Elder Abuse and Aging Top Issues at Boston Forum

“Older adults are an asset to our country,” said Sylvia Burwell, U.S. secretary of health and human services, at a White House Conference on Aging regional forum in Boston on May 28. Burwell was a keynote speaker at the final of five invitation-only regional forums designed to engage older Americans, their families, caregivers, advocates, community leaders and experts on key issues affecting seniors. Their ideas and opinions will help set the agenda for the White House conference on July 13 …

Paying for Home- and Community-Based Services: Lessons From Oregon

Many older adults need services to stay in their homes or in community-based settings. Getting help with shopping, meal preparation, transportation, medication management, bathing, dressing or mobility can extend community living. But Medicare and private health insurance do not pay for these types of services, and Medicaid (which does) is limited to people with low incomes and almost no savings. As a result, most people pay for these services out of their own pockets. The Symposium Even people who can …

The New Federal Rule on Home- and Community-Based Services: All Eyes on the States

The U.S. Centers for Medicare & Medicaid Services (CMS) recently took an important step toward helping low-income people with disabilities. In January, CMS issued a final rule [CMS-2249-F/CMS-2296-F] giving states new flexibility and responsibilities for using Medicaid dollars to pay for home- and community-based services (HCBS). The rule – which should help Medicaid recipients overcome fragmented systems of care and limited options for living in the community – is likely to affect states in three significant ways. New Definition of …

The Future Supply of Family Caregivers

   Shakespeare declared, “What’s past is prologue.” This statement captures the demographic trends that predict the future supply of family caregivers in the United States. The past may be prologue, but the future ability of families to care for their aging members who encounter disabilities will be a “brave new world,” to quote the Bard again. In a recently released paper, we defined a “caregiver support ratio” as the number of potential caregivers ages 45-64 for each person age 80 …

Medicare Does Not Pay for Long-Term Care

Many consumers and policymakers mistakenly believe that Medicare – the federal health insurance program for people age 65 and older and some younger people with disabilities – pays for long-term care. It does not, as stated in the official Medicare handbook. Millions of Medicare enrollees must pay for long-term care services (such as personal assistance at home, assisted living, and nursing home care) entirely from their own income and savings. Confusion often stems from misinterpretation of coverage provided by Medicare’s …

Home and Community-Based Services: The Right Place and the Right Time

As evidenced at a recent hearing of the federal Commission on Long-Term Care, broad support is building: It’s time to end Medicaid’s “institutional bias.” It’s not rational that Medicaid entitles eligible individuals to be placed in nursing homes, while limiting their ability to receive services at home. On average, the Medicaid program can serve about three older people or adults with physical disabilities with home- and community-based services (HCBS) for the cost of putting one in a nursing home. Moreover, …