states would have to pay for both persons who have left the nursing home and new persons who now go into the nursing home. The "woodwork" myth is premised on two fallacies. One, people do not enter a nursing home because there are no available beds. Two, people might enter a nursing home so that they could then leave the nursing home to receive services in the community. Let's look at both fallacies. First, the "woodwork" myth would have validity only if the reason that people with disabilities do not enter nursing homes is because there are no available beds for them. But that is not accurate or true. For many years there has been a national vacancy rate of nursing home beds of about 13%. Yes, even if no one moved out of a nursing homes, there are 13% beds empty. These vacant beds could be filled immediately and are not dependent on anyone moving out. If there are people who want to move into a nursing home, they do not need to wait for people to move out. Therefore, the reason people do not enter nursing homes has NOTHING to do with whether people in the nursing homes leave or not, or whether there are beds available or not. People could enter an institution as long as there are vacancies. Their entitlement to institutional services has nothing to do with other people leaving these facilities. Second, it is really hard to imagine anyone would enter a nursing home solely or even primarily to gain eligibility for community-based services. Living in a nursing facility is not like a hotel! Nursing facilities and ICFs are institutions with loss of privacy and other basic rights. Moreover, if this were a real reason for not eliminating the institutional bias, there are any number of ways to address and control it. It's just an excuse to continue denying people with disabilities their civil rights. What compounds the issue is that the data clearly shows that it is much, much less expensive to provide services, on average, to people in the community instead of in institutions. Providing Medicaid long-term services in the community to people in nursing facilities and other institutions will save substantial federal and state funds. So, next time you hear someone talking about the "woodwork" effect, tell them it's a myth. Talk to them about civil rights of people with disabilities. Steve Gold, The Disability Odyssey continues

Housing Vouchers for Non-Elderly Persons with Disabilities

Steve Gold's Information Bulletin # 290 (6/09). On the 10th anniversary of the Olmstead decision, June 22, 2009, the U.S. Department of Housing and Urban Development issued a Proposed Notice regarding funding for 4,000 Mainstream housing vouchers for non-elderly people with disabilities. Vol. 74 Federal Register, No. 118, 6/22/09, pages 29504-29510. The Proposed Notice described two categories of vouchers: Category 1: 3,000 vouchers for non-elderly people with disabilities; and Category 2: 1,000 vouchers for non-elderly people with disabilities to transition from nursing homes and other institutions into the community. There is good news and some troubling/not so good news. First some background information. All of the 4,000 vouchers are "competitive," i.e., your local public housing authority must apply to HUD and compete against other public housing authorities. HUD will review applications and decide which public housing authorities will receive these vouchers and how many. HUD has established threshold requirements and an application form [See pages 29505-07.] The good news: 4,000 non-elderly people with disabilities will receive vouchers to pay for affordable housing. Also, HUD recognizes that some people with disabilities live in nursing homes only because they cannot afford to rent apartments in the community and targets 1,000 of these vouchers to transition people out of these institutions. The troubling/bad news: the Proposed Notice limits vouchers in Category #1 to people on the public housing authority's waiting list, and limits vouchers in Category #2 to people who "must be admitted from PHA's waiting list and assisted through a preference as stated in the PHA's Administrative Plan for transitioning people from institutions." You might want to send HUD comments regarding the following: 1. Re Category #1: What if a public housing authority neither identifies people on its voucher waiting list by disability nor has many people with a disability on the list? Will the public housing authority open up its waiting list? Email and tell HUD either to require public housing authorities to open up the waiting list so people with disabilities can apply for these waivers, or HUD should administratively waive the "waiting list" requirement for these vouchers. 2. Re Category #2: People who are in nursing homes, most likely, are either not currently on a public housing waiting list or, if they were on the waiting list sometime in the past, probably have been dropped from it. We would be amazed if there were more than a handful of public housing authorities that currently gave a "preference as stated in the PHA's Administrative Plan for transitioning people from institutions." Email and tell HUD to waive this requirement - if it really wants these 1,000 vouchers to transition people from institutions to the community. 3. In the Proposed Notice, only public housing authorities can apply for these 4,000 vouchers. Email and tell HUD to change the regulation so that if a public housing authority does not apply for these vouchers, then a non-profit organization or a public entity other than the public housing authority should be permitted to apply. Otherwise, the disability community is at the whim of a local public housing authority. 4. Many state Medicaid officials and departments want to access these vouchers to assist persons with disabilities to transition out of institutions and to prevent people from going into these institutions. These state Medicaid folks could save considerable federal and state funds if they could apply for these vouchers. Email and tell HUD to permit state Medicaid departments, maybe in conjunction with a state housing department, to apply for these vouchers, if a local public housing authority does not apply. Even though the Proposed Notice had o deadline for applying and HUD is not accepting applications until after it reviews the comments in response to this Proposed Notice, it is very important for advocates for people with disabilities to contact their housing authorities NOW to discuss their willingness to apply for these vouchers. We hope that all of your housing authorities will apply for the maximum number of housing vouchers for which they are eligible, so that as many non-elderly persons with disabilities as possible can use them to access affordable housing. You should write to your public housing authorities requesting they apply for these vouchers. If they do not respond or if they give you the runaround, find out why. Comments to HUD must be submitted no later than July 13, 2009. If you wish to send in comments electronically, send to NEDVoucherNOFA@hud.gov Steve Gold, The Disability Odyssey continues Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects. To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100. -- Steve Gold, The Disability Odyssey continues

Record Number of People with Disabilities Voted in 2008 Election

New numbers released show Americans with disabilities voted in record numbers in the 2008 presidential election, according to the American Association of People with Disabilities (AAPD), the country’s largest cross-disability membership organization.

According to a study by Lisa Schur and Douglas Kruse, professors at the School of Management and Labor Relations, Rutgers University, who have conducted numerous studies on voting and people with disabilities, 3.8 million more people with disabilities voted in the 2008 presidential election than the 2000 presidential election.

According to the study, 14.7 million Americans with disabilities voted in the 2008 presidential election. About 10.9 million Americans with disabilities voted in the 2000 presidential election.

“The 2002 passage of the Help America Vote Act, which mandates voting be accessible, created enormous energy in the disability community,” said AAPD’s Vice President for Organizing and Civic Engagement Jim Dickson. AAPD has been leading nonpartisan voter registration and education drives amongst the nation’s 56 million people with disabilities since 2001.

Complete Press Release

On Memory, Older Americans Outsmart the English

(HealthDay News) -- Older people in the United States scored better than their counterparts in England on a memory and awareness test, possibly because of differences in levels of depression and education and the fact that American adults receive more aggressive treatment for heart disease, a new study suggests. More

Clinical Pathways Improve Joint Replacement Outcomes

Organizational strategies known as clinical pathways can significantly improve the quality of care, shorten hospital stays, and reduce the cost of hip and knee joint replacements, a meta-analysis found. Clinical Pathways Improve Joint Replacement Outcomes Shared via AddThis

Living Alone Increases Odds of Developing Dementia

Losing a partner through divorce or death in middle age may triple the risk, study shows

(HealthDay News) -- Middle-aged adults who live alone are twice as likely to develop dementia or Alzheimer's disease later in life compared to those who are married or live with a partner. And the risk is three times higher among those who are divorced or widowed, according to a new study by Swedish and Finnish researchers. More

The Need for New Research to Include Old Patients

By James A. White in Wall Street Journal Health Blog

One thing health-care practitioners know about treating the elderly is that they don’t know enough about treating the elderly.

The point is underscored today by Richard C. Frank, a doctor who writes in a WSJ.com guest column about a 83-year-old patient with heart problems seeking aggressive treatment to fight non-Hodgkin’s lymphoma. The cancer is often curable but there is precious little information about how much an elderly patient with a weak heart — or other serious conditions, for that matter — can handle the normal rigors of anti-cancer treatment.

CMS PROPOSES PAYMENT, POLICY CHANGES FOR PHYSICIANS SERVICES TO MEDICARE BENEFICIARIES IN 2010

CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association. More

Senators outline less-costly healthcare overhaul

Democrats on a key Senate committee outlined a revised and far less costly healthcare plan Wednesday night that includes a government-run insurance option and an annual fee on employers who do not offer coverage to their workers. The plan would cost about $600 billion, versus an earlier $1-trillion price tag, and eventually would cover 97% of Americans, Sens. Kennedy and Dodd say. LA Times

Medical News: Fish, Nuts Protective Against Macular Degeneration - in Ophthalmology, Ophthalmology from MedPage Today

Consumption of foods rich in omega-3 fatty acids may protect against development of age-related macular degeneration, researchers said. In a prospective study, regularly eating fish, greater consumption of omega-3 polyunsaturated fatty acids, and low intake of foods rich in linoleic acid, significantly reduced the risk of developing the condition, Paul Mitchell, M.D., Ph.D., of Westmead Hospital in New South Wales, Australia, and colleagues reported in the May issue of Archives of Ophthalmology. Medical News: Fish, Nuts Protective Against Macular Degeneration - in Ophthalmology, Ophthalmology from MedPage Today Shared via AddThis

Increased Medicare Rx Drug Use Partly Offset

An increase in spending on prescription drugs after implementation of Medicare Part D in January 2006 was partly offset by a decrease in nondrug medical spending, researchers found. Increased Medicare Rx Drug Use Partly Offset Shared via AddThis

CHAMPVA - Preauthorization of Durable Medical Equipment

This final rule amends the Department of Veterans Affairs (VA) 
medical regulations for the Civilian Health and Medical Program of the 
Department of Veterans Affairs (CHAMPVA) preauthorization section by 
increasing the dollar ceiling for purchase or rental of durable medical 
equipment (DME) from $300 to $2,000.

The final rule is effective July 31, 2009.

HIT Standards Committee Advisory Meeting

General Function of the Committee: to provide recommendations to 
the National Coordinator on standards, implementation
specifications, and certification criteria for the electronic 
exchange and use of health information for purposes of adoption, 
consistent with the implementation of the Federal Health IT 
Strategic Plan, and in accordance with policies developed by the HIT 
Policy Committee.

    Date and Time: The meeting will be held on July 21, 2009, from 9 
a.m. to 3 p.m./Eastern Time.
    
    Agenda: The committee will discuss the certification process. 
ONC intends to make background material available to the public no 
later than two (2) business days prior to the meeting. If ONC is 
unable to post the background material on its Web site prior to the 
meeting, it will be made publicly available at the location of the 
advisory committee meeting, and the background material will be 
posted on ONC's Web site after the meeting, at http://
healthit.hhs.gov.
    
Additional Information

HIT Policy Committee's Certification/Adoption Workgroup.

General Function of the Committee: to provide recommendations to
the National Coordinator on a policy framework for the development
and adoption of a nationwide health information technology
infrastructure that permits the electronic exchange and use of
health information as is consistent with the Federal Health IT
Strategic Plan and that includes recommendations on the areas in
which standards, implementation specifications, and certification
criteria are needed. The Certification/Adoption Workgroup is charged
with making recommendations to the HIT Policy Committee on issues
related to the adoption of certified electronic health records, that
support meaningful use, including issues related to certification,
health information extension centers and workforce training.

Date and Time: The meeting will be held on July 14, 2009, from 9
a.m. to 4 p.m./Eastern Time, and July 15, 2009, from 9 a.m. to 10
a.m./Eastern Time.

Agenda: The committee will be hearing testimony from stakeholder
groups, such as purchasers, vendors, and users, on the certification
process. ONC intends to make background material available to the
public no later than two (2) business days prior to the meeting. If
ONC is unable to post the background material on its Web site prior
to the meeting, it will be made publicly available at the location
of the advisory committee meeting, and the background material will
be posted on ONC's Web site after the meeting, at http://
healthit.hhs.gov. The meeting will be available via webcast; visit
http://healthit.hhs.gov for instructions on how to listen via
telephone or Web.

Additional Information

Health Information Technology Policy Committee

Agenda: The committee will discuss the preliminary draft
definition of Meaningful Use. ONC intends to make background
material available to the public no later than two (2) business days
prior to the meeting. If ONC is unable to post the background
material on its Web site prior to the meeting, it will be made
publicly available at the location of the advisory committee
meeting, and the background material will be posted on ONC's Web
site after the meeting, at http://healthit.hhs.gov.

Date and Time of Meeting:July 16, 2009; 10am to 2pm Eastern

Additional Information

Report Sets Priorities for Funding Effectiveness Research

Report Sets Priorities for Funding Effectiveness Research Treatments for atrial fibrillation, localized prostate cancer, and low back pain should be among the government's top effectiveness research priorities, while smoking cessation, migraine, and osteoarthritis are much farther down on the list, according to a new report. Shared via AddThis

CDC Warns of Fall Hazard with Canes and Walkers

Canes and walkers used to prevent falls are themselves associated with more than 47,000 serious injuries each year among older adults, the CDC warned. Fractures and bruises or scrapes were the most common injuries, Judy A. Stevens, PhD, of the CDC's National Center for Injury Prevention and Control in Atlanta, and colleagues reported online in the Journal of the American Geriatrics Society. CDC Warns of Fall Hazard with Canes and Walkers Shared via AddThis