“The Biden-Harris Administration is deeply committed to ensuring everyone is able to get the high-quality care they need – within the comfort of their own home or community,” said HHS Secretary Xavier Becerra. “Today we are expanding access to home and community-based services so even more states and territories are equipped to best serve the millions of seniors and people with disabilities across the country.”

“We’re putting the full weight of this agency behind solutions that can meet people where they are and help get them to where they want to be when it comes to health care,” said CMS Administrator Chiquita Brooks-LaSure. “Money Follows the Person has a proven track record of helping seniors and people with disabilities transition safely from institutional care to their own homes and communities. Letting ‘money follow the person’ is key to those successes, and to the Biden-Harris Administration’s commitment to affordable, accessible, person-centered care.”

Awards of up to $5 million are being announced for Illinois, Kansas, and New Hampshire, as well as for American Samoa and Puerto Rico – the first time MFP grants have been made available to territories. These awards will support the early planning phase for their MFP programs. This includes: 

• Establishing partnerships with community stakeholders, including those representing diverse and underserved populations, Tribal entities and governments, key state and local agencies (such as state and local public housing authorities), and community-based organizations;
• Conducting system assessments to better understand how HCBS support local residents;
• Developing community transition programs;
• Establishing or enhancing Medicaid HCBS quality improvement programs; and
• Recruiting HCBS providers as well as expert providers for transition coordination and technical assistance.

A new report from CMS also describes how MFP has helped facilitate more than 107,000 transitions out of institutional settings since 2008. It also indicates that, thanks in part to programs like MFP, more than 85% of people who used Medicaid long-term services and supports in 2019 received HCBS rather than institutional services. First authorized in 2006, MFP has provided states with more than $4 billion to support people who choose to transition out of institutions and back into their homes and communities.

Supporting HCBS is a critical part of the Biden-Harris Administration’s commitment to helping older adults and individuals with disabilities live safely and independently in their homes and communities. Medicaid is the primary funder of HCBS nationally, and plays a critical role in supporting states’ efforts to strengthen these services for their beneficiaries. Through the American Rescue Plan, President Biden temporarily increased Medicaid funding for HCBS, and every state elected to participate in this program has submitted a detailed plan for how they will use these funds. The administration estimates that this change will ultimately result in $25 billion in increased funding, allowing states to develop innovative ways to address existing HCBS workforce and structural issues, expand the capacity of critical services, and begin to meet the needs of people with disabilities, family caregivers, and providers. In June 2022, HHS notified states that they now have an additional year – through March 31, 2025 – to use this critical funding made available by the American Rescue Plan.

For more information on MFP, visit Medicaid.gov.

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The state of California has a $45 billion budget surplus. Gov. Gavin Newsom’s proposed $285 billion spending proposal kept the surplus in mind when earmarking money for COVID-19, climate change, homelessness and other issues. Missing, however, is adequate funding for California’s largest growing demographic – older adults – who continue being stiffed big time in government spending.

California’s high cost of living, coupled with inadequate state funding, has created massive shortages of affordable housing, caregivers, community-based resources, affordable long-term care services at all levels, and more. Factor in fixed-incomes and insufficient pensions (or no pensions), and you have an epidemic of suffering and expanded poverty.

We have played Ring-Around-the-Rosie with inadequate planning, data and no credible action plans for too long. Yes, we have plans, like the Master Plan on Aging – but no mandated, immediate action plan. Many of us see the Master Plan on Aging as a frustrating subterfuge for the decades of not addressing older adult issues.

Before President Ronald Reagan crippled public health , I was California’s last long-term care and intensive care neonatal health planner. I worked with local health systems agencies on data, planning and recommendations culminating in an annual action-driven state health plan.

The plan showed gaps in services, need assessments, data, and it specified immediate actions for improving the problems. Thanks to a lazy Legislature that doesn’t want state reports, lobbyists for special interest groups helped destroy data collection and made planning difficult. Chaos and guesstimating are how we operate now. It is nightmarish.

We don’t know how many long-term care facilities or how much home health we need in each of the 58 California counties. We don’t collect health professions data on geriatricians or other critical health professionals, so they’re not on the radar.

We lack sufficient state staffing to address escalating abuse and neglect in nursing homes. The conflicts and duplication of services among state-funded and state-supported organizations, like the Area Agencies on Aging, the Aging Disability Resource Centers, and the county information and referral nonprofits assisting older adults, lack oversight.

As a result, they trip over one another, and adequate reporting and responses on services and resources for homeless, hungry, abused and neglected older adults goes missing.

Of all the “isms” – ageism receives the least attention in our culture. As a septuagenarian observing declining budgets and services to older adults, I am furious that we ignore the geriatrician shortage, or that we don’t copy other successful state models addressing affordable housing.

We have a $45 billion surplus – so what’s the excuse for stiffing older adults in past and recent budgets? Why are we still bottom feeders?

Older adults are considered disposable. We are easily forgotten in budgets and programs. Years of inadequate California budgets testify to that. If you hurt one age group, ultimately, you hurt them all and cripple the intergenerational connection.

We don’t want any more stinking plans that end up in a slush pile. Budgets and legislation dictating mandated actions are needed immediately. We know the problems. If you don’t know what it’s like to be invisible, trust me you will as an older person.

—

Dev Berger is a retired health policy consultant and planner with more than 40 years of experience with the California Legislature, state government and in the private sector.

Dev Berger | Contributed

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With COVID-19, there are added complications, notably physical separation. Some people are supporting older relatives who live far away while others may be close by, but are maintaining a safe distance. The goal is to maintain social closeness while also practicing physical distance.

“As the primary caregiver to my parents, I know well that the ways we support the older adults in our lives have changed,” says Ray Spoljaric, CEO and Co-Founder of Aloe Care. “Caregivers are resilient, committed people and will go to any lengths to provide for those they care for. Now more than ever, communication and collaboration are key to providing the highest level of care.”

If you’re a new caregiver, or concerned about COVID-19 for someone you support, consider these five tips from nationally recognized expert Amy Goyer:

• Establish a Care Circle – Identify the people who can help. It may be a combination of professionals, family members, and/or friends.

Collect names, phone numbers, and email addresses of everyone in your Care Circle. This is also a good place to store elders’ information, particularly what you would need in case of an emergency (i.e., medications, pre-existing conditions, home access details).

• Stay Connected – Next, establish regular check-ins.

With new physical distancing guidelines, social connection is more important than ever. Prepare a schedule of remote check-ins by the Care Circle. Consider leveraging technology in a solution like Aloe Care, which facilitates easy check-ins and care collaboration.

• Maintain Medical Care and Support – Telehealth is a rapidly advancing option for safe care. In fact, the Centers for Medicare & Medicaid Services recently expanded coverage and loosened policies and regulations regarding telehealth.

Many pharmacies have mail- order options and are expanding support for caregivers to manage medications.

• Cover the Essentials – Assess the food, household, and personal supplies the elders have at home and what they need to keep in stock.

Many grocery stores now offer contactless delivery or pick-up. A quick online search should reveal the best local option. Additionally, the Area Agency on Aging’s Eldercare Locator is a great resource, as is Meals on Wheels.

• Well-Rounded Health – While it may take some creativity during COVID-19, everyone needs stimulation physically, cognitively, and emotionally to maintain their well-being (including you, dear caregiver). Find ways to keep your loved ones and yourself active with technology, puzzles, letter-writing, exercises and more.

For more advice and resources about remote caregiving, please refer to the complete “Apart, Not Alone” guide by Amy Goyer.

-NewsUSA

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