Aged & Disability Issues, & the Americans with Disability Act

Two Kentucky bills to protect seniors from abuse and exploitation

2011-03-24T04:10:00.003-04:00

3-24-2011 Kentucky:

LOUISVILLE, KY. (WDRB Fox 41) -- Kentucky Governor Steve Beshear on Wednesday signed two bills to protect seniors from abuse and exploitation.

The bill keeps people who abuse or neglect seniors or other "vulnerable" adults from benefiting after their deaths. Anyone convicted of felony abuse or exploitation would be barred from serving as the victim's guardian, executor, or power of attorney.

It also establishes a trust fund for programs that fight elder abuse.

"House Bill 52 closed a loophole in the current law and will prevent anyone who abuses or neglects an elderly person or vulnerable adult from benefiting financially from those actions," said Rep. Joni Jenkins, of Shively in a news release. "This bill is long overdue and I am proud to be the sponsor of such important legislation."

Rep. Mary Lou Marzian of Louisville, another sponsor of the legislation, said, "This will allow financial matters to be handled in a more timely and prudent manner. It will also permit discussion of personal matters with the appointed state guardian so that the wards' needs are adequately met."

The governor also wanted funding for an adult abuse registry in the 2012 budget, but the legislature did not approve it. Gov. Beshear says he will continue his efforts for that registry. ..Source.. by FOX41.com

Bill would help establish rules for sex in group homes

2011-03-24T04:03:00.002-04:00

3-24-2011 Florida:

State senators proposed reforms Wednesday to how developmentally disabled sex offenders are housed and want a task force of experts to recommend new guidelines for sex in group homes.

The changes are part of Senate Bill 2062, proposed by the Senate Committee on Children, Families, and Elder Affairs on Wednesday. They grow out of issues reported at a Seffner group home for developmentally disabled men where residents, including sex offenders, were permitted to have sex with one another even though some men lacked the ability to consent.

"Many issues have been brought to light through these shocking events," said Sen. Ronda Storms, who chairs the committee, "and I strongly believe it is the state's obligation … to ensure better environments."

According to a St. Petersburg Times story, staffers at the Human Development Center group home viewed sex between peers as part of a therapeutic program. A state disabilities official told senators last month that the group home matched up sexual partners.

Reports also documented one encounter in 2005 that the staff characterized as rape. But that case did not cause the home to curtail a program the men knew as "quiet time," during which sanctioned sexual contact occurred.

In 2008, Storms, R-Valrico, called for an investigation that stopped "quiet time" and state officials promised to tackle the issue of sexual activity in group homes. After a Times story in December revealed that the pledge and other changes hadn't been implemented, Storms convened Senate hearings last month to address the lingering issues.

One resident, upset about sexual activity in the group home, for instance, had been trying to move to another group home, but a judge's order kept him tied to the Human Development Center for years. The proposed bill would give the Agency for Persons with Disabilities more freedom to move these clients by barring judges from sending sex offenders to a particular home.

The bill would also give developmentally disabled sex offenders and their guardians more choices on where to live by making the agency create or license more group homes. Now, just a handful of state-licensed group homes, including the Human Development Center, accept men accused of sex crimes.

"Guardians of developmentally disabled deserve a choice in placement, even those who are sexual offenders," Storms said. "In some cases, there is only one provider in the entire state … and that … should not be allowed."

The bill also calls for a task force that would include officials from the state agency, Department of Children and Families, courts, prosecutors, public defenders, university experts and disabled advocacy groups to draw up policies to address sexual activity in group homes. The task force would present a report by Nov. 1.

Jim DeBeaugrine, a former director of the Agency for Persons with Disabilities, supported the bill.

"Most people with developmental disabilities are adults with full civil rights, and they do have the right to engage in lawful sexual activity. So it is a real tricky subject and one that's uncomfortable for a lot of people," he said.

The Agency for Persons with Disabilities declined to comment because it was analyzing the bill. ..Source.. by Justin George

Judge Dismisses Suit Brought by Plaintiffs Seeking to Opt Out of Medicare

2011-03-17T04:37:00.001-04:00

3-17-2011 National:

U.S. District Judge Rosemary Collyer dismissed a suit brought by a group of men seeking to cease their Medicare Part A coverage. In an opinion [.pdf] issued today, Collyer wrote that while the plaintiffs, which include former House Majority Leader Dick Armey, had a point that they are caught in a bind – the statute dictates that they can only opt out of Medicare Part A by forfeiting all of their Social Security retirement benefits – the court did not find that the government is required to provide a different way out.

The plaintiffs are three men over age 65 who want to opt out of Medicare coverage, arguing in their complaint that Medicare Part A coverage is inferior because of budget constraints and that staying enrolled in Medicare Part A could put their private coverage at risk. They also claim that they are entitled to less privacy under Medicare Part A coverage.

In the complaint, filed in U.S. District Court for the District of Columbia, the men claimed that the rules governing Social Security retirement benefits dictated that they could only pull out from Medicare coverage by forfeiting their Social Security benefits entirely. They argued that this statutory scheme is at odds with the Social Security Act and unconstitutional.

The U.S. Department of Health and Human Services and the U.S. Social Security Administration were named as defendants. A spokesperson for the U.S. Department of Justice declined to comment on Collyer's decision.

Frank Northam of Washington’s Webster Chamberlain & Bean represented the plaintiffs. He could not immediately be reached for comment.

Collyer wrote that she agreed the men are “trapped in a government program intended for their benefit,” but that the statutory scheme in question is legal, since the laws governing Medicare are clear that anyone entitled to Social Security retirement benefits is automatically enrolled in Medicare Part A when they turn 65.

“Requiring a mechanism for Plaintiffs and others in their situation to “disenroll” would be contrary to congressional intent, which was to provide “mandatory” benefits under Medicare Part A for those receiving Social Security Retirement benefits,” she wrote.

Updated at 7:25 p.m. to identify former House Majority Leader Dick Armey as one of the plaintiffs. ..SOurce.. by Zoe Tillman

Adult abuse registry clears Kentucky Senate committee

2011-02-10T05:09:00.000-05:00

2-10-2011 Kentucky:

FRANKFORT, Ky. — A bill to create a registry of people who have abused or neglected adults is headed for a Senate vote — backed by advocates who say it would help protect the elderly and disabled.

“We need a registry to stop these people from abusing others,” Penny Harbin told the Senate Health and Welfare Committee on Wednesday, displaying a photo of her disabled son who she said was physically abused by a home-care worker. “I ask for your help to protect those who cannot protect themselves.”

The committee voted 7-3 to send Senate Bill 38 to the full Senate.
Sen. Julie Denton, a Louisville Republican who is chairwoman of the committee and also the bill's sponsor, said it would simply provide a protection already in place for children.

Kentucky maintains a registry of those found by state social service officials to have neglected or abused children, and those individuals are barred from jobs caring for children, such as in day-care centers or schools.

But “no one is capturing that information so we can protect vulnerable adults,” Denton said. “That's just not acceptable.”

Denton cited the case of an elderly Louisville couple, Hans and Martha Rau, who were defrauded by two home-care workers of cash and jewelry, including their wedding rings. Hans Rau had hoped to testify Wednesday but is in declining health and wasn't able to attend the hearing, Denton said.

The Raus were profiled last year in a Courier-Journal series on adult abuse, neglect and exploitation. The newspaper reported that many groups support an adult abuse registry as a way to protect against unscrupulous workers.

Several advocates for elderly and vulnerable adults said after Wednesday's meeting that they hope SB 38 will become law. More disabled and elderly people are seeking care at home, they said.

“Seventy percent of people with Alzheimer's are cared for at home,” said Ellen Kershaw, a spokeswoman for the Alzheimer's Association in Kentucky. “For families who seek out caregivers, this will give them an additional tool.”

The Cabinet for Health and Family Services, which would maintain the adult registry, had opposed the measure in previous years, citing concern about potential costs.

But Eric Friedlander, deputy secretary of the cabinet, told the committee that the cabinet now supports the registry, although officials hope lawmakers also find a way to fund it.

“We feel that an abuse registry is absolutely needed,” he said.

Tracking abuse

Friedlander noted that a social service investigation may find that a worker has abused or neglected someone but that the finding doesn't always result in criminal charges. So it wouldn't show up on a criminal background check.

And many adult abuse cases aren't prosecuted, advocates say, in part because victims aren't able to testify because of their age or disabilities.
A registry that would include a social service investigation findng “would be a tremendous added protection,” Friedlander said of SB 38.

Several committee members questioned whether people would be unfairly placed on the adult registry or damaged by unfounded accusations. But Friedlander said no one would be put on the list until state social workers had investigated the allegations and individuals had exhausted all appeal rights provided by state law.

Anyone found to have abused or neglected children has the right to an administrative appeal before a state hearing officer. That decision may be appealed in court.

Harbin said her family's problems began after they hired a worker last year, through a personal care agency, to help with her son, Kristopher Worthington, 13, who has autism, suffers from frequent seizures and uses a wheelchair.

While her son's case falls under child-protection laws, Harbin said her main concern is that the worker they hired also cares for disabled adults.

If the new registry had been in place, they would have been able to determine whether he had been found to have mistreated adults in his care.

Harbin said the worker was charged in connection with her son's case after she reported the alleged abuse to police.

And there is nothing to keep the worker from continuing to care for disabled adults, she said.

“They can go from one employer to another,” she said.

Harbin said she and her husband — feeling uneasy about the worker caring for Kristopher — placed a hidden camera in the home. The video showed him striking the boy repeatedly and rapping him on the head with his knuckles while Kristopher cowered and cried, she said.

“I trusted a person with my most precious possession — my child,” she said. “How could anyone do such a thing?” ..Source.. by Deborah Yetter

Elderly offenders present challenge

2011-01-26T04:21:00.001-05:00

Whoever posted the comment (About their father dieing) here please contact eAdvocate@yahoo.com

1-26-2011 Georgia:

MARIETTA - As the number of registered sex offenders continues to expand, so have the laws surrounding their classifications, generally making it more difficult for the offenders to fall off the registry.

While on the active registry, offenders are not permitted to live in certain areas, like near schools or day cares, but there are no clear rules for senior centers or nursing homes.

Ohio Rep. Andy Thompson, R-Marietta, said no one wants to think of their mother or grandmother sharing a room or a wing at a nursing home with a sex offender. He said he has heard some recent talk in the news and legislature about addressing the issue.

"I'm very much concerned about the residents of these homes because they are very vulnerable," Thompson said. "But you have to be careful about this."

Thompson said at a certain age or medical condition, some sex offenders may no longer be a danger to others. For example, he said, if a person is confined to a bed, they should probably not be considered a risk to others.

Washington County sheriff's Sgt. Patrice Tornes, who monitors the area's 134 registered sex offenders, said she would have mixed feelings about a proposal to limit access to nursing homes. Thirteen of the county's sex offenders are over age 60, with the oldest turning 91 this year.

Tornes said she believes most of the area's nursing homes will not admit a registered sex offender. There is one sex offender currently residing at the Washington County Home, although the center has a clear policy against such individuals staying there. The woman is 41 and was convicted of rape and gross sexual imposition of a teenage boy.

"She was living there before the policy change and kind of grandfathered in," Tornes said.

Tornes said she has had two other cases where individuals on the sex offender registry have needed assisted living care. She said those individuals were turned away when the local facilities learned of their sex offender status.

"Neither experience was pleasant," Tornes said. "One gentleman was given just a short time to live and needed to be put in a facility in the area. Because he required community notification be issued, the facilities all turned him away. I tried to get an emergency meeting with a judge, because I think everyone is entitled to care, but he died before I got before the judge."

In the other case, Tornes said, a local nursing home determined a man was a sex offender then packed his belongings, took him out front and called a taxi.

"I thought that seemed out of line, but they obviously don't want sex offenders there, especially if they require community notification," she said.

No administrators of local nursing or assisted living centers returned phone calls seeking comment. ..Source.. by BRAD BAUER Special to The News and Sentinel

Placement of elderly sex offenders can be a challenge

2011-01-22T03:47:00.000-05:00

1-22-2011 Georgia:

As the number of registered sex offenders continues to expand, so have the laws surrounding their classifications, generally making it more difficult for the offenders to fall off the registry.

While on the active registry, offenders are not permitted to live in certain areas, like near schools or day cares, but there are no clear rules for senior centers or nursing homes.

Ohio Rep. Andy Thompson, R-Marietta, said no one wants to think of their mother or grandmother sharing a room or a wing at a nursing home with a sex offender. He said he has heard some recent talk in the news and legislature about addressing the issue.

"I'm very much concerned about the residents of these homes because they are very vulnerable," Thompson said. "But you have to be careful about this."

Thompson said at a certain age or medical condition, some sex offenders may no longer be a danger to others. For example, he said, if a person is confined to a bed, they should probably not be considered a risk to others.

Washington County sheriff's Sgt. Patrice Tornes, who monitors the area's 134 registered sex offenders, said she would have mixed feelings about a proposal to limit access to nursing homes. Thirteen of the county's sex offenders are over age 60, with the oldest turning 91 this year.

Tornes said she believes most of the area's nursing homes will not admit a registered sex offender. There is one sex offender currently residing at the Washington County Home, although the center has a clear policy against such individuals staying there. The woman is 41 and was convicted of rape and gross sexual imposition of a teenage boy.

"She was living there before the policy change and kind of grandfathered in," Tornes said.

Tornes said she has had two other cases where individuals on the sex offender registry have needed assisted living care. She said those individuals were turned away when the local facilities learned of their sex offender status.

"Neither experience was pleasant," Tornes said. "One gentleman was given just a short time to live and needed to be put in a facility in the area. Because he required community notification be issued, the facilities all turned him away. I tried to get an emergency meeting with a judge, because I think everyone is entitled to care, but he died before I got before the judge."

In the other case, Tornes said, a local nursing home determined a man was a sex offender then packed his belongings, took him out front and called a taxi.

"I thought that seemed out of line, but they obviously don't want sex offenders there, especially if they require community notification," she said.

No administrators of local nursing or assisted living centers returned phone calls seeking comment. ..Source.. Brad Bauer by

Florida Parole Commission releases dying inmate

2011-01-06T05:59:00.000-05:00

1-6-2011 Florida:

TALLAHASSEE, Fla. -- A 27-year-old prison inmate born with AIDS in Haiti and now dying of cancer will be released to a hospice after supporters, including three state lawmakers, spoke on her behalf Wednesday to the Florida Parole Commission.

The panel voted 2-1 to approve a medical release for Betsie Gallardo with conditions that amount to house arrest. Last week, she was moved from prison to a secure area of the Kendall Regional Medical Center where family visits are limited to two hours a day.

"A miracle has happened," said Jessica Bussert, one of Gallardo's adoptive parents. "I look forward to finally having her out of shackles."

Gallardo has served slightly more than a year of a five-year sentence, the maximum possible, for biting a Collier County sheriff's deputy and kicking another while intoxicated. It happened after her 2008 arrest in Naples on a child neglect charge that later was dropped.

Four months into her sentence, Gallardo was diagnosed with gall bladder cancer. It has since spread to her liver, lungs and ovaries. She's not expected to live more than 30 days, said HIV-AIDS activist Michael Emanuel Rajner of Fort Lauderdale.

Joshua and Sharon Bussert of Lafayette, Ind., adopted Gallardo in 1993. Joshua, a firefighter and emergency medical technician, changed his name to Jessica after having a sex change operation.

The commission majority also agreed to let Gallardo return to Indiana under the same conditions if that state agrees to accept her.

She may not last long enough for that process to be completed, though, so her supporters planned to ask Gov. Rick Scott and the Florida Cabinet to commute her sentence so Indiana's approval wouldn't be needed.

Rep. Daphne Campbell, D-Miami, said she spoke to Scott about Gallardo at his inaugural ball Tuesday night. There was no immediate comment from the governor's office Wednesday.

Campbell and Reps. Hazelle Rogers, D-Lauderdale Lakes, and Darryl Rouson, D-St. Petersburg, urged commissioners to unconditionally release Gallardo but the panel lacks that authority.

Campbell, a registered nurse, told the panel she recently visited Gallardo who said "I know by God's grace I will be released and my parents will see me dying."

Florida is among more than half of the states that allow sick and dying inmates to be released for humanitarian reasons and to reduce prison medical expenses. Florida's program has been in effect since 1992.

In the fiscal year ending June 30, Florida parole commissioners, though, released only nine of 19 inmates recommended by the Department of Corrections. They freed just 42 of 75 inmates who received recommendations over the past three years.

In October, the commission refused to free Gallardo but reconsidered.

Commission Chairwoman Tena Pate and Commissioner Cassandra Jenkins voted for her release. Pate said she changed her mind because Gallardo's deteriorated condition means she's no longer a public safety threat. Jenkins is a new member and Gallardo's case was her first vote. Commissioner Monica David dissented.

Sheriff's Cpl. Tracy Brown, who was bitten by Gallardo, opposed her release in a letter read to the commission. Brown underwent painful AIDS prevention treatments, missing four weeks of work. So far, she has tested negative.

"Receiving the appropriate treatment was literally a matter of life and death," wrote Brown, who is a mother, adding and that her family also would suffer if she gets AIDS.

Brown wrote that Gallardo was sentenced not just for spitting at and biting her but for trying to pass on "the same deadly illness, the same death sentence" that the inmate has.

"Ms. Gallardo carried a concealed weapon, understood its powerful effect and used it," Brown wrote.

Bussert later said as a first responder herself she identified with Brown and was sincerely sorry for the pain her daughter has caused. But she added, "there's nothing I can do to take that away just like there's nothing I can do to take away my daughter's cancer."

"Quite frankly, my daughter should have received a harsh punishment," Bussert said. "The question is should it have been a life sentence?"

Rajner, who also has AIDS, said he, too, had empathy for Brown but disagreed with her statement because the disease cannot be passed on through saliva.

"It is not a deadly weapon," Rajner said, noting that advancements have been made in AIDS treatment. "It is now considered a chronic disease."

The Centers for Disease Control and Prevention says HIV rarely is transmitted by saliva even if mixed with infected blood. Saliva, instead, inhibits HIV infection and levels of the virus are low in the saliva of infected people.

The commission did not have a telephone number for Brown and the sheriff's office said she was off duty and could not be contacted. ..Source.. by BILL KACZOR

Study Cites Dangers of Some Painkillers to Elderly

2010-12-14T02:23:00.000-05:00

12-14-2010 National:

Older patients with arthritis who take narcotic-based drugs to relieve pain face a higher risk of bone fracture, heart attack and death when compared to those taking non-narcotic drugs, according to a government-financed study published Monday.

The study, in a medical journal, The Archives of Internal Medicine, appears to be the first large-scale effort to look at the comparative safety risks for the elderly taking different classes of painkillers. It comes amid a large increase in the use of narcotic painkillers in recent years because of a prevailing belief that such drugs were safer for older patients than non-narcotic drugs like Advil and Motrin.

The review, financed by the federal Agency for Healthcare Quality and Research, appears to undercut that assumption. The report, which was based on an analysis of patient health care records, was conducted by researchers at Brigham and Womens Hospital in Boston.

“Doctors should not assume that opioids are a safer alternative,” to other painkillers, said Daniel H. Solomon, the study’s researcher, said in a telephone interview on Monday. “They seem to carry profound risks to cardiovascular system as well as increased risk fractures and appear to be associated with increased risk of death.”

The study does not raise questions about the use of powerful narcotics like OxyContin to treat severe pain resulting from cancer or other conditions.

To conduct the study, Dr. Solomon reviewed the experience of Medicare recipients in both New Jersey and Pennsylvania who were found during a six-year period to have osteoarthritis or rheumatoid arthritis. Using statistical methods, researchers divided those patients, predominantly women with a mean age of 80 years, into three groups based on their pain medications.

One group comprised patients who received a narcotic-based painkiller. The second group comprised those who took a nonsteroidal anti-inflammatory drug like Advil or Aleve. The third group comprised patients who took another class of pain drugs called coxibs, which include Celebrex and Vioxx, a drug that is no longer on the market.

Because the study was based on records, it could not identify all the factors that might have contributed to a patient’s problems. But in following their experiences, researchers found that the overall risk of death was twice as high for patients taking a narcotic painkiller when compared to those taking a nonsteroidal anti-inflammatory drug.

More specifically, patients in the narcotic group were four times more likely to experience a compound bone fracture, apparently as a result of a fall, and they were twice as likely to have a heart attack. The cardiovascular risks posed by narcotics were the same as for drugs like Celebrex and Vioxx, medications that have come under scrutiny for that hazard.

The review also found that the rate of gastrointestinal bleeding among patients taking narcotics was about the same as those taking drugs like Advil and Aleve. One principal reason that medical experts have advocated using narcotics in older patients is the belief that they reduce such problems.

In an commentary accompanying the new report, two physicians at Yale University Medical School, Dr. William C. Becker and Dr. Patrick G. O’Connor, wrote that the study’s findings, like those regarding bleeding ulcers, could be skewed by undocumented patient use of over-the-counter painkillers.

Dr. Becker and Dr. O’Conner added, however, that the high incidence of bone fractures, which often lead to fatal complications in the elderly, were particularly troublesome.

In a related study that was also published Monday in The Archives of Internal Medicine, Dr. Solomon and other researchers looked at the comparative risks posed by different types of narcotics.

Using the same patient records, they reported that cardiovascular risks were highest for codeine and that codeine and oxycodone, the active ingredient in drugs like OxyContin, posed higher mortality-related risks than hydrocodone, the active ingredient in drugs like Vicodin. ..Source.. by BARRY MEIER

ADAAA litigation "goes live."

2010-12-01T03:44:00.001-05:00

12-1-2010 National:

The ADAAA sleeping giant is finally awake . . . and he's not a morning person. The Americans with Disabilities Act Amendments Act, which dramatically expanded the definition of "disability" in the Americans with Disabilities Act, was signed into law by President George W. Bush in September 2008 and took effect in January 2009. However, it has taken until now for some of the cases applying the new law to bubble up through the court system. Recently, the Equal Employment Opportunity Commission announced that it was filing suits against three employers, and a federal court in Indiana denied summary judgment to an employer who sought to defend itself based on the ground of "no disability," formerly a strong defense under the ADA.

The EEOC suits include one against a drug store chain that allegedly refused to provide a stool to an employee who had arthritis in her knees, one against a surveying company that terminated two individuals in a reduction in force -- one of whom had hypertension, and the other of whom had diabetes, and one against a printing company that allegedly refused to allow an employee a part-time schedule so that he could receive chemotherapy.

In Hoffman v. Carefirst, one of the first known summary judgment decisions involving the ADAAA, the court found that the plaintiff - who had Stage III renal cancer which was in remission - was disabled and denied the company's motion for summary judgment on that ground. This means that the plaintiff's disability discrimination case will go to trial if it does not settle.

We expect the expanded definition of "disability" under the ADAAA to breathe new life into disability discrimination claims. Before the ADAAA, courts were routinely dismissing disability discrimination lawsuits on the ground that the plaintiffs were not "disabled" within the meaning of the law. If the plaintiff could "mitigate" the disability through medication or other means, then the plaintiff was not disabled. If the plaintiff was not substantially more impaired than the general population, then the plaintiff was not disabled. If the plaintiff had a condition that was in remission, then the plaintiff was not disabled.

That's all changed now. Under the ADAAA, if a condition would be disabling without mitigating measures or when not in remission, then it is a disability. This means that treatable but chronic conditions like hypertension, diabetes, and seizure disorders will now render a person disabled. The old ADA required that an individual be substantially limited in a "major life activity." The ADAAA adds new "major life activities" to the list and also provides that an impairment in a "major bodily function" will create a disability.

Does this mean that employers will now have to go to trial in all of their disability discrimination cases? Let us hope not. But what it does mean is that employers will have to be very careful that they do not discriminate against individuals based on their medical conditions, and that they appropriately consider reasonable accommodations. In a future post, I'll talk about best practices for employers in light of the ADAAA. ..Source.. by Robin E. Shea (See also: How to Survive the ADAAA: Seven Best Practices for Employers )

New lawsuit filed in case over abuse at Minn. nursing home

2010-11-11T05:28:00.000-05:00

11-11-2010 Missouri:

A seventh lawsuit has been filed in U.S. District Court in South Dakota on behalf of a deceased victim in a high-profile Minnesota elder abuse case.

Kenneth Hojberg's family filed a lawsuit Monday against the Evangelical Good Samaritan Society of South Dakota about abuse that occurred in 2008 at the company's Albert Lea home.

Hojberg died Oct. 15.

Civil lawsuits in Minnesota die with the victim, but the claims remain open for litigation in South Dakota.

Albert Lea residents Brianna Broitzman and Ashton Larson, both 20, were charged with assault, abuse of vulnerable adults, disorderly conduct by a caregiver and failure to report abuse. Four other women were charged as juveniles with failure to report.

Broitzman was sentenced Oct. 22 to 180 days in jail. Larson will be sentenced in December.

A 2008 investigation by the Minnesota Department of Health states that Broitzman and Larson were leaders of a group of young employees who poked residents in the breasts, rubbed their genitals, held them down until they screamed, hit them with canes and exposed their buttocks to other residents.

Hojberg's lawsuit, like the six filed in South Dakota before it, claims that Good Samaraitan failed to properly screen or monitor its employees.

The company cooperated with law enforcement once the incident was reported, however, according to police and court records.

Sioux Falls is home to the corporate offices of the Good Samaritan Society. ..Source.. by John Hult

IPad Opens World to a Disabled Boy

2010-11-05T01:37:00.004-04:00

Related Topic: Are there ways such technology can assist disabled adults?

11-5-2010 New York:

OWEN CAIN depends on a respirator and struggles to make even the slightest movements — he has had a debilitating motor-neuron disease since infancy.

Owen, 7, does not have the strength to maneuver a computer mouse, but when a nurse propped her boyfriend’s iPad within reach in June, he did something his mother had never seen before.

He aimed his left pointer finger at an icon on the screen, touched it — just barely — and opened the application Gravitarium, which plays music as users create landscapes of stars on the screen. Over the years, Owen’s parents had tried several computerized communications contraptions to give him an escape from his disability, but the iPad was the first that worked on the first try.

“We have spent all this time keeping him alive, and now we owe him more than that,” said his mother, Ellen Goldstein, a vice president at the Times Square Alliance business association. “I see his ability to communicate and to learn as a big part of that challenge — not all of it, but a big part of it. And so, that’s my responsibility.” ..See NYT for remainder of article: by EMILY B. HAGER

Financial exploitation of seniors estimated at $2.6 billion a year

2010-10-30T16:27:00.000-04:00

10-30-2010 Ohio:

A bank called Montgomery County Adult Protective Services concerning unusual activity in a 92-year-old man’s bank account. It was discovered he was writing checks totaling $2,000 a day to neighbors. He had signed the checks, but the neighbors were writing out the rest of them. More than $700,000 was lost. Stories like this happen in our community daily.

Financial exploitation is one of the fastest growing forms of elder abuse. A study estimates there is $2.6 billion in senior financial fraud annually. An Ohio Department of Jobs and Family Services report estimated more than 2,500 reports of senior exploitation in Ohio and APS reported more than 210 local cases in 2009.

Exploitation is the unlawful or improper act of obtaining or using a vulnerable adult’s funds, credit, assets or other property with intent to deprive them for the benefit of someone other than the vulnerable adult. Signs of exploitation include:

•Sudden changes in bank accounts or banking practices, including unexplained withdrawals by people accompanying seniors.

• Suspicious activity on credit cards.

• Abrupt changes in wills or financial documents.

• Forged signatures for financial transactions.

Seniors are targeted because they account for 70 percent of U.S. households’ net worth. They’re polite, trusting, fear losing their freedom and physical harm. Many are ashamed of being scammed or don’t know they’ve been scammed.

The best defense is knowledge. The Better Business Bureau advises seniors to:

• Get advice from trusted family members, friends, lawyers or bankers.

• Never give out personal information to unfamiliar people or companies.

• Get everything in writing.

• Be sure blanks are completed and review and understand contracts before signing.

• Use direct deposit for checks to prevent interception.

• Beware of unsolicited notifications with phony checks claiming you’ve won.

• Avoid high-pressure or scare tactics.

• Review bank, insurance, credit card and medical bill statements regularly.

Locally, the BBB is represented on the Collaboration Against Abuse, Neglect and Exploitation, a multi-disciplinary team formed to prevent and eliminate elder abuse, neglect and the exploitation of older and vulnerable adults through education, advocacy, intervention and services. Contact the BBB for more information on elderly fraud. Visit www.bbb.org or call (937) 222-5825 or (800) 776-5301.

John North is president and CEO of the Dayton Better Business Bureau. ..Source.. by John North, Better Business  Bureau

Former Albert Lea nursing home worker sentenced to 180 days in jail

2010-10-22T21:16:00.000-04:00

10-22-2010 Minnesota:

ALBERT LEA, Minn. -- A woman who entered a plea deal in August on charges she abused elderly women at an Albert Lea nursing home was sentenced Friday.

A Freeborn County District Court judge sentence Brianna Broitzman, 21, to 180 days in jail as a staggered sentence.

Boitzman will serve the first 60 days of the sentence immediately in the custody of the Freeborn County Sheriff's Department. The next 60 days are scheduled to be served in May of 2011, and the last 60 will be in October of 2011.

RELATED: Minn. woman makes plea deal in nursing home abuse case

RELATED: 6 teens charged in Albert Lea nursing home abuse

Broitzman was among several nursing aides accused of mistreating residents at the Good Samaritan Society in 2008 by groping, poking, taunting and simulating sex acts on them. The women are also accused of spanking and spitting on patients at the nursing home.

Broitzman can petition the court to remove her final 120 days pending her initial 60 days in jail. She was also sentenced to two years probation, during which she is not allowed to be in a caregiving role, she's not allowed to have contact with vulnerable adults without the permission of the court and is required to make herself available to meet with victim's families if they so request.

Four other aides were charged in juvenile court with not reporting the alleged abuse. ..Source.. by KARE11.com

Family sues S.D.-based company in elder abuse case

2010-10-04T13:41:00.000-04:00

10-4-2010 Minnesota:

Another lawsuit stemming from a high-profile elder abuse case at a Minnesota nursing home has been filed in U.S. District Court of South Dakota.

The family of Sylvia Wulff, a deceased victim of the alleged abuse at the Evangelical Good Samaritan Society in Albert Lea, Minn., filed the lawsuit against the South Dakota-based company on Sept. 29 in Sioux Falls.

Albert Lea residents Brianna Broitzman and Ashton Larson, both 20, were charged with assault, abuse of vulnerable adults, disorderly conduct by a caregiver, failure to report abuse and other charges. Broitzman pleaded guilty in August to three counts of disorderly conduct by a caregiver.

Four other women were charged as juveniles with failure to report.

A Minnesota Department of Health investigation in 2008 concluded that the two led a group of young employees at the facility who poked residents in the breasts, rubbed their genitals, held them down until they screamed, hit them with canes and exposed their buttocks to other residents.

The lawsuit claims the company failed to properly screen or monitor the employees at the Albert Lea facility. Court documents show that the company cooperated with law enforcement once the incident was reported.

Civil suits in Minnesota die with the victim, but the claims are still open for litigation in South Dakota. Sioux Falls is home to the corporate offices of the Good Samaritan Society.

Wulff is the sixth deceased victim whose case has migrated to South Dakota. Previous suits were filed in April and June. ..Source.. by John Hult

Deaths in adult homes hidden and ignored

2010-09-12T14:33:00.003-04:00

9-12-2010 Washington:

The deaths of hundreds of seniors at adult family homes may have been the result of neglect or abuse, but were never investigated.

Some fell to the floor and bled to death internally. Others choked on food and suffocated. Still others languished for weeks as bedsores burrowed to the bone, ultimately killing them.

In neighborhoods throughout Seattle and across the state, hundreds have died prematurely, many in avoidable misery, while living at state-licensed adult family homes.

A Seattle Times investigation has uncovered at least 236 deaths that indicate neglect or abuse in these homes but were not reported to the state or investigated.

Dozens of suspicious deaths occurred in adult homes with long histories of violations, including some whose owners employed caregivers with little training or forged credentials.

In the first accounting of such deaths, The Times identified these cases by analyzing death certificates of 4,703 Washington residents who died at adult homes from 2003 through 2008.

Adult homes are a less-regulated, less-expensive elder-care option than nursing homes, and are touted as providing personalized care in cozy, neighborhood settings.

But The Times also found that adult-home deaths indicating neglect occur at strikingly higher rates than comparable deaths at nursing homes:

• Pressure-sore deaths in adult homes occur at a rate more than 3.5 times higher.

• The rate of deaths from falls is four times higher.

• For choking deaths, the rate is 15 times higher.

Adult family homes are regulated by Washington's Department of Social and Health Services (DSHS), which licenses home owners to rent out spare bedrooms and provide long-term care for up to six seniors.

This housing option, which has boomed since the 1990s into a patchwork of 2,984 privately owned homes today, has earned the state a national reputation as an innovator in providing community-care choices for the elderly. Dozens of states plan to emulate Washington's program.

There is a dark side to that business boom. DSHS, for example, doesn't track how many residents die in the homes each year or question the circumstances.

The industry has expanded so swiftly and with so little oversight that it has attracted profiteers who, until The Times exposed the practice earlier this year, freely marketed homes and the residents as good investments.

Kathy Leitch, DSHS' head of aging and disability services, said that most adult homes provide safe care and represent an important option and first choice for many seniors.

Cindi Laws, executive director of the Washington State Residential Care Council of Adult Family Homes, said only a small fraction are problem homes.

None of the 236 deaths came to the attention of DSHS, records show. When such cases do get reported to the agency, Leitch said, it investigates them and routinely refers evidence of possible crimes to law enforcement.

But in dozens of cases, DSHS ignored or excused reports of suspicious deaths, including statements from witnesses, The Times has found.

By law, all caregivers are required to report suspected abuse of the elderly to DSHS. However, King County Medical Examiner Dr. Richard Harruff said he's learned, well after the fact, of elderly deaths that his office would have chosen to investigate. "Getting people to report seems to be a problem," he said.

Pain meds withheld after broken hip

Retired dairy farmer Clarence Yesland, 84, had struggled with Parkinson's disease and dementia for a decade until he became too frail to live at his Kirkland home. His wife, Marie, 82, moved him in 2004 to Houghton Lakeview adult home, also in Kirkland.

The five-bedroom home, blocks from Lake Washington, was licensed to owner Patricia Goodwill. She billed $3,500 a month for room and care.

"We thought the home was excellent," said Yesland's stepson, Gary Gelow, 67, of Kirkland.

What family members didn't know until much later was that the home, while Yesland lived there, had been cited for more than a dozen serious violations during DSHS' inspections.

One resident had not received enough fluids and was dangerously dehydrated. Caregivers considered another resident too active, so he was forced to consume anxiety medications prescribed for a different person.

Three staffers had convictions for felonies — assault, drug possession and child abuse — which by law should have disqualified them from working with vulnerable adults.

In January 2008, Yesland's family was told Clarence had fallen in the kitchen. The family would later learn that his primary caregiver, a woman they trusted named Effie Dutton, may have delayed getting any care for him for two days or more, worried about losing her job.

"We never did get a good explanation about how he fell," Gelow said.

After finally being taken to the hospital, Yesland was found to have a broken hip. But he was too weak to endure major surgery, his dementia was much worse, and he was unable to communicate coherently.

Yesland was given a narcotic to dull the pain from his hip. But Dutton told members of his family that the drug would hasten his death, Gelow recalled.

At the time, he was unnerved by Yesland's rapid decline from being active to spending all his time curled in a ball in bed.

"She said that these medications put people into vegetative states and they die more quickly," he said.

Dutton said that, as a favor to the family, she would not give Yesland the narcotics but falsify his medical record to show that she had, Gelow said. Trusting her, he agreed to the plan because he wanted his stepfather to live longer. Yesland died a month after breaking his hip.

A short time later, DSHS received a five-page, typewritten letter that described widespread abuse and neglect inside the Houghton Lakeview home. The letter was signed by Dutton's husband, Robert.

He and his wife had lived in the basement of the home for two years. Dutton wrote that his wife had pocketed prescription drugs from Yesland and several other residents. She told him that she had fabricated medical files to cover up the thefts and sold the pills to a caregiver with a drug problem at a different adult home owned by Goodwill, he wrote.

As proof, he later provided empty vials of the residents' medications, which he said he found in his wife's dresser.

Dutton also wrote that his wife had confided to him that Yesland was not promptly treated after falling, and that internal bleeding may have contributed to his death.

Dutton, who is now divorced, said he finally came forward because he couldn't live with the guilt and that it "made me sick to think of all the residents dying."

Gelow recently reviewed DSHS records and Robert Dutton's letter, provided by a Times reporter. Gelow said he was "stunned" to learn that Effie Dutton had been cited for using a forged nursing assistant license. DSHS considered it a minor violation because adult homes are not required to have licensed caregivers.

Gelow believes that Effie Dutton likely diverted the drugs, resulting in unnecessary pain for his stepfather, who, with his dementia, could not communicate at the end of his life.

Gelow said he feels guilty. "Now I realize how I was duped," he said.

DSHS failed to investigate Robert Dutton's accusations about drug thefts and sales, records show. Nor did DSHS, or any agency, look into Yesland's death.

Screams, stench and deadly infection

Dutton dropped another bombshell in his letter to DSHS: An elderly woman died from neglect just months after Yesland's death.

In May 2008, Dutton wrote, he received a panicked phone call for help from his wife. She had a medical emergency at the home with a female resident, but was afraid to alert 911.

The woman was Jean Rudolph, 87, a retired nursing educator who had Alzheimer's disease and heart problems. She had moved there six years earlier from her nearby home.

When Robert Dutton arrived, he learned that Rudolph had seven pressure sores, some so deep that muscles and bone were exposed.

"So we stripped Jean naked and the smell and her clothes were so bad, I opened the window and started gagging. Effie was gagging too," he wrote. "Jean's diaper was totally full of urine and poop and it looked like she hadn't been changed for at least 24 hours.

"When we stripped her down, I looked at the sores and they were very red, inflamed and very infected. Jean was screaming loudly when Effie touched her sores and was fighting but I kept talking to her and trying to distract her."

The Rudolph family had been told nothing about her pressure sores for 22 days, DSHS records show. Rudolph's son, James, said when Dutton finally called him about his mother's condition, he immediately went to the home and transferred her to the emergency room. It was too late — infection from the bedsores had spread to her vital organs.

Jean Rudolph died in June 2008 at her son's Bellevue home under hospice care.

"I think there's really a lot of guilt," said James Rudolph, 56, a Bellevue architect. "You kind of feel like: My God, how did this happen?"

The family contacted DSHS repeatedly about what happened to Jean at the adult home. DSHS eventually sent an investigator, who determined that Effie Dutton, instead of monitoring residents, often trolled the Web on her laptop computer, conducting a relationship with a man overseas via chat rooms and e-mails.

Dutton and Goodwill, the owner, were each charged with one felony count of criminal mistreatment for failure to provide proper care to Rudolph. Dutton, who remarried and was charged as Effie Tutor, pleaded guilty last month and awaits sentencing. Goodwill's case is pending. Both declined to comment.

DSHS now requires adult homes to publicly post copies of violations. The agency made this change in February, shortly after The Times' investigation showed how families were kept in the dark about a home's violation history. In addition, DSHS now lists violations for adult homes on its website.

Bedsores can be more than painful

The Times identified at least 29 adult-home deaths that were linked to advanced pressure sores.

In 2008 alone, three retirees in Puget Sound-area adult homes died from complications of advanced pressure sores: a Lynnwood hairdresser, 93, who had multiple sclerosis; an Everett homemaker, 93, with heart disease; and an Issaquah homemaker, 91, who had severe dementia.

None of the cases was reported to DSHS.

Asked about this recently, DSHS' Leitch said she is concerned that many cases of "elder abuse and neglect are not reported."

Pressure sores, also called bedsores, commonly plague seniors who are bedridden or rely on a wheelchair to get around.

Researchers disagree over how the sores develop — above or below the skin — and even how quickly they advance. Constant pressure against the skin, especially along bony areas, may reduce blood supply and kill tissue.

Sores have four classifications: a reddened area of the skin (Stage 1); a large blister (Stage 2); an open wound (Stage 3); and finally, a gaping wound with exposed muscle, tendon or bone (Stage 4).

Most medical professionals believe that Stage 3 or 4 pressure sores are likely signs of neglect.

If detected early, the sores are treatable with ointments or powders. But constant vigilance is needed. To avoid prolonged pressure that can develop sores, doctors sometimes require at-risk seniors to be shifted every one to two hours, particularly at night, which requires a well-staffed home with diligent caregivers.

Staffing, safety loosely regulated

Health-care research conclusively links higher staffing to lower fatality rates. It's a simple formula: More caregivers equals better care.

With nursing homes, the federal government has stepped in and mandated minimum levels of staffing, including a requirement of 24-hour care overseen by a registered nurse.

But Washington's adult homes are not regulated by federal law. And Washington law, so far, hasn't required adult homes to follow the dozens of safety standards required of nursing homes.

For example, an adult-home owner or sole staffer is not required to be awake at night when overseeing as many as six residents. Owners and staffers aren't even required to have a minimum health-care license, such as that of a nursing assistant.

State ownership rules are so loose that some adult-home owners are business investors who have no prior health-care experience, buying and leasing adult homes like fast-food franchises.

Washington legislators have tried but failed to fix some of these problems. The adult-home industry has opposed additional staffing requirements as unnecessary and too costly.

Lawmakers have been reluctant to impose tougher measures on what they often perceive as mom-and-pop enterprises.

A sharp rise in accidental deaths

For nearly a decade, Washington's rate of accidental deaths in adult homes and nursing facilities remained the same, about one out of 50 deaths. But the accidental-death rate for adult homes jumped 50 percent in 2007, and again the following year.

Adult-home residents now die from accidents at twice the rate of those in nursing homes, a Times analysis of death certificates shows. A key reason centers on the declining number of caregivers at homes. During this economic recession, scores of owners have cut staff and services to stay afloat, adult-home industry officials said.

State records reveal a pattern of problems during night shifts at adult homes. For example, in November 2007, a Seattle adult-home resident, 77, was found dead in his room. A catheter had dislodged from his arm and he slowly bled to death unnoticed during the night, according to DSHS, which received a complaint about the incident.

In another case, at a Kent adult home last year, a caregiver discovered an unconscious woman sitting in her wheelchair in the kitchen. The 61-year-old woman had accidentally taken too many prescription drugs. The caregiver wheeled her to her room. Not strong enough to lift her, the caregiver rolled the comatose woman onto the bed, face down. She was found dead in the morning.

In health care, these kinds of deaths are called "failure to rescue," meaning the deaths would have been avoided if a caretaker had noticed the problem and taken the correct action.

Choking to death on food falls into this category. The elderly often have trouble swallowing, a condition caused by dozens of medical maladies that interfere with this seemingly simple task.

Caregivers are required to properly prepare food, such as cutting hot dogs into small pieces, and then to monitor residents' mealtimes. But many homes employ just one caregiver during the day, making it difficult when overseeing six residents, the maximum allowed per home.

The Times identified seven adult-home residents who choked on food and suffocated from 2003 through 2008. In contrast, nursing homes, which have many more residents statewide — about 17,000, to adult homes' estimated 11,000 — had only one choking death.

The Times identified 128 adult-home residents who died from injuries related to falls but whose cases were never investigated. Among those who died, all from head injuries, were a retired seafood distributor, 94, of Darrington; a former Spokane medical tech, 94; and a retired Renton teacher, 88.

Not all accidental deaths can be prevented. But such deaths, at the very least, should spark a review of care at the homes, said Seattle police Detective Suzanne Moore, who specializes in investigating deaths of the elderly.

Strong resistance to fatality reviews

In 2006, King County prosecutors, the medical examiner and Seattle police came up with a plan to review adult-home fatalities. They believed that some were likely caused by neglect but had not been reported as suspicious deaths, said Harruff, the medical examiner. A Seattle police detective planned to visit each Seattle adult home when it had a death.

But the idea faced instant opposition. Families were apprehensive about privacy. Owners feared unnecessary disruption. Physicians worried about second-guessing from medically unsophisticated police officers.

"There was just huge push-back," said Detective Moore, part of the review team. "There were those who didn't want the police responding to every death."

Today, Harruff is trying again. He's collaborating with researchers at the University of Washington, which obtained a federal grant to examine deaths in all long-term-care settings, and they plan to publish their findings next year.

Autopsies, which are reserved for unexpected, violent, suspicious or unnatural deaths, are performed in about 10 percent of the state's 46,000 annual deaths. For adult-home deaths, which typically are not unexpected, the autopsy rate is just 1 percent, a Times analysis shows.

Barring an autopsy, the cause of death listed on a death certificate often represents a best guess, based on medical history. Frequently, the dead are not examined by physicians. So when doctors sign death certificates, they may be unaware of recent injuries, such as pressure sores or hemorrhages from falls.

As a result, the number of suspicious deaths at adult homes is almost certainly higher than the 236 identified by The Times.

In the case of Clarence Yesland, the physician who signed the death certificate had last examined him weeks earlier. Yesland's body was transferred directly from the adult home to a funeral home, then cremated.

Gelow said he and his mother are upset that DSHS kept them in the dark and then failed to pursue evidence of neglect.

"The state closed this case and never asked me or my mother a single question," Gelow said. "It makes you wonder how many times they've done this." ..Source.. by Michael J. Berens

Old Prisoners Denied Their Social Security

2009-08-03T05:23:00.004-04:00

8-3-2009 National:

AGING BEHIND BARS SERIES

From time to time, I’ve written about the growing numbers of older prisoners now filling up the country’s prisons and jails, in a series of posts called Aging Behind Bars. Many of these prisoners receive inadquate health care and are subject to special forms of cruel and inhuman punishment that have to do with age–i.e. requiring people with bad arthritis to climb to the upper bunk to sleep, or making it next to impossible for inmates in wheelchairs to access parts of prisons available to younger people, even including something as simple as handicapped showers. Among the worst incidents described to me by a medical consultant were ill women forced to get out of bed at 3 am,then stand in lines to obtain medicine in one Alabama women’s prison.

Older prisoners are also often denied the Social Security they earned for years before being convicted of a crime. Lois Ahrens, who runs the indispenable Real Cost of Prisons Project, alerted me to the situation of David Hinman, a prisoner in Iowa. Now 65, he contributed to Social Security for years while he was in the “free-world.” He is not eligible for parole for a number years. Hinman writes:

Currently the government will not pay people in prison social security. I am speaking about paying social security to those who paid into the fund. Payment is based on what they paid in. Even though I am now 65 and paid into the fund, since I am in prison I am not allowed to collect unless I am released from prison. By not paying inmates the social security to which they are entitled, I believe this is in some manner, theft.

My question to readers is: should prison inmates who paid into social security and reached 65 be allowed to collected social security while incarcerated or not.

(You can write to David Hinman, #25374, Anamosa State Penitentiary, 406 North High Street, P.O. Box 10, Anamosa, IA 52205-0010.)

Asked about this situation, Paul Wright, editor of Prison Legal News, the excellent magazine which tracks prison issues, wrote me:

Part of the problem I have with this is that someone can work their whole life, pay into Social Security, commit a crime at a later age, and go to prison for the rest of their life and never see a penny of the money they paid into SS. The lie used to justify this is prisoners have no need for money but that is not true. I think it is a backdoor way to trim the SS rolls. I think this is the exception. To put it into context, retirees can get their pensions in prison, veterans can get their VA benefits in prison. It follows that if you earn something you are entitled to it. It is not a freebie the government can take away because it doesn’t like you and that is exactly what they do here.

Wright attached an article from a 1998 isssue of Prison Legal News, describing a federal court decision on the subject, that sets the situation into the bleakest of terms.

The court of appeals for the Ninth circuit held that a statute denying Social Security benefits to prisoners is constitutional. Robert Butler is a 77 year old Nevada state prisoner. Butler was granted social security retirement benefits in 1983. He was later incarcerated and the Social Security Administration (SSA) determined he was not entitled to benefits while he was incarcerated pursuant to 42 U.S.C. § 402(X). An administrative law judge affirmed the SSA’s decision. Butler filed suit in federal court and it was dismissed for failing to state a claim upon which relief could be granted. The court of appeals affirmed. The appeals court noted that every court to consider the constitutionality of 42 U.S.C. § 402(X), this includes the Second, Fourth, Eighth, Tenth and Eleventh circuits, had upheld the law. Congress has wide discretion in administering welfare resources. The court held that § 402(X)’s ban on social security benefits to prisoners does not violate constitutional guarantees to due process, equal protection and protection against ex post facto laws and bills of attainder. The court also held that Butler was provided with ample due process before his benefits were terminated because he participated in the SSA hearing by telephone. Since the statute leaves no room for agency discretion and the only fact issue was whether or not Butler was a felon doing time in prison, the telephone hearing was sufficient to safeguard Butler’s due process interest in his social security benefits. See: Butler v. Apfel , 144 F.3d 622 (9th Cir. 1998).

..Source.. by James Ridgeway, the Unsilent Generation

IA- Hospice industry decries Medicare cuts

2009-05-23T14:55:00.003-04:00

5-23-2009 Iowa:

The president of a group representing the nation's hospice care industry says one of Iowa's two senators is supporting a bid to rescind a rule that cuts federal payments to hospices.

Don Schumacher, president of the National Hospice and Palliative Care Organization, says last year the Bush Administration enacted a rule which cut payments to hospices for treatment of elderly patients who're on Medicare.

"We're trying to make consumers aware all around the country that hospice care, which is one of the most successful choices for care at the end of life, is experiencing some potential difficulty in that as the Bush Administration left office last year they instituted a regulation that's cutting hospice reimbursement by $2.2 billion," Schmacher says.

Specifically, Medicaid payments for hospice care were cut by just over four-and-a-half percent.

"We did an economic survey of our members over the last couple of months and it shows that even without this rate cut the economic picture right now has hospice programs struggling 'cause of the tremendous costs and the reimbursement really, essentially being on the low end as it is," Schmacher says, "and this is an additional cut to us which will cost us dramatically."

Congress reversed the reduction in Medicaid payment rates for hospice care for this year, but Schmacher's group is now lobbying congress to keep hospice care rates the same for the next two years. Iowa Senator Tom Harkin has signed onto a letter, urging the Obama Administration to make the move. Hospice groups are asking Iowa's other senator, Chuck Grassley, to join the effort to keep hospice care payments for Medicare patients the same for the next two years.

"It's quite a bit of change for programs to lose," Schmacher says.

According to Schmacher, it makes economic sense for Medicare patients to choose hospice care.

"A study came out of Duke University two years ago and it shows that for every patient admitted to hospice, we save the Medicare system about $2200 to $2500 when compared with patients of similar disease and life trajectory," Schmacher says. "...Everybody who goes through hospice, for the most part, feels as though they received the opportunity to say good-bye in the most appropriate way possible."

The Hospice and Palliative Care Association of Iowa represents 74 hospice agencies providing end-of-life care at 103 different facilities in Iowa. Schumacher leads the national group which represents about 80 percent of the hospices in the United States. ..Source.. by O.Kay Henderson

MI- Editorial: Protect patients at care facilities

2009-05-08T14:39:00.003-04:00

5-8-2009 Michigan:

Congress should pass legislation to prevent criminals from securing jobs in long-term care fields. Those looking to abuse and steal from senior citizens should have to work harder at it than just filling out a job application at a nursing home. The bill would require a comprehensive nationwide program for background checks before a job could be given to anyone seeking elder-care employment. There is an unprecedented demand for long-term care housing because Americans are living longer. That has created more need for caregivers. More protection is needed to safeguard vulnerable residents from those who could do them harm.

While most states like Michigan require background checks for employees of long-term care facilities, there is no national or coordinated database that provides a thorough review of an applicant's criminal history. Too often predators, who frequently change states and jobs, have been able to evade detection because state-based background check systems, overall, are incomplete and inconsistent.

The bill introduced in Congress (HR 2223) by Rep. Joseph Sestak, D-PA and co-sponsored by Rep. Vernon Ehlers, R-Grand Rapids and Rep. Fred Upton, R-St. Joseph, calls for states to establish a cross-referencing system for national and state background checks of prospective employees. The checks would be applied to those people with direct access to patients in the long-term care facilities. Federal matching funds would be provided to help states pay for the system.

State information would be coordinated and applicants screened against the Federal Bureau of Investigation's criminal history database.

This legislation seeks to expand on a seven-state background check pilot program that included Michigan, operated between 2005 and 2007. Checks were done either statewide or for a few counties. As a result of that pilot, administered by the Centers for Medicare & Medicaid Services, more than 7,200 people with criminal histories of violence or abuse were prevented from working as caregivers.

Mr. Ehlers said the pilot has proved successful in Michigan, and he is dead-on about a national background system providing "safety and peace-of-mind to people staying in these facilities, and their families." There needs to be some faith that those entrusted to care for a person or his loved one is not going to kill, beat, rape or rob that person. This bill would be a big step in achieving that confidence. Kent County has 25 licensed long-term care facilities (2,560 beds) and Ottawa County has 14 facilities (908 beds).

There is a strong case for this measure. Besides the pilot program, a 2006 Health and Human Services (HHS) study points out several challenges of individual state registries. In addition, a 2004 national survey of State Adult Protective Services agencies identified more than 500,000 reports of elder abuse, including physical, sexual and financial exploitation.

In 2005, Michigan Attorney General Mike Cox reported that 25 percent of residential care facility employees committing crimes against residents since 2002 had past criminal convictions. His statewide investigation revealed criminal histories that included homicides, armed robberies and criminal sexual conduct. This led to a law that took effect in April 2006, making it a crime not to conduct a criminal background check. The law mandates fingerprint checks and expands the number of crimes that can disqualify a job applicant, including drug and theft offenses. These are important safeguards, but the FBI screening and enhanced state-to-state information from a national database would bolster protections in the state.

America's baby boomers are beginning to turn 65. People who reach that age have a 40 percent chance of entering a nursing home, according to HHS. Those who do will stay there five years or more. According to the Census Bureau, 10.3 percent of Kent County's population was 65 or older in 2007, 10.7 percent of Ottawa County's and 12.7 percent statewide.

The bottom line is that the current background check system is not thorough enough, and allows criminals to slip through. Congress knows that. Now lawmakers need to do something about it so the elderly and disabled are not easy prey for shady characters. ..Source.. Opinion of Grand Rapids Press Editorial Board

OH- Proposed law would ensure nursing homes be informed when a sex offender moves in

2009-04-28T12:31:00.004-04:00

This proposed law makes no sense because it puts the onus on law enforcement to do something (administrative clerical type work) that takes them away from law enforcement work. To take time to personally notify nursing homes when a registered sex offender moves into an address which is classified as a nursing home. Further, LE would have to keep track of every nursing home as well. It would be far easier and more cost justified if nursing homes would check the public registries on some regular basis for their new admissions, or on preadmission. If families of nursing home residents are concerned they can do the checking as well.

4-28-2009 Ohio:

You don't have to wait for a new Ohio law to pass to find out if a sex offender is living in the same nursing home where your mom or dad or other loved one lives.

You can find out right now.

The legislation, House Bill 98, introduced last month by State Rep. Courtney Combs, Republican of Hamilton, would require local sheriff's offices to notify nursing homes -- and other long-term care facilities -- when a sex offender moves in.

The facilities, in turn, would be required to tell patients and whoever looks out for them.

Combs introduced the law because an 18-year-old mentally retarded woman was raped by the man in the next room at a long-term care facility in his district. He doesn't want that to happen again.

The way the existing law is written, schools, day-care centers and homes -- but not long-term care facilities -- that are within 1,000 feet of where an offender lives are notified.

That means a sex offender could be sharing a room with Grandma or Grandpa and you'd never know it.

So how can you find out now? All you need is the address of the nursing home and a computer.

Go online to the Ohio attorney general's website and you can search for sex offenders. Type in the address of the nursing home. You'll get the name, photograph and address of each registered sex offender who lives within -- and you can choose this -- a quarter-mile, a half-mile, one or two miles.

Click on the offender's name, and you'll get a little more information on his or her crime.

The problem with the system, says John Saulitis, is that you have to keep checking back. A sex offender may not live in your mother's nursing home today, but he could move in next week. And that, Saulitis says, puts an unrealistic burden on nursing home residents and their families.

Saulitis runs the Youngstown office of Ohio's Long-Term Care Ombudsman Programs, part of a state and national system of people who look out for the rights and safety of those living in group homes, nursing homes and assisted-living centers, as well as those who receive in-home care.

He's also the guy who spent weeks combing through the registry to find out how many sex offenders live in Ohio's nursing homes.

It's a changing number. But when he finished his research on March 23, he'd discovered 107 offenders living in 47 nursing homes across the state.

Keeping tabs on them is a time-consuming process. That's one reason Saulitis wants to see the law changed.

He knows you can go to the attorney general's Web site listed above and sign up for an automatic e-mail alert whenever a sex offender moves close to any address -- including a nursing home's -- that you type into the site. The problem, he says, is that you get an alert whenever an offender moves into the surrounding area, not just the nursing home.

"The more notifications you get," Saulitis says, "the less you're going to pay attention to them."

And when you stop paying attention, what good is the notification?

That's another reason he's pushing for passage of House Bill 98 and urging all of us who have a loved one in long-term care to call our lawmakers.

"Contact your legislators," he says, "and say 'Look, there's a simple solution to this. It's called House Bill 98. We want to you support it.'

"It simplifies the system incredibly for the families and relatives," Saulitis says. "It's just much more efficient."

If you want a more complete picture about the safety and quality of a nursing home, make sure you go to the Department of Aging's Long-Term Care Consumer Guide.

Follow the instructions and the site will tell you how people who live in nursing homes feel about each facility. You can see, for example, what percentage of patients actually said they liked the home and what percentage would recommend it to someone else.

Not only will you get that from the patient's perspective, you'll get it from the family's, too.

You'll also find more specific survey results about things like clothing getting lost, residents being treated with respect, and how satisfied people are with the food and medical care.

What's more revealing, though, are the inspection reports you'll find when you click on the "Inspections" tab. That will lead you to a description of what Medicare/Medicaid inspectors found when they stopped by the facility -- unannounced and sometimes at night or on weekends -- to visit.

From those reports you can learn, for example, if a nursing home was cited for not providing a safe, clean environment; for medication errors that caused harm; for allowing pressure sores to develop; or for failing to notify family members when a resident was injured.

The information is even more helpful, says Beverley Laubert, the state long-term care ombudsman who oversees Ohio's 12 offices, when you click on the date under "Most Recent Annual Survey" and see the details of what officials call the "deficiencies."

What the Web site doesn't provide, though, is what action the nursing home took to solve the problem.

Each home is required to have that on hand, in an easy-to-see spot, says Laubert. Look for it at the front desk, nurses station or on a bulletin board.

If it's not there, ask for it, says Laubert. If you're not comfortable doing that, contact the state ombudsman's office at 1-800-282-1206 and someone will put you in touch with the office closest to you.

But don't stop there.

Spend some time at the nursing home and check it out for yourself.

"Nothing beats going there and visiting," says Kathy Keller, spokeswoman for AARP Ohio.

"You need to see it, you need to get the feel for the institution, you need to be able to walk around and see what is going on, you need to smell it, you need to see if the residents there seem to be happy or if they're not very happy."

That's the only way you'll know for sure if it works for you and your loved one. ..Source.. by Diane Suchetka/Plain Dealer Reporter

WA- Bill targeting those who exploit vulnerable adults approved

2009-04-21T12:09:00.002-04:00

4-21-2009 Washington:

Legislation may soon go to governor for her signature

A bill that would prevent those who exploit elderly or otherwise vulnerable persons from inheriting money or property from their victims has passed both the House and Senate and may soon be on its way to the governor's desk.

House Bill 1103, sponsored by Rep. Jim Moeller, is the latest in a series of bills the Vancouver Democrat has sponsored in recent years to protect vulnerable adults from exploitation. Moeller has worked closely with the Clark County Vulnerable Adults Task Force to develop the legislation.

"As we age, we become more dependent upon people close to us for taking care of our basic necessities," Moeller said in a statement. "Yet some of the people closest to us, sometimes even our own children, take advantage of the situation."

Nothing in existing state law prevents a person who is found guilty of committing financial exploitation from inheriting property from the victim if the perpetrator is named in the victim's will.

Vancouver attorney Jessica Dimitrov said the new law will have significant impacts.

She is a partner in Dimitrov & Senescu, a law firm that represents exploited and vulnerable adults and works to change state law.

"We are seeing an increase in financial exploitation of vulnerable adults, and given the current economic situation, we can expect it to get much worse before it ever stops happening," she said in an e-mail. "But this law seeks to serve as a very severe and tough deterrent to this type of activity."

Moeller said he expects the House to concur with an amendment to the bill added by the Senate and then send the bill to the governor for her signature. ..Source.. by KATHIE DURBIN, COLUMBIAN STAFF WRITER

IN-Indiana bill would allow alerts for missing seniors

2009-04-21T04:20:00.002-04:00

4-20-2009 Indiana:

INDIANAPOLIS (AP) — Indiana residents could soon get public warnings similar to Amber Alerts when seniors with Alzheimer's disease or other endangered adults go missing.

A bill that won final legislative approval Monday would create silver alerts, which would be issued by police and broadcast by media outlets.

Bill supporters say the proposal could protect thousands of Indiana residents with Alzheimer's disease or other cognitive problems. But some were concerned that the system would result in so many alerts that the public would tune them out.

At least 10 states have notification systems for people with some form of mental impairments.

The bill now goes to Gov. Mitch Daniels for his consideration. ..Source.. by SOuth Bend Tribune

In early Alzheimer's, when to give up the car keys

2009-04-18T06:18:00.002-04:00

4-18-2009 National:

WASHINGTON — Scientists are creating tests to show when it's time for people with early Alzheimer's disease to stop driving.

It's one of a family's most wrenching decisions, and as Alzheimer's increasingly is diagnosed in its earliest stages, it can be hard to tell when a loved one is poised to become a danger.

Factor in that much of the country lacks public transportation, and quitting too soon restricts independence for someone who otherwise may function well for several years.

"That's a real cost to the individual and family and society," says Jeffrey Dawson of the University of Iowa. "You have to have some sort of trade-off between the individual's independence along with the safety of the driver and with other people on the road."

Typically, specialists say, patients gradually scale back their driving, avoiding busy freeways or night trips or left-turn intersections. Alzheimer's Association adviser Sue Pinder, 58, recently gave up big-city driving even though it meant fewer visits to a daughter in Dallas.

Shortly after Pinder's diagnosis in 2004, she signed a form designating her husband to decide when she'll quit driving altogether. He gave her a GPS system for her last birthday. It helped Pinder navigate unfamiliar streets when, to be near another daughter, the couple recently moved to West Monroe, La., from a nearby town.

"That's helped a lot where I don't have to worry, I can concentrate on my driving and not the directions," Pinder says.

Working on ways to help similar patients, Dawson's team in Iowa developed an intricate behind-the-wheel exam: A 35-mile drive through rural, residential and urban streets in a tricked-out Ford Taurus able to record just about every action the driver takes, much like an airplane "black box" does. Lipstick-size video cameras were positioned to show oncoming traffic, too.

Researchers recruited 40 people with early-stage Alzheimer's who still had their driver's licenses to take the road test, and compared how 115 older drivers without dementia handled the same trip.

The results, reported in the journal Neurology, are striking. On average, the Alzheimer's drivers committed 42 safety mistakes, compared with 33 for the other drivers.

Lane violations, such as swerving or hugging the center line as another car approaches, were the biggest problem for the Alzheimer's drivers. They performed 50 percent worse.

Overall errors rose with increasing age whether or not the driver had Alzheimer's, an extra 2 1/2 mistakes for every five years of age.

But some Alzheimer's patients drove just as well as their healthier counterparts, stresses Dawson, a biostatistics professor. Here's the key: Researchers also checked whether any of a battery of neuropsychological tests given beforehand accurately predicted who would drive worse _ and some did.

Flunking simple memory tests didn't make a difference. Standard neurologic tests of multitasking abilities did, ones that assess if people's cognitive, visual and motor skills work together in a way to make quick decisions. Examples include showing patients geometric figures for a few seconds and having them draw the shape from memory, or drawing paths between a sequence of numbers and letters.

Alzheimer's patients who scored average or better on those types of written tests were likewise no worse behind the wheel than other older drivers _ but those who scored worse than average tended to commit about 50 percent more errors on the road, Dawson says.

More research is needed but the ultimate goal is an easy doctor's-office exam to help guide when patients should give up the keys.

About 600,000 elderly adults stop driving for some health reason every year, according to the National Institute on Aging. But there's little clear guidance for the roughly 2 million people estimated to be in Alzheimer's early stages, and the disease is poised to skyrocket in two decades as the population grays.

States have varying laws on when aging drivers must pass a road test for a license renewal, but they seldom address specific diseases; California requires reporting of Alzheimer's diagnoses so driving can be assessed. The Alzheimer's Association tells families warning signs of unsafe driving.

But as Alzheimer's worsens, patients often vehemently deny that they're a hazard, says Dr. Gary Kennedy, geriatric psychiatry chief at New York's Montefiore Medical Center.

"I can be the bad guy," he tells families, sometimes reporting patients to the Department of Motor Vehicles for a driving test or advising relatives to disable the car.

"Giving up the car is not like going into the nursing home," Kennedy counsels patients, trying to recruit relatives or friends to schedule rides. "If as a society we recognize this as a danger, we need to help them compensate." ..Source.. by LAURAN NEERGAARD

Medicare's Hospice Benefit

2009-04-17T13:43:00.003-04:00

4-17-2009 Washington DC:

Summary:
Hospice care provides an interdisciplinary approach to services for Medicare beneficiaries with a terminal illness. This care specializes in the relief of the pain and symptoms associated with a terminal illness and in the provision of supportive and counseling services to patients and their families during the final stages of a patient's illness and death.

The benefit covers a broad range of services, including prescription drugs for pain control and symptom management, skilled nursing care, physician services, home health aide services, homemaker services, patient counseling, and family bereavement counseling. Services are provided primarily in the patient's home, but may also be provided in institutional settings, such as nursing homes.

Hospice care is provided in lieu of most other Medicare services related to the curative treatment of the terminal illness. For a person to be considered terminally ill and eligible for Medicare's hospice benefit, the beneficiary's attending physician and the medical director of the hospice (or physician member of the hospice team) must certify that the individual has a life expectancy of six months or less.

Beneficiaries electing hospice are covered for two 90-day periods, followed by an unlimited number of 60-day periods. Medicare payments to hospices in 2007 totaled $10.1 billion, having more than tripled since 2000. Medicare spending for hospice is expected to continue growing and to more than double by 2018, reaching a projected $21 billion and outpacing the projected growth rates for Medicare payments in hospitals, skilled nursing facilities, physician services, and home health care.

Growth in spending to date has been driven, in part, by increased utilization of hospice as well as spending per hospice user. For example, spending per user grew between 2004 and 2005 by 8%. Growth in spending per user may be in part a result of increasing lengths of stay among certain hospice providers.

The number of hospices participating in Medicare also grew by 33.4% during the four-year period from 2003 to 2007. As of 2007, for-profit hospices constituted the majority of these hospices, and since 2000, made up over 90% of hospices participating in Medicare. Medicare pays hospices using a prospective payment system containing four categories of daily rates, which are predetermined, fixed amounts intended to pay for the costs of care for a hospice beneficiary, on average.

These amounts are adjusted annually by the hospice market basket. Hospice payments are also adjusted for geographical differences. Total payments to hospices may not exceed an aggregate per beneficiary cap amount. Some analysts have expressed concerns about Medicare margins earned by certain types of hospice providers, the growing number of hospices exceeding the aggregate per beneficiary cap, increasing lengths of stay, and the three-year phase out of the budget neutrality factor authorized under regulation in August of 2008. All of these topics are discussed in this report, which will be updated as necessary.

For the full report: by Medicare

OR- Bill would admit some sex-crime confessions

2009-04-17T03:08:00.002-04:00

4-17-2009 Oregon:

A bill that cleared the Oregon House without dissent Wednesday would allow admission of confessions to sex crimes against vulnerable adults and children as evidence in a trial, even when the victim is unable to speak in court.

"When the defendant has confessed, it is heartbreaking that justice cannot be served because of the victim's inability to testify," said Rep. Sara Gelser, D-Corvallis, floor manager for House Bill 2441, which moves to the Senate.

The bill would apply only to sex crimes committed against individuals that the court has determined unable to testify in court. In addition, a judge must determine that the confession is trustworthy in a pre-trial hearing before the confession can be admitted. If the defendant is a person with a developmental disability, a person with a mental illness, or a juvenile, the confession won't be admitted.

Once the confession is deemed admissible, it would be entered into evidence at a trial and considered by the jury like any other evidence. ..Source.. by Peter Wong

SC- Bill aims to protect vulnerable adults

2009-04-17T02:55:00.003-04:00

4-17-2009 South Carolina:

A Senate subcommittee approved a resolution Thursday to establish a registry of convicted offenders of vulnerable and abused adults.

The resolution directs the state Budget and Control Board to order agencies that deal with the Adult Protection Act to report convicted cases of adult abuse and neglect to a state agency that will post the convicted on a state Web site.

State Sen. Joel Lourie, D-Richland, who is sponsoring the bill, said the Web site would function much like the state’s sex offender registry, serving as a clearinghouse for employers and others who hire workers to care for vulnerable adults.

Under the proposal, offenders’ names would remain on the registry for five years after completion of their sentence for the crime of abuse, unless the offender committed another offense. ..Source.. by S.C. Politics Today

Bill in Congress - HR 1374

2009-04-11T15:48:00.000-04:00

4-9-2009 National:

`Elder Abuse Prevention Act'

Sponsor: Rep Chandler, Ben [KY-6]
Introduced 3/6/2009) Bill HR 1374

The STATED intent of the bill is: To prevent the abuse and exploitation of older individuals.

UPDATE: Thanks to a reader reminding me of a portion of the U.S. Constitution I have revised my analysis.

My REVISED Summary:
A bill to force states (under threat of denial of various grant money) to deny parole for: 1) any sexually violent predator, 2) and ANY person who has committed a sexual crime against an elderly person, which includes offenses under state law that are equivalent to certain federal offenses, and including offenses committed in the "special maritime and territorial jurisdictions" or in a federal prison, are to be denied parole. Because the U.S. Constitution Article 1,Sec. 8(10) permits Congress "to define and punish ... and Felonies committed on the HIGH SEAS, and Offenses against the Law of Nations," the U.S. would have jurisdiction under this bill. I disagree with denying those folks parole should they be eligible and have completed what was asked of them.

My Analysis:

Who the bill pertains to:

SEC. 3. NO PAROLE FOR SEXUAL OFFENSES COMMITTED AGAINST THE ELDERLY OR FOR SEXUALLY VIOLENT PREDATORS.

(a) In General- For each fiscal year after the expiration of the period specified in subsection (b)(1) in which a State receives funds for a program referred to in subsection (b)(2), the State shall have in effect throughout the State laws and policies that prohibit parole for any individual who is--

(1) convicted of a criminal sexual offense against a victim who is elderly, which shall include any such offense under State law for conduct that would constitute an offense under chapter 109A of title 18, United States Code, had the conduct occurred in the special maritime and territorial jurisdiction of the United States or in a Federal prison; or

(2) a sexually violent predator.

"Elderly" is not defined but in the "Congress finds" section it mentions 65 or older.

In essence, any person who has committed a sexual crime against an elderly person, which includes offenses under state law that are equivalent to certain federal offenses, and including offenses committed in the "special maritime and territorial jurisdictions" or in a federal prison, are to be denied parole.

The most interesting portion of this bill is the definition of "special maritime and territorial jurisdictions" which goes so far to say in "Outer Space." How many of those are ever going to occur, I don't think I know of an elderly person (65 or older) who is up to travel in outer space, but maybe there are folks capable.

Denial of grant money:

(2) INELIGIBILITY FOR FUNDS- For any fiscal year after the expiration of the period specified in paragraph (1), a State that fails to fully implement this Act shall not receive 10 percent of the funds that would otherwise be allocated for that fiscal year to the State under subpart 1 of part E of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3750 et seq.), whether characterized as the Edward Byrne Memorial Justice Assistance Grant Program, the Edward Byrne Memorial State and Local Law Enforcement Assistance Programs, the Local Government Law Enforcement Block Grants Program, or otherwise.
......

I would OPPOSE this bill 100% just because it automatically denies parole to persons who may have completed everything asked of them.. Contact lawmaker, with your views, by clicking on his/her name above, as well as your own folks in Congress. Today, folks can contact the Committee working on this bill, by simply clicking on the bill number above, going to the "Congressional Actions" section and find the name of the committee to contact.

Thanks,
eAdvocate

Note: To see all bills concerning sex offenders or their families currently in Congress simply click here. At the present time I do not review sex offender bills concerning Immigration or Appropriations, they get very involved and are time consuming.

Note: Full bill text WILL NOT be included in this blog because as time goes on bills are amended by Congressional Committees and also on the floor of either house, and it is too easy to confuse folks who may not realize that. Further, links to the bill in Congress will be provided so folks can always see the latest version of the bill.

MA- State puts porn pervs in sights

2009-03-26T17:18:00.000-04:00

3-26-2009 Massachusetts:

Pervs preying on the elderly or disabled could soon face harsh new penalties under a first-of-its-kind proposed law that would punish sicko peddlers of geriatric and handicapped porn the same as child pornographers.

Fueled by a rise in sex abuse against the elderly and disabled and a string of cases involving photography and cyber postings, the proposed legislation would add seniors and the handicapped to kiddie porn laws.

“Obviously with the technology evolving, the crimes committed using that technology have increased. That’s clearly the case,” said Northwestern District Attorney Elizabeth Scheibel, who covers parts of western Massachusetts and helped craft the proposal. “All we’re trying to do with these two pieces of legislation is to protect our two most vulnerable populations.”

Emil DeRiggi, spokesman for the state Disabled Persons Protection Commission, said the agency has “certainly seen an increase” in sex abuse cases involving pornography. One case currently being investigated involves a twisted online posting offering sex with a “cognitively impaired” virgin.

Other recent cases include:

A pair of caretakers who took their disabled boarder on a “state-to-state party,” taking sexual photos along the way;

A man with cerebral palsy who can talk only with a communication board was mocked and harassed by caretakers who snapped pictures of his genitals;

A mentally retarded woman had pornographic pictures taken of her and posted on the Internet by relatives.

The DPCC reported 44 rapes and 29 indecent assault-and-battery cases in the past three months of 2008. In the past year, the agency reported 92 cases of sexual exploitation.

Officials said there have been other recent cases involving seniors and the state Executive Office of Elder Affairs is backing the bill.

“Elder Affairs supports policies that protect vulnerable seniors from exploitation,” spokeswoman Kristina Barry said.

There are currently no federal laws against elderly or disabled porn, and Massachusetts officials were unaware of any similar legislation in other states. A similar effort, though, is underway in Illinois, where new child porn laws also protect the “severely mentally retarded.”

Rep. Kathi-Anne Reinstein (D-Revere), who backs the bill, said she’s spoken with senior advocacy groups who report that elder exploitation and pornography is on the rise.

“We know that it’s happening. I didn’t realize until this whole scenario was brought to my attention that it was an issue,” Reinstein said. “If we can extend protection to the elderly and the disabled, I think it’s kind of a no-brainer.”

But prominent civil rights attorney Harvey Silverglate said the proposal “amounts to blatant censorship” and is “unconstitutional.”

“It seems to be the latest in a long effort to broaden the definition of obscenity,” Silverglate said. “We’ve already got (laws) against coercion. Why is that not adequate?” ..News Source.. by Dave Wedge

Improvements Needed to Address Improper Medicare Payments in Home Health

2009-03-14T02:33:00.002-04:00

3-13-2009 National:

Report to the Ranking Member, Committee on Finance, U.S. Senate

Why GAO Did This Study

Medicare spending on home health totaled $12.9 billion in 2006, up 44 percent from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization. The Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, is responsible for minimizing improper payments made on behalf of Medicare beneficiaries. GAO was asked to examine the growth in Medicare home health spending and utilization and the benefit’s vulnerability to improper payments. GAO focused on states with the highest growth in Medicare home health spending or utilization; fraudulent and abusive practices contributing to recent spending and utilization; and administrative issues that make it vulnerable to improper payments. GAO analyzed Medicare claims data; reviewed Medicare laws and regulations and CMS documents; and interviewed stakeholders and contractors that administer and protect the home health benefit. ..For the remainder of this report.. by GAO Office

LA- Infirm prisoners no threat

2009-03-08T04:57:00.005-04:00

3-6-2009 Louisiana:

The recent refusal of the Louisiana State Pardon Board to release Angola inmate Douglas Dennis points to an increasingly expensive and worrisome situation within the Department of Corrections: the large number of infirm geriatric prisoners in state custody. With the economy in such bad shape and state taxpayers struggling, is it necessary that we continue to endlessly support those aging prisoners who are deemed to present no danger to the general public?

Dennis is 73 years old and confined to a wheelchair, having barely survived open-heart bypass surgery with complications resulting in many months of hospitalization at state expense. He has been incarcerated for nearly half a century, since he was in his 20s, and during his time in prison has made a number of positive contributions.

At Angola he implemented and ran the sports programs that provide much-needed physical release. He wrote thoughtful book reviews and judicial interpretations for The Angolite newsmagazine and co-wrote a textbook on criminal justice, and during the federally mandated integration of the prison population in the early 70s, he was one of the inmate leaders upon whom the administration relied to defuse a dangerously volatile situation. He has never excused nor denied the senseless stupidity of his criminal acts; instead, he has accepted responsibility and has paid with most of his life.

Now he has arrangements for housing and support outside Louisiana, and yet the Pardon Board summarily dismissed his application for release. As a crime writer and a crime victim myself, I well understand that there are incarcerated criminals who must remain behind bars for the protection of the public. I certainly do not condone violence and deeply sympathize with the suffering of victims and their survivors.

Yet at the hearing in Baton Rouge, pardon board members paid scant attention to several corrections professionals who offered their unqualified support for releasing Dennis. These were not emotional bleeding-heart liberals, but career criminologists and law enforcement officials whose opinions the board would have done well to heed.

Former Angola warden John Whitley, making what he said was his first and only appearance before a pardon board on behalf of an inmate, recalled earlier days at the Louisiana State Penitentiary at Angola when he would arrive for work each morning to find a trail of blood from the dorms to the infirmary where inmates stabbed or beaten overnight had been dragged. Citing the uncontrolled violence within the prison in those days, he attempted to provide a feel for the atmosphere when the administrative staff relied on the judgment and assistance of only a few sensible inmates in attempts to control the prison population, and Douglas Dennis was one of those.

A former career FBI agent also spoke on Dennis' behalf, citing his ability to live outside prison as a contributing, taxpaying citizen without problems. Others attending the hearing, allowed to comment only in writing, included the former counsel for the state corrections department; the ex-wife of a deceased warden who cited his respect for Dennis; and the daughters of Elayn Hunt, late head of the corrections department, who said their mother's dying wish had been that Dennis, who had served as her inmate chauffeur, be released.

At the same Pardon Board hearing were considered requests from other inmates who undeniably presented a clear and continuing danger to the public; the board denied these applications, and rightfully so. But if the board routinely denies all applications without considering their individual merit, that removes one of corrections' officials most effective motivational tools, the hope of release in response to clean records and good behavior. It also means that Louisiana taxpayers must continue to bear the burden of supporting an over-the-hill gang of inmates whose increasing medical requirements and expensive support need not be the continuing responsibility of the state when there are safe alternatives, elderly sick inmates who are taking up space badly needed for more dangerous younger criminals. ..Source.. by Anne Butler, of St. Francisville, is an author.

OK- Bill to Prevent Abuse of Elderly Passes Committee

2009-02-18T18:36:00.003-05:00

2-18-2009 Oklahoma:

OKLAHOMA CITY – Legislation to protect the elderly from abuse or neglect while in the care of a nursing home passed the House Human Services Committee this week thanks to state Rep. Anastasia Pittman.

House Bill 1627, by Pittman, requires a nursing facility to notify local law enforcement, in addition to the Department of Human Services, if an incident of physical or sexual abuse occurs in the facility and requires the administrator of the facility to preserve the scene in which any alleged criminal act took place. If sexual assault is suspected, the bill directs that the administrator arrange for sexual assault examination.

“As legislators, we need to do whatever we can to protect the elderly from being abused,” said Pittman, D-Oklahoma City. “I am shocked and appalled to know that people would take advantage and assault these vulnerable individuals. I hope my bill puts a stop to such horrendous crimes.”

In 2008, Adult Protective Services confirmed a total of 10,315 reports of abuse, neglect or exploitation.

Another provision in the bill requires a person who has reason to believe that a vulnerable adult is being abused, neglected or exploited to report it to both the Department of Human Services and local law enforcement and to preserve any evidence of the abuse or neglect.

“This will address cases involving home health care providers or anyone visiting an incapacitated and/or defenseless elder and abusing them in their own home,” said Pittman. “Without this provision, a person could experience months of abuse without any law enforcement investigation taking place-this bill will hopefully not let that happen.” ..Source.. by Bixby Bulletin.com

AL- Judge delays sentencing in porn case involving paralyzed man

2009-02-13T03:01:00.002-05:00

2-13-2009 Alabama:

After a 5cm HALF-hour hearing that focused largely on a Satsuma man's paralysis, a federal judge in Mobile on Wednesday said she needs more information from prison officials before sentencing the man, who admitted to secretly videotaping young girls who used his bathroom.

Under advisory sentencing guidelines, Robert Vezendy faces at least 14 years in prison on the charge he pleaded guilty to: receipt of child pornography.

But defense lawyer Dennis Knizley contended that anything longer than the five-year statutory minimum would be a "death sentence" for a 43-year-old man who has been paralyzed since an accident that occurred when he was 17.

Chief U.S. District Judge Ginny Granade heard conflicting descriptions of the capability of the federal Bureau of Prisons to accommodate Vezendy. She continued the hearing until Feb. 25 and demanded testimony or other information from government officials with firsthand knowledge of the prison system.

"I do, frankly, have some concerns about the Bureau of Prisons' ability to address the medical needs of Mr. Vezendy," she said.

Immigration and Customs Enforcement agents arrested Vezendy last year after finding his credit card number in the computer system of a Web site that sold child pornography over the Internet.

Investigators found thousands of images on Vezendy's computers and discovered videos of four naked girls that appeared to have been photographed in the defendant's bathroom.

Vezendy later admitted that he set up a hidden camera in his bathroom and made videos of girls from his neighborhood as they showered, used his toilet and danced in front of the bathroom mirror.

Wes Anthony, an Immigration and Customs Enforcement investigator, testified that the girls were between the ages of 6 and 13. He said investigators found 47 videos taken of the girls from July 2005 until the end of 2007.

Gus Dimitrelos, a consultant who examined Vezendy's computer equipment, testified that he identified more than 1,000 child pornography images of children who have been identified by the National Center for Missing & Exploited Children.

"These are real victims that have been identified over the years," he said.

Vezendy, seated in a wheelchair before the judge, apologized for downloading the child porn and making the secret videos. He said he never would have harmed the children, but offered little explanation for his conduct.

"There's really no good reason why I made them," he said. "I have a lot of regret. I was just curious."

A doctor testified that Vezendy has no movement from about the middle of his back down. She said he has limited use of his hands and arms and can perform basic tasks, such as writing and eating, only with the assistance of special splints on his arms.

Vezendy has been that way since a car hit him in New York while he was riding his bicycle to his job. He was in the hospital for two months, much of that time in a coma. He then spent seven months in a rehabilitation facility, where he defied doctors' predictions by regaining partial movement above the waist, according to testimony from his parents.

Vezendy got a job at Ciba Specialty Chemicals and moved to Mobile County when the company transferred him to the McIntosh plant in 1996. Knizley said Vezendy was a model employee, who worked his way up to a $75,000-a-year managerial position.

Susan Wardell, a mitigation and alternative sentencing specialist from Atlanta, testified that imprisoning Vezendy would be costly for the government as well as the defendant.

She said her inquiries to prison officials revealed that Vezendy would not be allowed to have his splints, which would render him virtually helpless.

Wardell said prison authorities also told her they do not have trained medical personnel who would be able to take care of him around the clock. Instead, she said, the responsibility would fall to fellow inmates.

"It's cruel and unusual punishment," she said.

A probation officer who made a call to the Bureau of Prisons on Wednesday afternoon said the system does, in fact, have medical facilities with 24-hour nursing staffs that could take care of Vezendy.

Granade said she will decide after she receives more definitive information. ..Source.. by BRENDAN KIRBY, Staff Reporter

ID- Nursing homes are no longer just for the aged

2009-01-20T12:32:00.003-05:00

1-20-2009 Idaho:

LEWISTON, Idaho -- When Lori Hagedorn was working at area nursing homes, she never dreamed she'd be living in one at age 45.
"I used to help elderly people and now I'm living with them 24/7," says Hagedorn, who has been a resident at Orchards Rehabilitation and Care Center in Lewiston since June.

Plagued with chronic medical problems, she is part of a growing population of younger people who need the long-term care, skilled nursing and structure offered in a nursing home.

Two decades ago, about 1 percent of nursing home residents were under the age of 65, estimates Robert Vande Merwe, executive director of Idaho Health Care Association -- Idaho Center for Assisted Living, headquartered in Boise.

Now it's closer to 10 percent, according to statistics from the Department of Social and Health Services in Washington state.

"It used to be a place where the aged went," Vande Merwe says. "Now 80 percent of new admissions are coming for short-term rehabilitation."

Some eventually return home or go to an assisted living setting. Some stay until their death, he says. "It becomes their home and we do everything we can to make it a home environment."

Four or five people under the age of 55 are currently living at Orchards, says administrator Mindy Shepard.

"It's not that uncommon because we have a gap in the health care system between the hospital and the nursing home. People like Lori are younger, but they need the medical care. The structure and support of the staff helps people to remain as independent as possible."

Vande Merwe expects the upswing in younger patients to continue. A major cause is obesity and all of its complications, such as diabetes, he says. "People are crashing earlier now because they're not managing their chronic diseases."

Some children are in nursing homes because of severe birth defects and disabilities caused by drug and alcohol abuse during their mothers' pregnancies. Other young people have diseases with no cure, such as multiple sclerosis, and may reside in nursing homes for many years.

In addition, stroke and heart attack victims are surviving at higher rates and they often need rehabilitation, Vande Merwe says.

"A lot of the younger people are there for a short term to stabilize so they can live on their own again," he says.

"They're not just coming there to die. They're coming there to live, and, hopefully, achieve a higher quality of life. That's not how people saw nursing homes 20 years ago."

Hagedorn's lengthy list of ailments include chronic kidney disease, chronic obstructive pulmonary disease and chronic asthma.

"My major problems are my lungs," she says, adjusting the tube that connects her to an oxygen tank. "I smoked for over 30 years. I started when I was 13 and, over the years, progressed to almost three packs a day."

She also believes inhaling volcanic ash when Mount St. Helens erupted and working at a fertilizer plant may have caused some damage.

Her chronic health problems forced her to stop working about six years ago. It was when she began having trouble managing her pain medication that she had to leave her apartment in Lewiston.

"My doctor said I had to go to assisted living or a nursing home or find a new doctor. I ended up in the hospital way too much. I was on a lot of pain pills and I was overdosing myself. I agreed, as long as I could take some of my hobbies, my TV and VCR and my cat."

She was living alone in low-income housing when she moved to Orchards, and most of her belongings were sold at a yard sale. Choking back a sob, Hagedorn says she had to leave her cat with a neighbor.

"My cat and my computer were my best friends at the time. It seems like I got sick and my friends just disappeared."

She doesn't sit in the blue recliner in her room because it brings back too many memories of what her life used to be like. "It was me, my blanket and cat all snuggled up. I would rather be home in my own place."

Hagedorn, who is single, has been married three times and has three children and four grandchildren. Her oldest daughter, Christina Erb of Lewiston, visits at least once a week.

"It's hard knowing she's 45 and has to live with older folks and doesn't have anyone her age to socialize with," Erb says. "In the other sense, it's a relief to me knowing she's there getting proper care and has someone with her 24 hours a day. She was unable to live on her own with no one to monitor her meds."

Instead of dwelling on the past, Hagedorn tries to keep busy. In addition to watching TV and taking naps, she works on beading projects and crafts. The rest of her time is consumed with the daily routine of a nursing home. Activities are posted on a calendar at her bedside table, along with a menu listing the current month's meals.

One of Hagedorn's favorite activities is going to Rosauers once a week and using her laptop in the coffee shop area there. She also enjoys a monthly trip to Wal-Mart and an occasional restaurant outing.

"I thank my lucky stars I can do all I can," she says.

At the nursing home, Hagedorn begins her day at 5 a.m. when the staff wakes her to take her first round of medications. "Sometimes I can get back to sleep, sometimes I can't."

Meals are brought to her room when she doesn't feel like going to the dining room. On a recent morning, breakfast consisted of scrambled eggs, toast and milk. "The food here is actually pretty good," she says. "The spaghetti is my favorite."

Hagedorn showers twice a week and can walk around her room and use the bathroom on her own. When she leaves the room, she uses a wheelchair. She is looking forward to getting an electric wheelchair and plans to go for a spin around the block on the day it arrives.

When she visited nursing homes as a kid, she remembers seeing old people tangled in bed sheets or sitting in the hallways and the smell. "It's a lot better now. There are times it reeks and I tell them."

The administrator says when you get so many people living in close quarters, there are bound to be some odors. "For the most part, they eat on the same schedule and go to the bathroom on the same schedule. If the smell is the first thing you notice when you walk in a nursing home, you have a problem."

Hagedorn never turns off the television because the constant drone keeps her company. Her days are often lonely, and she finds conversing with the older residents somewhat difficult. Some are bedridden, others are hard of hearing or have trouble communicating. Her elderly roommate rarely speaks.

"The worst thing for me is the loneliness. It's hard. I suffer from depression anyway, and it's worse this time of year."

Activity directors say keeping younger residents active and stimulated can be a challenge. For years, most programs were geared to a different generation. The new clientele would rather surf on the Internet, send e-mails or play video games.

"They don't want Lawrence Welk," says Judy Wood, who has been an activity director at Orchards Rehabilitation and Care Center for more than 20 years. "The younger residents have different interests in music, technology. It's challenging. I try to gear activities to their interests and give them group opportunities to express their feelings about being in a long-term care facility."

Wood recently tried to organize a group activity for younger residents, but it kind of fizzled out. She doesn't push it, if the interest isn't there.

"I try to make them decide what they want to do," Wood says. "You want them to have self-esteem, self-worth and have a choice. We try to maintain their independence as much as possible."

Among the older population at Orchards, bingo is a big draw, along with exercises, reminiscing and music. "Religious programs and musicians are popular, and the residents love the Wii games. They like the bowling and the baseball. It's good exercise."

Wood has worked in nursing homes since 1974. She says it's not an easy job, but it is rewarding.

"I think I make a difference in people's lives, at least I hope I do. I hope I increase their quality of life. I like the elderly people. I love listening to their stories, their history, the technology changes they've seen, their hardships and how they met their spouses. It's interesting, and I've learned a lot from them."

At Orchards Rehabilitation and Care Center, there are about 100 employees and 66 residents. The majority of people who reside there are covered under state-funded Medicaid. For the 10 percent or so who have to pay privately, the cost is $5,500 per month.

The staffing ratio at the nursing home is good, Shepard says. The state mandates 2.5 hours of care per day for each patient. At Orchards, she says the average is 3.2 to 3.3 hours.

"It's definitely not a job for everybody," she says. "It's for people who have a lot of patience, energy and a true desire to care for people. It's not for the weak stomached because you're dealing with human bodies and all that entails. It takes integrity. And it's very addictive if it's a good fit."

Each nursing home has its own admission guidelines. Considerations include how much it will cost to care for a patient, the level of skills required, staffing and equipment. Lately, there has been an increase in patients who weigh more than 300 pounds, Shepard says. They require special equipment and lifts.

People who are considering placing a loved one in a nursing home should tour various facilities without an appointment, she advises. "You need to be comfortable."

Idaho has about 6,075 nursing home beds and the occupancy rate is about 76 percent. In Washington, there are approximately 21,000 beds and 87 percent are filled.

Some families opt to provide care at home, which can be a major undertaking for the primary caregiver. "Any family member who does this I give my kudos to," Shepard says. "It's a full-time job, emotionally, physically and financially."

For those looking for information about nursing homes, there is a Web site developed by Medicare that offers nationwide survey results and other relevant information. It can be viewed at www.medicare.gov/nhcompare. The federal government's new five-star rating system is also available on the site (see related story). Orchards received an overall three out of five-star rating, which is average.

Hagedorn says her situation at the nursing home has improved since she was first admitted. For the most part, the staff is friendly and accommodating.

"They try real hard to make it where I'm not considered elderly. Now they tell me when my appointments are and don't go through my daughter."

Although she dreaded spending her first Christmas in a nursing home, Hagedorn says it went better than expected. On Christmas Eve, she had take-out food from Applebee's and went to her daughter's house, where she visited with family members and opened presents. "It was actually pretty good."

She hopes someday she can live with family or in an assisted-living environment. Until then, she says it's the little things that make her happy, such as waking up every morning.

"I'm not one to really give up. I still haven't made my will out. I'm not going to accept it because I'm too young." ..Source.. by The Plain Dealer

HI-80 Year-old Nursing Home Resident Evicted and Left at Emergency Room - What do you think about that?

2009-01-09T17:47:00.004-05:00

1-9-2009 Hawai'i:

Florence Ko, 81, had lived at Nu’uanu Hale in Honolulu for 18 months when a week before Christmas the staff at Nu'uanu Hale dropped her off at Straub Clinic & Hospital Emergency Room dressed in a hospital gown and holding her only personal belongings – a purse and a cell phone, according to the Honolulu Advertiser.

The nursing home claimed she had not paid her bill in months, and they had no choice but to discharge her. With no family to call on, nursing home officials dropped her off at the next best place they could think of, the hospital emergency room. Later that evening, Ko was taken to an Aiea respite home for temporary care.

“I wish someone (at the nursing home) had the courage to tell me what was going on,” Ko told the newspaper reporter.

A Hawaii state agency determined that that no abuse had occurred because the nursing home had dropped Ko off at a safe place, a hospital. However, the Department of Human Services called the drop-off inappropriate, and said it would refer the case to the Department of Health.

Nu’uano Hale is rated as “poor” on a new rating system recently unveiled by the federal government, earning one star out of a possible five.

Ko is in a situation referred to by officials as the“gap group.” Her personal finances did not allow her to qualify for Medicaid but she earned too little from Social Security and an annuity to cover nursing home costs.

“We will likely see more people needing assistance,” says Anne Holton, a long-term-care ombudsman specialist with the Hawaii Executive Office on Aging. “With the boomers coming up, there’s going to be a whole new tide of people looking at that.”

This story has been reported all the way to Alabama where it showed up in web story from a prominent consumer advocate law firm, Beasley Allan . Their website is a good place to get the truth about health and safety risks and your rights. In the Rob Perez story in the Honolulu Advertiser it is interesting that the comments on the Advertiser website are highly critical of Ko and the Ko family. website includes a much more detailed analysis.

So what are your thoughts Honolulu? Thumbs up or thumbs down? ..Source..

First national study on nursing home social workers

2009-01-08T05:41:00.002-05:00

1-7-2009 National:

Social workers play a vital role in improving the quality of nursing home residents' lives.
But qualifications of nursing home social workers vary wildly in part because of low federal standards and inconsistent state laws, the first national study on nursing home social workers reveals.

Only half of nursing home social workers have a degree in social work, and 20 percent do not have a four-year degree, a University of Iowa survey of 1,071 nursing home social service directors shows.

Despite their desire to learn, two-thirds of nursing home social workers report they do not belong to a professional organization that helps to keep them up to date on nursing home social work issues, and only 38 percent are licensed in social work.

For-profit nursing homes are 31 percent less likely to hire a degreed social worker.

The numbers are concerning, given the important responsibilities nursing home social workers have, said Mercedes Bern-Klug, the assistant professor of social work in the UI College of Liberal Arts and Sciences who led the study.

Nursing home social workers advocate for residents and watch for signs of stress and depression. They connect residents and families with resources in and outside the nursing home and facilitate transitions such as hospice, a hospital stay or a return to independence. They guide families, residents and care providers through difficult conversations or conflicts.

"Nursing home social workers handle very serious emotional issues affecting residents, family members and other staff members, and they deserve to be educated on how to handle these issues," Bern-Klug said. "Everyone benefits when nursing homes hire qualified social workers."

Older adults struggle with dementia, and the highest rates of suicide are among older adults. Some are victims of physical, emotional or financial abuse.

"Still, many people in charge of social work in nursing homes aren't social workers, and the federal government doesn't require that they be social workers," Bern-Klug said.

Homes with more than 120 beds are required by federal law to employ a full-time social worker, but anyone with a bachelor's degree in any human service field -- not necessarily social work -- and one year of supervised experience in the field is considered qualified.

Seventy percent of nursing homes have less than 120 beds, and therefore are not required by federal law to employ a social worker. Most homes do employ one -- but typically only one -- which means devoting adequate time to each client is difficult, Bern-Klug said. Many times social workers' jobs involve other duties like marketing or activity planning.

"I asked 1,000 social workers, 'How many residents can you handle? Federal guidelines say you can do 120,'" Bern-Klug said. "An overwhelming majority said fewer than 60.

"We need legislation to demand well-prepared social workers and to set reasonable social worker-to-resident ratios, but unless families demand changes, it will be difficult to get them," Bern-Klug said. "Decades of research has documented the negative consequences of having too few nurses in a nursing home, and still we don't have strong laws demanding a realistic nursing ratio."

Bern-Klug examined state laws and found that 10 states don't address qualifications for nursing home social workers, and seven state codes do not appear to comply with federal standards. Twenty-one states require a social work degree, and most others require a four-year degree, but not in social work.

Iowa's guidelines for social services in nursing homes with more than 120 beds are identical to the federal guidelines. Iowa code does not address the social service credentials of the majority of its nursing homes, which have fewer than 120 beds.

The research also uncovered loopholes in state laws. In Colorado, for-profit nursing homes in rural areas don't have to hire a qualified social worker if they advertise for a week in a local paper and don't find one. In Indiana, social services can be provided by a member of the clergy who completes a 48-hour course and consults with a social worker.

"We need to standardize nursing home social worker qualifications, regardless of the number of beds, and nursing homes need to make sure their social workers have access to the training they deserve in order to do their jobs well," Bern-Klug said.

Nursing homes need to support existing social workers by providing educational and professional development opportunities, along with decent salaries and benefits, she said. Full-time salaries in some regions are as low as $15,000 per year, while others exceed $60,000, the study showed.

"Nursing homes tend to focus on physical care -- the risk of falling, the risk of bed sores or skin wounds -- which are very serious issues," Bern-Klug said. "But people need more than good physical care to thrive, and physical conditions have emotional consequences that social workers can help address. As individuals and families compare nursing home options, they should ask about the qualifications of the social worker and the number of residents under his or her care. "

The analysis of laws on nursing home social worker qualifications was published in the fall issue of the Journal of Gerontological Social Work . Results of the national survey will be published in an upcoming issue of the Journal of American Medical Directors Association . ..Source.. by Healthcare News

VA- Growing old behind bars

2009-01-04T01:57:00.002-05:00

1-4-2009 Virginia:

The number of older prisoners in Virginia has more than doubled in the past 10 years, creating new issues for the state's prison system.

CAPRON Winter sunshine slices through a narrow security window and falls on Aloysius Joseph Beyrer's white hair, slight shoulders and the linen covering his fractured hip.

Like the rest of the country, Virginia is coping with a growing number of aging inmates. Beyrer, 84, is the state's oldest and his home, the Deerfield Correctional Center, focuses on geriatric inmates.

In 1999, Virginia had 2,015 prisoners 50 or older. Today, there are almost 4,700, and by 2011, state officials expect there to be 5,057.

A drop in the number of paroles granted to inmates who remain eligible is a factor in Virginia's increasing number of older inmates. Truth-in-sentencing reforms that in 1995 led to stiffer, no-parole sentences for violent crimes are expected to contribute to Virginia's aging prison population in coming years.

At Deerfield, wheelchairs and walkers line aisles in the secured assisted-living dormitory, where it would be easy to confuse the frail residents with those in nursing homes. But it would be a mistake to do so.

Beyrer, a veteran of prisons in Virginia and elsewhere, thinks Deerfield, "is pretty good," though security comes first there, even for octogenarians like Beyrer, who is serving 100 years for sex crimes. The prison's goal is to provide older inmates care and some dignity, not freedom.

The warden, Keith W. Davis, who has a master's degree in social work, makes it clear he is not running a spa for the golden years. "This is not a perfect world. We do not have unlimited resources," he said.

Even with a blank check to meet all their medical and mental-health needs, Davis said no one wants to grow old or die in a prison. "That's a big challenge for the staff. . . . We do what we can do, but we can't cure oldness," he said.

"Offenders are like the rest of us. We get old, we get ill, we die," he said. Deerfield provides a continuing-care community, he said, "so they can reach what we believe is their fullest potential -- body, mind and soul."

. . .

Experts say substance abuse, little or no health care before imprisonment and the stress of living behind bars can leave a 50-year-old inmate physiologically 10 to 15 years older than his chronological age.

In general, older inmates require more supervision and medical and mental-health care, as well as special diets, mobility aids and special housing.

Deerfield, Virginia's only prison dedicated to geriatric inmates and inmates with special medical needs, accommodates 1,080 inmates, 90 of them in wheelchairs and 65 percent over the age of 50.

Other older inmates and older female inmates are in prisons such as the Fluvanna Correctional Center for Women and the Greensville and Powhatan correctional centers.

Critics point out that many older inmates are far less likely to commit new crimes and could be released at great savings. Prison officials, however, believe their care would largely be at public expense in or out of prison.

And though older people are less likely to commit crimes, some still do. Beyrer was 67 when he was convicted in Virginia Beach of statutory rape, aggravated sexual battery and forcible sodomy.

Deerfield's head nurse, Bonita Badgett, said 800 of the inmates there have at least one chronic medical condition such as diabetes, high blood pressure or asthma. The prison psychiatrist, Dr. Amit Shah, said the major problem he treats is depression.

In October alone, the prison handled 5,200 prescriptions.

Badgett has a staff of 14 registered nurses, 25 licensed practical nurses and 21 nursing assistants. Two physicians are at the prison three days a week and the psychiatrist visits once a week. At least one registered nurse is on hand at all times.

. . .

Deerfield was selected 10 years ago as the site for older offenders. An expansion opened in 2007 and there is now an 18-bed infirmary, a 57-bed assisted-living dorm, a larger ancillary-care dorm, a dorm for diabetics and a dorm for other special-needs inmates.

More than 75 percent of Deerfield's prisoners have violent records and nearly 30 percent are sex offenders. Security measures are complicated by health-care needs, said Maj. Stanley Mayes, chief of security for the prison.

"These guys have a lot of serious medical needs and . . . there are a lot of unusual [and potentially dangerous] pieces of equipment or property that we will allow them to have that you typically wouldn't see in another prison," he said.

Officers must be sensitive to prisoners who are gravely ill, suffering a heart attack or a stroke. "But not be deceived by someone who is faking to get an advantage to facilitate an escape," Mayes said.

Not everyone at Deerfield is happy. More than 200 inmates signed a letter to Gov. Timothy M. Kaine last year complaining about the parole board's low grant rate. One inmate claims staff stole his pain medication as he recovered from an injury.

Parole issues aside, inmates interviewed during a recent tour said they liked Deerfield.

James Henry Tinsley, 59, and partially paralyzed, has been there since 2003. "I been locked up 26 years," said Tinsley, convicted of 55 felonies, including capital murder, robbery and burglary.

"You've got some good people here. I ain't got nothin' bad to say about'em. . . . As far as the medical, I give it a double A plus," he said.

Another well-traveled inmate, William H. Glazebrook, 74, has been in the state system for 25 years and at Deerfield for a year and a half. "This is Boy Scout Camp compared to the rest of'em. This is a hell of a lot better," he said.

The Rev. Lynn Robinson, the prison chaplain, says, "These guys here, man, this is a special group of fellows." He said the inmates recently arranged to have Thanksgiving food baskets sent to five families and raised $500 for breast-cancer research.

"The one thing, I think, the community can be aware of is that . . . they need support when they come home," Robinson said.

Also, he said, "Saturdays and Sundays are visiting days, and some of them have family in the general area, and for some reason they don't come to see them. They need to stay in contact with [their] children."

. . .

Beyrer, Virginia's oldest inmate, was a resident of Deerfield's infirmary in November. Aside from six 1992 felony convictions, little information was available about Beyrer because of privacy rules.

He says that he was a once a prisoner at California's San Quentin State Prison. California authorities could not confirm they had ever held him, but New York state archives show he was released from Attica Correctional Facility in 1956.

Dawn Mosena, the nurse manager of the infirmary, said inmates are held there for observation and treatment before and after hospitalization, in addition to long-term care and special-needs inmates such as Beyrer.

She said the staff is planning how to make room for what is expected to be more long-term patients such as Beyrer.

Last year, an inmate's mother was allowed to be with her son in the infirmary when he died. "We want the patient to feel comfortable and the family to feel comfortable and know that they can be with them in those last hours," Mosena said.

"We want to get a hospice program going," she added.

Davis said another problem is that, "a lot of these guys have outlived their families. . . . We could open the door to let them go, and where would they go?"

Badgett, Deerfield's head nurse, agreed. "Some of them we had to keep beyond their release date because we couldn't find a placement for them. There was no family out there, no home, there was nowhere to send them," she said.

Sex offenders, particularly, are difficult to place. Most nursing homes do not want them, and families often reject them because of their crimes, or, "the families simply cannot take care of the needs and medications."

. . .

At Deerfield, younger and healthier inmates -- dubbed "pushers," short for wheelchair pushers -- assist the older inmates and perform a wide variety of essential jobs for 45 cents an hour, primarily janitorial and in health care, that help keep the prison running.

One "pusher," James Lee Wainwright, 47, imprisoned in 1990 for armed robbery, helps in the infirmary. He said he has also assisted with health care at another prison before arriving at Deerfield.

"I plan on taking it up when I get out of here," he said.

An infirmary nurse said, "We couldn't function without these guys, literally, without their eyes and their help."

William Robison, chief psychologist at Deerfield, said some inmate helpers perform odious jobs, peculiar to hospitals and rest homes, for infirm inmates. A program has been set up to help the helpers, Robison said.

"The caregivers support group is . . . for guys who are caring for other guys here. You know, if that isn't therapeutic education, what the hell is?" Robison asked.

"It's a little different here, the way we even think of mental health. We try and redeem a guy."

Said Robinson: "What we do is to find them a purposefulness in living in prison and maybe dying in here." He is familiar with programs in other states and said, "I think we're light years ahead."

"We're not soft on crime. Tough love'em, and they could still die here with some atonement . . . with a sense of humanity and self worth." ..Source.. by Frank Green

TN- Federal court to TennCare: Nursing home placements violate ADA

2008-12-23T14:07:00.001-05:00

12-23-2008 Tennessee:

The Legal Aid Society announced this morning a win in a case that sought to keep TennCare patients using home health care from being forced into nursing homes.

Citing budget cuts, TennCare wants to move about 1,000 people from home health care into nursing homes. In its ruling, the federal court in Nashville ordered TennCare to keep funding home health care for 20 plaintiffs.

Placing them into nursing homes without evaluating the financial, medical and social impacts would likely violate the federal Americans with Disabilities Act, the court ruled.

If you or someone you know is potentially being forced into a nursing home over TennCare cuts, please contact reporter Kate Howard at (615) 726-8968. ..Source.. by Heidi Hall • The Tennessean

OH- Bill To Protect Residents From Sex Offenders Dies

2008-12-18T15:38:00.003-05:00

The last sentence of this report shows why it should not become law, there is a registry where folks can check regularly. Special Interest groups do not have to have their own system when what is available to the public accomplishes the same thing.

12-18-2008 Ohio:

An important piece of legislation designed to protect elderly people in our society crashed and burn in the Ohio Senate. The Ohio bill called for care facilities to notify residents when registered sex offenders move into the homes.

The idea came up after a series of reports on Local 12 in which Reporter Rich Jaffe exposed the fact there was no such notification. The bill sailed through the House but died this week in the Senate.

According to its author, House Bill 57 is just common sense.
State Rep. Courtney Combs: "Nursing homes, assisted care must give the same notification that you get in your neighborhood. If you have a sexual predator who lives in your neighborhood two blocks away you get notification, you've got a sexual predator. Why shouldn't your mom your grandmother get the same notification if she's got a sexual predator in the room next to her?"

It was common sense to Ray McDaniel too when he testified in Columbus. His daughter was raped by convicted sex offender Rickey Smith, in a Bond Hill care facility. No one ever knew Smith and other sex offenders were residents, because currently the facilities are not required to tell anyone. "I wouldn't have let her go in there period, my wife wouldn't have let her go in there neither, we would have told them to find another place."

After unanimous support in the house, the bill died this week in front of Senator Tim Grendell's Criminal Justice Committee in the Senate. "I called at least six times, I talked face to face with Senator Grendell. What's going on? Well we've got more important things to do. What's more important than notifying my mom, gramma, grandpa tHat there's a sexual predator in proximity to them?"

Grendell told Combs the notification would upset residents, it would be one more paper people have to sign, and he wanted to know what kinds of facilities would be next. Some nursing homes make big money providing housing to sex offenders through Medicaid.

They also have powerful lobbyists. Combs say he thinks he knows what happened. "Big money got grandma... It's sad but I think that's what's going on."

We called Senator Grendell's office for an answer as to why the bill died in his committee we're still waiting for a response. Courtney Combs tells us he'll re-introduce the bill next year.

If you have a loved one in a facility, you can still find out if sex offenders are living there by typing the address of the home in to a sex offender registry. We have the registries for Indiana, Kentucky and Ohio posted in the "Get it section" of Local 12.com. ..News Source.. by Local 12 News

TN- Nursing Homes To Be Evaluated Using New System

2008-12-18T04:43:00.001-05:00

12-18-2008 Tennessee:

NASHVILLE, Tenn. - A new system is about to be unveiled that rates nursing home care across the country.

But there are questions about how well state facilities will do at a time when the number of complaints have reached record levels.

Less than 10 percent of Tennessee nursing homes have a five-star rating, which is the highest rating. There's concern about how Tennessee will fare, especially after the past two years when they've seen a record number of admission suspensions, and complaints.

Investigating two cases at a Tullahoma nursing home, the Tennessee Bureau of Investigation discovered a resident was raped, another was sexually assaulted.

"The victims in both instances are elderly females," said Kristin Helm, TBI spokeswoman. "It's hard to say what exactly they went through, but of course, anything like that is going to be very traumatic."

While the TBI checks out the complaints, state health investigators are checking out thousands more.

The number of nursing home complaints has climbed to almost 3,700, which is higher than last year.

"I think we also understand that the number of suspended admissions is the same as it was last year, and that was an increase from the year before," said Patrick Willard, AARP Tennessee assistant director for advocacy.

The state has ordered 25 nursing homes not to admit any new patients until serious problems are resolved.

Starting Thursday with a key stroke, anyone will be able to find more information about the quality of nursing home care. The Centers for Medicare and Medicaid Services have created a five-star rating system for each facility.

"They are going to be looking at staffing. They are going to be looking at quality of care," Willard said.

And they'll look at health inspection reports, to create their rating.

The AARP believes the new system will be a good way of explaining where nursing homes stand, especially at a time when some Tennessee homes face big problems.

"I think it's always going to be a matter of concern when you see the number of complaints increase," Willard said. "I think you are always going to want a health department that's going to do a good job of investigating those complaints, making sure they are resolved, and making sure that the number of complaints goes down because nursing homes understand what is behind these complaints."

If anyone wants to check out the new rating system, they can do so Thursday afternoon by visiting the Centers for Medicare & Medicaid Services Web site. The federal agency oversees the quality of care in the nation's nursing homes.

CMS officials said their rating system should not be used as the only piece of information when choosing a nursing home. They believe there's no substitute for visiting a facility and meeting with staff, residents and other families. ..Source.. by News Channel5

Research helps nursing homes deal with residents’ sexual expression

2008-11-23T16:04:00.001-05:00

11-23-2008 National:

“Do not disturb” signs aren’t just for newlyweds anymore.

They are also a way to give nursing home residents some privacy for sexual expression, according to Kansas State University aging experts.

“By law you can’t always lock a room, but you can offer residents some privacy,” said Gayle Doll, who directs K-State’s Center on Aging.

She said semi-private rooms pose a problem for nursing home residents who want to engage in sexual activity, either alone or with a partner. That’s why two of the center’s researchers are looking at ways to make nursing home staff more comfortable accommodating the sexual needs of residents.

Doll said that because nursing home staff don’t receive any education in this area, they tend to either ignore or condemn these needs.

“We just want people to start talking about these issues,” she said. “Once you start talking about it with nursing home staff, everyone has a story.”

The center is part of the College of Human Ecology.

Majka Jankowiak and Laci Cornelison, research assistants at the Center on Aging, studied nursing home staff attitudes about sexuality in three Kansas nursing homes. The research was presented in October at the American Association of Homes and Services for the Aging conference.

The researchers surveyed the staff before and after a workshop they presented. The surveys, as well as anecdotal feedback from the participants, showed a marked change in attitudes.

“They really felt this was a topic that they needed to be educated on,” Jankowiak said. “Part of it is that American society is not supportive of older people and sex. It’s been a taboo, and it’s an even bigger taboo in nursing homes. After the presentation, the participants felt more confident talking about it and dealing with sexual expression of residents.”

These shifting attitudes translated into a positive experience for one particular couple, Cornelison said. A married couple moved into a nursing home room with two hospital beds. One spouse had to have a leg elevated, but it was on the same side as the partner’s bed, which made it hard for them to hold hands. Some staff members didn’t see the importance of allowing the couple intimacy and said the problem couldn’t be fixed.

“But someone who had been to our presentation encouraged everyone to move the furniture,” Cornelison said.

The researchers said that sexuality and nursing home residents brings up issues beyond just acknowledging and accommodating sexual expression. HIV and other sexually transmitted diseases can be concerns for a generation that may have not have the same awareness that younger people do.

Also, adult children may have concerns about their parent’s safety or how a new relationship will affect the family or their inheritance. The researchers are developing materials to help family members deal with these questions.

“What they fear is exploitation or that the role the parent played will go away,” Doll said.

In addition, Alzheimer’s and dementia raise questions about the ability to consent, and these conditions also may spur sexual behavior that’s inappropriate.

“Even though we advocate for residents’ rights, there are things that are inappropriate,” Doll said. “But staff must be able handle this without residents feeling embarrassed. Inappropriate behavior can just come from people needing relationships, not necessarily sexual ones.”

Doll said the researchers hope to see federal guidelines developed to help all nursing homes deal with sexuality in a positive way, especially as baby boomers age and bring their attitudes about sex with them to the nursing home.

“Nursing homes are the second most regulated industry next to nuclear power, and yet these regulations don’t address sexuality,” Doll said. ..Source..

Sex and the Nursing Home

2008-11-23T15:59:00.002-05:00

11-23-2008 National:

Charles Bukowski once said that having sexual intercourse was like kicking death in the butt while singing. But for many older Americans in nursing homes, that joy is often hindered both because of the lack of privacy at some facilities and the negative attitude from staff on the topic of sexual activity among the elderly.

Before joining AAHSA, I can honestly say I never thought about the issue of sexual activity in nursing homes or how staff members deal with sexually active residents. But after reading a new study from Kansas State University, I say let’s make nursing homes more comfortable and private places for older adults to have safe, consensual sexual intercourse. After all, many of us may spend some time in one at some point in our lives.

For that to happen, says Gayle Doll, author of the study and director of the university’s Center on Aging, nursing home staff need to be educated on how best to accommodate the sexual needs of residents. Many nursing home staff do not receive education in this area, which, the researchers say, tends to cause a dismissive attitude toward residents’ sexual needs.

“We just want people to start talking about these issues,” Doll explains. “Once you start talking about it with nursing home staff, everyone has a story.”

For their research, which was presented in at our 2008 Annual Meeting in Philadelphia, Doll and colleagues surveyed staff from three Kansas nursing homes about their attitudes toward sexuality. Their goal was to find ways to make nursing home staff more comfortable accommodating the sexual needs of residents.

Majka Jankowiak and Laci Cornelison, research assistants at the Center on Aging, found that after a workshop on the topic, survey participants showed a notable change in their attitudes.
“Part of it is that American society is not supportive of older people and sex. It’s been a taboo, and it’s an even bigger taboo in nursing homes,” says Jankowiak. “After the presentation, the participants felt more confident talking about it and dealing with sexual expression of residents.”
Whether or not the general public likes to think about it, older Americans are engaging in sexual activity. According to a survey published in the August 2007 issue of the New England Journal of Medicine, roughly 53 percent of respondents aged 65 to 74, and 26 percent of respondents aged 75 to 85 years of age said they were sexually active.

However, some concerns exist about sexual activity in nursing homes. For example, the issue of consent is one that needs to be addressed as many residents live with Alzheimer’s or dementia. Beyond the possibility of these residents being victims, those conditions can alter the brain, causing a person to act in a sexually inappropriate and, sometimes, a sexually aggressive manner.

Because of that, many nursing homes err on the side of caution, Daniel Engber, an editor at Slate, writes in his article Naughty Nursing Homes. According to Engber, “The most liberal institutional policies on sexual contact (pdf) call for psychiatrists or social workers to review each situation and decide whether the participants are capable of saying no. Another approach uses a standardized test of mental state, with a minimum score required for consensual sexual activity.

As a result, a patient with advanced dementia can summarily lose her right to have any sex whatsoever.”

In the film Freedom of Sexual Expression: Dementia and Resident Rights in Long-Term Care Facilities, Dan Reingold, executive director of Hebrew Home for the Aged at Riverdale, says, “It’s absolutely critical that long-term facilities have written policies and procedures regarding sexual expression, particularly dealing with residents who have dementia because there are so many ethical issues that arise in connection with persons with dementia.”

Focusing on the education aspect of the issue, the Kansas State researchers suggest that staff must be able to deal with both appropriate and inappropriate sexual situations “without residents feeling embarrassed.”

According to Doll, the researchers are advocating for federal guidelines to help all nursing homes deal with sexuality in a positive way. In addition, they are developing materials to help family members deal with questions about their parents’ safety or how a new relationship will affect the family or their inheritance.

Education efforts like these, along with a little Viagra, perhaps, will allow America’s nursing home residents to kick death in the butt, while singing…as much as they like. ..Source..

MI- Computer program at the Gilbert Residence helps seniors get back in the world

2008-08-31T14:25:00.004-04:00

8-31-2008 Michigan:

It's like using a cell phone..

At first, reception is great, but as you move around, you start losing a word here and there, then whole phrases, then, finally, the connection.

That's how it is with your brain.

Gilbert Residence, a nonprofit senior care center in Ypsilanti, has become the first facility in Southeast Michigan to use a science-based computer program intended to help seniors rewire their brains, and tune back in to the world around them.

Unlike most mind-fitness software in an industry that raked in $225 million last year, Brain Fitness is based on medical studies that indicate that, as vision, hearing and fine motor skills worsen with age, people start getting garbled signals, which they eventually just tune out.

In addition, when people retire from work, most stop learning new skills, remembering names, figuring out how to make something work, and actively listening to the people around them.

All of that leads to a loss of what scientists call brain plasticity, its ability to change throughout life.

Five days a week, for eight weeks, four Gilbert residents have been donning headphones that come with the program. They spend an hour listening to prompts, clicking on answers. As their listening skills improve, the program ratchets up the difficulty level.

Contact reporter Susan Oppat at soppat@annarbornews.com
or 734-482-1166.

Some of the Gilbert seniors had computer skills before they started the program, and some didn't. Computer skills aren't necessary - users need only be able to point and click.

Once Gilbert CEO Mary Jo Gibbons researched Brain Fitness, she worked out a discounted license and training for it with the Center for Speech and Learning, the Michigan dealer for the program. She doesn't charge residents more to use the program, because she considers it part of Gilbert's wellness program, she said.

She got computers from the Washtenaw Community College computer-building class, and obtained wireless computer access for the whole building through Wireless Ypsilanti.

Four of the first five students have finished about two-thirds of the program, and the next round of students is already signed up, she said.

The fifth student loved the program so much that she finished it in four weeks, even though she was supposed to take eight weeks, to force her brain to "work out" over an extended period of time.

Elaine Seelhorst, 81, said she just couldn't help herself. She plans to restart the program at a new, hard-earned, more difficult level.

She said she had trouble understanding consonants before she blasted through the program that she hopes "put neurons back where they belong" in her brain.

Now, she said, she's able to concentrate and pay more attention to what's going on around her. She said she can follow conversations better, even with people whose speech was previously too fast for her to catch.

She was skeptical of the program before she used it. She said she only tried it out of curiosity.

"But it's fixing my brain," she said.

Howard Brown's daughter, Linda Eggan, feared she was sending her beloved, 92-year-old father to Gilbert to die this summer. He had just lost his wife of 64 years, and has Parkinson's and end-stage heart disease. He was depressed and in hospice care.

After six weeks in Brain Fitness, she said, "he has made this miraculous comeback. He looks good; cognitively, he's bright as a button. He doesn't miss a trick." He's e-mailing, reads the newspaper for the stock reports, she said, and misses working on the program on the weekends.

"It's really made him attentive, again, to all the details and events in life that interested him before. I'm thrilled," Eggan said. "It warms my heart to see him happy.

Brown himself grinned from ear to ear when he said, "I'm a little sharper. I think I remember things better, and have more confidence in a crowd. I'm able to focus more."

He can get frustrated when he's working the program, he said, but that's because the tremors in his hand from Parkinson's sometimes click an answer that he knows is wrong, and he doesn't like to get things wrong.

Next up for Gilbert, Gibbons said, is the planned purchase of a similar Posit Science program called InSight. Where Brain Fitness works with listening skills, InSight attempts to improve the quality and quantity of the information the brain absorbs from the eyes.

Brain Fitness

Controlled, randomized, double-blind studies of 524 people, ages 65-93, with similar baseline cognitive skills were conducted at the Mayo Clinic, the University of Southern California and Posit Science, using the Posit Science Brain Fitness program and conventional cognitive programs. The study indicated:

• The Brain Fitness program may help seniors delay the onset of significant brain deficits for up to 10 years, or regain about 10 years of ability they've lost.

• Users increased their information-processing speed an average of 131 percent, helping them keep up with the speed of speech and improve comprehension and memory.

• About 90 percent of participants reached processing speeds typical of people under age 40.

• Users gained an average of 10 years improvement in memory.

• Users improved in clinical tests of memory, focus, and complex thinking, even though the testing tasks were not used in direct training in the program.

• More than 75 percent of users reported benefits in their daily lives, including remembering a shopping list without writing it down, hearing conversations in noisy restaurants more clearly, and feeling more independent, more self-confident, and better about themselves. ..News Source.. by Susan L. Oppat

Administration Move Jeopardizes Hospice Care

2008-08-25T13:05:00.002-04:00

8-25-2008 National:

Hospice providers and terminally ill patients prepare for worst, Congress
urged to act quickly

WASHINGTON, Aug. 1 The Centers for Medicaid and Medicare Services (CMS) announced today that it will cut Medicare reimbursement rates for hospice, forcing many hospice providers across the country to either significantly scale back the care they provide to terminally ill patients or to shut their doors altogether. The final rule, published in The Federal Register, is effective October 1, 2008.

"Let's be clear, the Administration's cuts will seriously hurt the most vulnerable -- the terminally ill," said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO), which represents 4,000 hospices nationwide. "By issuing this rule, CMS is taking an end run around Congress and its longstanding role protecting hospice."

"The government's reason for its decision that would effectively cut rates -- the need to save money -- simply isn't true," noted Jonathan Keyserling, executive director of the Alliance for Care at the End of Life, an affiliate organization of the National Hospice and Palliative Care Organization. "Research has shown that hospice saves the Medicare system money, is highly rated by family members of hospice patients, and enables the patient to die at home in most cases," says Keyserling. "This rule defies logic, and will have a direct, negative impact on care at the bedside."

According to an independent 2007 Duke University study, hospice saves Medicare an average of $2,300 per patient, amounting to a total savings of about $2 billion a year.

Considered to be the model for high-quality care for terminally ill patients, hospice focuses on caring, not curing, and, in most cases, is provided in the patient's home. Hospice professionals are experts in providing pain and symptom management to the dying. Additional services include emotional and spiritual support to patients and their family caregivers as well as caregiver training. More than 1.3 million dying Americans received care from the nation's hospice providers last year, a number that continues to rise.

A Gallup poll found that nine out of 10 Americans, if faced with a terminal illness, would want to remain in their homes and receive the services that hospice provides. In fact, more than 80 percent of hospice care in the U.S. is provided in the home. And patient satisfaction with hospice approaches 100 percent as shown by data collected from family caregivers.

Congress Should Preserve Hospice

Congress has historically rejected Administration requests to reduce the level of hospice reimbursement, realizing the harmful impact such cuts would have on care at the bedside. "And this time is no different," says Keyserling. "Congress should intervene to stop the Administration's cut to hospice care, before the rule goes into effect."

Today, sentiment on Capitol Hill largely remains the same -- a bicameral and bipartisan group of more than 90 members of Congress has sent a letter to Health and Human Services Secretary Mike Leavitt in opposition to the proposed rule.

"It is in our nation's fiscal and moral interest that high-quality hospice care remains an option for all who need these unique services and support," said Keyserling.

NHPCO is the oldest and largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. NHPCO's mission is to lead and mobilize social change for improved care at the end of life, www.nhpco.org.

The Alliance for Care at the End of Life is a 501(c) 4 organization created by the National Hospice and Palliative Care Organization (NHPCO) to provide a more aggressive and comprehensive advocacy voice to serve the entire field and, ultimately, one of America's most vulnerable populations -- those nearing the end of life, www.afceol.org. ..News Source.. by National Hospice and Palliative Care Organization

Prison Medical Care: Special Needs Populations and Cost Control

2008-08-24T17:52:00.002-04:00

September 1997

Introduction
Corrections agencies are currently providing many specialized medical services to individuals in their inmate populations who require more extensive care than that provided to most inmates. One result is rising medical care costs for state corrections agencies. It is in this context that the NIC Prisons Division and Information Center initiated a national survey on special issues in prison medical services.

The project was intended:

--To explore how corrections agencies are providing medical care to three inmate populations with special needs: the elderly, the terminally ill, and the chronically ill, particularly the degree to which DOCs have consolidated specialized services at one or more facilities; and

--To assess the use of cost management initiatives in the medical division of each prison system.

NIC distributed a survey instrument to departments of corrections (DOCs) nationwide in May 1997. Staff made follow-up contacts among the DOCs during the summer to promote a high response rate. Completed surveys were returned by 46 states; the District of Columbia; New York City, New York; the Virgin Islands; and the Federal Bureau of Prisons. A list of agency respondents is provided as an appendix to this report.

..For the rest of the report.. by U.S. Department of Justice, National Institute of Corrections, Information Center Longmont, Colorado

HOSPICE AND PALLIATIVE CARE IN PRISONS

2008-08-24T15:15:00.002-04:00

September 1998

Background: The Hospice Movement

The nationwide hospice movement addresses the special needs of the terminally ill. Focusing on managing pain rather than curing illness, hospice programs emphasize humane care designed to provide the best quality of life for the terminally ill. The commitment of hospice programs is to make the patient comfortable; to provide “palliative care” rather than to cure the underlying disease. 1

According to the National Prison Hospice Association, hospice “is an interdisciplinary comfort-oriented care that allows seriously ill and dying patients to die with dignity and humanity with as little pain as possible in an environment where they have mental and spiritual preparation for the natural process of dying.” Hospice programs provide a wide array of services, including pain management, spiritual support, and psychological counseling, as well as grief counseling for bereaved families.

Over the past decade, hospice programs have become increasingly common in communities around the country. The movement is also slowly gaining a foothold among state, federal, and municipal prison administrations. 1.

Prison administrators develop formal hospice programs primarily to enhance the quality of care given to dying inmates. According to Elizabeth Craig of the National Prison Hospice Association, “Hospice care is known to be effective in providing a compassionate environment for dying persons and their families. In general, the cost of hospice care is less than that of traditional treatment.”

In addition, a growing number of inmates are dying in prisons. Two primary factors are behind this increase: the prevalence of HIV infection in prison populations, and the imposition of longer prison sentences as a result of tougher sentencing laws.

..The Rest of the Report.. by U.S. Department of Justice, National Institute of Corrections, Information Center, Longmont, Colorado

Will Anybody Cry When I Die?”

2008-08-24T05:10:00.000-04:00

A video illustrating this important service, “Will Anybody Cry When I Die?” shows hospice inmates helping a fellow prisoner during his end-of-life journey at the Louisiana State Penitentiary in Angola, Louisiana. Later, they prepare and honor him with a death ritual.

Hospice in Prison vs. Hospice for Released Prisoners

2008-08-24T05:04:00.002-04:00

8-24-2008 National:

Multiple news organizations have recently highlighted the release of aging and terminally ill prisoners back into the community. Of course if you have very sick and possibly dying people coming into your community one of the services they may need is hospice. While in the prison system, the health care is paid for by the government, but once they leave the prison, they have to find their own coverage most likely through Medicare (if eligible), but of course there is a very good chance they may not ever get any coverage. The main focus of the news articles is the ballooning cost of health care for prisoners.

Many hospice agencies are likely to get at least a few referrals from recently released prisoners, which brings up many logistical issues about safety, potential charitable coverage for their care, addiction or diversion concerns, and possible complex family dynamics with the reintroduction of the person back into the family. These issues can come up in any hospice admission of course, but this unique situation may take some detailed care planning on the part of the hospice team.

Interestingly, few of the articles highlighted the role of prison hospice, which was featured in a excellent JAMA article last year. The focus on medical release for terminally ill patients was relegated to two paragraphs at the end of the article. The article cited a stat on average 8 of 18 annual requests are granted for release secondary to a terminal illness.

For our field, it can pose a major dilemma. Do we advocate for the well-being of our patient to possibly return home despite being a criminal who has not completed their given sentence? How do we compare our duty to the patient versus the societal justice and completion of the punishment accorded the prisoner? Should it matter what the offense is for? ..News Source.. by Pallimed

Compare hospitals on heart attack, heart failure and pneumonia

2008-08-20T22:21:00.003-04:00

8-20-2008 National:

Welcome to a new era of openness in medical care.

In this interactive USA TODAY graphic, you'll find medicine's best-kept secret revealed: death rates for heart attack, heart failure and pneumonia for every hospital in the nation.

USA TODAY created this graphic using data compiled by the federal government's Center for Medicare and Medicaid Services (CMS). The agency also has supplied the information to the more than 4,000 hospitals included and posted them on a government website called Hospital Compare.

ON THE WEB: Compare hospitals in your ZIP code

STANDOUTS: Hospitals with highest and lowest death rates

USA TODAY has used the information to create an easy-to-navigate database that allows you to compare the performance of the hospital next door with the hospital across town. Want to check the performance of every hospital in your state? See the 100 hospitals that performed the best? The worst? We've put the information at your fingertips.

You can view the hospitals on a map, chart or several lists. When you click on a hospital, you'll see an estimate of the hospital's average death rate for one of the three conditions, bracketed by a high-end estimate or a low-end estimate. By presenting the information in this way, we can say with 95% confidence that the hospital falls in that range. We've included separate estimates for 2005-06 and 2006-07.

Underlying the calculations is a complicated "risk-adjustment" formula for ironing out differences in hospitals' patient mix, so the comparison will be fair.

The formula focuses on all deaths of heart attack, heart failure and pneumonia patients that occur within 30 days of a patient's admission to a hospital. If a patient is admitted more than once, one admission is randomly plucked out for analysis. CMS chose to include all deaths for any cause so that no death is missed that might be meaningful.

CMS picked 30-day mortality as its main benchmark of performance so it can include in the analysis patterns of deaths that might have escaped hospitals' notice because the patients didn't die until several days after they were discharged.

Finally, patients who were transferred from one hospital to another for more sophisticated care were credited to the first hospital. That's to avoid penalizing hospitals that receive the sickest patients. ..News Source.. by USA Today

MO- Missouri uses special unit to cope with growing numbers of geriatric inmates

2008-08-17T17:08:00.002-04:00

8-17-2008 Missouri:

Missouri inmate Larry Burton, 66, has just one crime on his record, but it is as dark as dried blood.

“I’m in here for killing my wife,” the former St. Louis area engineer said in a prison visiting room.

“I’m not proud of it, but it was a shotgun,” he said. “She was asleep at night and never knew what hit her.”

That was in 1990, when Burton was 48. He got life plus 15 years and is now part of the nation’s growing population of aging prisoners with costly health-care needs.

As states and the federal government struggle to deal with the result of inmates serving more time, corrections experts seek solutions or at least ways to cope. One is the “Old Timer’s Unit” at Moberly Correctional Center. Burton is one of 22 prisoners there. The average age is 63.

Kansas provides hospice care at prisons and is building a $6 million clinic at Lansing that will house its sickest male prisoners. Florida has geriatric wings in four prisons.

In California’s huge penal system, a federal receiver who oversees prisons recently asked a judge to seize $8 billion from the state to build medical units for sick and mentally ill inmates.

In light of the mounting costs, some experts suggest releasing far more of these older inmates. Research shows older inmates are much less likely than younger ones to commit crimes again after leaving prison.

In a balance between high costs and fear, society needs to take a smarter approach, said Lonn Lanza-Kaduce, chairman of the criminology department at the University of Florida. But, he said, “some old codger is going to get released and do damage” and become a Willie Horton-like “attention grabber.”

“People should look systematically at what is happening instead of the dramatic exception,” he said.

In a December hearing before a U.S. House committee, a Justice Department representative presented another view. He attacked a bill that would have allowed the release of nonviolent criminals who were at least 45 years old and had served half their sentences.

“This legislation would be completely contrary to the longstanding policy of the United States government,” said Drew Wrigley, U.S. district attorney of North Dakota and “subvert … the federal government’s criminal justice system of truth in sentencing.”

There are other tough issues. Does letting killers out early show a lack of respect for dead victims and heinous crimes? Are the many older sex offenders still a threat, especially ones whose crimes came later in life?

“It seems like nothing is cut-and-dried,” said Bill Miskell, a spokesman for the Kansas corrections department.

Meanwhile, more prisoners are aging behind bars. Only 5.24 percent of Missouri inmates were over the age of 50 in 1995, compared with 13.4 percent last year. In Kansas it was 6.1 percent in 1995 and twice that last year.

A cell to themselves

The Old Timer’s Unit could be one way to cope. It is in a small section of the sprawling acreage of brick and glistening razor wire of the Moberly prison. It opened in 1994 for well-behaved older and sicker inmates. Partly, it protects them from younger bullies.

The old prison has no air conditioning. Only huge fans in hallways and small fans in the tiny cells cool the sultry Midwestern air. A cage separates the old timers from other inmates. A stroll along the unit’s catwalk found many of the gray solid-steel doors open.

Like the younger prisoners, the old timers work and can leave their cells during the day.

Each cell is a steel-walled room, 7 1/2 feet by 9 feet, with a small louvered glass window on one wall that lets in wisps of outside air. Some prisoners place their fans and cassette tape players on their small desks. A few books line up on some desks. Shirts or other clothes somehow hang neatly from the steel walls.

Unlike the other inmates, these men do not share their cells. Perhaps most important to them, they have their own toilet and a small sink.

Each cell has a button that can be used to call for medical help.

Fred Givens, 67, shot and wounded his girlfriend and a man with her in 1984 in Kansas City. He suffers from chronic asthma and said the unit was the best thing that could have happened to him.

“You don’t have to walk to a toilet and you have hot and cold water right there.”

And people there get along. Givens said: “I’ve never seen fights up there. We don’t think about violence.”

Few are released

The Old Timer’s Unit remains the only one of its kind in the state, but that could change, Warden Dean Minor said. He is on a corrections department task force studying how to handle the aging prisoner problem.

Putting them in a cell alone made obvious sense because some could not climb to a top bunk, he said, and the personal toilet and sink give them privacy.

“At that juncture in life,” he said, “privacy becomes more of an issue.”

Reducing problems for prisoners reduces problems for the staff, he said. “We’re not trying to give them special favors, but we’re trying to meet their special needs,” Minor said.

Occasionally a man placed there does not work out, he said, and it becomes obvious. “I don’t mean to say we’ve got a bunch of grumpy old men up there, but it just takes one to irritate them all.”

A long list of inmates awaits entry into the unit, but once there, few get released.

Only two have been freed directly from it, the warden said. Also, some sex offenders were moved from the unit to an 18-month sex offender treatment program elsewhere for possible release. A dozen of about 150 men who have spent time in the unit died there or at hospitals, he said.

In general, Minor breaks down older prisoners this way:

•One third are aging lifers.

•Another third are there for crime after crime — “life on the installment plan.”

•The final third enter prison later in life, usually for serious crimes like sex offenses or murder.

“Once you get over 60, you don’t see many petty thieves,” Minor said.

Parole denied twice

The guards who usher Burton into the visiting room said the wife-killer was a hard man to dislike. Friendly and bright-eyed behind thick glasses, he made no excuses.

In 13 miserable years of marriage, he and his wife argued often at home but not in front of others. “The marriage wasn’t working; she didn’t believe in divorce.”

One day he was upset and distraught and he killed, he said. He’s sorry, remorseful, and now knows: “There are a lot of ways to end a relationship without killing your wife.”

Burton first came up for parole in 2003 and didn’t get it. He failed again two months ago.

“All they tell you is if they release you now, it would depreciate the seriousness of the crime,” he said.

Burton illustrates the dilemma that parole boards face.

What does society do with an aging killer, like Burton, who expresses remorse? ..News Source.. by JOE LAMBE, The Kansas City Star

FL- Laws Still Not in Place to Protect Nursing Home Residents from Sexual Assaults

2008-08-15T21:32:00.002-04:00

7-23-2008 Florida:

A 58-time sexual offender was placed in a Florida nursing home in 2002 at the order of a district court judge. Ivy Edwards, 83, sexually assaulted a 77-year-old female resident suffering from dementia. Exactly six years ago tonight, Edwards wheeled himself into the patient’s unlocked room, used his cane to block the door, and assaulted Virginia Thurston. Staff making rounds found Thurston’s door locked. They found Edwards in the patient’s bed.

Thurston’s daughter, Sandy Banning, was told nothing occurred; however, a social worker told Banning her mother had been sexually assaulted. Edwards was arrested for the 59th time. “She didn’t remember,” Banning said, “I had to take her to be examined and watch her cry.” Meanwhile, Banning has been waiting six years for Florida lawmakers to protect vulnerable nursing home residents from sexual abuse by known predators.

Unbelievably, the Florida state Legislature considered legislation—only this past spring—to require criminal background checks of prospective nursing home residents, and to deny admission to those with a history of sexual offenses or other violent crimes. This legislation is still not in place, which means predators, regardless of how nefarious their histories, are able to gain access to untold numbers of victims who are not in a position to protect themselves. Florida Senator Durell Peaden Jr., Republican-Crestview, co-sponsored the Florida bill, which was passed by the Senate but failed in the House. “The House will be put on notice to pass this,” Peaden said of next year’s session when he and co-sponsors will bring the Florida bill back next session.

Banning says she will push again for the bill next year and today is in Washington, D.C., testifying before the House Subcommittee on Investigations and Oversight. “I’m mad. I’m mad because nothing has been done,” Banning said. And Banning has every right to be angry. No one in the nursing home knew of Edward’s history because his 58 known sexual crimes occurred before sexual predator registration laws were enacted.

Without mandatory background checks, there is no telling how many sexual predators are living in nursing homes, said Wes Bledsoe, whose grandmother died after being victimized in an Oklahoma nursing home in 2000 and who is founder of the non-profit organization A Perfect Cause, formed to crusade for frail elders in long-term care facilities from sexual offenders. The group is pushing for state laws and federal legislation for required background checks and separate nursing homes for sexual offenders. Bledsoe found that from 2002-2006, there were 60 murders and 1,600 registered sex offenders living in US nursing homes. Figures do not include non-registered offenders at high risk—such as 59-time offender Edwards—parolees, and assaults occurring inside facilities.

Oklahoma just passed legislation requiring background checks and a separate nursing home for sex offenders and is planning—via a separate entity–to build and manage an offenders’ nursing home, Bledsoe said. “My hope is Florida will follow Oklahoma’s lead and not just look at background checks but also separate and secure facilities,” he said. ..news source.. by NewsInferno.com

Seniors at Risk: Sex Offenders, Parolees Living at Nursing Homes

2008-08-15T21:18:00.003-04:00

Reporter is sensationalizing due to missing and misconstrued facts in the lower report "Predators in Nursing Homes."

7-22-2008 National:

Hundreds of thousands of senior citizens are at risk because they are living among registered sex offenders, parolees and residents with violent histories, according to a nursing home watchdog who studied residents at nursing homes, assisted living homes and long term care facilities.

"What is shocking is we have now found 1,600 registered sex offenders across the country [in facilities with seniors]," said Wes Bledsoe, who is set to testify tomorrow at a Congressional hearing on predators in these facilities. Bledsoe tracked the number of offenders living at these homes over the past four years by matching addresses from sex offender registries with a database of care facilities from Medicare.

Bledsoe said that in many of these cases the offenders are young adults who are often placed in the facilities because of disabilities or behavioral problems.

"We found teenagers, two nineteen year olds living in these facilities, many in their twenties, thirties, and forties," Bledsoe said.

"We have also documented over 60 rapes, murders, and assaults committed by criminal offenders in these facilities," he said.

Pennsylvania Attorney Sean McDonough will appear at the hearing to speak about Lillian Guernsey, who was 86 years-old in 2002 when she was raped by another resident at a Pennsylvania facility. The assailant, a 31 year old fellow resident, had eight prior adult arrests, three convictions and two adult commitments to correctional facilities before he arrived at the home, according to McDonough's statement. Her assailant is now in prison, convicted of rape and sexual assault.

And six years to the day after her elderly mother was raped in a Florida nursing home, Sandra Banning will also testify.

Banning said she had no choice but to place her mother Virginia Thurston in a nursing home after Thurston, who suffered from dementia, was repeatedly found wandering the streets alone in the middle of the night.

"Growing up, Momma always said, 'If you place me in a nursing home, I'd never forgive you'," said Banning. "But that's what we had to do for her safety."

Banning, 60, said she had no idea that the facility she placed her mother in was also the home of a violent offender with a history of arrests. She found out after nursing home staff called her July 23, 2002 to tell her the offender had raped Thurston, then 77, in her bed.

"They found him right in the act," said Banning. "This man was 83 years-old and in a wheelchair. Not someone you'd think would be a rapist."

But Banning says it was only after the rape occurred that she found out the man had been arrested 58 times and that a court ordered him to move from a homeless shelter into the assisted-living facility.

Banning said she'll never forget the "look of terror" in her mother's eyes when she had to explain to her that she had been raped or the moment when she had to hold her mother's hand inside a sexual assault response center when she was examined.

"I think that at that point reality was there and she knew what was going on," Banning said of her mother, who didn't recall the rape because of her dementia. "The tears were streaming out of her eyes."

Banning says that despite physical evidence of sexual assault, the man was found incompetent to stand trial and has since been relocated to another Florida nursing home. She won a civil suit against the nursing home in the amount of $750,000 last year, which has not yet been paid out.

"She was my best friend," said Banning of her mother, who passed away in 2003. "After that happened, I had such guilt from putting her away where that could happen. So I vowed that I would make a change."

Tomorrow, Banning will tell her story to Congress, an opportunity she calls "awesome." And when she retires August 1 from her job as a medical staff manager for the Navy Medicine Support Command, she says she will "take up predators in nursing homes full-time."

"I believe that's why God put me here on this Earth," said Banning, fighting off tears. "It may be trips back and forth to Washington, but I'd go to the moon if I had to. Because someday it could be me; it could be you."

"There is no law, federal or state, that keeps violent or sexual offenders out of long-term care facilities as residents," said Bledsoe, who founded the citizens' advocacy organization A Perfect Cause in 2001 after his grandmother died in an Oklahoma City nursing home from what he says were negligent acts. A civil suit against the facility was settled out of court.

"The problem we have is that these offenders are being warehoused in nursing homes because the excuse is, 'Well, where else are we going to put them?'"

Bledsoe will present his findings on what he calls a "national disgrace" to the House Subcommittee on Investigations and Oversight tomorrow. In his prepared testimony, Bledsoe calls for the establishment of separate and secure long-term care facilities for violent and sexual offenders, criminal background checks for all residents, and notification of offenders residing in the facilities, among other recommendations.

Bledsoe said that offenders are placed in long-term care facilities by district court judges, county sheriffs, adult protective services workers, and corrections workers, as well as by offenders themselves and their families. And he said that while these offenders deserve care, seniors living in the homes deserve protection.

"I hope that some of the congressional leaders don't sleep soundly tomorrow," said Bledsoe, "and that this makes an impression on them that right now, in this moment, we have people in harm's way."

Rep. Mary Fallin (R-OK), who organized tomorrow's hearing, issued a statement today in which she described seniors living in long-term care facilities as "some of the most vulnerable of our citizens."

"The rare cases of sexual assault and abuse that have been documented in these facilities are particularly abhorrent," said Fallin, adding that the hearing will "investigate both the scope of the problem and the possible roles the federal government might play to eliminate it."

Joining Bledsoe to speak at the hearing will also be Oklahoma State Representative Kris Steele, who authored legislation passed in Oklahoma in May to establish separate living facilities for registered sex offenders. The state is now preparing a request for private bids to build such a facility. ..News Source.. by MEGAN CHUCHMACH (Megan Chuchmach is a 2008 Carnegie Fellow at ABC News in New York. She recently graduated from Columbia University's Graduate School of Journalism.)

Blog Overview

2008-07-05T21:46:00.000-04:00

Mission & Purpose .. Privacy Policy .. Copyright Issues .. Resources
I must begin by thanking folks who have taken the time to forward all the links to the Papers, Research and Studies that are now within this blog. Please continue to do so as it can only grow in content if we all find related materials and get them posted.

If you have a question, or want to proivde input, simply click on eAdvocate where ever it appears and send a e-mail with your comments. They will be reviewed and appreciated.

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NY- Hospitals forced into holding pattern

2008-07-02T04:38:00.006-04:00

7-2-2008 New York:

Keith Shortsleeves knew he was going to have to stay in Glens Falls Hospital for at least a few weeks when he checked in on Jan. 20 for diabetes-related problems.

Circulation problems required partial amputation of his left leg.

But within a few weeks, Shortsleeves had recovered to the point he was ready to be discharged.

"I thought I'd just be going home," he said.

Nearly five months later, Shortsleeves is still in the hospital, despite the fact he is no longer in need of treatment there.

The hospital's staff won't let him go because he doesn't have a home that meets his needs for post-hospital care, he said during an interview in his room last week.

He is a Level 3 sex offender who can't go back to his former apartment in Fort Edward because of handicapped accessibility issues, but can't find an accessible apartment anywhere else because of laws that dictate where sex offenders can live.

So since February, Shortsleeves has stayed in a variety of hospital rooms, most recently in a third-floor corner room overlooking the front parking lot, waiting for a solution to his housing woes.

"I don't want to be here, but I got no choice," he said. "I ain't got no place to live."

Shortsleeves is the poster boy for a little-known state law that requires hospital patients to show they have somewhere to go that meets their care needs before they can be discharged,

His presence for such an extended period of time has raised the hackles of many hospital employees on the heels of job cuts there, according to two hospital staff members who spoke the condition of anonymity. (They could not be identified because they are not allowed to discuss patient issues with the media.)

Many hospital employees refer to them as "custodial" patients because many of them want to leave but they aren't allowed to by hospital administrators.

"People wonder why the hospital is losing money," said one of the staff members. "This guy (Shortsleeves) isn't the only one. We get lots of them. We've got a lot of little old ladies who are there (in the hospital) for months when they don't need to be."

"There's nowhere for them to go, so they stay here," the other staff member added.

The tab for many of their stays falls to taxpayer-funded Medicaid or Medicare.

But Ray Agnew, a hospital spokesman, acknowledged some stay past the point where those programs will pay for their hospitalization, so the hospital has to absorb the cost of their stay.

"We can't discharge a patient unless their discharge plans meets their needs," he said. "It happens from time to time. In these cases, we rely on community resources. We really leave no stone unturned."

Agnew said he could not discuss specific patients. He also said the hospital could not say how many patients were required to stay past, or how much it was estimated to cost the hospital to house them.

Hospital "discharge planners" and physicians determine whether a patient's plan is appropriate. The most basic requirement is to have a home to go to.

"Most of the time, it's people who need to be discharged to a nursing home, but often there is no (nursing home) space available," Agnew said.

Beth Goldberg, a spokeswoman for the state Department of Health, said the state Compilation of Rules and Regulations governing hospitals spells out the procedures and requirements of hospitals

"The hospital is required to release a patient to the least restrictive environment that meets their post-hospital needs," she said.

'Dumped'

One of the two anonymous employees, a nurse, said the hospital sometimes sees people drop their elderly parents off when they can't care for them or find nursing or adult homes that will take them.

"Children aren't legally responsible for their parents, so sometimes they're just dumped at the emergency room," the employee said. "We had an intoxicated guy left with a mattress outside the ER door."

These patients who can't leave cost the hospital money because staff members must attend to them, even if they don't need medical care. Their rooms need to be cleaned, they must be fed and the elderly, sick or injured who need assistance but not full hospitalization have to be catered to as well, one employee said.

Many are frustrated at their situations, and take it out on hospital staff members, one of the employees said.

One employee said "custodial" patients were also problem at Albany Medical Center when the employee worked there a number of years ago.

Greg McGarry, a spokesman for Albany Medical Center, said patients having to stay after they could be discharged has long been a "significant issue" at Albany Med. He said the costs of those patients are part of the $35 million-a-year in charity and unreimbursed care for which Albany Med picks up the tab.

"It was an issue when I got here 23 years ago, and it's still an issue," he said. "Part of the problem is nursing homes are getting pickier and pickier about who they will take."

A bill introduced in the state Assembly last year would change the law relating to patient discharge.

It would require the state Department of Health to create "transitional units" with 4,000 beds for use by Medicare patients who no longer need to be treated in the hospital but can't go home, either. It was sponsored by Assemblyman Tom McKevitt, a Nassau County Republican.

However, the bill was first put in last year, and has not passed the Assembly either this year or last year. Companion legislation has not been introduced in the Senate.

Reluctant resident

Shortsleeves is a Level 3 sex offender because of a 1995 conviction for sexually abusing a 12-year-old girl and a 2002 conviction for having child pornography. He served nearly 8 years in state prison between the two cases, but is no longer on parole.

He weighs more than 300 pounds and is wheelchair-bound, with part of his left leg amputated, and part of his right foot amputated as well. He said he has asthma and heart problems.

"I'm not going to hurt anybody. I'm in a wheelchair for gosh sakes," he said.

Shortsleeves said he has a number of relatives in the region, some of whom would take him in, "but they're all in the red zone." He has two former roommates, who he calls "Ma and Pa," who lived with him in Fort Edward, but they have to leave their home because it has been sold.

He said hospital staff have done everything they can, and he recently put an advertisement in The Post-Star seeking housing.

"I know they want to get rid of me because there are other people who need the room," he said. "They've been really good to me and they're trying to help me, but they just can't find nothing."

Shortsleeves had lived on Mosher Hill in Hudson Falls until a few weeks before he was hospitalized.

The state sex offender registry still lists that address for him. Glens Falls Police Sgt. Marty Chittenden, who monitors the Glens Falls Police Department's registry, said he was aware of Shortsleeves' location at the hospital, but he has not had to register as a resident of the hospital because it's not his permanent residence.

Hudson Falls Police Chief Randy Diamond said his office has gotten a number of calls from Washington County Adult Protective Services looking for assistance in figuring out what parts of the village he can live in.

A law that spells out where sex offenders can live has resulted in much of the village being off-limits. Shortsleeves was grandfathered under the law at his prior village residence, but when he moved out, he could not return.

"They (Adult Protective Services) has been trying to find a place for him," Diamond said. "He's always been very cooperative with us. But there are laws that say where he can go.

"It seems like it's one of those situations where it's kind of falling between the cracks," Diamond added. ..News Source.. by Don Lehman

The Rights of Older Persons

2008-06-17T04:13:00.001-04:00

6-17-2008 National:

Collection of International Documents

Please note** - The first printing of The Rights of Older Persons was a great success and has already sold out. We would like to thank all those that have taken an interest in this important collection of documents. The IFA has now received the second printing, and will be able to meet the demand and fulfill all orders for this important book. To cover the costs of reprinting, a small increase in the price of the book has been made. Click here to order your copy.

Over the past few decades, many diverse documents concerning the rights and status of the aged have been prepared at the international level. Each of the various bodies and organizations has regarded the subject from a slightly different angle. This has resulted in the preparation of an extensive set of international documents that cover a wide spectrum of subjects and issues relevant to older persons all over the world.

This book provides a unique collection of all the main, important international documents relating, at the international level, to the status of the aged and the phenomenon of ageing. For the first time, readers, the aged and professionals all over the world can obtain a comprehensive picture of the worldwide activities in the field of international law and ageing.

The editors of this collection of documents are active and respected international elder law scholars. Dr. Israel Doron teaches elder law at Haifa University and has published and presented various papers regarding international dimensions of elder law and older persons' rights. Prof. Kate Mewhinney is a Clinical Law Professor and the Managing Attorney of the Elder Law Clinic of Wake Forest University School of Law. She is certified as an Elder Law Attorney by the National Elder Law Foundation, edited a special international issue of the NAELA Quarterly, and has organized and moderated programs on international law. ..News Source..

OK- Steele Nursing Home Bill Passes Both House, Senate Unanimously

2008-05-30T02:14:00.007-04:00

Issue - Nursing Homes

5-29-2008 Oklahoma:

The Oklahoma Legislature voted last week to establish separate nursing home facilities for convicted sex offenders in need of long term care.

House Bill 2704, by state Rep. Kris Steele and Sen. Tom Adelson, directs the Department of Health to request bids for the operation of a stand-alone, long-term care facility that will house only elderly, registered sex offenders.

"This legislation will allow for the operation of a home that includes additional security measures for offenders," said Steele, R-Shawnee. "This is a common-sense, fiscally responsible way to reduce the risk for abuse and protect our aging population from predators."

There are approximately 30 known sex offenders currently residing in Oklahoma nursing homes. The Oklahoma Department of Corrections estimates 2,250 inmates convicted of sex crimes will be released from prison in the next 10 years. Twenty-six percent of these convicts will be age 51 or older and potentially in need of long-term care. In addition, recent data indicates the number of registered sexual offenders in Oklahoma is increasing.

Currently, federal law requires the state of Oklahoma to pay for long-term care services for individuals who are Medicaid eligible - whether or not they are convicted felons. Registered sex offenders living in nursing homes can create a dangerous environment for other residents in the home.

In 2005, the Legislature passed a law requiring nursing homes to post public notification whenever a registered sex offender is admitted as a resident. However, because of low staff levels and a short supply of security guards, Steele noted some nursing homes are finding it difficult to properly monitor sex offenders who reside in a facility. Federal regulations also prevent nursing homes from restraining residents except in rare circumstances.

Under the legislation, any facility bidding to house sex offenders would have to meet surveillance and security requirements necessary to protect the public.

House Bill 2704 also requires the Oklahoma Health Care Authority to develop a payment methodology that offsets the cost associated with the heightened security measures. Any provider interested in managing a stand-alone facility for offenders would net the same reimbursement rate currently provided to care for persons in need of long-term care.

"Protecting our senior adults is a primary responsibility of state government," Steele said. "Oklahoma's most vulnerable citizens should be able to live the latter years of life with dignity, free from fear. Implementing appropriate safeguards for the elderly can make this goal a reality."

House Bill 2704 passed unanimously in both the House and the Senate. ..News Source.. by County Wide News

CA- Disabled inmates subjected to shocking conditions in Los Angeles County jails, advocates say

2008-05-29T11:56:00.002-04:00

Issue: Jail Conditions If Arrested

5-29-2008 California:

Report by the ACLU and the Disability Rights Legal Center finds dreary, overcrowded cells, a lack of accessible bathroom facilities and limited access to recreation opportunities.

For several hours, as he waited to get booked for petty theft at the Los Angeles County Jail in October, Peter Johnson told deputies he needed to go to the restroom.

Although other inmates were free to use the facilities, Johnson -- a paraplegic -- was told there were none in the area equipped to accommodate the physically disabled. Guards, he said, seemed indifferent to his plight, telling him he simply had to wait.

"We are treated like the worst of the worst because of our disabilities," said Johnson, who ultimately lost control of his bowels and was forced to sit in his own feces for more than six hours.

Johnson, who is still incarcerated, and more than a dozen other disabled inmates complain that the county jail system, by design, discriminates against them.

Simple tasks like taking a shower, getting onto a bunk or using the lavatory become impossible.

A recent study commissioned by the Disability Rights Legal Center and American Civil Liberties Union of Southern California found severe problems with how disabled inmates are treated. The report concluded that the Sheriff's Department was violating the Americans with Disabilities Act (ADA), which prohibits discrimination against people with disabilities.

Lawyers for the two groups say they plan to file a lawsuit against the county today that would seek a court order requiring that the jails to comply with anti-discrimination laws.

Logan Hopper, an expert on ADA requirements who conducted the study for the ACLU and disability rights center, reported that during his three-day inspection of the jails he found disabled inmates struggling to overcome physical barriers to toilets, shower stalls and visitor areas.

In his 31-page report, he said the housing areas for disabled inmates had broken plumbing, lacked natural light and had limited access to recreational areas.

"These were the most overcrowded, dreariest and poorest maintained rooms or cells observed," he wrote.

Hopper also said the problems extended beyond poorly equipped facilities. Inmates with disabilities are often precluded from educational and job training programs because those are held in parts of the jail system they cannot access, he said.

Also, Hopper reported that jailers failed to properly classify inmates as having disabilities. Some paralyzed inmates said in sworn declarations that their wheelchairs were confiscated, forcing them to use crutches or crawl around in their cells.

"This is some of the most shocking stuff we've seen. There are clear human rights issues here," said Shawna Parks, an attorney for the disability rights center. "This is a systemic problem beyond the fact that the toilet is inaccessible. It is shameful that people with disabilities are being punished doubly because they have disabilities."

Sheriff's officials say they have met with lawyers for disabled inmates and are trying to address their concerns. "We don't have a magic wand we can wave to fix it all," said Sheriff Lee Baca, who added that many of the jails were designed 50 years ago, before the courts and lawmakers saw the need to accommodate inmates with disabilities.

Baca said disabled inmates are now housed in Twin Towers and in the old medical wing of the Men's Central Jail, which he said was a far less crowded and better place than general lockdown.

He said he hoped to eventually close Men's Central Jail and build newer, better equipped, facilities in Lancaster, Castaic and near East L.A.

Baca said his jails have more disabled inmates than ever because more people with disabilities are committing serious crimes.

"We do, quite frankly, the best we can. But we can do better," he said. "The ACLU is wonderful at presenting our problems but never comes up with any solutions."

Baca said he believes that the courts should try to assign severely disabled inmates to home detention.

"It costs us $700 to $800 a day to keep them in the jail," Baca said.

The sheriff said he also would consider allowing care workers for the most severely disabled into the jails.

ACLU officials said the Sheriff's Department is in a position to address many of the obstacles that disabled inmates face.

Ramona Ripston, executive director of the ACLU of Southern California, said that inmates in their declarations gave vivid and frightening accounts of the deplorable conditions in the jail. ..News Source.. by Richard Winton, Los Angeles Times Staff Writer

High-Tech Tools Keep Elderly Safe From Afar

2008-05-24T23:49:00.003-04:00

Issue: Security at home

5-24-2008 National:

First thing every morning, Lynn Pitet, of Cody, Wyo., checks her computer to see whether her mother, Helen Trost, has gotten out of bed, taken her medication and whether she is moving around inside her house hundreds of miles away in Minnesota.

Last summer, Mrs. Trost’s husband had a stroke and died, but she wanted to stay in the house, in Mankato, where she had lived for 36 years. She did not want a live-in helper, and she cannot drive. At 88, Mrs. Trost has macular degeneration and takes medications for seizures, memory loss and restless leg syndrome.

“She’s a feisty gal,” Mrs. Pitet said of her mother. “She is fine when she takes her medicines, but, even so, I was terrified of leaving her alone.”

Mrs. Pitet and her sister decided to become part of a small but growing number of people who have installed motion sensors and a remote monitoring system to keep aging relatives safe. Sensors attached to the wall are able to register when Mrs. Trost gets out of bed and whether she stops at her medication dispenser, and to alert her daughters to any deviations from her routine that might indicate an accident or illness. The family is updated by electronic report every morning.

Monitoring systems like these, which go far beyond the emergency response buttons that have been around for years, are not found in many homes yet. Privacy is an issue for some older people, and the basic package can range from $50 up to $85 a month for the motion sensors and remote monitoring system like Mrs. Trost uses. More comprehensive packages can include devices to track blood pressure, weight or respiration.

Experts on aging say the systems will become commonplace as the 76 million baby boomers approach ages when disabilities or conditions like diabetes and failing eyesight jeopardize the ability to live independently. The population of those 65 years and older is almost 40 million today, and the federal Census Bureau says that will more than double, to nearly 87 million, by midcentury.

Right now, there is little federal health care reimbursement for such devices. And private insurance coverage is evolving because the area is new, said Dr. Jeremy Nobel, a professor at the Harvard School of Public Health who co-wrote a study on the feasibility of such technologies. “We are at the beginning stages regarding the availability of such services and before business models are developed,” said Dr. Nobel, a medical doctor. “I expect we’ll see a significant increase in the adoption of such systems in two to five years, and widespread adoption in 10 years.”

The coming wave of aging Americans threatens to swamp the existing stock of retirement communities, assisted living and nursing home facilities — making it impossible to accommodate everyone who will need, or might want, more structured care.

Experts on aging say motion sensors and other high-tech devices will help cover the shortfall, allowing older people to live independently for longer.

The growing number of Alzheimer’s sufferers, which is expected to more than triple from the current four million by 2050, may also spur wider adoption of technologies like motion sensors to alert others to deviations in routine, trackers to assure medications are taken and emergency response buttons.

Technology systems to underpin living independently, or what some call “aging in place,” are still years from being rolled out in a big way, awaiting adequate financing for research and other incentives, like coverage by insurance companies, according to Mr. Nobel’s study, which was released in March by the Center for Aging Services Technologies, a program of the American Association of Homes and Services for the Aging.

But projects are under way around the country to test high-tech gadgets for home use, including wireless sensors and devices to regulate temperature, lights and appliances, and sophisticated medical monitors. And some care providers have begun to equip clients with devices that fit their needs.

NewCourtland Elder Services, a care provider for some 2,000 people in Philadelphia, started a yearlong pilot in 2006 that equipped 33 patients living on their own with remote sensors that tracked changes in their health or living patterns that required early medical intervention, said Kim Brooks, the vice president for housing and services at NewCourtland.

One of the patients is Cleora Coley, 77, a retired pharmacy technician, who is in a wheelchair after losing a leg to diabetes. Two years ago, Ms. Coley moved to a living complex for the elderly because she could not maneuver the stairs in her family home.

In her apartment, she checks her blood pressure with a cuff that automatically sends the reading to a monitoring center, which notifies her and her doctor of any change. Sensors placed in each room keep track of her movements, and she has a button to summon assistance, which she used in April when she fell.

“I’m alone but I know I’m not all by myself,” Mrs. Coley said, adding, “And I really like my independence.”

NewCourtland is starting a trial in cooperation with health insurance companies and home health agencies, installing medical monitoring devices in 1,000 residences over the next six months.

One major roadblock for wider adoption of in-home monitoring has been concern that older people, unused to everyday technologies like the Internet, would resist their use. That was true for Mrs. Trost, who said she was apprehensive about having electronic gadgets around but said she had found that “they are really no bother.” A survey by AARP found that older people were willing to use high-tech devices at home, and to pay about $50 a month.

The privacy issue made John T. Fowlkes, 86, of Raleigh, N.C., hesitate last year when his children wanted to install a motion sensor system.

“What convinced me was that there are no cameras,” said Mr. Fowlkes, a retired postal service distribution clerk who lives by himself in an apartment building for retired people. “I get peace of mind, but no one is looking at me.”

Some exploration into future technologies is being financed by the National Institute on Aging, part of the National Institutes of Health, which has been giving grants to entrepreneurs to develop devices like a video data collection system to analyze an elderly person’s activity level.

But most research dollars have come from private companies like Intel Corporation.

Intel researchers are developing devices like a “memory bracelet” that vibrates at a specified time to remind the wearer of a doctor’s appointment or to take medication. Also in trials are sensor-infused carpets — Eric Dishman, Intel’s director of product research, calls them “magic carpets” — and wearable sensors, which would measure changes in gait, to help avoid falls.

Intel invested $3 million with the Oregon Center for Aging and Technology, which runs what it calls a living laboratory, with 225 volunteers. The project, which also received $7 million from the federal aging institute, uses sensors on walls, doorways and appliances — and computer games — to detect cognitive decline.

“There is going to be a major transformation in health care because of these technologies,” said Dr. Jeffrey Kaye, director of the center, at the Oregon Health and Science University in Portland, who oversees the project. “It’s more a question of when rather than whether.”

Recognizing the commercial potential of technologies for the aging, dozens of companies, including GE Healthcare, IBM and Medtronic, two years ago formed the Continua Health Alliance to develop products to aid older people. Despite the projects, trials and commercial interest, Mr. Dishman said the United States was “missing in action” in aging technologies, compared with Europe.

“There just hasn’t been enough research and development yet to prove these technologies work,” he said. “None of us wants to put a bunch of technology in homes of frail elders unless it does.”

He said the European Union had committed $1.5 billion to developing independent-living technologies.

Last year, Intel partnered with Ireland’s government to open the Technology Research for Independent Living Center, known as Tril, in Dublin, to invent and test independent-living technologies in the households of hundreds of older people.

So far, he said, a dozen other countries and 30 universities have approached Tril for advice and assistance. ..News Source.. by ELIZABETH OLSON

I'm writing on behalf of a 19-year-old guy with cerebral palsy.

2008-05-21T03:46:00.004-04:00

5-21-2008 National:

Q: I'm writing on behalf of a 19-year-old guy with cerebral palsy.

As you may know, CP is a brain affliction resulting from insufficient oxygen at birth, and it causes the part of the brain responsible for motor function to work incorrectly. Troubles for people with CP include muscle spasticity, weakness or painful contraction, and, in some cases, a life spent in a wheelchair.

My buddy is, like any 19-year-old, interested in finding out more about his sexuality. He has watched his peers develop sexually, but hasn't had the opportunity to do so himself. Intimacy aside, are there any services that you know of that could help him to experience sex for the first time? I don't mean to buy the guy a hooker or anything like that, but I wondered if there are people who would assist him and a girl (disabled or otherwise) into bed.

Thanks, and keep up the great column. I've been a reader for years... —Friend In Deed

A: "Your reader shouldn't make assumptions about what having sex or being sexual means to his friend," says Cory Silverberg, co-author of The Ultimate Guide to Sex and Disability. What if your friend doesn't want to get into bed with a girl, but head into a dungeon with one? Or two?

"Just like we do with everyone," says Cory, "we tend to assume folks with disabilities are straight and just want to have penile-vaginal intercourse and some oral sex. We're almost always wrong. So the first thing he should do is ask his friend what he's interested in."

Cory also suggests that you ask your friend if he's having sex with himself, since masturbation is the easiest way for a person to explore his sexuality. "Mobility disabilities can make masturbation tricky," says Cory, "but never impossible. Privacy and motor control can be challenging, but there are many workarounds."

If your friend has or finds a partner and needs physical assistance during sex, you might want to help him find an attendant, a person who works with physically disabled people, who is comfortable positioning him and a partner in bed, assisting with condoms, and cleaning up. "In my experience," says Cory, "attendants who are queer tend to be more comfortable talking about sex and making that kind of assistance part of their job description, but that doesn't rule out straight ones."

So if your friend has plenty of sex with himself and has a good idea what he'd like to do, but doesn't have a partner to do it with, what do you do then? "I don't have any new suggestions here," says Cory. "He should get out there, use online and virtual spaces, join a social group related to something he's passionate about — all of these are good ways to meet people. Paying for sex is also an option, but avoid the escort ads and try to get a referral from someone you know and trust." ..more.. by Dan Savage

Disabled Want Better Web Access

2008-05-21T03:05:00.001-04:00

5-22-2008 National:

Target Corp.'s alleged refusal to create user-friendly options on its retail Web site for disabled customers has sparked a legal battle that could have ramifications for all Web-based businesses.

In some jurisdictions, the term "handicapped accessible" no longer applies only to companies' brick-and-mortar buildings. Under the Americans with Disabilities Act, disabled customers are entitled to access to the marketplace and, increasingly, that pertains to cyberspace.

"I think we will see an increase in lawsuits" based on this issue, said Gary E. Phelan, managing partner of Outten & Golden's Stamford, Conn., office. "It's a very important issue because it opens the door to people with disabilities."

BLIND INTERNET USERS

Last year, federal Judge Marilyn Hall Patel in the Northern District of California certified the National Federation for the Blind's lawsuit against Target as a class action on behalf of blind Internet users throughout the country.

The plaintiffs allege that Target, since February 2003, has discriminated against the blind by "failing to ensure that all functions can be performed with a keyboard and not just a mouse." The complaint also said the Minneapolis-based retailer fails to make its site compatible with screen access software, also known as a screen reader, which converts the screen display into audible speech.

The court granted the plaintiffs' motion to certify a nationwide class under the ADA for injunctive relief to ensure Target keeps its site fully accessible to the blind. The court also denied Target's motion for summary judgment.

"This is a tremendous step forward for blind people throughout the country who for too long have been denied equal access to the Internet economy," said Dr. Marc Maurer, president of the NFB. "All e-commerce businesses should take note of this decision and immediately take steps to open their doors to the blind."

The court certified Brown, Goldstein & Levy, a Baltimore civil rights law firm, and three others as counsel for the class. "This is an area where litigation is only going to escalate," said Daniel Goldstein, partner of the Baltimore firm.

Federal circuits have split on whether Web sites constitute "places of public accommodation" for purposes of ADA coverage, he said.

The 1st Circuit has said Web sites are covered in its ruling in Carparts Distribution Center Inc. v. Automotive Wholesalers Assoc. of New England. But the 9th Circuit rejected the concept in Wyer v. Twentieth Century Fox Film Corp.

"The introduction of new technologies happens at a dizzying pace," Goldstein said. "Most can be accessible at marginal cost, but designers are not considering the needs of the disabled."

Goldstein predicted that many disabled customers will seek help in state courts, which can allow for significant damages compared to federal court, which allows for injunctive relief and attorneys' fees.

Phelan isn't so sure. Because of the limited damages available, he said, "I don't think you'll see a flood" of lawsuits.

CALIFORNIA LEADS

Lawrence Berliner, of Klebanoff & Alfano in West Hartford, Conn., is a veteran ADA lawyer who handled public accommodation issues dating to 1983, when he was employed by the State Office of Protection and Advocacy for Persons with Disabilities before joining his current firm. Historically, he said, when it comes to disability advocacy, California often has been a leader.

"Sometimes what's happening in California, with winds blowing West to East, will catch up elsewhere in the country," and because of that, he believes the class action lawsuit "certainly could have an impact" throughout the country.

Depending on what happens to Target, "other large corporations will pick up and take notice to see if they have any potential exposure," he said.

But there's no guarantee that there will be an increase in lawsuits filed here in state courts because of civil rights statutes on the books, Berliner said. Though the state has a broader definition of what it means to be disabled, the Connecticut General Statutes contain a more restrictive definition of public accommodation, he noted.

Sec. 46a-63 defines a place of public accommodation as "any establishment which caters or offers its services or facilities or goods to the general public ... ," which creates an interesting legal question in terms of defining a Web site as an establishment.

And for those found to be in violation of the statute, the penalties outlined in Sec. 46a-64 call for a fine of between $25 and $100 or 30 days in jail or both.

Phelan, of Outten & Golden in Stamford, said, "Rather than see [this debate] as a burden, businesses should see this as a marketing opportunity."

Indeed, online retailer Amazon.com announced in March 2007 that it was entering into a cooperation agreement with the NFB to make its Web site and some affiliated Web sites fully accessible to disabled people now and going forward with changing technology. ..more.. by

MA- Enforcing bylaw on sex offenders may be a challenge

2008-05-10T19:04:00.011-04:00

ISSUE : Senior Housing. Can registered sex offender STOP the aging process? Since every human being will age, it is likely that elderly sex offenders would need housing typical to anyone else who is elderly. This ordinance would prevent elderly sex offenders from obtaining the senior housing they need.

5-10-2008 Massachusetts:

It's one thing to adopt a bylaw restricting where convicted sex offenders can live. It's another matter to enforce the new rules.

'It really has been relatively quiet, much to my surprise. At least now we have this ability to have something to fall back on.'

Southborough adopted such a bylaw at Town Meeting on April 17. If approved by the state attorney general's office, which has approved similar bylaws in Dedham, Marlborough, and West Boylston, registered sex offenders would be barred from residing in 90 percent of the town, according to a presentation delivered by Police Chief William Webber to Town Meeting members.

The bylaw bars registered offenders from living within 1,000 feet of schools, day-care centers, elderly housing, parks, and other facilities. Convicted offenders deemed likely to commit another sexual assault - those classified as Level 2 or 3 predators - would also be barred from living within 1,000 feet of places of worship.

The bylaw also prohibits registered sex offenders from loitering within 500 feet of school bus stops. A grandfather clause allows offenders living in Southborough prior to the bylaw's enactment to remain in their residences.

The question now is how rigorously the bylaw can be enforced. Based on Marlborough's experience with a similar law, the question remains unanswered. Marlborough police say they've invoked the city's ordinance only three times since it was adopted in May 2007. They stand by the law as an important tool to protect children and others from sexual predators, but admit it doesn't have much of a track record.

"It really has been relatively quiet, much to my surprise," said Marlborough Police Chief Mark Leonard, adding, "At least now we have this ability to have something to fall back on."

Detective Martha Shea, who oversees enforcement of Marlborough's ordinance, said the law's residency requirement has been used twice, while its loitering clause has been invoked once.

In one case, she said, a registered offender went to jail for a short time, and since he had continued paying his rent he was allowed to return to his home. In another case, an offender left his residence and wanted to move back. Police decided the grandfather clause didn't apply and denied his request.

In October, police determined that a registered sex offender was loitering near a housing area for senior citizens on Main Street, Shea said. He was cited, but his case was dropped in Marlborough District Court at a pretrial hearing with the court's clerk-magistrate, she said. Under the bylaw, the penalty for violating the loitering clause is $150.

Shea said she thinks the ordinance has discouraged registered sex offenders from moving to the city. "We have a lot of rooming houses, so we had a lot of Level 3s coming in on a pretty consistent basis," she said. "Now there's not. I can't prove the ordinance did that. But I have to think it did."

The state Sex Offender Registry Board's website counts 33 Level 2 and nine Level 3 offenders living in Marlborough. A board spokesman, Terrel Harris, said a total of 51 sex offenders were registered in Marlborough in April 2007. The board did not have a breakdown of offender levels from past dates, he said.

'It really has been relatively quiet, much to my surprise. At least now we have this ability to have something to fall back on.'

A single Level 3 offender and four Level 2 offenders live in Southborough, according to the registry board's website, mass.gov/sorb.

Webber plans to assign an officer to handle Southborough's new bylaw and develop a system to monitor the town's 750 bus stops. That's too many for his force to patrol, so he'll probably depend on help from citizens, he said.

"Anyone loitering in Southborough, they're going to call," he said. "They call about people driving too fast. They're certainly going to call about some seedy looking character."

Webber acknowledged the possibility that offenders could circumvent the bylaw by not telling police they're moving into town. But state law also mandates that sex offenders register their whereabouts, he said; if they don't and are caught, they go back to jail.

Short of creating a massive surveillance operation, Webber said, state and local laws depend on compliance from registered sex offenders. "In an open society, these are some of the risks we take," he said.

Since July, Framingham officials have been considering a bylaw like the ones in Marlborough and Southborough. Board of Selectmen chairman Jason Smith said no decision has been made, but he supports a mechanism to keep tabs on convicted sex offenders.

"We have an abundance of them, to the point where public safety comes first," Smith said. "You should never be afraid of walking out of your front door knowing in the back of your mind a Level 3 offender is watching your every move."

Framingham has 19 Level 2 and 74 Level 3 registered sex offenders, according to the state's website.

Smith said he and his colleagues need to study how prohibiting offenders from some areas might push them into others. He would support state legislation requiring registered sex offenders to wear electronic bracelets that would give police their location at all times, he said. ..more.. by John Dyer, Globe Correspondent

OH- State Takes Action On Sex Offenders In Nursing Homes

2008-05-09T22:33:00.002-04:00

5-9-2008 Ohio:

COLUMBUS, Ohio – A newly proposed sex-offender law soon could include offenders living in nursing homes of other long-term care facilities.

There was a bill within the statehouse Thursday that would require neighbors to be notified of registered sex offenders living in nursing homes, NBC 4’s Mike Bowersock reported.

Hundreds of people turned out for the Ohio Health Care Association’s annual conference Thursday in Columbus.

On the agenda were speakers and presentations about the skilled nursing profession.

Not on the agenda was a discussion about House Bill 57 — a bill that if passed would change the way nursing facilities deal with their patients.

“It’s a difficult question we’re wrestling with,” the association's President and CEO Peter Van Runkle said.

The difficult question? How to deal with registered sex offenders living in nursing homes?

There currently is no state law that requires residents in the homes as well as neighbors nearby to be notified about who may be living in those types of facilities.

“It kind of freaks us out a little bit, but at the same time they’ve paid their debt to society already,” Jay Smalley said. Smalley talked with NBC 4 last year. At the time, he lived across the street from a nursing home that housed 19 sex offenders.

The bill will move from the House to the Senate and could be passed within the next month. ..more.. by Ashley Brown

Being Deaf and Having to Register as a Sex Offender

2008-04-30T17:24:00.005-04:00

ISSUE-2: Being deaf and registering as a sex offender. A visitor is developing a list of the challenges faced when registering. That list and whatever resolves that6 person faced will be posted. In the meantime I have found a few resources for folks to read.

4-30-2008 National:

To be posted....

==========
RESOURCES:
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Mental Health Care of Deaf People: A Culturally Affirmative Approach by Glickman, Neil S, . Glickman, Sanjay
Gulati specifically these pages: CLICK

DEAF & CRIMINAL JUSTICE RESOURCES excellent list of resources by scrolling down.

VA- Bill Would Identify Sex Offenders at Nursing Homes

2008-04-29T11:30:00.008-04:00

Issue-1: Nursing Homes and Assisted Living Centers for the Aged. It seems to me that registered sex offenders, as humans, and needing the services of a nursing home, would have no other way to obtain them. Accordingly, lawmakers should not deny services to this subgrooup of society, to do such is against the principles of government.
4-29-2008 Virginia:

The Virginia State Crime Commission is calling for closer scrutiny of convicted sex offenders who live in nursing homes after finding more than a dozen housed in facilities across the state.

The commission has endorsed legislation that would require nursing homes and assisted-living facilities to check residents' names against the state sex offender registry within three days of admittance. Nursing homes also would be required to direct new patients and their families to the state's online registry to find information about offenders at a given facility.

Virginia law requires convicted sex offenders to regularly report their whereabouts to authorities. The online registry contains photos, addresses and information about their offenses.

The measure would not bar sex offenders from nursing homes, but it would put facilities and new residents on notice when an offender has been admitted, commission members say. The legislation would make Virginia one of a growing number of states to require people in long-term care to be checked against a sex offender registry.

Last year, the commission conducted a study that found three to six sex offenders living in Virginia nursing homes and about 16 in assisted-living facilities. Those numbers, however, represent only a fraction of the thousands of residents living in the more than 265 nursing facilities in Virginia.

An investigation by The Washington Post in 2004 revealed that more than 40 violent sex offenders -- including rapists and pedophiles -- had lived in licensed Virginia assisted-living facilities during an 18-month period, according to state registries.

--Notice the reporting, no mention of whether or not these folks needed the services of the nursing home. So again, the media is lobbying under the pretext of reporting.--

The Crime Commission's chairman, Sen. Kenneth W. Stolle (R-Virginia Beach), said the notification requirement could be an important tool for staff members at nursing homes to increase the safety of patients.

"The patients in nursing homes may be some of the most vulnerable people in the community," Stolle said. "The idea that they could be vulnerable to attack is very unsettling."

The push for greater scrutiny of sex offenders in Virginia comes as more than a dozen states are grappling with concerns that convicted sex offenders in long-term care facilities could victimize the elderly and the disabled.

Last year, the Government Accountability Office reported finding about 700 registered sex offenders living in about 23,000 nursing homes and assisted-living facilities across the country. But the actual number is probably larger, in part because of discrepancies between the national sex offender registry and individual state registries, according to the GAO report.

--Again, notice the reporting, no mention of whether or not these folks needed the services of the nursing home. See below cited from that report:

Nursing homes provide a residential setting and a range of health care services for individuals who can no longer care for themselves because of physical or mental limitations. According to the most recent National Nursing Homes Survey (NNHS), approximately 90 percent of nursing home residents were age 65 and older and more than two-thirds were female.4 ICFs-MR are intended to provide a residential setting for treatment, rehabilitation, and supervision of people who have mental retardation or other disabilities, such as seizure disorders or behavior problems. In 2005, approximately 85 percent of ICF-MR residents were from 22 to 65; only 7 percent of the total resident population was over 65 years of age. In addition, unlike the nursing home population, the majority of ICF-MR residents were male. pgs- 6-7.

Earlier in that report is this comment which says nothing about whether this group needed the services of the nursing home:

Using the FBI’s NSOR, we identified about 700 registered sex offenders living in long-term care facilities during 2005, representing 0.05 percent of the 1.5 million residents of these facilities. About 3 percent of nursing homes and 0.7 percent of ICFs-MR housed a registered sex offender during 2005. Almost 90 percent of registered sex offenders we identified lived in nursing homes and were considerably younger than the general nursing home population, with 57 percent under age 65 compared to about 10 percent of all nursing home residents. pg-3.

In Illinois, a statewide review conducted last year turned up 1,000 convicted felons, including 60 sex offenders, among 100,000 residents in facilities there. The review was conducted after Illinois enacted a law requiring criminal background checks on nursing home patients and treatment evaluations for patients who are sex offenders. Recently, state and local lawmakers in California, Minnesota, New York and Oklahoma have considered adopting similar measures.

Some advocates for the elderly in Virginia say the Crime Commission's recommendations do not go far enough.

Madge Bush, director of advocacy for the Virginia chapter of the AARP, said the notification legislation would put an unfair burden on patients' families to find out about sex offenders at nursing homes. Bush said her organization is pushing for signs to be posted in "conspicuous places" at nursing homes to notify patients of the presence of sex offenders.

"If I'm a new patient or I'm taking my mother to a nursing facility in the state, the last thing on my mind at such a stressful and difficult time is going to be checking on the Internet for sex offenders there," Bush said. ..more.. by Candace Rondeaux, Washington Post Staff Writer. Staff writer David S. Fallis contributed to this report.

Welcome Message

2008-04-28T21:27:00.007-04:00

4-28-2008 National:

Welcome,

This blog is established to identify and develop, any age or disability issue, related to - former sex offenders - who are required to register under a state or the federal registry (SORNA).

In time we will categorize issues and try, with the help of our vistors, to find ways to resolve them, posting the resolution. Hopefully these resolves can be used, as a pattern, with subtle changes necessitated by local laws.

Further, if there is no real resolve, then it is an issue which needs to be brought to the attention of lawmakers. Knowing the way lawmakers feel about former sex offenders we can, at best, raise the issues and hope they do not fall on deaf ears as so many issues do.

We are open to ways to make the theory of this blog work, to the benefit of all those who are aged or with disabilities no matter what the issue is, they all need to be identified; our main goal.

Accordingly, all visitors comments and suggestions are welcomed, and we hope constructive. Long term we hope that lawmakers will listen as most of these issues are lifetime and affect major life functions of registrants.

It is likely this blog will change over time as visitors make suggestions and submit issues (See link in lefthand column), please describe issues as clearly as possible. Finally, bear with us as we develop a workable format.

Thanks, and have a great day and a better tomorrow.

eAdvocate

New Bills in Congress Affecting Registered Sex Offenders

2008-04-28T16:38:00.001-04:00

4-27-2008 National:

In the U.S. House:

HR-4094 To amend the Adam Walsh Child Protection and Safety Act of 2006 to modify the minimum standards required for the electronic monitoring units (GPS) used in the pilot program for monitoring sexual offenders. Requires "ACTIVE MONITORING" rather than "passive monitoring."

HR-5722 `International Megan's Law of 2008' (' The purpose of this bill: If a RSO is going to another country, for whatever reason including things like vacation, this bill requires notifying the country the RSO is going to. I am quite sure if this passes, the countries notified will prevent the RSO from entering their country.)

HR-5760 An appropriations bill to extend funding (to 2011) for certain programs defined in the original Adam Walsh Act.

HR-5876 This bill pertains to "sex abuse" rather than "sex offenses" or "sex offenders"

In the U.S. Senate:

None

All Bills in Congress:
All Congressional Bills affecting all registered sex offenders