Education

OP-ED: Home Health Services Under Medicare

Published

12 years ago

July 15, 2013

Medicare covers a variety of heath care services that you can receive in the comfort and privacy of your home.

These include intermittent skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy.

Such services used to be available only at a hospital or doctor’s office. But they’re just as effective, more convenient, and usually less expensive when you get them in your home.

To be eligible for home health benefits, you must be under a doctor’s care and receive your services under a plan of care established and reviewed regularly by a physician. He or she also needs to certify that you need one or more home health services.

In addition, you must be homebound and have a doctor’s certification to that effect. (Being homebound means leaving your home isn’t recommended because of your condition, or your condition keeps you from leaving without using a wheelchair or walker, or getting help from another person.)

Also, you must get your services from a home health agency that’s Medicare-approved.

If you meet these criteria, Medicare pays 100 percent for covered home health services for as long as you’re eligible and your doctor certifies that you need them.

For durable medical equipment (like a walker, wheelchair, or oxygen equipment), you pay 20 percent of the Medicare-approved amount, after you pay the Part B deductible ($147 in 2013).

Skilled nursing services are covered when they’re given on a part-time or intermittent basis. In order for Medicare to cover such care, it must be necessary and ordered by your doctor for your specific condition. Medicare does not cover full-time nursing care.

Skilled nursing services are given by either a registered nurse or a licensed practical nurse under an RN’s supervision.

Nurses provide direct care and teach you and your caregivers about your care. Examples of skilled nursing care include: giving IV drugs, shots, or tube feedings; changing dressings; and teaching about prescription drugs or diabetes care.

Any service that could be done safely by a non-medical person (or by yourself) without the supervision of a nurse, isn’t skilled nursing care.

Physical therapy, occupational therapy, and speech-language pathology services have to be specific, safe, and effective treatments for your condition.

Before your home health care begins, the home health agency should tell you how much of your bill Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare, and how much you’ll have to pay for them.

This should be explained by both talking with you and in writing. The agency should give you a notice called the Home Health Advance Beneficiary Notice before giving you services and supplies that Medicare doesn’t cover.

What isn’t covered? Some examples are 24-hour-a-day care at home; meals delivered to your home; homemaker services like shopping, cleaning, and laundry (when this is the only care you need, and when these services aren’t related to your plan of care);

Personal care given by home health aides like bathing, dressing, and using the bathroom (when this is the only care you need).

If your doctor decides you need home health care, you can choose from among the Medicare-certified agencies in your area. (However, Medicare Advantage plans may require that you get home health services only from agencies they contract with.)

One good way to look for a home health agency is by using Medicare’s “Home Health Compare” web tool, at www.medicare.gov/HHCompare.

This tool lets you compare home health agencies by the types of services they offer and the quality of care they provide.

For more details on Medicare’s home health benefit, please read our booklet, “Medicare and Home Health Caree,” on line at www.medicare.gov/publications/pubs/pdf/10969.pdf.

David Sayen is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories.

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Desmond Gumbs — Visionary Founder, Mentor, and Builder of Opportunity

Gumbs’ coaching and leadership journey spans from Bishop O’Dowd High School, Oakland High School, Stellar Prep High School. Over the decades, hundreds of his students have gone on to college, earning academic and athletic scholarships and developing life skills that extend well beyond sports.

Published

3 weeks ago

December 20, 2025

Oakland Post

NCAA football history was made this year when Head Coach from Mississippi Valley State, Terrell Buckley and Head Coach Desmond Gumbs both had starting kickers that were Women. This picture was taken after the game. Courtesy photo.

Special to the Post

For more than 25 years, Desmond Gumbs has been a cornerstone of Bay Area education and athletics — not simply as a coach, but as a mentor, founder, and architect of opportunity. While recent media narratives have focused narrowly on challenges, they fail to capture the far more important truth: Gumbs’ life’s work has been dedicated to building pathways to college, character, and long-term success for hundreds of young people.

A Career Defined by Impact

One of his most enduring contributions is his role as founder of Stellar Prep High School, a non-traditional, mission-driven institution created to serve students who needed additional structure, belief, and opportunity. Through Stellar Prep numerous students have advanced to college — many with scholarships — demonstrating Gumbs’ deep commitment to education as the foundation for athletic and personal success.

NCAA football history was made this year when Head Coach from
Mississippi Valley State, Terrell Buckley and Head Coach Desmond
Gumbs both had starting kickers that were women. This picture was
taken after the game.

A Personal Testament to the Mission: Addison Gumbs

Perhaps no example better reflects Desmond Gumbs’ philosophy than the journey of his son, Addison Gumbs. Addison became an Army All-American, one of the highest honors in high school football — and notably, the last Army All-Americans produced by the Bay Area, alongside Najee Harris.

Both young men went on to compete at the highest levels of college football — Addison Gumbs at the University of Oklahoma, and Najee Harris at the University of Alabama — representing the Bay Area on a national level.

Building Lincoln University Athletics From the Ground Up

In 2021, Gumbs accepted one of the most difficult challenges in college athletics: launching an entire athletics department at Lincoln University in Oakland from scratch. With no established infrastructure, limited facilities, and eventually the loss of key financial aid resources, he nonetheless built opportunities where none existed.

Under his leadership, Lincoln University introduced:

Football
Men’s and Women’s Basketball
Men’s and Women’s Soccer

Operating as an independent program with no capital and no conference safety net, Gumbs was forced to innovate — finding ways to sustain teams, schedule competition, and keep student-athletes enrolled and progressing toward degrees. The work was never about comfort; it was about access.

Voices That Reflect His Impact

Desmond Gumbs’ philosophy has been consistently reflected in his own published words:

“if you have an idea, you’re 75% there the remaining 25% is actually doing it.”
“This generation doesn’t respect the title — they respect the person.”
“Greatness is a habit, not a moment.”

Former players and community members have echoed similar sentiments in public commentary, crediting Gumbs with teaching them leadership, accountability, confidence, and belief in themselves — lessons that outlast any single season.

Context Matters More Than Headlines

Recent articles critical of Lincoln University athletics focus on logistical and financial hardships while ignoring the reality of building a new program with limited resources in one of the most expensive regions in the country. Such narratives are ultimately harmful and incomplete, failing to recognize the courage it takes to create opportunity instead of walking away when conditions are difficult.

The real story is not about early struggles — it is about vision, resilience, and service.

A Legacy That Endures

From founding Stellar PREP High School, to sending hundreds of students to college, to producing elite athletes like Addison Gumbs, to launching Lincoln University athletics, Desmond Gumbs’ legacy is one of belief in young people and relentless commitment to opportunity.

His work cannot be reduced to headlines or records. It lives on in degrees earned, scholarships secured, leaders developed, and futures changed — across the Bay Area and beyond.

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Oakland School Board Grapples with Potential $100 Million Shortfall Next Year

The school board approved Superintendent Denise Saddler’s plan for major cuts to schools and the district office, but they are still trying to avoid outside pressure to close flatland schools.

Published

3 weeks ago

December 14, 2025

Oakland Post

OUSD Supt. Denise Saddler. File photo.

By Post Staff

The Oakland Board of Education is continuing to grapple with a massive $100 million shortfall next year, which represents about 20% of the district’s general fund budget.

The school board approved Superintendent Denise Saddler’s plan for major cuts to schools and the district office, but they are still trying to avoid outside pressure to close flatland schools.

Without cuts, OUSD is under threat of being taken over by the state. The district only emerged from state receivership in July after 22 years.

“We want to make sure the cuts are away from the kids,” said Kampala Taiz-Rancifer, president of the Oakland Education Association, the teachers’ union. “There are too many things that are important and critical to instruction, to protecting our most vulnerable kids, to safety.”

The school district has been considering different scenarios for budget cuts proposed by the superintendent, including athletics, libraries, clubs, teacher programs, and school security.

The plan approved at Wednesday’s board meeting, which is not yet finalized, is estimated to save around $103 million.

Staff is now looking at decreasing central office staff and cutting extra-curricular budgets, such as for sports and library services. It will also review contracts for outside consultants, limiting classroom supplies and examine the possibility of school closures, which is a popular proposal among state and county officials and privatizers though after decades of Oakland school closures, has been shown to save little if any money.

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How Charles R. Drew University Navigated More Than $20 Million in Fed Cuts – Still Prioritizing Students and Community Health

Named after the pioneering physician Dr. Charles R. Drew, famous for his work in blood preservation, CDU’s mission is to cultivate “diverse health professional leaders dedicated to social justice and health equity for underserved populations through education, research, clinical service, and, above all, community engagement.”

Published

2 months ago

November 16, 2025

Oakland Post

Photo Caption: The campus of Charles R. Drew University of Medicine and Science (CDU) in Los Angeles. CBM photo by Max Elramsisy.

Charlene Muhammad | California Black Media

Earlier this year, when the federal government slashed more than $20 million in grants to Charles R. Drew University of Medicine and Science (CDU), the leadership of California’s only historically Black medical school scrambled to stabilize its finances — while protecting its staff and students.

The school is widely recognized as a vital pipeline for Black doctors and other health professionals throughout California.

Dr. David Carlisle (center), President of Charles R. Drew University of Medicine and Science (CDU), with two of the university’s students. Photo Courtesy of Charles R. Drew University of Medicine and Science.

Dr. Jose Torres-Ruiz, CDU’s Executive Vice President for Academic Affairs and Provost, said the university—designated as a Historically Black Graduate Institution (HBGI)—was notified in early March 2025 that most of its major grants, including the Research Centers in Minority Institutions (RCMI) award, known at CDU as the “Accelerating Excellence in Translational Science” (AXIS Grant), would be terminated. Initially renewed, the grant was later revoked because its language did not align with the current federal administration’s priorities.

The AXIS Grant provides $4.5 million per year for five years through the National Institutes of Health’s National Institute on Minority Health and Health Disparities. CDU quickly reallocated other funds to protect its scientists, staff, and technicians, though some personnel losses were unavoidable.

“We didn’t want to fire them because these people have expertise that takes years to gain,” Torres-Ruiz said.

The grant is crucial, he added, funding research in cancer, diabetes, and metabolic diseases that affect the Willowbrook community in South Los Angeles, training the next generation of scientists, and supporting community outreach.

Programs at the school, including its youth and teen mentoring programs reach beyond the walls of the university, impacting the lives and quality of health care of people in the surrounding community, one of the most underserved areas in Los Angeles County.

Confronted with the harsh reality of funding cuts, the university’s leadership made an early, strategic choice to honor its foundational commitment and prioritize its students. Dr. Deborah Prothrow-Stith, dean of CDU’s College of Medicine, highlighted the school’s deliberate focus on admitting students from economically disadvantaged backgrounds — many of whom are Pell Grant recipients and graduates of public high schools.

“We are staying true to our mission, finding creative ways to prioritize what’s most important,” she said. “I’m optimistic because of our students—they are dedicated and committed to service.”

In addition, the $2 million-per-year John Lewis NIMHD Research Endowment Program, intended to strengthen CDU’s research infrastructure, was terminated with three years remaining after a February 2025 freeze on nearly all federal grants for public health, education, and infrastructure projects.

Following an appeal, CDU learned in June that the RCMI grant had been fully reinstated, along with all but eight smaller grants. The university’s next priority is restoring the John Lewis Endowment.

“We are working with NIH staff to adjust the language. Certain words like ‘diversity’ and ‘equity,’ which are core values of our institution, are now under scrutiny,” Torres-Ruiz explained.

CDU has also expanded funding sources by targeting foundations and private donors. “This may happen again. We cannot rely solely on federal agencies,” Torres-Ruiz said, emphasizing the importance of building relationships with politicians and private partners.

Prothrow Stith echoed Ruiz’s perspective on cultivating multiple funding sources. “Building bridges with private foundations helps, but it doesn’t erase the disruption,” she said.

Many students rely on federal loans, CDU leaders say. Those loans are now capped at $150,000. So, most medical students graduate with $300,000–$350,000 in debt when accounting for tuition and living expenses.

To lower the burden on students, CDU is exploring options to make education more affordable, including overlapping school years to reduce annual costs.

Students like Isaiah Hoffman and Bailey Moore epitomize CDU’s values.

Hoffman, an aspiring orthopedic surgeon from Inglewood, credits Drew for inspiring his career choice. Out of 12 medical school acceptances, he chose CDU to give back to his community and continue Drew’s legacy. Hoffman also founded H.O.M.I.E.S. Inc., a nonprofit pairing Black K–12 students with mentors to support academic and personal growth.

Moore, 23, from Southeast Washington, D.C., pursued CDU to address maternal health disparities she observed in her own community – an underserved area of the nation’s capital city. “CDU pours into you. It emphasizes service, and I hope for a world without health disparities,” she said. “Drew may be small, but Drew is mighty. It was created out of necessity to save lives and empower communities.”

CDU President and CEO Dr. David Carlisle acknowledged during the Aug. 28 “State of the University” that the institution faces ongoing challenges. Political threats and grant disruptions contributed to a sizable unrestricted budget deficit, despite achievements over the past year.

Successful appeals and alternative sources of funding, led by Vice Provost Dr. Ali Andallibi, have now restored all the monies previously lost in research funding, he said.

Carlisle expressed gratitude to L.A. Care Health Plan and Sutter Health for providing multimillion-dollar scholarships and highlighted that CDU would welcome approximately 1,050 incoming students—near its highest enrollment ever. “I’m deeply grateful for the resolve, diligence, and unwavering commitment of everyone here, even when the path is not easy,” he said.

At the gathering, Carlisle referred to the sounds of ambulances passing by with blaring sirens as- the “music of healthcare,” while students and the school’s leadership attending expressed resilience in their speeches and conversations. The activities of the day captured the institution’s focus on education, service and advancing health care across disadvantaged communities in California – and beyond.

Video Report: How Charles Drew Stayed Strong Amid Federal Funding Cuts