CMS Offers Extra Year to Spend Enhanced Medicaid Home Care Funding 

Modern Healthcare | By Maya Goldman
 
States will get an extra year to use enhanced Medicaid home- and community-based services funding, the Centers for Medicare and Medicaid Services announced Friday.
 
The dollars will now be available through March 31, 2025, for states that want the additional time, CMS wrote in a letter to Medicaid directors.
 
Congress provided states with a 10-percentage-point increase in federal Medicaid matching funds for home- and community-based services spending as part of COVID-19 relief legislation last year. States were originally required to spend the money by March 31, 2024.
 
"We are addressing states' concerns, giving states the time and resources to strengthen connections to care at home and in communities," CMS Administrator Chiquita Brooks-LaSure said in a news release.
 
States can use the funds to increase home care workers' pay, invest in capital improvements, expand home care offerings, broaden eligibility for services, improve health equity and support regulatory compliance.
 
As a condition of the increased matching funds, states cannot create stricter eligibility standards for Medicaid home care, reduce home- and community-based service payment rates or scale back the scope of services. All 50 states and the District of Columbia earned approval to claim the higher funding.
 
President Joe Biden's administration pushed for permanent expanded funding for home- and community-based services but the effort stalled in the Senate. The administration asked for $400 billion to be included in a budget reconciliation package last year. The House passed a bill in November that would have authorized an additional $150 billion for home- and community-based services, but the measure died in the upper chamber.
 
Senate Aging Committee Chair Bob Casey (D-Pa.) and other proponents continue to press for the more money to support these services.
 
"An investment in home-based care is urgently needed. It will help people get back to work. It will give families peace of mind because they know that their loved ones are cared for. It will also give home care workers, the majority of whom are women from communities of color, a much-needed and long overdue raise," Casey said in a news release in March.

To Treat or Not to Treat Disease at the End of Life

Barbara Karnes

Dear Barbara, my friends are getting terrible diagnoses. The women I am seeing are way too young to die. How do they make the decision to throw everything at their disease in the form of treatments that offer the low odds they will survive and poor quality of living during the treatment time or to “make the best” of the time they have left with no treatment?

The uncomfortable truth is disease and dying have no age barrier, it happens when it happens. You are so right that the decision to treat or try to live your best life is monumental, and age does play a factor in those decisions.

I have no answer in the decision making---too many circumstances come into play for a one size fits all answer---but here are some things I would consider:

*Age: I’ll get some slack on this statement but anyone over 75 in my mind requires quality of life thinking. What is the quality of the living I have left compared to being VERY sick with treatment options for an undetermined amount of time, if not always? Are many months of response to treatment (and maybe for the rest of my life) worth the extra breaths? For some, it will be. For others, maybe not.

*Extent of disease progression: How advanced is the disease in its progress toward ending life? What is the prognosis for the end result of treatment? Is it simply to reduce the tumor size and limit further disease progression? Is the purpose of treatment to eliminate or simply control? Is it to offer an active, fulfilling lifestyle when treatments are finished? Does treatment bring about a cure and a return to a normal, active life or is treatment slowing the disease progression but not eliminating it?

*What happens if I say no to treatment options? A scary question to ask, but important when making a quality of living decision. No one can put a number on how long someone has to live. There are too many personal factors determining the breaths we take BUT guesstimates can be made in years and months…

Read Full Article

NIHCM Foundation COVID-19 Updates

The U.S. is entering the third summer of the pandemic, the sixth wave of COVID, and many people  are getting sick for the first time. Cases are six times higher than last summer, fortunately, hospitalizations remain in check. In addition, people are likely to get COVID multiple times. See the latest developments on the pandemic:

• New Vaccine: The Food and Drug Administration met Tuesday and endorsed the Novavax shot. This vaccine was developed using decades-old technology and is an important option for those who are unable to take an mRNA vaccine.
• Children’s Vaccinations: Kids are at risk of severe COVID outcomes and almost 90% of children hospitalized during the omicron wave were unvaccinated. Fortunately, the White House says COVID vaccination for kids under five could start in a few weeks.

Long COVID: A CDC study suggests that more than one in five adult COVID survivors in the U.S. may develop long COVID. Many want to know whether they have long COVID and there are more than 200 symptoms of the condition.

Memory Loss and Brain Health Resources for Veterans and Caregivers

June is Alzheimer’s and Brain Awareness Month. An entire section of www.va.gov/Geriatrics is devoted to Mental Health, Memory Loss and Brain Health information for Veterans, their families and caregivers:

• Alzheimer’s and Dementia Care – Care for Veterans with Alzheimer’s or dementia is provided throughout the full range of VA health care services. Learn more about resources for Veterans, families and caregivers.

• Brain Health – There are many links between brain health, physical health and mental health. VA’s booklet, Brain Health and Quality of Life in Aging: Tips on Staying Sharp and Active, lists some of the reasons for problems with memory and thinking and what you can do about them.

• Delirium – Delirium is also known as “brain failure” or “confused state” and happens rapidly. It causes problems with attention, thinking, memory, and emotion. Learn more about what causes delirium, who is at risk for delirium, what can be done about delirium and resources about delirium.

• Mental Health and Suicide Prevention – VA provides a range of mental health programs and resources for Veterans of all ages, backgrounds and service eras. Learn more about programs that focus on the needs of older Veterans.

To learn more visit www.va.gov/Geriatrics.