Georgia is the statewide association of over 150 key not-for-profit and
other mission-focused organizations dedicated to providing quality
housing, health care, community-based and other related services for
older Georgians. The mission of LeadingAge Georgia is to represent and
promote the common interests of its members through leadership,
advocacy, education and other services in order to enhance each
member's ability to serve older Georgians.
Conversations with Ginny
"What'll Ya Have? What'll Ya Have?" Varsity
If you grace the doors of the Varsity, one of Atlanta's best known and often revered institutions, you will always be greeted at the counter with a chorus of "what'll you have!" The Varsity celebrates sixty years this August and while the infamous home of the "naked dog, yellow dog and walk a dog," has some things that never change, like their greeting and their lingo for frosted Varsity Orange (F.O.), they also have several things to brag about. Through the years, they've not only had loyal customers, they've had loyal employees including some who have worked there fifty plus years! They survived the depression, they've had visitors like Clark Gable who was there during the premier of Gone with the Wind in 1939, they've served multiple presidents and a beloved member of the Varsity was tapped to carry the torch during the 1996 Olympics. They've adapted with the times like adding a parking deck when the City of Atlanta took a chunk of their parking and they hoisted a giant high-tech sign of a V along their property keeping the Varsity on the minds of the 200,000 plus individuals who drive by their site along the interstate every day.
At LeadingAge Georgia we too want to know "what'll you have?" We partnered with our national association and asked for your input regarding concerns that should shape our future public policy direction on the national level. See the Town Hall Conversation Recap in the newsletter. This week, we also sent out a survey to ask you what your concerns are for the elders you serve and how we might address the concerns through public policy/advocacy on the State level. Please take the time and fill out this very important survey. If you haven't already filled it out, click here, fill it out and tell us what'll you have.
Expect a couple more short but important surveys to come your way to get your input on what LeadingAge Georgia should be doing to address the workforce shortage and what we should be doing to foster the use of technology for our members and those you serve. All of the nation-wide experts say that older adults want access to technology so they can stay connected to family and friends. We know it will play a greater role in the future for tele-health so we need to get a pulse on where are members are – what percent have Wi-Fi access, what are those you serve asking for in terms of technology and what are the training needs to help older adults "be connected" and less isolated.
You know best what you and the elders you serve need, so when surveys come your way, please take a few minutes to fill them out. I promise we'll keep the surveys short and we'll use the information to pursue legislation, policy and grant opportunities for you and those you serve.
We Need You
We've all heard the saying "it takes a village" and when it comes to enhancing the lives of older adults, LeadingAge Georgia members are the village! We are the trusted voice for aging, we create opportunities to better serve elders and we are responsible guardians for our field. Together, we're working to improve the workforce and to enhancing the well-being of those we serve. We have important work to do. If you haven't yet sent in your 2018 dues, please send them in and continue your support of our association. Your village needs you. If you have already sent them in, thank you for being a vital part of the village.
Take Advantage of Mental Health First Aid Classes As our society becomes more aware of the nation-wide mental health crisis, we're seeing efforts to address the needs of individuals with mental health concerns. There is a national goal to train one million individuals in Mental Health First Aid so that when someone has a mental health crisis there are individuals who can help them – much like individuals trained in CPR can save the life of someone having a heart attack. A number of our members have taken the course and are better prepared to help individuals in crisis – but a large number of our members have not yet taken advantage of this important training. Fortunately for LeadingAge Georgia members, this training is available in Georgia through our valued partner, Alliant Health Solutions. We have a Mental Health First Aid course scheduled for July 12th at Mauldin & Jenkins located at 200 Galleria Parkway. Click here to register.
If you are interested in hosting a Mental Health First Aid course please contact Jacque Thornton at jthornton@LeadingAgeGa.org. Alternatively, if you would like to attend the course on September 11th or November 7th at the Alliant Health Solutions, Inc. office located at 1455 Lincoln Parkway, please contact Ashley Washington at email@example.com. For more information about the Mental Health First Aid USA for Public Safety course, click here: https://www.firstquotehealth.com/health-insurance-news/mental-health-first-aid.
We All Need to Care About Medicare By Ginny Helms
The Associated Press sounded an alarm this week when they reported that Medicare will run out of money sooner than expected and will become insolvent in 2026. If unaddressed, this will bring devastation to Americans, wiping out savings and retirement accounts. Tackling the overhaul of a payment system for long-term care is an overwhelming thought to most people but LeadingAge is leading the way, championing a solution with the Medicare Long-Term Care Services and Supports Act of 2018. The legislation calls for long-term care services to be provided through a Medicare Part A benefit. To get up to speed on the Act click here: http://leadingage.org/sites/default/files/LTSS%20Act%20Fact%20Sheet%20May%202018.pdf.
To read the full Associated Press article about Medicare becoming insolvent in 2026, click here: https://www.apnews.com/604e68f172cb4a50848f1b92512e86dc/Trustees-report-warns-Medicare-finances-worsening. We all need to be part of ensuring the viability of Medicare.
2018 Profiles of Positive Aging Honoree Entry Form
You're invited to experience an inspiring event with your colleagues and community heroes & heroines for the sixth annual Profiles of Positive Aging Awards Gala. This event is intended to unveil the beautiful truths about aging. On November 4, 2018 (3:00 pm – 5:00 pm), we'll pay tribute to Elders who have changed our lives, achieved a positive aging lifestyle, and continue to give of their tremendous talents and wisdom across our great state and nation.
The Profiles of Positive Aging Gala is designed to support the educational arm of LeadingAge Georgia, the Georgia Institute on Aging. The purpose of the Institute is to provide affordable, quality professional development for individuals working in the field of aging. Currently, the Institute provides education to over 1300 professionals, via 25-30 events each year, who are dedicated to providing the best care and services to older Georgians.
POSITIVE AGING PROFILE ~ ENTRY FORM 2018
A Profile of Positive Aging honors someone who IS CURRENTLY MAKING a difference in your community, your organization, and/or our state/society. It is the gift of legacy. By recognizing someone who exemplifies Positive Aging, you honor those who are standing on the shoulders of years of wisdom and positive aging experiences, who have lived life to the fullest and inspire us by their examples.
Honorees will participate in this special Awards Gala to be held in their honor on November 5, 2018 at the annual "Profiles of Positive Aging Gala". Profiles submitted by August 31, 2018 to the Association office will be evaluated. Elders will be featured along with the 2018 Icon in Positive Aging.
Register your honoree by downloading the entry form or complete the nomination by submitting a brief profile of the individual at: https://form.jotform.com/21493468894166
►How much does your community spend on janitorial and housekeeping supplies? Do you know if you are getting the best prices?
A cost study is an excellent management tool for determining if you are getting competitive pricing for what you purchase. From paper towels to cleaning chemicals, LeadingAge's group purchasing organization, Value First, can compare what you are currently paying to pricing available through the GPO. Your community's janitorial supplies distributor may already be affiliated with Value First. To do a cost study, you provide the list of items you want to compare. Value First does the analysis.
►Does your community use a different group purchasing organization for janitorial supplies?
Even if you are purchasing through a group purchasing organization other than Value First, Value First can do a cost study for you. The primary goal is to work with LeadingAge members to make sure they are getting the best pricing—with Value First or through other sources.
►Not sure if you want to use Value First for housekeeping supplies?
The choice is yours. You can continue with your current arrangement. Or, if the cost study results indicate potential savings, you can consider purchasing through Value First. This is your GPO!
►How do you request a cost study for your community?
Contact Value First representative Vanessa Ceasar at firstname.lastname@example.org. Call (404) 421-3956 or click HERE.
Value First is a group purchasing organization owned by LeadingAge national and twenty five state associations, including LeadingAge Georgia. Value First is designed to leverage the buying power of thousands of senior service providers across the country to get the best pricing on a comprehensive array of products and services.
8200 Roberts Drive Suite 600
Atlanta, GA 30350
6730 Jones Mill Court
Norcross, GA 30092
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assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for August
August 5 Friendship Day
August 19 National Aviation Day
August 21 Senior Citizen's Day
August 26 Women's Equality Day
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LeadingAge Georgia Public Policy Report
By Tom Bauer, LeadingAge Georgia Policy Advisor
Many people tend to think of advocacy in terms of the General Assembly, but in fact the executive branch, which carries out state laws and "puts meat on the skeleton" (i.e.,provides rules and regulation with greater detail to carry out state laws and programs), is equally important. Since May is a traditionally slow month for public policy, this month's report will focus on two key state agencies which greatly affect seniors: the Georgia Departments of Community Health (DCH) and Human Services (DHS) respectively.
Department of Community Health (DCH)
DCH, whose commissioner is Tim Berry, is important because it administers both the Medicaid program (health coverage for low income individuals) and through the Division of Healthcare Facility Regulation enforces regulation of institutional care, such as that provided in nursing homes, assisted living communities, and personal care homes.
Most seniors served by Medicaid fall under Long Term Services and Supports (once called Aged, Blind and Disabled). This includes both the institutional care mentioned above and "home and community based services" (HCBS) through "waiver" programs. Under such programs the requirement to receive institutional care is "waived" in order for the individual to receive HCBS. Examples of HCBS are:
- Adult Day Centers
- Nutrition (e.g., congregate meals or home meals (aka "meals on wheels")
- Case management
- Emergency Response
- Home Health
- Homemaker services
- Personal Care (,e.g. assistance with activities of daily living such as eating, bathing, dressing, toileting, ambulation)
Such services are provided under two similar waiver programs:
- Community Care Services Program (CCSP)
- Services Options Using Resources in a Community Environment (SOURCE)
While the two programs are similar, there are some differences. SOURCE recipients must be eligible for SSI, receive a primary care physician, and does not generally have a waiting list as is the case with CCSP. Under both programs a person must be assessed as functionally in need of skilled nursing (nursing home) services to be eligible for HCBS.
The Medicaid program also includes Non Emergency Transportation (NET) to Medicaid recipients who need transportation to medical and health services such as adult day centers, pharmacies, dialysis, and doctor appointments. NET is administered by two brokers on a managed care basis, and LeadingAge has an ongoing dialogue with DCH concerning NET issues, some of which have been resolved due to LeadingAge advocacy.
Department of Human Services (DHS)
DHS, whose commissioner is Robyn Crittenden, also provides many services to seniors and administers the Georgia Alzheimer's and Related Dementia Plan (GARD).
While the DHS Divison of Aging Services (DAS), whose director is Abby Cox, administered the Community Care Services Program before its transfer to DHS, Aging Services still has multiple programs, many funded through the federal Older Americans Act. DAS contracts with area agencies on Aging (AAAs) which contract with local service providers to deliver services to seniors, including non-Medicaid HCBS. The list of programs under DAS includes:
- Adult Protective Services (reporting of abuse, neglect or exploitation of disabled adults or elder persons who are not residents of nursing homes or personal care homes)
- Aging and Disability Resource Connection (streamlines access to long-term care by serving as a one-stop-shop for consumers' aging and disability-related information)
- Caregiving (e.g. adult day care, respite)
- Elder Rights & Advocacy Programs
- Home & Community-Based Services Program (non Medicaid)
- Long-Term Care Ombudsman Program
In the past, LeadingAge Georgia worked with the Department of Community Health to re-write adult day, personal care home and assisted living regulations. We're always interested in working with these agencies to get changes made that you feel will better meet the needs of the elders you serve.
If you have an issue that you think needs to be addressed regarding services provided by the Department of Community Health or the Department of Human Services, please contact Ginny Helms at ghelms@LeadingAgeGa.org and Tom Bauer at email@example.com.
14th Long Term & Post Acute Care (LTPAC) Health IT Summit
Technology Connecting the Healthcare Eco-System
June 24-26, 2018
Mental Health First Aid
July 12, 2018
GAAP Summer Symposium
July 20, 2018
Fair Housing & Ethics Symposia
July 25, 2018
Leadership Academy Fourth Event
August 15, 2018
Maintenance Professionals Forum
August 29, 2018
Registration coming soon
Dementia & Mental Health Symposium
September 13, 2018
Registration coming soon
Culture Change Summit
September 27, 2018
Registration coming soon
Center for Positive Aging Golf Tournament Fundraiser
October 8, 2018
Leadership Academy Fifth Event
October 10, 2018
Adult Day Services Symposium
October 19, 2018
Registration coming soon
LeadingAge National Conference
October 28-31, 20018
Philadelphia Convention Center (Georgia Night Dinner TBA)
Profiles of Positive Aging Gala
November 4, 2018
Information coming soon
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City of Atlanta Snack & Learn Sessions
The City of Atlanta's Department of Parks and Recreation will host its' annual Senior Summer Camp June 4th through July 20th. During this time, they are offering seniors a series of life enrichment sessions called SNACK & LEARN.
Four times each week, there will be an opportunity for seniors to learn about an issue or service that will help enhance the quality of their lives. If you have a product/service/issue that you would like to share with seniors in Atlanta, you are invited to participate. SNACK & LEARN sessions will be offered Monday, Tuesday, Wednesday & Friday mornings at 11:00 am. Each session should last 30-40 minutes. Monday and Friday sessions are offered at C.A. Scott and Zaban locations. Tuesday and Wednesday sessions are offered at Old Adamsville & Rev. James Orange recreation facilities. Time slots will be assigned in the order that the requests are received.
For more info contact Magdalene Womack Anderson @ 404.546.7129
Putting Health First
June is an exciting month ... summer officially arrives, we celebrate Father's Day and most importantly we promote Men's Health Month! Recently I read a U.S. Census Report that concluded slightly more men are born than women. However, it went on to state that as we age, men die at a 2:1 rate of women! As we celebrate Father's Day, please be encouraged to do something to engage the men in your life, during Men's Health Month. We want our men to be healthy, happy, and around for the long haul! Let's provide support and encourage our men to lead healthier lives!
One of my contributions to the quest of helping men lead healthier, happy lifestyles is our hike for 'older' men. What better way than to be in the great outdoors while enjoying social time with some wonderful people. The hike from Unicoi State Park to the mountain town of Helen, an Alpine Village known for its Bavarian-style building designs is wonderful. We have lunch at the Gazebo in downtown Helen and enjoy the sights before we return. Our free monthly hikes are held on the first Saturday of every month and open to everyone. Our motto is "We are as fast as the slowest person." For more information, go to the Monthly Hikes page at www.CarolynHartfield.com.
I have been participating in various Senior Games and Olympics for almost 20 years. Growing up, my participation in any sports activity was very limited, as in next to none. I was introduced to Senior Women's Basketball at age 50. Our coach, now age 87 recently fell down his basement stairs and had to have brain surgery as a result of hitting his head in the fall. I last saw him, before his fall, at the 2017 World Senior Games in St. George, Utah. I am happy to add he is doing exceptionally well now. He has overcome bouts with colon and prostate cancer through his years after age 50. His doctors are always amazed at his astonishing rate of recovery. They all have conceded it is attributed to his active and healthy lifestyle. There is a moral to this story!
With that said, I want to share that the Georgia Golden Games/Olympics registration is now open. This non-profit organization is celebrating 36 years. It's primary purpose is to promote healthy active lifestyles of men and women age 50 and older. Currently, as a member of the planning committee, my commitment it to help expand participation as we bring people together for fun, fitness and friendly competition. No matter your level of ability, there is something for you. From my personal experiences, you are guaranteed to have fun, meet new friends and have an impactful positive life experience. Get more information about the Georgia Golden Games at their website: www.georgiagoldenolympics.org.
As seasoned adults, let's make a commitment to enjoy the spices of life and encourage friends, neighbors and family members to join in the many fun, active and social events that are happening in our communities!
I close with … to enable active participation, we must have a healthy diet. June is also Fresh Fruits and Vegetables Month promoted by the U.S. Department of Agriculture. Here is a helpful, healthy hint: Buying in season not only gives you the healthiest choices, it saves you money! Here is a link to a page that lists the seasons of many fruits and vegetables:
Our JUST WALK! a Walk with a Doc program is up and running weekly ... weather permitting .... every Wednesday morning at 10:00a.m.. Don't want to walk alone, or would love to meet other health-minded people. Join us. All you have to do is show up. We have water and healthy snacks available. We are as fast as the slowest person, so no need to feel you must keep up with others. We stroll the wonderful PATH Foundation South Peachtree Creek Trail at Mason Mill Park in Decatur, GA. A Special Shout Out to our sponsor AARP Georgia!
For more information visit www.CarolynHartfield.com
Carolyn L. Hartfield, Guest Contributor
Carolyn's experience in the health and wellness arena started when she opened her first health food store in 1985 and expanded it to 4 locations. She received her Health Coach certificate from Emory University. She is a 2016 recipient of the LeadingAge Georgia Profiles in Positive Aging Award, representing AARP. She is a National Senior Games (NSG) Athlete earning numerous gold and silver medals; she is featured in the 2017 National Senior Games Non-Ambulatory Athlete Exercise Videos; featured on the TV News Magazine for Baby Boomers 50Plus Prime; she was featured in the Atlanta Journal Constitution (AJC) newspaper; the cover story for the GirlFriends Lifestyle - A Women's Guide to Healthy Living Magazine, Special Edition for the White House Conference on Aging; and interviewed for various other media outlets. She is the founder of Hartfield's Hikers, Older People with Active Lifestyles (OPALs), Atlanta African American Baby Boomers and the Walk Outdoors for Wellness! (WOW!) program. For more information visit www.CarolynHartfield.com or send Carolyn an email at CH@CarolynHartfield.com
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2018 CCNG Advisory Group Meeting Dates & Update
Friday, August 24, 2018 | 9:30am – noon | Location: TBA
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Adult Day Services Symposium: SAVE THE DATE
October 19, 2018
Information coming soon
2017 GADSA Leadership Team
President: Claire Russell, The Homeplace
Vice-Presidents Public Policy: Ned Morgens, Skylark Senior Care;
Aysha Cooper, SarahCare of Snellville
Vice-Presidents of Members: Carla Jones, Rosswoods; Peggy Padgett, Georgia Infirmary Adult Day Health
2018 Training Events
GAAP Summer Symposium: "When Pinterest Doesn't Match Your Budget"
Pinterest is a wonderful resource for lovely and creative party planning ideas. As activity & wellness life enrichment professionals, our goal is to plan so much more than lovely parties--we want to create opportunities of purposeful engagement. What would a Pinterest party look like through the lens of well-being? Please join us on July 20, 2018 from 9-3:30 p.m. as we flip our perspective on activities into events of purposeful engagement with the residents/clients we serve throughout our communities. As part of our summer symposium, a graphic recorder will be joining us for this interactive activity planning experience. Prepare to be inspired!
Who should attend: novice, intermediate and pro activity, wellness, and life enrichment professionals.
CEUs: 5.5 Hours
Relevant topics covered during the symposium:
- Activities (Flip or Flop)
- The Big Reveal… How to Flip Your Event
- Budget Friendly Activity Planning and Engagement Experiences
- Out of Town Trips/Activity Planning & Proactive Problem Solving by aligning Activities with your Organization's Mission
Click HERE to register
If you have questions, please feel free to contact the following GAAP Leadership Team colleagues:
2018 GAAP Leadership Team
President: Scott Bassett (Philips Tower, Decatur) firstname.lastname@example.org
Vice-President: Amanda Bennett (Campbell-Stone Sandy Springs; Atlanta) email@example.com@campbellstone.org
Program/Education: Liana Sisco (Lutheran Towers; Atlanta)firstname.lastname@example.org
So much of the success of activities professionals depends on the networking and ideas shared by those of us "in the trenches." Opportunities for collaboration with peers, in addition to the vendors and speakers, helps to expand our knowledge, our inspiration, and our personal emotional investments in our communities. Every community is different, to be able to attend events that encourage the sharing of our success stories and positive experiences, is vital for the industry as a whole.
- Amanda Bennett, Campbell-Stone Sandy Springs
Food is Medicine
In 431 B.C., Hippocrates, father of medicine said "let food be thy medicine and medicine be thy food." Since inflammation is being considered a possible root cause of many of the medical conditions experienced by older adults – like cardiovascular disease, diabetes, high blood pressure, high cholesterol levels, Parkinson's and Alzheimer's disease, understanding the role food plays in causing inflammation and which foods can help prevent inflammation is important. LeadingAge Georgia invited Jack Brill of Metz Culinary Management to provide a presentation on "Food is Medicine" to our Life Plan Community members. Kim Brenkus, MBA,RDN, Director of Leaning & Development for Metz provided a n informative presentation on Food is Medicine and gave practical guidance on which foods lower inflammation, which foods to avoid due to causing inflammation and she gave general tips to our members on foods to serve improve the health of the older adults we serve. Thank you to Jack Brill and Kim Brenkus from Metz for providing this important information.
Click here to review the Power Point from Kim's presentation.
Click here for a more in-depth article on the role of inflammation on health.
2018 Senior Living Trends
In their new 2018 Senior Living Trends white paper, CliftonLarsonAllen (CLA) explores the tremendous potential for disruption within the current senior living environment, as well as the opportunities the trends present to providers. In response to this risk of disruption, senior living organizations should answer this simple question: What business are you really in? Download the white paper to understand these trends and position your organization for success in the future. CLAconnect.com/2018trends
But the history of population health management predates fee for service payments or the American colonies and contributes significantly to the story of modern day medicine. It is a fact that for all the attention that is generated with the advent of new drug therapies or invasive procedures for the health-related maladies that plague mankind today the greatest reductions in deaths from diseases throughout written history are largely due to our collective ability to identify and document the cause of the congenital or acquired conditions and, where possible, mount society supported efforts to eliminate or eradicate them. The mobilization of the communities of Europe during the bubonic plague of the 1300s, the use of Variolation in Africa in the 1700s to provide immunity from smallpox, the eradication of the London Cholera epidemic of 1854, the 1860 publication of The etiology, concept and prophylaxis of childbed fever by Ignaz Semmelweis which led to the widespread practice of routine handwashing by physicians, iodization of salt in 1924 to reduce thyroid disease, the fortification of bread with niacin in 1934 to reduce pellagra, the enrichment of milk with Vitamin D in the 1930s to reduce rickets, the addition of fluoride to community water supplies in 1945 to reduce tooth decay, the vaccines for polio, German measles, diphtheria, and influenza, the Framingham heart study, the eradication of blindness from guinea worm infestations, safety belts for automobiles, the detection and removal of colon polyps to reduce colon cancers and the distribution of clean needles and condoms to reduce the spread of HIV. None of these advancements would have been possible in the absence of the collection, aggregation, analysis, reporting and utilization of data on populations of afflicted individuals in conjunction with a perception of the benefit to society at large from the reduction of illness from these conditions. The importance of this element of the transformation of medicine is critical. First because all of these are examples of primary and secondary prevention-based interventions versus treatment for an individual. Of equal importance, no direct transactional benefit is accrued to the individuals allocating the resources to support them. These advancements are not possible without first understanding the cause of the condition and then designing, developing and deploying resources first for the benefit of those at greatest risk for acquiring the affliction and, as is often the case, on reducing the burden of illness on those in the earliest stages of affliction. Many of these interventions have their origins in the military. Most of them required a level of organizational structure, processes and outcome monitoring and management beyond the singular scope of even the best practitioners of their day. All of them were aided by the marshalling of the resources of society either through civic, non-profit or governmental support for the benefit of the community at large.
The true origin of population health management, then, lies here; in the understanding that even as we have evolved newer methodologies to treat and cure diseases it is our society-funded advancements in prevention and early detection that have led to the greatest decreases in human suffering. Regardless of your political proclivities the evidence here suggests that it takes a village to eradicate or control the greatest health threats to a population. The one patient at a time business model of fee for service medicine evolved alongside and benefitted from the collective wisdom gained from managing community health issues. The aggregation and management of victims of tuberculosis led to the specialty of thoracic surgery, the treatment of injuries in the theater of war led to the field of trauma surgery, the development of antibiotics and the use of helicopter transport for emergency medical services. But with each new diagnostic and therapeutic modality the cost of health care escalated to the point where the expense incurred from the treatment of one individual with a severe illness could exhaust the generational wealth of an entire middle class family. The desire to reduce the risk of financial ruin from catastrophic illness was, in part, the genesis of employee sponsored health insurance. The subsequent belief as a nation that American seniors should be protected from destitution related to the cost of medical care led to the establishment of the single-payer, national social insurance program known as Medicare.
The introduction of Medicare Part A and Part B in 1966 were game-changers for low-income seniors in communities around America and, frankly, for the hospitals and providers that had served them for years without compensation. Prior to the establishment of this citizen-funded, government-managed health insurance option many of these seniors had been turned away from some hospitals or impoverished due to the cost of treatment for a catastrophic illness. But as beneficial as Medicare was its Fee for Service model led to misaligned incentives by compensating for the treatment of illness and not the prevention of disease. The predictable consequence spawned the medical industrial complex, with the design and development of larger brick and mortar medical treatment infrastructures, the buying up of providers of care and the arms-race-like acquisition of health centered technologies to attract and retain this new revenue stream. Early on it became evident that the system as implemented provided little supervision with regard to over-utilization of diagnostic and therapeutic resources, showed disregard for site of service as a variable in care delivery and rewarded poor performance by paying for complications and their resultant prolonged hospitalizations. The financial impact was so great that many of the medical groups, hospitals and drug manufacturers that were opposed to the passage of Medicare in the beginning became less vocal in their protestation of "government intervention in health care" as they began to reap the benefits of more patients with the ability to pay for the increasing cost for their services. By 1973 Congress and the President were enacting legislation in an attempt to manage the rising costs of government funded health care. But despite the best efforts of the executive and legislative branches U.S. healthcare costs as a percentage of Gross Domestic Product continued to grow at non-sustainable rates. This backdrop sets the stage for the tectonic shift in the U.S. healthcare landscape euphemistically known as managed care.
The epochal shift in the health care terrain is being driven by the convergence of three distinct but related factors in managed care: 1) the lack of personal accountability of a large segment of society for their health and well-being, 2) the realization that the fee for service employer-based and government sponsored insurance models reward the treatment of disease vs the prevention or reduction of illness and has led to the current medical industrial complex and 3) that the cost of primary or even secondary prevention of illness is cheaper than treatment by orders of magnitude for most conditions. Health policy in the United States for the last 45 years has been shaped around the second and third of these factors. We have not focused on the first because as a society we lack the desire or the capacity to hold individuals accountable for the modifiable risk factors that drive the majority of preventable deaths in this country. It is a fact that diet, sedentary lifestyle, obesity, smoking and alcohol are the cause of the majority of premature deaths in this country. We have decided as a nation to hold the providers and underwriters of health care costs accountable for increasing the engagement, education and empowerment of individuals with regard to their health.
All substantive health policy in the U.S. since the Health Maintenance Organization Act of 1973 has attempted to shape U.S. health care based on these two premises. The legislative solutions have attempted to catalyze the collaboration of payers, providers and high performing integrated care delivery system by ratcheting down the pool of inflation adjusted per capita dollars available for total cost of care. The architects of these social engineering policies are aware that the current state individual provider's practice, designed for optimization of the fee for service model, lacks to tactics, the team and the tools to successfully meet the performance and quality benchmarks to be competitive in this new environment. One recent study observed that for the average primary care provider with a panel of 2300 members it would take 21 hours a day for them to provide all of the annual acute, chronic and preventive care functions necessary for their membership3. Health policy architects are counting on market forces to drive the evolution of new symbiotic relationships while eliminating non-competitive models and rewarding those that lower costs, improve quality and enhance the experience of the member receiving care. The most sweeping and recent of these solutions is the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. The stated intend of the legislation is to improve access, increase quality and lower the cost of health care through (among other mechanisms) moving the majority of government sponsored health payments to value-based compensation and away from volume based fee for service compensation. As could be expected all major commercial health plans have quickly followed this trend.
So while the Fee for Service based health care delivery industry has invested time, talent and resources toward maximizing profits in a volume-based, unit-cost maximizing, specialist incentivizing, complication rewarding treatment of disease-based business model the payers of health care are economically catalyzing an antithetical care management model that rewards prevention, health maintenance and reduced utilization of services. As in the case of the ice shipping service and refrigeration these two models could co-exist together for a time. But in the same way that the Industrial Revolution gave the refrigeration proponents a competitive advantage over the ice shippers, the Information Revolution that the electronic age as spawned will provide opportunities to change health care delivery in ways that have yet to be imagined. And those changes are not 100 years into the future but are happening today.
Simply stated health care providers today are first and foremost in the information management business. The successful emerging health care organizations will be the ones that collect, store, analyze, report and utilize health information in a manner that delivers the most value to health care consumers and payers. The tactics for doing so and the importance of population health in achieving this goal are the topic of the next installment in this series.
3Annals of Family Medicine; www.annfammed.org; VOL. 10, NO. 5; SEPT/OCT 2012 396
By: Michael Vincent Smith, MD
News Throughout the Spectrum of Aging Services
Assisted Living Communities/Personal Care Homes
694 Ways to Improve Services and Supports for People with Dementia
A new federal report offers 694 recommendations for conducting research to advance care and services for people living with dementia and their families. Those recommendations can also guide providers of aging services as they design and implement programs for this population, says Kirsten Jacobs, director of dementia and wellness education at LeadingAge.
The recommendations are included in a May 2018 report on the National Research Summit on Care, Services, and Supports for Persons with Dementia and their Caregivers. Several LeadingAge members served on the summit's Service Provider Stakeholder Group.
Summit recommendations span 12 themes designed to guide research investments by public and private stakeholders in the field of care, services, and supports for people living with dementia. Five of those themes are particularly relevant to LeadingAge members, says Jacobs.
Capture the Moment' is the theme for National Assisted Living Week
"Capture the Moment" will be the theme of this year's National Assisted Living Week, Sept. 9 to 15, the National Center for Assisted Living announced Thursday.
The annual observance, established by NCAL in 1995, celebrates assisted living residents and offers an opportunity for others to learn more about this sector of long-term care.
Federally Assisted Housing (HUD-Subsidized)
What RAD for PRAC Means for Affordable Housing for Older Adults
With such a high need for affordable housing, it is critical that we preserve existing affordable housing as we also work to expand its supply.
That's particularly true for the Department of Housing and Urban Development's (HUD's) Sec. 202 Supportive Housing for the Elderly homes, a program that serves older adults with average incomes of $13,300. In fact, in some cases, such as homes built as part of the Sec. 202 program with Project Rental Assistance Contracts (PRAC), preservation has become a near form of art.
Across the United States, just over 130,000 older adults live in Sec. 202 housing built using HUD's PRAC subsidies, which became available in 1990. As of 2017, there are 125,141 PRAC-subsidized apartments in use, according to HUD.
Home and Community Based Services
CMS Floats New Version of Pre-Claim Review for Home Health
The Centers for Medicare & Medicaid Services (CMS) is seeking public input on a new proposal that would bring back the controversial pre-claim review process for home health Medicare claims. Under the new program, home health agencies (HHAs) could choose to undergo either pre-claim or post-payment reviews, or to forgo reviews but take a 25% payment reduction on all claims submitted for home health services, CMS explained in a memo issued May 29.
Life Plan Community/CCRC
More CCRCs part of larger systems now, Ziegler says
Life plan communities have become more likely to be part of larger systems and slightly less likely to be sponsored by a not-for-profit organization over the past several years, according to specialty investment bank Ziegler.
Almost 65% of life plan communities now are part of multi-site organizations, compared with 62% approximately two years ago, Lisa McCracken, director of senior living research and development at Ziegler, wrote in the company's latest Senior Living Finance Z-news newsletter. The percentage is even higher among for-profit communities, 80% of which are part of multi-site organizations, she said.
Life plan communities thrive through connectedness
Eat well. Exercise. Get enough sleep. Keep stress to a minimum.
This is indeed sound advice when it comes to taking care of ourselves. There's something else, however, that needs to be added to this list of priorities, and that's social connectedness. Research shows that social connectedness improves physical health, mental and emotional well-being and even longevity, thereby enabling individuals and communities, including life plan communities, to thrive.
Rehab Business Model Will Change 'Substantially' Under PDPM
Therapy companies that provide services to skilled nursing patients must radically change their business models if the Centers for Medicare & Medicaid Services' (CMS) proposed Patient Driven Payment Model (PDPM) is finalized and takes effect next year. That doesn't mean that rehabilitation services for skilled nursing facilities will go away. But under PDPM, providers will no longer have an incentive to chase therapy minutes — and according to Brad Schopp of Integra Realty Resources, they're already scrambling to adapt.
FY2019 SNF PPS Proposed Rule Analysis – Part III: PDPM Summary
LeadingAge staff will provide analysis on the three key aspects of the FY2019 SNF PPS proposed rule, which CMS issued April 27, 2018:
- SNF prospective payment rates including a proposal for a new case mix methodology to replace the current RUGs-IV, called Patient-Driven Payment Model;
- Updates to the SNF Value-Based Payment(VBP) program and Quality Reporting Program (QRP); and
- Requests for Information on interoperability and electronic healthcare information exchange.
Skilled Nursing Providers Need Steady Vision to Survive Value-Based Struggles
While skilled nursing operators have increasingly faced stresses related to the ongoing shift to value-based care — primarily the threat of decreased reimbursements — at least one observer says the industry hasn't seen anything yet. "You're just entering the value-based dynamic right now," Mountasser Kadrie, a health care management consultant, said during a presentation at the American College of Health Care Administrators' annual convocation in Orlando last month. "By 2019, when all the programs are online and kicking in, you have to make sure that your facility has
something to do with this."
New law brings tougher eldercare background screening — for employees AND owners
A new law in Georgia signed by Gov. Nathan Deal (R) on May 7 will provide additional safeguards against elder abuse at long-term care facilities.
The "Georgia Long-Term Care Background Check Program" will require that owners, applicants and employees of long-term care facilities in Georgia be subject to a national fingerprint-based background check system through the FBI database. The law takes effect Oct. 1, 2019.
Senate Committee Examines Healthcare Workforce Shortage In commending the HELP Committee for its attention to workforce issues, LeadingAge President Katie Smith Sloan stated, "This is one of the top concerns of our members in all parts of the country. In the long-term services and supports sector, the most critical workforce need is for nurses at every level of the profession and for direct care workers. Quality long-term services and supports cannot be provided without a well-qualified workforce. Regulatory requirements increasingly emphasize adequate staffing and training for long-term services and supports. To achieve excellence, providers will need a larger pool of qualified workers."
Confessions of a Culinary Director: Senior Living Dining Staff 'Very Insecure' Even if they're turning out impressive and delicious plates of food like clockwork, chefs in senior living are probably very insecure. Chefs tend to be insecure due to the nature of their work, and knowing that should help senior living executives provide more consistent and helpful support to these teams, according to a culinary operations director with a senior living provider, who is featured in this latest installment of Senior Housing News'"Confessions" series.
Living Well with Diabetes
We're pleased to present this month's topic, Managing Those Fidgety Legs: Restless Leg Syndrome. Characterized by pulling, creeping, throbbing, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them, Restless Leg Syndrome may affect as much as 10-20 percent of the U.S. population. This month we will explore causes, treatments and prognosis for people suffering from Restless Leg Syndrome.
This month's resources are available here and include:
- A short article for distribution / use in community newsletters that can be customized for your facility here
- Talking Points that can be distributed as handouts to residents, staff & caregivers
- Patient exercises and the Restless Leg Syndrome guide by Harvard Medical School
- Follow-up form for distribution to residents attending the Healthy Living Series talks hosted at your facility
The Healthy Living Series (HLS) is a monthly newsletter designed to provide practical educational information and resources on older adult healthy living and health promotion for the residents, caregivers and staff in your community. HLS offers clinicians several resources including Clinician Talking Points, handouts, newsletter articles and follow-up forms for people who attend the Healthy Living Series talks you may provide at your site.
Findings on Falls and Fall Prevention from the CDC
"The first wealth is health." Ralph Waldo Emerson
With falls being one of the factors that often lead to a decline in health for older adults, it's important to be proactive in preventing falls. Linda Kluge, director of quality for Alliant GMCF and a great partner to LeadingAge Georgia provided an article about the recent study from the CDC on falls among the elderly and specific steps that can be taken to prevent falls. One of the key findings is the importance of screening for fall risks at the annual wellness visit, a free Medicare service.
Click here for information on the annual wellness visit to share with the individuals you serve: https://www.medicareinteractive.org/get-answers/medicare-covered-services/preventive-services/annual-wellness-visit.
Click here for the full article about the CDC study
Calling Millennials Caring for a Friend or Family Member
When individuals become caregivers and start looking around for long-term care services and supports, they often find a lack of affordable services. That's why LeadingAge is taking the lead on campaigning for long-term services and supports financing reform. With recognition of the capabilities of millennials, LeadingAge has launched a campaign that calls on millennials to help raise awareness about the prevalence of young caregivers ages 20-36 and the lack of affordable long-term services and supports options available to them and their families. We're calling on millennials caring for a friend or family member to sign up and show support for and build awareness of long-term services and supports financing reform. Your part is easy – sign up, take a selfie with your care partner and share it using #careandshare and dial 804-596-9846 and leave a message of up to 2 minutes sharing your experience about caring for a loved one. For more information, click here:http://www.leadingage.org/carrytheconvo.
Senior Living Providers, Residents Have Huge Appetite for Aging Innovations
It's a misconception that seniors are resistant to change.
In fact, there's a strong appetite for innovations in technology and service delivery among both senior housing providers and the older adults they serve, recent developments indicate.
A fund targeting investment companies that are improving the aging experience—including through technology, home-based care and data analytics—has recently closed, with the backing of roughly 100 not-for-profit senior housing providers and specialty investment bank Ziegler. And a new survey from Revera, one of the largest owners and operators of senior living in North America, has revealed that seniors believe in the power of innovation to maintain their independence as they age.
Administrator - Calvin Court
See full job description at: http://leadingagega.org/jobmart/public/job/213/
Bus Driver - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/224/
Client Administration Coordinator - Personal Care, Inc.
See full job description at: http://leadingagega.org/jobmart/public/job/221/
Executive Director - Clairmont Place
See full job description at: http://leadingagega.org/jobmart/public/job/219/
Facility Operations Manager - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/223/
Home Services Director of Nursing - Lanier Village Estates
See full job description at: http://leadingagega.org/jobmart/public/job/210/
Supportive Services Director - Decatur Christian Towers
See full job description at: http://leadingagega.org/jobmart/public/job/222/
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