Volume 18, No. 2, Spring 2010
By George Heufelder, MS, RS, Director,
Barnstable County Department of Health & Environment
If you are like me, your eyes glaze over at the thought of one more commentary on the healthcare bill, never mind wading through the 2074-page document formally called HR3200 America's Affordable Health Choices Act of 2009. What I would like to provide now is a few of the less-discussed aspects of the new bill that affect us perhaps as directly as the costs.
Some of the lesser known provisions of the bill include considerable attention to issues concerning nursing homes and care of the elderly.
Relevant to many on Cape Cod who are struggling with care of elderly parents and trying to make decisions regarding long-term care, funding will be provided for compiling information on comparison of nursing homes.
The information will be posted and updated on the official Internet website of the federal government for Medicare beneficiaries commonly referred to as the “Nursing Home Compare” Medicare website. Relevant items such as staff/patient ratios, staff turnover rates and hours spent per resident will be provided along with clear means or interpreting the data.
The bill also includes funding for a pilot project to develop a “Five-Star Quality” rating system for nursing homes. Closely allied to these efforts will be funding for the investigations of elder abuse, neglect and exploitation. These elements include the establishment of a federal advisory board and the availability of grants for eligible entities to establish and operate stationary and mobile forensic centers, to develop forensic expertise regarding, and provide services relating to these issues.
Related efforts to develop training programs to prevent and detect elder abuse will also be funded under the bill with special emphasis on abuse issues of patients with dementia.
In keeping with the overall intent of the bill to reduce healthcare costs, a special section of the legislation commits to the support of employer-based programs that assist in the promotion of healthy lifestyles, including health screenings, and other activities that build capacity for employers to convey information and encourage activities that promote good health.
There is also a specific provision for the evaluation of present federal wellness programs and a requirement that the Secretary of Health and Human Services report to Congress on the effectiveness of these programs. This emphasis on wellness is gratifying, since the Barnstable County Department of Health and Environment has emphasized this aspect in our community health efforts for the past 10 years. These efforts recognize the principle that we see demonstrated time and time again that prevention and early detection of problems helps avoid debilitating illness and reduce medical costs.