{"version":"1.0","provider_name":"Adultday care group","provider_url":"http:\/\/www.adultdaycaregroup.com\/blog","title":"Biden's 400 Billion Dollar Plan - Adultday care group","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"oesVspzGpy\"><a href=\"http:\/\/www.adultdaycaregroup.com\/blog\/news\/bidens-400-billion-dollar-plan\/\">Biden&#8217;s 400 Billion Dollar Plan<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"http:\/\/www.adultdaycaregroup.com\/blog\/news\/bidens-400-billion-dollar-plan\/embed\/#?secret=oesVspzGpy\" width=\"600\" height=\"338\" title=\"&#8220;Biden&#8217;s 400 Billion Dollar Plan&#8221; &#8212; Adultday care group\" data-secret=\"oesVspzGpy\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n\/*! This file is auto-generated *\/\n!function(d,l){\"use strict\";l.querySelector&&d.addEventListener&&\"undefined\"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!\/[^a-zA-Z0-9]\/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret=\"'+t.secret+'\"]'),o=l.querySelectorAll('blockquote[data-secret=\"'+t.secret+'\"]'),c=new RegExp(\"^https?:$\",\"i\"),i=0;i<o.length;i++)o[i].style.display=\"none\";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute(\"style\"),\"height\"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):\"link\"===t.message&&(r=new URL(s.getAttribute(\"src\")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener(\"message\",d.wp.receiveEmbedMessage,!1),l.addEventListener(\"DOMContentLoaded\",function(){for(var e,t,s=l.querySelectorAll(\"iframe.wp-embedded-content\"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute(\"data-secret\"))||(t=Math.random().toString(36).substring(2,12),e.src+=\"#?secret=\"+t,e.setAttribute(\"data-secret\",t)),e.contentWindow.postMessage({message:\"ready\",secret:t},\"*\")},!1)))}(window,document);\n\/\/# sourceURL=http:\/\/www.adultdaycaregroup.com\/blog\/wp-includes\/js\/wp-embed.min.js\n\/* ]]> *\/\n<\/script>\n","thumbnail_url":"http:\/\/www.adultdaycaregroup.com\/blog\/wp-content\/uploads\/2022\/07\/train.png","thumbnail_width":624,"thumbnail_height":624,"description":"There&#8217;s widespread agreement that it&#8217;s important to help older adults and people with disabilities remain independent as long as possible. But are we prepared to do what&#8217;s necessary, as a nation, to make this possible? That&#8217;s the challenge President Biden has put forward with his bold proposal to spend $400 billion over eight years on home and community-based services \u2014 a major part of his $2 trillion infrastructure plan. It&#8217;s a &#8220;historic and profound&#8221; opportunity to build a stronger framework of services surrounding vulnerable people who need considerable ongoing assistance, says\u00a0Ai-jen Poo, director of Caring Across Generations, a national group advocating for older adults, individuals with disabilities, families and caregivers. POLITICS\u00a0 By The Numbers: Biden&#8217;s $2 Trillion Infrastructure Plan SHOTS &#8211; HEALTH NEWS\u00a0 Caregiving For A Loved One? How To Get The Help You Need It comes as the coronavirus pandemic has wreaked havoc in nursing homes, assisted living facilities and group homes, killing\u00a0more than 174,000 people, by some estimates, and triggering awareness of the need for more long-term care options. &#8220;There&#8217;s a much greater understanding now that it is not a good thing to be stuck in long-term care institutions&#8221; and that community-based care is an &#8220;essential alternative, which the vast majority of people would prefer,&#8221; says\u00a0Ari Ne&#8217;eman, a doctoral student in health policy at Harvard University, and\u00a0senior research associate at Harvard Law School&#8217;s Project on Disability. Sponsor Message &#8220;The systems we do have are crumbling&#8221; due to underfunding and understaffing, and &#8220;there has never been a greater opportunity for change than now,&#8221; saids\u00a0Katie Smith Sloan, president of LeadingAge, at a recent press conference where the president&#8217;s proposal was discussed. LeadingAge is a national association of more than 5,000 nonprofit nursing homes, assisted living centers, senior living communities and home care providers. But prospects for the president&#8217;s proposal are uncertain. Republicans\u00a0decry its costand argue that much of what the proposed American Jobs Plan contains, including the emphasis on home-based care,\u00a0doesn&#8217;t count as real infrastructure. &#8220;Though this [proposal] is a necessary step to strengthen our long-term care system, politically it will be a challenge,&#8221; suggests\u00a0Joseph Gaugler, a professor at the University of Minnesota&#8217;s School of Public Health, who studies long-term care. SHOTS &#8211; HEALTH NEWS\u00a0 Patients Like Hospital Care At Home, But Some Insurers Are Skeptical Even advocates of Biden&#8217;s proposal acknowledge it doesn&#8217;t address the full extent of care needed by the nation&#8217;s rapidly growing older population. In particular, middle-income seniors won&#8217;t qualify directly for programs that would be expanded. They would, however, benefit from a larger, better paid, better trained workforce of aides that help people in their homes \u2014 one of the plan&#8217;s objectives. &#8220;This [plan] isn&#8217;t everything that&#8217;s needed, not by any step of the imagination,&#8221; Poo says. &#8220;What we really want to get to is universal access to long-term care. But that will be a multistep process.&#8221; Understanding what&#8217;s at stake is essential as communities across the country and Congress begin discussing Biden&#8217;s proposal. The services in question Home and community-based services help people who need significant assistance live at home as opposed to nursing homes or group homes. Services can include home visits from nurses or occupational therapists; assistance with personal care such as eating or bathing; help from case managers; attendance at adult day centers; help with cooking, cleaning and other chores; transportation; and home repairs and modifications. It can also help pay for durable medical equipment such as wheelchairs or oxygen tanks. SHOTS &#8211; HEALTH NEWS\u00a0 Can Home Health Visits Help Keep People Out Of The ER?\u00a0 The need SHOTS &#8211; HEALTH NEWS\u00a0 How Helping Patients Get Good Care At Home Helps Rural Hospitals Survive Statistics suggest that, at some point in their lives,\u00a070% of older adults in the U.S.\u00a0will require help with dressing, hygiene, moving around, managing finances, taking medications, cooking, housekeeping and other\u00a0daily needs, usually for two to four years. As the nation&#8217;s aging population\u00a0expands to 74 million in 2030\u00a0(the year the youngest baby boomers reach age 65 ), that need will expand exponentially. Younger adults and children with conditions such as cerebral palsy, blindness or intellectual disabilities can similarly require significant assistance. The burden on families Currently,\u00a053 million family members\u00a0provide most of the care that vulnerable seniors and people with disabilities require \u2014 without being paid and often at significant financial and emotional cost. According to AARP, family caregivers on average devote about 24 hours a week to helping loved ones and spend around\u00a0$7,000 out-of-pocket on that care. This reflects a sobering reality: for most individuals and families paying for long-term care services is even more expensive than providing the care themselves.. According to a survey last year by Genworth, a financial services firm, the hourly cost for a home health aide averages $24. Annually, assisted living centers charge an average $51,600, while a semiprivate room in a nursing home goes for $93,075. Medicare limitations Many people assume that Medicare \u2014 the nation&#8217;s health program for 61 million older adults and people with severe disabilities \u2014 will pay for long-term care, including home-based services. But Medicare coverage is extremely limited. Medicare covers home-based health care services only for older adults and people with severe disabilities who are homebound and need skilled services from nurses and therapists. It does not pay for 24-hour care or care for personal aides or homemakers. In 2018, about 3.4 million Medicare members received home health services. In nursing homes, Medicare pays only for rehabilitation services for a maximum of 100 days. It does not provide support for long-term stays in nursing homes or assisted living facilities. Medicaid options Medicaid \u2014 the federal-state health program for 72 million children and adults in low-income households \u2014 can be an alternative, but financial eligibility standards are strict and only people with meager incomes and assets qualify. Medicaid supports two types of long-term care: home and community-based services and those provided in institutions such as nursing homes. But only care in institutions is mandated by the federal government. Home and community-based services are provided at the discretion of the states. Although all states offer home and community-based services of some kind, there&#8217;s enormous variation in the types of services offered, who is served (states can set caps on enrollment) and state spending. Generally, people need to be frail enough to need nursing home care to qualify. Nationally, 57% of Medicaid&#8217;s long-term care budget goes to home and community-based services \u2014 $92 billion in the 2018 federal budget year. But half of states still spend twice as much on institutional care as they do on community-based care. And 41 states have waiting lists for home and community-based health services, totaling nearly 820,000 people, with an average wait of 39 months. Based on the best information available, between 4 million and 5 million people receive Medicaid-funded home and community-based services \u2014 a fraction of those who need care. Workforce issues Biden&#8217;s proposal doesn&#8217;t specify how the $400 billion in additional funding would be spent, beyond stating that access to home and community-based care would be expanded and caregivers would receive &#8220;a long-overdue raise, stronger benefits and an opportunity to organize or join a union.&#8221; Caregivers, including nursing assistants and home health and personal care aides, earn $12 an hour, on average. Most are women of color; about one-third of those working for agencies don&#8217;t receive health insurance from their employers. THE CORONAVIRUS CRISIS\u00a0 &#8216;Who&#8217;s Going To Help Them?&#8217;: Caregivers Brace For The Spread Of Coronavirus By the end of this decade, an extra 1 million workers will be needed for home-based care \u2014 a number of experts believe will be difficult, if not impossible, to reach given poor pay and working conditions. &#8220;We have a choice to keep these poverty-wage jobs or make them good jobs that allow people to take pride in their work while taking care of their families,&#8221; says Poo of Caring Across Generations. Next steps Biden&#8217;s plan leaves out many details. For example: What portion of funding should go to strengthening the workforce? What portion should be devoted to eliminating waiting lists? What amount should be spent on expanding services? How will inequities of the current system \u2014 for instance, the lack of accessible services in rural counties or for people with dementia \u2014 be handled? &#8220;We want to see funding to states tied to addressing those inequities,&#8221; says\u00a0Amber Christ,\u00a0directing attorney of the health team at Justice in Aging, an advocacy organization. Meanwhile, supporters of the plan suggest it could be just the opening of a major effort to shore up other parts of the safety net. &#8220;There are huge gaps in the system for middle-income families that need to be addressed,&#8221; notes\u00a0David Certner, AARP&#8217;s legislative counsel. Reforms that should be considered include tax credits for caregivers, expanding Medicare&#8217;s home health benefit and removing the requirement that people receiving Medicare home health support be homebound, says Christ of Justice in Aging. &#8220;We should be looking more broadly at potential solutions that reach people who have some resources, but not enough to pay for these [long-term] services as well,&#8221; Christ says. Kaiser Health News\u00a0is a nonprofit, editorially independent program of\u00a0the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente. &nbsp;"}