By Geralyn Magan
The LTSS Center recommends that you put these 5 articles on your reading list for September.
ON THE JOB, 24 HOURS A DAY, 27 DAYS A MONTH
“Rather than calling them low-wage workers, I would call these workers professionals who are paid low wages,” LTSS Center Co-Director Robyn Stone told New York Times writer Andy Newman for a Sept. 2 article about home health workers.
“They are taking care of people with very complex needs, people who have multiple chronic conditions, who may have all kinds of varied living environments,” Stone continued. “A lot of the families are really dysfunctional, and the aides have to deal with that, too. And they’re getting paid chump change, and it’s a travesty.”
The article follows Marjorie Salmon, a live-in home health worker, as she cares for a 77-year-old man named Bob in his Stamford, CT, home. Bob lives with Alzheimer’s disease and Parkinson’s Disease. Marjorie serves as “social worker, housekeeper, behavioral-modification expert, dietitian, diaper changer, day planner, de facto case manager, warden, and more,” writes Newman.
Newman intersperses poignant scenes from Marjorie’s challenging work day with disturbing statistics about home health care, including the fact that home care aides and personal care aides earn an average $11.52 an hour, and 45% of those who work full time are on public assistance.
“It is a vicious circle,” writes Newman. “Because these have always been poor-paying jobs, they are seen as lousy, low-skill jobs. And because they are seen as lousy, low-skill jobs, they pay poorly.”
STATES SCRAMBLE FOR NEW WAYS TO PAY FOR LATE-IN-LIFE CARE
“A lot of states have concluded that the cost of doing nothing now exceeds the cost of doing something,” LTSS Center Co-Director Marc Cohen told Boston Globe staff writer Robert Weisman for an Aug. 28 article about state efforts to finance long-term services and supports (LTSS).
The article describes why many states, “holding out little hope that a gridlocked Congress will come to the rescue,” are crafting policies to help millions of older adults with disabilities afford LTSS costs.
Weisman describes efforts in Massachusetts to address LTSS financing issues by making more residents eligible for the state Medicaid program. He also touches on LTSS financing efforts in other states, including New York, Illinois, Iowa, Minnesota, and Washington. Washington state recently created an insurance fund, seeded by a monthly 0.58% payroll tax, that will provide all residents up to $36,500 for LTSS expenses.
SASH: LOWERING MEDICAL COSTS FOR ELDERS LIVING AT HOME
Howard Gleckman, senior fellow at The Urban Institute, gave the Support and Services at Home (SASH) program a qualified endorsement in his Aug. 7 column for Forbes. Gleckman described a study conducted by RTI International and the LeadingAge LTSS Center @UMass Boston (formerly the LeadingAge Center for Applied Research).
The study, writes Gleckman, “finds that delivering care management and wellness nursing to an apartment building with large numbers of low-income seniors can produce a win-win for residents and developers.” Researchers found that SASH helped older adults stay at home and that it reduced Medicare costs by as much as $1,450 annually for some SASH participants.
“The model may not work for everyone,” writes Gleckman. “There appear to be important differences among rural and urban sites, among older adults and younger people with disabilities, and even among property managers. But for some, the SASH model is one that other states and developers should consider.”
EASING RURAL ISOLATION FOR YOUNG AND OLD
About 7% of the rural population in the U.S.—or 2.5 million people—say they have no friends or family nearby on whom they can rely, according to a recent poll by NPR, Harvard, and the Robert Wood Johnson Foundation. An additional 39%—about 14 million people—say they have only a few people who fit this description.
People in rural areas report “feeling lonely or left out,” researcher Carrie Henning-Smith told NPR for an Aug. 7 report on All Things Considered. Henning-Smith is one of the authors of a recent study on rural isolation, which has increased in recent years as rural economies declined and young people moved away.
The report focuses on a group in northeastern Minnesota that’s addressing rural isolation by bringing together young people and older adults to support each other. AGE to age connects more than 4,000 young people with almost 2,500 older adults each year. Children and older adults work on projects together while developing meaningful relationships.
CAPABLE: ON THE VERGE OF “EXPONENTIAL GROWTH”
An August 28 article in Home Health Care News shines a spotlight on CAPABLE, the evidence-based program that combines nursing care, occupational therapy, and handyman services to help older adults age in community. CAPABLE stands for “Community Aging in Place — Advancing Better Living for Elders.”
CAPABLE, developed at the Johns Hopkins School of Nursing, “is on the verge of ‘exponential growth’ and 1 step closer to becoming Medicare-reimbursable,” reports writer Robert Holly.
In June 2019, the Physician-Focused Payment Model Technical Advisory Committee (PTAC) voted unanimously to recommend that the Centers for Medicare & Medicaid Services test CAPABLE on a bigger scale “to inform payment model development.”
“There are many more hurdles to clear before CAPABLE has the chance to be reimbursed by Medicare, but getting PTAC’s support is an important first step,” said Sarah Szanton, the Hopkins professor who developed the program.