Medical Aid in Dying Waiting Period Would Shorten from 15 days to 48 Hours Under Colorado Bill
Greeley Tribune | By Meg Wingerter
A bill in the Colorado legislature would shorten the mandatory waiting period for medical aid in dying from more than two weeks to two days, opening the option to more critically ill people, but raising concerns for some about rushed decisions.
Colorado legalized medical aid in dying in 2016, when voters passed Proposition 106. Under the law, two physicians must agree that an adult patient is mentally competent to make the decision to die and would have less than six months until natural death. If approved, the person would then give themselves a drug cocktail meant to cause death painlessly.
Under current Colorado law, a patient has to request medical aid in dying twice, at least 15 days apart, before they can get a prescription. Senate Bill 24-068 would shorten the timeline to 48 hours, and allow physicians to waive the waiting period if they believe the patient will die in less than two days.
It would also allow people who aren’t Colorado residents to end their lives under the state’s law, and let advanced practice registered nurses prescribe the drug cocktail. Colorado allows APRNs to prescribe most drugs, but limits medical aid in dying prescriptions to physicians…
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Final Rule Strengthens Social Needs Programs for Seniors Aging in Place
McKnight’s Home Care | By Adam Healy
The Administration for Community Living on Tuesday released a final rule affecting the Older Americans Act (OAA) — the first significant change to the act in more than 35 years.
Among various updates, ACL’s rule specifies what people are eligible for assistance under the OAA, clarifies how federal funds can be used to provide supportive services, and spells out requirements for state and local programs helping older adults aging in place. There have been small modifications to the act in recent years, but this week’s final rule marks the first major changes to the OAA since 1988, according to the ACL.
“Updates are needed to align regulations to the current statute and reflect the needs of today’s older adults,” ACL wrote in a Notice of Proposed Rulemaking in June 2023. “[The rule] aims to better support the national aging network that delivers OAA services and improve program implementation, with the ultimate goal of better serving older adults.”
Also since 1988, the population of older adults in the United States has nearly doubled, seniors on average are living longer and expectations for aging have changed, according to ACL. The provisions finalized in the rule aim to reflect these changing standards and provide more comprehensive care for aging adults. Its ultimate goal, ACL noted, is helping seniors receive services and support to live at home and in their communities as they age.
“The overwhelming majority of Americans want to live in their own homes as they age … For many, this is possible because of the programs and services provided through the Older Americans Act,” Alison Barkoff, ACL administrator and the assistant secretary for aging, said in a statement. “The updated regulations strengthen the stability and sustainability of these programs.”
Some services provided by OAA programs include rides to medical appointments, nutritious meals, in-home care and support to family caregivers, according to Barkoff.
The final rule also solidifies flexibilities put in place during the COVID-19 pandemic that promoted aging in place. For example, the rule now allows some meal programs to offer carry-out meals for seniors.
In 2022, USAging, the national association that supports area agencies on aging called for OAA expansion. Meanwhile, workforce-challenged aging service providers — including home care agencies — struggle with a lack of resources to serve the growing number of older adults in need.
The rule has been filed in the Federal Register and is scheduled for publication on Feb. 14. |
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10% of People with Dementia May Actually Have Different Disease, Research Suggests
Becker’s Clinical Leadership | By Ashleigh Hollowell
Certain cases of dementia — potentially up to 10% — could instead be undiagnosed liver disease and related neurological issues, according to a study published Jan. 31 in JAMA.
Additionally, researchers believe that the 10% of undiagnosed liver disease and brain dysfunction could possibly be resolved with treatment.
For the study, researchers analyzed a decade of data — spanning 2009 to 2019 — from 177,422 veterans who had a diagnosis of dementia, and looked for a high Fibrosis-4 score, which is a sign of advanced liver fibrosis that can lead to cirrhosis.
Across the dataset, around 10.3% of patients who did not previously have a cirrhosis diagnosis showed high Fibrosis-4 scores and signs of hepatic encephalopathy (HE), a neurological disorder that is often challenging to distinguish from dementia.
But, a reversal of symptoms is possible through treatment for metabolic encephalopathies like HE, and researchers suggest clinicians pay particular attention to "the determinants of undiagnosed cirrhosis among veterans with dementia" and use that information to help properly "identify those eligible for screening and subsequent HE therapy." |
For Home Care Providers Still Invested In Medicare Advantage Business, Patience Is Wearing Thin
Home Health Care News | By Andrew Donlan
Around 2019, Medicare Advantage (MA) was all the rave among home care providers.
That’s because, in 2018 and 2019, two pathways opened for MA plans to provide more benefits to beneficiaries: the primarily health-related benefit pathway and the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway.
Included in those were plenty of areas of opportunity for personal home care providers to step in and become more involved with the Medicare dollar. In-home support services (IHSS), namely, were a popular benefit that providers theoretically stood to benefit from.
But, since 2019, that optimism around MA has waned for most. The return on the investment has largely not been there.
For one, providers that generally dealt with private-pay clients were met with less favorable rates in MA, plus less reliable scheduling for their caregivers. Then, particularly recently, the growth in plans’ adoption of SSBCI and primarily-health related benefits has slowed.
This year, for instance, 867 plans are offering IHSS as a supplemental benefit, according to the research and advisory firm ATI Advisory. That’s a significant drop off from 2023, when 1,308 plans were offering the benefit.
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