John Paul Jebian communicates with his son Pierre, in Miami, Fla. – Scott McIntyre for STAT
by Leila Miller
“The chest pain was bad enough. Then John Paul Jebian asked staff at Baptist Hospital of Miami for an American Sign Language interpreter. They instead brought a video screen with an internet link to a remote interpreter to help him understand what the doctors and nurses were saying.
“Jebian, who is deaf, said a nurse struggled to set up the equipment as he anxiously wondered whether he was suffering a heart attack.
“‘I was panicked,’ said Jebian, 46, recalling that July 2012 day. ‘I didn’t know if I had to have surgery. Everything was going past me. I didn’t know what was happening, when it was happening.’
“With the minutes ticking by and staff still unable to operate the video interpreting service, the hospital turned to another option.”
Click here to continue reading this article at STATNews.com.
“The U.S. House of Representatives on May 4 passed the American Health Care Act by a razor-thin margin: 217 to 213.
It includes an “age tax” that would add up to $13,000 to the cost of insurance for those 50 to 64 and would discriminate against people with preexisting health conditions such as cancer and diabetes. What’s more, it would cause millions of Americans to lose coverage and put Medicare in worse financial shape. That’s just a partial list of what’s wrong with the legislation, which is now under Senate consideration. AARP promised to hold Members of Congress accountable if they voted for this harmful bill. Here they are.
Call 1-844-259-9351 and urge your Senators to vote NO on this high-cost, high-risk health care bill.
Click here to see the lists.
An event center floor becomes a makeshift dental surgery area during the Mission of Mercy clinic in Salisbury on March 10. (Linda Davidson/The Washington Post)
“SALISBURY, Md. — Two hours before sunrise, Dee Matello joined the line outside the Wicomico Civic Center, where hundreds of people in hoodies, heavy coats and wool blankets braced against a bitter wind.
“Inside, reclining dental chairs were arrayed in neat rows across the arena’s vast floor. Days later, the venue would host Disney on Ice. On this Friday morning, dentists arriving from five states were getting ready to fix the teeth of the first 1,000 people in line.
“Matello was No. 503. The small-business owner who supports President Trump had a cracked molar, no dental insurance and a nagging soreness that had forced her to chew on the right side of her mouth for years.
“‘It’s always bothering me,’ she said.”
Click here to continue reading this Washington Post article.
Pennsylvania ranks 26th in the country for senior citizens, according to the 2017 America’s Health Rankings Senior Report released by United Health Foundation.
“Minnesota is the leading state for senior health in 2017, a title it also held in the first two years of the America’s Health Rankings Senior Report. Utah (second) reached its highest ranking in the report’s five-year history, after rising four spots this year. Hawaii (third), Colorado (fourth) and New Hampshire (fifth) round out the top five states.”
WASHINGTON, DC – the National Association of States United for Aging and Disabilities (NASUAD) is pleased to announce the release of a new report, Demonstrating the Value of Medicaid MLTSS Programs, developed in partnership with the Center for Health Care Strategies (CHCS). The report also marks the first in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans.
In recognition of a lack of reliable and robust information on the value of state managed long-term services and supports (MLTSS) programs nationally, the report aims to partially fill the gap with data and evidence from a survey of state agencies and a review of relevant outside research. It is also intended to serve as a jumping off point for future study.
Martha Roherty, NASUAD Executive Director, believes this study is badly needed. “As we are out providing technical assistance to states seeking to implement MLTSS, we are continually asked by stakeholders for evidence that MLTSS works. We are so pleased that this study begins to answer those questions with hard state data.”
States identified the following issues as important outcomes to pursue when implementing an MLTSS program and to measure when demonstrating its value:
- Rebalancing Medicaid LTSS spending from institutional care to home and community based services;
- Improving member experience, quality of life, and health outcomes;
- Reducing waiting lists for waiver services and increasing access; and
- Increasing budget predictability and managing costs.
“As states collect and share more MLTSS program data–such as measures of consumers’ health status and other variables like cost and service utilization–they can demonstrate value and build stakeholder support for their programs,” said Stephen A. Somers, CHCS President and CEO.
NASUAD hopes that this report will generate a national dialogue on the value of MLTSS programs, stimulate thoughtful policy development and program design, and promote high performing state systems that provide care for older adults and persons with disabilities.
Read the report here.
Click on the graphic to download the handbook.
“Good communication is an important part of the healing process. Effective doctor-patient communication has research-proven benefits: Patients are more likely to adhere to treatment and have better outcomes, they express greater satisfaction with their treatment, and they are less likely to file malpractice suits.
“Studies show that good communication is a teachable skill. Medical students who receive communication training improve dramatically in talking with, assessing, and building relationships with patients. Time management skills also improve.
“Interpersonal communication skills are considered so important that they are a core competency identified by the Accreditation Council on Graduate Medical Education and the American Board of Medical Specialties.”
Continue reading this article at the National Institure on Aging Website, click here.
by Allison Aubrey
Registered dietitian Anna Ziegler counsels Tom Shicowich, who has a Type 2 diabetes. Since enrolling in the Fresh Food Pharmacy program, Shicowich has lost about 45 pounds. His A1C level has dropped significantly. – Allison Aubrey/NPR
“The advice to eat a healthy diet is not new. Back around 400 B.C., Hippocrates, the Greek doctor, had this missive: Let food be thy medicine.
“But as a society, we’ve got a long way to go. About one out of every two deaths from heart disease, stroke and Type 2 diabetes in the U.S. is linked to a poor diet. That’s about 1,000 deaths a day.
“There are lots of places to lay the blame. Calories are cheap, and indulgent foods full of salt, sugar and fat are usually within our reach 24/7.
“So, how best to turn this around? Consider Tom Shicowich’s story. It begins with a toe. His left pinky toe.”
Continue reading this NPR article, click here.
“The U.S. geriatrician population has been hovering around 7,000 for several years without much change. At the same time, the elder population grows by about 10,000 a day. You see the problem.
One reason is that geriatrics is at the bottom of the pay scale for doctors and one reason for that is the time-consuming nature of the field wherein patients’ needs are more complex than younger adults. As U.S. News reported in 2015:
”Unlike other physicians who might specialize in one organ system or disease, geriatricians must be adept at treating patients who sometimes are managing five to eight chronic conditions …
Click here to read this column at TimeGoesBy.net in its entirety.
At Gerald Chinchar’s home in San Diego, Calif., Nurse Sheri Juan (right) checks his arm for edema that might be a sign that his congestive heart failure is getting worse. – Heidi de Marco/Kaiser Health News
“Gerald Chinchar, a Navy veteran who loves TV Westerns, isn’t quite at the end of his life, but the end is probably not far away. The 77-year-old’s medications fill a dresser drawer, and congestive heart failure puts him at high risk of emergency room visits and long hospital stays. He fell twice last year, shattering his hip and femur, and now gets around his San Diego home in a wheelchair.
“Above all, Chinchar hopes to avoid another long stint in the hospital. He still likes to go watch his grandchildren’s sporting events and play blackjack at the casino.
“‘If they told me I had six months to live, or [could instead] go to the hospital and last two years, I’d say leave me home,’ he said. ‘That ain’t no trade for me.’
“Most aging people would choose to stay home in their last years of life. But for many, it doesn’t work out:” Click here to continue reading this NPR article.
“The Pennsylvania House of Representatives has passed a Fiscal Year 2017-18 general fund budget that could have significant implications for the state’s Medicaid program. House Bill 218 (HB 218) was approved along strict party lines and referred to the Senate Appropriations Committee on April 4. At $31.5 billion, the House Republican budget proposal is considerably more austere than the $32.3 billion budget proposed by Governor Wolf in February, and would reduce overall state spending by just under one percent compared to the current fiscal year.
“Among other funding reductions, and without specifying how such savings would be achieved, House Bill 218 contained the following Medicaid appropriations:
- MA – Capitation: $178 million less than the Governor’s Budget
- MA – Fee-for-Services: $2.6 million less than the Governor’s Budget
- MA – Long Term Care: $25 million less than the Governor’s Budget
- Behavioral Health Services: $4 million less than the Governor’s Budget
- Home & Community Based Services: $2.2 million less than the Governor’s Budget
- Services to Persons with Disabilities: $2.1 million less than the Governor’s Budget
“Without further explanation, House Majority Leader Dave Reed, R-Indiana, told reporters that implementing managed care ‘lock-in’ – by which Medicaid recipients could change insurance plans only once per year – would achieve $100 million in Medicaid savings. Whether the remaining Medicaid savings would require cuts to reimbursement rates, waiting lists for HCBS waiver programs, or still-to-be-announced policy changes is not yet known.
“HB 218 did include the funding for the consolidation of four Departments—Aging, Drug and Alcohol Programs, Health, and Human Services. Over the last month, Legislative Committees have been holding hearings regarding consolidating the Departments and forming one Department of Health and Human Services (HHS). Separate legislation would be needed before the departments could consolidate, and lawmakers have expressed concerned about the lack of details available thus far about plans to bring the agencies together as of July 1st-the proposed start date for this action. Legislative committees held two hearings in Harrisburg on this issue with another hearing scheduled in Pittsburgh on May 1, 2017. More information about the hearings held thus far can be found here. Governor Wolf has released a website that details draft HHS unification legislation and organizational charts. The website also includes a way for the public to provide feedback.
“Both chambers of the General Assembly and Governor Wolf are now expected to continue budget negotiations, with a final agreement expected before the next fiscal year begins on July 1st.”