What is Long-Term Care?
Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. It is important to remember that you may need long-term care at any age.
You may never need long-term care. This year, about nine million men and women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. A study by the U.S. Department of Health and Human Services says that people who reach age 65 will likely have a 40 percent chance of entering a nursing home. About 10 percent of the people who enter a nursing home will stay there five years or more.
Medicare and Long-Term Care:
While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the care you get. Generally, Medicare doesn't pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn't pay for this type of care called "custodial care". Custodial care (non-skilled care) is care that helps you with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring. Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is medically necessary. You may have to pay some of the costs. For more information about Medicare Advantage Plans, look at the Medicare Personal Plan Finder.
Medicaid and Long-Term Care:
Medicaid is a State and Federal Government program that pays for certain health services and nursing home care for older people with low incomes and limited assets. In most states, Medicaid also pays for some long-term care services at home and in the community. Who is eligible and what services are covered vary from state to state. Most often, eligibility is based on your income and personal resources.
Choosing Long-Term Care:
Choosing long-term care is an important decision. Planning for long-term care requires you to think about possible future health care needs. It is important to look at all of your choices. You will have more control over decisions and be able to stay independent. It is important to think about long-term care before you may need care or before a crisis occurs. Even if you plan ahead, making long-term care decisions can be hard.
Monday, February 23, 2009
HEALTH PROVISIONS IN THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009: FREQUENTLY ASKED QUESTIONS
The American Recovery and Reinvestment Act of 2009 includes important investments in health information technology and in research on the comparative effectiveness of various health care tests and treatments. These investments will quickly grow jobs in the health care sector and eventually improve the quality of health care for every American. Unfortunately, incorrect rumors about these provisions and their likely effects threaten to undermine these good policies.
Following are the most Frequently Asked Questions – and accurate answers – about how health information technology provisions in the American Recovery and Reinvestment Act will work:
Health Information Technology
Q: What will the “National Coordinator of Health Information Technology” do?
A: Under this bill, the National Coordinator of Health Information Technology will set minimum standards for the technology systems your doctor may choose to store and maintain your medical records – making sure, for instance, that the systems are configured to keep your information from getting loose to the public, but still allowing your various doctors to share the information easily and confidentially. The coordinator will also work to support doctors and hospitals as they transition to electronic records. Actually, the Office of the National Coordinator of Health Information Technology is not even new. President George W. Bush created the office by Executive Order a number of years ago. The bill simply codifies the office and gives it a specific job.
Q: Will the health IT director have any influence on the decisions doctors and patients can make together about tests and treatment?
A: Absolutely not. This position’s function is to make sure that doctors and other health care providers use good, secure technologies as they change their record-keeping systems from paper to computers.
Q: Will the government have access to my electronic medical record?
A: No. Federal law makes your medical records – whether they’re on paper or in a computer – confidential to you and your health provider.
Q: What‟s the “meaningful use” of health IT? Does this bill say that my doctor has to use health information technology and provide only certain treatments to me, or risk a penalty from the government?
A: To improve the quality of American health care, it’s important for doctors and providers to move to an electronic system of records. This will reduce medical errors, improve efficiency, and help doctors for a single patient work together better to keep that patient healthy. The bill requires health providers to be “meaningful users” of health IT by 2015 – meaning, they have to have a system of electronic records to achieve these goals. This bill does not, however, require physicians to follow any particular treatment guidelines, protocols, or other research in order to meet the “meaningful use” standard. They just have to have electronic records by 2015.
Comparative Effective Research
Q: What is comparative effectiveness research?
A: Comparative effectiveness research compares clinical outcomes, or the “clinical effectiveness,” of alternative therapies for the same condition. More evidence on what works and doesn’t work can help patients and doctors make better health care decisions together, thus improving the quality of patients’ care, improving efficiency by focusing on what works, and ultimately saving money throughout the health system.
Q: Why should the government be doing this research?
A: Right now, much of health care research is funded by companies trying to sell a drug or treatment. The comparative effectiveness research provisions in the Senate economic recovery legislation are designed to allow unbiased research that simply gets the facts – and the provision will create jobs in the research sector as well.
Q: Can the government use the results of this research to tell me, or my doctor, what tests and treatments I can or cannot have?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.
Q: Will this bill allow the government to apply the results of comparative effectiveness research to deny me end-of-life care or medicines that I choose?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.
Q: Is there some kind of health care "czar" in this bill with access to this comparative effectiveness research and my electronic medical records, who might make decisions about what my doctor or insurance company can do about my medical treatment?
A: No. Comparative effectiveness and health IT are separate in this bill. There’s no crossover in the administration of these provisions, research, or technology.
The American Recovery and Reinvestment Act of 2009 includes important investments in health information technology and in research on the comparative effectiveness of various health care tests and treatments. These investments will quickly grow jobs in the health care sector and eventually improve the quality of health care for every American. Unfortunately, incorrect rumors about these provisions and their likely effects threaten to undermine these good policies.
Following are the most Frequently Asked Questions – and accurate answers – about how health information technology provisions in the American Recovery and Reinvestment Act will work:
Health Information Technology
Q: What will the “National Coordinator of Health Information Technology” do?
A: Under this bill, the National Coordinator of Health Information Technology will set minimum standards for the technology systems your doctor may choose to store and maintain your medical records – making sure, for instance, that the systems are configured to keep your information from getting loose to the public, but still allowing your various doctors to share the information easily and confidentially. The coordinator will also work to support doctors and hospitals as they transition to electronic records. Actually, the Office of the National Coordinator of Health Information Technology is not even new. President George W. Bush created the office by Executive Order a number of years ago. The bill simply codifies the office and gives it a specific job.
Q: Will the health IT director have any influence on the decisions doctors and patients can make together about tests and treatment?
A: Absolutely not. This position’s function is to make sure that doctors and other health care providers use good, secure technologies as they change their record-keeping systems from paper to computers.
Q: Will the government have access to my electronic medical record?
A: No. Federal law makes your medical records – whether they’re on paper or in a computer – confidential to you and your health provider.
Q: What‟s the “meaningful use” of health IT? Does this bill say that my doctor has to use health information technology and provide only certain treatments to me, or risk a penalty from the government?
A: To improve the quality of American health care, it’s important for doctors and providers to move to an electronic system of records. This will reduce medical errors, improve efficiency, and help doctors for a single patient work together better to keep that patient healthy. The bill requires health providers to be “meaningful users” of health IT by 2015 – meaning, they have to have a system of electronic records to achieve these goals. This bill does not, however, require physicians to follow any particular treatment guidelines, protocols, or other research in order to meet the “meaningful use” standard. They just have to have electronic records by 2015.
Comparative Effective Research
Q: What is comparative effectiveness research?
A: Comparative effectiveness research compares clinical outcomes, or the “clinical effectiveness,” of alternative therapies for the same condition. More evidence on what works and doesn’t work can help patients and doctors make better health care decisions together, thus improving the quality of patients’ care, improving efficiency by focusing on what works, and ultimately saving money throughout the health system.
Q: Why should the government be doing this research?
A: Right now, much of health care research is funded by companies trying to sell a drug or treatment. The comparative effectiveness research provisions in the Senate economic recovery legislation are designed to allow unbiased research that simply gets the facts – and the provision will create jobs in the research sector as well.
Q: Can the government use the results of this research to tell me, or my doctor, what tests and treatments I can or cannot have?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.
Q: Will this bill allow the government to apply the results of comparative effectiveness research to deny me end-of-life care or medicines that I choose?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.
Q: Is there some kind of health care "czar" in this bill with access to this comparative effectiveness research and my electronic medical records, who might make decisions about what my doctor or insurance company can do about my medical treatment?
A: No. Comparative effectiveness and health IT are separate in this bill. There’s no crossover in the administration of these provisions, research, or technology.
Saturday, February 14, 2009
Legislative update
ESHB 1694 - the “pre-emptive” budget cutting bill that passed the House last week was heard in the Senate Ways and Means Committee on Wednesday, and while it has yet to be scheduled, it may see executive action this week. Thanks to all of you who have continued to communicate your concerns. In testimony before the Ways & Means Committee, the Washington Health Care Association pointed out that the proposed cuts go into effect in the last two or three months of the FY 2009, leaving very little time for providers to make adjustments to their budgets. WHCA continues to argue that providers will not be able to reduce payments for fixed operations costs. The only area of flexibility is in staffing where approximately 65 percent of the costs occur and the result will be layoffs and job losses that will impact direct care to the state’s most vulnerable. The job loss cannot help but impact unemployment costs, health care costs for the uninsured and put more stress on our food stamp and welfare programs, and comes at a time when the long term care industry is one of the few significant sectors of job growth in this country. WHCA also shared concerns with those Senators who do not serve on Ways and Means, and reminded them that the Obama economic stimulus package will result in millions of dollars of unanticipated federal matching funds from the nursing home and boarding home portion of the FMAP (Federal Medical Assistance Percentages), many times greater than the targeted $2.4 million GF-S (General Fund – State) cuts for nursing facilities and $375,000 GF-S cuts for boarding homes. It is important that we continue to remind legislators that these new resources make nursing home and boarding home rates cuts unnecessary.
Legislative discussions regarding both the 2009 Supplemental Operating Budget and 2009-2011 Biennial Operating Budget continue. This week, WHCA has a number of key meetings with legislators and legislative staff to discuss the enhanced FMAP revenues from the federal economic stimulus package. WHCA’s goal is to ensure that those monies are used to ensure stable and adequate funding. Nursing home and boarding home rates continue to fall short by over $18 per resident day, and the $92 million total funds cuts proposed in the Governor’s budget for nursing homes will have a detrimental effect on quality of resident care.
St. Francis wants to encourage you to continue your communications efforts with your legislators regarding all of these issues. As a reminder, you want to make sure that your communications are factual and non-aggressive in nature. While we may be disappointed in the vote of House members who voted in favor of budget cuts in ESHB 1694, it’s important that we avoid assessing blame for these actions. The leadership in the House is locked up in support of the proposed cuts until they have a better picture of the state’s revenue picture and the economic stimulus package. We have heard there may be an effort to backfill cuts with the enhanced FMAP dollars.
The supplemental and biennial budget proposals are slated for release following the March revenue forecast and caseload updates; then it will be more important than ever that your contact your legislators to oppose cuts to nursing homes and boarding homes.
Here is contact information for our elected officials:
Senator Dale BrandlandRepublican Whip(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:203 Irv Newhouse BuildingPO Box 40442Olympia, WA 98504-0442(360) 786-7682Fax: (360) 786-1999
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=S&District=42
Rep. Doug Ericksen(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:425B Legislative BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7980
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=1
Rep. Kelli Linville(D) 42nd LEGISLATIVE DISTRICT
Olympia Office:204 John L. O'Brien BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7854
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=2
ESHB 1694 - the “pre-emptive” budget cutting bill that passed the House last week was heard in the Senate Ways and Means Committee on Wednesday, and while it has yet to be scheduled, it may see executive action this week. Thanks to all of you who have continued to communicate your concerns. In testimony before the Ways & Means Committee, the Washington Health Care Association pointed out that the proposed cuts go into effect in the last two or three months of the FY 2009, leaving very little time for providers to make adjustments to their budgets. WHCA continues to argue that providers will not be able to reduce payments for fixed operations costs. The only area of flexibility is in staffing where approximately 65 percent of the costs occur and the result will be layoffs and job losses that will impact direct care to the state’s most vulnerable. The job loss cannot help but impact unemployment costs, health care costs for the uninsured and put more stress on our food stamp and welfare programs, and comes at a time when the long term care industry is one of the few significant sectors of job growth in this country. WHCA also shared concerns with those Senators who do not serve on Ways and Means, and reminded them that the Obama economic stimulus package will result in millions of dollars of unanticipated federal matching funds from the nursing home and boarding home portion of the FMAP (Federal Medical Assistance Percentages), many times greater than the targeted $2.4 million GF-S (General Fund – State) cuts for nursing facilities and $375,000 GF-S cuts for boarding homes. It is important that we continue to remind legislators that these new resources make nursing home and boarding home rates cuts unnecessary.
Legislative discussions regarding both the 2009 Supplemental Operating Budget and 2009-2011 Biennial Operating Budget continue. This week, WHCA has a number of key meetings with legislators and legislative staff to discuss the enhanced FMAP revenues from the federal economic stimulus package. WHCA’s goal is to ensure that those monies are used to ensure stable and adequate funding. Nursing home and boarding home rates continue to fall short by over $18 per resident day, and the $92 million total funds cuts proposed in the Governor’s budget for nursing homes will have a detrimental effect on quality of resident care.
St. Francis wants to encourage you to continue your communications efforts with your legislators regarding all of these issues. As a reminder, you want to make sure that your communications are factual and non-aggressive in nature. While we may be disappointed in the vote of House members who voted in favor of budget cuts in ESHB 1694, it’s important that we avoid assessing blame for these actions. The leadership in the House is locked up in support of the proposed cuts until they have a better picture of the state’s revenue picture and the economic stimulus package. We have heard there may be an effort to backfill cuts with the enhanced FMAP dollars.
The supplemental and biennial budget proposals are slated for release following the March revenue forecast and caseload updates; then it will be more important than ever that your contact your legislators to oppose cuts to nursing homes and boarding homes.
Here is contact information for our elected officials:
Senator Dale BrandlandRepublican Whip(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:203 Irv Newhouse BuildingPO Box 40442Olympia, WA 98504-0442(360) 786-7682Fax: (360) 786-1999
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=S&District=42
Rep. Doug Ericksen(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:425B Legislative BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7980
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=1
Rep. Kelli Linville(D) 42nd LEGISLATIVE DISTRICT
Olympia Office:204 John L. O'Brien BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7854
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=2
Sunday, February 8, 2009
Getting Enough Sleep
by Susan Churchill
According to the National Sleep Foundation (NSF), more than two-thirds of older adults suffer from sleep deprivation and many American adults don't get the minimum amount of restorative sleep needed to stay alert and maintain a healthy body.
Sleep is vital to good health and to mental and emotional well being. The NSF reports that people who don't get enough slumber are more likely than others to develop psychiatric problems and to use health care services. Sleep deprivation can negatively affect memory, learning, and logical reasoning. It puts stress on the cardiovascular and musculoskeletal system and makes us more prone to injuries. There is even new research that shows that successful weight loss occurs only if a person is getting enough sleep.
Not getting adequate sleep can also be hazardous and dangerous. More than one-half of adult drivers -- some 100 million people -- say they have driven drowsy in the past year, according to NSF polls. About one out of five of these drivers -- 32 million people -- say they've fallen asleep while driving. Each year drowsy driving causes more than 100,000 car crashes, 1,500 deaths, and tens of thousands of injuries, reports the National Highway Traffic Safety Administration.
To avoid the pitfalls of insufficient sleep, make sure to get at least 7-10 hours of slumber each night. Kids need more sleep, depending on their age. We all lead very busy lives and our chores and responsibilities sometimes seem endless. However, if you rely on cutting back on sleep to help accomplish more in your day, you are possibly setting yourself up for some serious health problems. Getting adequate sleep is a commitment and sometimes we have to plan it into our day just as we plan for meals, work and exercise. Sometimes it means shutting off the TV an hour early and simply going to bed. Providing your body with the amount of sleep it needs is an important step to a healthier life.
# # #
Susan Churchill, PT, is Director of Therapy at St. Francis.
by Susan Churchill
According to the National Sleep Foundation (NSF), more than two-thirds of older adults suffer from sleep deprivation and many American adults don't get the minimum amount of restorative sleep needed to stay alert and maintain a healthy body.
Sleep is vital to good health and to mental and emotional well being. The NSF reports that people who don't get enough slumber are more likely than others to develop psychiatric problems and to use health care services. Sleep deprivation can negatively affect memory, learning, and logical reasoning. It puts stress on the cardiovascular and musculoskeletal system and makes us more prone to injuries. There is even new research that shows that successful weight loss occurs only if a person is getting enough sleep.
Not getting adequate sleep can also be hazardous and dangerous. More than one-half of adult drivers -- some 100 million people -- say they have driven drowsy in the past year, according to NSF polls. About one out of five of these drivers -- 32 million people -- say they've fallen asleep while driving. Each year drowsy driving causes more than 100,000 car crashes, 1,500 deaths, and tens of thousands of injuries, reports the National Highway Traffic Safety Administration.
To avoid the pitfalls of insufficient sleep, make sure to get at least 7-10 hours of slumber each night. Kids need more sleep, depending on their age. We all lead very busy lives and our chores and responsibilities sometimes seem endless. However, if you rely on cutting back on sleep to help accomplish more in your day, you are possibly setting yourself up for some serious health problems. Getting adequate sleep is a commitment and sometimes we have to plan it into our day just as we plan for meals, work and exercise. Sometimes it means shutting off the TV an hour early and simply going to bed. Providing your body with the amount of sleep it needs is an important step to a healthier life.
# # #
Susan Churchill, PT, is Director of Therapy at St. Francis.
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