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Center for Personal Assistance Services Bulletin

January 2010 - Volume 7, Issue 1

In this issue:

The Center for Personal Assistance Services provides research, training, dissemination and technical assistance on issues of personal assistance services (PAS) in the United States. Personal assistance services (PAS) refer to help provided to people with disabilities to assist them with tasks essential for daily living. These tasks include bathing, dressing, getting around, toileting, eating, shopping, remembering things, and other activities. PAS, along with assistive technology such as wheelchairs, text readers, and hearing aides, help people with disabilities to participate in activities at home, at work, and in the community.

The purpose of this newsletter is to provide the latest news on issues relating to formal and informal PAS, home & community-based services, the PAS workforce, and workplace PAS within and outside of the Center.

Further detail about the Center staff and advisors can be found at

Research Articles and Reports

New Article Highlights The Substantial Savings That Can Be Made In Long-Term Care By Redistributing Spending Across Care Settings

This PAS Center article published in Health Affairs by H. Stephen Kaye, Charlene Harrington and Mitch LaPlante looks at long-term care costs amongst the 10.9 million community residents and the 1.8 millions nursing home residents. The authors found that per person expenditures are five times as high, and national expenditures three times as high, for nursing home residents compared to community residents, suggesting that a redistribution of spending across care settings might produce substantial savings or permit service expansions.

For more information go to:

New Article Looks At Inefficiencies In The Medicare And Medicaid Health Programs

In this PAS Center article published in Health Affairs, Terence Ng, Charlene Harrington and Martin Kitchener examine the two publicly funded health care programs, Medicare and Medicaid. The authors identified gaps and overlaps in the services provided, which in turn led to inefficiencies and confusion amongst the program recipients. The authors conclude that these systems of long-term care are in much need of structural reform.

For more information go to:

New Article Presents A Summary Of The Main Trends To Emerge From Three Main HCBS Programs

Developing home and community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007.

This Center article by Terence Ng, Charlene Harrington and Molly O'Malley presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid Home and Community-Based Service programs.

For more information go to:

Article Finds Improved Systems Of Care For Children With Special Health Care Needs (CSHCN) May Have The Potential To Optimize Work Productivity For Families

Parents of CSHCN are at risk of work loss as a result of the complex health needs of their children. A new article by Megumi Okumura, Jeanne Van Cleave, Sangeeth Gnanasekaran and Amy Houtrow of the PAS Center looks at determining how child- and family-level factors and the medical home are associated with work loss for these families. The results of these studies showed that approximately 24% of families with CSHCN have experienced work loss to meet the medical needs of their child.

For more information go to:

New Paper Details Requirements And Process For Obtaining Continuing And In-Service Education For CNAs And HHAs In California

This PAS Center paper by Susan Chapman and Debra Bakerjian was commissioned by the SCAN Foundation for the purpose of describing the requirements for and process of obtaining continuing and in-service education for CNAs and HHAs in California. The goal is to address how well current continuing education requirements address the needs of the geriatric population and to make recommendations about potential policy changes.

For more information go to:

New Study Examines Cost Of Workplace Accommodations For Individuals With Disabilities

In this study from the PAS Center, Tatiana Solovieva, Richard Walls, Deborah Hendricks & Denetta Dowler compare the expense associated with use of personal assistance services (PAS) for individuals with disabilities to the expense incurred by individuals with disabilities who did not use PAS. The intent of this investigation was to assess the disability accommodation costs and benefits of PAS and non-PAS cases.

For more information go to:

New Report Highlights Latest Data On Medicaid Home And Community-Based Service Programs

Developing home and community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007.

This new report from the Kaiser Commission on Medicaid and the Uninsured, presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid Home and Community-Based Service programs: optional 1915 (the letter "c") HCBS waivers; the mandatory home health benefit; and the optional state plan personal care services benefit.

For more information go to:

The Centers For Medicare & Medicaid Services In Final Stages Of Developing A Checklist Called "Planning For Your Discharge."

The checklist re-emphasizes the importance of talking to healthcare providers about where one is to go following care in a particular healthcare setting, as well as the need to consider how, and by whom, care will be provided after such transitions. In conjunction with the discharge planning rights outlined in the article, it gives beneficiaries and their advocates more tools to use in assuring that beneficiaries receive the healthcare services they need as they move from care setting to care setting.

For more information go to:

Data Released On Crimes Against People With Disabilities

This study from the Bureau of Justice Statistics presents the first findings about nonfatal violent and property crime experienced by persons with disabilities, based on the National Crime Victimization Survey. The report includes data on nonfatal violent victimization (rape/sexual assault, robbery, aggravated and simple assault) and property crime (burglary, motor vehicle theft, theft) against persons with disabilities in 2007. It compares the victimization experience of persons with and without disabilities, using population estimates based on the Census Bureau's American Community Survey.

For more information go to:

The National Center On Caregiving At Family Caregiver Alliance Recently Released "Making The Case: Saving Your State's Caregiver Support Programs"

From our friends at the Family Caregiver Alliance. For over a year, states have been struggling with one of the deepest recessions on record. One casualty of this economic downturn is caregiver support programs. Across the country, budgets for publicly funded caregiver support programs are among those not only reduced, but threatened with further cuts or elimination as the economy promises to get worse. Now with the new year upon us, most states are starting the budget process for the next fiscal year - governors are proposing budgets and legislators are trying to figure out how to balance their budgets with a mixture of spending cuts and new taxes.

For more information go to:

Union-Management Partnership Benefits Nursing Home Consumers and Staff

From our friends at PHInational.org. A recent study on whether - and how - a partnership between a New York City nursing home union and 40 homes helped to facilitate "person-centered care" (PCC) found that the partnership led to improvements for both nursing home consumers and staff.

For more information go to:


PAS Center Mourns the Passing of Advisory Committee Member Judi Chamberlin

Judi Chamberlin who passed away peacefully on January 16th, will be greatly missed by the PAS Center.

For over 40 years, Judi Chamberlin had been an activist in the survivor/consumer/ex-patient movement. Amongst Judi's many achievements was helping found the Ruby Rogers Advocacy and Drop-In Center, which is run by and for people who have received psychiatric services.

Most recently Judi was the co-founder and the Director of Education and Training at the National Empowerment Center, in Lawrence, MA as well as a board member of the National Association for Rights Protection and Advocacy, the American Association of People with Disabilities, the Center for Public Representation, and Mental Disability Rights International. She was Director of Education at the National Empowerment Center, a federally funded technical assistance center which serves the consumer/survivor/ex-patient movement.

For more information go to:

Dr. H. Stephen Kaye Participates In Briefing On Advancing Long-Term Services & Supports

January 5th, 2010. Dr. H. Stephen Kaye participated in the briefing on advancing long-term services & supports, sponsored by the journal of Health Affairs. Dr. Kaye, Adjunct Professor, Institute for Health and Aging, University of California San Francisco and Center for PAS researcher, was joined by key lawmakers and leading experts in aging and health policy to talk about the policies and new approaches needed to address the challenges of long-term care. This briefing was televised and archived on CSPAN.

For more information go to:

PAS Center Presents Webinar On Medicare And Medicaid In Long-Term Care

Please join us for a webinar hosted by the Center for Personal Assistance Services on Wednesday, February 10th, 2010. In this webinar, Terence Ng will talk about, "An Analysis Of Medicare And Medicaid In Long-Term Care And Suggestions Of Reform". Terence Ng will explore the patterns in services and spending under long-term care programs and examine the rise in home and community-based services, the existence of waivers from federal and state coverage requirements, and the changing population groups who use long-term care services.

For more information and to view an archive of the webinar go to:

Congress Acknowledges Nation's Caregiving Challenge

In a move that does not create binding law but does reflect the growing significance of eldercare as a rising political issue, Congress has unanimously approved a resolution recognizing the need for affordable, quality caregiving in America.

For more information go to:

Judge Halts California Home Care Cuts

From our friends at PHI National. A federal judge stopped the state from sending notices to 130,000 elderly and disabled Californians to inform them that their home care supportive services would be reduced - or eliminated entirely - on November 1.

A temporary restraining order - granted the day before the letters were to be dropped in the mail - prohibits the state from sending the notices until a court decides on October 19 whether it should issue a longer preliminary injunction.

The ruling is a win for advocates and unions that filed a federal class-action lawsuit on behalf of California's home care supportive clients.

For more information go to:

Winners Announced In The 2009 Rosalinde Gilbert Innovations In Alzheimer's Disease Caregiving Legacy Awards

Family Caregiver Alliance and The Rosalinde and Arthur Gilbert Foundation are pleased to announce the recipients of the 2009 Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards.

Awards of $20,000 each will be presented to three organizations to recognize extraordinary programs that address the needs of Alzheimer's caregivers. The winning programs qualified in one of three categories: creative expression; diverse/multicultural communities; and policy and advocacy. The programs will be honored at the American Society on Aging/National Council on Aging (ASA/NCOA) Conference in Chicago, March 2010.

For more information go to:

Companionship Exemption Doesn't Apply to Workers in Community-Based Settings, Court Confirms

From our friends at PHInational.org. Supportive services workers who care for people with Medicaid in community-based residential care settings are not exempt from federal minimum wage and overtime requirements, confirmed a U.S. district court in Western Missouri.

For more information go to:

Policy and Legislation

Side By Side Comparison Of House And Senate Health Care Reform Bills

As the House and Senate move toward merging the two health care reform bills, the SCAN Foundation have highlighted several provisions that seek to improve the access, delivery, and quality of care for seniors across the health and long-term care continuum. This comparison document will be updated as new information emerges.

For more information go to:

Long-Term Care Stirs Health Care Debate

From Robert Pear of the New York Times. Embedded in sweeping health legislation passed by the House and being debated on the Senate floor is a major new federal insurance program for long-term care.

The bill would provide cash benefits if a person had a substantial cognitive impairment or was unable to perform two or three "activities of daily living," like eating, bathing or dressing.

For more information go to:

On the Center for PAS Website

The following are new resources available on the Center for PAS website (PAS Center):

New PAS Center Webinar, "The Long And Winding Road To Reform Of Long-Term Services And Supports"

On 4th November Dr. Joshua M. Wiener presented a webcast titled, "The long and winding road to reform of long-term services and supports" to an audience of over 100. In this webinar Dr. Wiener examined the provisions on long-term services and supports in the health reform bills and discussed issues related to more comprehensive reform. The webinar has been archived on the PAS Center website along with the full transcript and a PowerPoint presentation.

For more information go to:

New Caregiver Resources Available

A new caregiver resource has been added to the PAS Center website. The resource provides lists of helpful training tools and programs for caregivers. These listings are divided into 4 areas, family, professional, consumer-directed caregiving resources, and self-care resources for people with disabilities. Various information is included with each resource, such as cost, where available, evidence-based results, and the content of the materials. Many of these products are free and available on the web; others may have costs associated with them.

For more information go to:

Updated Policy/Legislation Page On PASCenter.org

Updated audio and text comments on the status of policies and legislation by Mike Oxford, Executive Director of the Topeka Independent Living Resource Center and former President of the Governing Board of the National Council on Independent.

The following have recently been added to the policy/legislation page:

  • Caregivers and Veterans Omnibus Health Services Act of 2009 (S. 1963)
  • National Defense Authorization Act for Fiscal Year 2010 (H.R.2647)
  • Alzheimer's Treatment and Caregiver Support Act (H.R. 4123)

For more information go to:

New US Nursing Home Report Released

A new report has been completed by the PAS Center, showing trends in U.S. nursing homes by state for 2003 through 2008. The data are from the federal On-Line Survey and Certification System (OSCAR) reports that are completed at the time of the annual nursing home surveys by state Licensing and Certification programs for the U.S. Centers for Medicare and Medicaid Services.

For more information go to:

Selected Conferences During January, February and March 2010

For more detail about these conferences, go to:


January 03 - January 06, 2010
Mission:Possible. 2010 SILC Congress
Hosted By: SILC
Location: Las Vega, NV.

January 19, 2010
Service Animals: Unraveling the differences and best practices
Hosted By: National Network of DBTAC-Regional ADA Centers
Location: Webcast, 1 pm central

January 20, 2010
Community Supports For Transition
Hosted By: HRTW
Location: Webinar, 3.00-4.00 pm ET

January 21, 2010
Overview of Benefits Programs for Veterans with Disabilities
Hosted By: RRTC
Location: Webcast, 2 pm eastern

January 27 - January 30, 2010
ATIA 2010 Orlando
Hosted By: Assistive Technology Industry Association
Location: Orlando, FL.

January 27, 2010
Women With Disabilities: Effects Of Gender, Race And Disability On Employment
Hosted By: DBTAC NE ADA Center
Location: Webinar, 1:00 - 2:30 pm EST

January 28 - January 29, 2010
4th Annual Leadership Forum on Accessibility
Hosted By: Assistive Technology Industry Association
Location: Orlando, Florida


February 08 - February 09, 2010
National Health Policy Conference
Hosted By: AcademyHealth and Health Affairs
Location: Washington, D.C.

February 09, 2010
Current Events in Accommodation
Hosted By: JAN
Location: Webcast, 2 pm eastern

February 16, 2010
Aging Workers with Disabilities: Implications for Employers
Hosted By: National Network of DBTAC-Regional ADA Centers
Location: Webcast, 1 pm central

February 17, 2010
Principles Of Medical Ethics In Health Care Provision
Hosted By: AAIDD and others
Location: Webinar, 1:00 - 2:00 pm ET

February 17 - February 20, 2010
LDA 47th Annual International Conference
Hosted By: Learning Disabilities Association of America
Location: Baltimore, Maryland

February 24, 2010
Can't Ask, Afraid To Tell: Disability Inquiries And Disclosure In The Workforce Development System
Hosted By: Dynamic Works Institute
Location: Webinar, 2:00 - 3:30 PM ET


March 09, 2010
Accommodation Ideas for Employees with Traumatic Brain Injuries
Hosted By: JAN
Location: Webcast, 2 pm eastern

March 11 - March 15, 2010
National Conference for Counselors Working with People who are Deaf or Hard of Hearing
Hosted By: PEPNet
Location: Olathe, KS

March 15 - March 19, 2010
2010, Aging in America Conference
Hosted By: Council on Aging and the American Society on Aging
Location: Chicago, IL.

March 16, 2010
Conducting Effective Accessibility Surveys Part I
Hosted By: National Network of DBTAC-Regional ADA Centers
Location: Webcast, 1 pm central

March 18, 2010
South Carolina Assistive Technology Expo 2010
Hosted By: South Carolina Assistive Technology Program
Location: Spartanburg, SC

March 22 - March 27, 2010
The 25th Annual International Technology & Persons with Disabilities Conference
Hosted By: California State University
Location: San Diego, CA

This document was developed by the Center for Personal Assistance Services, funded by the National Institute on Disability and Rehabilitation Research (NIDDR) of the US Department of Education, grant #H133BO31102. The opinions contained in this publication are those of the grantee/contractor and do not necessarily reflect those of the US Department of Education. Please credit the source and support of federal funds.

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