Updates

Communications from SPW

Why Medicare Advantage In-home Services Should Learn from Medicaid

A senior holds her glasses and handbag. New services may help more seniors stay at home.

As people age, they typically need more help doing everyday things, whether it’s getting the groceries or taking a shower or remembering to take their meds. In many cases, even limited assistance can allow a senior to remain in their home for many years, even decades.

The logical program to provide in-home services is Medicare, which pays for most of seniors’ medical care. But Medicare does not cover them. Medicare does cover skilled medical services like physical therapy or nursing care when you’re ill or recovering from an illness or surgery, but you must be certified by a doctor as homebound, and even then it will not cover non-medical home services such as help bathing or dressing or preventive aids such as grab bars. The result is that many seniors end up spending down their resources to be eligible for Medicaid to get the non-medical care they need in order to live at home. Our system makes middle class people become poor to get the care they need – and, ultimately, states pick up the tab. Medicaid has been covering a growing portion of long-term care in the U.S. – 53% in 2018.

But 2019 ushers in help at home services for Medicare – and the change may be the catalyst for a more dramatic transformation in healthcare delivery and effectiveness.

Continue reading “Why Medicare Advantage In-home Services Should Learn from Medicaid”

“But What If the Terrorist Is You?”

Warrior Songs vol 2 cover art“They say that you’re my battle buddy, they say that you’re my friend, that I’ll never have to make you answer to business end, of this weapon I was issued, to give terrorists their due – but what if the terrorist is you?”

That’s Emily Yates singing a song of her own composition on a new album released in November. The album, Women at War: Warrior Songs Vol. 2, is a full-length CD devoted solely to the experiences of women in the military, and created by women. It is a work, as the promotional material says, “by women, about women, for women.” The 15 tracks tell the stories of 18 women veterans and two Gold Star family members.

Women make up more than 15% of the US military, but their presence and their contributions can be all but invisible in the public mind. And although they are subject to the same hardships, risks, and physical and mental traumas as their male comrades, those scars and harms are not on the radar of most people when they picture what a soldier has to face. This album makes it concrete for us. Continue reading ““But What If the Terrorist Is You?””

Will 2019 Bring a Medicaid Buy-in to Illinois?

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When Governor-elect JB Pritzker and incoming legislators take office a few days from now, we hope among the top-of-mind issues for them will be healthcare – and the possibility of creating a public option that would allow Illinois residents to purchase a premium to participate in the state’s Medicaid program. Candidate JB Pritzker talked about his vision for such an initiative, which he called “IllinoisCares,” and his platform included a public health insurance option that would be available to all residents.

IllinoisCares would allow Illinois residents to purchase health insurance from the state, rather than a commercial plan. Forty-two states – including Illinois – already have Medicaid buy-in programs, but they are limited to working people with disabilities who have not been able to purchase affordable health insurance coverage that meets their health needs in the private market. Continue reading “Will 2019 Bring a Medicaid Buy-in to Illinois?”

Challenging the remark – with patience – can make change happen

“These women are hurting my soldiers’ careers. You’re wasting OUR time.” A major lambasted me during a training’s break. He continued: “My soldiers would never do that. Can we get back to our real work.” Although worded like a question, his last sentence spewed at me with such authoritative, deep guttural tones, that I clearly knew he meant it as a command.

Here I was, my very first training working with military victim advocates. Green as can be and the highest-ranking figure in the course commanding me to release the class. Of course, I couldn’t dismiss the class; and he technically didn’t have any authority over the matter. Continue reading “Challenging the remark – with patience – can make change happen”

From Research Readiness to Empowering Action

It was a delightful surprise to hear from our cohort member Jody Verble last month that she had just created a website that offers tips and help on disability employment. Jody took part in our “research readiness” training. This course was put together for people with traumatic spinal cord injury to have a greater voice in the scientific studies that are done about that condition.

We invited our research readiness graduates and expert panel members to an On The Table event – one of the many gatherings held citywide in May as part of the Chicago Community Trust’s initiative to bring people together to spark conversations and projects for the public good.

“The message was TAKE ACTION,” Jody told us. “So I went home that day and bought this domain.” Continue reading “From Research Readiness to Empowering Action”

Would You Wait Three Decades?

Whether you wait three hours or three decades, you’re damned if you do and damned if you don’t.

Politics aside, the media and others should be incredibly ashamed of their behavior.

The reckless victim-blaming appalled me.

In no case have I ever seen one’s unwillingness to come forward affect one’s credibility. Continue reading “Would You Wait Three Decades?”

Feds Will Subsidize Junk Health Coverage

Washington Post tweet about new guidance, featuring CMS Administrator Seema VermaRecent guidance from the Centers for Medicare and Medicaid Services encourages states to take new steps to circumvent the ACA. Specifically, it invites them to apply for Medicaid Section 1332 waivers in order to use ACA subsidies for short-term insurance and association health plans. These plans, originally intended only to tide people over between periods of more-permanent coverage, are little more than flimsy stop-gaps that scarcely merit the name of real health insurance. Continue reading “Feds Will Subsidize Junk Health Coverage”

Sexual Assault: A Community’s Responsibility

Mural of womanOnce at a high school track meet, a boy grabbed my butt. Before I could do anything, he scurried back to his group of male friends where they proceeded to point and laugh at me.

Later I told my mother what happened. She shared with me that a similar thing had happened to her when she was my age. It was comforting knowing that I was not alone. But it was frustrating knowing that my experience, like hers, would most likely not be addressed or taken seriously by any authority figure. Continue reading “Sexual Assault: A Community’s Responsibility”

VA Wrongly Denies MST Claims

We were distraught and disheartened – but sadly, not surprised – by the Department of Veterans Affairs’ Office of Inspector General report released Tuesday, which found that nearly half of the denied claims related to military sexual trauma were denied due to improper processing.

Wrongly denying services for MST is life-threatening. It is hard enough for a survivor to trust someone enough to disclose their experience in the first place – let alone go through this challenging process of applying for benefits only to be turned away. Continue reading “VA Wrongly Denies MST Claims”

Empowering Patients to Drive Research

SCI Research Readiness Training Cohort
SCI Research Readiness Training Cohort
Visit the site – see their stories
We spend a great deal on medical research that often does not reflect the interests of people who have the condition.

In 2016, $171.8 billion was spent on medical and health research and development in the United States, the majority (67.4%) financed by industry, which includes biopharmaceutical developers, medical technology developers and healthcare service companies. Federal spending on medical and health research is subject to statutory budget caps. The American Journal for Managed Care estimates that the US spends less than 5 cents of each health dollar on research and development. The result is industry-driven research that doesn’t reflect the needs and priorities of those who stand the most to gain from it – real people with the actual condition being studied. Continue reading “Empowering Patients to Drive Research”