In The News

National Organizations Support ‘The Resetting the IMPACT Act’

Major post-acute care organizations, including the National Association for Home Care & Hospice (NAHC), have commended members of Congress for introducing The Resetting the IMPACT Act (TRIA) of 2021 and urge legislators to support the bill.

This legislation would make amendments to the unified post-acute care payment prototype that was mandated under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.

NAHC reports, “While we support many of the goals of the Act — such as the standardization of key patient assessment elements like social determinants of health — we also jointly share a number of concerns that predated the PHE. One of our primary concerns relate to the fact that each of our PAC settings have undergone significant payment system reforms in the past few years, and these changes have not been fully reflected in the Centers for Medicare & Medicaid Services’ (CMS) prototype work-to-date. To help address this issue, we have urged collection and incorporation of more current data to ensure payment adequacy for all providers.”

Additionally, factors related to the COVID-19 pandemic would significantly complicate the use of data from this period in any sort of unified PAC payment analysis and modeling effort. NAHC therefore, “applauds TRIA of 2021’s provisions that would exempt any data from the PHE from being captured in the unified PAC payment prototype,” and, “views this legislation as being a critical safeguard for patients, providers, and the Medicare program at large. “


A Third of Americans Rely on the Unregulated ‘Gray Market’ for Senior Care

Home Health Care News
By Andrew Donlan | June 21, 2021
Nearly a third of Americans who pay for senior care hire workers that aren’t tied to a regulated agency, a new study from RAND Corporation suggests. Instead, these individuals hire or use workers from the “gray market,” or the unregulated market of under-the-table labor.
For professional home-based care agencies, the findings suggest there’s a huge, untapped market for their services, but only if they can tailor costs to middle-income individuals.
Generally, families use the gray market for a variety of reasons, some of which are still unclear. But often, it’s because they don’t qualify for Medicaid and cannot afford private-pay services.
“They don’t really have a good care solution to be able to provide affordable, high-quality care to their loved one,” Regina Shih, the study’s lead author and a senior policy researcher at RAND, told Home Health Care News. “They’re kind of stuck in the middle with no other choice. And the gray market might be filling that need to be able to find affordable, good quality care.”…
The US. is “in a crisis right now,” she explained. Beyond Medicaid, there just isn’t a cost-effective option for people looking to age in place.

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When Is It Time To Say "Good bye"?

There is a saying, “Live each day as if it were your last.” It makes sense that last day of our lives is the day we would want to say goodbye. Unfortunately, on our last day we probably won’t be able to say goodbye. If we are dying a gradual death from disease we will be non responsive. If it is a fast death those people who mean the most to us probably won’t be with us.

SO--when is it time to say goodbye? Everyday! Live each day so that at the end of it there are no regrets, no unfinished business, and nothing that will create guilt feelings later.

The above is actually my life philosophy. I really think the person who asked the question, "When is it time to say goodbye?" was referring to "when do we say our final goodbye to someone who is dying?" I believe we say our goodbye in stages.

Ideally, we have already expressed our appreciation for the relationship and our goodbyes in the months to weeks before death actually occurs. We have an intimate conversation when the person who is dying is still alert and interacting with us. Later, in the hours to minutes before death, when the person is non responsive we say goodbye again. It is easier to talk to a person who is non responsive, to say everything our heart tells us to say. This is the goodbye where you talk about the difficult times as well as the good times. A cleaning of the slate so to speak. 

Another goodbye is said after the person we care about is dead. This is done at the bedside before the body is taken to the mortuary or at the coffin. This goodbye is said out loud or within your heart.

Then there is a final goodbye. I recommend we write a letter to put all of our thoughts on paper. Write about the relationship, positive and challenging, write about love, forgiveness, and understanding. Whatever is in your heart that still needs to be said, write it down. That letter can go into the coffin (under the hands, or pillow, wherever you feel led to place it), or, if there is no coffin, do something special with the letter. Keep the letter in a special place, burn it and release the ashes to the wind, or put it over flowers in a garden. Do something special with it.

When is the time to say goodbye? Many, many, times. 

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U.S. Hits Encouraging Milestones on Virus Deaths and Shots

The Associated Press reports, “COVID-19 deaths in the U.S. have dipped below 300 a day for the first time since the early days of the disaster in March 2020, while the drive to put shots in arms hit another encouraging milestone Monday: 150 million Americans fully vaccinated. The U.S. death toll stands at more than 600,000, while the worldwide count is close to 3.9 million, though the real figures in both cases are believed to be markedly higher. About 45% of the U.S. population has been fully vaccinated, according to the CDC. Over 53% of Americans have received at least one dose of vaccine. But U.S. demand for shots has slumped, to the disappointment of public health experts.”

Despite the progress, WebMD Health News reports, “More people need to get vaccinated if the United States wants to prevent the spread of deadly variants this winter, says a top vaccine expert. ‘Vaccines are our only way out of this,’ Paul Offit, MD, a member of the FDA Vaccines and Related Biological Products Advisory Committee, said on CNN. ‘Unless we vaccinate a significant percentage of the population before winter hits, you're going to see more spread and the creation of more variants, which will only make this task more difficult.’”


Better Care Better Jobs Act

While progress seems to being made towards a bipartisan infrastructure bill (or at least on its framework) without including HCBS funding as part of the plan, House and Senate supporters of HCBS aren’t waiting to carve-out a stand-alone bill. 

Senators Casey, Wyden and Schumer, along with Senators Murray, Duckworth, Brown and Hassan, and Representatives Dingell, Pallone, Schakowsky and Matsui will soon introduce the bicameral Better Care Better Jobs Act. The legislation would make President Biden’s bold vision to expand home and community-based services infrastructure, a key component of the American Jobs Plan, a reality. 

A one-pager and section-by-section of the billcan be found here. The legislative text can be found here.

If your organization would like to be listed as a supporting organization of the bill please email: [email protected]  

For questions about the policy, contact Liz Dervan ([email protected]), Keith Miller ([email protected]), Michael Gamel-McCormick ([email protected]), Tim Huebner ([email protected]) or Rick Van Buren ([email protected]

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