10 Ways to Stay Connected with The National Resource Directory

By the National Resource Directory Staff

Do you know about the National Resource Directory (NRD)? The NRD connects Wounded Warriors, Service Members, Veterans, family members and caregivers with services and resources at the national, state and local levels that support recovery, rehabilitation and community reintegration. The site offers a number of ways to stay connected, receive valuable information and find resources.

10 Ways to Stay Connected with The National Resource Directory

1. Keep your family, friends and colleagues up to date on programs and services helping Veterans, Service Members and their families by suggesting that they subscribe to National Resource Directory email updates.

2. Become a part of the growing National Resource Directory family on Facebook.

3. Get news and information about resources delivered directly to your desktop when you subscribe to the National Resource Directory’s RSS (Really Simple Syndication) feed.

4. Find programs and services near you by visiting the National Resource Directory’s Information by State section.


5. Spread the word about the National Resource Directory by putting a link on your website or blog.

6. Recommend a resource, organization or program in your community that you think should be included on the National Resource Directory through Suggest A Resource.

7. View automatically updated resources available in your state directly on your own website or blog by adding the National Resource Directory's State Widget.

8. Become a member of the National Resource Directory's LinkedIn group and connect with people who share your interests and concerns.

9. Stay up to date on news and events of interest to Veterans and military families by visiting the National Resource Directory's In The News page.

10. Visit the National Resource Directory's Facility and Records Locator page to find the locations of VA facilities and Social Security offices, as well as locations and contact information for military installations and VA records and military personnel records.

Posted by Diana Z. on Apr 5, 2011 5:50:21 AM in Veterans & Military

Elena Portacolone Research Published in Ageing and Society

Elena Portacolone (Elenaportacolone.com), noted researcher and lecturer on aging in America, is sharing her findings in the June issue of Ageing and Society, a Cambridge University Press academic journal.

Ms. Portacolone challenges the belief that elderly Americans living alone can only enjoy life if they are self-reliant and “independent”.  Her research on the hardships associated with living independently runs counter to conventional thinking and is rarely portrayed in the media.  The American elderly who live alone do not want to be a burden to others and fear moving to a nursing home As a result, they avoid assistance when they need it most – as their bodies, energy, and social circles decline, yet as income is fixed and healthcare expenses increase.

According to the U.S. Census in 2000, over 38% of Americans over 85 lived alone.  Researchers believe this percentage is increasing steadily because the U.S. population is living longer.
“Ms. Portacolone’s work in the field of older people living alone is cutting-edge and extremely valuable not only to me, but to the United States,” says Eric Klinenberg, author of the book Heat Wave.

The elderly do not ask for help because they feel like a failure if they do.  Shunning help, however, can lead to a precarious existence characterized by constant crisis.

“There are elders who are living alone, isolated, and chronically ill who risk dying helplessly at home alone.  Elena’s research offers ideas and solutions to hidden and chronic problems,” says Carroll Estes, Founder of The Institute for Health and Aging, UCSF.

Ms. Portacolone will be a featured speaker at the following conferences: 1) “Aging in America” (San Francisco, CA), 2) “Aging in Society (Berkeley, CA), and 3) “Society for the Study of Social Problems” (Las Vegas, NV).  She has been quoted in the San Francisco Chronicle.  Her dissertation, titled “Precariousness among older Americans living alone in San Francisco: Towards a sociological theory”, will be presented in May 2011 at UCSF.


About Elena Portacolone
Ms. Portacolone is a researcher on aging in America.  She holds two masters degrees in business administration and public health from the UC Berkeley.  She will receive a PhD in medical sociology at UCSF in June. More information is available at Elenaportacolone.com.

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

Service Coordinators in Multifamily Housing Program - Funding Opportunity

HUD
Department of Housing and Urban Development

Service Coordinators in Multifamily Housing Program

Modification 1
http://www07.grants.gov/search/search.do?&mode=VIEW&oppId=66313

Connecting the Long-Term Care Partnership and CLASS Act Insurance

The link below is to a copy of a recently published policy brief by Mark Meiners. Connecting the Long-Term Care Partnership and CLASS Act Insurance is a brief designed to help states with Partnership programs inform consumers and other stakeholders in considering these different approaches for long-term care insurance. It compares the two programs in a wide variety of areas including benefits, eligibility, affordability, etc. The brief can be accessed at www.chcs.org. Please feel free to contact Professor Meiners with any questions or comments.

Sebelius Vows To Ensure CLASS Program Is Financially Viable - Kaiser Health News

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By Marilyn Werber Serafini

The Obama administration is working aggressively to fend off critics of the CLASS Act, a voluntary insurance program created by the new health law to help individuals who require long-term care remain in the community. Health and Human Services Secretary Kathleen Sebelius today promised to pursue changes to ensure the program is financially self-sustaining into the future.

The Community Living Assistance Services and Support Act, to be run by HHS, would provide cash benefits that could be used for a variety of non-medical expenses, such as paying for a home health aide or a family member who provides care, modifications to a home and special transportation needs.

Full Article

AARP: CLASS Program Gives Americans New Option to Plan for Long-Term Care

AARP Executive Vice President John Rother released this statement following today’s remarks by Health and Human Services Secretary Kathleen Sebelius on the Community Living Assistance Services and Supports (CLASS) program, a voluntary insurance option for long-term services and supports created in the Affordable Care Act:

“American families are struggling with the staggering cost of long-term care while state governments look to reduce costs in their Medicaid programs—the largest payers of long-term care.  The CLASS program created by the Affordable Care Act gives Americans a new option to plan for the cost of long-term services and supports through a voluntary insurance program.  At the same time, the program will help take some of the burden off of Medicaid over time as more people are able to plan and pay for their own care.

“We know that 86 percent of our members want to live in their homes for as long as possible, yet too few are able to get the services they need to continue living independently.  The CLASS program can help offer peace of mind to American families and help cover some of the costs of services and supports they need to live independently in their homes and communities.  AARP is committed to giving our members and all older Americans the information they need in the coming months and years to decide if CLASS is right for them.”

Moving Out of Nursing Home Care; Independent Assisted Living - AARP Bulletin

by: Cynthia Ramnarace | from: AARP Bulletin

For eight years, Thomas Smallwood got around relatively well for a man with no legs. Poor circulation had led Smallwood, 63 at the time, to a difficult choice: his legs or his life. He chose the latter. You don't need legs to be a man, he thought. The man makes the legs.

Smallwood was among as many as 12 percent of nursing home residents — 168,000 out of the 1.4 million — designated "low-need," meaning that the assistance that they do need could conceivably be delivered in their own homes or in assisted living. And according to a recent November 2010 pilot study by researchers at Cornell University, more than half of that low-need population could transition back into the community with the right social supports.

"People just assume that a nursing home is a one-way street," says Rhoda Meador, associate director of outreach and extension at Cornell's College of Human Ecologyand author of the study. "But many practitioners don't accept that."
Full Article

A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community - Kaiser Family Foundation

The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care.

The Affordable Care Act (ACA) provides incentives for states to implement certain policies and practices that have proven effective at promoting access to long-term services and supports in the community. States’ experience has shown that operational details can have a significant impact on whether plans to provide more services and supports in the community succeed.

This brief highlights two important aspects of operations in state Medicaid programs that affect access to long-term services and supports in the community: efforts to provide accurate and timely information to consumers, and procedures to make Medicaid eligibility determinations quickly and efficiently.
Issue Brief (.pdf)

Information provided by the Kaiser Commission on Medicaid and the Uninsured
Publication Number: 8144
Publish Date: 2011-02-07

Money Follows the Person: A 2010 Snapshot - Kaiser Family Foundation

With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended five years through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting.

Twenty-nine states and DC are currently participating in this demonstration program and more states plan to apply for MFP grants in the coming year. In July 2010, the Kaiser Commission on Medicaid and the Uninsured (KCMU) surveyed states about the current status of their MFP program including trends in enrollment, services and per capita spending. This year’s survey is a follow-up to the 2008 KCMU MFP survey and highlights findings based on responses from 26 states.

Snapshot (.pdf)
Previous version:
June 2009 (.pdf)

Related:

Case Study: Ohio's Money Follows the Person Demonstration (HOME Choice)

Profiles: Money Follows the Person Transitions Individuals from Nursing Homes to the Community

Information provided by the Kaiser Commission on Medicaid and the Uninsured
Publication Number: 8142
Publish Date: 2011-02-07

Money Follows the Person: A 2010 Snapshot - Kaiser Family Foundation

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

CHOICES – Tennessee Long Term Care Services Program

In June 2008, Tennessee passed legislation restructuring LTC service delivery, including the expansion of HCBS services by integrating LTC within a managed care environment and providing consumer direction options. In March 2010, the state implemented the CHOICES program, wherein persons enrolled in TennCare that needed LTC services would receive them through a managed care organization. Review a presentation given at the 2010 HCBS conference and the CHOICES website.

PowerPoint Presentation

TennCare Choices Web Site

Marki Flannery: Home Health Aides: On the Front Lines of Caregiving

by Marki Flannery

Although home health aides provide assistance with all the "stuff" of daily life, the job of a home health aide cannot and should not be done by just anybody -- contrary to all-too-popular belief. Trained home health aides are highly skilled, compassionate caregivers; every day they man the vital front lines of healthcare for vulnerable seniors and others who are not stable enough to be on their own. These talented aides are the best offense for keeping at-risk individuals out of the hospital and living safely and as comfortably as possible in their own homes.

A good home health aide knows that daily activities -- bathing, dressing, eating, sleeping -- are really barometers of health. Subtle changes may indicate deteriorating health or issues with medication.

• If a patient is eating less or sleeping more than usual, do medications or dosages need adjusting?
• If the patient did not previously need help dressing and now does, has his or her condition degenerated?
• If a patient is refusing to bathe, are there emotional issues that need addressing?

A well-trained home health aide is much more likely to notice changes in a patient's behavior or well-being and act immediately and appropriately.
Full Article

More Veterans To Receive Options for Living Independently Under New VHA Partnership with National Resource Center for Participant-Directed Services - RWJF

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Veterans of all ages with disabilities will gain additional support in 28 states under a new program designed to help them live independently, with more choice and control over the services they receive in their homes. Through a contract with the Veterans Health Administration (VHA), the National Resource Center for Participant-Directed Services (NRCPDS) will provide training and assistance to VA Medical Centers that are implementing participant-directed services for Veterans.

In 2008, the U.S. Administration on Aging’s Community Living Program partnered with VHA to create the Veteran Directed Home and Community-Based Services (VD-HCBS) Program. The Program allows Veterans of all ages to have more control over services provided in their homes to allow them to continue to live independently in their communities. Veterans enrolled in the program can manage their own flexible spending budgets, decide for themselves what mix of goods and services can best meet their needs, hire and supervise their own workers, including family and friends, and purchase items or services that help them live more independently. We call this approach "participant direction."

The NRCPDS at Boston College is the only national center of its kind that helps people of all ages and disabilities get the support they need to live as independently as possible. The Center provides research, policy, training and assistance for participant-directed programs. In addition, NRCPDS has a National Participant Network that works with these programs to ensure that they are designed and implemented with the needs and preferences of the individual at their core. The Center will offer a wide variety of training and technical assistance to staff at VA Medical Centers for the benefit of Veterans in the VD-HCBS Programs.

Full Article

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

Source 1: Tapping Into Self-Pay : NCOA, National Council on Aging

The Older Americans Act (OAA) plays a vital role in funding services for our nation’s older adults. Yet, government funding has not kept pace with the rapidly growing aging population. As a result, nonprofits must look for other sources of revenue.

Some members of the aging network see an opportunity in charging clients for services. Others struggle with whether charging for services compromises their mission and how to charge fairly.
Read More

HUD and HHS Announce Joint Effort to Assist Persons with Disabilities to Move from Institutions to Independence

U.S. Housing and Urban Development (HUD) Secretary Shaun Donovan and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today a joint partnership between the two agencies to help nearly 1,000 non-elderly Americans with disabilities leave nursing homes or other healthcare facilities to live independently.  This is the first time two federal agencies are offering a combination of rental assistance, health care and other supportive services targeted to this population.
     
HUD is providing $7.5 million in rental assistance vouchers that will help nearly 1,000 individuals with disabilities rent private apartments.  Public housing authorities in 15 states will administer the rental subsidies and will work with state human service agencies to identify eligible individuals who could benefit from the program.  For a local breakdown of the funding announced today, visit HUD's Web site. 
       
Individuals receiving rental assistance through the program will also receive health and social supports that will enable them to live independently.  These supports are provided through the HHS Centers for Medicare and Medicaid's "Money Follows the Person" (MFP) grant program, which allows individuals who qualify for Medicaid-funded nursing home or other institutional care to receive supports - such as in-home nursing and personal care services - while living in the community instead.  In places where the MFP program is not available, services will be provided by a state-sponsored institutional transitional program comparable to MFP that includes dedicated supportive services.
     
As part of President Obama's Year of Community Living initiative, HUD and HHS launched a joint effort to provide housing support for non-elderly persons with disabilities who are currently receiving long-term care in institutional settings.  The interagency collaboration is intended to allow persons with disabilities to live productive independent lives in their communities rather than in institutions. 

"The Obama administration is committed to helping Americans with disabilities live independent lives. Housing is a critical piece of the equation when it comes to transitioning out of institutions," said Donovan.  "Coordinating this effort with the Department of Health and Human Services is an important step in ensuring that more Americans with disabilities will have the housing and support they need to fully participate in community life." 

"Through our collaboration with the Department of Housing and Urban Development, I know that we will be able to dramatically change peoples' lives," said Sebelius.  "Individuals with disabilities can have a life in the community that serves their needs and supports them in leading productive, meaningful lives."
     
The funding announced today is being provided through HUD's Rental Assistance for Non-Elderly Persons with Disabilities Program.  It is part of the $40 million HUD made available April 2010 to public housing authorities across the U.S. to fund approximately 5,300 rental assistance vouchers for non-elderly persons with disabilities to promote independent living for this community.  Public housing authorities applied for funding under two categories. 
     
Last October, HUD awarded $33 million to support a first round of 4,300 vouchers, making it possible for non-elderly individuals with disabilities and their families to access affordable housing in communities that meet their housing needs and so avoid potential institutionalization.  Today's announcement is for the second round funding to provide 948 vouchers targeted for non-elderly individuals with disabilities currently living in institutional settings, such as nursing homes, but who could move into a community with assistance. 

These vouchers will augment work already being done by HHS' Centers for Medicare & Medicaid Services (CMS) through its Money Follows the Person (MFP) rebalancing demonstration program.  Now in its fourth year, the MFP program has made it possible for almost 12,000 individuals to live more independent lives by providing necessary supports and services in the community.  Twenty-nine states and the District of Columbia are currently participating in the MFP program and CMS is expecting a new round of grant applications on January 7th.
     
State Medicaid agencies and local human service organizations will link eligible families to local public housing authorities that will administer voucher distribution.  To improve the connections between the housing authorities and Medicaid agencies, HUD and HHS have launched the Housing Capacity Building Initiative for Community Living Project to assist seniors and individuals with chronic conditions who are at risk of institutionalization or who currently receive care in institutional settings, in finding appropriate housing in order to live more independent lives.   
     
The Community Living Initiative is an outgrowth of the 1999 landmark Supreme Court ruling in Olmstead v. L.C.  In that case, the Court ruled that the Americans with Disabilities Act (ADA) protects a person with a disability from being unnecessarily institutionalized.  The Court said that such forced institutionalization can lead to isolation and segregation of individuals with disabilities and be a serious and pervasive form of discrimination.

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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HCBS / More Info:Aging and Disability Resource Centers (ADRC): Federal and State Efforts to Guide Consumers Through the Long-Term Services and Supports Maze

Summary

The ADRC program’s purpose is to help people of all ages, disabilities, and income levels more easily access LTSS through single points of entry, make more efficient use of care options, and maximize the services available. This publication provides background on the evolution of ADRCs, their functions and implementation, grants to states, and state and federal evaluation efforts. It also points to selected issues in continuing ADRC implementation.

Author

O’Shaughnessy, Carol V.

Available Files

• Report PDF (1,779K, 30 pages)
• Report Off-site link (30 pages)

HCBS / More Info:Achieving Better Chronic Care at Lower Costs Across the Health Care Continuum for Older Americans

Summary

A conference was held to inform potential solutions to improve the cost and quality of care across the health care continuum for older Americans. Synthesizing the conference, this report addresses many of the challenges facing individuals with chronic conditions and functional impairments, and identifies new opportunities for the integration of medical services and social supports tailored to older Americans and supported by new payment designs.

Available Files

• Report PDF (723K, 14 pages)
• Report Off-site link (14 pages)