"The afternoon that I went for a walk with Linda for the first time was one of the moments I’ve been proudest of as a hospice volunteer, odd though that may seem. I’d first met Linda a few months prior to that, when the late fall and winter light made her and her husband Joseph’s small and cluttered apartment dark in the early afternoons.

I was there mainly to visit Joseph who was immobile and unspeaking in his hospital bed in the living room following a devastating stroke.

In theory, a volunteer’s role is to keep ill people company and give their caregivers a break. But I’ve found that caregivers often opt to stay home with their loved ones instead. Why? It may be a fear that something awful will happen in their absence, worry that only they know how to best care for their loved one, or a simple desire to have company themselves once a week for a couple of hours."

Go here -> https://www.timegoesby.net/weblog/2020/02/a-tgb-reader-story-how-can-i-help-you.html

sted February 24, 2020 at 2:47pm
"OPINION — The wafting smell of cleaning supplies and a lack of ventilation was overpowering as I walked through the nursing home door. I could feel the anxiety I shared with my parents and my uncle as we approached my great-aunt’s room. I love my great-aunt dearly, as does my whole family. But after her dementia prevented her from living on her own, the only care option within our family’s means was a nursing home covered by Medicaid. As we walked back to our car, my uncle turned to me and said, “When the time comes, I don’t ever want to be in one of these places.”

Seeing a loved one suffering from an illness such as dementia is stressful. But the anxiety I felt visiting my great-aunt last fall wasn’t only about her condition. I was haunted by the fact that a nursing home was her only option and that many Americans won’t get the care they need because our policies don’t support family caregiving."

Go here -> https://www.rollcall.com/2020/02/24/taking-care-of-loved-ones-shouldnt-be-so-taxing/

"Every day, nearly 4.5 million direct care workers support older adults and people with disabilities across the United States.
Their role is invaluable to the individuals they support, their families, and the long-term care system—and to our economy and society. Yet direct care
workers are often overlooked, their contribution unrecognized, and their efforts undercompensated. It’s time to care about direct care workers.
This report is the first in a year-long series—culminating in a comprehensive final report in January 2021—that will examine the importance and impact of
the direct care workforce. Each report in the series will provide original data, in-depth analyses, and policy and practice recommendations, as well as feature individual direct care workers from around the country—because it’s critical that we include workers’ voices, and their experiences and insight, in efforts to shape and improve this sector."

Go here -> https://phinational.org/wp-content/uploads/2020/01/Its-Time-to-Care-2020-PHI.pdf

And here -> https://phinational.org/7-reasons-we-need-the-caring-for-the-future-report-series/

"Wisconsin is facing a deficit in caregiver positions after a new report revealed 1 in 4 positions in the state’s nursing homes and assisted living facilities are currently open.

A recently released report said there are 20,655 vacant caregiver positions across the state. This number has increased when a 2018 report revealed 1 in 5 positions were vacant.

The same report found filling positions has been more difficult because wages are simultaneously becoming less competitive due to Wisconsin’s Medicaid nursing home reimbursement plan."

Go here -> https://www.dailycardinal.com/article/2020/02/2020-report-declares-long-term-care-workforce-crisis

And here -> http://www.leadingagewi.org/media/83454/2020ltcworkforcecrisis.pdf

"Assisted living will need to fill 1.2 million direct care jobs over next decade: report," Lois A. Bowers, McKnight's Senior Living, January 22, 2020
"Residential care settings such as assisted living communities will need to fill more than 1.2 million direct care jobs over the next decade, including new jobs and positions that become available as existing workers leave the field or the labor force, according to a report released Tuesday.

The number is small, however, compared with the 4.7 million direct care jobs that will be available in home care from 2018 to 2028, according to “It’s Time to Care,” a report citing data from the U.S. Census Bureau and the Bureau of Labor Statistics and released by national research and consulting organization PHI. But it’s more than the estimated 621,000 direct care positions that nursing homes will need to fill in the same timeframe, PHI said."

Go here -> https://www.mcknightsseniorliving.com/home/news/assisted-living-will-need-to-fill-1-2-million-direct-care-jobs-over-next-decade-report/

"During a recent workshop at the National Academies of Sciences, Engineering, and Medicine in Washington, DC, another panelist and I raised a complaint familiar to many leaders working in the long-term care field.

“‘Unskilled’ is the most inappropriate moniker you could ever hear,” said Joanne Spetz, Health Economics Professor at the University of California, San Francisco and Director of its Health Workforce Research Center on Long-Term Care, referencing a term frequently used to describe home care workers."

Go here -> https://phinational.org/lets-call-home-care-work-what-it-is-skilled-work/

"The Centers for Medicare and Medicaid Services (CMS) is rolling out a program to encourage people to become volunteer caregivers for older adults and other people with disabilities living in their communities. The Community Care Corps  will fund local non-profits to recruit and train those volunteers.

The idea is well-intentioned and an important recognition by the Trump Administration that the nation faces a growing shortage of both family and paid caregivers. But, at best, it will be a small step toward closing the nation’s caregiving gap. And it raises some important questions about how we perceive the economic value of caregiving. "

Go here -> https://www.forbes.com/sites/howardgleckman/2020/02/21/volunteers-cant-close-the-nations-caregiving-gap-for-frail-seniors/#369bda4334bf   

"President’s Budget Previews Administrative Actions That Would Weaken Medicaid," Jessica Schubel, Center on Budget and Policy Priorities, February 25, 2020
"The President’s 2021 budget outlines Medicaid changes the Administration plans to make unilaterally, using executive authority, that will eliminate health coverage for many people, cut benefits for others, and make it harder for states to administer their programs. These policies will cut Medicaid by $28 billion over ten years, the budget estimates — on top of the deep Medicaid cuts the budget proposes to accomplish through legislation.

While the budget claims that its proposed regulatory changes are needed to improve program integrity, this claim lacks foundation. The data do not show large numbers of ineligible people enrolling in Medicaid;  in fact, they show that large numbers of eligible people aren’t enrolled, a problem that appears to be growing and contributing to rising uninsured rates for children and adults. Moreover, the budget’s regulatory proposals aren’t well targeted to prevent ineligible people from enrolling in Medicaid, but rather would make it harder for eligible people to enroll and stay enrolled, as well as to obtain needed health care."

Go here -> https://www.cbpp.org/sites/default/files/atoms/files/2-25-20health.pdf

"What Does New Block Grant Guidance Mean for the Medicaid Program?"  Cindy Mann, The Point/Commonwealth Fund, January 31, 2020
 "The policy, released not as a new regulation but as guidance to states, invites states to apply for what the Centers for Medicare and Medicaid Services (CMS) refers to as the “Healthy Adult Opportunity.” Targeted to the adult expansion population — that is, parents and other adults who can be covered through the Medicaid expansion created by the Affordable Care Act (ACA) — the central feature of the initiative is the imposition of capped funding. Under Medicaid law, states and the federal government jointly finance the cost of the program; all program expenditures are shared without a cap. That means that when spending increases as a result of rising drug prices, newly available treatments, or an enrollment surge during an economic downturn, the federal contribution automatically adjusts. For states that opt into a capped funding waiver, that would no longer be the case."

Go here -> https://www.commonwealthfund.org/blog/2020/what-does-new-block-grant-guidance-mean-medicaid-program

"With lowering prescription drug costs a top priority for Americans, the Trump Administration, presidential candidates, members of Congress, and several states are proposing to allow the importation of drugs from abroad, chiefly Canada. The idea of allowing drugs to be imported from Canada and other countries is popular with Americans across the political spectrum, but has yet to be implemented due to concerns about safety, and strong opposition from the drug industry."

Go here -> https://www.kff.org/medicare/press-release/questions-about-prescription-drug-importation-kff-has-answers/

And here -> https://www.kff.org/medicare/issue-brief/10-faqs-on-prescription-drug-importation/

"As debates over high drug prices continue to grab headlines, it’s worth taking a deeper dive into the substance of the policy issues at stake. Recent Kaiser Family Foundation polling found that while almost 90% of Americans supported Medicare negotiating drug prices if it could help people save money, around two-thirds opposed that same measure when told it could limit innovation.

Studies indicate that limiting drug industry profits would negatively impact innovation. So how can we balance this apparent tradeoff between making drugs affordable and preserving future innovation?"

Go here -> https://theincidentaleconomist.com/wordpress/the-drug-price-innovation-tradeoff-ideas-and-points-of-contention/

"At your local pharmacy, the options can feel overwhelming, even in the deodorant aisle. Dove, Axe, or Degree? Or maybe Secret, Gillette, or Old Spice? Or maybe Speed Stick? While the brands and labels are different, you actually don’t have that many choices at all. Three companies basically own the aisle — Unilever, Procter & Gamble, and Colgate-Palmolive. They’re three of the biggest consumer goods conglomerates in the world.

That’s the thing about the choices you think you have in spending your money: A lot of the time, they’re just not real.

That’s the conclusion of a new report from the American Economic Liberties Project. The organization launched in February and is headed by Sarah Miller, former deputy director of the anti-monopoly think tank Open Markets Institute and an antitrust expert. Its mission is to combat monopolistic behavior and corporate power and their effects on democracy and the economy. It’s part of a growing push for antitrust enforcement on the left."

Go here -> https://www.vox.com/2020/2/25/21147280/illusion-of-choice-monopolies-brands-sarah-miller

And here -> https://www.economicliberties.us/

"In the summer of 2017, I decided it was time to put on my big-girl pants and try to talk to my internet provider about my bill. It had been gradually ticking up over the past several months without explanation — let alone better service — and I wanted to know what was up. When I called the company’s customer service line, the woman on the phone knew something I did not: I didn’t really have other service options available in my area. So, no, my bill would not be reduced.

More than two years later, I’m still mad about it. And yes, that could seem a little petty. But that monthly annoyance speaks to a broader trend that all Americans should be aware of — and angry about. Across industry after industry, sector after sector, power and market share have been consolidated into the hands of a handful of players.

Lately, you’ve probably heard a lot of complaints about the size and scope of big tech companies: Facebook, Google, Amazon, and Apple. But competition is lacking across countless industries, including airlines, telecommunications, lightbulbs, funeral caskets, hospitals, mattresses, baby formula, agriculture, candy, chocolate, beer, porn, and even cheerleading, just to name some examples. When you look, monopolies and oligopolies (meaning instead of one dominant company, there are a few) are everywhere. They’re a systemic feature of the economy."

Go here -> https://www.vox.com/the-goods/2020/2/18/21126347/antitrust-monopolies-internet-telecommunications-cheerleading

"Research has established that as much as a quarter of American health spending is waste.

There are two basic ways of tackling it, by focusing narrowly on specific types of patients or on the system as a whole. The patient-centered approach starts with this fact: A relatively small group of patients — 5 percent — account for half of all health spending.

It’s widely believed that making so-called super-utilizers even a little healthier — for example, giving them extra help once they’re out of the hospital to prevent a quick return there — would yield substantial savings. This idea, based on some weak evidence, has received considerable media attention and government support.

A rigorous study, published Wednesday, makes clear it’s not so easy. In fact, the study’s results are likely to be viewed by many as a major disappointment. Yet they also help guide us to what may be better strategies for cutting waste."

Go here -> https://theincidentaleconomist.com/wordpress/deflating-results-of-major-study-point-to-better-ways-to-cut-health-care-waste/

And here -> https://www.nejm.org/doi/full/10.1056/NEJMsa1906848

And here -> https://www.washingtonpost.com/national/health-science/hospitals-and-insurers-struggle-to-reduce-costs-by-patients-dubbed-super-utilizers/2013/10/07/2963b048-14ae-11e3-a100-66fa8fd9a50c_story.html?noredirect=on

"Many Wisconsin low-income families miss out on their full tax refund because they do not claim tax credits for which they are eligible – particularly the Earned Income Tax Credit, the Homestead Tax Credit, and the federal child tax credit.

Based on the most recent estimates of participation in the federal Earned Income Tax Credit, we calculate that almost 90,000 Wisconsinites who are eligible for it do not receive that credit.  That helps illustrate the need for better outreach and education to ensure that these important sources of assistance for low-income Wisconsinites are reaching everyone who is eligible.

Increasing the participation rate for these credits would not only help thousands of low-income families, but would also provide a significant economic boost to many communities of color and other communities furthest from opportunity.

Please help us get these flyers, which explain the eligibility for these credits, into the hands of low-income families who could benefit."

Go here -> http://www.wisconsinbudgetproject.org/get-the-credit-you-deserve-tax-credit-information-in-english-spanish-and-hmong-2

“An ombudsman is the voice of the people—that’s the literal translation of the word,” Kim Marheine tells some 150 undergraduate students at the University of Wisconsin–Madison School of Nursing.

Marheine oversees Wisconsin’s long-term care ombudsman program. “It’s very fulfilling work,” she says.

“I’ve never worked anywhere other than long-term care. I was that 15-year-old nursing assistant. I worked in a tiny little nursing home out in the country with only 21 beds. I learned great skills from the nurses who I worked hand in hand with, every day. They inspired me to pursue a career in gerontology.”

Go here -> https://care.nursing.wisc.edu/2020/02/26/ombudsman-advocacy-and-nurse-leadership-in-long-term-care/

On Wisconsin.
"Rural communities are aging more rapidly than other parts of the country. Vickie Stangel has witnessed her city’s changing needs firsthand as director of the Dodgeville Public Library.

“We have patrons who have been using our library probably 70 or 80 years,” Stangel says. “We’re seeing them going from regular print to large print and audiobooks. We take books out to the senior living facilities. Families come in with questions about dementia care and senior resources.”

That’s what prompted Stangel to join the Iowa County coalition of the Healthy Aging in Rural Towns (HeART) project. For two years, HeART has brought together coalitions from Iowa and Langlade counties and the city of Waupun with the School of Nursing’s Center for Aging Research and Education (CARE) to support rural aging-in-place."

Go here -> https://nursing.wisc.edu/new-strategies-for-aging-communities/

And here ->https://care.nursing.wisc.edu/heart/