scholarly journals Pre-existing Inequality II: Social Workers Assess Impact of COVID-19 on Medicare Home Health Beneficiaries

2021 ◽  
pp. 108482232110204
Author(s):  
William Cabin
Keyword(s):  
Mental Health ◽  
New York ◽  
Home Care ◽  
Social Workers ◽  
Psychosocial Interventions ◽  
Home Health ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Nurses Perceptions ◽  
The Impact

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicated there were no studies on the impact of COVID-19 on Medicare home health beneficiaries. In a previous issue of this journal, the author addressed the literature gap by presenting a study on home care nurses’ perceptions of the impact of COVID-19 on Medicare home health beneficiaries. The current study is a companion qualitative study to the nurses’ study. It is based on interviews of a convenience sample of 52 home care social workers from 11 different home health agencies in New York City between April 1 and September 30, 2020. Seven major themes emerged, 6 of which were identical to the themes identified by the nurses. The only new theme was limits on the ability to provide psychosocial interventions had more severe consequences. The 7 themes were: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; there was limited staff and equipment to care for patients; and limits on the ability to provide psychosocial interventions had more severe consequences.

scholarly journals Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries

2021 ◽  
Vol 33 (2) ◽  
pp. 130-136
Author(s):  
William Cabin
Keyword(s):  
Mental Health ◽  
New York ◽  
Home Care ◽  
Population Based ◽  
Home Health ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Medicare Population ◽  
Home Health Agencies ◽  
The Impact

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.

scholarly journals HOME CARE SOCIAL WORKERS CLAIM MEDICARE IGNORES PATIENT NEEDS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S325-S325
Author(s):  
William D Cabin
Keyword(s):  
New York ◽  
Home Care ◽  
Social Workers ◽  
Home Health ◽  
Additional Patient ◽  
Convenience Sample ◽  
Related Services ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Improve Health

Abstract There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 29 home care social workers between January 2013 and May 2014 in the New York City metropolitan area. Results indicate social workers believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs. Policymakers are urged to consider adding coverage of SDOH to Medicare home health primarily through expanded social work coverage.

Painful Places: Medicare Fails Homebound Patients With Substance Abuse Disorders

2021 ◽  
pp. 406-419
Keyword(s):  
Substance Use ◽  
Home Care ◽  
Social Workers ◽  
The Elderly ◽  
The United States ◽  
Home Health ◽  
Extensive Literature ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Substance Use And Abuse

There is extensive literature on the significance of substance use, misuse, and abuse among the elderly in the United States. A literature review indicates a paucity of information on the nature, significance, or impacts of the lack of substance use and abuse coverage in Medicare home health. This article presents background on the topic and an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 48 home care social workers between January 2013 and May 2015 in the New York City metropolitan area. Results indicate social workers believe substance use and abuse occurs frequently among Medicare home health patients; substance use and abuse is not assessed and treated professionally in Medicare home health; the lack of coverage in Medicare home health results in exacerbation of existing patient physical and mental health conditions, which, in turn, worsen substance use and abuse conditions; the homebound requirement and lack of coverage of transportation and personal care assistants limits home care patients ability to obtain outpatient substance use and abuse treatment; and lack of home-based assessment and treatment contributes to increased home care readmissions, re-hospitalizations, and increased caregiver burden.

The impact of COVID-19 quarantine measures on the mental health of families

2021 ◽  
pp. 146801732110117
Author(s):  
Fakir Al Gharaibeh ◽  
Laura Gibson
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Digital Media ◽  
Mental Health Problems ◽  
Eating Habits ◽  
Strong Shock ◽  
Psychosocial Interventions ◽  
Snowball Sampling ◽  
Long Term Effects ◽  
The Impact

Summary COVID-19 is shaping all aspects of life throughout the world. The unexpected number of people who have been infected with and died from coronavirus disease (COVID-19) is evidence that the pandemic has affected families and societies. The strong shock wave that has resulted in the international response has focused more on medical rather than psychosocial interventions. Little has been written or studied about the impact of COVID-19 on families. This article explores the impact of the COVID-19 quarantine on the mental health of families. We conducted 20 in-depth interviews with Jordanian families through snowball sampling. Findings The results show that 20 interviewees described varied and new experiences. Many of the families we interviewed displayed symptoms of mental health problems, including disrupted sleep patterns, changes in eating habits, excessive digital media use, anxiety, depression, excessive smoking, stomach aches, bedwetting among children, and persistent headaches. The study also demonstrated the psychological stress partners felt during the lockdown due to their worries about job security. They also communicated their hope that renewed family commitments might bring more stability to their relationships. During the lockdown, family members spent more time together, and it became harder to conceal any issues from each other. Applications The findings of this research demonstrate a critical need for social workers, and it is hoped that future legislation will include a role for social workers in various fields of crisis. Moreover, social workers should encourage families to ask for intervention to overcome the long-term effects that may result from COVID-19.

Lost in Translation: The Jimmo Case as Policy Implementation Failure

2020 ◽  
pp. 108482232095813
Author(s):  
William Cabin
Keyword(s):  
New York ◽  
New York City ◽  
Home Health ◽  
Medicare Beneficiaries ◽  
Convenience Sample ◽  
Education Campaign ◽  
Adverse Impacts ◽  
Implementation Failure ◽  
The Impact ◽  
Lost In Translation

The Jimmo case involved a 2011 lawsuit against the Centers for Medicare and Medicaid Services (CMS) alleging they illegally used an improvement standard instead of a need standard to make coverage decisions for Medicare home health and other Medicare beneficiaries. In 2013 CMS and the plaintiffs reached a settlement with CMS agreeing to replace the improvement standard with a need standard and conduct an education campaign to ensure its proper implementation. A literature review indicates no studies on the nature, significance, or impacts of the Jimmo case in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 28 home care nurses between January 2019 and May 2019 in the New York City metropolitan area. Results indicate nurses believe they had little to no knowledge of the Jimmo case; there was limited communication about the case from their agencies; they lacked guidance on the implications of the case on intake and eligibility decisions; they received no guidance on the impact of the case on documentation; and that their lack of knowledge and guidance had adverse impacts on patients.

Home Care Nurses Claim Medicare Ignores Social Determinants of Health

2019 ◽  
Vol 31 (4) ◽  
pp. 224-230 ◽  
Author(s):  
William Cabin
Keyword(s):  
New York ◽  
Home Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Home Health ◽  
Determinants Of Health ◽  
Additional Patient ◽  
Convenience Sample ◽  
Related Services ◽  
Home Care Nurses

There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded the ability of Medicare Advantage plans to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate that nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs.

scholarly journals HOME CARE NURSES CLAIM MEDICARE IGNORES SOCIAL DETERMINANTS OF HEALTH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S154-S154
Author(s):  
William D Cabin
Keyword(s):  
New York ◽  
Home Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Home Health ◽  
Determinants Of Health ◽  
Additional Patient ◽  
Convenience Sample ◽  
Related Services ◽  
Home Care Nurses

Abstract There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs.

Social Workers Assert Medicare Home Care Ignores Social Determinants of Health

2020 ◽  
Vol 32 (4) ◽  
pp. 199-205
Author(s):  
William Cabin
Keyword(s):  
Social Work ◽  
Home Care ◽  
Social Determinants Of Health ◽  
Social Workers ◽  
Social Determinants ◽  
Home Health ◽  
Determinants Of Health ◽  
Additional Patient ◽  
Convenience Sample ◽  
Related Services

There is significant literature on the importance of addressing social determinants of health (SDOH) to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 29 home care social workers between January 2013 and May 2014 in the New York City metropolitan area. Results indicate social workers believe the lack of SDOH coverage, including social work, in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and rehospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs. Policymakers are urged to consider adding coverage of social work and SDOH to Medicare home health.

scholarly journals Queensland Family Cohort: a study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044463
Author(s):  
Danielle Borg ◽  
Kym Rae ◽  
Corrine Fiveash ◽  
Johanna Schagen ◽  
Janelle James-McAlpine ◽  
...  
Keyword(s):  
Mental Health ◽  
Family Environment ◽  
Biological Samples ◽  
Local Governments ◽  
Financial Stability ◽  
Federal State ◽  
Physical And Mental Health ◽  
Future Health ◽  
The Impact

IntroductionThe perinatal–postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice.Methods and analysisThe Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease.Ethics and disseminationEthical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.

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