Since 2005, AOTA has been urging all Americans to contact their congressional and senatorial representatives regarding passage of the proposed Medicare Home Health Flexibility Act(HR2468). The primary purpose of the flexibility act is to gain inclusion of payment for non-rehabilitative occupational therapy coverage under Medicare Part B.

Passage of the act would result in a dynamic cost-saving measure in terms of Federal Government expenditure for healthcare. According to the AOTA, an occupational therapist should be a member of every senior citizen’s primary healthcare team. The primary responsibility of the occupational therapist would be to educate seniors in the role occupational therapy techniques can play in fall prevention and overall safety during pursuit of daily activities.

Research statistics prove the goal of most seniors is to lead an independent life remaining in their own home for as long as possible. Having more people deemed capable of safely remaining in their own home as opposed to seeking entrance into assisted living or nursing home facilities will result in a drastic reduction in budgetary considerations for the Federal Government healthcare system.

Under current Medicare Part B, occupational therapy coverage must be strictly on a rehabilitative-need basis with treatment required to occur in an assisted-living or nursing home facility or out-patient therapy department of a hospital. In addition to an initial physician’s order, consideration for continuation of coverage requires submission of a patient-progress report every 30 days.

Unless treatment takes place in the out-patient therapy department of a hospital, the patient’s out-of-pocket expense is 20 percent until Part B deductible is reached. Expenditures beyond the current $1,880 cap require 100 percent responsibility on the part of the patient.

imagecredit: © spuno – Fotolia.com

Home health care delivers medical professionals to the client’s home in accordance with an arranged schedule suited to the client’s preferences. These professionals consist of licensed nurses, social counselors, therapists, medical technicians and even doctors. Their goal is to provide the client the means necessary to (1) treat illnesses, injuries and/or overall poor health; (2) reacquire physical strength and (3) conduct daily life. This means that home health care is not only medical in nature, but also occupational.

Physical therapists help the client develop a regime consisting of exercise, message and heat application. Skilled nurses, who work close with physical therapists, conduct regular check-ups that include taking blood pressure, temperature-and blood work as necessary. They even hook up intravenous feeds for nutrient buildup. Doctors make regular house calls to discuss the client’s progress and future needs. Medically, nothing is overlooked or neglected.

Other professionals, known as occupational therapists, assist the client in everyday tasks, like getting out of bed, bathing, dressing and cooking meals. Counselors offer access to resources that will help the client achieve social and emotional balance in life. Speech therapists are more like linguists and audiologists, but their services deal with the development of communication skills, so they work closely occupational therapists in many respects, especially social re-integration.

Insurance is also available, although in a variety of forms. Those requiring it should determine which insurance package will provide the right benefits. No one should fret, though, because everybody is covered.

This leads to another extremely important fact: Home health care is better than inpatient care because it is significantly cheaper. Money is saved and clients can always afford services. Those with low-income or living on a fixed budget will find this wonderful.

The Division of Health Care Facilities ensures an ongoing quality of life for those who need it and cannot provide for themselves. Clients in outpatient status receive the same comfort, care and treatment as those who stay in hospitals and other temporary care facilities, and at a lower expense. So those who are homebound need not worry—compassion and relief are there for them, always.

imagecredit: © WavebreakMediaMicro – Fotolia.com

The purpose of Community Care is to organize public health departments, mental health agencies, local doctors, hospitals and various community providers. The goal is to improve a patient\’s care and save on the costs for local health programs and money for state Medicaid.

Children are the majority of the clients for the Community Care networks in most states. Other clients may include elderly individuals or people with disabilities. A medical condition, disability or drug issues are a high percentage of these clients.

Costs that are saved will vary from state to state. Medicaid savings can reach millions of dollars or more in a state that can realize savings. The cost of Medicaid may increase in various states that can offset savings for a Community Care network.

Improvement in the quality of care for patients is included in performance information that is offered to each of the physicians in the network. This information can be use to make improvements to care. Doctors that provide care will work together to drive down costs to save money and to improve care.

Goals for Community Care networks will depend on their priorities. These may include patients having a specific disease, decreasing the readmission rate for hospitals and lowering the costs incurred when a prescription drug is needed. The reduction of the emergency room visit rate for the elderly and disabled is also a goal.

Achieving the goals set by Community Care networks is done by using various methods. These include coordinating resources for doctor visits and hospitals stays for patients. Access to resources that are available in a community is also provided to patients. Coordination between agencies is required to prevent patients from receiving duplicate services.

To put this is plain English; the bill would require all US citizens to have insurance. While they will only require a minimal coverage, they still must have coverage for themselves and their dependents. There are many ways to purchase insurance, including employers, or through companies who sell policies.

The people who do not obtain insurance will have a penalty. However, the consequences will not begin until the year 2014, but those who defy this bill will experience the wrath of the US government. The fines for not having insurance will begin as minor in the year 2014 and by 2016 the fines will be significant.

The part that really gets tricky is the costs. A person who does not have insurance will have to pay per person or 2.5 percent of the income of the home. There will be no exceptions, save those who have religious convictions and do not use the public health system. Other groups that will be unaffected by this bill, are those who are in prison or illegal immigrants. Those who do not have insurance would have to pay $695 a month for each household member who does not have insurance. The maximum out of pocket that a family could be required to pay is $2085.

While some of the bill sounds unfair, there are parts that are great for American people. The fact that those with pre-existing conditions and those who would usually be denied insurance, will now easily be able to purchase the health insurance is needed. The government expects this to help increase the insurance market as those who think they do not need insurance or healthcare in general, will now be forced to have coverage.

The people that will be mostly affected by this bill are the middle class. The affluent people will be able to afford coverage as usual. The poor people will still continue to receive help from Uncle Sam. It is the middle class, working folks who will feel the greatest financial pain from this new healthcare reform.

imagecredit: © ISO K° – photography – Fotolia.com

When someone undergoes comprehensive rehabilitation, it may take several months for them to return to their normal lives depending on the severity of the trauma. Since this rehabilitation is often hard work for people who are still recovering, these sessions may be only one hour a day and sometimes not even every day. Usually these sessions start out being short and as the patient recovers their strength, and then become longer and several times a week, or even every day.

These rehabilitation sessions will also address several different concerns. Someone recovering from a car accident may need to build up their stamina and also learn to walk again. These issues are usually done in individual sessions, working on one issue at a time. People who have suffered from strokes will or more extensive issues may be in rehabilitation for several months learning to move and talk again with their changed physical abilities.

These sessions often take place in a hospital but can also be done at special medical centers or even the patients home. Usually these sessions start out being done at hospitals or medical centers because many times initial rehabilitation requires special medical equipment, especially for someone learning to walk or move themselves in and out of a wheelchair. Once the patient has improved to the point of being able to be alone these sessions can take place in their home.

Patients that don’t need intensive medical care can receive care in their own homes from registered nurses, certified nursing assistants and home health aides, physical therapists, occupational therapist, social workers and chaplains. Registered nurses perform tasks like changing dressings, monitoring and administering medications, drawing blood samples for laboratory tests and educating patients and family members. Home health aides performs tasks like assisting patients with personal hygiene, preparing meals and helping patients eat, checking vital signs and performing light housekeeping tasks, allowing patients to remain in their own homes with their families while receiving the help that they need.

There are numerous benefits of community home health care. It costs less than hospitalization or nursing home care. It allows patients to be with their loved ones, with their pets, in comfortable and familiar surroundings. Many patients report feeling more comfortable in their own homes and say that they sleep better in their own beds and eat better when served the home cooked food they are used to eating. They have more privacy at home, it’s quieter and more peaceful at home and they retain more control over their own lives and health care in the home setting.

Community home health care benefits families, too. Family members get to spend time with loved ones without making regular trips to a hospital or nursing home; some family members have trouble arranging transportation and the hospital might be quite a distance from the home. With home health care services, though, family members do not become so overwhelmed with the care of their loved one. Most family members are not trained to provide the kind of help patients need and having in-home professional help relieves them of the need to do work for which they are not prepared. Perhaps most importantly, it allows families to stay together.

imagecredit: © gilles lougassi – Fotolia.com

Originally hospice care began in London, circa 1967, taking place in a hospital-type setting especially catering to terminally-ill patients. During the 1970s, the concept of hospice entered into the medical realm of the United States. It was not until 1987 that Medicare entertained the idea of coverage under Part A. In the 21st century, in-home hospice care came into usage by 70% of those deemed to be facing an extremely limited life expectancy. While most hospice candidates are 65 years of age or older, 20% of hospice patients are below age 65.

Eligibility for hospice care begins once the physician of record deems all indications of life expectancy to be less than 6 months. The patient and/or the power-of-attorney holder must sign an agreement stipulating no further curative measures are desired or will be attempted, no CPR measures will be instituted, and acceptance of care-management by a hospice team.

Among the many advantages of hospice care at home are the patient will only be hospitalized for issues not directly related to the terminal condition. No restrictions are placed on visitation and care- participation by family members as normally occurs in non-home hospice settings.

Working with a hospice team is of great value to both the patient and family members. In addition to doctors, nurses and medical aides, the hospice team includes social services and spiritual-care providers. Medical team members are qualified to train and provide support to caregivers. All team members are available, 24/7, to answer questions, encourage, and provide support to both the patient and the family.

While the hospice team is both qualified and willingly-ready to provide assistance in so far as possible, some things hospice care at home teams, Medicare/Medicaid or private insurance policies do not cover are: full-time caregivers and no in-home respite care arrangements.

Many home care providers are considered glorified babysitters. They don’t have any real experience in the medical industry. They will sit and read a book when they are not needed and they will cook and clean when they are needed. However, many people need more than that from their preferred home care provider.

There are a lot of different companies that offer home care providers. These people are usually licensed or certified in the medical profession and are capable of changing bed pans, can help a person with showers and even give a person various forms of medication.

It’s important for a person to meet with different individuals from different companies before choosing a preferred home care provider. This will prove that the person is capable of performing the various required tasks and that they get along with the person who actually needs the services. The cost of the provider should also be inquired about.

Ensuring the Preferred Home Care Provider is Licensed

When a person is looking for a preferred home care provider, it is not enough to just find out what their experience is or meet with them to see if they are friendly. They should be licensed as a Home Health Aide (HHA) at the very minimum and preferably a Certified Nursing Assistant (CNA). This will prove that they have gone to school to get an education in the type of care that they are providing.

Without the licensing, a person may have learned what they needed to through experience alone. Depending upon the situation that calls for a home care provider, people should want the education backing up what they do. This way one can trust that they are in good hands.

There are many physical therapy activities and exercises that are used for home care therapy to help patients regain their physical strength and coordination. These exercises can help the patient to relieve pain that they might be experiencing due to an operation or injury. Family members of home care patients are also included in the rehabilitation process. Home Care Therapists will work with these family members and help them to make the rehabilitation process for the patient easier.

It is extremely important for these patients to be rehabilitated in order to help them to regain their independence and home making skills. These programs will also help the patient to stay strong mentally and emotionally because it is easy for these patients to become depressed due to their immobility.

In Home Care can be provided for many types of patients. These services can be provided for patients who have had strokes, mental and physical injuries. A therapist can be provided for any specific need such as an in home occupational therapist that will treat patients with injuries or illnesses. Speech Therapists will help stroke patients to regain their speech and with swallowing disorders.

There are many home care therapists that will provide therapy for each patient with a specific need or service.

Quality, professional licensed home health care agencies are available to provide your loved ones with care associates, physical and/or rehabilitation therapists, HHA\’s, STNA\’s and even LPN\’s. All companies hire only staff members that have been screened for criminal and driving background checks to ensure your family member and their personal items will be safe. These staff members are trained to run errands, pick up prescriptions, shop or take residents out to shop, etc., pet care, assist with showers and toileting, lifting, moving, tend to laundry, light housekeeping, cooking or monitor the patient while the patient sleeps, assist in therapy exercises and administer all prescribed medications. The benefit provider will evaluate the potential recipients medical charts to assign the correct combination of providers per week to each patient. The patient or family then can choose their preferred assistance provider to assist them in their daily or weekly routines.

The utmost attention is given to detailing the patients care each visit. Home health care workers chart in detail the services they provided each time. Their charts have four copies to ensure payment is provided and adequate documentation can be given should a copy get lost. A copy is turned into the benefit provider, another kept on file at the home health care office, a third is given to the client or patient for their records and the last copy is for the health care provider to have records of services provided.