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Senate hearing reveals discrimination against medicaid LTC patients
Senate Hearing Reveals Discrimination Against Medicaid LTC Patients WASHINGTON -Medicaid patients are strongly discriminated against when seek ing admission to nursing home s, according to Sen. John Heinz (R-PA) . Heinz, who is chairman of the Senate Committee on Aging , has sent a letter to Department of Health and Human Services Secretary Margaret Heckler requesting that immediate action be taken by DHHS to end such discrimination. The Senate Committee on Aging had held hearings in late 1984 during which witnesses testified th at nursing home residents or their fam ilies were told they would have to sign private contracts with the longterm care facility they were seeking admission to as a condition of acceptance or in order to stay in the facility they resided in. This " priva te" contract would stipulate that the patient or family would pay full private nursing rates for a specified period of time before switching over to Medicaid reimbursement.
Heinz: Angered by the Administration's refusal to participate in the hearing.
Heinz has requested DHHS secretary Heckler to take action on proposed legislation that prohibits nursing homes from asking for money from Medicaid patients or families beyond Medicaid reimbursement. Heinz and other members of the committee expressed resentment at DHHS's failure to send a representative to the Senate hearing. The committee has warned that if no action is taken by DHHS on discrimination against Medicaid nursing home patients the committee will draft legislation to protect Medicaid recipients.
Western Gerontological Society Meeting Focuses on Respite Care, Mental Health, Nutrition, and Protective Services VANCOUVER, W A-New respite care, protective services for abused elders, mental health, and nutrition were among topics considered at the Western Gerontological Society meeting that took place here and in Portland, OR, October 21-24. Spokesmen for the Washington State Bureau of Aging and Adult Services criticized state legislation passed earlier this year on respite care. These speakers charged that strict eligibility requirements may prevent participation by many poor applicants. The state had approved a
$500,000 a year demonstration project for respite care. Legislation enacting the program set what some have claimed are restrictive criteria for both the disabled participants and their caregivers. The caregiver must be a spouse, friend, or relative who has responsibility for the care of the functionally impaired adult. The covered participant must be an adult who needs almost continuous care because of disability and who would need to be institutionalized unless admitted to the respite program. The program is designed to prevent the emotional and
physical exhaustion of caregivers. A respite program considered by many at the meeting to be simpler and better suited to the needs of state residents was discussed by Louise Dunn. Ms. Dunn is program director of the Senior Respite Care Program in Portland, OR. The SRCP gives income supervision and companionship for overwhelmed caregivers. It provides 16 hours per week of respite on weekdays and was designed to give shortterm relief. A copy of the plans on which the program is based is available for $5 each. SRCP can be contacted at 503-229-7706. Alvin Levenson of the University of Texas Medical School discussed mental illness in the aged at the conference. Levenson emphasized that while an estimated 3 to 5 million aged Americans are thought to suffer from a mental illness requiring treatment, many elders are incorrectly diagnosed as mentally ill when a physical ailment is at fault . Levenson went on to state his belief that elders should be medicated (whether for physical or emotional illnesses) at one-third to one-fourth the generally accepted adult dosage. This dosage can then be incrementally increased. Levenson believes this approach will lead to fewer drug overdoses . Washington State spokespersons described legislation that allows the use of legal guardians as a last resort in cases of extreme elder abuse. The guardianship provision would be invoked in situations where state authorities are denied access to persons suspected of being abused or in cases of repeated physical or emotional abuse. Aged women should have an intake of at least 1,500 mg. per day of calcium, according to a report at the meeting by Robert Hackman, MD, of the University of Oregon. The additional calcium should be achieved through supplements that also provide a 2: I ratio of magnesium, according to Hackman. He estimates that 10 percent of women over 60 have osteoporosis and that another 20 to 30 percent are developing this bone disorder. See "Calcium Update," p. 48. Geriatric Nursing January/February 1985 7
Heinz: Angered by the Administration's refusal to participate in the hearing.
Heinz has requested DHHS secretary Heckler to take action on proposed legislation that prohibits nursing homes from asking for money from Medicaid patients or families beyond Medicaid reimbursement. Heinz and other members of the committee expressed resentment at DHHS's failure to send a representative to the Senate hearing. The committee has warned that if no action is taken by DHHS on discrimination against Medicaid nursing home patients the committee will draft legislation to protect Medicaid recipients.
Western Gerontological Society Meeting Focuses on Respite Care, Mental Health, Nutrition, and Protective Services VANCOUVER, W A-New respite care, protective services for abused elders, mental health, and nutrition were among topics considered at the Western Gerontological Society meeting that took place here and in Portland, OR, October 21-24. Spokesmen for the Washington State Bureau of Aging and Adult Services criticized state legislation passed earlier this year on respite care. These speakers charged that strict eligibility requirements may prevent participation by many poor applicants. The state had approved a
$500,000 a year demonstration project for respite care. Legislation enacting the program set what some have claimed are restrictive criteria for both the disabled participants and their caregivers. The caregiver must be a spouse, friend, or relative who has responsibility for the care of the functionally impaired adult. The covered participant must be an adult who needs almost continuous care because of disability and who would need to be institutionalized unless admitted to the respite program. The program is designed to prevent the emotional and
physical exhaustion of caregivers. A respite program considered by many at the meeting to be simpler and better suited to the needs of state residents was discussed by Louise Dunn. Ms. Dunn is program director of the Senior Respite Care Program in Portland, OR. The SRCP gives income supervision and companionship for overwhelmed caregivers. It provides 16 hours per week of respite on weekdays and was designed to give shortterm relief. A copy of the plans on which the program is based is available for $5 each. SRCP can be contacted at 503-229-7706. Alvin Levenson of the University of Texas Medical School discussed mental illness in the aged at the conference. Levenson emphasized that while an estimated 3 to 5 million aged Americans are thought to suffer from a mental illness requiring treatment, many elders are incorrectly diagnosed as mentally ill when a physical ailment is at fault . Levenson went on to state his belief that elders should be medicated (whether for physical or emotional illnesses) at one-third to one-fourth the generally accepted adult dosage. This dosage can then be incrementally increased. Levenson believes this approach will lead to fewer drug overdoses . Washington State spokespersons described legislation that allows the use of legal guardians as a last resort in cases of extreme elder abuse. The guardianship provision would be invoked in situations where state authorities are denied access to persons suspected of being abused or in cases of repeated physical or emotional abuse. Aged women should have an intake of at least 1,500 mg. per day of calcium, according to a report at the meeting by Robert Hackman, MD, of the University of Oregon. The additional calcium should be achieved through supplements that also provide a 2: I ratio of magnesium, according to Hackman. He estimates that 10 percent of women over 60 have osteoporosis and that another 20 to 30 percent are developing this bone disorder. See "Calcium Update," p. 48. Geriatric Nursing January/February 1985 7