Week of January 25, 2010

The sudden halt to health care reform’s steady march forward came as a shock to many who saw an upset win by Republican Senator-elect Scott Brown in Massachusetts as all but impossible. But if many took delight in the election outcome’s impact on health reform legislation, Aetna Chairman Ronald A. Williams made it clear in a New York Times story last week that the country still needs meaningful health care reform – reform that addresses access as well as affordability. Everyone benefits by health reform that gets at the factors driving soaring health care costs and the loss of coverage for so many Americans. While Congress thinks carefully about its next steps, Aetna will continue to support meaningful health care reform and continue to offer responsible solutions to legislative leaders.

Federal

The election of Republican Scott Brown as the new senator from Massachusetts has derailed the Congressional health care reform train, less because Brown denies Democrats the 60th filibuster-proof vote, though that is certainly a major result, and more because it collapsed the Democratic political house of cards by highlighting the power of independent voters and the frustrated anti-incumbent mood of the electorate. Whether Democrats can regroup from this wake-up call will consume their leadership from now until the November off-year elections. How Democrats handle, and how Republicans respond to, health care reform in the short term and other key priorities – such as jobs, the economy, energy and security – over the rest of the session will underscore all Congressional decisions from now until the first Tuesday in November. In short, the 2010 elections started in earnest with Brown’s victory.

Once Democrats get past the shock of losing Kennedy’s seat, they will have to grapple with health care reform, one way or the other. The early favorites, including passing the Senate bill “as is” in the House, have been dropped for now as Democrats recognize the political cost of ramming through something unpopular propelled by political muscle only. Passing a smaller, less invasive and mostly Democratic bill has only a slightly better chance, as Republicans are not too likely to “crossover” quite yet. There is a growing interest in using reconciliation (the 51-vote tactic) down the road to pass a Democratic-only bill, once the House and Senate Democratic leadership can agree to a single bill. And, there is the outside chance that Democrats will see the Massachusetts election as an imperative to craft a bipartisan bill with Republicans that can secure 70-plus votes in the Senate. Wednesday’s State of the Union speech, followed by the party issues retreats later in the week, will go a long way toward determining which path will be pursued.

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Republican Scott Brown, fresh off his victory in the Massachusetts race for U.S. Senate, called on the secretary of state to send him to Washington immediately, saying Wednesday that he wants to send health insurance reform “back to the drawing board.”

Though the state typically waits at least 10 days to collect absentee ballots before certifying, the senator-elect said he’s “confident” his margin of victory — 5 points and nearly 110,000 votes — was greater than the number of outstanding ballots.

Brown is champing at the bit to be sworn in since he would become the 41st Republican in the Senate, breaking the Democrats’ 60-vote supermajority and potentially scuttling health care reform if it returns to the chamber for a final vote.

“Since the election is not in doubt, I’m hopeful that the Senate will seat me on the basis of those unofficial returns,” Brown said, adding that he’s already spoken to members of the state’s congressional delegation, including Sen. John Kerry, and will travel to Washington Thursday. “I think it’s important that we hit the ground running because there’s some very important issues facing our country.”

On health care reform, he said he wants “everyone” to have some form of health care coverage, but questioned plans to slash Medicare and raise taxes to do it.
video
Brown Ready to Hit Ground Running

Brown ready to hit ground running

“I think we can do it better,” he said.

The Republican senator-elect said he was focused on moving to Washington as soon as possible to try to free up some of the political gridlock there.

“I have always just wanted to go down and solve the problem regardless of party,” Brown told NBC’s “Today” Show.

“While they’re in Washington talking about what someone said in a book and what this happened, we have some very serious problems when it comes to over-taxation, overspending and Al Qaeda who are trying to kill us. So we need to get back to the basics and start solving problems that affect every person in this country,” he said.

Brown’s insurgent candidacy has forced Democrats to rethink the basics on several matters, including the massive health insurance reform bill that is tagged to cost nearly $1 trillion over 10 years. They are also reconsidering agenda items they plan to use in November’s midterm election campaigns.

By winning the Senate seat in Massachusetts by nearly the same margin that President Obama defeated Sen. John McCain in November 2008, Brown takes away Democrats’ filibuster-proof majority and can pull a reverse-Obama — claiming a mandate to defeat the health care legislation now stuck in Congress.

Despite the upset, Obama adviser David Axelrod said administration officials will take into account the message voters delivered Tuesday but declined to go further.

“It’s not an option simply to walk away from a problem that’s only going to get worse,” Axelrod said of the health care bill.

Sen. Susan Collins, R-Maine, said one of the many messages coming out of the Massachusetts election is that Americans are sick of partisan gridlock, but voters also had a much more expansive recommendation.

“They want better performance out of Washington, they want us focusing on the troubled economy and the need for more jobs and … they’re tired of sweetheart deals that were sneaked into the health care bill. They want that kind of bill to be negotiated in the open. And they’re tired of politics as usual and they also want controls. They don’t want unfettered, one-party control,” Collins told Fox News.

Collins said she cannot support a bill “that imposes billions of dollars for new taxes, slashes Medicare by $500 billion and would actually cause insurance rates to go up.”

“We really should start from scratch and do a completely bipartisan bill,” she added

But Pennsylvania Gov. Ed Rendell said that Americans oppose the health insurance changes because “the administration and its supporters, myself included, haven’t done a good enough job explaining to people what’s in this bill.”

Rendell said he wants to go back to the drawing board in order to better communicate the message. If that fails, and a filibuster is threatened, then Democrats shouldn’t “just cave” but should make the other side “explain why they’re trying to block the bill with this type of political chicanery.”

“I haven’t heard one good alternative offered by any Republican except let’s start at the beginning, let’s start all over. Start all over to do what?” he asked.

Rendell added that he wants to call the GOP’s bluff.

“Let them filibuster, let them take to the floor and speak endlessly and endlessly about why this is bad for the American people and what the alternative is,” he said.

As the debate continues over whether to scrap the year-long health insurance reform effort, some are also looking at whether Republicans can repeat the feat in Massachusetts in other states.

Seven Senate seats now held by Democrats are now considered toss-ups in November — Nevada, Colorado, Arkansas, Illinois, Pennsylvania, Delaware and Connecticut. Four Republican seats are in the same situation — Missouri, Kentucky, Ohio and New Hampshire.

“I think anybody who’s up for election this November ought to take seriously what the people of Massachusetts had to say in that special Senate election,” said Sen. Joe Lieberman. D-Conn.
Sen. John Cornyn, R-Texas, head of the National Republican Senatorial Committee, said Democrats nationwide should be on notice

“Americans are ready to hold the party in power accountable for their irresponsible spending and out-of-touch agenda.”

But Democratic Senatorial Campaign Committee Chairman Robert Menendez cautioned against “taking a single unique election and extrapolating what it means for the midterms 10 months away.”

Still, Menendez said he doesn’t want to sugarcoat what happened and Democrats will be sorting through the lessons in the days ahead.

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Republican state senators called on California Attorney General Jerry Brown Tuesday to join other states and sue the federal government over health care reform.

The legislators said Congress cannot force people to buy health insurance or any other products.

Attorneys general in 13 other states have already filed suit against the health care overhaul that President Barack Obama signed into law. The bill will require most Americans to carry health insurance.

“I think that many Californians share the same view that this is the greatest expansion of government in a generation,” said Senate Minority Leader Dennis Hollingsworth, R-Murrieta.

State Sen. Tom Harman, R-Huntington Beach, sent the letter to Brown.

“The federal government is limited in what it can and can’t do by the Constitution,” Harman said, calling the measure a violation of the commerce clause.

Brown issued a statement saying he had instructed his deputies to review the claims made by the senators.

However, Brown, a Democrat and former two-term governor, noted that all but one of the 13 attorneys general who vowed legal action were Republicans.

“Health care is not the place, with people’s lives at stake, to engage in poisonous partisanship,” Brown said in the statement.

Republicans seeking their party’s nomination for governor, Steve Poizner and Meg Whitman, opposed the health care package and supported a state lawsuit.

Poizner, the state insurance commissioner, said consumers could face higher health insurance premiums and an onerous mandate to get health insurance whether they want it or not.

Whitman campaign spokeswoman Sarah Pompei called the health care plan a “new, big government program.”

The Republican lawmakers also decried what they called an unfunded mandate, estimating the plan would cost California taxpayers $3 billion.

Sen. Tony Strickland, R-Thousand Oaks, said voters should have final approval over the measure.

“It’s clear to me that people’s voices are not being heard in Washington, D.C., or in Sacramento,” Strickland said. “At a time when we a have high unemployment rate, this is going to be devastating to our California economy.”

The California Democratic Party said the health care overhaul will provide insurance coverage to 7.3 million Californians who do not currently have it and give a tax credit to some 390,000 small businesses in the state.

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Q: What is home health care?
A: Home health care is a service that permits patients to receive personalized health care, maintaining their quality of life in the privacy and comfort of their homes.

Q: Why home health care?
A: Home health care is a cost-effective option for receiving health care services. Returning to one’s home and family can quicken recovery and improve the quality of life for both patient and family or caregiver.

Q: Who pays for home health care?
A: Most health insurance companies, HMOs, PPOs and Workers Compensation cover home health care. In addition, Medicare and Medicaid pay for home care services. Some insurance providers do not cover all home health services. Our staff will verify health coverage for the patient.

Q: What criteria are required for Medicare to approve services?
A: The following criteria are used to meet Medicare requirements:
• The patient is a Medicare recipient.
• The patient must be homebound. This is defined by Medicare as “normal inability to leave the home and that leaving the home requires considerable and taxing effort.”
• The skilled care must be medically necessary as determined by the physician.

Q: What if I have a problem at night or on the weekend?
A: We have registered nurses on call 24 hours a day, 7 days a week.

Q: Do I need a physician’s order for home health care?
A: Yes, all health care provided in the home occurs under direct order and supervision of the patient’s physician.

Q: What types of services can be provided at home?
A: Many medical conditions that previously required hospitalization can safely be treated in the home. Home care services may include but are not limited to:

Skilled Nursing:
• Observation and assessment of condition
• Patient and family education of disease process
• Management and evaluation of patient care plan
• Medication education and management
• Dressing changes
• Home safety education
• Wound care
• Catheter care
• Injections
• IV therapy
• Ostomy care
• Pain management
• Diabetic care
• Nutritional support

Assistance with Daily Living:
• Bathing/dressing
• Transfer/ambulation
• Light meal preparation
• Light housekeeping
• Grocery shopping
• Medication reminder
• Laundry
• Companionship/Conversation
• Reading/writing
• Pet sitting/walking
• Escort to appointments
• Live-ins
• Respite
• Exercise therapy assistance

Q: How does Paloma Home Health Care, Inc. ensure quality care in the home?
A: Providing continuous quality care to patients is paramount to all we do. All patients are given a patient satisfaction survey that is incorporated into our ongoing evaluation process to continually increase our patient satisfaction. New programs and processes are developed through our quality improvement team to promote favorable outcomes.

Q: How do I find out more about home health care?
A: Please call our office to learn more about how you can benefit more about the service, at 972 346 2013

Q: What services can Paloma Home Health Care, Inc. offer?
A: Our services include but are not limited to:
• Supportive Care Education of Disease Process
• Individual and Family Counseling
• Management and Evaluation of Patient Care
• Observation and Assessment
• Home Safety and Emergency Education
• Medication Education
• Assistance with ADLs
• Nutrition Education
• Restorative Therapy (Physical, Occupational and Speech)

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The health care reform bills being debated in Congress threaten to shut out millions of immigrants. But Congress’ exclusionary policies toward immigrants will not simply leave immigrants worse off. They will inevitably jeopardize the nation’s economy and the health of all of us.

President Obama has prioritized health care reform to ensure that millions of Americans have a fair, affordable and efficient health care system. For immigrants, this vision is far from a reality. First, the current health care reform bill treats legal immigrants unfairly. Individuals who have waited years to come to the United States will be required to wait years in order to obtain affordable health care.

Immigrants are generally younger and healthier than the U.S. population at large. However, no one is immune to falling ill or having an accident. The current health care bill would require recently arrived, legal immigrants to wait five years to obtain the only option for affordable health care coverage, Medicaid. While low-income citizens will have access to Medicaid, the most vulnerable among us will continue to wait for affordable health care despite the fact that they pay taxes for the very programs from which they are excluded. There is no sound reason for Congress to discriminate against these individuals and prevent them from receiving basic medical care.

Congress and the White House also took an unprecedented step to prohibit individuals from buying — with their own hard-earned money — an American good that could help their families. The Senate version of the health care bill forbids undocumented immigrants from purchasing private insurance at full cost in the newly created insurance marketplaces. As a result, undocumented immigrants as well as their family members, who are often U.S. citizens or legal immigrants, will likely remain uninsured and will be forced to seek care in the emergency room.

The costs of providing health care for undocumented immigrants will not disappear after passing health care reform. It is unlikely that millions of immigrants, whose contributions keep up our standard of living and our economy functioning, will be deported. Instead, the cost of care will become the financial responsibility of the patient, the provider, the local and state governments, and every single taxpayer. Moreover, in order to exclude a few, there will be additional forms, documents, and bureaucrats that the rest of us will be subjected to. Buying the mandated health insurance could feel like a trip to the Department of Motor Vehicles. Taxpayers will have to pay millions for this additional red tape and delay, all to keep a few people from buying health insurance with their own money.

Providers, employers, consumers, religious leaders, and state and local governments recognize that these policies are short-sighted and will cost all of us more in the long-run. Policies that attempt to exclude and ostracize immigrants also disproportionately harm all communities of color and immigrant-rich states like California and New York, further widening existing inequities in our nation. Yet because immigrants live in all 50 states, the intended and unintended consequences and costs of these restrictions will be far-reaching.

Ending discriminatory and exclusionary policies in this final round of negotiations is not only a matter of fundamental fairness and sound economics. It is required in order to not leave all of us worse off. Congress has a short window of opportunity to remove the restrictions on legal and undocumented immigrants in the health care reform bill. Doing so will not jeopardize the passage of the bill. Failing to doing so, however, will leave all of us, immigrant or not, worse off and wondering what happened to the promise of health care reform.

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As the members of the class of 2010 prepare to flip their tassels to the left in May, there’s more than just studying to cross off of their to-do lists. While stressing over where to live and finding a job, many young adults do not address the issue of health insurance.

Reality will set in for some graduates when their parents’ plan or student insurance coverage expires, if it hasn’t already. Whether these current students are busy studying sociology or calculus, they need to make time to read up on their health insurance options before they suddenly find themselves uninsured.

“Thirty percent of people ages 19 through 29 are uninsured,” said Steve Trattner, president of Cinergy Health, in his article “Congratulations on Your College Graduation – Now Get Health Insurance.”

“Instead of being smart about the frailty of life, this age group tends to believe they’re invincible or simply do not recognize the necessity of health insurance, especially as we confront seemingly ever-rising health care costs,” Trattner continues in the article.

CNN Senior Medical Correspondent Elizabeth Cohen agrees with Trattner’s viewpoint in her article, “What’s a Recent College Graduate to do about Health Insurance?” Cohen acknowledges that some students are trying to find health insurance, but “others, dubbed the ‘young invincibles’ think they don’t need it since they’re young and healthy.” Cohen makes the point that all it takes is “a car accident, a cancer diagnosis” to put a 20-something college grad in “real trouble.”

To save themselves the pain and hassle of acquiring medical debt on top of already-looming college loan debt, students should check out their options now.
Insurance laws vary by state. As of Jan. 1, 2009, Connecticut law states that “Every individual health insurance policy providing coverage of the type specified in [certain] subdivisions… shall provide that coverage of a child shall terminate no earlier than the policy anniversary date on or after whichever of the following occurs first, the date on which the child: Marries; ceases to be a resident of the state; becomes covered under a group health plan through the dependent’s own employment; or attains the age of twenty-six.” This law does not apply to all insurance plans.

In “What’s a Recent College Graduate to do about Health Insurance?” Cohen suggests looking into the Consolidated Omnibus Budget Reconciliation Act (COBRA). According to the U.S. Department of Labor Web site, COBRA “gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances.”

COBRA is not a free option. The Web site explains that “Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost of the plan.”

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      What is Home Health?

Home Health Care is skilled nursing care and certain other health care services that you receive in your home for the treatment of an illness or injury. This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).
This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).  

***FREE OF CHARGE***if Medicare approved

Call or email now to see if you are Medicare/Medicaid Qualified
If you or someone you know needs help with
1. Diabetes
2. High Blood Pressure
3. Wound Care
4. Arthritis/Joint Pain
5. Any Chronic Illness or Disease
We Also Provide:
1. Light House Keeping/Laundry Services
2. Senior Transportation
3. Meal Preparation
4. And Much More At No Charge to YOU!!

CLICK LINK BELOW TO WATCH VIDEO ABOUT HOME CARE  http://www.tahc.org/associations/1626/files/TAHC new VO.wmv

II. How to get Medicare Home Health Care: 

• Your doctor must determine you need medical care in your home.

 • You will need at least one of the following services: skilled nursing care, physical or speech therapy. 

• You must be homebound. Homebound means that leaving your home is a considerable and taxing effort

III. What qualifies as Skilled Home Care Services?

• Wound Care for pressure ulcers or surgical wounds 

• Physical Therapy (fall prevention, recent fractures, recent stroke, TIA’s, endurance issues, or transfer training) 

• Occupational Therapy (recent strokes, ADL training-such as dressing, grooming, and bathing)

• Speech Therapy (swallowing issues, aspiration, recent stroke, pneumonia)

 • Patient and Caregiver education

• IV Therapy

• Injections (diabetes, B-12)

• Medication Management

IV. Home Health vs. Hospitalization:

• In many cases home health care services may be appropriate to prevent an individual from being hospitalized.

• Most patients and their families prefer to stay at home rather than be placed in the hospital or skilled nursing facility when their condition allows them to remain at home.

• Home health care is usually less expensive and in some cases just as effective as care in a hospital or skilled nursing facility. 

Home health care assists a person in their recovery from an illness, accident, surgery, or change in their medical condition. Professional health care and rehabilitation services are delivered in a person’s home environment under the direction of their personal physician.        

Services offered include:     

Skilled Nursing 

24/7 Availability     

Physical Therapy 

Wound/Ostomy Care   

Occupational Therapy  

Infusion Therapy   

Speech Therapy 

PT/TNR results in home  

Home Care Aides 

Pain Management    

Medical Social Workers 

Rehabilitation 

Who pays for home health care?

If you are Medicare eligible and qualified for care, there is no out of pocket cost to you. Home care can also be paid for by many private insurances or a variety of public programs.

To qualify for Medicare home health services, there are five basic requirements:

1. Your physician must determine that you need home health care services

2. Your own physician must write the orders for home health services, and oversee your care

3. You must need skilled services that are provided by a nurse or therapist

4. Your physician must determine that you are homebound, requiring considerable effort and help to leave home

Because benefits and requirements can vary, we can help you check with payors about your specific benefits, even before beginning services, so you can have this information at the start of care. 

-Medicare pays 100% of the cost for home health care for individuals 65 years of age or over or permanently disabled.

-Private insurance will pay for home health care. Benefits vary per policy and verification of benefits is required.

-Medicaid pays 100%. Pre-authorization is required.

-Workers Compensation Insurance.-Private Pay.

We can HELP you in a number of ways.      

   ·     Patient specific health data with observations by a professional nurse are reported to the physician. 

 Helping patients and their families to understand and follow physician’s orders regarding nutrition, special diets, medications, and general nursing care:

 ·       Assisting with home management of catheters and feeding tubes.

 ·     Giving injections ordered by the physician and teaching patients and family the proper techniques for doing so. 

  ·       Helping patients restore strength and independence through physical therapy exercises, 

Educating diabetic patients on how to manage diet, insulin, and other health related measures.  Enabling the patient with ostomy how to resume a full, active life.

 ·        Assisting patients with bathing and personal grooming (ADLS).  

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