Compare Proposals to Replace The Affordable Care Act | The Henry J. Kaiser Family Foundation

President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other?Plans available for comparison:The American Health Care Act as introduced by the House Republican leadership, March 6, 2017 (PDF)The Affordable Care Act, 2010 (PDF)More plans for comparison:Rep. Tom Price’s Empowering Patients First Act, 2015 (PDF)House Speaker Paul Ryan’s A Better Way: Our Vision for a More Confident America, 2016 (PDF)Sen. Bill Cassidy’s Patient Freedom Act, 2017 (PDF)Sen. Rand Paul’s Obamacare Replacement Act, 2017 (PDF)House Discussion Draft, February 10, 2017 (PDF)Click the column header to view available plans to compare. You may compare up to 3 plans.

Source: Compare Proposals to Replace The Affordable Care Act | The Henry J. Kaiser Family Foundation

YOU MANY ALSO BE INTERESTED IN…

 

SUNspot – Wireless Device Ownership by People with Disabilities

Wireless Inclusive Technologies RERC

This SUNspot addresses the following question related to ownership of wireless devices by adults with disabilities:  Do people with disabilities own wireless devices (regular phones, smartphones and tablets) at the same rates as the general population?

Comparison of the results from the SUN and the Pew Research Center show that people with disabilities own cellphones at a high rate (83%), but still substantially lower than the general population (92%). Drilling down to examine the rates of ownership of specific types of mobile wireless devices shows that people with disabilities own smart devices (smartphones and tablets) at slightly higher rates than the general population. People with disabilities own basic cellphones at much lower rates than the general population.

Nurses’ experience of caring for people with intellectual disability and dementia

Josephine Cleary and Owen Doody

Aims and objectives. To explore nurses’ experiences of caring for older people with intellectual disability and dementia.

Background. Ageing and dementia prevalence is increasing along with the life expectancy of people with intellectual disability. As a population group, people with intellectual disability have a high prevalence of dementia, which is higher within the subpopulation of Down syndrome. People with intellectual disability live in residential care, community or residential settings, and nurses are required to adapt their practices to meet the changed needs of the individual.

Design. A qualitative Husserlian descriptive phenomenological methodology facilitated the researcher to become absorbed in the quintessence of meaning and explore nurses’ experience of working with older people with intellectual disability and dementia.

Methods. Ethical approval was obtained, and data were collected utilising semistructured interviews (n = 11). Interviews were transcribed and analysed using Colaizzi’s framework for data analysis.

Results. Three key themes were identified: ‘knowledge of dementia’, ‘personcentred care’ and ‘transitioning within the service’. The study highlights the need for proactive planning, life story books of the patient, and funding to support client and staff.

Conclusions. Overall, the study highlights the importance of knowing the person, supporting the individual and recognising presenting behaviours as outside the control of the individual. Relevance to clinical practice. This article presents the experiences of nurses caring for the older person with intellectual disability and dementia. Transitions are often very difficult for both the person and their peers, and they experience benefit from the efforts of a multidisciplinary team facilitating a person-centred approach.

The State of the Science of Health and Wellness for Adults With Intellectual and Developmental Disabilities

Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater attention to the training of health care providers. Gaps in the literature include the lack of intervention trials, replications of successful approaches, and data that allow for better comparisons between people with IDD and without IDD living in the same communities. Implications for future research needed to reduce health disparities for people with IDD include: better monitoring and treatment for chronic conditions common in the general population that are also experienced by people with IDD, an enhanced understanding of how to promote health among those in the IDD population who are aging, addressing the health needs of people with IDD who are not part of the disability service system, developing a better understanding of how to include people with IDD in health and wellness programs, and improving methods for addressing the healthcare needs of members of this group in an efficient and cost-effective manner, either through better access to general medical care or specialized programs.

Source: The State of the Science of Health and Wellness for Adults With Intellectual and Developmental Disabilities

New Issue Brief Available: Opportunities to Improve Nutrition for Older Adults and Reduce Risk of Poor Health Outcomes


http://bit.ly/2mJpAdx

http://nutritionandaging.org/

A new Issue Brief is now available that addresses opportunities to improve nutrition for older adults and also reduce the risk of poor health outcomes. During National Nutrition Month we focus time on the issue of nutrition, because as people age, they may experience malnutrition.  Appetite and the body’s ability to process food may decrease with age, while health conditions and use of medications that can affect nutrition status may increase.  In addition, limited ability to shop for and prepare food can affect a person’s access to it.  Factors like isolation and depression also can affect nutrition.

nTIDE February 2017 Jobs Report: Americans with Disabilities Continue to Contribute to Job Gains

nTIDE February 2017 Jobs Report: Americans with Disabilities Continue to Contribute to Job Gains

Source: nTIDE February 2017 Jobs Report: Americans with Disabilities Continue to Contribute to Job Gains

by Anna Brennan-Curry | Mar 10, 2017

Kessler Foundation and University of New Hampshire release nTIDE Report – Monthly Update

Durham, NH – Employment continues to increase for Americans with disabilities, building on the solid start to the new year, according to today’s National Trends in Disability Employment – Monthly Update (nTIDE), issued by Kessler Foundation and University of New Hampshire’s Institute on Disability (UNH-IOD). Achieving positive employment outcomes is especially challenging for high schools that serve young adults with moderate to severe disabilities. Promising approaches are based on intervening early, coordinating educational and vocational resources, and cultivating local employers.

nTIDE: Comparison of People with and without Disabilities (February 2016 & 2017)

The February numbers indicate that people with and without disabilities are contributing to U.S. job gains. In the Bureau of Labor Statistics (BLS) Jobs Report released Friday, March 10, the employment-to-population ratio for working-age people with disabilities increased from 26.0 percent in February 2016 to 28.1 percent in February 2017 (up 8.1 percent; 2.1 percentage points). For working-age people without disabilities, the employment-to-population ratio increased slightly from 72.3 percent in February 2016 to 72.8 percent in February 2017 (up 0.7 percent; 0.5 percentage points). The employment-to-population ratio, a key indicator, reflects the percentage of people who are working relative to the total population (the number of people working divided by the number of people in the total population multiplied by 100).

“The improvement in the proportion of people with disabilities working continues for the eleventh consecutive month,” according to John O’Neill, PhD, director of employment and disability research at Kessler Foundation. “This is the longest run of positive news since we began reporting the employment situation of people with disabilities in 2013,” he added.

The labor force participation rate for working-age people with disabilities increased from 30.2 percent in February 2016 to 31.5 percent in February 2017 (up 4.3 percent; 1.3 percentage points). For working-age people without disabilities, the labor force participation rate increased slightly from 76.1 percent in February 2016 to 76.4 percent in February 2017 (up 0.4 percent; 0.3 percentage points). The labor force participation rate is the percentage of the population that is working or actively looking for work.

“The trend in the employment of people with disabilities keeps marching upwards; of course there is still quite a ways to go,” said Andrew Houtenville, PhD, associate professor of economics at UNH.

Students with disabilities often struggle after graduating from the supportive environment of special services high schools, and are unprepared to transition into the work force. Bridge to Employment, a promising new pilot program funded by Kessler Foundation, is an example of the efforts to ease this transition for students in New Jersey who attend the Atlantic County Special Services School District (ACSSSD).

JEVS Human Services created the program to address the employment needs of the hardest to serve students. Taking a sophisticated approach, the program begins with a holistic assessment of the values, interests, personalities, and aptitudes of the students, in order to find work placements that are a good fit and provide possibilities for the students to develop—thus improving retention and reducing the long-term burden on the workforce development system. The program also connects students early on with the New Jersey Division of Vocational Rehabilitation Services (DVRS), a program collaborator, so there’s no gap in services for the students. Another key element to the program is the addition of a dedicated professional called a career navigator to help place students, in part by developing visual resumes using PowerPoint format, an engaging format for presenting their individual skills, interests, and strengths.

“We look forward to seeing how well the program fills the vital need for supports and services for high school students transitioning to the workplace,” said Elaine E. Katz, MS, CCC-SLP, senior VP of grants and communications at Kessler Foundation. “If Bridge to Employment succeeds in transitioning the ACSSSD students who are hardest to serve, this program could serve as a model for effective transition programs in other counties in New Jersey as well.”

In February 2017, among workers ages 16-64, the 4,409,000 workers with disabilities represented 3.1 percent of the total 142,437,000 workers in the U.S.

The next nTIDE will be issued on Friday, April 7, 2017. Follow the news on Twitter #nTIDE.

Join our nTIDE Lunch & Learn series, starting today, March 10 at 12:00pm EST. This live broadcast, hosted via Zoom Webinar, will offer attendees Q&A on the latest nTIDE findings, provide news and updates from the field, as well as host-invited panelists to discuss current disability-related findings and events. Rita Landgraf, Professor of Practice and Distinguished Health and Social Services Administrator in Residence, University of Delaware, College of Health Sciences, joins Drs. Houtenville and O’Neill, Michael Murray of Office of Diversity and Inclusion at the U.S. Office of Personnel Management (OPM), and Denise Rozell, Policy Strategist at the Association of University Centers on Disabilities (AUCD), to discuss today’s findings as well as the positive return on advancing employment of individuals with disabilities. You can join live, or watch the recordings at: www.ResearchonDisability.org/nTIDE.  Find updates on Twitter #nTIDELearn.

NOTE: The statistics in the National Trends in Disability Employment Update are based on Bureau of Labor Statistics numbers, but are NOT identical. They’ve been customized by the University of New Hampshire to efficiently combine the statistics for men and women of working age (16 to 64). NTIDE is funded, in part, by grants from the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (9ORT5022-02-00 & 90RT5017) and Kessler Foundation.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes – including employment – for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit www.KesslerFoundation.org.

About the Institute on Disability at the University of New Hampshire

The Institute on Disability (IOD) at the University of New Hampshire (UNH) was established in 1987 to provide a coherent university-based focus for the improvement of knowledge, policies, and practices related to the lives of persons with disabilities and their families. For information on the NIDILRR-funded Employment Policy and Measurement Rehabilitation Research and Training Center, visit www.ResearchonDisability.org.

For more information, or to interview an expert, contact:

Carolann Murphy, 973.324.8382, CMurphy@KesslerFoundation.org

Self-Directed Care May Help People with Serious Mental Illness Take an Active Role in Their Recovery

Source: National Rehabilitation Information Center | Information for Independence

Serious mental illnesses (SMI) are conditions like schizophrenia, bipolar disorder, or depression. People with serious mental illness often receive traditional mental health services funded by Medicaid, such as medications or psychotherapy. These services may help reduce SMI symptoms, but they may not be effective enough to help people with SMI participate fully in their communities. Self-directed care (SDC) is a new and alternative approach to traditional care for people with SMI. In one version ofSDC, people with SMI can request funding through their provider for nontraditional goods or services that they need to achieve their wellness goals. For example, someone in an SDC program could request funding for a gym membership, a bus pass, or clothes for a job interview. In a recent NIDILRR-funded study, researchers looked at the types of SDC requests people with SMI made while participating in such a program and their reasons for making the requests. The researchers also wanted to find out how often people with SMI requested nontraditional items through SDC, and the most common wellness goals that people with SMI hoped to meet by making those SDC requests.

Researchers at the Rehabilitation Research and Training Center on Community Integration and Participation for Individuals with Psychiatric Disabilities (TU Collaborative) looked at data from 120 participants enrolled in a larger study about SDC. The participants were adults with a SMI (schizophrenia, bipolar disorder, or depression) who were receiving Medicaid-funded mental health services in Delaware County, Pennsylvania. Half of the participants took part in an SDC program and half received usual care. For this study, the researchers focused on the 60 participants who were offered the SDC program. The SDC program participants were paired with a recovery coach who explained the program and helped them set personalized wellness goals. The coach also reviewed the participants’ current mental health services with them and encouraged them to decide whether or not they were satisfied with their current services and whether or not they wanted to request any nontraditional goods or services. The participants who decided to request a nontraditional item submitted a written justification explaining how the requested item would help them achieve specific wellness goals. The participants also submitted the estimated costs to the behavioral health managed care agency for approval. All of the SDC requests were approved. After approval, the participants were given debit cards to purchase their requested items.

The researchers looked at how many participants requested nontraditional items, how many requests they made, how long it took to make their first request, and what types of items were most often requested and the wellness goals those items addressed. The researchers found that:

  • Almost all SDC participants (87%) requested at least one item, with an average of about 10 items requested per person.
  • On average, it took the participants about 3 months to make their first request after they joined the SDC program.
  • Participants made requests to improve broad wellness goals in diverse areas including: Self-Care; Domestic Life; Mobility; and Community, Civic, and Social Life.
  • The most common specific wellness goals that SDC requests addressed were: managing diet and fitness, using public transportation, and handling stress. Most of the participants made requests related to more than one wellness goal.
  • The participants with schizophrenia requested more items related to managing their health and fitness, such as gym memberships. The participants with bipolar disorder and depression made more requests related to reducing stress, such as paying the electric bill or legal fees related to a divorce.

The authors noted that traditional, medically-oriented mental health services may not fully meet the individual needs of people with SMI. Traditional care may also put people with SMI in a passive role regarding their care. This approach to SDC can give people with SMI a more active role in their recovery by letting them identify and request the goods and services that they feel would be most relevant to their personal wellness. SDC may also help people with SMI overcome financial barriers, such as the inability to pay for a bus pass, which might prevent them from fully participating in valued activities like employment and social gatherings. The ability to participate in meaningful activities, in the long run, may beneficially impact overall health and wellbeing. It may be beneficial for behavioral health agencies and policymakers to broaden the definition of “medical necessity” to include nonmedical goods and services that individuals with SMI feel are important for achieving wellness goals. This study did not test the effectiveness of SDC; it just looked at the types and number of requests that people made. Also, the SDC program was new, and the types and number of requests could change as the program matures.  More research is needed to evaluate the long-term impact of an SDC approach to mental health services.

To Learn More

The TU Collaborative website features several resources on self-directed care including factsheet, a guide to creating self-directed care programming, and a self-advocacy planning tools.

The NIDILRR/SAMHSA-funded Center on Integrated Health Care and Self-Directed Recovery is dedicated to advancing knowledge and utilization of innovative models to promote health, recovery, and employment among people with mental health conditions. The Center’s website features resources for practitioners, policymakers, and self-advocates interested in SDC.

To Learn More About this Study

Snethen, G., Bilger, A, Maula, E.C., Salzer, M.S. (2016) Exploring personal medicine as part of self-directed care: Expanding perspectives on medical necessity. Psychiatric Services In Advance, 2016, 1-7. This document is available from the NARIC Collection under Accession Number J74076.

Date published:

2017-03-15

Kessler Foundation Signature Employment Grants

Kessler Foundation

Signature Employment Grants yearly to support  non-traditional solutions  that increase employment outcomes for individuals with disabilities.

Our success is in stimulating ideas from the field that spark new models that are adaptable to replication and scalability, and may be models for policy change. Kessler Foundation’s flexible funding dollars encourage organizations to pursue promising approaches and concepts beyond what they might have done without our support.

What We Fund  Signature Employment Grants are awarded nationally to fund new pilot initiatives, demonstration projects, or social ventures that lead to the generation of new ideas to solve the high unemployment and underemployment of individuals with disabilities. Preference is given for interventions that overcome specific employment barriers related to long-term dependence on public assistance or advance competitive employment in a cost-effective manner.

Continue Reading