Family Caregiver Alliance
Volume XIII, Number 10, November 14th, 2013

This month is National Caregiver's month . . .      

. . .and this issue of Policy Digest includes two legislative developments surrounding the quality of life for the caregiver in the workplace.

In one progressive West Coast city we see the efforts of city leaders encouraging businesses to work cooperatively with employees who have family caregiving obligations that demand  more flexible work hours; while on the East Coast we see the first city-wide requirement for paid sick leave being enacted in New Jersey. As the San Francisco story mentions, employees with flexible schedules [and we'll add, the ability to take some time to rest and heal when sick, without losing pay] are more satisfied, committed to their employers and produce a higher quality work product.'
Can we safely assume that this positivity/productivity could translate to their effectiveness as caregivers as well?
 . . . . . . . . . . . . . . . . . . .

So what gift might be the best to give a caregiver this official month for caregivers? Perhaps the news that they may enjoy better health and longer life as the Johns Hopkins (Caregivers Live Longer) Study below argues. Conflicting reports, studies and commentaries exist . . . it is worth the read for a positive perspective on caregiver mortality.


State Legislation, Policy & Reports
Articles of interest on pending and proposed legislation as well as current policies and new reports surrounding caregiving and healthcare at the state level.

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Federal Legislation, Policy & Reports 

Articles of interest on pending and proposed legislation as well as current policies and new reports surrounding caregiving and healthcare across the United States.

International News

Articles on pending/proposed caregiving legislation, or current policies and reports on caregiving, healthcare around the world.   
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Research Reports & Journal Articles

Organizational reports and professional journal articles of interest surrounding caregiving and healthcare nationally and world-wide.

Conferences & Trainings

Upcoming trainings, educational conferences, summits and speaker series on caregiving and related healthcare topics

1. National Transitions of Care Summit - Dec. 2nd
2014 California Women's Policy Summit

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Funding, Media & Miscellaneous 

Information and links related to funding and media and more...

STATE . . .

CA (SF): Family Friendly Workplace Ordinance Becomes Effective Jan 1, 2014
On October 9th, San Francisco Mayor Ed Lee signed an Ordinance encouraging employers to work with employees to create a flexible work schedule if they have family caregiving obligations. The Ordinance grants workers the right to request flexibility without fear of retaliation. Employers can deny requests, but only for bona fide business reasons that they explain in writing. In the first year after the United Kingdom enacted a similar law, over one million employees made requests for a flexible work schedule, and almost all were granted. Research done by the Urban Institute and Georgetown Law School found that employees with flexible schedules are more satisfied, committed to their employers and produce a higher quality work product. More and more workers find themselves not only caring for children, but also for aging parents. Over 30% of American households reported having an unpaid caregiver in 2009----most of whom reported caring for an adult. Over 70% of those caregivers were also employed.



MA: Palliative Care Bill Introduced H2104- Improve Quality of Life by Expanding Access to Care 

This Massachusetts bill shall establish a State Palliative Care and Quality of Life Interdisciplinary Advisory Council. Palliative care throughout the continuum of illness involves addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. The Council will consist of licensed doctors, nurses, social workers, pharmacists, patient & family caregivers, spiritual leaders, and other relevant appointees who have certification or experience in a variety of palliative care settings. The state will maintain a website with info about palliative care with information for health professionals, caregivers, and other parties. Council members will serve without financial compensation.


NJ: Jersey City, First in NJ with Sick Leave Legislation

Mayor Steve Fulop recently signed legislation requiring all businesses in Jersey City with 10 or more employees to provide one hour paid sick leave for every 30 hours worked, with a maximum of five paid sick days each year. Businesses with 9 or fewer employees must allow workers to accrue up to 5 unpaid days. The legislation goes into effect January 24, 2014, and only private employers are subject to the law. Jersey City is the second largest city in the state, and now joins the ranks of Portland, San Francisco, Seattle, Washington D.C. and New York City as municipalities that have enacted sick leave legislation. Advocates see this as a first step in efforts to pass a state sick leave law.  


MA: HOUSE  Bill 956 Introduced: Insurance Coverage for Electronic Tracking Devices for Persons with Autism and Alzheimer's
This bill requires health plans to provide full coverage for the elective use (by patient or caregiver) of electronic tracking devices to protect the safety of individuals who have been diagnosed with dementia, Alzheimer's disease, or Autism spectrum Disorder, by a licensed physician. The wearable Technology-Assisted Tracking Device must be waterproof, wearable on the ankle or wrist, and meet technological criteria specified in the bill.


CA: AB 602 Abuses Of Mentally and Developmentally Delayed Persons Signed by Governor

This bill amends Section 4427.5 of the Welfare and Institutions Code, and expands the scope of reporting for suspected abuse of the mentally or developmentally disabled. A new state mandated program will be created, requiring the Commission on Peace Officer Standards and Training to establish and maintain a training course for law enforcement interactions with mentally or developmentally disabled persons living in a state mental hospital or developmental center. The training course is required for personnel in all law enforcement agencies with jurisdiction over state mental hospitals and state developmental centers. Incidents of abuse must be made to designated investigators of the State Department of State Hospitals or the State Department of Developmental Services, and also to the local enforcement agency, as specified, if the suspected or alleged abuse or neglect occurred in a state mental hospital or state developmental center and resulted in any specified incidents, including a death or a sexual assault. Reports of abuse must be made within 2 hours of observing the abuse.  


2013 Nobel Prizewinner in Medicine Loses NIH Research Funding Due to Government Shut Down and Budget Problems
James Rothman, 62, of Yale University has been doing research that provides the intellectual framework that scientists use to study how brain cells communicate and how other cells release hormones. In October 2013, he and two other American researchers received the Nobel Prize in Medicine for their important work that may help understand and prevent diseases such as Alzheimer's, Parkinson's and Diabetes. Ironically, despite the Nobel recognition of of his work, his NIH funding is being cut due to budget fights and government shut-down.  
Center for Medicare Advocacy:  Medicare Patients in Hospitals Surprised to Receive Bills for Observation, Not Covered by Medicare Part A

Many seniors who have been hospitalized for up to 14 days, are discovering that a 2003 Medicare policy is being increasingly used which changes billing for all hospital costs from Part A to Part B, resulting in much higher out of pocket costs. Patients hospitalized for a 3 day observation stay may receive the same care as the patient in the next bed, but unlike a 3 day stay categorized as an admission, the patient with a 3 day (or even 10 day) observation stay does not qualify for the Medicare rehabilitation coverage. While hospital admissions for Medicare patients are declining, more and more patients are entering hospitals with observation status each year. Observation visits lasting more than 24 hours doubled from 2006-2011. The Center for Medicare Advocacy had sued to change the application of this policy, and legislators in both the House and Senate have introduced legislation to change how it is applied.  


U.S. Senate Panel Advances Older Americans Act 

On October 30, a Senate Committee approved a bill by Sen. Bernie Sanders reauthorizing the Older Americans Act (OAA) for a five year period. The OAA was initially enacted by Congress in 1965 and provides essential services for seniors such as nutrition programs, caregiver support, job training, transportation, preventative health services, and protections against physical and financial abuse of seniors. The OAA, usually reauthorized every 5 years, was overdue by 2 years since the last reauthorization in 2006. States have experienced the pressure of continuing to provide senior services, while the population over the age of 60 has increased 20% since 2006.


House Resolution 396 - Supporting the goals and ideals of November as National Alzheimer's Disease Awareness Month  

Representatives Chaka Fattah (D-Penn) & Glenn Thompson (R-Penn) acknowledge the 20th Anniversary of the first time November was designated National Alzheimer's Disease Awareness Month, in 1983 during the Reagan Administration. In the 20 year span from 1983-2013 the number of Americans diagnosed with Alzheimer's disease increased from 2,000,000 to 5,000,000.  



Belgium Considering Unprecedented Law to Grant Euthanasia for Persons with Dementia and Children
Belgium, the only European country besides the Netherlands which allows Euthanasia for terminally ill adults, is currently considering legislation that would extend the same rights to children under the age of 18 and adults with early dementia. The Socialist Party introduced the legislation, while the Christian Democratic Flemish party opposes the legislation and states they will challenge it in the European Court of Human Rights if it passes. A final decision has cleared the Senate, and now goes to Parliament for approval.
John Hopkins Study: Caregivers Live Longer  
In a recent study, researchers at John Hopkins found that informal caregivers experienced an 18% lower rate of mortality compared to non-caregivers. Data was extracted from the national Reasons for Geographic and Racial Differences in Stroke (Regards). All-cause mortality from 2003 to 2012 for 3,503 caregivers was compared to a propensity-matched sample of 3,503 non-caregivers. These findings contradict much of the existing research showing that caregivers experience higher levels of stress, depression and other negative outcomes when compared to non-caregivers. However, the authors included limitations of this study that included such factors as: lack of knowledge of ADL and IADL tasks performed by informal caregivers and whether dementia was present in the population in the study.
Annals of Internal Medicine:  Cognitive Impairment in Older Adults; Is Early Identification Useful? 
Researchers analyzed English language studies of primary care screening instruments and treatments for persons with mild cognitive impairment, or mild to moderate dementia published between 2000 and December 2012. The primary purpose of the study was to determine if early identification of cognitive impairment and various interventions reduced patient and caregiver mortality. While medication for dementia did not seem to provide benefits for patients or caregivers, cognitive stimulation and physical exercise did appear somewhat promising. Although dementia can be accurately diagnosed by short tests in a primary care setting, diagnosis of mild cognitive impairment cannot be made using standard short screening tests. More research is needed to determine the effects of testing on patients, as well as the accuracy of testing, and treatment efficacy.
RAND Corp: Factors Affecting Physician Satisfaction    
A Rand Study Commissioned by AMA to determine factors increasing physician satisfaction, found that physicians' ability to deliver high quality care, and the potential for Electronic Health Records (EHR) to improve upon this, were the two greatest factors affecting professional satisfaction. Data for the survey was gathered by interviewing staff in 30 medical practices of various sizes in 6 states. Dissatisfaction arose from a lack of leadership support of quality improvement initiatives, and multiple difficulties with current EHR programs. Other factors important to respondents included autonomy of practice, support of management, fairness and respect between all parties in the practice, sufficient time and attention for patient care,  and income stability and fairness.
National Transitions of Care Summit - Dec. 2nd

The Care Summit will be held December 2nd at the National Press Club in Washington DC and will feature key health care professionals working to improve the transitions of care through development and use of new models, software and other initiatives. Sponsored by the National Transitions of Care Coalition.  

2014 California Women's Policy Summit 


California Center for Research on Women and Families (CCRWF) is encouraging early registration for its January 16th, 2014 Policy Summit at the Sacramento Convention Center in California. Leading advocates will discuss health care reform, health disparities and gender, the backlog of rape kits, Title IX Compliance, women and economic empowerment, work life balance and more. Co-sponsors include California Legislative Women's Conference and the California Commission on the Status of Women and Girls, among others. 

Program Shows Us "Something More" About Hospice  

A special program offered us a glimpse into the lives of hospice patients last Thursday evening. "Hospice: Something More" premiered Thursday, November 7 at 9pm ET on RLTV (formerly Retirement Living TV). The program was produced by Hospice Foundation of America and funded by a grant from the John and Wauna Harman Foundation. Email for more information on this program and additional air dates.   


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