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New voluntary disability insurance program would provide relief to millions of all ages

As part of national heath care reform, individuals will now have new access to the assistance they need to stay in their homes while simultaneously cutting health care costs by preventing institutionalization in hospitals or assisted living facilities.

The Community Living Assistance Services and Supports (CLASS) Act creates a national, voluntary disability insurance program under which: (1) all employees are automatically enrolled, but are allowed to waive enrollment; (2) payroll deductions pay monthly premiums; and (3) two-tiered benefits are provided, based on the level of disability, to purchase non-medical services and supports that the beneficiary needs to maintain independence.

“This issue transcends individual politics,” says Laurie Edwards-Tate, MS, President and Founder of At Your Home Familycare in San Diego, California. “Whether you support or oppose the recently passed national health care reform legislation, there is a basic issue we can all agree on. It is far more humane and cost effective to take care of people in home care and maintain their independence for as long as possible, as opposed to an acute care setting.

“Passage of the CLASS Act is welcome news to those of us in the home care field. As a private duty provider with 26 years of experience, I welcome the CLASS Act as a simple, cost-effective program that will help millions of people get the assistance they need to stay in their homes while cutting health care costs at the same time.”

The need for services to support an aging and disabled population is expanding at a faster rate than ever before. Currently there are 10 million Americans in need of long term services and support, and the number is expected to increase to near 15 million by 2020.  In 2009, the market for in-home care nationwide hit approximately $15 billion.

According to a recent study from the SCAN Foundation (“Caring,” January 2010), Americans across all demographic groups are concerned about the future of long-term care, which is critical in providing products and services to the aging population.  92 percent of people surveyed say it’s important to improve coverage for services that help people remain in their homes instead of going into nursing homes; 90 percent of Republicans, 89 percent of Independents, and 97 percent of Democrats say improving coverage to help people remain in their homes is important.

The CLASS Act will make about $27,000 per year in assistance available to those who need it and that would take a big chunk out of the financial obligation, according to the Private Duty Homecare Association.

Most private-sector disability or long-term care insurance plans are limited in the insurance protection they can offer at an affordable price. Many Americans who have or develop disabilities can only access coverage for the services critical to their independence such as housing modifications, assistive technologies, transportation, and personal assistance services through Medicaid.  This creates a strong incentive for them to “spend down” assets and remain poor and unemployed.

With Medicaid paying 50% of the costs of long term services, without CLASS coverage expenses in tandem with private insurance plans, increased expenditures on long term services would add $44 billion annually to the cost of Medicaid over the next decade, just as Medicaid funding is being reduced.

“I urge Secretary of Health and Human Services Kathleen Sebelius to implement the CLASS Act as swiftly as possible,” added Edwards-Tate.

NOTE: For more information on the CLASS Act, visit www.passtheclassact.org

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Years ago, I volunteered at a local convalescent home throughout the summer before high school. My grandmother was a resident there.

She glowed and smiled as I assisted residents with their bingo games, wheelchairs, and bedside water carafes. I never fully understood why she was so proud of me or why my presence meant so much to her.

As a home care professional today, running my company At Your Home Familycare for 26 years, now of course I understand how much a young person’s time and attention means to an older adult.

While spending time at my grandmother’s convalescent home, I met Mrs. Lloyd. Much younger than my grandmother, I was surprised to see her there.  When I was informed that Mrs. Lloyd had multiple sclerosis or MS, I did not know what it was or what it meant.

My grandmother would socialize with her, and both her and Mr. Lloyd when he came to visit, which was frequently.  When chatting with them, I asked about Mrs. LLoyd’s condition. Mrs. Lloyd openly shared information about her disease, how it had affected her, and that it had now progressed to a point where she could hardly move which is why her home was now a convalescent home.

I remember Mrs. Lloyd being an almost motionless being, always dressed well, hair always in place, smile always on her face – but motionless. When joining my grandmother and the Lloyd family for meals, Mrs. Lloyd required assistance to eat. She was completely dependent on a caretaker’s help.

I also remember that Mrs. Lloyd was radiant, sweet, caring, peaceful, and reassuring to those around her, as if to give us permission to be OK with HER disease.  Most of all, I remember how much she smiled – almost all the time, as if to give a gift to those around her.  I recall liking her very much, and not understanding HOW she could be so nice or so pleasant.

At Your Home Familycare has provided respite care services for those with MS for several years as a contractor of the National Multiple Sclerosis Society, Pacific Coast Chapter, based in Carlsbad.

For several years, Karen Hooper, Vice President, had invited me to attend the CEOs Against MS Breakfast, and I finally did. It was truly one of the most powerful experiences I have had while working in the human services field.

Personal stories were shared by heroes whose lives are being affected by this incurable, neurological disease.  Working professionals, families, children, trying to managing their lives while struggling to cope. Some described having to inject themselves daily with unbearably painful drugs to stave-off MS’s progression. Some of our heroes are coping as their MS has progressed causing mild to severe incapacitation.  These are all amazing individuals, with a positive attitude, an inspiring story, and a zest for life despite having so many hopes and dreams dashed.

I was so impacted by this experience that I created Team At Your Home Familycare in 2009. We participated in an MS Walk at Liberty Station that year.

I’ve since learned that MS is a chronic, unpredictable, and terribly disabling disease of the central nervous system. There is no known cause, cure, or method of preventing MS. This neurological disease interrupts the flow of information from the brain to the body and stops people from being able to move. Most people are diagnosed between the ages of 20 and 50. More than twice as many women as men are affected, like Mrs. Lloyd. Symptoms cannot be predicted. They vary greatly from person to person, ranging from numbness in the limbs to loss of balance to paralysis, like Mrs. Lloyd. MS affects more than 400,000 people in the United States and 2.5 million people worldwide.

This year, I am honored to be among San Diego’s Honorary CEOs Against MS, and Team At Your Home Familycare is walking again. We hope to double our fundraising this year!

Please join us April 24 at Liberty Station. You can even bring your favorite canine and best-friend to walk with you.

It’s easy to donate. Click on the MS Walk button on the At Your Home Familycare web site to contribute online, or to get information about other ways to donate. Every little bit adds up to a lot.

I now understand in retrospect how significantly my early-life experience knowing Mrs. Lloyd has impacted me. Thinking about Mrs. Lloyd, and the affect MS had on her and her entire family, I feel grateful to be able to do what I can today through your support to help raise awareness AND dollars.

We simply must find a cure for debilitating diseases such as MS. Until then, I’m privileged through At Your Home Familycare to provide services and support to those affected until we do.

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“Our home care aide is a loving, caring, professional home care specialist. She treats her patient like family and our entire family cannot thank you enough!”
TG  | Del Mar

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Interesting article on “Family Caregivers Play Vital Role” in the Disabled American Veterans monthly magazine.

Click on the link below and navigate to page 22 using the page controls at the top of the screen.

http://www.dav.org/news/magazineGallery.html

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Due to unprecedented growth in the senior population over the next 30 years, and the uncertainty regarding the future of national health care reform, the Private Pay Market is on the throes of explosive growth, especially in the area of Private Duty/Private Pay services in one’s home as a preferred alternative to institutionalization.

According to a recent study from the SCAN Foundation (“Caring,” January 2010), Americans across all demographic groups are concerned about the future of long-term care, which is critical in providing products and services to the aging population.  Here are the key findings:

• 92 percent of people surveyed say it’s important to improve coverage for services that help people remain in their homes instead of going into nursing homes;

• 90 percent of Republicans, 89 percent of Independents, and 97 percent of Democrats say improving coverage to help people remain in their homes is important;

• 78 percent of Americans say they would benefit personally if health care reform included coverage for long-term care services; and

• 68 percent say it’s very important to improve coverage for services that help people remain in their homes.

Given these beliefs and desires shared by the majority of Americans, it’s surprising and dismaying to find that both the House and Senate budget proposals contain cuts to Medicare home health funding. The House proposal contained $54.9 billion over 10 years, while the Senate version proposed home health cuts of $39.4 billion over the same period.  (NAHC Report, January 28, 2010).  These proposed cuts will come nowhere near serving the anticipated needs of Medicare recipients.

With these proposed Medicare cuts to home health care (medical care in the home which is generally episodic), we will see a corresponding growth in the need for Private Pay services (supportive, often non-medical, and long-term).

It is evident that something must be done to care for seniors, disabled, and chronically ill which will help them remain safely and securely at home. It is by far the most efficient and cost-effective form of support versus placing an individual in an assisted living or institutional situation, something the vast majority of families wish to avoid. As a result, expectations appear to be transitioning to the individual and their families to bear both the responsibility and the cost. Potential sources include family, private long-term care insurance, personal savings, reverse mortgages, and other forms of out-of-pocket payment.

So, “as the name suggests, private pay home care services are those which are arranged and paid for by individuals or members of their family” (Val Halamandaris, President, NAHC, “The Best of Caring,” 2009).

I remember working at a hospital years ago. I walked into a patient’s room and saw a nurse, sitting by her bedside, dressed in a white nurses’ uniform and adorned with a crisp, white cap.  When I asked who she was, she said:  “I am a private duty nurse….I was hired by the family to provide extra supervision for their family member.”

Now, as the economics of health care change, and the senior demographic expands, no longer is Private Duty merely a nurse providing extra duty at a hospital.  The potential scope of Private Duty/Private Pay services has expanded considerably, and may include an array of services ranging from personal care services to skilled nursing to telehealth to supervised home maintenance–and countless, potential additional services, some of which we may not have yet envisioned– which help maintain an individual safely and securely in his home.

This reality hits just as the need for services to support an aging population is expanding at a faster rate than ever before. In 2009 the market for in-home care nationwide is projected to reach approximately $15 billion, exhibiting a decade-long average compound annual growth rate of 10%. This industry is in its infancy.

Today, there are 36 million adults age 65 and over in the United States. This population is expected to nearly double to 70 million over the next 30 years. With an increasing average life expectancy for Americans reaching over 75 years of age, the need for senior care will continue to escalate.

Considering the growing potential for costly institutional, long-term care caused by the loss of publicly funded home care, Private Duty/Private Pay services will be eagerly sought ought and privately funded. The question is whether the industry will be ready with the capacity needed to provide these services to all those who seek them.

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Tips for aging well increasingly focus on mental health as well as keeping active.

Living a healthier lifestyle is the most common New Year’s resolution. It’s a resolution that takes on even more importance as we age.  Losing weight, eating healthier, quitting smoking, and exercising are all important factors in staying healthy.

But research now shows that a positive attitude, social interaction and mental exercise may play an even more important a role in aging well.

Researchers from Boston University School of Medicine’s New England Centenarian Study found that people who were less uptight and friendlier lived longer, healthier lives. Other researchers including University of California Irvine psychologists conducting a study of people over 90 years old agree that mental engagement such as doing crossword puzzles, reading books, and even playing bridge prevents memory loss. Social connections including interaction with friends appear to play a critically important role. In isolation, a healthy human mind can go blank and quickly become disoriented, psychologists have found.

Laurie Edwards-Tate, MS, President and Founder of At Your Home Familycare, says she’s also found this to be true, based on her experience working in the home care field for 26 years. Edwards-Tate says maintaining mental toughness, choosing a positive outlook and forging close ties with family and friends can set the stage for healthy aging.

“We cannot always control what happens to us, but we can control our reaction to what happens,” said Edwards-Tate.  “Gratitude and acceptance, taking personal responsibility and choosing to overlooking the negative and be happy despite life’s imperfections help people maintain a good quality of life.”

Edwards-Tate says resolving to push back against ageism is a resolution all of us can keep. “How old would you be if you didn’t know how old you actually are in numbers? Paying attention to both your physical and mental health, having a purpose in life, connecting with others and above all, embracing resilience allows us to age well.”

Edwards-Tate says it’s not about denying aging or trying to stop the clock. It’s defying society’s negative expectations about what age means.

Edwards-Tate offers up her personal “Aging Well Checklist.” How many of these traits do you possess?

•    Strong self-esteem
•    A well defined inner compass
•    Strong ethics and personal integrity
•    Mental toughness
•    Close loving ties with supportive family and friends
•    Knowing your passions
•    Doing activities you truly enjoy, not necessarily the ones others expect you to do
•    Being able to sometimes say “no”
•    Giving of yourself to charitable causes and to others
•    Healthy eating habits on a consistent basis
•    Caring for mind, body, and spirit
•    Having a purpose to your life
•    Taking personal responsibility for the quality of your life
•    Acceptance of life’s ups and downs, including losses
•    Gratitude for the good and even the “not-so-good”
•    Overlooking the negative and embracing the positive
•    Facing life realistically without losing your sense of wonder and discovery
•    Choosing to be happy despite life’s imperfections
•    Experiencing growth by working through the painful aspects of life
•    Not settling for less than what will make you truly happy and healthy
•    The determination to survive no matter what
•    Resilience in the face of any challenge – the ability to pick yourself back up no matter what
•    Rejecting ageism!

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At Your Home Familycare’s Laurie Edwards-Tate is quoted in an article on the San Diego News Network about how pending legislation could affect senior San Diegans.

“Senate health care bill could hit senior San Diegans hard”
Read more: http://www.sdnn.com/sandiego/2009-12-21/health-fitness/senate-health-bill-could-hit-senior-san-diegans-hard##ixzz0blIACDO6