California will be the first state in the country to receive new Medicaid dollars under the Affordable Care Act to provide community-based personal attendant services and supports to beneficiaries as an alternative to nursing facility and other institutional services, according to an announcement made Tuesday by the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner.
“Thanks to the Affordable Care Act, seniors and persons with disabilities in California will have better options that will help them get the care they need in their own homes and communities, rather than institutions like a nursing home,” said Acting Administrator Tavenner.
The “Community First Choice Option” was established under the Affordable Care Act and is a new State plan option under Medicaid.
It allows states to provide home and community-based attendant services to certain Medicaid enrollees who require an institutional level of care.
States choosing to participate in this option receive a 6 percentage point increase in their federal medical assistance percentage for expenditures related to this option.
California will receive an estimated $258 million for the first year of implementation, and $315 million for the second year.
The increased funding is available as long as the option is included as a benefit in the State’s Medicaid program, known as Medi-Cal.
Community First Choice ensures that each beneficiary has a person-centered plan that reflects the individual’s choices and preferences about how services and supports are provided to achieve or maintain independence.
For more information on this Community First Choice option, visit www.hhs.gov/news/press/2012pres/04/20120426a.html .
NORTHERN CALIFORNIA – The Northern California Network of Adventist Health has established the Adventist Heart Institute, a network of physicians that incorporates specialists from the regions served by four Adventist Health hospitals – Frank R. Howard Memorial Hospital, St. Helena Hospital Napa Valley, St. Helena Hospital Clear Lake and Ukiah Valley Medical Center.
“We’re consistently working to improve outstanding care for the communities we serve,” said Northern California Network President Terry Newmyer.
“The Adventist Heart Institute provides access to a full spectrum of cardiac and vascular services to patients from Napa, Lake, Mendocino, Humboldt, Solano and Sonoma counties, and beyond,” he said.
Physicians of the Adventist Heart Institute have access to modern operating suites, the latest technology and one of the region’s most highly respected cath labs.
This will deliver to each patient comprehensive coordinated cardiac care, including diagnostics, intervention, surgery, rehabilitation and follow up in their own community.
To learn more about Adventist Heart Institute visit www.AdventistHeart.org .
For referrals please call 888-529-9018.
Patients with psoriasis are at high risk of new-onset diabetes mellitus, according to research presented at ESC Congress 2012.
The findings were presented at the press conference by Dr Ole Ahlehoff from Copenhagen University Hospital, Gentofte, Denmark and at the scientific session by Usman KHALID.
Psoriasis is a common chronic inflammatory disease that affects approximately 125 million people worldwide.
A new study of the entire Danish population confirms previous reports of increased risk of diabetes mellitus in patients with psoriasis and shows that risk increases with severity of psoriasis.
Psoriasis, atherosclerosis and early steps in the development of diabetes mellitus are characterised by chronic inflammation, i.e. a chronic state of alert.
“This chronic state of alert may explain the increased risk of cardiovascular diseases and diabetes mellitus seen in these patients,” said Dr Ahlehoff.
The study comprised more than 4 million people, including approximately 50,000 patients with psoriasis, who were followed for 13 years.
The overall rates of new-onset diabetes mellitus per 1,000 observational years were 3.67 in the reference population who did not have psoriasis, 6.93for patients with mild psoriasis and 9.65 for patients with severe psoriasis.
The risk of new-onset diabetes mellitus was increased in all patients with psoriasis compared to people who did not have psoriasis.
Risk increased with the severity of psoriasis. Compared to people without psoriasis, patients with mild psoriasis were 1.5 times more likely to acquire new-onset diabetes mellitus and patients with severe psoriasis were more than twice as likely.
The results remained significant after adjustment for potential confounders, including age, sex, socioeconomic status, use of medication and comorbidity.
Dr Ahlehoff said: “The major conclusion of the study was that psoriasis was associated with increased risk of diabetes mellitus and the risk was highest in patients with severe psoriasis.”
“The results add to current evidence of increased risk of cardiovascular and metabolic disease in patients with psoriasis,” he added. “More needs to be done to increase awareness in this large group of patients on what steps they can take to decrease their risk factors for cardiovascular disease.”
Dr Ahlehoff continued: “Studies are urgently required to examine the impact of aggressive psoriasis treatment on cardiometabolic outcomes.”
DURHAM, N.C. – The persistent, dependent use of marijuana before age 18 has been shown to cause lasting harm to a person’s intelligence, attention and memory, according to an international research team.
Among a long-range study cohort of more than 1,000 New Zealanders, individuals who started using cannabis in adolescence and used it for years afterward showed an average decline in IQ of 8 points when their age 13 and age 38 IQ tests were compared.
Quitting pot did not appear to reverse the loss either, said lead researcher Madeline Meier, a post-doctoral researcher at Duke University.
The results appear online Aug. 27 in PNAS.
The key variable in this is the age of onset for marijuana use and the brain’s development, Meier said.
Study subjects who didn’t take up pot until they were adults with fully-formed brains did not show similar mental declines.
Before age 18, however, the brain is still being organized and remodeled to become more efficient, she said, and may be more vulnerable to damage from drugs.
“Marijuana is not harmless, particularly for adolescents,” said Meier, who produced this finding from the long term Dunedin Multidisciplinary Health and Development Study.
The study has followed a group of 1,037 children born in 1972-73 in Dunedin, New Zealand from birth to age 38 and is led by Terrie Moffitt and Avshalom Caspi, psychologists who hold dual appointments at Duke and the Institute of Psychiatry at King’s College London.
About 5 percent of the study group were considered marijuana-dependent, or were using more than once a week before age 18. A dependent user is one who keeps using despite significant health, social or family problems.
At age 38, all of the study participants were given a battery of psychological tests to assess memory, processing speed, reasoning and visual processing.
The people who used pot persistently as teens scored significantly worse on most of the tests. Friends and relatives routinely interviewed as part of the study were more likely to report that the persistent cannabis users had attention and memory problems such as losing focus and forgetting to do tasks.
The decline in IQ among persistent cannabis users could not be explained by alcohol or other drug use or by having less education, Moffitt said.
While 8 IQ points may not sound like a lot on a scale where 100 is the mean, a loss from an IQ of 100 to 92 represents a drop from being in the 50th percentile to being in the 29th, Meier said. Higher IQ correlates with higher education and income, better health and a longer life, she said.
“Somebody who loses 8 IQ points as an adolescent may be disadvantaged compared to their same-age peers for years to come,” Meier said.
Laurence Steinberg, a Temple University psychologist who was not involved in the research, said this study is among the first to distinguish between cognitive problems the person might have had before taking up marijuana, and those that were apparently caused by the drug.
This is consistent with what has been found in animal studies, Steinberg added, but it has been difficult to measure in humans.
Animal studies involving nicotine, alcohol and cocaine have shown that chronic exposures before the brain is fully developed can lead to more dependence and long-term changes in the brain.
“This study points to adolescence as a time of heightened vulnerability,” Steinberg said. “The findings are pretty clear that it is not simply chronic use that causes deficits, but chronic use with adolescent onset.”
What isn’t possible to know from this study is what a safer age for persistent use might be, or what dosage level causes the damage, Meier said.
After many years of decline among US teens, daily marijuana use has been seen to increase slightly in the last few years, she added.
Last year, for the first time, US teens were more likely to be smoking pot than tobacco.
“The simple message is that substance use is not healthy for kids,” Avshalom Caspi said via email from London. “That’s true for tobacco, alcohol and apparently for cannabis.”