Digital Commons Network^™

Between Private Equity And Housing Discrimination: The Long-Term Crisis In St. Louis And Beyond, Harold Braswell, Alexandra Mcnamee, Charitha Bodepudi

Saint Louis University Journal of Health Law & Policy

On December 15, 2023, Northview Village, the largest skilled nursing facility in the Saint Louis region, closed abruptly, leading to the nighttime discharge of 170 residents. This emergency, while unique to that facility, is indicative of a broader crisis in both local and, to a significant extent, national nursing homes. This crisis has partly been catalyzed by the COVID-19 pandemic, but it rests on underlying factors that are unfortunately integral to the financing and operation of long-term care. This article will argue that understanding it requires situating long-term care at the intersection of two broader historical processes: the rise of …

The Intersection Of Regulation, Quality Care Delivery, And Ethics And Compliance: Look Carefully Before Crossing!, David R. Hoffman, Ilene Warner-Maron

Saint Louis University Journal of Health Law & Policy

Quality and compliant care delivery in nursing homes remains elusive. Four main interests are currently misaligned, thereby putting nursing home residents at risk of harm. Without a clearly defined commitment to quality and compliant care and alignment of these interests, nursing home residents will remain vulnerable to severe harm.

The first key interest concerns nursing home ownership and management. Currently, over seventy percent of nursing homes are owned by for-profit entities. Previous ownership models, including non-profit, religious-based, and county-owned facilities, have largely closed or transitioned to for-profit entities. The shift in ownership significantly impacts quality and compliant care delivery. Unfortunately, …

What Went Wrong? Identifying The Historical Roots Of Racial Disparities Among Older Adults In Nursing Facilities, Gelila Selassie

Saint Louis University Journal of Health Law & Policy

In early 2020, as the nation was just becoming familiar with COVID-19, over a million nursing facility residents were already experiencing crisis-level disasters. Extreme lockdowns, increased hospitalizations, and high mortality rates plagued nursing facilities earlier and far worse than the rest of the population. Data gradually showed that facilities with higher numbers of residents of color were facing particularly dire outcomes.

Although the severity of COVID-19 was surprising, the pandemic highlighted existing and long-standing problems with the country’s long-term care facilities. Many of the problems that led to the horrible disparities during COVID-19 are rooted in a wholly insufficient long-term …

Advancing Virtual Care Practices Across The Cognitive Impairment Continuum, Tara Sklar, Kathryn Huber

Health Matrix: The Journal of Law-Medicine

As the population of older adults grows, providing high-quality, costeffective healthcare for those with cognitive impairments is an increasing priority. The COVID-19 pandemic accelerated the shift towards receiving virtual care at home through temporary Medicare flexibilities. However, the uncertainty surrounding the continuing extension of these flexibilities at the federal level and variations in reimbursement policies across the states present challenges for virtual care practices to meet the rising demand for care amid unprecedented workforce shortages. Sustainable, long-term reimbursement at the federal and state levels, a trained and integrated healthcare workforce, and adherence to recognized accreditation standards and guidelines are essential …

If Memory Serves: Navigating Cognitive Impairment Within Congress, Gracemary R. Zizzo

Oklahoma Law Review

No abstract provided.

Putting The “Social” Into Social Determinants Of Health: Why Policymaking For Improving Health Must Tackle Social Isolation And Loneliness, Laura C. Hoffman

Oklahoma Law Review

No abstract provided.

The Intersection Of Dementia And Criminal Behavior, J. Taylor Humphrey

Marquette Law Review

As the number of individuals affected by dementia increases, the criminal justice system continues to face questions about dementia and criminal responsibility. However, gaps in the legal process have left these individuals, incapable of forming intent, vulnerable to wrongful punishment. Courts rely on traditional culpability frameworks that fail to account for the nuance in dementia-related cognitive decline, and, as a result, prisons are forced to function as de facto nursing homes lacking adequate resources to provide proper care. This Comment proposes treating dementia as a sliding scale, arguing for a context-specific response through streamlined crisis response, use of diversion programs, …

Reproductive Rights: How Voting Behavior Illustrates Shifting Political Attitudes, Keavy Callwood

Williams Honors College, Honors Research Projects

This research project intends to explore a causal link between the Supreme Court decision in Dobbs v. Jackson Women's Health Organization (2022) and shifting political attitudes as modeled through voting behaviors. Research will be conducted by using data from government and reputable sources that are representative of the general public to show that political attitudes have shifted since the release of the Dobbs decision. Additionally, the question will be analyzed through discussing several political theories and applying them to the current issues being studied. This research could help show how the Supreme Court is an important actor in the political …

The Face Of Ageism, The Reach Of Ageism: Law, Medicine And Society, Janet Dolgin

Hofstra Law Faculty Scholarship

No abstract provided.

Decision-Making Supports And Cognitive Decline, Rebekah Diller

Articles

For persons with a range of cognitive disabilities, supported decision-making, rooted in a human rights approach to disability, has emerged as a tool that permits them to make legally binding decisions and avoid guardianship. As supported decision-making policy has evolved in the United States, state statutes have primarily focused on formal agreements through which individuals can designate trusted supporters to assist in obtaining information, processing that information, and communicating a decision. This Article argues that supported decision-making has promise for preserving the autonomy of persons living with dementia, but that the model of a supported decisionmaking agreement embodied in the …

How To Design A Program For The Poor That Is Not A Poor Program: Explaining The Political Sustainability Of The Guaranteed Income Supplement, Daniel Béland, Patrik Marier

Osgoode Hall Law Journal

Created in 1967 as a temporary program aimed at supporting low-income people during the maturation of the Canada and Quebec Pension Plans, the Guaranteed Income Supplement (GIS) has since become a permanent policy that remains a central component of Canada’s multi-layered public pension system. In this article, we explain why GIS is a popular and politically successful program that challenges the common wisdom in political science and policy analysis that “programs for the poor are poor programs.” The article shows that the success of GIS stems from its policy design (e.g., income-tested rather than means-tested benefits), the social construction of …

The Canada Disability Benefit: Battling Ableism In Design And Implementation, Jennifer Robson, Lindsay Tedds

Osgoode Hall Law Journal

This article, written shortly after the framework legislation for the Canada Disability Benefit was introduced, discusses the key benefit design elements and options facing policymakers. We contrast these elements with the directional parameters set in the legislation. In the intervening months, the Government of Canada released an estimate of the annual costs of the new benefit and eventually drafted regulations that detail the actual design of the benefit in the Summer of 2024. These developments are outside the scope of this article, but the analysis in this article provides a foundation for other researchers and stakeholders to interpret and critique …

Medical Board Of California, Steven Soldani, Marcus Friedman

California Regulatory Law Reporter

No abstract provided.

Board Of Registered Nursing, Julia Thompson, Marcus Friedman

California Regulatory Law Reporter

No abstract provided.

Negara Hukum Kesejahteraan Di Batas Pantai: Paradoks Perlindungan Negara Terhadap Masyarakat Pesisir Di Tengah Perubahan Iklim, Aji Baskoro

Jurnal Ilmu Kesejahteraan Sosial

Climate change poses significant challenges to vulnerable coastal communities in Indonesia. As a welfare state, the Indonesian government is expected to safeguard these vulnerable groups through policies that promote their welfare and sustainable livelihoods. However, current policies create a paradox. This article explores this paradox: on the one hand, Indonesia adheres to the welfare state principle, which demands that all government actions be grounded in law, ensuring public safety and welfare. On the other hand, the policies focus on exploiting natural resources, exacerbating the vulnerabilities of coastal communities, particularly in the face of climate change. The article employs a normative …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Testamentary Freedom: A Constitutional Perspective, Richard J. Goralewicz

ACTEC Law Journal

No abstract provided.

Deserts Still Need Water: Using Adr Processes To Support Rural Residents And Counter The Challenges Stemming From The Shortage Of Lawyers In The “Great American Legal Desert”, Whitney Heuermann

Pepperdine Dispute Resolution Law Journal

Researchers dub rural America the “Great American Legal Desert,” deriving its nickname from the fact that roughly 20% of the nation's population lives in rural America while only 2% of small law practices are located in rural areas. This comment proposes that an increase in alternative dispute resolution (ADR) programming and usage serves as a viable avenue to alleviate the lawyer shortage’s harmful effects in rural America. This note begins by generally identifying ADR’s pros, such as cost, privacy, and community preservation, and then correlating these advantages to various aspects of rural America. ADR programming in Kentucky, Idaho, and Kansas …

The Hidden Struggle: Challenges Older Women Face In Nevada, Annie Vong

Student Research

In 2020, almost one in five Nevadans was over the age of 65.[1] However, within this age group, women outnumber men due to longer life expectancies[2] and migration patterns. Women over 65 years of age make up an estimated 18.1% of the female population in Nevada.[3] Of the male population in Nevada, 15.1% are over 65 years of age.[4] Older women are less likely to be married, are less likely to have completed a bachelor’s degree, are more likely to drop out of the labor force, and are more likely to be living in poverty in …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Peer-Mediated Family Support Project: Evaluation Of Changes In Family Quality Of Life, Preethy S. Samuel, Elizabeth Janks, Nia S. Anderson, Michael Bray, Christina Topolewski, Sharon Milberger

Developmental Disabilities Network Journal

The Family Quality of Life (FQOL) approach represents a paradigm shift from fixing to supporting people with intellectual/developmental disabilities (I/DD) by changing the focus from the individual to the family and highlighting strengths rather than deficiencies. Aging family caregivers of individuals with I/DD often encounter obstacles, including accessibility, acceptability, and affordability of services. Little is known about best practices to support aging families of adults with I/DD. Understanding how a state-wide peer-mediated family support project implemented in this study helped improve the FQOL of aging caregivers is important in broadening participation of other caregivers in these types of programs. To …

Big Data Searches And The Future Of Criminal Procedure, Mary Fan

Articles

This Article proceeds in three parts. Part I illuminates the nostalgic Luddism that influences Fourth Amendment jurisprudence and the challenges posed by evolving technologies to this dominant lens. This Part explains the operation of geofence and keyword warrants and how their power to crack cold cases by unidentified perpetrators both tempt and terrify. The confusion in the courts over the constitutionality of geofence and keyword warrants is emblematic of the larger challenges of the Romantic Luddism in Fourth Amendment originalism that has grown in influence over the decades.

Part II frames and theorizes the concepts of collateral impact and collateral …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan Wolf, Frances Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien Fair, Martha J. Farah, Michael Garwood, S. Duke Han, July Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

Articles

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

Ethical, Legal, And Policy Challenges In Field-Based Neuroimaging Research Using Emerging Portable Mri Technologies: Guidance For Investigators And For Oversight, Francis X. Shen, Susan M. Wolf, Francez Lawrenz, Donnella S. Comeau, Kafui Dzirasa, Barbara J. Evans, Damien Fair, Martha J. Farah, S. Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Karen S. Rommelfanger, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan, Michael Garwood

Articles

Researchers are rapidly developing and deploying highly portable MRI technology to conduct field-based research. The new technology will widen access to include new investigators in remote and unconventional settings and will facilitate greater inclusion of rural, economically disadvantaged, and historically underrepresented populations. To address the ethical, legal, and societal issues raised by highly accessible and portable MRI, an interdisciplinary Working Group (WG) engaged in a multi-year structured process of analysis and consensus building, informed by empirical research on the perspectives of experts and the general public. This article presents the WG’s consensus recommendations. These recommendations address technology quality control, design …

Interpreting The Ambiguities Of Section 230, Alan Rozenshtein

Articles

As evidenced by the confusion expressed by multiple Justices in last Term’s Gonzalez v. Google, there is little consensus as to the scope of Section 230, the law that broadly immunizes internet platforms from liability for third-party content. This is particularly striking given that no statute has had a bigger impact on the internet than Section 230, often called the “Magna Carta of the internet.”

In this essay I argue that Section 230, despite its simple-seeming language, is a deeply ambiguous statute. This ambiguity stems from a repeated series of errors committed by Congress, the lower courts, and the Supreme …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan M. Wolf, Frances P. Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien A. Fair, Martha J. Farah, Michael Garwood, Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

UF Law Faculty Publications

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.