Legal Aspects of Elder Care

Planning, providing, and evaluating geriatric care raises a wide variety of legal issues for health and human services practitioners and those who advocate for, develop, and enforce the public policies within which services are delivered. This text offers excerpts from selected statutes and regulations, judicial opinions, and the legal and health care journal literature, as well as commentary on these materials, discussion questions and hypothetical cases, and suggestions of other information sources for the teacher and student. Ideal for courses or programs in health administration, nursing, law, ethics, social work, or gerontology, this text will stimulate class reflection and interaction regarding the meaning and relevance of key legal concepts for the present or future health care professional. For the healthcare professional, it will inform and sensitize those who will deal with older persons about some of the current and potentially emerging legal issues they may encounter in providing services to older patients/clients, and to help them respond intelligently to legal issues and the responsibilities they impose.

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The Politics of Medicaid

In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people.

Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.

In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people.

Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.


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Reform Medicaid First: Laying the Foundation for National Health Care Reform

As Congress contemplates major revisions to America’s health care system, two leading health economists warn that significant differences among state Medicaid programs will hinder national health care reform. Thomas W. Grannemann and Mark V. Pauly argue that Medicaid will need to be reformed as an early step in any serious health care reform effort. While states such as Mississippi and Nevada spend as little as ,000 per poor person annually, New York and Alaska annually spend more than ,000 per Medicaid patient. Large differences remain even after correcting for cost-of-living and medical-price differences. This imbalance among states creates an uneven and unstable foundation for any national program to address the needs of uninsured Americans. The authors offer principles for reform designed to encourage equity, efficiency, and accountability in all publicly funded health care programs. They suggest changes in provider payment methods and federal/state financing designed to promote interstate equity, equality of payment across settings, claims-based accountability, provider network control, and value-based cost containment. Such reform will require upfront changes in Medicaid to improve access to high-value health care for low-income persons (particularly those in low-Medicaid-benefit states) and to help slow the rate of growth in medical costs. These changes will level the playing field for state programs and provide a crucial foundation for further national reform.

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Elder Law: Cases and Materials

The Fourth Edition of Elder Law integrates new developments in law and policy into the familiar framework of past editions. A mix of the specific and the general, the book examines the response of our society to an aging population, the legal rights of the elderly, and the legal, economic, and health challenges of the elderly. The authors use carefully edited classic and new cases, excerpts from the experts, and descriptive commentary to challenge and instruct students. Questions and problems provide the instructor an opportunity to query students and expand their understanding of the material.

The perspectives of legal practice and legislative development receive due attention in chapters that cover income and employment, housing and supportive services, nursing home quality and costs, substitute health and final decision making, and elders and crime. The broad scope of the book builds on foundational legal education in property rights, civil and human rights, and government action, while permitting the teacher the opportunity to supplement or expand upon the material.

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The Politics of Medicaid

In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people.

Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.

(4/15/10)

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