House Committee Hearing ‘Setting the Stage’ for Home Care Support, Policy Expert Says

McKnight’s Home Care | By Adam Healy
 
A House Ways and Means Committee hearing last week reinforced congressional support for home care, stakeholders said. Home-based kidney care and telehealth were two big topics of discussion.  
 
“Seemingly, the hearing was setting the stage for consideration of a number of pieces of legislation on these topics,” Mollie Gurian, vice president of home based and HCBS policy at LeadingAge, said during a policy update call on Wednesday. “A lot of the committee members on both sides of the aisle showed up and almost all of them were touting a bill that they were working on in one of these spaces.”
 
Such bills ranged from narrow regulatory fixes to broader policy change, she said, including legislation that could make permanent some waiver flexibilities implemented during the COVID-19 pandemic. Notably, telehealth and hospital-at-home programs received waiver extensions as a result of the pandemic. 
 
“It was a very interesting hearing and there was a lot of support for expanded care at home, generally, which we found to be very positive,” she said. 
 
Experts supporting home dialysis, hospital-at-home, telehealth and more testified last Tuesday. Among those testifying was Ateev Mehrotra, MD, a professor of health policy and medicine at Harvard Medical School, who recommended policy changes that could make virtual care services more accessible to Medicare beneficiaries.
 
“I believe it is critical to give Medicare as much flexibility as possible in adapting telehealth policy,” Mehrotra said in his testimony. “Telehealth use is rapidly changing, and policy must adapt accordingly.”
 
And Nathan Starr, medical director of home services and tele-hospitalist programs at Intermountain Health, advocated for the expansion of home-based services such as hospital-at-home during the Tuesday hearing.
 
“I have personally seen patient, family, community, and caregiver benefits of care at home,” Starr said. “Our positive experience has reinforced our commitment to increasing access to care at home. That is also why we are so pleased to be here today to advocate for the federal health policy changes needed to enable and support current and future hospital-at-home and patient needs.”

 

Ghostbots: AI Versions of Deceased Loved Ones Could be a Serious Threat to Mental Health

The Conversation | By Nigel Mulligan

We all experience loss and grief. Imagine, though, that you don't need to say goodbye to your loved ones, that you can recreate them virtually so you can have conversations and find out how they're feeling.

For Kim Kardashian's fortieth birthday, her then husband, Kanye West, gifted her with a hologram of her dead father, Robert Kardashian. Reportedly, Kim Kardashian reacted with disbelief and joy to the virtual appearance of her father at her birthday party. Being able to see a long-dead, much missed loved one, moving and talking again might offer comfort to those left behind.

After all, resurrecting a deceased loved one might seem miraculous—and possibly more than a little creepy—but what's the impact on our health? Are AI ghosts a help or hindrance to the grieving process?

As a psychotherapist researching how AI technology can be used to enhance therapeutic interventions, I'm intrigued by the advent of ghostbots. But I'm also more than a little concerned about the potential effects of this technology on the mental health of those using it, especially those who are grieving. Resurrecting dead people as avatars has the potential to cause more harm than good, perpetuating even more confusion, stress, depression, paranoia and, in some cases, psychosis.

Recent developments in artificial intelligence (AI) have led to the creation of ChatGPT and other chatbots that can allow users to have sophisticated human like conversations.

Using deep fake technology, AI software can create an interactive virtual representation of a deceased person by using their digital content such as photographs, emails, and videos.

Some of these creations were just themes in science fiction fantasy only a few years ago but now they are a scientific reality.

Digital ghosts could be a comfort to the bereaved by helping them to reconnect with lost loved ones. They could provide an opportunity for the user to say some things or ask questions they never got a chance to when the now deceased person was alive.

But the ghostbots' uncanny resemblance to a lost loved one may not be as positive as it sounds. Research suggests that deathbots should be used only as a temporary aid to mourning to avoid potentially harmful emotional dependence on the technology.

AI ghosts could be harmful for people's mental health by interfering with the grief process

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How CON Laws Influence Hospice Quality, Program Integrity [Featuring HHAC]

Hospice News / By Holly Vossel

Variations in hospice certificate of need (CON) state laws are raising program integrity concerns.

However, this coin has two sides. CONs have a big role to play when it comes to quality and utilization, according to Susan Ponder-Stansel, president and CEO of Florida-based Alivia Care.

“What ends up happening in states without CON is actually lower hospice utilization with way too many hospices in one service area, and often fragmented care without all four levels of hospice offered,” Ponder-Stansel told Hospice News. “In states with CON, we see much higher utilization rates and more scaling down on quality. You can’t create an unlimited demand or more demand without understanding consumer preferences and regulatory barriers. You have to walk in line with the [patient] demand and regulatory requirements.”…

If a state does not have a CON program in place, then local governing bodies are often unable to play a direct role in the hospice needs determination process, according to Matt Hansen, deputy director of the Home Care and Hospice Association of Colorado (HHAC). Hansen also serves as executive director of the Homecare & Hospice Association of Utah (HHAU).

“They may be aware of a need due to reports from referring parties that they aren’t able to find a provider. However, approving a new license is not based on how many providers are already in an area,” Hansen said.

Without having a role in the determination process, it can make it difficult to balance quality with supply and demand of hospice in a region, according to Hansen.

“Demand and supply of hospice resources is balanced by market conditions,” Hansen said. “If there are too many hospices in an area to meet current demand, those hospice agencies that do not have a large enough referral base and patient census will typically flounder until they sell to another provider or close.”

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Breaking Down Biden's $7.3T Proposed Budget for 2025: Here are his Top Health Priorities

Fierce Healthcare / By Noah Tong

President Joe Biden unveiled a proposed $7.3 trillion budget for fiscal year 2025 on Monday, which continued upon and expanded key health items from previous years.

The administration said his budget (PDF) will lower healthcare costs and drug prices, expand access to prescription drugs, build upon the Affordable Care Act (ACA) and fortify Medicare through a tax on the wealthy. Many of these priorities were previewed during Biden's State of the Union address last week.

Biden argues his plan will reduce the deficit by $3 trillion, whereas Republican-backed plans do the opposite over 10 years. The national debt would rise to $45.1 trillion by 2034.

"The national debt is on a steady march upwards, and it would take nearly $8 trillion of savings just to stabilize the debt over the next decade," said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, in a statement. "It’s dangerous that we’ve let things get this bad, and we need to treat it like the priority that it is. The President’s call for over 3 trillion of deficit reduction is a welcome start, and he deserves credit for presenting a budget that pays for new initiatives and improves our fiscal situation, but the budget doesn’t go nearly far enough."

Department of Health and Human Services (HHS) Secretary Xavier Becerra said the fiscal year budget proposes $130 billion in discretionary spending and $1.7 trillion in mandatory funding.

While not necessarily a focus of the budget itself, much of the news briefing was dedicated toward the administration's stance on defending abortion rights.

"The department is fighting tooth and nail to protect and expand reproductive health care including making contraception, IVF, and basic pre- and postnatal healthcare not only available, but more affordable," said HHS Deputy Secretary Andrea Palm during a press briefing.

Becerra said federal agencies are focused on how they can help protect reproductive rights. He cited the FDA working to protect patient access to mifepristone along with the Office of Civil Rights allowing patients to receive the right care for them.. He also referenced the Braidwood case, where the federal government is trying to protect the ACA's preventive services clause in court, and the Centers for Medicare & Medicaid Services (CMS) working to provide adequate maternal health care.

Click here for three of the top health policies to be aware of in the budget.

 

That’s A Wrap! CDC Reduces Recommended COVID-19 Isolation Period

Littler / By Devjani Mishara and Alka Ramchandani-Raj

On March 1, 2024, the Centers for Disease Control and Prevention announced that it is updating its COVID-19 guidance and is no longer recommending that individuals who test positive for COVID-19 isolate for five days.  The agency is recommending a new, “unified approach” to respiratory viruses, including not only COVID-19 but also flu and respiratory syncytial virus (RSV). 

Under the new guidance, individuals should monitor themselves for various respiratory virus symptoms, including fever, chills, fatigue, cough, runny nose and headache.  Those who develop such symptoms are recommended to “stay home and away from others,” but also advised that they can return to normal activities “when, for at least 24 hours,” their symptoms are improving and they have not had a fever without the use of fever-reducing medication.  The CDC’s recommendations are now independent of whether an individual actually has tested positive for COVID-19 or any other respiratory virus, and do not include any minimum isolation period.

What does this mean for employers?

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