Tag Archives: disabled

People with disabilities face barriers to get dental treatment

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo by Royal Navy Media Archive via Flickr

Photo by Royal Navy Media Archive via Flickr

We’ve read about the difficulties of getting dental care to patients in nursing homes and other institutions. People living with disabilities in the community may also face formidable challenges in getting the dental care they need.

Finding a dentist with the training and willingness to accept a patient with special needs can be tough. Medicare and Medicaid benefits may be inadequate. Patients who need to undergo general anesthesia in a hospital because they are frightened or physically unable to lie still in a dental chair often face particularly high barriers to getting dental treatments.

Elizabeth Simpson offered readers of The Virginian-Pilot a detailed look at this issue in a January story that centered on the experiences of one local woman and her family. Continue reading

Clearing up confusion about those enrolled in both Medicare, Medicaid

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

dual-eligiblesDual eligibles are low-income elderly or disabled people enrolled in both Medicare and Medicaid. The distinctions are sometimes bewildering. It’s easy to confuse which program pays for what, what each agency considers “appropriate” care, what factors go into measuring outcomes and how the separate structures of Medicare and Medicaid affect costs and quality.

According to the Congressional Budget Office, in 2009, the federal and state governments spent more than $250 billion, combined, on health care benefits for the 9 million dual eligibles. There is growing concern about the high costs of dual eligibles and the type of care they receive. They may be treated by a variety of health care providers who are not coordinating their care, potentially increasing costs and worsening outcomes.

Many states are already struggling to meet current Medicaid demand, and as boomers age, more stress will be placed on an already fragile system. Learn more about dual eligibles and what issues to look for in your state with this tip sheet.

New models of caring for frail elderly needed, expert says

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

aging-woman-readingOlder Americans can live in comfortable health, without needless treatment – and we can save money in the process, but only if we change the way we think and talk about the issue, according to Joanne Lynn, M.D., from the Center for Elder Care and Advanced Illness at the Altarum Institute. Lynn spoke about the need for reliable and sustainable comprehensive care for frail elderly during yesterday’s media briefing from the Journal of the American Medical Association on critical issues in U.S. health care. Authors of several of the articles in this special issue, published today, spoke about policy, economic, and societal changes needed for a viable, quality health system. 

In a follow up-call today, Lynn said that, although most frail elderly – those over age 85 or anyone 65+ with multiple chronic conditions – would prefer to live out their lives at home comfortably and with adequate function and quality of life, that’s not how our system is set up.

“We have an array of disjointed services, that don’t take patient values about what matters to them most, into account,” she said. “We have all kinds of metrics that measure clinical outcomes but we don’t evaluate metrics that put patient priorities first.” Continue reading

Investigation exposes police inaction in face of abuse allegations at Calif. facilities

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In recent weeks, California Watch’s long-running focus on abuse of the developmentally disabled at state-run institutions has coalesced into a broad indictment of the flawed oversight and enforcement programs at those facilities.

Ryan Gabrielson’s centerpiece is a classic deep investigation which relies on a mix of data and anecdotes to show that, even though the centers are equipped with a state-run police force, in 36 incidences of alleged abuse over the past four years, “documents obtained by California Watch reveal that patients suffered molestation, forced oral sex and vaginal lacerations. But for years, the state-run police force has moved so slowly and ineffectively that predators have stayed a step ahead of law enforcement or abused new victims, records show.”

Beyond that, California Watch has gone above and beyond to make their investigation as accessible and shareable as possible with a share-friendly chart, an 11.75-minute YouTube video, or even an “explainer” companion piece.

CLASS Act is gone but long-term care problem remains

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

The ill-fated CLASS Act is gone.

What’s not gone is the problem of how to provide long-term care to the millions of disabled and/or elderly people who need it – numbers that will only grow as the baby boomers age.

What, if anything, does the Affordable Care Act do to address the problem?

What questions do you have about health reform and how to cover it?

Joanne KenenJoanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.

The health reform law did not solve the long-term care problem. Not today’s problem, not the growing problem of the future. Even the most ardent backers of the CLASS Act (Community Living Assistance and Services and Supports), which was part of the health care law, did not see it as a complete answer. CLASS was designed to ameliorate, but not eliminate, long-term care costs, which can easily run $70,000 or more a year. Had CLASS been implemented, it would have given families who chose to participate about $18,000 (the finances were never finalized) a year that could pay a piece of a nursing home bill, or for assistance at home, or to build or a wheelchair ramp or accessible-bathroom etc to enable someone to stay at home.

But CLASS sank in an actuarial/legal/political swamp.

Is there anything else in the ACA to help family caregivers?

The law does have dozens of provisions that – depending on how well they are funded and implemented, how widely they are adopted and, quite frankly, how well some of the new care models turn out to work in the real world – can at least nibble around the edges of the long-term care needs.

New models of care

Some of you have started reporting on hospital readmissions. If we’re going to keep older people out of that revolving hospital door, they are going to need to be taken care of – well – outside the hospital. And that’s where a lot of the new models step in – community health teams to support primary care practices, the independence at home act, medication reconciliation programs, transition teams etc. A part of the legislation called “rebalancing” addresses some of the requirements and obstacles that up until now have led states to put institutional/nursing home care ahead of home and community based services.

The AARP just put out a report on how health reform addresses aspects of long-term care and family caregivers. It’s just nine pages, and some of the programs are going into effect this fall, or early next year. There are lots of good local angles for stories there. (The SCAN Foundation is also a good resource on these issues, and I wrote a while back about some of the relevant care models here.) We tend to think of the elderly when we think about long-term care but remember families of the disabled, whether adults or children, and some of people with serious mental disabilities also have these needs.

The report from the AARP Public Policy Institute by Lynn Feinberg and Allison Reamy notes that the health reform law explicitly includes both individuals and their caregivers in shared decision making an in quality assessment. What the family thinks and experiences matters; the family is a partner in care. The law includes family caregivers in some of the programs to improve caregiver training. The AARP report notes, in fact, that “The law explicitly mentions the term ‘caregiver’ 46 times and ‘family caregiver’ 11 times.”

Passengers with disabilities encounter obstacles in everyday commuting

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Despite progress prompted by the Americans with Disabilities Act, public transportation for people with disabilities is still challenging in many places.

The Washington Post‘s Dana Hedgpeth found that, on D.C.’s Metro system, people who rely on wheelchairs, canes and other aids are confronted by broken elevators, narrow walkways, dilapidated platforms, poor lighting and signage.

Metro has a door-to-door shuttle called for those with disabilities called MetroAccess but Hedgpeth says it is more costly, charging based on the time of day and distance a customer travels. One passenger says the service isn’t reliable and forces her to make travel arrangements a day in advance.

The accessibility issues can be downright dangerous at times. Hedgpeth cites cases in which people in wheelchairs have fallen and a blind man fell onto the tracks.

How do people with disabilities in your community get around? Is the system truly useful? Hedgpeth’s article should give you plenty of ideas about what to look for in a transportation system from the perspective of people with disabilities:

  • Can someone sitting in a wheelchair see signs?
  • Are announcements clear for people with impaired hearing?
  • How often are elevators out of service and, when they are broken, what is the alternative?
  • If there is an alternative system for passengers with disabilities, is it affordable? Do people using it face extremely long commutes or wait times?

The National Center on Disability & Journalism has information and a style guide for journalists covering disability issues.