Education

OP-ED: Home Health Services Under Medicare

Published

11 years ago

July 15, 2013

Medicare covers a variety of heath care services that you can receive in the comfort and privacy of your home.

These include intermittent skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy.

Such services used to be available only at a hospital or doctor’s office. But they’re just as effective, more convenient, and usually less expensive when you get them in your home.

To be eligible for home health benefits, you must be under a doctor’s care and receive your services under a plan of care established and reviewed regularly by a physician. He or she also needs to certify that you need one or more home health services.

In addition, you must be homebound and have a doctor’s certification to that effect. (Being homebound means leaving your home isn’t recommended because of your condition, or your condition keeps you from leaving without using a wheelchair or walker, or getting help from another person.)

Also, you must get your services from a home health agency that’s Medicare-approved.

If you meet these criteria, Medicare pays 100 percent for covered home health services for as long as you’re eligible and your doctor certifies that you need them.

For durable medical equipment (like a walker, wheelchair, or oxygen equipment), you pay 20 percent of the Medicare-approved amount, after you pay the Part B deductible ($147 in 2013).

Skilled nursing services are covered when they’re given on a part-time or intermittent basis. In order for Medicare to cover such care, it must be necessary and ordered by your doctor for your specific condition. Medicare does not cover full-time nursing care.

Skilled nursing services are given by either a registered nurse or a licensed practical nurse under an RN’s supervision.

Nurses provide direct care and teach you and your caregivers about your care. Examples of skilled nursing care include: giving IV drugs, shots, or tube feedings; changing dressings; and teaching about prescription drugs or diabetes care.

Any service that could be done safely by a non-medical person (or by yourself) without the supervision of a nurse, isn’t skilled nursing care.

Physical therapy, occupational therapy, and speech-language pathology services have to be specific, safe, and effective treatments for your condition.

Before your home health care begins, the home health agency should tell you how much of your bill Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare, and how much you’ll have to pay for them.

This should be explained by both talking with you and in writing. The agency should give you a notice called the Home Health Advance Beneficiary Notice before giving you services and supplies that Medicare doesn’t cover.

What isn’t covered? Some examples are 24-hour-a-day care at home; meals delivered to your home; homemaker services like shopping, cleaning, and laundry (when this is the only care you need, and when these services aren’t related to your plan of care);

Personal care given by home health aides like bathing, dressing, and using the bathroom (when this is the only care you need).

If your doctor decides you need home health care, you can choose from among the Medicare-certified agencies in your area. (However, Medicare Advantage plans may require that you get home health services only from agencies they contract with.)

One good way to look for a home health agency is by using Medicare’s “Home Health Compare” web tool, at www.medicare.gov/HHCompare.

This tool lets you compare home health agencies by the types of services they offer and the quality of care they provide.

For more details on Medicare’s home health benefit, please read our booklet, “Medicare and Home Health Caree,” on line at www.medicare.gov/publications/pubs/pdf/10969.pdf.

David Sayen is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories.

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California Black Media

State Ed Chief Tony Thurmond Pushes Bill to Train Educators

State Superintendent of Public Instruction (SSPI) Tony Thurmond is advocating for comprehensive training for teachers in reading and math, emphasizing the urgent need to improve student academic outcomes across California. On April 24, during testimony in the Senate Education Committee, Thurmond backed Senate Bill (SB)1115, which aims to provide evidence-backed educator training. The committee passed the bill with a 7-0 vote.

Published

2 mins ago

May 3, 2024

Oakland Post

California State Superintendent of Public Instruction Tony Thurmond.

By California Black Media

On April 24, during testimony in the Senate Education Committee, Thurmond backed Senate Bill (SB)1115, which aims to provide evidence-backed educator training. The committee passed the bill with a 7-0 vote.

Thurmond pointed out to the committee that existing funding for educator training in literacy and math only covers about one-third of California’s educator workforce. SB 1115, Thurmond said, would fund the remaining two-thirds.

“This is an issue of moral clarity,” according to Thurmond. “In the fifth-largest economy in the world, and in an age when we have access to substantial brain science about how students learn, it should be unacceptable to train only some educators in the best strategies to teach essential skills.”

SB 1115 incorporates multiple research-backed methods, including phonics, and it aligns with the California ELA/ELD Framework, which encourages biliteracy and multilingualism.

Thurmond emphasized the moral imperative behind the push for enhanced training by noting that 70% of incarcerated adults struggle with reading or are illiterate.

“Every child should feel supported as they learn to read and every teacher should feel confident in their ability to support students’ foundational literacy,” Thurmond said. “SB 1115 is about ensuring that all children have the opportunity to read by third grade, and that all children have a shot at the life-changing outcomes that come from early literacy.”

The next step for SB 1115 is a hearing in the Senate Appropriations Committee on May 6.

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Commentary

Opinion: Lessons for Current Student Protesters From a San Francisco State Strike Veteran

How the nation’s first College of Ethnic studies came about, bringing together Latino, African American and Asian American disciplines may offer some clues as to how to ease the current turmoil on American college campuses over the Israel-Hamas war. After the deadline passed to end the Columbia University encampment by 2 p.m. Monday, student protesters blockaded and occupied Hamilton Hall in a symbolic move early Tuesday morning. Protesters did the same in 1968.

Published

18 mins ago

May 3, 2024

Oakland Post

iStock Photo

By Emil Guillermo

After the deadline passed to end the Columbia University encampment by 2 p.m. Monday, student protesters blockaded and occupied Hamilton Hall in a symbolic move early Tuesday morning.

Protesters did the same in 1968.

That made me think of San Francisco State University, 1968.

The news was filled with call backs to practically every student protest in the past six decades as arrests mounted into hundreds on nearly two dozen campuses around the country.

In 1970, the protests at Kent State were over the Vietnam War. Ohio National Guardsmen came in, opened fire, and killed four students.

Less than two weeks later that year, civil rights activists outside a dormitory at Jackson State were confronted by armed police. Two African American students were killed, twelve injured.

But again, I didn’t hear anyone mention San Francisco State University, 1968.

That protest addressed all the issues of the day and more. The student strike at SFSU was against the Vietnam war.

That final goal was eventually achieved, but there was violence, sparked mostly by “outside agitators,” who were confronted by police.

“People used the term ‘off the pigs’ but it was more rally rhetoric than a call to action (to actually kill police),” said Daniel Phil Gonzales, who was one of the strikers in 1968.

Gonzales, known as the go-to resource among Filipino American scholars for decades, went on to teach at what was the positive outcome of the strike, San Francisco State University’s College of Ethnic Studies. It’s believed to be the first of its kind in the nation. Gonzales recently retired after more than 50 years as professor.

As for today’s protests, Gonzales is dismayed that the students have constantly dealt with charges of antisemitism.

“It stymies conversation and encourages further polarization and the possibility of violent confrontation,” he said. “You’re going to be labeled pro-Hamas or pro-terrorist.”

That’s happening now. But we forget we are dealing not with Hamas proxies. We are dealing with students.

Gonzales said that was a key lesson at SF State’s strike. The main coalition driving the strike was aided by self-policing from inside of the movement. “That’s very difficult to maintain. Once you start this kind of activity, you don’t know who’s going to join,” he said.

Gonzales believes that in the current situation, there is a patch of humanity, common ground, where one can be both pro-Palestine and pro-Israel. He said it’s made difficult if you stand against the belligerent policies of Benjamin Netanyahu. In that case, you’re likely to be labeled antisemitic.

Despite that, Gonzales is in solidarity with the protesters and the people of Gaza, generally. Not Hamas. And he sees how most of the young people protesting are in shock at what he called the “duration of the absolute inhumane kind of persecution and prosecution of the Palestinians carried out by the Israeli government.”

As a survivor of campus protest decades ago, Gonzales offered some advice to the student protesters of 2024.

“You have to have a definable goal, but right now the path to that goal is unclear,” he said.

About the Author

Emil Guillermo is a journalist and commentator. A veteran newsman in TV and print, he is a former host of NPR’s “All Things Considered.”

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Bay Area

Obituary: Former California Education Superintendent Delaine Eastin Passes at 76

Delaine Eastin, who served as a former state Assemblymember representing parts of Santa Clara and Alameda County — and the first woman elected as State Superintendent of Public Instruction — died at age 76 on April 23. Eastin passed away from complications caused by a stroke.

Published

34 mins ago

May 3, 2024

Oakland Post

Former California Education Superintendent Delaine Eastin.

By California Black Media

Eastin passed away from complications caused by a stroke.

Known for her power of persuasion, Eastin used her influence to be a champion for bipartisan issues that helped raise academic standards, lower class sizes, and emphasize the importance of conserving nature and the environment in schools.

Former Assembly Speaker Willie Brown and fellow legislative colleagues said that Eastin was in demand on the speech circuit while serving as a legislator.

“Few could engender the kind of emotion and passion she delivered in every speech,” Brown said.

State superintendent Tony Thurmond called Eastin a trailblazer who inspired fellow public servants.

“California lost an icon in our school system today. Delaine Eastin’s legacy as a trailblazer in public education will forever inspire us. Her unwavering dedication to California students — from championing Universal Preschool and the “A Garden in Every School” program to honoring our educators by establishing the California Teachers of the Year Awards — has left an indelible mark on our state’s educational landscape,” said Thurmond.

Thurmond honored Eastin’s legacy at the California Teacher of the Year Program, an honor that she established during her time as superintendent.