For the Second Year in a Row... Others may have to look to Med- _ icaid to provide long-term care mibe nefits for a nursing home, said Mr. Konop. Seniors who prefer not to en- ter a nursing home do not count on Medicaid. Nearly all of Michi- gan's $1 billion Medicaid bud- get is allocated towards state approved nursing homes. Pro- viding adult daycare and other home-based services can be emotionally and financially de- manding for families without outside assistance. "The system needs to accom- modate both home health care and adult day services, instead of favoring a bias to one style," said Mr. Conners. "There needs to be a people-centered form of long-term care that is based on quality, not cost." A recent study, "Doing With- out: The Sacrifices Families Make to Provide Home Care" sponsored by the Families USA Foundation, said two out of three patients receiving long- term care at home can't afford to pay friends and family for-as- sistance. Among those unable to pay for care at home, the average amount of service amounted to 27 hours per week, leaving many hours without necessary supervision and assistance. Lisa Landsman, social work director at the new Marvin and Betty Danto Center in West Bloomfield, said the ones who "adjust the best are the ones who had some control over com- ing here." Mr. and Mrs. Bloom hope their long-term care package will enable them to remain at home for as long as possible. Their policies provide funds to train a family member to care for them and receive a wage for their time. The policy benefits are indexed to grow with infla- tion and cannot be canceled re- gardless of any changes in the Blooms' health. Differences between seem- ingly obscure details among bet- ter long-term care insurance contracts are the deal-breakers when selecting an appropriate insurance carrier. Joel Garfield of Garfield Insurance Group suggests asking friends what features motivated them to choose a particular company and style of policy. Elite contracts cover Alz- heimer's disease and offer flexible designs for home and nursing home benefit schedules. Mr. Garfield also recommends paying attention to which specific cir- cumstances trigger a benefit to be paid. The insurance industry ac- knowledges six Activities of Daily Living (ADLs): eating, bathing, dressing, toileting and basic mental and ambulatory functioning linked to the lifestyles of most fully function- ing individuals. Companies vary over how many ADLs an illness or injury must wipe out before a benefit is paid. Understand- ing the subtle nuances spelling out when and how benefits are paid are just as important, if not more so, than focusing solely on how much a policy costs when shopping for an insurance car- rier, said Mr. Garfield. Policy premiums vary de- pending on the amount of cov- erage, age, health and how many years coverage lasts. Mr. Conners is still skeptical about long-term care insurance because many of the first poli- cies were poorly written and few claims have been paid since the product emerged 18 years ago. However, part of the new Med- icaid legislation makes a portion of long-term care policy premi- ums tax-deductible after a for- mula calculating age, income and total medical expenses. ❑ Teva Medical In Joint Venture Jerusalem (JPFS) — Teva Med- ical, Israel International Fund and Taoz announced plans to in- vest $4.5 million in a joint ven- ture to establish community medical centers internationally. Using Teva Medical's devel- opments, the centers will pro- vide dialysis treatments for people suffering from kidney ail- ments. According to international fig- ures, 500 out of every one mil- lion people worldwide suffer from kidney problems and require dialysis treatments two or three times a week. The six-month-old, $30 mil- lion fund, a joint venture be- tween Bank Discount and Great Britain's Hambros Bank, invests in Israeli firms whose products mostly go for export. Teva Medical, a subsidiary of Teva Pharmaceutical Industries based in Ashdod, manufactures and markets medical devices. In addition to dialysis treatments, it makes products used in blood transfusions, blood banks and home treatments. Taoz is a local private compa- ny that provides medical ser- vices. The joint venture's first cen- ter is scheduled to open in an undisclosed European country soon. 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