Monthly Archives for January 2002

The Best of…Age-beat Journalism Brings Issues Affecting Seniors to Light

Published January 28, 2002, Pawtucket Times

          Some people ritually read the sports or business sections, browse the stock listings, or even glance at the comics.  But a growing number of  middle-aged and senior readers are turning to the print or electric media for the latest info on aging.

          With the graying of America, news organizations are creating the age beat, where journalists cover various aspects of aging, including lifestyles, health care, politics, ethics and even economics.  A newly released national survey published in the San Francisco-based Age Beat, a newsletter disseminated to 700 journalists who cover aging, reflects this growing trend.

        Out of 580 non-random surveys sent to Age Beat readers, 152 responses were received. “This was better than a one-in-four response rate,” states Paul Kleyman, editor of Aging Today, the newspaper of the American Society of Aging and national coordinator of the Journalist Exchange on Aging.  The group was started in 1993.

        According to Kleyman, the third Age Beat survey findings indicated about 60 daily newspapers around the United States have a reporter partly assigned to the coverage of aging; 16 use a full-time reporter to cover the issue; and 24 newspapers use columnists.

       Although the findings of three surveys of age -beat reporters reflect a small growth of coverage in aging, it has been steady, Kleyman says.  While the age beat does not have economic clout in newsrooms (it is difficult to sell advertising around aging), this steady growth has occurred over the last 10 years through two economic slumps.

      There are more journalists covering the aging beat than last year, according to the survey report.

      The slow-but-steady growth of the age beat in journalism is a result of journalists – and their parents -aging, Kleyman noted. “Some of these aging journalists are finding this a very important area and have taken it upon themselves to begin to cover these issues.

       “There were more stories about aging because they are important in people’s lives- including those of reporters and editors,” Kleyman observed.  Thus, more than 90 percent of the survey respondents say that they now have direct personal experiences with the issues of aging, both personally or in their family, he said.

       Many of the respondents became interested in covering aging after they had to help their aging parents find a nursing home or move into a retirement community, Kleyman said.  “In doing this, they learned there is a huge amount of information they had to dig out and learn – [information] most of the public is unaware of.

       “Today’s journalists believe their personal experiences do not affect their objectivity in writing stories,” noted Kleyman.  Experience gives them both the perspective and information they need, but they still can approach each story with balance, he added.

       Kleyman said that journalists on the age beat will care about the issues enough to follow them over a longer period, and they will develop more sources and a greater depth of knowledge and understanding.

       “This is why they will write stories that are more technically accurate and factual,” he said.

       According to the survey, age-beat reporters who are devoting more of their time and energy to covering aging issues are generally veteran reporters.  On average, the respondents have more than 20 years of professional experience as journalists.

      Ageism occurs in the news media, says Kleyman.

      ‘”There is an atitude that all stories must have focus on medical and health care,” he said.  “This ageism centers on an attitude that getting older is getting sicker and becoming a burden on your family.  This is not so.”

      The Age Beat survey also found that, consistently across the board, 50 percent of the stories being weritten by age-beat reporters releate to health care and medical issues.  The other 50 percent cover different aspects of senior life.

      “Aging is about everything that people experience in their older years,” says Kleyman. “Stories range from sex and intimacy to housing, to income issues, to crrime, even to issues surrounding older drivers.”

       Finall, the survey revealed a growing percentage of reporters getting more requests from their editors and producers to tie their stories into the baby boomer generation, whose members are in their late 40s to mid-50s.  However, about two thirds of the reporters written by the respondents covered issues that affected those age 65 and over.

      The survey results were clear.  “Baby boomers are interesting, but the stories on those 65 and older stories are those that reporters feel must be told to readers,” Kleyman said.

      Like my colleagues on the age beat, this columnist will continue to bring you the latest, most informative coverage of aging issues you need to know about — stay tuned.

      Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues for the Pawtucket Times.  He can be reached at hweissri@aol.com.

Adequate Medicaid Payments Can Bring High Quality Health Care

Published in the Pawtucket Times on January 21, 2002

Like clockwork each year, Robert Hawkins, the state’s best-known consumer advocate for quality nursing home care and the state’s nursing facility industry, came to Smith Hill, calling on the General Assembly to adequately fund long-term care.

While representing different constituencies, both Hawkins and the nursing home industry were on the same page regarding this policy issue. Both groups strongly urged the Rhode Island General Assembly to adequately fund the state’s Medicaid program. For its Medicaid dollars, the Rhode Island Department of Human Services got: 24-hour nursing care; three meals per day with dietary supplements; other care services like grooming, personal care, bathing and assistance with eating; medical supplies, such as beds and wheelchairs; social services and activities.

Some years were better than others, especially last year. Responding to a serious statewide nursing assistant shortage, Rhode Island lawmakers gave an additional $9 million to pay for nursing facility direct care staff. However, the Rhode Island Health Care Association said that those funds did not cover the spiraling costs of operating a facility.

Liability insurance has doubled, energy costs have risen by approximately 25 percent and Providence-based facilities have been hit with tax increases with some facilities being assessed close to $ 100,000, noted the state’s largest nursing facility trade group.

Now, a recently released national study supports nursing facility and consumer concerns that the Rhode Island Medicaid program has not paid the “real” cost of providing care to Medicaid patients.

According to an independent analysis of the nation’s Medicaid pr.0ogram by the accounting firm of BDO Seidman, the Ocean State’s Medicaid program underfunds its nursing facility industry by more than $25 million annually or about $10.04 per patient day.

According to the national study, most states fail to adequately account for escalating Medicaid costs. They do this by using cost inflators that are not reflective of actual nursing facility cost increases and by using extremely outdated data.

For instance, Rhode Island uses data using 1991 costs in setting rates for most nursing facilities.

“The most disturbing finding of this study is that the state is reimbursing senior’s long-term care for substantially less than the acknowledge cost of that care,” says Alfred Santos, executive vice president of the Rhode Island Health Care Association (RIHCA). “Medicaid pays just slightly more than $4 per hour per patient, less than most people pay a teenage babysitter,” Santos charges.

Adds Hugh Hall, administrator of the Cherry Hill Manor, the cost of care in his facility is higher than most because of the acuity of his residents. Being under paid by Medicaid by $40 dollars per day significantly impacts the operation of his Johnston-based 172-bed skilled nursing facility, Hall says, noting that it forces the facility to look for other sources of payment to compensate for the state’s shortfall.

Hall called for a national commitment to adequately pay for care provided to the elderly and the younger subacute care population coming in nursing facilities.

“In Rhode Island, we’re working to educate the General Assembly so they understand the shortfall of the current Medicaid system, says Hall, specifically noting that the negative impact of not keeping up with annual cost changes affecting nursing facilities and not recognizing more immediately the capital costs required to maintaining a physical plant.

Hawkins, executive director of the Alliance for Better Long-Term Care and the state’s ombudsman brings the Medicaid payment issue down to a personal level: “How would any person like to have their salary level based on 1991 costs?”

“As a society, all of us are responsible for the care being provided to nursing facility residents. IF we don’t provide the best of care, we are partially responsible for that care not being provided,” says Hawkins.

“While we are demanding the highest quality of care to be delivered in Rhode Island facilities, we are not ensuring that the facility is being paid adequately to reach the quality that we are demanding from them,” adds Hawkins.

“While there may be areas where a facility can save money, it should certainly not come from a facility’s budget to ensure appropriate staffing levels or to pay for qualified nursing staff,” notes Hawkins.

“Nursing facilities are between a rock and a hard shell because they cannot recruit staff because of low wages that result from the current Medicaid reimbursement system, and they cannot hire additional staff either,” says Hawkins.

Lt. Governor Charles J. Fogarty, who heads the state’s Long-Term Care Coordinating Council, states that the General Assembly is now working to address the concerns of consumers and providers over the state’s inadequate Medicaid reimbursement policy.

Fogarty stated that he serves on a work group, administered by the state’s Department of Human Services with members from the House and Senate, to review the state’s current reimbursement Principles for Nursing Homes and other components of the long-term care system. The state-level work group has been meeting for several months and came into existence as a result of lawmakers confronting the severe certified nursing assistance shortage in nursing facilities, the Lt. Governor said.

Fogarty states the work group is in the process of considering the hiring of a consultant to ultimately shape the state reimbursement policy on Medicaid.

“This issue will not go away,” he said, noting the state’s growing aging population. “Nursing facility residents are now sicker and require more intensive care than they did 14 or 20 years ago, noted Fogarty.

Jane Haywood, director of the state’s Department of Human Services, says that her agency recognizes there is a myriad of issues relating to nursing facilities and the long-term care continuum the state must address. The legislatively mandated workgroup is expected to develop proposals of reforming the state’s Medicaid system and entire long-term care system by spring, Hayward adds.

When something is broke fix it.

No Rhode Island company can not survive for long with their revenues not covering their operating costs.

Now it is time for the state to follow this longtime sound business principle when it revamps its ailing Medicaid program. With adequate state funding, Rhode Island regulators can rightfully better demand quality from nursing facilities. With more money in their coffers, facilities had better produce that quality of care, too.

The message should be clear to the nursing home industry – it’s now time to get the gang for the buck.



Confronting the Long-Term Care Dilemma in Uncertain Times

Published in the Pawtucket Times on January 14, 2002

 Aging advocates are about to find out how many slides you can cut the Rhode Island budgetary pie, especially when lawmakers are predicting that the state’s deficit could soar to hundreds of millions.

With the backdrop of a recession, pushing to keep funding at current levels for existing programs and services this legislative session may be their only hope as advocates for affordable health care and housing, education, disabled persons, seniors, and low-income families call for their fair share, too.

Meanwhile, CHOICES, a broad-based coalition of provider organizations and advocate organizations, will push this legislative session for more funding to keep Rhode Island seniors in their homes.

The coalition representing home care agencies, assisted-living facilities, adult day care, housing, senior center, disabled and senior advocates and Meals on Wheels, will continue its efforts to urge the General Assembly for reforms to Rhode Island’s long-term care system, said Paula Parker, Executive Director of Rhode Island Partnership of Home Care and a CHOICES member.

“Consumers must have options to choose programs and services that can provide them with greater independence in familiar surroundings,” Park told ALL About Seniors, adding that this is an underlying principle of CHOICE’S philosophy.

During the state’s prosperous years, Rhode Island’s allocation for home and community-based services slowly inched up from seven to eight percent of the state’s total long-term care budget.  Parker noted, however, that General Assembly funding for long-term care services continued to be heavily weighted toward funding institutional facility care.

“The challenge today is to continue the momentum of increasing state support for home and community-based services in less prosperous times,” Parker said, because the start’s rising elderly population creates a need to expand options in long-term care.

Susan Sweet, a consultant, long-time consumer advocate and CHOICES member, added that the seven-year-old coalition plans to continue its education efforts to inform legislators and the public about the cost savings of home and community care for elders as opposed to institutional care.

For example, Sweet stated that full-time adult day care five days a week may cost up to $ 10,000 annually as compared to an average $38,000 bill for nursing facility care.

Options in the state’s continuum of care include assistance with the costs of pharmaceutical drugs, community-based programs, rehabilitation facilities and nursing facility care. Sweet said, “A menu of available choices allows seniors and their families to seek out and receive the most appropriate and cost-effective care for their current situation. That’s what CHOICES is all about.”

Can long-term care options assist lawmakers in controlling the state budget while providing needed services for seniors?

Yes, said Sweet. “Not only is the quality of life greatly enhanced for elders and their families when institutionalization is delayed or eliminated, but also individual assets and state contributions to care through the Medicaid program are greatly reduced or eliminated,” she said.

Recognizing that lawmakers must work within severe budgetary constraints. Sweet said she believes it should be fiscally short-sided not to recognize the significant budgetary savings that home and community-based care- and preventative care- bring to situations that, without intervention, would lead to costly health care such as hospitalization and protracted institutional stays.

“The challenge for Rhode Island is to continue progress on creating less restrictive and less expensive community services while continuing funding for needed acute and long-term care,” Sweet said, stressing that in a tie of decreasing revenues, this will not be an easy task.

Lawmakers must either conform the long-term care crisis now for today’s seniors in the shadow of the state’s current budget deficit or in later years, when the state’s demographic time bomb I ready to explode. For today’s seniors and for the aging baby boomers who follow in their footsteps, lawmakers, state agencies, providers and seniors  must cooperate in crafting a seamless long-term care system with options that enhance quality of life and provide independence. This may take years.

But until then, amid competing interests for limited state dollars, advocates for better long-term care will have to roll up their shelves with the support of senior and disabled constituents to get this year’s slice of the state budget pie.