Welcome to the blog sub-site for The Center for Long-Term Care Reform. If you subscribe to the Health & Medicine comment feed, you will be able to post comments to some of the posts that appear in this section.
Two recently released reports from HMPRG's Center for Long-Term Care Reform (The Determination of Need Study and the Home Again Report)
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July 8, 2010
20-30 Year Olds - You Can Do Your Part To Ensure Social Security's Robust Survival!
Posted by
Kristen Pavle, Policy Analyst, Center for Long-Term
Care Reform
Social Security Will Be Around When You Retire… If You
Want It To Be!
There seems to be a growing opinion among 20 and 30 year olds about the United States Social Security program: that it will not exist upon our retirement, so why should we care? Perhaps I am missing something here, but the mere fact that we are paying into the Social Security program NOW, for others’ benefits, is reason enough to care! I want this program to exist in my retirement, too. But even this is only a minor reason to become more involved in the discussion surrounding Social Security as a younger person.
As of 2006, the
Social Security
program has provided more than $541.6 Billion dollars in benefits to
over 49
million individuals. Social Security
allows citizens of this country to retire with the earned privilege—an
enforceable right—of an income after a lifetime of work. Social
Security retirement income, with
benefits also paid to spouses, widows (or widowers), minor children, and
people
with disabilities represents a fundamental cornerstone of our society. Because
of Social Security, older Americans
are no longer the poorest demographic in the country. It
is the most visible symbol of
intergenerational connectedness and the last remaining leg of the
three-legged
stool (savings, pensions, and Social Security) that its founders
envisioned. Today it is the bedrock of economic
security, particularly in old age, for thousands of people, especially
older
women. Not only do I urge you to care
about Social Security, but I want to start the discussion on WHY we
should all
care about the concept of “social security” as manifested by the Social
Security program.
What Does the Data
Say About Social Security in the Long-Term?
Did your parents ever tell you not to worry about Social Security, because the program would not be around for you would not enjoy its benefits? Well, they were not exactly right. According to the “2009 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and the Disability Insurance Trust Funds” (read: Annual Report on the Social Security Program), intermediate (neither conservative nor liberal) projections for the solvency of the Social Security program are as follows:
- By 2016 the benefits program will be paying out more than it will be gaining in revenues, thus beginning to deplete the trust fund.
- By 2024 the Social Security pot of money, the trust fund, will no longer be growing.
- By 2037 the Social Security trust fund will be exhausted, empty, no money left. But income will still be coming into the system from payroll taxes so benefits will be paid but at a reduced amount.
Maybe your parents were right…? But, these figures about financing Social Security in the long-term function under a rather large assumption: that there will be no structural changes in how the Program operates. However, last time I checked we live in a democratic nation. As citizens, we have a choice to demonstrate our commitment to Social Security so that benefits can be available IN FULL when we retire.
Advocates
for Social Security are equipped with many ideas
for how we can change the structure by which the Program operates,
giving it full
financial sustainability beyond 2037, when WE retire. Social
Security’s problems are political, not
financial. Contrary to popular opinion
it is not in crises; it does not contribute a single penny to the
deficit. In fact, it is in surplus.
A Call for Your Voice to be Heard: Focus Group
- Are
you in your 20’s or 30’s?
- Do you
have an opinion on Social Security?
- Do you
have questions about Social Security or an interest to learn more?
In an attempt at brevity, I
will close this blog article
with an invitation to continue the discussion.
Health & Medicine
Policy Research
Group (HMPRG) wants to talk with you. On Wednesday, July 28th
from 6-8pm, HMPRG will host a focus group for individuals in
their 20s and 30s on Social
Security. We look to you to help us
build a campaign to get all younger people committed to Social
Security’s
robust survival. Quite honestly, we want
to turn you into an informed advocate for a strong Social Security
program, one
that will be there for each succeeding generation. Remember,
it is the only source of income that
you cannot outlive.
Please contact Kristen
Pavle
for details and to RSVP.
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May 27, 2010
CMS Actively Promotes the Community Living Initiative, Offers Assistance for State Long-Term Care Reform
We'd like to share a letter from Cindy Mann, Director
of Centers for Medicare & Medicaid (CMS), to State Medicaid Directors
promotes the Community Living Initiative, and offers assistance to states to
balance the long-term care system to reflect more home and community based
options for older adults and persons with
disabilities.
In Ms. Mann’s letter to State
Medicaid Directors, she outlines “Opportunities and Partnership –Tools for
Community Living”. CMS offers, among other
supports:
·
technical assistance,
·
waiver programs,
·
information on managed care models
for long-term care,
·
information on affordable housing
options,
·
support for infrastructure reforms,
·
financial support for demonstration
projects,
·
guidance in discharge
planning.
May 26, 2010
Amidst Federal and State Budget Crises, are Elderly Safety-Net Programs, Social Security, Safe?
Photo from Organize for America- Barack Obama -
on flickr
National Commission on Fiscal Responsibility and Reform, and Social Security
On February 18, 2010, President Barack Obama issued an Executive Order to establish the National Commission on Fiscal Responsibility and Reform (Commission). The Commission aims to provide recommendations on balancing the federal government’s budget by 2015. Further, the Commission will recommend action to improve the fiscal outlook of the country in the long-term. A lot of discussion about the country’s long-term fiscal outlook has centered on entitlement programs, specifically where money coming in to fund programs has fallen below program expenditures. There has been quite a bit of conversation about the Social Security entitlement program as a possible way to help reign in spending and balance the budget.
The Social Security entitlement program in the United States has a long history; President Franklin D. Roosevelt signed it into law in 1935, passing Congress as part of the New Deal. Social Security is a social insurance program for retired persons, disabled individuals, and individuals who depended on a family worker who has died. Social Security is a safety net for many Americans, and specifically many older adults. With more than 47 million Americans depending on Social Security income, and over two-thirds of retirees relying on Social Security for the majority of their income, it is imperative we protect and strengthen the Social Security program. As the National Commission on Fiscal Responsibility and Reform continues to meet, behind closed doors, advocacy to preserve Social Security must be a priority.
The True
Cost of Living for Older Adults, Illinois Perspective
Wider
Opportunities for Women (WOW), a non-profit based out of
Washington D.C., created the Elder Economic Security Initiative (EESI)
several years ago. EESI approaches building economic security through
advocacy, organizing, and research. A key part of EESI is the Elder
Economic Security Standard™ Index, calculating the cost of living for an
older adult. The Illinois state partner for EESI is Health &
Medicine Policy Research Group (HMPRG) and detailed
information about EESI can be found on the HMPRG website. In
Illinois, and across the country, EESI is revealing that frequently
older adults cannot make ends meet based on their income and the cost of
living.
According to the policy brief, “Elders
Living on the Edge: When Meeting Basic Needs Exceeds Available Income in
Illinois” in
Illinois 1 out of 5 older adults relies solely on Social Security.
Unfortunately, the average Social Security payment for a single, retired
Illinoisan does not cover the cost of living. Using EESI as a tool,
specifically the data of the Elder Economic Security Standard™ Index,
Illinoisans can advocate in many ways to protect the economic security
of its older adult population. One way is to advocate for the
strengthening and preservation of the Social Security program. With so
many older adults in Illinois relying on Social Security and currently
unable to afford the cost of living in the community, any disruption of
Social Security benefits would be tragic.
Fiscal Budget & Illinois State Budget, How Does This Affect YOU?
As Washington D.C.
tackles the federal budget, states have the task of managing their own
budgets. Illinois is in a
budget crisis, with a deficit of $13 billion, almost half of the state’s
general fund revenue. Attempting to come up with a solution to
this deficit has not been easy—state employee pension plans, social
service agencies, health care agencies, and the education system have
all been threatened by budget cuts. Illinois'
budget deficit threatens important health and social programs, and
is already affecting social service agencies throughout the state.
Particularly concerning to the aging community is the delay in paying
social service agencies that provide care for the elderly.
Without
providing payment to state-funded social service agencies, many older
adults will not be able to access the services they need to remain
healthy and viable in their communities. As the Federal Commission
researches ways to balance the federal budget and talk of changing
Social Security continues, the economic well-being of older adults has
never been a more pertinent issue.
What You Think About the Budget Matters! Let Your Voice Be Heard!
Wider Opportunities for Women (WOW) is hosting its second annual Blog Day, Wednesday May 26th, 2010: “America’s Budget Matters, So Does Yours.” The posts on HMPRG's about the impact of both the federal and state budget deficits and their impact on the aging community are only the beginning to an ongoing discussion of elder economic security, and we want to hear from you:
• Do you have anything to contribute to this conversation about the federal deficit?• About Illinois’ budget deficit?
• About cuts to social service programs in Illinois?
• About preserving Social Security?
• How do potential budget cuts affect you?
Please leave your comments below. HMPRG is working with WOW to make sure that your voice is heard, that the Federal Commission and the Illinois state government knows that their decisions affect you. Our country, and our state of Illinois, is in difficult times. Now is not a time to be quiet, but a time to advocate for your right to remain economically secure in your homes and communities as you age.
May 19, 2010
Elder Economic Security—UpdateThe U.S. Census Bureau recently announced the creation of a supplemental measure to the federal poverty level. It’s about time! It’s been 50 years since the original poverty level was developed and its methodology has yet to be updated. This antiquated measure fails to capture the true number of Illinois elders and families struggling to meet their basic needs.
Elders in Illinois are having a tough time making ends meet with one out of five living on Social Security alone. The average Social Security payment for Illinois’s elders is $12,996. This payment barely surpasses the original federal poverty line, and is not enough for these elders to be economically secure. According to the Illinois Elder Economic Security Standard™ Index (Elder Index), a geographically-based measure of what elders need to age in place created by Wider Opportunities for Women and the Gerontology Institute at the University of Massachusetts-Boston, a single elder renter needs $19,810 a year.
The proposed supplemental poverty measure is a good first step, because it will improve on how poverty is currently measured by providing new data including the cost components of food, housing, and clothing. But, the supplemental poverty measure alone is not enough.
Decision makers need tools that accurately reflect the real cost of aging in place. For instance, the Elder Index demonstrates that seniors have high health costs, which may affect their ability to pay for other basic needs. In Illinois an elder in fair health pays $357 a month for health care while an elder in poor health pays $387. And if long-term care services are needed, these costs can double or even triple what an elder needs to make ends meet.
Additional data is necessary to better capture elders’ real costs and to determine the best way policy makers, administrators and service providers can utilize funds and target strategies to promote economic security.
The supplemental measure is sure to spur continuous and much needed discussion as we grapple with how best to define economic security in our state and in our country. We’ve already waited too long. Too many elders and their families live without enough to meet their basic needs. Now is the time to move past simply measuring what it means to be deprived to what it means to be secure.
Please see, “Elders Living on the Edge: When Meeting Basic Needs Exceeds Available Income in Illinois” for more information, and check out Health & Medicine’s involvement with the Elder Economic Security Initiative----------------------------------------------------------------------------------------------------------------
April 26, 2010
Update on Illinois' Money Follows the Person (MFP) Program
Health
&
Medicine’s Center for Long-Term Care Reform has supported the supported
the Money
Follows
the Person (MFP) program in Illinois since 2007, when the demonstration
project began in the state. MFP
is
a federal demonstration grant to assist individuals living in
nursing
homes for 6 months or longer to transition back into a home and
community based
setting. Through MFP,
Although
As a result of the passage of the Health Care Reform legislation, the MFP grant has been extended through 2016 with additional federal funds allocated to the program. The eligibility requirements have also been changed, including the length of stay in the nursing facility; individuals who have been in a nursing facility under Medicaid payment for at least 3 months are now eligible for MFP transitional services.
As
Check out this Kaiser Family Foundation article for more information on the Money Follows the Person grant: http://www.kaiserhealthnews.org/Stories/2010/April/22/states-struggle-to-move-people-out-of-nursing-homes.aspx
Questions? Contact Kristen Pavle, Policy Analyst, Center for Long-Term Care Reform--------------------------------------------------------------------------------------------------------------------------------------
April 12, 2010
Author: Nadia Chivers, Policy Intern, Health & Medicine Policy Research Group
Editor: Kristen Pavle, Policy Analyst, Center for Long-Term Care Reform, Health & Medicine Policy Research Group
The Outlawing of Physical and Chemical Restraints
Since October 1990, nursing homes across the country have had to comply with a federal mandate, The Omnibus Budget Reconciliation Act of 1987, that restricts the use of inappropriate physical and chemical restraints on nursing home residents unless the restraint is necessary to treat their medical symptoms.
Physical restraints restrict a person’s movement and may include leg and arm restraints, hand mitts, vests, ties, and trays/tables/bars that cannot be removed from a chair or bed and limit the person’s mobility.
While the use of physical restraints in nursing homes serves some legitimate purpose, unnecessary use has drastically reduced in the past 20 years. The same cannot be said for the use of chemical restraints. While psychotropic drugs are often an essential form of treatment in nursing homes, they become chemical restraints when they are used to control a resident’s behavior rather than administered for medical purposes.
The misuse and overuse of psychotropic drugs on nursing home residents has been well documented and is now considered by some experts to be the newest form of nursing home abuse. It is estimated that 1 in 4 patients in the
As a response to the inappropriate use of psychotropic drugs in
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March 10, 2010
The Nursing Home Safety Task Force has released its final recommendations and has a working group meeting twice a week to discuss translating these recommendations into legislation. However, AARP and Advocates have also been busy drafting their own legislation addressing nursing home care in Illinois. Per AARP’s press release early March 9, 2010:
“The legislation – Senate Bill 685 – is sponsored by Senators Heather Steans (D-Chicago) and Jacqueline Collins (D-Chicago), and is supported by AARP Illinois, The Community Renewal Society, SEIU Healthcare Illinois, Illinois Citizens for Better Care, the Jane Addams Senior Caucus, AFSCME, Illinois Association of Long Term Care Ombudsman, the Illinois Trial Lawyers Association, Age Options, Next Steps, Supportive Housing Providers Association, Health & Medicine Policy Research Group, and the Shriver Center on Poverty Law, the Illinois Network of Centers for Independent Living and Health and Disability Advocates.”
Click here for a view of video footage from the AARP Press Release,from NBC Central Illinois News
We will continue to keep you up-to-date on the various pieces of legislation concerning Nursing Home Reform and let you know how you can become involved as opportunities arise. For more information, please contact: Kristen Pavle, Policy Analyst, Health & Medicine’s Center for Long-Term Care Reform. 312.372.4292 x 27 or email Kristen.
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February 25, 2010
Nursing Home Reform in Illinois
On October 3, 2009, Governor Pat Quinn formed the Illinois Nursing Home Safety Task Force. The Task Force was charged with addressing the serious issue of mixing populations of persons with mental illness with the elderly and other physically disabled.
On February 19, 2010, the Task Force released its Final Report to the Governor. The Final Report includes 38 recommendations applying to persons with mental illness that currently occupy nursing home beds.
Three broad categories are used to organize the recommendations:
- Enhance Pre-Admission Screening and Background Check Process,
- Set and Enforce Higher Standards of Care, and
- Expand Home and Community-Based Residential and Service Options.
Task Force on Aggressive Timeline for Reform
Task Force chairperson Michael Gelder has set an aggressive timeline to achieve the proposed recommendations. Nine “Immediate Implementation Workgroups” have been assigned to implement recommendations by April 30th, 2010. These workgroups will focus on areas including:
- Pre-Admission Screen and Resident Review (PASRR) enhancement,
- Criminal Background Checks,
- Psychotropic Drugs, and
- Supportive Housing Expansion.
Center for Long-Term Care Reform Influences Task Force
Recognition from Federal Government & Moving Forward
The Illinois Nursing Home Safety Task Force has done a great job at convening the major state departments and producing recommendations to reform the current system of nursing home referral, admission, and care. There has been a lot of movement around nursing home reform since the inception of the Task Force:
- In a letter to chairperson Michael Gelder, Assistant Attorney General Thomas Perez of the United States Department of Justice expressed praise for the reform the Task Force promises.
- A Chicago Tribune article publicized Illinois Attorney General Lisa Madigan’s office and local police are performing unannounced visits and safety checks at troubled nursing facilities as a result of the Task Force.
- Multiple parties are drafting legislation for nursing home reform: the Nursing Home Safety Task Force, advocates for the elderly and mentally ill (AARP and others), and the nursing home industry.
February 18, 2010
Illinois Nursing Homes as Care Providers for Mentally Ill: How Did We Get Here?
The Illinois Nursing Home Safety Task Force has taken the initiative to address the serious situation of mixing populations of persons with mental illness with the elderly and others with physical disabilities in nursing homes. In moving forward to address the current challenges, it is helpful to look historically at how we arrived here.
Please read Health & Medicine's Center for Long-Term Care Reform’s research report that looks at the care of persons with mental illness after deinstitutionalization in the United States and in Illinois. It is our hope that this review will help as we plan for the future. If you have questions or comments about the document, please do not hesitate to call or email Kristen Pavle, or call Kristen at (312) 372-4292 ext. 27.
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November 24, 2009- Observations from Kristen Pavle, MSW Policy Analyst at Health & Medicine's Center for Long-Term Care Reform:
Recently attending an Elder Economic Security Initiative state partner summit in Washington, D.C., I had the privilege to meet with two Congressional staff policy advisors who worked for the Senate Special Committee on Aging.
The Senate Special Committee on Aging was established as a temporary committee in 1961 and was granted permanent status in 1977. Special committees do not have legislative authority, but are a reliable and essential source of research and information, and often useful in pushing legislation for consideration. It is currently chaired by Senator Herb Kohl (D-Wisconsin).
Some key Senators who have played a role in the Senate Special Committee on Aging include:
• Senator Frank Moss (D-Utah)—worked on paying attention to unacceptable nursing home conditions
• Senator Frank Church (D-Idaho)—focused on protecting older Americans from age discrimination
• Senator John Heinz (R-Pennsylvania)—researching the Medicare’s Prospective Payment System and the “quicker and sicker” discharge idea
The Special Committee on Aging staffers had much valuable information about current health and aging legislation, for example: the Nursing Home Transparency and Improvement Act(Senate Bill 647), the Physicians Payments Sunshine Act (Senate Bill 301), and the Medicare Payment Improvement Act of 2009 (Senate Bill 1249).
Health & Medicine is partnering with the University of Illinois at Chicago School of Public Health—Great Lakes Centers for Occupational and Environmental Safety and Health, in convening an Older Health Care Workers Workgroup. It was reassuring to hear that a key focus of this Special Committee was older workers! Here is a summary of current legislation on older workers from the Special Committee on Aging.
Please contact me if you have any comments or questions about my experience with the Senate Special Committee on Aging, the Elder Economic Security Initiative, or our Center on Long-Term Care Reform.
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CLASS Act - Long Term Care Receives Support at the National Level
Long-term care is receiving attention on a national level! Currently over 10 million people need long-term care services and supports, with an aging population this number is continuously growing. Long-term care services and supports are essential to helping older American age in their homes and communities. While we at Health & Medicine’s Center for Long-Term Care Reform recognize the dire need for a long-term care system in Illinois, it is good to see some recognition of these issues at a federal level as well.
The Community Living Assistance Services and Support (CLASS) Act is a bill “to amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes.”
The CLASS Act was introduced in both the House of Representatives (HR 1721) and the Senate (S 697), and is also included in the final health reform bill in the House, “America’s Affordable Health Choices Act (HR 3200).
The CLASS Act makes it more affordable and accessible for older adults and persons with disabilities who have long-term care needs to purchase care services helping them remain in their homes and communities.
Key Points:
• The CLASS Act would establish automatic enrollment of workers by employers in a national insurance program; workers may opt-out
- Enrollment in the program consists of monthly premium deductions from payroll
- Individuals must pay into the program for 5 years before claiming benefits
• The CLASS Act insurance program benefits persons needing non-medical long-term care services and supports, with two or more activities of daily living
- Activities of Daily Living include things like: eating, bathing, dressing, and transferring
• The Congressional Budget Office (CBO) concluded that the CLASS Act will not cost the government during the first 10 years
• The CLASS Act also alleviates the burden of financing long-term care for Medicaid
- A projected $2.5 billion will be saved in the first 10 years
The Kaiser Family Foundation does a great job explaining all the details. Check out their site There “The Sleep in Health Care Reform: Long-Term Care and the CLASS Act” has a wealth of information.
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HMPRG Testimony delivered to The Illinois Nursing Home Safety Task Force - October 20, 2009
Some background on the task force: Governor Pat Quinn appointed the Nursing Home Safety Task Force in response to a series of articles in the Chicago Tribune by David Jackson and Gary Marx. The central issue currently being addressed is the mixing of two populations with very different care needs: those with severe mental illnesses and the elderly. Yesterday at the
Illinois Nursing Home Safety Task Force Website:
Chicago Tribune coverage of Public Testimonies at October 20th Task Force Meeting ( Health & Medicine’s co-director of the Center for Long-Term Care Reform Phyllis Mitzen testified at the meeting and is quoted.)
Nursing Home Expose Series in Tribune:
http://www.chicagotribune.com/health/chi-nursing-home-screening-30sep30,0,4763747.story
http://www.chicagotribune.com/health/chi-nursing-home-businessoct01,0,4644230.story
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Older Health Care Workers Conference Follow-Up
Health & Medicine Policy Research Group and the Great Lakes Centers for Occupational and Environmental Safety and Health (University of Illinois at Chicago, School of Public Health) co-hosted the Older Healthcare Workers Conference in the morning of Tuesday September 29th, 2009. The conference, on campus at the University Illinois of Chicago, included roughly 50 participants with a diverse range of backgrounds. The conference was a successful stepping stone to convening major home care agencies, health care organizations and workers, policy and research professionals, and labor unions in addressing the important and growing population of older adult healthcare workers. Participants and organizers alike agreed that this conference is only the beginning of a dialogue that must be continued on the topic.
Speakers and workshops focused on five main areas of Older Healthcare Workers:
1.) recruitment and retention issues
2.) training and promotion
3.) workplace design and accommodating workers with disabilities
4.) wellness and health promotion programs
5.) workplace policies and legislative initiatives.
If you subscribe to the Health & Medicine comment feed, you will be able to post comments to some of the posts that appear in this section.
Conference Materials
- Conference Agenda
- Conference Speaker Bios
- Employer Case Examples
- Reading Resources Packet
- Vendor List
Conference Presentations (You can also view these in the slideshare.net reader in the far right column.)
- Keynote Presentation
- Civic Engagement and Older Adults
- Workplace Design for Workers with Disabilities
Additional Materials
- Averting a Care Crisis
- LEAP Towards Culture Change
- Building the Foundation for Quality Improvement
- Northwestern Memorial Hospital Safe Lifting Proram
Workshop Summaries
- Policy and Legislative Initiatives Workshop Summary
- Recruitment and Retention Workshop Summary
- Training and Promotion Workshop Summary
- Wellness and Health Promotion Workshop Summary
- Workplace Design Workshop Summary
Hello! Just wanted to open the discussion board up on the topic of Older Healthcare workers. Conference participants, please feel free to contact me (Kristen Pavle, kpavle@hmprg.org) to start a discussion on this page.
Posted by: Kristen Pavle | 10/08/2009 at 10:34 AM
I have spoken to one specialist, who has worked with HMPRG on the coordination of several conferences, including the Conference on Rural Aging and Translating Values into Action, both events hosted through HMPRG's Center for Long Term Care Reform.
Posted by: Sandres | 02/01/2012 at 11:36 PM