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
One of my biggest take-aways in my first three months with LeadingAge Georgia is that our members truly earn the stellar reputations that mission-based organizations share. As I visit our members and meet residents, I hear residents talk about how happy they are and I meet staff who help me see why the residents feel the way they do. I have been delighted to see members taking part in our programs like the Leadership Academy and the Eden at Home training and believe that it is investing in staff that helps make the difference in the caliber of care our members provide. I'm delighted that Alliant Health Solutions Inc. awarded a grant to us to help support the Leadership Academy and the Eden at Home training. I eagerly look at our rosters for class to see who is attending upcoming trainings! This week at the Eden program, we had seven administrators or directors attend which shows me these leaders are committed to furthering a culture of person-centered care and we had a total of forty-eight individuals in the class which shows me that our members are investing in their staff. This feels great! At our recent symposiums for adult day and elderly housing there was some vital and timely information shared and I feel that any of our members in these categories who did not attend missed out!
We have three upcoming opportunities that I hope you take advantage of including our conference which has the topics that are important to our members – staffing and workforce challenges and solutions, social wellness for your current and future residents, turning your staff into champions of resident-based technology and building high performing clinical teams. The conference will be in Greenville South Carolina April 17th through the 19th. If you haven't registered please do so and make your reservation at the Marriott – everyone loves the location which is in walking distance to gorgeous Falls Park and great restaurants. We are also co-sponsoring a workforce symposium along with the Atlanta Regional Commission on March 28th "Reimagining the Workforce: What's the Reality for Aging." This symposium will feature two of our board members Mark Lowell and Deke Cateau as well as Walter Coffey and LeadingAge members Norene Mostkoff, Alexandria Giles, David Brooks and Robert Bowles as speakers. We have our PEAK Leadership Conference coming up March 18th-21st with national thought leaders with innovative presentations like "Addressing the Challenges for Senior Living: Planning for the Future." On Wednesday, March 21st we'll visit our legislators to discuss important legislative asks like changes at CMS to have better surveys, funding to support seniors in our HUD homes and beginning dialogue about universal health coverage. I hope you can join us for this important conference and visit to the Hill.
When I visited Canterbury Court Life Plan Community a few weeks ago, I noticed a resident who appeared to be young – in her mid 70's and I commented that she seemed younger than some of the other residents and I was curious about her decision to move into a life plan community so young. She said that she and her husband had moved in several years ago and she moved in young so she could build her tribe. She said her husband since passed away but she had her tribe and was quite happy. What a great concept and kudos to our members who create an environment that allows one to feel at home with their tribe! This same woman volunteers and visits people when they move in helping them to feel at home too. It's a joy to see residents who are so happy and I know each of you have worked hard to earn the smiles I am seeing in your homes. I'd like to visit more member's homes and organizations.
Please email me to arrange a visit: ghelms@LeadingAgeGa.org.
Community Profiles Radio Interview
Mark Lowell, Executive Director, St. George Village | Roswell Georgia and Ginny Helms , CEO, LeadingAge Georgia discuss the benefits of living in mission-based senior communities, which focus on individualized care and enhancing well-being.
New Power of Attorney Statute: A Tool for Protection Against Elder Abuse By Ginny Helms
In "A Conversation with Katie" our LeadingAge president wrote about elder abuse "It's not something you hear about very often, but it is happening all around us. Often, the family members and caregivers that older people rely on are the offenders, and the consequences can be devastating, both physically and emotionally." Now in Georgia we have a new Power of Attorney Statutory Form that will help cut down on financial abuse. The Power of Attorney (POA) document which Georgia Bureau of Investigator (GBI) director Vernon Keenan called "a license to steal" has been revamped after a law was passed last year designed to reign in abuse of the document. The new Statute allows an individual (principal) to give specific authority to his/her agent for a list of subjects for which the agent may conduct legal transactions (ex. real property, stocks and bonds, commodities and options, etc.). It also allows the principal to prohibit an agent from conducting specific acts on behalf of the principal. The document clearly defines the agent's legal duties for carrying out the functions allowed in the POA and stipulates that the agent may be liable for any damages caused by violation of the document. The Power of Attorney in the hands of a fiscally responsible and ethical person is one of the tools for helping to ensure funds are protected for the care needed by those we serve. We all owe a huge thank you to GBI director Vernon Keenan who used his well-earned reputation to lead the charge for this legislation. A copy of the POA statutory form was provided by DeKalb District Attorney Jean Canavan, one of the strongest advocates for protection of elders from elder abuse.
In the past, family members were caught off guard when they tried to use the Power of Attorney forms in banks and were told the bank would only honor a Power of Attorney form of the bank's and not the one the family member was trying to use. The new law requires banks to honor the new Power of Attorney form giving families better protection they need to do banking on behalf of a loved-one.
Click HERE to download the form.
LeadingAge GA|SC Annual Conference on Aging
Many leadership principles are timeless. And, when the stakes are highest, these principles are put to the test. In the Battle of Gettysburg, thousands of lives were at stake, and moreover, the future of our nation weighed in the balance. With the help of astute historians, we can gain invaluable insights to sharpen our own leadership skills by studying the decisions and actions of battlefield leaders who contributed to the outcome of this important conflict.
Using the Battle of Gettysburg as a backdrop, this session will explore three important team dynamics that all leaders face today:
- Organizational Alignment – how to create it and keep it.
- Creating a culture of Healthy Conflict – how promoting and nurturing executive disagreement creates trust and better outcomes.
- Leadership Preparation – how leadership identification is not enough to create effective leaders.
Understanding these insights can help leaders at all levels in the senior living sector create successful organizations.
~John Franklin, BB&T Capital Markets
Opening General Session Speaker
Join us for the LeadingAge GA | SC Annual Conference on Aging, April 17-19, 2018! Whether you're seeking continuing education, transformation in your work experience, impactful learning nuggets, deeper dives into topic areas, learning vignettes which incite you and your team to action, thought leader space for intriguing conversations or all of the above—join us for the 2018 LeadingAge Georgia Regional Conference on Aging. Access up to 15 CORE & ETHICS CEU hours for you and your staff!
REGISTER NOW: Early Bird Rate Ends March 15th
Click HERE for Hotel Reservations
(Group Rates End March 16th or until the room block fills to capacity)
Click HERE for the Attendee Registration Brochure
Click HERE for the 2018 Exhibitor | Sponsor Prospectus (Only 8 Booth Spaces Left)
The Evolving Workforce: What's the Reality for the Aging NetworkAs communities grow older at a faster rate than ever before, the needs of the workplace and requirements of the workforce are also quickly evolving.
Join us at a workforce summit presented by the Atlanta Regional Commission, the Thanks Mom & Dad Foundatin and LeadingAge Georgia. At the summit we will…
- Explore how to recruit and retain the best direct care workers, nurses, caregivers and others who care for older adults
- Look at how the workplace can adapt to attract and retain talented individuals regardless of age
- Investigate how to sustain workplace productivity following the retirement of the Boomers
- Learn what's happening in higher education to attract nursing, para-pro and other students to community settings and to the aging network
RSVP by March 21
Click HERE to register.
Peak Leadership Summit
Public Policy is one of the most global and impactful ways we can command the support we need for those we serve and fortunately we have a great public policy leader on the national level in our president Katie Sloan. We have a great opportunity to increase our knowledge and effectiveness so that collectively we can leverage our public policy efforts and have some much needed legislative wins. The Peak Leadership Summit will be held in Washington, DC March 18th - 21st. There are some incredibly innovative thought leaders speaking on topics like Provider Innovations in Care Integration and Managed Care, Social Connectedness and Engagement Technologies: Resident and Caregiver Perspectives, Addressing the Challenges for Senior Living: Planning for the Future, New Directions in Strategic Expansion and Growth, From Generation Cohorts to Embracing Age Diversity: A Shifting Mindset, Integrated Service Delivery: A Vision for America's Aging Population and It's A New Day for Nursing Homes: Post Implementation Lessons from Survivors. LeadingAge Georgia board member Gwen Hardy will be representing us at a meeting during the conference to learn about convening a town hall meeting for our members to give input on future policy direction.
Click HERE to register for the Conference
It's official! LeadingAge members can now buy from US Foods through Value First GPO (group purchasing organization). Contact your representative Vanessa Ceasar for additional information about the new US Foods contract. firstname.lastname@example.org, 404-421-3956.
Employee Discounts - Telecommunications
Eligible Plans: Voice plans $39 and above. Data Plans $50 and above.
Discounts: Corporate and Individual Employees 25% off recurring monthly charges for eligible plans.
Eligible Plans: Calling plans $34.99 or higher. Data features $24.99 or higher.
Corporate Discount: 22% off recurring monthly charges
Individual Employee Discount: 22% (19% plus 3% with electronic bill pay)
Looking for savings? Now is a good time to compare what you are currently paying for housekeeping and janitorial supplies to pricing available through Value First GPO.
Call or send an email to Vanessa Ceasar to schedule a housekeeping supplies cost study for your community, and to sign up for AT&T or Verizon employee cellular discounts. email@example.com, 404-421-3956.
Value First, an affiliate of Vizient/Provista, 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.
Pam Van Ahn
14 Sloan Street
Roswell, GA 30075
Adult Day Services
3611 Valley Centre Drive, Suite 300
San Diego, CA 92130
20 Ramsey Road
Shirley, NY 11967
2314 Route 59. Suite 384
Plainfield, IL 60586
TESCO (Transportation Equipement Sales Corp)
6401 Seaman Road
Oregon, OH 43616
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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 May
May 5 Cinco de Mayo
May 6 National Nurses Day
May 13 Mother's Day
May 16 Ramadan
May 28 Memoria Day
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LeadingAge Georgia Public Policy Report
By Tom Bauer, LeadingAge Georgia Policy Advisor and Ginny Helms
The Georgia General Assembly is in a hectic state, here towards the end of the session as everyone is vying to get their bills passed and get their money in the budget. The LeadingAge Georgia team has been working hard on several issues, including the public policy agenda item to secure increased funding for adult day (health) centers. In addition, several bills affecting seniors are winding their way through the General Assembly.
LeadingAge Georgia, in concert with the Georgia Adult Day Services Association, has been advocating for a 5%increase in Medicaid reimbursement rates for adult day centers. On March 7th the House budget reflected an appropriation recommendation of 56% of our ask. While it is not 100% of our ask, the only other proposed funding increase for aging was a $5 per day increase for the personal needs allowance for residents on Medicaid funding in nursing homes. No funding increase was recommended for home and community based increase and no funding was appropriated for the Aging and Disability Resource Centers which fund the resource function of the Agency Agencies on Aging. We are now working on the Senate side of the legislature to ask for the 5% increase. After they establish their budget a conference committee will hash out a final budget. LeadingAge Georgia adult day members Ned Morgens and Claire Russell testified to the House Appropriations Community Health Subcommittee in February and the LeadingAge team has met individually with representatives and senators from the sub-committees who oversee the Department of Community Health budget where the funding goes for Adult Day Health Centers. LeadingAge Georgia members Joe Robbins and John Sims also worked with Representative Carolyn Hugley who championed the ask. State appropriated funding for the day centers will allow over a 60% match of funds to be drawn down from the federal government.
LeadingAge Georgia has been advocating and/or closely monitoring several bills affecting provider members, as well as the seniors they serve.
SB 406 (Strickland)- This bill, which was introduced on behalf of Governor Deal, evolved from one of the priorities of CO-AGE (the Coalition of Advocates for Georgia's' Elderly), creation of an Elder Abuse Registry. SB 406 would revise the law requiring background checks on personal care and nursing home employees to require a fingerprint check for all applicants and current employees who have direct access to patients, residents, and clients of the following:
- Nursing homes
- Assisted Living Communities
- Personal Care Homes
- Adult Day Centers
- Home health agencies
LeadingAge Georgia is working with the Department of Community Health and the author of the bill to ensure that implementation of SB 406 is not overly burdensome in:
- Delaying the hiring process
- Sufficiency of locations to obtain fingerprint checks
- Ensuring employer (provider) access to results of the test
SB 406 also authorizes the creation of caregiver registry so that family members or guardians of elders who want to hire caregivers in the home may check with DCH on the background of a prospective employee. The bill passed the Senate with a vote of 52-1 and has been assigned to House Human Relations & Aging.
SB 444 (Unterman)- This bill creates the Georgia Alzheimer's and Related Dementia Advisory Council to provide input to the Georgia Alzheimer's and Related Dementia State Plan. It also directs the Department of Human Services to staff a position for the Advisory Council and serve as the State Plan coordinator. This bill passed out of the Senate on Crossover Day unanimously.
HB 635 (Cooper) This bill is called The Disabled Adults and Elder Persons Protection Act and encourages the creation of coordinating teams similar to what has been created in Augusta to increase prosecution of elder abuse in the area. The bill passed the House on February 15 in a vote of 158-0.
SB 370 (Wilkinson)- This bill exempts the first $25,000 of a person's assets from estate recovery under the Medicaid program. Currently only estates that have $25,000 or less get an exemption from recovery so this bill is an effort to create fairness for all families facing estate recovery. The bill passed the Senate unanimously and has been assigned to the House Health and Human Services committee.
HB 803 (Willard)- This bill creates the criminal offense of trafficking an elder or disabled person for the purpose of appropriating the financial resources of the person for one's own personal or another's benefit. This bill passed the House with a vote of 165 – 1.
LeadingAge National Advocacy Public Policy Priorities for 2018
The LeadingAge national board of directors earlier this week approved their Legislative and Regulatory Advocacy Priorities for 2018.
LeadingAge will LEAD in five policy areas. Leading means we will exert maximum organizational effort and make a nationwide commitment to the policy:
- Affordable Senior Housing
- Quality Measurement and Quality Assurance, Including Substantive Improvements to Nursing Home Survey & Certification
- Promote LTSS Finance Reform
- Integrated Health and Long-Term Services and Supports
- Improve the Ability of Medicare Post-Acute Care Programs to Better Serve Beneficiaries
LeadingAge will ENGAGE in five policy areas. Engaging means we will exert moderate organizational effort on targeted activities.
- Safety Net Programs for Older Adults
- Protect Non-Defense Discretionary Funding
- Telemedicine and Health Information Exchange
- Hospice Services
- Include Home Health in the Rural Health Care Connectivity Act of 2015
LeadingAge will MONITOR three legislative policy issues (at present, these do not involve regulatory solutions). Monitoring means we will actively track these issues.
- Net Neutrality
- Continue to Ensure Fair Tax Policy
- Home and Community-Based Services Funding
Winter Maintenance Forum
If you missed the Winter Maintenance Forum—you missed a treat! The Create Center did not disappoint! New innovations in flooring systems from tread to seam, to production, and everything in between--was fascinating! Thanks to Kevin Bettis and the Shaw Contract innovations and design team who hosted us and provided much insight to what's in the market place and on the horizon for healthcare and senior living markets. A big thanks to Charlotte Williams from Vertical Systems for an informative update on elevator maintenance. Top notch experience and don't miss our next Maintenance Professionals Forum on August 29, 2018. Registration is coming soon.
Assisted Living Symposium
March 13, 2018
Leadership Academy - Second Event
March 14, 2018
March 28, 2018
2018 Annual Conference
April 17-19, 2018
Leadership Academy - Third Event
May 9, 2018
May 11, 2018
Registration coming soon
Mental Health First Aid
July 12, 2018
Registration coming soon
GAAP Summer Symposium
July 20, 2018
Registration coming soon
Fair Housing & Ethics Symposia
July 25, 2018
Registration coming soon
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Seminar: Speaking about Wellness
WellStar Atlanta Medical Center will launch a Speaking about Wellness for Healthy Aging program this month. This program targets people ages 50 and older giving them tools to make lifestyle enhancements for their personal health and wellbeing. Their first seminar, "All About Diabetes," will be on Tuesday March 20 at 6:30 p.m. at WellStar Atlanta Medical Center South in the Auditorium located in East Point. Diabetes is a chronic disease that impacts over 29 million people in the United States. Lisa Thomas, who is a WellStar Diabetes Educator will be the keynote speaker and will address ways to prevent or manage diabetes to help maintain a high quality of life through a healthy diet and exercise.
The seminars will rotate between WellStar Atlanta Medical Center (AMC) and WellStar Atlanta Medical Center South (AMCS) throughout the year. The cost is $10, and participants receive a healthy dinner, complimentary valet parking and giveaway items.
To register, call 770-956-STAR (7827). For more information, contact Rashan Noble at Rashan.firstname.lastname@example.org or call 404.466.1117.
Homestead Exemption Deadline is April If you live in a home you own, you may be able to reduce your property taxes by making sure you are taking advantage of all exemptions. This is especially important as property values continue to rise across the state in metro areas.
To qualify for homestead exemptions, the property owner claiming the exemption must own, occupy, and claim the property as their legal residence on January 1 of the year in which they first qualify for the exemption.
In addition to basic homestead exemptions, there are other exemptions available for seniors, particularly in Fulton County. These exemptions have requirements for both age and income. Some require an age of 62 and others require that the applicant is age 65 or 70. Exemptions are available for people qualifying for full disability and other special circumstances.
Homeowners must apply for exemptions – they do not take effect automatically. Basic homestead exemptions renew each year automatically as long as you own the home. Most senior exemptions also remain in place as long as you own the home. If any changes are made to the deed, even if the occupants remain the same, you will need to re-file for homestead exemption.
To apply, you need to bring your driver's license or Georgia ID and all vehicle registrations. If you are applying for a senior homestead exemption, you should also bring both your Georgia and your Federal tax returns.
The first stop is the Fulton County Tax Assessors' Office to apply for exemptions with Fulton County, Atlanta and Fulton County school systems and basic city exemptions (if any). Fulton County seniors who live in the cities of Alpharetta, College Park, East Point, Fairburn, Hapeville, Milton, Palmetto, Roswell or Union City should also contact their city directly about any available senior homestead exemptions.
The 2018 homestead exemption deadline is Monday, April 2. Fulton County residents can learn more online at www.fultonassessor.org or by calling 404-612-6440 X 4.
FULTON COUNTY TAX ASSESSORS
404-612-6440 X 4
TAX ASSESSORS OFFICES
Peachtree Center, North Tower
235 Peachtree Street, NE, Suite 1100, Atlanta, GA 30303
Fulton County Government Center
141 Pryor Street, SW, Suite 1018, Atlanta, GA 30303
Fulton County Customer Service Center at Maxwell Road
11575 Maxwell Road, Alpharetta, GA 30022
North Fulton Service Center
7741 Roswell Road, NE, Suite 261, Atlanta, GA 30350
South Fulton Service Center,
5600 Stonewall Tell Road, Suite 224, College Park, GA 30349
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2018 CCNG Advisory Group Meeting Dates & Update
Friday, April 20, 2018 | 9:30am – noon | Location: TBA
Friday, August 24, 2018 | 9:30am – noon | Location: TBA
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Adult Day Symposium
If you missed the LeadingAge Adult Day Symposium on February 23rd, you missed a lot of great information from our speakers and fantastic exchange of concerns and solutions from our members. You missed a presentation by Karin Pendley Koser, owner and creative director of KPKinteractive. She shared some interesting and practical tips for public relations and marketing and she stressed the need of telling your story – telling human interest stories about your staff and information about programs that sizzle and individuals you serve--- the ones who bring sparkle to your center. "Our adult day members provide an incredibly important form of care that allows people who need oversight to stay in the community, yet they struggle to get referrals from hospitals, case managers and they struggle to get needed funding. I think marketing our adult day centers well is one of the areas we can all work on to let our communities know of the great benefits of adult day centers and to garner the financial support that our centers deserve" said Ginny Helms, LeadingAge Georgia president. Take a look at Karin's website and look in to the services of other PR firms and consider how you can up your game in marketing your adult day center.
Did you know that all staff and volunteers who provide direct care to participants must have received a report of physical examination by an authorized healthcare professional within twelve months prior to employment and that it is to be done by a physician or other qualified health care professional? And do you know the definition of a qualified health care professional? Apparently a lot of providers do not know this because it is the number one violation on surveys for adult day health centers. Shirley Rodrigues, manager of the personal care home program of the Department of Community Health gave a very informative talk on the top ten survey violations of adult day health centers. She also gave some great tips. Shirley said that centers are concerned that some of the potential hires do not have insurance and thereby access to physical exams. She recommended two options for this – exams at urgent care centers or county health departments. Click HERE for Shirley's presentation.
If the new bill passes that requires fingerprint background checks, adult day centers will be required to have them for direct care workers. Carla Jones shared at the symposium that they are already having fingerprint background checks conducted on future employees by COGENT, the same organization that will be doing the background checks if the bill passes. Carla indicated that the system is working well for the most part and that occasionally follow-up is needed if there is a miss-hap with the background check.
Make sure to attend the next Adult Day Symposium which will be in October and please contact Jacque or Ginny with suggestions for topics – jthornton@LeadingAgeGa.org and ghelms@LeadingAgeGa.org
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
GAAP Winter Symposium
They say those who are closest to the problem are the best at creating the solutions. This adage was particularly profound during the collaborative approach guided by our most talented and astute Georgia Association of Activity Professionals who attended the Winter GAAP Symposium on February. Activity, Life Enrichment/Engagement Coordinators, and Wellness professionals across the state began the process of promising practices for the development of standards in person-centered care planning and documentation for resident/client wellness and engagement—a framework toward elder-hood wellbeing. Join the leaders in LeadingAge member organizations who are crafting the model for the change we all want to see in the area of resident engagement as well as person directed care and experiences—regardless of where older adults call home.
Our GAAP Supper Symposium is scheduled for July 20, 2018. Registration is coming soon!!
Thanks to the GAAP Leadership Team:
- Symposium facilitators Melissa Scott-Walker, Consultant & Liana Sisco, Lutheran Towers
- Start with Why by Simon Sinek (A Guide to Getting to Purpose in your Work) facilitated by Scott Bassett, Philips Tower
- Planning and Convening by Amanda Bennett, Campbell-Stone Sandy Springs
- Poignant opening session by Lisa Kiely, Lenbrook-Atlanta Life Plan Community
2018 Training Events
July 20, 2018 GAAP Summer Symposia - Save the Date
Activity and Life Enrichment professionals are a critical asset to creating an environment for lives worth living in the senior living and aging services arena.
That's why we're happy to announce the return of the Georgia Associaiton of Activity Professionals! Your significant involvement will ensure the future of this great organization contiues its mission of providing Activity Professionals with quality and affordable opportunities for professional development and personal growth.
2018 GAAP Leadership Team
President: Scott Bassett (Philips Tower, Decatur) email@example.com
Vice-President: Amanda Bennett (Campbell-Stone Sandy Springs; Atlanta) firstname.lastname@example.org@campbellstone.org
Membership: Melissa Scott-Walter (A.G. Rhodes Health & Rehab; Atlanta)email@example.com
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
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
New GAO Report Focuses on CMS but Could Have Direct Effects on Assisted Living
A report publicly released February 5th by the Government Accountability Office contains
a to-do list for the Centers for Medicare & Medicaid Services related to state reporting of
deficiencies in care and services provided to Medicaid beneficiaries in assisted living
communities. Some federal lawmakers and consumer advocates, however, say they will
push for changes in assisted living because of the report's findings.
CDC Data Show How Small, Large Assisted Living Communities Differ
Smaller assisted living communities, on average, have more residents who need
assistance with activities of daily living, more residents with Alzheimer's disease or
depression, more residents who are Medicaid beneficiaries and younger residents
compared with larger communities, according to a data brief published Tuesday by the
Centers for Disease Control and Prevention's National Center for Health Statistics.
Federally Assisted Housing (HUD-Subsidized)
HUD Asks Congress for Deep Cuts
The initial request would underfund Section 202 Project Rental Assistance Contract and
Project-Based Rental Assistance contract renewals, zero out the Public Housing Capital
Fund (33% of public housing homes are senior households), and would result in 200,000
fewer housing choice vouchers in use in FY19 than in fiscal year 2018 (24% of voucher
homes are senior households). The request would zero out the HOME and Community
Development Block Grant programs, and eliminate the National Housing Trust Fund.
President Trump's request would fund homeless assistance programs at FY17 levels, at
a time when homelessness among older adults is on the rise.
Home and Community Based Services
CMS to Allow Non-Skilled Home Care Benefit in Medicare Advantage
Non-skilled in-home care supports will be included as a supplemental benefit in Medicare
Advantage plans in 2019, according to the Centers for Medicare & Medicaid Service
(CMS), which announced the policy change February 1. The move marks the first time
that CMS has allowed an item or service to be eligible as a supplemental benefit that
covers daily maintenance. Along with non-skilled in-home care supports, CMS will also
include portable wheelchair ramps and other assistive devices and modifications when
patients need them.
White House Budget Calls for Home Health Payment Cuts
The White House on Monday released its proposed 2019 federal budget, which calls for
the home health groupings model (HHGM) to be implemented along with a unified postacute payment system, and allocates more money to crack down on home health fraud. The budget document provides insight into what policies President Donald Trump's
administration would like to implement, but it is not likely to be enacted. This is true of the
White House budget proposal every year, but especially this year, given that Congress
recently passed a bill—signed by the president—that lays out federal spending for 2018
Life Plan Community/CCRC
LeadingAge CCRC and Nursing Home Studies Underway
The 2018 CCRC and Nursing Home Salary & Benefits studies are now underway. Both studies are published by HCS in cooperation with LeadingAge.
• CCRC - Deadline April 9th
• Nursing Home - Deadline May 7th
• Discounted participant rate for LeadingAge members: $165
HCS questionnaire link:
To view a complete press release on the studies, click here. A separate Assisted Living Report was published last month. Please email Rosanne Zabka, RZabka@hhcsinc.com or call (201) 405-0075 with any questions.
Number of CCRCs Decreases for First Time in at Least Seven Years
After increasing every year since at least 2010, the number of continuing care retirement
communities decreased in 2017, according to Ziegler's national CCRC listing. The
specialty bank shared data going back to 2010, current as of Dec. 31, in its latest "Senior
Push for Therapy Caps' Elimination Takes on New Urgency
Several therapy associations February 1 called on Congress to permanently end
Medicare Part B caps on physical, speech and occupational therapy by adding
language to an expected funding measure. Though Congress agreed in theory last
year to remove hard limits, action fell to the wayside as Democrats and Republicans
battled over a budget resolution — a fight that ultimately ended in a three-day
$1.96 Billion Nursing Homes Cut Will Force Hard Look at Regulation, Payment, Experts Say
The federal budget deal struck last week will squeeze nursing homes tighter than ever,
advocates said as they began strategizing about how to stem the damage. The
American Health Care Association/National Center for Assisted Living said it will focus
on winning more regulatory reductions to help compensate for a 10-year, $1.96 billion
cut to skilled nursing that Senate leaders lobbed onto their two-year spending plan.
"The issue for us is, we continue to have deteriorating margins, projected to be south
of 1% next year," Clifton J. Porter II, AHCA's senior vice president of government
relations told McKnight's Friday. "When you combine the overall margins with the
occupancy rates and then you compound that with a rate reduction, it's a clear
New CMS Frequently Asked Questions About Long Term Care Regulations
Click herefor a copy of the newly updated CMS document "Frequently Asked Questions Guide about Long Term Care Regulations", the survey process, technical questions, and other related LTC areas.
Free Webinar: The Nuts & Bolts of the New LTC Survey Process
Thursday, March 22 -
3:30 p.m. ET, 12:30 p.m. PT
The new procedures for the Long-Term Care Survey Process (LTCSP), conducted by the Centers for Medicare & Medicaid Services, went into effect in November. But many LTC facilities are still scrambling to understand and follow the new procedures.
In this one-hour webinar, you'll discover why the LTCSP matters to your organization. You'll know what to expect, from the minute the surveyors enter your facility. You'll learn exactly what information you'll need to provide at specific intervals during the survey. We'll also give you details about each of the seven steps of the new LTCSP.
Click HERE to Register
Webinar and Issue Brief on the Topic of Opioid Use Among Older Adults
Opioid use among older adults is a growing concern particularly since it is thought that opioid use may contribute to cognitive decline. To learn more about the issue, consider joining the webinars scheduled for March 21st and 22nd. Registration is open through March 16th. The webinars are being presented by the Substance Abuse and Mental Health Services Administration.
Click HERE to Register
A Conversation with Dr. Atul Gawande
Grantmakers in Aging recently hosted " A Conversation with Dr. Atul Gawande." During the webinar, Dr. Gawande best known for his book and movie "Being Mortal: Medicine and What Matters in the End" spoke of two important issues – well-being throughout a lifetime and a systematic approach to managing health risk factors.
If you missed the webinar click here to hear Dr. Gawande's insight on these important topics.
2018 Healthy Communities Summit
The 2018 Healthy Communities Summit is coming up May 16-18th. This conference brings together 350 professionals from around the state of Georgia including: senior center managers, Area Agency on Aging staff, dietitians, nurses, care coordinators, health educators, centers for independent living staff, and others involved in planning and providing care for older adults and those with disabilities. The summit provides sessions and workshops on a variety of topics that focus on healthy aging and healthy living. The goals of the summit is to improve the integration and seamlessness of services to older adults and people with disabilities.
All the info about the conference (conference program, exhibitor prospectus and registration) can be found here:
Hotel booking info can be found by clicking HERE
Free Webinar: The Top Tech Trends That Will Transform Senior Living In 2018
Technology is dramatically improving the level of care senior living residents receive. But in order for providers to truly differentiate themselves, they need to identify and focus on the technologies driving the greatest change. Join CDW Healthcare and Senior Housing News in this free webinar where panelists will dive into the five tech trends that represent the next iteration of human-centered care.
Our experts will discuss:
- Wearable devices
- The Internet of Things
- Voice activation technology
- IT Security
March 14, 2018 -
Click HERE to register
Administrator - Calvin Court
See full job description at: http://leadingagega.org/jobmart/public/job/213/
Chief Operating Officer - A.G. Rhodes Health & Rehab
See full job description at: http://leadingagega.org/jobmart/public/job/211/
Director of Operations - Athens Community Council on Aging
See full job description at: http://leadingagega.org/jobmart/public/job/212/
Executive Director - Campbell-Stone Apartments
See full job description at: http://leadingagega.org/jobmart/public/job/208/
Home Services Director of Nursing - Lanier Village Estates
See full job description at: http://leadingagega.org/jobmart/public/job/210/
Manager of Resident Services - Wesley Woods Towers
See full job description at: http://leadingagega.org/jobmart/public/job/217/
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2018 LeadingAge Awards Call for Submission: Now Open The LeadingAge Annual Awards honor LeadingAge member organizations and individuals that embody excellence in nonprofit aging services. Award recipients make outstanding contributions to our field and represent models of leadership, quality, and innovation.
Submission Deadline: Monday, April 30, 2018
Click Here to Submit