Obama’s Family Leave Proposals Largely Ignore Caregivers of Frail Seniors and Disabled Adults

Note to President Obama: Families don’t just care for young children. They also care for aging parents, spouses, and adults with disabilities.

In his State of the Union address last night and in an announcement last week, Obama proposed a number of steps aimed at helping working parents care for sick kids. Among his ideas: requiring employers to offer up to seven days of paid sick leave each year, expanding access to paid family and medical leave, providing up to six weeks of paid family leave to federal workers, and allowing federal agencies to advance up to six weeks of paid sick leave.

Hospice Is Becoming a Chain Business

Large multi-agency, multi-state hospices are fast become the primary source of end-of-life care in the U.S.

According to a new study, chains cared for nearly half of all hospice patients in 2011, a dramatic increase from a decade before when small organizations (mostly non-profits) provided three-quarters of all care. And my own review of their financial reports suggests the biggest chains have grown even more since 2011.

The Coming Congressional War Over Social Security Disability

A technical rule change engineered by House Republicans on the first day of the new Congress may signal the beginning of a major battle over the future of the Social Security Disability program—and, more broadly, other federal programs for people with disabilities.

The immediate issue is the fate of the SSDI trust fund, which is expected to become exhausted in 2016. If new funding is not found, SSDI benefits will be cut by about 20 percent for 9 million workers, 2 million of their children, and about 160,000 spouses.

A Provocative New Way To Think About Dementia

Just about everything you think you know about Alzheimer’s disease and other dementias is wrong. And because the conventional wisdom is so off-track, so are the ways we—both family members and professionals– respond to those with dementia.

That’s Dr. G. Allen Power’s provocative message. He wants us to stop thinking that people with dementia are victims of a terrible debilitating disease that destroys their memory and perception. Instead, Power argues, dementia is “a shift in the way a person experiences the world.”

New Federal Budget Freezes Most Spending for Senior Services—Again

Congress has again frozen funding for most senior services programs, from Meals on Wheels and other nutrition programs to falls prevention and state health insurance assistance programs (SHIPs). This has been the trend throughout most of the Obama Administration. But it may be about to come to an end, as we near a time when federal funding for senior programs is not frozen, but cut—hard.

Why are So Few Low-Income Seniors Enrolling in Managed Care Plans?

What if they gave a managed care plan and nobody came?

That seems to be the problem with California’s ambitious effort to enroll more than 400,000 low-income seniors and younger people with disabilities into a fully-integrated care program that covers both medical treatment and long-term supports and services.  The idea has enormous promise, but relatively few Californians seem willing to participate. And many who have been automatically enrolled are dropping out.

The California program, called Cal MediConnect, is a demonstration program aimed at the so-called dual eligibles–people who receive benefits from both Medicaid and Medicare. The goal is to improve health outcomes and save money by managing care for those who are high-risk and high-cost patients.

Are Tax-Free ABLE Accounts The Right Financial Solution For People With Disabilities?

For the first time since 2010, Congress may be about to acknowledge that people with disabilities cannot have a decent quality of life with limited financial resources and modest government support. It is on the verge of approving the Achieving a Better Life Experience (ABLE) Act, which would create tax-free savings accounts to assist some people with disabilities while not jeopardize their eligibility for Medicaid or Supplemental Security Income (SSI).

The New World of Assisted Living

Assisted living facilities (ALFs) may be going the way of cable TV.  Still around, but with a limited future.

Their residents are changing. Even as their needs become more complicated, they are demanding less institutional-like care.  At the same time, assisted living will have to find its place in a world where medical and social care are becoming better coordinated and providers will be expected to organize themselves in very different ways than today.

Assisted living was once a creative alternative to nursing homes. Soon, something new will replace ALFs. The details remain uncertain, but we can begin to see what this new model of residential care will look like.

What Does Genworth’s Bad News Mean for the Future of Long-Term Care Insurance?

Last week, Genworth Financial, the dominant player in the traditional long-term care insurance market, acknowledged it is continuing to struggle to keep the product afloat. The firm announced it increased its reserves against future insurance claims by $531 million and said it is reviewing outstanding policies to determine whether it will have to take an additional charge before the end of the year. Its stock price plummeted by more than one-third (though it has rebounded a bit since) and the firm is facing enormous pressure from Wall Street to stop selling LTC policies.

What the GOP’s Congressional Victory Means for Senior Services

Republican control of Congress means that senior service programs—most of which have been frozen for years—will face growing budget pressures. At the same time, the GOP also may try to give states more flexibility in the way they provide Medicaid and other benefits to the elderly and disabled. And while the GOP leadership will be under pressure from Tea Party conservatives to trim Social Security and Medicare benefits, it is less likely a Republican Congress will try to do so without bipartisan support.