792 Signatures. Rose Comes Home Next Week.

 
Hello Caregiver Advocates:

792 signatures. 208 from 1,000. I want to thank the kind and powerful people who shared this petition - and to everyone who signed, your voice IS making a difference.

My mother Rose is okay this week. I can write that without my hands shaking.-Julia Temple gave us our first assessment meeting Wednesday - the case manager and Rose's physical therapist in the same room. Since my initial email, the correspondence has been steady and transparent. They set us a packet of documents. After the ER, after the hip fracture, after two weeks where every call felt like extracting information from a building that didn't want to give it up - that is what relief looks like. Responsiveness.

But the question ahead is the one that every family caring for someone with a progressive condition will eventually face: is she improving?

It's been the wrong question since 2013. A federal court -Jimmo v. Sebelius - settled it: Medicare coverage for skilled therapy does not depend on improvement. It depends on whether the patient needs skilled care to maintain function or slow decline. The enforcement infrastructure was never built to hold. The practice never fully went away - it just stopped being written down.

Colorado has an independent external review pathway that can overturn a denial. It works. Almost nobody navigating a dementia care authorization knows it exists - because the pathway was built for someone with the bandwidth to use it, not someone providing twenty-four-hour care.

This week I published two dispatches - the personal piece and a systems companion. Together they propose what dyadic diagnosis would look like as policy: insurance that measures both halves of the care equation, not just the patient. The scoring tool that authorized Rose's home discharge did not measure caregiver capacity. It asked for a home address.

The Colorado CARE Act addresses the employment side of the same gap - protections that exist on paper need a floor underneath them.

Up is not the same as better. Rose got up off that floor. She is not going to get better. Both of those things are true. Only one was ever supposed to determine whether she keeps her care.

Please share this petition today - with one person who has watched a door close on someone they love.

Read "The Missing Half of the Diagnosis" - Care Futures: https://open.substack.com/pub/therevenueneutralcaregiver/p/care-futures-7d8?r=6a52ih&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

Read "The Phone Call" - Our Lives On Hold: https://open.substack.com/pub/therevenueneutralcaregiver/p/our-lives-on-hold-73a?r=6a52ih&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

Kindly and Gratefully,

Mark Fukae
Director of Advocacy, Professionals Who Care
Founder, CASI — Caregiver Advocacy Support Initiative
Colorado Registered Volunteer Lobbyist
Lead Architect, Colorado CARE Act — 2027 Legislative Session

mark_fukae@casiadvocacy.org | casiadvocacy.org