12 November 2008

HHS & VA Team Up in Alzheimer's Intiative

The U.S. Department of health and Human Services has joined with the U.S. Department of Veteran's Affairs in a new $36-million grant program for states to help older Americans and veterans remain independent and to support people with Alzheimer's to remain in their homes and communities, according to HHS Secretary, Mike Leavitt, and VA Secretary, Dr. James Peake.

The joint initiative builds on similar missions of HHS and the VA by providing "essential consumer directed" home and community based services to older Americans and veterans of all ages, as part of an existing Nursing Homes Diversion grants program.

Secretary Leavitt touts the program as a means to insure that "many people who would have been placed in nursing homes will be able to remain at home." According to the Administration on Aging, the number of veterans over age 85 has tripled during the past decade, creating a tremendous demand for long-term health care.

This joint VA - HHS program targets people not eligible for Medicaid, but who are at high risk of nursing home placement and "spend-down" to Medicaid, says, Assistant Secretary for Aging, Josefina Carbonell. "The program offers consumers more control over their long-term care, including the ability to determine the types of services they receive and the manner in which they receive them, including the option of hiring their own care workers", she said.

A little over $19-million of the grant goes to the new collaboration between the HHS and the VA, and the other $17-million goes to improve existing home and community based services to people with Alzheimer's and their family caregivers.

One does not have to be an expert to recognize that this level of funding barely amounts to seed money and that much more will be required to make the program effective and to carry it forward to meet current and future needs. Secretary Leavitt says the initiative supports Bush's New Freedom Initiative which calls for all federal agencies to help people who need long-term care and prefer to live in their own homes and communities.

On the face of it, that sound laudable. But, without significantly more funding and infrastructure such as local, visiting para-medicals equipped with wireless telemetry to a presiding physician's office or clinic, suburban and rural care-givers and patients will be adrift.

We are not entirely prepared to criticize this small initiative as cynical, or too little, too late. But, we are concerned that it is a very, very small and hesitantly tentative step onto a path which leads a great distance through many obstacles.

We hope the Obama administration will recognize the dire and immediate need facing today's and future generations of older Americans and veterans as we search for effective ways to help them age in place.

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