HUD Section 811 Listening Session - April 14th

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This past January, President Obama signed into law the Frank Melville Supportive Housing Investment Act, amending and updating the Section 811 Supportive Housing for Persons with Disabilities program.  Among other things, this bill provides a new authority to HUD to allocate long term operating assistance funds to states where a strong supportive housing plan exists to link services to mainstream affordable housing for persons with disabilities.

HUD will be holding a listening session on April 14^th from 1:00 – 3:00 pm to get stakeholder input and hear suggestions on how HUD might implement this new authority.  You are invited to attend.  However, participation is limited to 50 individuals so please RSVP by April 4^th, 2011 to Lisa Wimbush-Lathern at lisa.a.wimbushlathern@hud.gov.

The session will be held in the Brooke-Mondale Auditorium at HUD Headquarters in Washington , DC .  A conference call-in number will be provided for those unable to attend in person.

We look forward to your input and thank you in advance for your participation.

Carol J. Galante

Deputy Assistant Secretary

    for Multifamily Housing Programs

U.S. Department of HUD

451-7th Street, SW Room 6106

Washington, DC   20410

(202) 708-2495 (main line)

(202) 708-2583 (fax)

My Therapy

by Elena Portacolone

There is one life, live it to the fullest. James Pye, a 78-year old lanky man, hands me a visiting card with this motto at the end of my visit. An authority in African American history, last January he traveled for five entire days to Washington DC “to witness the inauguration of the President. That was great. I went there; I was there on crutches [he laughs]. And I was cramped up on a bus.”

His elongate face has a scar below the left temple, “It was an accident, trying to save somebody.” His brown darting eyes often make contact with mine; his full lips sometimes open to a boyish smile. A veteran, James is proud of his rigorous work ethic: “I have been in the military, working, and just teaching my kids to work. You didn’t sit down and do nothing.” Familiar with different political systems, James is well aware of the inequalities of the American one:

We have the highest living conditions in the world, but we’ve also the lowest. […] There’s a whole race of people that they kidnapped and brought over on the ship. […] And now, 400 years later, we’re in the same boat. We’re not in slavery, we’re not under the gun per se, but we’re not economical.

His struggle to get affordable housing hints to the hurdles to improve one’s living conditions. As tenant of an apartment in a Victorian building, James is afraid to be evicted once the 90-year landlady dies. At the same time, he has been waiting for nearly 30 years for an adequate public housing apartment in a safe environment. He says,

There was a lady, she was a lawyer. She said, “I can’t believe that you’ve been turned down that many times.”[…] She just stumbled into my case.

James searches in vain his apartment for a paper showing his eternal stand-by status. He walks through narrow paths carved between boxes, open suitcases, books, bags, and half-inflated party balloons, the lash of the oxygen cannula trailing behind his legs. Superimposed upon the fight for housing is his battle with cancer. A survivor of five heart operations, two back surgeries, and two low bowel surgeries, he explains that he contracted lung cancer “breathing asbestos trapped in the wall” of his ship during the Korean and Vietnams Wars. Where does James get all his strength? He says,

I recommend people, even if they are sick, take a walk or breathe some fresh air, or just get out and see something. Get out. Get out of your problems, your worries, and your situation. At some point, you know, God will help. That’s my therapy.

One of six stories on living alone in San Francisco published in Elena Portacolone’s monthly column in the newsletter of Planning for Elders -September 2010 – February 2011

States Turn to Private Insurance Companies for Managed Care - USATODAY.com

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By Phil Galewitz Kaiser Health News

Desperate to rein in rising Medicaid costs, Tennessee last year became the sixth state to require its frailest and costliest patients — the elderly and disabled who need long-term care — to enroll in managed care plans.

At least 10 other states, including Florida, Maryland, New Jersey and Rhode Island, are considering introducing or expanding the use of managed long-term care. The trend is sparking opposition from the nursing home industry and raising some concerns from AARP and other patient advocates.

Traditionally, states pay Medicaid providers, such as doctors and nursing homes, directly for individual services. But many officials say that system makes it hard for them to predict and control Medicaid spending. Under managed care, states pay health insurers a fixed monthly fee for each Medicaid patient. The lump sum is used for all the patient's costs, including physician and nursing home care.

Managed care companies, including UnitedHealthcare and Wellcare Health Plans, say they can save money for states by keeping Medicaid patients who need long-term care at home, whenever possible, rather than in more-expensive nursing homes. They use care coordinators to monitor patients to help ensure they're getting the right care in the most appropriate setting.

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Capitol Weekly: Opinion: California Should Take the Lead in Reducing Long-term Care Costs

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By David Kieffer

For those of us who work in long-term care, California’s budget crisis can be viewed in two ways – as yet another devastating blow to the seniors and people with disabilities we care for – or as an opportunity to get things right. Which of these views turns out to be accurate will depend on the choices we make.

Formulaic cuts to hours or types of services are not the right approach. The necessary search for savings has the potential to help California develop a more forward-looking approach to long-term care, but only if we go about it strategically. We need to use the federal funds available to us and expand the savings we have already achieved by taking more aggressive measures to care for more people at home instead of in more expensive institutions.
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Mather LifeWays Institute on Aging Identifies 10 Senior Living Trends | Aging In Action

by Linda Hollinger-Smith - Aging In Action blog

Mather LifeWays Institute on Aging derived 10 top senior living trends after surveying 600 senior living organizations representing more than 1,000 communities from 15 states. Trends indicate that older adult living communities and care providers must anticipate and cater to the personal needs and interests of residents by offering options beyond the basics and include more comprehensive provision for in-home care.

Trends are identified to allow developers and providers to address opportunities and create innovations to help shape the future of senior living relative to services, programs, amenities, and design. The ultimate goal is to create environments and lifestyles where people want to live, not where they need to live.

Based on survey results, the following are the top 10 emerging senior living trends.

1, Senior living residents are choosing to “age in place.”

2. Health and wellness programs and services are top priorities.

3. Technology will be key to promoting and sustaining independent lifestyles among senior living residents.

4. Resident programs must focus on meaningful activities and intellectual stimulation.

5. Senior living providers will provide services “beyond” their four walls.

6. Long-term care is transforming to support person-directed care and meaningful relationships.

7. Residents are demanding “customized services” driving the need for senior living providers to offer a customer-driven portfolio of services and programs.

8. Language, perceptions, and attitudes of care providers must be updated to reflect changing older adults’ needs and expectations.

9. Senior living industry may become a hotbed for job creation.

10. Above all, consumers want choices and value.
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VA Caregiver Support Line

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On February 1, 2011, the Department of Veterans Affairs (VA) opened a toll-free National Caregiver Support Line.  The support line serves as a primary resource/referral center to assist caregivers, Veterans and others seeking caregiver information to help in the care of our Nation's Veterans.

Calls to The National Caregiver Support Line will be answered by VA employees who are licensed clinical social workers.

The Support Line provides information on VA/ community caregiver support resources and "warm" referral to dedicated Caregiver Support Coordinators located in every VA Medical Center; emotional support for the caregiver is an integral component of this service. The National Caregiver Support Line is also available to respond to inquiries about the caregiver benefits associated with Public Law 111-163, Caregivers and Veterans Omnibus Health Services Act of 2010.

The National Caregiver Support Line will be open Monday through Friday 8:00 a.m. to 11:00 p.m. and Saturday 10:30 a.m. to 6:00 p.m. Eastern Time, the Toll-Free number is 1-855-260-3274.

You can also visit the VA's updated VA Caregiver Support: Caring for those Who Care Website

Managing the Transition to Post-Acute and Long Term Care | Aging In Action

by John Davy on January 31, 2011

Transitions to long-term care, assisted living, and other supportive living options are often made in difficult conditions, under the financial and time pressure that follows acute care and other crises. A recent article (Kane 2011) in the Journal of the American Medical Association’s “Care of the Aging Patient” series reviews transitional and long-term care options for older adult patients who are transitioning from acute care, and argues that physicians should familiarize themselves with such options and, when possible, be involved in the transition.

The article provides a review of the last two decades of research on transitional (post-acute) care, long-term care, rehabilitation and other assisted living options.
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Family Value: When Insurers Deny Claims - WSJ.com

By ANNE TERGESEN

Some families with long-term-care insurance policies—under fire recently for steep premium increases—are encountering claims denials that can prevent or delay the collection of benefits. But there are ways policyholders can avoid such problems.

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Grandma's Vital Signs on Your Phone

by Eric Bogatin

Automated home health monitoring may finally become practical with the HealthTune 360 from Boston LifeLabs. Cambridge, Mass. start-up Boston LifeLabs recently announced a new product for at-home health monitoring, which the company plans to make available within a few weeks in the U.S. pending FDA approval.

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Nationwide Poll: Americans Say No To Medicaid Cuts

Coming on the heels of a major research report finding that long term care is paid less on an hourly basis than the national minimum wage, a new nationwide poll shows that 65 percent of Americans would oppose further cuts to funding for long term care.

"As a former governor, I know firsthand the difficult decisions lawmakers face during these tough economic times," stated Governor Mark Parkinson, President & CEO of the American Health Care Association (AHCA). "Despite the nation's fiscal difficulties, the American people are very clear on where they don't want cuts - at the expense of the frail and elderly."

According to the survey results, there is broad concern among likely voters of the impact inadequate funding - specifically Medicaid - has on the nation's seniors. Supporting those concerns, researcher Eljay yesterday release new projections showing that state Medicaid programs underfunded nursing facility care by $5.6 billion in 2010 - on average paying only $7.17 per hour per patient, less than the national minimum wage of $7.25 per hour.

"America's greatest generation deserves a secure health care delivery system," concluded Parkinson. "This poll shows the bottom line fact that Americans recognize the critical importance of stable funding for the care of seniors in our facilities."

The survey was conducted by Zogby International via an interactive poll of 2,067 likely voters from 1/7/11 to 1/10/11 and has a margin of error of +/- 2.2 percentage points.

Top-line results of the survey from Zogby include:

About two-thirds of likely voters (65%) say they oppose policies that resulted in cuts to Medicaid funding for nursing home care for America's poor and elderly. A plurality (40%) say they strongly oppose such cuts to nursing home care.

A strong majority (66%) say they would oppose policies that resulted in additional cuts to Medicare funding for nursing home care for seniors, with 39% saying they strongly oppose such action.

Nearly three-quarters of likely voters (72%) say the Federal Government's role in helping states meet their financial obligations to cover programs such as Medicaid is important, with nearly half (45%) saying it is very important.

Nearly two-thirds (65%) of likely voters say they support extending additional Medicaid funding to state governments in response to state deficits and economic difficulties, with a third (33%) saying they strongly support such action.

To access the full poll results or the analysis from Eljay, A Report on Shortfalls in Medicaid Funding For Nursing Home Care, please visit here.

Source:
American Health Care Association

The Miracle Workers - NYTimes.com

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by Jane Gross

Some of the most compelling first-person accounts of family caregiving I’ve ever read come from the “Narrative Matters’’ section of the policy journal Health Affairs. Often these stories are written by medical professionals who have found all of their training and expertise useless when faced with responsibility for a parent or spouse. What they thought they knew they didn’t, and what they did know got lost in the emotional upheaval of caring for a loved one rather than a patient.

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The “Narrative Matters” essay in the current issue, published online on Wednesday, is not about caregiving, but rather struggling to find care for oneself in middle age. It was written not by a medical professional but by a former physics professor who is profoundly disabled by multiple sclerosis. Michael Ogg, 56, lives alone in West Windsor, N.J., and gets by with difficulty, pluck and the assistance of two home health aides, who work for him three hours a day at a cost of $1,800 a month.

That is all Mr. Ogg can afford. He offers his story in support of the Class Act, a part of the new health care law that establishes a government insurance program for long-term care, limited in its benefits but available for as long as needed and regardless of pre-existing conditions.

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Trained Capuchin Monkeys Assist People with Disabilities | Wheelchair Accessibility Blog and Disability News

by Destiny in the Disability News

Specifically trained Capuchin Monkeys are used as aids for people who are physically disabled. They are specially trained to help with housework that might be difficult for a person with disabilities such as removing garbage, fetching the telephone, or switching on the microwave. The Capuchin monkey has small hands with slim fingers making it quite easy to open bottles, grab the telephone, and many other useful tasks. They can also be cute little buddies that help avoid loneliness by providing their companionship.

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HOW TO EASE THE STRUGGLES OF CARE GIVING

By Alice Iseminger ( Seniors Helping Seniors in Lorain County Ohio)

Caring for an elderly loved one can be very rewarding. But being a caregiver can also become a struggle to cope with emotional family relationships and often, financial hardships because of missed work due to care taking.

According to a survey by the Family Caregiver Alliance and AARP, “nearly 25% of working Americans provide care to an elderly friend or relative.” Look around you. That means one in four employees have care giving responsibilities that can negatively impact their work life.

Working caregivers often have to leave their jobs early, come in late, or take extra time off for their care taking responsibilities. The stress level of juggling work, family and care giving can cause guilt, anger, exhaustion, anxiety, and depression in the caregiver.

Women caregivers are especially hard hit as they continually juggle more of the demands of family and care taking as well as their careers.

As baby boomers age, more resources are becoming available. The first place to start is by creating your own list of who, what, when, where, how and why.

• Who is available in the community to provide information and assistance? For example, Lorain County Office on Aging, and Seniors Helping Seniors

• What are the different levels of care needed? (Companionship, transportation, housekeeping, personal care, etc.?) For example, I would like someone to assist mom with her personal bathing and dressing.
• When is care needed? For example, Three days a week I would like someone to visit with my loved one and make lunch.
• Where is the best place for care? Most people prefer to stay in their own home. Being at home is where they feel safe and comfortable and it improves physical and mental well being.
• How much can the family afford and how will services be covered? It can be a combination of private funds, insurance and other resources.

• Why should I make a decision now? Don’t wait until there is an emergency to provide care for a loved one and support for the care giver.

You cannot control every situation. In all likelihood, caring for an older adult means that over time, more help will be needed, not less. As a care giver you can learn that you have options, and that you are not alone.

Medicare Coverage Standards Are Too Strict, Courts Find - NYTimes.com

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Two federal courts have ruled that the Obama administration is using overly strict standards to determine whether older
Americans are entitled to Medicare coverage of skilled nursing home care and home health care.

Medicare will pay for those services if they are needed to maintain a person’s ability to perform routine activities of daily living or to prevent deterioration of the person’s condition, the courts said.

Medicare beneficiaries do not have to prove that their condition will improve, as the government sometimes contends, the courts said.

The rulings are potentially significant for many people with chronic conditions and disabilities like multiple sclerosis, Alzheimer’s disease and broken hips. Skilled care may be reasonable and necessary and covered by Medicare even if the person’s condition is stable and unlikely to improve, the courts said.
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When the Family Needs an Umpire - NYTimes.com

Image via CrunchBaseBy JOSHUA TAPPER

The home care aide didn’t expect her new charge to be particularly cantankerous. After all, she had worked for the elderly woman’s sister for four years, and they’d gotten along well.

But the new relationship was rocky from the start. More than once the aide received confusing calls from the 88-year-old woman late at night. She traveled to the woman’s apartment on the Upper West Side, only to be met with a curt “What’s going on? Why are you here?” The older woman, bedridden and recovering from a broken hip, repeatedly told the caregiver to leave because she didn’t need help.

Frustrated and angry, the aide threatened to quit. That’s when the patient’s family called in Joy Rosenthal, an elder mediator.

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California has paid scores of criminals to care for vulnerable residents - latimes.com

By Evan Halper

Scores of people convicted of crimes such as rape, elder abuse and assault with a deadly weapon are permitted to care for some of California's most vulnerable residents as part of the government's home health aide program.

Data provided by state officials show that at least 210 workers and applicants flagged by investigators as unsuitable to work in the program are nonetheless scheduled to resume or begin employment.

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