WASHINGTON — President Obama signed a measure into law on Thursday to fight a wave of suicide among veterans struggling with post-traumatic stress, a problem that has won increased attention as American troops have returned from Afghanistan and Iraq.
The measure, passed by unanimous votes in the House and Senate, was designed to make it easier for veterans to find mental health resources, do more to recruit and retain professionals to help them and increase accountability for the government programs serving them.
By some estimates, 22 veterans commit suicide every day in the United States. While that includes older veterans who kill themselves years after their service, not just those who have recently come home from Iraq and Afghanistan, studies show that the rate is higher among those who do not receive mental health care. But in his remarks on Thursday, Mr. Obama stressed that fixing the Department of Veterans Affairs is only part of the solution.
“This is not just a job for government,” he said at a signing ceremony at the White House. “Every community, every American can reach out and do more with and for our veterans. This has to be a national mission. As a nation, we should not be satisfied until every man and woman in uniform, every veteran, gets the help that they need to stay strong and healthy.”
The new law was named for Clay Hunt, a Marine from Texas who served in combat only to struggle with post-traumatic stress after returning home. He took his own life four years ago at age 28, and ever since, his family and friends have lobbied Washington to focus more intently on the problem of veteran suicide.
Jake Wood, who served alongside Mr. Hunt in the Marines, said after the ceremony that 15 members of his unit in Afghanistan had killed themselves since coming home, and that he learns about a new death through Facebook every month or so.
“How can we have 22 veterans committing suicide every day in this country, and that’s not a national issue?” he asked. “This is an issue that needs to be seared into the forefront of every citizen of this country.”
Under the Clay Hunt Suicide Prevention for American Veterans Act, the Department of Veterans Affairs’ suicide prevention and mental health treatment programs will be subjected to outside evaluations; an interactive website will be set up with the department’s various resources; incentives will be offered to recruit and retain mental health professionals; and veterans will have an extra year to obtain health care through the department without first proving service-related disability.
“What this bill does is take away some barriers, some needless barriers, that shouldn’t be there and make it easier for these veterans to get the health care they’re so entitled to,” said Richard Selke, Mr. Hunt’s stepfather.
Susan Selke, Mr. Hunt’s mother, said she wanted to prevent other families from going through what hers did. “We are just so grateful for the passage of this bill today,” she said. “It’s only the beginning.”
Mr. Obama paid tribute to Mr. Hunt, saying that he had served bravely in combat and returned home determined to help his fellow veterans. Mr. Hunt recognized his own problems and sought help, the president said, but the severity of his condition was not fully recognized until too late.
“This law will not bring Clay back, as much as we wish it would,” Mr. Obama said. “But the reforms that it puts in place would’ve helped, and they’ll help others who are going through the same challenging process that he went through.”
By: Tim Mullaney
Home health agencies are outperforming the post-acute sector as a whole in preventing patient rehospitalizations, according to data released Wednesday by the Alliance for Home Health Quality and Innovation.
The numbers suggest that home health providers are taking steps to protect and expand their referral streams from hospitals, Alliance Executive Director Teresa Lee tells Home Health Care News. Since 2012, hospitals have faced Medicare reimbursement cuts if too many patients return within 30 days, meaning they are looking for post-acute providers that can help prevent readmissions.
Between 2011 and 2012, hospital readmissions from home health settings decreased about 2%, from 19.2% to 17.4%, according to the Alliance’s Chartbook report. For the post-acute sector overall, including skilled nursing and other provider types, the 2012 readmissions rate was 18.4%. These numbers were calculated for readmissions within 30 days of discharge, for the top 20 most common diagnosis groups sent to a post-acute setting.
Home health providers have taken a variety of steps to cut hospital readmissions, such as using checklists to ensure ongoing care coordination with the hospital after the patient has returned home.
Given the shifts in Medicare incentives, other types of providers also have sought to decrease rehospitalizations, and there has been a system-wide reduction, Lee notes.
“There is this overall trend, and we’re very pleased to see home health is part of that trend,” she tells HHCN.
Still, the fact that home health agencies are performing especially well on readmissions, coupled with the lower costs for home care versus facility-based care, could make HHAs particularly attractive partners for hospitals — particularly those that are part of accountable care organizations and similar provider groups that are financially rewarded for bringing down Medicare spending while meeting quality objectives.
“I hear anecdotally about agencies interacting with ACOs,” Lee says, noting that she does not have hard numbers on home health participation in ACOs. “It does seem to me that within the Alliance membership, there’s a great deal of engagement with ACOs, bundled payments, these different types of programs.”
Lee also points out that the percentage of patients who go from the hospital to home care has remained relatively stable over the past several Chartbook reports. However, she thinks it is reasonable to expect the proportion to increase in coming years. Medicare data does not immediately become available for analysis, so this shift might be underway well before it is reflected in an Alliance Chartbook report, she notes.
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