Whether favorably or unfavorably, a vast majority of congressional campaigns addressed the health care reform law that was enacted earlier this year. (Twenty-four of the 34 Democratic incumbents who were defeated voted for health care reform.) Brookings Institute Senior Fellow for Economic Studies Henry J. Aaron wrote in an article today that while voters have spoken, it is not entirely clear what they “said” regarding health care reform. While a complete repeal is unlikely given a Democratic president and Democratic majority in the Senate, some aspects of the law could be changed or limited in scope.

“The serious risk now is that opponents of the health reform bill, lacking the votes to repeal it, will have enough to cripple implementation, and that supporters will not have the votes or the determination to see that the reform bill is properly implemented,” Aaron argues in his article.

Current Minority Leader Rep. John Boehner (R-OH), who is likely to be elected by fellow Republicans to serve as Speaker of the House for the 112th Congress, has discussed plans to roll back aspects of health care reform, consider changes to Social Security and Medicare, and limit overall federal spending on government programs.

Once the Republican majority in the House was solidified, President Barack Obama called Boehner and Senate Minority Leader Mitch McConnell (R-KY), according to the White House. The president said he looked forward to working with Republicans “to find common ground, move the country forward and get things done for the American people.” At a press conference today, Obama alluded to calls to repeal or limit elements of health care reform, contending that Americans “don’t want us to re-fight the same political battles we fought over the last two years.”

Source: National Association for Home Care and Hospice

Q:  How much does companion care typically cost?

Ellen Barrone

North Providence, RI

A:  The cost of companion services will vary from agency to agency, and is dependent on management, resources, and licensure.  Reputable agencies will generally charge more per hour than small agencies who have no back up personnel for call-outs,  no human resource department to perform background checks, and/or no bonding in case something is stolen or damaged.  These agencies typically have no 24-hour support, and are not able to provide more skilled services in case a patient’s condition worsens, which requires more hands-on assistance that a companion legally cannot perform.  Do your homework when selecting a home health agency.  As with most things, you usually get what you pay for.
Q:  Are there any social service or entitlement programs that would pay for the cost of companion care or home care?

Doreen Swanson

Rehoboth, MA

A:  Generally speaking, companion care requires private funds only, as is the case in Rhode Island.  However, each state has different government and social service programs so if you’re not from Rhode Island, check with your state’s department of elderly affairs.  In regard to home care, Medicare and Medicaid pay for eligible services/citizens.  Visit the RI Department of Human Services website to find out more at http://www.dhs.ri.gov/Elders/LongTermCare  or call the Rhode Island Department of Elderly Affairs at 401-462-0570.

Q:  Five years ago, we brought my mother to live with us in Rhode Island from overseas.  She is starting to show small signs of dementia so we would like to hire a companion care company to stay with her while we’re not at home.  She speaks very little English.  Is there a way to find a multi-lingual companion company?

Monique Mousseau

Providence, RI

A:  Some agencies have specifically hired multi-lingual staff to provide service and assistance but you will have to call a few agencies to make this inquiry.  While you are making calls you will also get a feel through your interaction on what to expect in your continued relationship with the agency.

Q:  Of all the home care agencies in Rhode Island, how many are certified by the Department of Health?

Maria Lombardi, Scituate

A:  23. You can find a list of certified agencies on the RI Department of Health’s web site at http://www.health.ri.gov/chic/performance/homehealth/agencies.pdf.

Q: How many home care agencies offer companion programs? 

Julie Brown, Jamestown

A:  Only a small percentage. If you think you or a loved one may need companion services like errands or help with household maintenance during and/or after the need for home health services, be sure to ask if the home health care agency offers them.  That will provide continuity of care and eliminate the need to start the search process all over again.

Q.  My sister has early signs of dementia and lives on her own. Are there caretakers available in the community that have specialized dementia training?

Lois Vicario, Rehoboth

A: Yes, some home care agencies or companion services companies employ people specially trained in caring for people with Alzheimer’s, dementia or other cognitive impairments.  If dementia is a concern when looking for community-based services, be sure to ask if the caretakers that will be taking care of her have had this type of training.  The Alzheimer’s Association of RI is a valuable resource.  They can be reached at 401-421-0008.