Asset Dumping Rare
Most nursing home residents don’t sell off assets at below market value to qualify for Medicaid long-term care coverage, says a new report from the Government Accountability Office. Concerns that the practice might be widespread prompted Congress in 2006 to expand from three years to five years the “look back” period in which seniors who transfer their assets at less-than-market value are ineligible for Medicaid. Previously, states had been able to apply for federal waivers that would allow them to “look back” for more than three years. The report, which examined 540 nursing home applications in three states, found that the practice is “generally limited and often based on anecdote.” More than 90 percent of seniors entering nursing homes with Medicaid coverage had assets of $30,000 or less, not including their homes; 85 percent had annual incomes of $20,000 or less. In addition, the report found that Medicaid beneficiaries in nursing homes had a median income of about half that of non-Medicaid nursing home residents, and were less likely to report transferring cash than their non-Medicaid counterparts. “This report confirms that the Medicaid long-term care program is not rife with cheats and scam artists,” Representative John Dingell said in a statement. A congressional aide, however, suggested that the small sample size doesn’t mean that there aren’t “rich people who pretend to be poor so they can qualify for welfare.”
HIV Testing Requirements
Illinois Representative LaShawn Ford has introduced legislation (HB 980) that would drop the requirement for patients to give written consent to an HIV test. Currently, a patient cannot be tested for HIV without his or her knowledge, under the state’s 20-year-old AIDS Confidentiality Act. Part of the impetus for the bill is to make HIV testing more routine. Making the test a part of standard medical care would help diagnose the virus for those who are unaware of their infections, backers say. “You have to know you have it, and the only way to do that is to get tested,” Representative Mary Flowers, a co-sponsor of the bill, told the Chicago Tribune. Opponents argue that involuntary testing will deny individual choice and lessen the likelihood that patients will be educated about HIV prevention. “Because HIV remains a deeply stigmatized disease with life-long medical, social and emotional consequences, all patients must be fully informed and actively involved in the decision to accept HIV testing,” said a statement from the AIDS Foundation of Chicago.
Infectious Disease Control
A bill (HB 3078) currently being considered by the Illinois Legislature would require hospitals to test for methicillin-resistant staphylococcus aureus, or MRSA, a drug-resistant bacterium that kills thousands of people in the United States every year. Hospitals would have to test patients that they consider to be “at-risk” for infection. MRSA infections can come from community settings such as gyms, but are most commonly transmitted at health-care facilities. Nearly 11,000 patients in Illinois were infected last year, representing a 54 percent rise over three years, according to the Illinois Hospital Association. To combat the spread, the bill would require that those who test positive be isolated, and hospitals would have to report infections annually to the Department of Public Health. A similar strategy is employed by the Department of Veterans Affairs at its hospitals; Minnesota, New York and Pennsylvania are considering similar legislation. Some critics worry that these efforts will detract from other patient safety efforts. Supporters counter that hospitals have not done enough on their own. “The hospitals have said they want to deal with this for at least 20 years, and the incidence of MRSA infections keeps rising at an alarming rate,” Senator Christine Radogno told the Chicago Tribune.
Oral Health
Preschoolers today are more likely to have cavities than children in the 1990s, according to a survey released May 1 by the Centers for Disease Control and Prevention. The report found that the rates of permanent tooth decay among certain children ages two to five rose from 24 percent in the period of 1988 to 1994, to 28 percent in 1999 to 2004. While the study did not officially examine causes for the increase in cavities, researchers pointed to a greater consumption of soda and sweetened fruit juice, along with a lower intake of milk and fluorinated water. But the report wasn’t all bad news. Dental health overall has been improving, and older children and adolescents were found to have fewer cavities and fewer adults had gum disease. In addition, the use of dental sealants—a plastic, protective coating applied to teeth to prevent tooth decay—increased from 22 percent to 30 percent among children ages six to 11; gum disease fell from 27 percent to 17 percent in seniors age 65 and older. Disparities, however, in access to oral health care persist. About 31 percent of Mexican-American children ages six to 11 had decay in their permanent teeth, compared to 19 percent of non-Hispanic white children. About 12 percent of children from families below the federal poverty line have untreated tooth decay, compared to 4 percent of children in families with higher incomes.
Drug Use and Depression
A new report from the Substance Abuse and Mental Health Services Administration has found that youth with depression are twice as likely to use drugs or drink for the first time than youth without depression. The report references teens aged 12 to 17 who have had a major depressive episode within the past year. Of those who had, 29 percent of them took their first drink, compared to 14.5 percent for those who had not had an episode. Similar rates were found for use of other drugs, such as marijuana and heroin. Approximately 9 percent of youth reported experiencing depression in the past year. Rates for girls were triple that of boys—13.5 percent vs. 4.5 percent. Overall rates were similar across racial/ethnic groups.
© Copyright 2007, State Health Notes
|
