Aging and Disability Resource Center and MHDS Commission Home Modification Assistance Program Plan, December 2015

This report was prepared as a directive to Aging and Disability Resource Centers and The Mental Health and Disability Commission to jointly develop a plan for a home modification assistance program to provide grants and individual income tax credits to assist with expenses related to the making or permanent home modifications that permit individual with a disability to remain in the homes.

Financial Power of Attorney

A financial power of attorney (FPOA) is a document authorizing someone else (an agent) to manage your finances on your behalf if you (the principal) become incapacitated and are unable to make financial management decisions for yourself. If you become unable to decide for yourself and you have not prepared a financial power of attorney, a court proceeding will likely be required before a loved one will be able to assume authority over at least some of your financial affairs. Your FPOA can be drafted to go into effect as soon as you sign it or it can become effective at a later date or only in the case that a physician certifies that you have become incapacitated.

Healthcare Power of Attorney

A health care power of attorney (HC-POA) is a document authorizing an attorney-in-fact (your designated agent) to make health care decisions on your behalf if you (the principal) are unable, in the judgment of your attending physician, to make health care decisions. Health care is defined as any care, treatment, service or procedure required to maintain, diagnose or treat a physical or mental condition. Through your HC-POA, you may authorize someone else to consent, refuse or withdraw consent to health care on your behalf. The attorney-in-fact is permitted to make only health care-related decisions on your behalf. In exercising this authority, the attorney-in-fact must act consistently with your desires (as stated in the HC-POA document).

Involuntary Discharge from a Long-Term Facility

An involuntary discharge from a long-term care (LTC) facility occurs when the facility provides a 30-day written notice to a resident informing him/her of the need to move out of the facility. The notice must set out the reasons for the transfer or discharge as well as state the effective date, location of transfer or discharge, statement of appeal rights and the contact information (name, address and telephone number) for the Office of the State Long-Term Care Ombudsman.

Medicaid Home and Community Based Services Elderly Waiver Program

The Medicaid Home and Community Based Services (HCBS) Elderly Waiver program provides assistance to qualified individuals who are 65 or older and prefer to stay in their own home or another community setting when needing long-term health care services. The Elderly Waiver program provides services and support to older Iowans who are medically qualified for the level of care provided at a nursing facility but do not wish to live in a nursing home. The program allows older Iowans to age in environments that are familiar and comfortable, while saving money from expensive nursing home costs.

Volunteer Ombudsman Program

The Volunteer Ombudsman Program places volunteers in long-term care facilities across Iowa to assist the state’s team of Local Long- Term Care Ombudsmen carry out the duties of the Older Americans Act of 1965. The Office of the State Long-Term Care Ombudsman coordinates the Volunteer Ombudsman Program (VOP) to train and certify individuals who are interested in listening, empowering and serving as a voice for long-term care residents. Unlike facility volunteers, VOP volunteers do not assist residents with daily activities. Rather, they are responsible for making several unannounced visits to a specific facility each month to talk to residents and family members and identify concerns.

Long-Term Care Choices

Consumers today have many choices when it comes to considering long-term care – whether they wish to remain in their home or community or move into an assisted living program or nursing home. Choosing a long-term care option that best fits your individual situation can depend on the level of care you need, your location preferences, your lifestyle needs and your ability to pay. The best time to begin exploring your options is long before the need arises. That way, you can communicate your preferences to your loved ones and create a plan that meets your needs as well as your wishes.

Long-term Care Payment Options

As the population ages, many of us will be faced with the prospect of moving either ourselves or a loved one into a long-term care setting (nursing home, assisted living facility or elder group home). Whether the decision comes up suddenly following a hospitalization or gradually as care needs evolve, the question of how to pay for long-term care is certain to arise. Some people mistakenly believe that Medicare will pay for their long-term care stay, but while Medicare will pay for hospital costs and skilled nursing facility stays, it does not pay for long-term care. Rather, possible payment options for long-term care include private pay, Medicaid or long-term care insurance or veterans benefits.

Chaperones and proteases: cellular fold-controlling factors of proteins in neurodegenerative diseases and aging.

The formation of toxic protein aggregates is a common denominator to many neurodegenerative diseases and aging. Accumulation of toxic, possibly infectious protein aggregates induces a cascade of events, such as excessive inflammation, the production of reactive oxygen species, apoptosis and neuronal loss. A network of highly conserved molecular chaperones and of chaperone-related proteases controls the fold-quality of proteins in the cell. Most molecular chaperones can passively prevent protein aggregation by binding misfolding intermediates. Some molecular chaperones and chaperone-related proteases, such as the proteasome, can also hydrolyse ATP to forcefully convert stable harmful protein aggregates into harmless natively refoldable, or protease-degradable, polypeptides. Molecular chaperones and chaperone-related proteases thus control the delicate balance between natively folded functional proteins and aggregation-prone misfolded proteins, which may form during the lifetime and lead to cell death. Abundant data now point at the molecular chaperones and the proteases as major clearance mechanisms to remove toxic protein aggregates from cells, delaying the onset and the outcome of protein-misfolding diseases. Therapeutic approaches include treatments and drugs that can specifically induce and sustain a strong chaperone and protease activity in cells and tissues prone to toxic protein aggregations.

Managed Care Ombudsman Program

In Iowa, the Managed Care Ombudsman Program was established to advocate for the rights and wishes of IA Health Link members who live or receive care in a health care facility, assisted living program or elder group home, as well as members enrolled in one of the seven home and community-based services (HCBS) waiver programs: AIDS/HIV, Brain Injury, Children’s Mental Health, Elderly, Health and Disability, Intellectual &/or Physical Disability. All services provided by the Managed Care Ombudsman Program are confidential and free of charge.

Capacity vs Competency

“Capacity” and “competency” are terms that are often used interchangeably. However, under Iowa law and specifically within the context of an individual’s rights to make his/ her own decisions, there is a very important difference between the two words. An understanding of the difference between “capacity” and “competency” (as explained on this fact sheet) is essential to determine whether an individual’s consent is valid.

Health Care Power of Attorney FAQs

A health care power of attorney (HC-POA) is a document authorizing an attorney-in-fact (your designated agent) to make health care decisions on your behalf if you (the principal) are unable, in the judgment of your attending physician, to make health care decisions. Health care is defined as any care, treatment, service or procedure required to maintain, diagnose or treat a physical or mental condition. Through your HC-POA, you may authorize someone else to consent, refuse or withdraw consent to health care on your behalf.

Trends in nursing 2013 (Nursing trends)

This report is a high level analysis of trends in workforce and available nursing education programs in Iowa. Unless otherwise noted, data is reported for the last 11 years (2004-2014).