Resources About Alzheimer’s and Dementia

Care for Veterans with Alzheimer’s or dementia is provided throughout a full range of Department of Veterans Affairs (VA) health care services.

Based on the Veterans’ needs, services may include Home Based Primary Care, Homemaker and Home Health Aide, Respite Care, Adult Day Health Care, outpatient clinic, inpatient hospital, Nursing Home, Palliative Care, or Hospice Care. 

Caregiver Support is also an essential part of these services. If you’ve been diagnosed with dementia, Alzheimer’s disease, or are caring for someone who has, become familiar with the types, stages, symptoms, and treatments.

Over 50 video and print resources have recently been added to the sections on:

• Dementia Care including Alzheimer’s
• Veteran Caregiver Family Resources

Topics include daily plans, communication, behavior changes, next steps, and more. The Veterans Health Library has helpful resources about Coping with a Dementia Diagnosis.

Need more help or information? Find a VA social worker in your area or visit www.va.gov/Geriatrics.

Crisis Averted as Senate Sends Debt Limit Package to Biden

Roll Call
 
Senators staved off a financial crisis — and a weekend of voting in Washington — on Thursday night [June 1] when the chamber signed off on a bipartisan deal to suspend the debt limit into 2025, giving the Treasury authority to borrow trillions of dollars more to pay its bills.

With only days to spare before a Monday deadline, the Senate cleared for President Joe Biden’s signature a measure that would suspend the statutory $31.4 trillion debt ceiling and impose two years of caps on discretionary spending.

The bill also would claw back unspent pandemic aid, redirect some IRS funding for other uses, streamline energy permitting, end a pause on student loan repayments and toughen some work requirements for certain recipients of food stamps and cash assistance.

Passage of the measure was virtually ensured after Biden and Speaker Kevin McCarthy, R-Calif., reached a bipartisan deal on the debt limit over the weekend to end months of partisan wrangling. It also ends fears of triggering what Treasury Secretary Janet L. Yellen warned could be an "economic catastrophe" if the debt limit were breached and government payments had to be delayed.

"It is so good for this country that both parties have come together at last to avoid default," Senate Majority Leader Charles E. Schumer, D-N.Y., said before passage.

The bipartisan Senate vote of 63-36 came after a day of backroom negotiating, as senators aired their grievances over the package and sought votes on amendments that were designed to lodge protests without blocking final passage.

The biggest threat to the bill erupted on the Senate floor around midday, when several Republican defense hawks and top appropriators said they could not vote for the measure without a commitment from leadership to take up a supplemental defense spending bill.

They said the 3 percent defense spending increase allowed in the debt limit deal for the coming fiscal year, and a 1 percent increase allowed the following year, amount to cuts after adjusting for inflation.

"We'll be here ’til Tuesday until I get commitments that we're going to rectify some of these problems,” said Sen. Lindsey Graham, R-S.C., who wanted to ensure there would be more money for the Pentagon, as well as for Ukraine, Taiwan and Israel.

Senate Appropriations Chair Patty Murray, D-Wash., said any supplemental bill would also need to include funding for domestic purposes such as border security and disaster relief.

To remove that obstacle, Schumer and Minority Leader Mitch McConnell, R-Ky., entered a statement into the record pledging that the debt ceiling package wouldn't preclude consideration of emergency supplementals, whether for defense and national security-related purposes or domestic needs.

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CMS Pulls Back COVID-19 Vaccination Requirement 

CHAP

The following final rule was posted on the Federal Register Public Inspection desk on 5/31/2023. 

This final rule from CMS withdraws the regulations in the interim final rule with comment (IFC) “Omnibus COVID-19 Health Care Staff Vaccination” published in the November 5, 2021, Federal Register.  The regulations in this final rule are expected to be published in the Federal Register on June 5, 2023, and are effective 60 days after publication, or on Friday, August 4, 2023. Until the effective date, the requirement for staff to be vaccinated against COVID-19 or documented as exempt is in effect and will be assessed during a compliance survey.

Specific provider-specific regulations that will be removed by the effective date include:

Home health: § 484.70(d) 
§ 484.70(d) Standard: COVID–19 Vaccination of Home Health Agency staff. The home health agency (HHA) must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine. 

Hospice: § 418.60(d) 
§ 418.60(d) Standard: COVID–19 Vaccination of facility staff. The hospice must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine.

Home Infusion Therapy: § 486.525(c)
§ 486.525(c) COVID–19 Vaccination of facility staff. The qualified home infusion therapy supplier must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine.

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Denials of Health Insurance Claims are Rising—and Getting Weirder

Fierce Healthcare | By Elisabeth Rosenthal
 
Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims—sometimes bundles at a time—without reviewing the patient’s medical chart. A job title at one company was “denial nurse.”
 
It’s a handy way for insurers to keep revenue high—and just the sort of thing that provisions of the Affordable Care Act (ACA) were meant to prevent. Because the law prohibited insurers from deploying previously profit-protecting measures such as refusing to cover patients with preexisting conditions, the authors worried that insurers would compensate by increasing the number of denials.
 
And so, the law tasked the Department of Health and Human Services (HHS) with monitoring denials (PDF) both by health plans on the Obamacare marketplace and those offered through employers and insurers. It hasn’t fulfilled that assignment. Thus, denials have become another predictable, miserable part of the patient experience, with countless Americans unjustly being forced to pay out-of-pocket or, faced with that prospect, forgoing needed medical help.
 
A recent KFF study of ACA plans found that even when patients received care from in-network physicians—doctors and hospitals approved by these same insurers—the companies in 2021 nonetheless denied, on average, 17% of claims. One insurer denied 49% of claims in 2021; another’s turndowns hit an astonishing 80% in 2020. Despite the potentially dire impact that denials have on patients’ health or finances, data show that people appeal only once in every 500 cases.
 
Sometimes, the insurers’ denials defy not just medical standards of care but also plain old human logic. 

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