Dearden: Nursing care for hard-to-place Iowans

3-23-2015 Iowa:

Iowa's long-term care services receive high praise for quality and affordability. In fact, Iowa's long-term care services are ranked 13th best in the nation in the AARP's most recent Long-Term Care Scorecard.

However, Iowa has struggled to find appropriate nursing facility placements for sex offenders and those who are aggressive or violent, as well as older Iowans who require psychiatric services and nursing home care. Unfortunately, there have been cases in which staff and other residents have been harmed, and facilities have been fined for not providing adequate security when caring for these individuals.

Providing long-term care for sex offenders and those who are aggressive or violent is costly. It requires special training, security and insurance coverage.

The Legislature has attempted to research the issue, most recently in 2013 when a study committee was approved by the Legislature but vetoed by Gov. Terry Branstad. At the governor's direction, the departments of Corrections, Human Services and Inspections & Appeals created an informal work group that met over the past couple of years but produced no policy or funding recommendations.

Bill seeks nursing home unit for aggressive elderly

2-13-15 Iowa:

Iowa would consider setting up a special nursing home unit for elderly people who are combative or sexually aggressive, under a bill that took its first step forward Thursday.

The bill, Senate File 142, comes amid questions about what will be done with elderly psychiatric patients — including four sex offenders — now living at the state mental institution at Clarinda. Gov. Terry Branstad’s administration is moving to close that hospital and another one at Mount Pleasant.

State officials have been talking for several years about designating a nursing home facility for elderly people whose sexual or physical aggression poses a danger to other residents.

The new bill calls for a task force to be formed to look at how the state could set up such a facility, which could be run by the government or by a private agency using state money.

Administration Move Jeopardizes Hospice Care

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