Cathy Cress

Expert in Aging Life and Geriatric Care Management

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What is President Biden’s New Infrastructre Caregiver Plan?

April 14, 2021

President Biden announced the American Jobs Plan, a $2 trillion investment in infrastructure, jobs, and home care. It includes a $400 billion investment to expand access to Medicaid home and community-based services (HCBS)

Why This Plan for Home-Based Care?

Only 15% of U.S. seniors 80 or older receive care at home. In Switzerland, Denmark, Mexico, and Sweden, that figure is above 30%, with numbers even higher in Israel and Lithuania.

Medicaid has slowly evolved over the years, placing a greater emphasis on home- and community-based services. But the ground gained has been relatively minor compared to investments in other settings like nursing homes.

In 1995, Medicaid spent about 18 cents out of every long-term care dollar on HCBS services. Today, that number has reached 57 cents per dollar.

The Scale of the Problem is Mamouth

The number of seniors is projected to grow by more than 40 million, approximately

doubling, by 2050, while the population older than 85 will nearly triple. Unlike most other industrialized nations, the United States does not provide a public long-term-care benefit for all older adults.

Only10-15% of Americans can Afford Private Duty Homecare

Because Medicare does not pay for home care, only the top 10-15 % can afford private duty home care, while in many other nations it is a right and free to all through the government. What Biden’s new plan does is take a giant step in making home care possible a greater number of Americans.

The plan calls for expanding access to and quality of HCBS to help more older adults and people with disabilities live in the community and extending the Money Follows the Person program to help individuals who are in nursing facilities and other institutions return to the community. 

What The Pandemic Has taught us about Aging and Dying

at Home

What the continuing pandemic has painfully taught us is when we are ill- we want to be home in the arms of our family. When we are threatened with or facing death, we do not want want to be in a sterile hospital with only anonymous caring nurses and zoom to comfort us in our last minutes in this world. We want to be at home- in the arms of our family and loving caregivers.

Long before the COVID-19 emergency, health care policy experts have increasingly recognized the value of home-based health care. A recent AARP survey found that three in four adults 50 years and older would prefer to age in their homes and communities. And a growing body of evidence suggests it is less expensive to deliver care in the home.

Indeed, for years we’ve seen hospitalized patients more quickly returning to their homes and communities to heal and recover safely, reducing costs for themselves and the health care system.

The Plague of Isolation on top of the Plague of COVID -in Locked Down Nursing Homes

Home-based care addresses negative health effects of social isolation and loneliness, which drive poorer health outcomes that annually cost billions of excess health care dollars. 

Isolation is also equal to 15 cigarettes each day. Elders in a nursing home during the pandemic were isolated from the families and their fellow residents so much so that despair may have led to the 174000 deaths as of March 2021. 

So Biden has launched a bill the builds the infrastructure of home care for the lower 30% on Medicaid until in America’s future, Medicare and home care for all is reached.

 

Filed Under: Age at home, AGING IN PLACE, American Jobs Plan, Blog, COVID-19 Recover at Home Plan, COVID-19 Safety, Expanding Medicare to Home Care, FOLLOW THE MONEY, geriatric care management emergency proceduress, geriatric care manager, Geriatric Care Managers value, geriatric social worker, Good Death, Home Based Care, home care, Home Care for All, Home From the Hospital, LOSING CLients TO COVID, Monet Follows the Person Program, Quality of Life, quality of life -COVID-19, Quality of Life for elders Tagged With: aging life and geriatric care manager, aging life care management, aging life care start up, aging life geriatric care manager, aging life or geriatric care manager, American Jobs Plan, Biden's Home Care Plan, Biden's Infastructure Bill, Deaths in Nursing Homes, Expanding Home Care, Home and Community Based Care, Home Based Care, home care, Isolation in Nursing Homes, Medicaid & Community Based Care, Medicaid funded Home Care, Medicare for All, Money Flows to the Person, nurse advocates, nurse entrepreneur

Medicare For All Includes Long Term Care – Perhaps Pay Attention Now With -Covid 19 Raging ?

March 25, 2020

Long Term Care Not Covered by Medicare

Geriatric Care management and home care, among other critical services tin aging are not covered Long term care services, is not covered by Medicare. In Bernie Sanders & Elizabeth Warren’s Plan, Medicare for all would cover long term care, a point that the Washington Post said that Sanders did not emphasize enough.

Medicare For ALL Would Cover Long Term Care 

Time Magazine, recently reported that Covid-19 ‘s effect right now is making Medicare for all seem like the present need nor an unaffordable dream . The “Department of Housing and Urban Development halted foreclosures and evictions during the emergency; the Department of Education slashed federal student loan interest rates to zero and will allow borrowers to completely suspend payments if needed; Congress is negotiating a plan to send direct cash payments to families, and a version of paid sick leave just became law.”

What If We Had Medicare For All During Covid 19 Pandemic?

If we had Medicare for all during the Covid 19 pandemic, we would be better able to disburse funds in emergency situations and to purchase necessary machinery, such as ventilators ( that only the president seems to be able to dispense through the Defence Production Act & does not, during a crisis and get them where they need, like the 30,000 needed and missing in New York) face masks that as so needed that the CVC recommended bandanas and a 10-year-old student in Boston is sewing herself the height of the pandemic right now.

Unlike our current health care system, Medicare for All would include specific funding for dealing with pandemics or other health emergencies that could be distributed quickly without requiring additional legislation of presidential planning, which seems not to have happened at all. The United States cannot be left unprepared for mass health risks like COVID-19. It is time to put in place Medicare for All and better protect the health of the American public.

 

Ethical Dilemma

This lack of Medicare covering Long term care leaves geriatric care managers in an ethical dilemma of being able to only be able to serve the upper 10% and leaving 90% of seniors and thus under 64 with chronic care needs like MS, unserved.

 

Elizabeth Warren’s plan for Medicare for all could cost 20 Trillion over 10 years. Existing Medicare over the 10-year period would cost 16 trillion. The bill we are just passing in Congress to fund is 2 Trillion. We will need another bill. Are all the mounting deaths from Covid 19, 55,000 people with Covid 19 and counting, disruption to business, our lives and the hospital really worth not paying attention to Medicare for All- which it looks like we just might be able to afford?

Find out about this ethical dilemma and what care managers must do to serve the upper 10%, and ignore lower 90%, who have no long-term care under Medicare .

Since geriatric care management must be privately paid for, in the absence of coverage under present Medicare, in spite of our moral dilemma

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Ethical Dilemma in serving only Top 10%

Who They Are- 4 Types

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Filed Under: ALCA Disaster Plan, ALCA Ethical Dilemma, Blog, concierge clients, Concierge Senior, coronavirus, Elderly Disaster Plan, Emergency Plan, FREE MARKETING WEBINAR, FREE WEBINAR, geriatric care manager start up, marketing to concierge clients, marketing to the top 10$, marketing to upper 10%, nurse advocate, nurse care manager, Nursing Home disaster plan, on-call staff, Paying for Long term care Tagged With: adding geriatric care management, aging life care manager, aging life geriatric care billing data base, aging life or geriatric care marketing plan, aging parent crisis, Care Management marketing plan, Coronavirus & Medicare For All, coronavirus and seniors, Coronavirus disaster plan, cost of long term care, free webinar, Free webinar marketing, geriatric care manager, geriatric care manager. webinar. free welinar, Medicare for All, nurse advocate, nurse care manager, pandemic, paying for geriatric care management, paying to long term care, seniors &Coronavirus

Can Retirees Who Worked Hard All Their Lives Afford Long Term Care?

March 15, 2020

NEW TYPE OF FAMILY THAT CAN AFFORD LONG TERM CARE LIKE GERIATRIC CARE MANAGEMENTiStock_000063346301_Medium-1.jpg

Four types of aging families can afford geriatric care management, home care, and long term care, not covered by Medicare, because they have financial resources, usually over a million dollars in assets.

Two groups of these four do not have severe entitlement issues. One group is professionals, including physicians. attorneys, dentists. They are now retired but went to college when it was affordable and in some case free( in California in the ’50s). They came from  working-class families and climbed up through the American dream that once was available to all, joining professions that gave them the wealth to be in the top 10% of retirees today

Professionals- Physician, Attorneys, CPAs

This group made a very healthy living during the late 20th Century, probably had a

defined pension and have very lucrative investments that allow them to afford home care and care management. They usually come from nearly normal families and have been well parented although you will find a mixture of dysfunctional aging families. Their adult children tend to be supportive of their parents, although again you will find a mixture of dysfunctional families in this category. They are not among the two groups that are dysfunctional aging families who take extensive psychodynamic skills. One is the narcissistic entitled family.

THE ALCA TARGET MARKET THAT CAN AFFORD WHAT MEDICARE DOES NOT COVER- LONG TERM CARE

The target market for a private geriatric care management business is not the 65 million families who need care management services, but the much smaller subset of those families who can afford to hire a GCM or aging life care manager can pay the $4000-6000 a month for home care, uncovered by Medicare, and are willing to pay for the services that GCMs and can actually find their way to you. But they still demand gold standard service – not drivers chefs but expert professional assistance they gave to their own customers before they retired.

 

How Do you find these aging families to sign up new concierge clients?

Your marketing message must say your business:

  • offers seamless concierge solutions to the grueling aging care decisions families and clients must make.
  •  offers expert professional assistance, as they gave in their working life, with the tough choices aging family members must make about elder housing, medical care, personal care, finances, end of life and the myriad mind-boggling decisions they face.
  •  offers support to the aging client, as they did with their clients, and the whole aging family and can transform the family to get care for the client 
  • offers support and care  to the caregiver to keep them from burnout
  • offers the exact product they will need to solve their problem like dementia care, moving an elder, quality of life, VIP care, home from the hospital

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Filed Under: aging life business, Aging Life Care Assocaition, aging life care manager, Blog, Concierge aging clients, Concierge Client, Concierge Senior, Geriatric Care Management Business, Geriatric Care Manager, marketing to the top 10$, marketing to upper 10%, Medicare For All, normal aging famiilies, parent care, Private Duty Home Care, Professional class retirees, profit in ALCA, Selling ALCA Business, Selling GCM Business, Uncovered Long Term Care, Uncovered MedicareServices, VIP Syndrome Tagged With: aging family, aging life care manager, aging parent crisis, care manager, case manager, Concierge Care management, concierge marketing, Entitled aging client, Gold standard services, marketing geriatric care management, marketing home care, marketing to entitled adult children, Medicare for All, nurse advocate, nurse care manager, Private duty homecare, Uncovered Medicare Services

Care Managers , Hospitals & Physician Serve The Top 10% – Ethical Dilemma or Move Towards Medicare for all?

March 14, 2020

GCM ALCA Stuck in An Ethical Dilemna

B

 Concierge clients in a GCM or aging life practice are the clients that a practice needs to serve. They are not covered by Medicare so a private fee-based company, like aging life or geriatric care management agency, must serve them to keep a healthy bottom line. But this leaves us as a care manager with an unhealthy ethical dilemma 

VIP Hospital Can Fall Into the VIP Syndrome

Hospitals can bill Medicare and there are ethical questions about pandering to the wealthy. Empty Mansions ( a must-read for professionals in aging) an expose

of a wealthy heiress, Huguette Clark, an heir to a copper mine fortune, who was taken advantage of by Beth Israel hospital in New York, who allowed her to live there for a decade, hoping for a “super mega gift” a crime of undue influence.

Beware of the VIP Syndrome

The New York Times did a great story about hospitals with VIP Syndrome. ,

Medicare does not cover the stay in a nursing home unless the person is on Medicaid in which case they get an inferior “Medicaid bed”.Medicaid recipients can also get

really inferior care in a skilled nursing facility  that may even be life-threatening with the coronavirus epidemic

Half of American Cannot Fund Long Term Care

According to the Washinton Post “Research, about two-thirds of Americans over the age of 40 say they expect they’ll need to provide assistance to a close family member or friend over the next five years. Nearly half believe they cannot fund their own long-

term care. More than 60 percent of this cohort expect they will need some form of long-term care in the future, only slightly below the real number of 69 percent.

Care Managers Must Serve top % until US Politics/ Health Policy Changes

We in Aging Life and Geriatric Care Management remain in this wrenching ethical dilemma that only 10% of the population can afford us, so we have to serve and market to the top 10%. We should work towards a health system that includes a version of Medicare for all and covers long term care but in the meantime, we have to be keep our business afloat by serving the top 10%.

Learn How to Do That, Even With Belief it Needs To Change

Learn how to market to this top 10% that at this point in time, who until long term care is a national right, we must serve.

Webinar-Sales and Marketing to Find the VIP Concierge Client in the top 10%

March 31, 2020 -2PM -3:30 PM PST

Concierge Clients are the only way a GCM or ALCA care manager can make a profit and have their business thrive. Find out who are they, how you find them, design GCM Products they will purchase, and create a marketing plan and gold standard services to have them sign your contract and use your services long term

Learn

Who They Are- 4 Types

How to Locate them in your service area

How to create a strategic marketing plan to sell to them

How to Develop Gold Standard GCM Products and Services

 

SIGN UP NOW

Filed Under: Aging, Aging Life Care, aging life care manager, ALCA Ethical Dilemma, care manager, Concierge Client, concierge clients, Concierge Senior, FREE MARKETING WEBINAR, FREE WEBINAR, GCM Ethical Dilemma, geriatric care manager, geriatric social worker, Long Term Care Coverage, marketing care management, marketing to concierge clients, marketing to the top 10$, marketing to upper 10%, Medicare For All, nurse advocate, nurse care manager, VIP Syndrome, Webinar ALCA GCM Tagged With: aging life and geraitric care manager, Aging Life Ethical Dilemma, aging life target audience, Changes in Medicare, cost of long term care, GCM ethical dilemma, geriatric care managers, long term care insurance, Medicare, Medicare & coronavirus, Medicare for All, VIP clients, VIP hospital clients, VIP Syndrome

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