Medicaid expands funding for home and community-based care : Shots

Expanded funds for in-home care can help seniors and disabled Americans stay in their homes. Here, Lidia Vilorio, a home health aide, gives her patient Martina Negron her medicine and crackers for her tea in May in Haverstraw, N.Y.

Michael M. Santiago/Getty Images

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Michael M. Santiago/Getty Images

For older people and people with disabilities, solving everyday practical problems can be the difference between being able to live at home or being forced to move to an institution. Sometimes people need help getting dressed or making meals. Sometimes they need help managing medications or shopping for groceries.

Originally, these things weren’t paid for by Medicaid, the federal health care program that many low-income and disabled Americans rely on. In recent years, the program has worked to expand coverage of home-based care but it’s still optional for states. Some states have adopted it widely, while in others, more care still happens in nursing homes and other institutions.

In April, the Biden administration rolled out funding from the American Rescue Plan to help states boost these services. And Thursday, the federal Department of Health and Human Services unveiled every state’s plan for how they’ll use the funds. An estimated $12.7 billion dollars in federal matching funds are available to “encourage states to expand home and community-based services and strengthen their programs,” according to an agency press release.

There's A Shortage Of Home Health Aides For The Elderly, And It's Getting Worse

“More and more people are saying, if I need care, I’d like it to be done at home or here in my community versus an institution or a hospital or a nursing home,” says Health Secretary Xavier Becerra. “In the 21st century, we’re moving closer to a care model that’s based on giving people services in their home.”

Becerra adds that his own father spent his last few months in hospice at home. “When he passed, he was in my home, he was surrounded by family,” he says.

Medicaid recently surpassed 80 million beneficiaries — the most ever since the program was created in the 1960s. It is the primary provider of long-term care services for older people, since these are not covered by Medicare or private insurance.

Add five-minute stints of fun and easy exercise to your day at home by working with what’s around you, says trainer Molly McDonald.

Cha Pornea for NPR

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Cha Pornea for NPR

Add five-minute stints of fun and easy exercise to your day at home by working with what’s around you, says trainer Molly McDonald.

Cha Pornea for NPR

Of all the ways in which the pandemic has affected Americans’ well-being, perhaps the one we’ve noticed least is how much we’re sitting. And it’s not just bad for our waistlines — it’s hurting our mental health.

More than a year and a half of social distancing and work-from-home policies have led to less time moving around and more time sitting and looking at screens — it’s a potentially toxic combination that’s linked with poorer mental health.

“The sneaky effects of the pandemic that we might not even notice [is] that we’ve changed our sitting patterns,” says Jacob Meyer, director of the Wellbeing and Exercise lab at Iowa State University.

His own research showed that in the early weeks of the pandemic, people who exercised less and had more screen time were likely to be stressed, depressed and lonely.

And though most people saw their mental health gradually improve as they adapted to a new reality, people who stayed mostly sedentary didn’t see get the same improvement, according to a follow-up study by Meyer. “People who continued to have really high levels of sitting, their depression didn’t improve” as much, says Meyer.

The good news is that something as simple as some very light movement around the house to break up all that couch surfing time can make a difference in mood, as Meyer’s earlier research has found.

Scores of previous studies confirm that being physically active boosts mood, lowers anxiety and improves sleep quality.

“We know consistently that the more people are active, the more that they exercise, the better their mental health is,” says Meyer.

For many office workers like me, working from home means we’ve fallen into a routine of spending hours at our desk. With another pandemic winter about to hit us and much of the country and the world still dealing with COVID-19, we are often stuck at home more than we’d like, so it’s time to start sitting less and moving around more.

Meyer and other exercise experts shared some tips

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Medicaid expands funding for home and community-based care : Shots

Short home workouts can boost your mood and reduce stress : Shots