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.
LeadingAge Georgia Announces 2018 Icon in Positive Aging - Beverly "Guitar" Watkins
Legendary Blues Guitarist Still Making Music at 79 Years of Age
ATLANTA --- After six decades of working with the likes of Ray Charles, James Brown, and BB King, Beverly "Guitar" Watkins will be the star of the show on November 18 at the Atlanta History Center when she will receive LeadingAge Georgia's Positive Aging Icon Award.
Ms. Watkins has been a fixture in the blues community for years after starting her musical journey near Atlanta in 1959. She has played throughout Georgia and toured the United States and Canada. Locally, she was a beloved fixture at Underground Atlanta for many years. With the advent of YouTube and Facebook, a whole new generation of fans have also found Ms. Watkins. Known for her intense guitar playing, she opened the door for other female blues guitarists and is still playing at 79 years of age.
Jacquelyn Thornton, Senior Vice President of LeadingAge Georgia, said: "Ms. Watkins' talent, longevity, and spirit is a shining example of positive aging. She sets the stage for others by showing that age doesn't have to slow you down or keep you from doing what you love … and providing joy to others."
Ms. Watkins is the seventh recipient of LeadingAge Georgia's Positive Aging Icon Award. Past recipients including US Olympiam Dr. Mel Pinder, Ambassador Andrew Young, Bishop Dr. Barbara L. King, former Atlanta Mayor Sam Massell, former Atlanta news anchor Monica Kauffman Pearson, and Atlanta Braves President John Schuerholz.
In addition to Ms. Watkins, there will be other honorees at this year's ceremony. These 19 elders were selected based on those who have changed lives, achieved a positive aging lifestyle, and continue to give of their tremendous talents and wisdom. They include Michael Halpern, a Lenbrook resident and 27-year volunteer with YES! (Youth Experiencing Success), a program that works with at-risk inner-city youth to give them tools to open new life possibilities; and Sondra Rhoades-Johnson, the Principal of Rhoades Strategies Consulting. Ms. Rhoades-Johnson has previously worked as Fulton County Tax Commissioner; Georgia Technology Authority's Chief Planning Officer for IT Strategic Planning; and Executive Director of the Georgia Council for the Hearing Impaired. She currently serves on the AARP Georgia Executive Council.
"These two recipients, as well as the others who will be honored demonstrate the positive aspects of aging and how at any time of life, we can give back and make a difference in the community and the world at large," said Thornton.
If you haven't already done so you can REGISTER HERE.
For more information please contact Jacquelyn Thornton of LeadingAge Georgia at 404-889-8536 or firstname.lastname@example.org.
Conversations with Ginny
"Act as if what you do makes a difference, it does."
- William James
As Thanksgiving Day approaches, I am very grateful that together, we're identifying ways we can improve lives of older adults and we're making needed changes.
Our adult day center members tell us that over ninety-five percent of the older adults they serve have Alzheimer's disease or another form of dementia. Day centers are truly special communities where individuals thrive with companionship, enjoy super fun activities, medical oversight and good meals. With the care of creative and compassionate staff drawn to the work by a sense of mission, participants in day centers are given the opportunity to stay in the community until frail health warrants long-term care. The two biggest challenges adult day providers have identified are inadequate funding and problems with transportation. Over the last couple of months, we've been working with the Georgia Adult Day Services Association leadership to address transportation issues. The day center operators were most concerned about client safety because transportation providers were not ensuring that clients with dementia walked safely through the door of the centers. This left the clients at risk for wandering, falls and in one case a person with Alzheimer's was dropped off at Lowe's by mistake. James Peoples and his team at the Georgia Department of Community Health heard our concerns and worked with us and the transportation brokers to make needed changes. We are grateful to James and the teams at Logisticare and Southeast Trans for working with us to ensure the safety of individuals living with dementia. See article in the adult day section.
LeadingAge national is also listening to members and utilizing the information to make needed changes. As you may know, our national office encouraged us to host town hall meetings in each state to get input from our members for the purposes of forming our public policy initiatives for the coming year. These meetings have been going on for the past year including ours which was held at our conference last April. At a recent state exec meeting, Katie Sloan our president said that managed care bubbled to the top as one of the issues that our members are concerned about. National has responded to the concern with the launching the LeadingAge Center for Managed Care Solutions & Innovation to address both Medicare Advantage (MA) and Medicaid Managed Long-Term Services and Supports (MLTSS) and related challenges. The objective is to help members cope with immediate concerns as well as to enable members to understand and participate in new program and financing approaches that integrate primary and acute care, post-acute care, and long-term services and supports. See "When Members Talk, We Listen" article.
Speaking of LeadingAge national, I hope you have your calendar marked to attend our annual business meeting on December 6th at Canterbury Court. Katie Sloan will be joining us and sharing her thoughts on how we're working together to improve the lives of older adults. Katie truly listens to our members and she and her team at national are incredibly effective at developing public policy initiatives based on the input of LeadingAge members.
In case you didn't see the email we sent out regarding a change in the national dues structure, I want you to know that national has worked over the past year with a committee to restructure dues so that they will be equitable to all members. The dues will be based on the program revenue and a dues band will be used. The net result will not be an increase to national; however, members will likely see an adjustment to dues. Some members will see a decrease in dues and some will see an increase. Know that if you have concerns, you are welcome to contact me. The team at national has been very conscientious about the changes for our members and will work with us when there are concerns.
Many of you know the incredible work of Dr. Robyn Stone, a noted researcher, leading authority on aging and long-term policy, and fortunate for us, she's the Senior Vice President of Research, LeadingAge and Co-Director, LeadingAge LTSS Center @UMass Boston. LTSS' mission is to create a bridge among the policy, practice and research communities to advance the development of high quality services. At the state exec meeting in Philadelphia, Robyn spoke about the member survey that is underway at national. The purpose of the survey is to develop a clear picture of who our members are and who our members serve. The information will be used for important policy meetings with Congress, CMS and other governmental agencies who shape policy. National will be contacting your organization directly so please ensure that your team participates with the survey.
Mark your calendar to attend the Tech and Aging Summit on December 12th. We have some outstanding speakers and topics lined up based on the input from our members. Click here for registration.
Finally, we hope to see you at Profiles of Positive Aging Sunday, November 18th at the Atlanta History Center. Click here to purchase tickets.
Thank you for what you do to make a difference in the lives of older adults.
LeadingAge Georgia to Hold 2018 Annual Business Meeting
Representatives from provider member organizations will come together from all over the state for the 2018 Annual Business Meeting to be held on Thursday, December 6th.
The main contacts for each provider member organization were sent registration information via email.
The Board of Directors request that a representative from your organization attend this meeting to be a significant part of the following agenda for the day:
Reflections by Katie Sloan, LeadingAge National
Caring Heart Awards
Volunteer of the Year Award
Innovative Programs/Services Award
Distinguished Service Award
Award of Honor
Highlights of accomplishments of LeadingAge Georgia and the Georgia Institute on Aging
Approve the 2019 budgets as well as support the installation of new officers and board members for the Association and the Institute
Understand the strategic priorities and how the Association plans to support your staff and organizations
Receive an update of the comprehensive public policy/advocacy issues for 2019
Honor the staff who completed the 2018 LeadingAge Georgia Leadership Academy
End the morning with a Networking Luncheon with Colleagues
2019 Leadership Academy Registration Now Open
LeadingAge Georgia Leadership Academy offers members a challenging and engaging year-long learning experience, designed to help aging services professionals at any level in their organization accelerate their leadership development so they are better equipped to serve our field.
The vision of LeadingAge Georgia is to create a generation of authentic, open-minded and transformational leaders who will collaboratively and innovatively create the future of aging services in America.
The 2019 class begins in February. This class is limited to 24 participants.
Click HERE for application
Home Depot ProPurchase Program
LeadingAge members who purchase maintenance, janitorial, or housekeeping supplies from SupplyWorks (aka Interline Brands) through Value First can save money and keep better track of in-store Home Depot purchases.
Why worry about collecting receipts after staff go to Home Depot? You can have one-account billing with total visibility! All in-store purchases using the Home Depot ProPurchase card can appear on your community’s SupplyWorks account invoice.
Contact Value First representative Vanessa Ceasar at email@example.com or call 404-421-3956 to save money by enrolling with SupplyWorks under Value First, and to enroll in the Home Depot ProPurchase Program.
Click here for more information about the ProPurchase Program and click here for a copy of SupplyWorks Home Depot Healthcare Guide for Facility Maintenance.
Request a Cost Study Today!
Click HERE to submit your cost study request
This is your GPO!
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. This is your GPO
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CaraVita Home Care
648 Mimosa Blvd
Roswell, GA 30075
Home Care/Home Health
Congratulations to Ellen Miller on her retirement from Clairmont Oaks!
Congratulations to Kathryn Duke on her promotion to Administrator at Clairmont Oaks!
Congratulations to Maria Manahan, new CEO for Campbell-Stone Retirement Living!
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for January
January 4 - National Spaghetti Day
January 14 - Orthodox New Year
January 21 - Martin Luther King, Jr. Day
January 23 - National Pie Day
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LeadingAge Georgia Public Policy Report
by Ginny Helms
The public policy committee, LeadingAge Georgia staff and our lobbyist Tom Bauer are in the process of conducting background work to prepare for the upcoming legislative session.
Several of our assisted living provider members told us that individuals at end of life often experience severe pain because state regulations do not allow staff in ALs to administer pain relieving medications like morphine when needed. Our members indicated that the Georgia Department of Community Health (DCH) regulators indicated that the statute does not allow for AL staff to administer medications that require "judgment" on the part of the nurse. We're investigating the limitations set forth in the law and potential remedies including legislation.
We are continuing to have conversations with leadership of the Georgia Bureau of Investigation (GBI) and DCH regarding the implementation of the fingerprint background check program resulting from recent legislation. Selena Norris, GBI Program Manager, NCJ Services and Sakinah Johnson of DCH spoke at our Adult Day Services Symposium about the upcoming plans for implementing the fingerprint background check. Ms. Johnson indicated that all owners, staff and unsupervised volunteers working in long-term care will have to pass fingerprint background checks when the law goes into effect in November, 2019.
We have been working with the GBI to make the background checks more readily available for our members. Ms. Johnson confirmed our previous discussions which include allowing our members to purchase a GAPS livescan machine from Gemalto. The initial cost is $4,995 which includes a full warranty, maintenance and support for the first year. Then there is an annual maintenance cost of $600. Ms. Johnson confirmed that if there is not a GAPS print site in the area, it is very likely that the GBI can get the machine installed at no cost as long as our member is willing to make the service available to the community. Members interested in further information about purchasing or being a host site can contact Selena Norris at 404-270-8642. We will be following up with the GBI over a concern that we have that we learned about at the adult day symposium. We were told that the FBI will not allow a background check outcome to be shared with more than one organization even if the individual has provided consent for it to be shared with more than one employer.
The Joint Study Commission of the legislature has conducted four hearings for making medical marijuana accessible in Georgia. The hearings have now concluded and the Joint Study Commission will be writing a report to submit to the full legislature. Medical marijuana is legal now in thirty-three states and is showing relief for older adults from pain from chronic conditions like arthritis and Parkinson's disease. If you haven't heard the podcast from LeadingAge national on the use of medical marijuana at the Hebrew Home in New York, take a few minutes and listen.
At the Joint Commission hearing on November 14th, there was strong opposition from the Sherriff's Association and overcoming their concerns will be the biggest hurdle for passing laws in Georgia that will make medical marijuana accessible in Georgia. Their biggest concern seems to be the growing of marijuana in Georgia which they think will be difficult to control within a legal framework. If this issue is to be resolved, work will need to be done on best practices of other states that may mitigate the concerns of law enforcement.
Here are the 2018-2019 Public Policy Issues that LeadingAge Georgia has chosen for priorities:
LeadingAge Georgia 2018-2019 Public Policy Issues
Position and Involvement:
- Adult Day Services
- Cost Studies for Services & Transportation
- Medicaid Waiver (Expansion and Waiver Programs)
- Cost Studies for In-home Services
- Medicaid Non-Emergency Transportation (NET)
- Physical and Behavioral Health Needs: Aging in Place
- Mental Health
- Access to Medical Cannabis
- Medicaid Funded Assisted Living Communities
- Nurses being able to administer end of life medications as needed
- Research challenges for members, investigate statute and need for legislation
- Life Plan Communities/CCRCs
- Legislation to Change Name in Statute to Life Plan Community
- Implementation of SB 406 (Fingerprint Background Check)
- Accessibility to Fingerprint Sites
Position and Monitor:
- Home and Community-Based Services: CMS Rules
- Community Care Services Program (CCSP)/Service Options Using Resources (SOURCE)
- Proxy Caregiver Rules
- Continuing Care Retirement Communities (CCRCs): Department of Insurance
- Property Tax Issues concerning Not-for-Profit Organizations
Position and Involvement:
- Home and Community-Based Services Medicaid (CCSP) and Non-Medicaid
- Adult Day Center Reimbursement Rates
- Financial Resources/Loan Forgiveness for Gerontology Education/Aging Services Professionals
- Health Coaches (for Mental Health Concerns)
- Funding for Increased Staffing in Nursing Homes
Position and Monitor:
- Nursing Home Provider Tax
- Use of Civil Monetary Penalty Funds
Profiles of Positive Aging Gala
November 18, 2018
Click HERE for tickets
Annual Business Meeting
December 6, 2018
Technology & Aging Summit
December 12, 2018
Activity/Life Enrichment/Wellness Professionals Symposium
February 8, 2019
Registration coming soon
Maintenance Professionals Symposium
February 20, 2019
Registration coming soon
Service Coordinators Forum/American Association of SC GA Meeting
February 20, 2019
Registration coming soon
2019 Southeast Finance Conference "The Evolving Consumer"
February 20-21, 2019
Information coming soon
Adult Day Services Symposium
February 22, 2019
Registration coming soon
Elderly Housing Symposium
February 28, 2019
Registration coming soon
Assisted Living Symposium
March 12, 2019
Registration coming soon
LeadingAge PEAK Leadership/Advocacy Conference
March 17-20, 2019
LeadingAge GA/SC Annual Conference on Aging
Hilton Head Island, SC
March 25-27, 2019
Registration coming soon
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The top 5 aging-in-place trends
By Dan DiClerico, Home Advisor
As aging in place gains momentum, the tools and tactics for making homes safe and accessible are becoming ever more sophisticated. And manufacturers are responding with a slew of products designed to make homes more accessible for people of all ages and abilities. Here are five enhancements to consider for your home:
1. Slip-resistant flooring
Falls are the leading cause of fatal and non-fatal injuries among seniors. Flooring manufacturers are coming out with more materials that meet the industry standard for slip-resistance (0.42 or higher on the dynamic coefficient of friction, or DCOF). Wood-look porcelain tile is hugely popular in bathrooms and kitchens, the two most dangerous rooms in the house.
Another way to minimize falls in the bathroom is by installing a curbless shower. It's a significant investment, with an average cost of $3,346, according to HomeAdvisor's True Cost Guide, but it's one of the best ways to increase safety and comfort in the home.
2. Safer cooking
Bums from hot stoves are a risk for all homeowners, but especially those with limited mobility. That makes induction cooktops an aging-in-place essential. The technology uses electromagnetism to generate heat, instead of an open flame or coil. And only the cooking vessel gets hot, not the cook top surface. Best of all, induction burners are incredibly precise, so cooking performance isn't compromised by the increased safety.
3. Home automation
Smart-home technology makes it possible to control lighting, locks, appliances and more with a smartphone or voice-controlled speaker, improving accessibility and ease of living throughout the home. For example, keyless locks are a boon for people with arthritis, and smart lighting and thermostats mean never having to come home to a cold, dark house. Wi-Fi cameras, meanwhile, make it possible for loved ones to check in on aging or infirm relatives.
4. Smart toilets
Toilets with built-in cleansing sprays and air dryers facilitate hygiene for people with limited range (and users of every age agree the experience is pleasant). If you're not ready for a full toilet replacement, smart seats can be retrofit to any existing toilet. Whichever option you choose, you'll need a GFCI outlet nearby to power the device; that could add a couple of hundred dollars to the project, according to HomeAdvisor's True Cost Guide.
5. Sleek supports
Even grab bars are evolving, well beyond the institutional versions that defined the early days of aging in place. You can find bars and other supports that double as towel bars, shower shelves and toilet paper holders, all in sculptural designs and luxury finishes. Beautiful sink basins with built-in handles are another helpful option for people with balance challenges.
These attractive supports are one more example of how aging in place is becoming synonymous with smart design. The result is that it's easier than ever to create a home for all ages without any tradeoff in aesthetic.
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Adult Day Centers Making Headway on Transportation
By Ginny Helms
Based on the concerns expressed by many LeadingAge Georgia adult day center members, LeadingAge Georgia staff and the leadership of the Georgia Adult Day Services Association reached out to James Peoples, director of the Georgia Medicaid Non-Emergency Transportation program for the Department of Community Health to ask for help resolving transportation issues. James convened a meeting a couple of months ago with us along with the leadership of DCH and the two transportation brokers in Georgia – LogistiCare and Southeastrans. We then followed up and invited James and representatives from LogistiCare and Southeastrans to speak to our members at our Adult Day Symposium on October 19th.
James and the teams from LotistiCare and Southeastrans spoke about their commitment to providing transportation to Georgian's older adults. Our members were both forthright and respectful in presenting examples of concerns – clients sitting in vans for too long, clients with dementia being dropped off without oversight to ensure the person entered the day care building, clients wandering from the parking lots, being unable to schedule routine pick-up for less than three visits per week and not getting satisfactory resolution of reported problems.
The leadership of LogistiCare and Southeastrans indicated a strong commitment to addressing the issues. They asked our members to always use the portal for scheduling appointments, to make sure to also use the portal to indicate that a client had special needs such as Lyft or Uber not being appropriate due to conditions of the client. They also asked for our members to reiterate the need for a person to be at the home when the client is returned home after the end of the adult day visit.
James Peoples as well as the leaders from LogistiCare and Southeastrans appealed to our members to always contact Logisticare and Souteastrans when there is a problem and then if the problem is not resolved, to contact DCH.
James indicated that the transportation brokers are currently being paid based on a 2012 contract and that DCH will be conducting feasibility studies for revamping their payment systems.
Claire Russell, president of Georgia Adult Day Services Association called last week to express appreciation for our work addressing the transportation issues. She said she has received several calls from adult day providers who are pleased with improvements in transportation. Claire said the five centers that she operates have all seen improvements as well.
The improvement in transportation for day centers was truly us all working together – adult day members, GADSA leadership, DCH, Logisticare, Southeastrans, and LeadingAge Georgia. As for LeadingAge Georgia, we thank everyone who is making efforts to improve the transportation issues and we are committed to working with you as we continue to support members providing adult day services.
2018 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
Save the Date: February 20, 2019
GAAP Winter Symposium speakers:
- Meaningful Connections: Positive Ways to be Together When a Loved One Has Dementia: Nancy Kriseman, Consultant
- Multi-generational Approach to Engagement: Meagan Jain, Ageless Interactions
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
Program/Education: Liana Sisco (Lutheran Towers; Atlanta) firstname.lastname@example.org
Service Coordinators (AASC GA Chapter)
Service Coordinators Forum/American Association of SC GA Meeting
Save the Date:
February 20, 2019
Information coming soon
Residents and Their Role in Governance By Tom Bowden, Vice President, BB&T Capital Markets
The role of residents in the governance of a Life Plan Community (LPC) in general, and specifically their potential role on the board, has been debated as long as LPCs have existed. Residents and management alike often have strong opinions on the subject. Residents generally feel their constituency should have seats on the board. Management teams, in particular, frequently argue to the
contrary. So, who is right?
Using our observations as long-time industry professionals, we will explore the merits and drawbacks of direct resident representation on the board. We will draw from our experiences in working with several well-known, not-for-profit senior living providers, as well as conversations with those willing to share their experiences and opinions on the matter. Specifically, we will contemplate the benefit of resident board representation in the context of "resident engagement," a more global strategic endeavor of which resident board membership can be a key component.
Let's step back a minute and explore this from a high level. Not-forprofit LPCs (good ones, anyway) are mission driven organizations. While there are as many different mission statements as there are NFP LPCs, there is usually
to guess what it is, but as a hint, a sampling of mission statements is included below:one central theme in all of them. You may be able to guess what it is, but as a hint, a sampling of mission statements is included below:
"Empowering individuals with choices in purposeful living."
– Lifespire of Virginia
"Serving generations of aging adults, encouraging individuality, worth and well-being throughout life."
– Oakwood Lutheran Senior Ministries
"We honor elders and are committed to creating and
fostering diverse, caring communities where everyone has a voice and value."
– Aldersgate United Methodist Retirement Communities
To no surprise, the residents are central to each mission statement.
Basic Position of Those That Favor the Practice
So the basic position of the residents' – "we deserve a voice in the
governing of a community whose explicit purpose is to benefit us, so
save us a spot on the board" – is by no means far-fetched. After all,
many would agree the voice of a constituency should be accounted
for in the managing and governing of an organization meant to benefit
Click HERE to read more
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
HCS Assisted Living Salary & Benefits Study
Deadline Extended to 12/3
Oakland, NJ, November 2018—The deadline for the Assisted Living Salary & Benefits study, conducted by Hospital & Healthcare Compensation Service (HCS) has been extended to December 3rd. The study is supported by LeadingAge, as well as NCAL. Nationally known, the Report is recognized as the standard for reliable and comprehensive compensation data for ALFs/PCFs/RCFs.
The Report covers management salaries, nonmanagement wages, and fringe benefits. Salaries and bonus payments will be reported according to unit size, profit type, revenue size, county, state, region, and nationally. In addition, for-profit and not-for-profit data will be separately covered in the Report. Information on 18 fringe benefits will be reported according to region. Percent increases planned for 2019 will be reported for management, nonmanagement, RNs, LPNs, and CNAs.
Questionnaires can be downloaded at: https://www.hhcsinc.com/survey-questionnaires.html
There is no cost to participate in the study. LeadingAge member participants may purchase the results at the reduced price of $165, versus the $350 nonparticipant rate. The results will be published in January 2019.
Since 1971, HCS has served the healthcare industry by conducting and publishing an array of comprehensive, reliable compensation reports. HCS currently publishes ten different Reports on an annual basis. In addition, the firm conducts custom marketplace studies to support its clients. A complete listing of all HCS products and services is available on our website: www.hhcsinc.com.
Federally Assisted Housing (HUD-Subsidized)
Affordable Housing Highlights from Philadelphia
By Colleen Bloom
At this year's LeadingAge annual meeting, affordable housing providers had a chance to literally celebrate the recent successes in FY18 at an enthusiastically well-attended Housing Celebration Reception and to hear about new opportunities and challenges expected in the coming year in three sessions outlined below. While we cannot recreate the energy of the reception gathering, we can share the highlights and many of the details from the Housing Policy Forum, HUD Management Update and RAD for PRAC sessions.
HUD Deputy Assistant Secretary for Multifamily Programs Lamar Seats spoke at the Housing Policy Forum in Philadelphia. This year's Housing Policy Forum also featured Linda Couch, LeadingAge's Vice President for Housing Policy. The forum included an update on the facts and figures of growth in the older adult population and increasing gap of affordable supportive housing with services for older adults, current happenings in Congress and the development of LeadingAge's housing policy platform for 2019.
New Report on Low Income Housing Tax Credits
For the report, the GAO reviewed 2011 – 2015 data from 1,849 communities from 12 LIHTC allocating agencies (state agencies in AZ, CA, F:, GA, IL, NY, OH, PA, TX, WA and two local allocating agencies: Chicago, New York City). GAO found a median total development cost per unit of $204,000, with outliers ranging from $107,000 per unit in Georgia to as much as $606,000 per unit in California. Generally, GAO found that new construction total development costs are higher than rehabilitation costs per unit.
Home and Community Based Services
Understanding Medicare Advantage Plans
by Ginny Helms
Changes are underway with Medicare Advantage Plans and LeadingAge National is working to ensure that our members are prepared to work within the new bundled system. Some insurance companies will cover adult day and in-home care. Stay abreast of the implications of the advantage plans by visiting our national website.
Life Plan Community/CCRC
3 Words That Life Plan Communities Must Know
As life plan communities and their residents become more involved in managed care, they need important information about 3 words included in the Medicare, Medicaid, and SCHIP Improvement Act, which was passed in 2000. Those words are "return to home." The "return to home" provision of the law guarantees the right of Medicare Advantage members to return to their home skilled nursing facility (SNF) after a hospital stay, even if the SNF is not part of the provider network of the resident's Medicare Advantage plan.
There's a catch, however.
LeadingAge Ziegler list adds 50, sees some changes at the top for 2018 by Lois A. Bowers
The annual LeadingAge Ziegler list of the largest not-for-profit senior living providers grew by 50 organizations and saw some changes at the top for 2018.
Renamed the LeadingAge Ziegler 200, succeeding the LeadingAge 150 (which in 2014 replaced the LeadingAge 100, which had begun in 2004), the latest report was released Tuesday and includes the list and industry trend information.
"By analyzing the country's 200 largest senior living providers, we are able to keep a steady pulse on what is growing, shrinking and changing so the industry is prepared to adapt to the needs of seniors and provide the highest quality of care," Ziegler President and CEO Dan Hermann said.
Organizations in the top 10 on the list remained the same for 2018 compared with 2017, although two moved up on the list and one moved down.
Medical and Recreational Marijuana in Senior Living Senior living providers struggle to navigate the legal risks of recreational and medical marijuana laws. While 31 states and the District of Columbia have laws legalizing medical marijuana in some form, there are some states who have additionally legalized recreational marijuana use. Despite these state efforts, marijuana remains illegal on the federal level.
Wednesday, Dec. 12
2-3 p.m. ET
Member Rate: $99
- Consider legal and practical differences between the use of medical and recreational marijuana.
- Identify best practices for mitigating risk when permitting marijuana use by residents or staff.
- Explore the conflict between state and federal laws that impact how senior living providers address marijuana use by residents and staff, including use outside their communities.
Questions? Contact Webinars@LeadingAge.org or 1-866-898-2624 option 1.
Click HERE to register
State of the Region Breakfast Engages Leaders on Critical Regional Issues
More than 1,400 leaders from across metro Atlanta convened at the Atlanta Regional Commission's State of the Region Breakfast on Nov. 3 to take stock and explore the issues we must tackle to ensure the region's future success.
ARC executive director Doug Hooker presented the State of the Region message, reflecting on the region's significant growth in population and jobs, as well as the strides we're making in addressing traffic congestion.
He also talked about challenges. In the form of an open letter to Georgia's yet-undecided governor-elect, he addressed the need to work together on issues like housing affordability, addressing regional transit expansion, and improving educational opportunities.
New HHS Guidelines Recommend 3-Pronged Approach to Exercise for Older Adults
Physical activity for older adults should include balance training as well as aerobic and muscle-strengthening exercises, according to updated physical activity guidelines released Monday by the U.S. Department of Health and Human Services.
"All three aspects are important for this population because older adults are at an increased risk of falls, and strength and balance are needed to prevent falls," noted the authors of "Physical Activity Guidelines for Americans, 2nd edition," an update of guidelines issued in 2008. The new recommendations were published in JAMA, the journal of the American Medical Association.
"Older adults who are physically active can engage in activities of daily living more easily and have improved physical function (even if they are frail)," the HHS authors said. "They are less likely to fall, and if they do fall, the risk of injury is lower."
Assistant Administrator - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/238/
Bus Driver - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/236/
Executive Director - The Jewish Tower
See full job description at: http://leadingagega.org/jobmart/public/job/231/
Executive Director - Presbyterian Village, Athens
See full job description at: http://leadingagega.org/jobmart/public/job/234/
Housekeeper - Saint Anne's Terrace, Atlanta
See full job description at: http://leadingagega.org/jobmart/public/job/235/
Service Coordinator - Cathedral Towers
See full job description at: http://leadingagega.org/jobmart/public/job/233/
Staffing Coordinated - Personal Care, Inc.
See full job description at: http://leadingagega.org/jobmart/public/job/239/
Vice President of Operations - Wesley Woods Senior Living
See full job description at: http://leadingagega.org/jobmart/public/job/240/
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When Members Talk, We Listenby
Katie Sloan, LeadingAge
Over the last year, our state partners have hosted Town Hall Conversations across the country to hear members talk about their pain points and ideas about future directions. The goal of these conversations is to gather input for our public policy priorities for the upcoming year. But the Town Halls serve another important purpose: to identify issues that we can act on immediately.
Managed care is one of the issues that has risen to the top of that list.
In the coming days, we are launching the LeadingAge Center for Managed Care Solutions & Innovation to address both Medicare Advantage (MA) and Medicaid
Managed Long-Term Services and Supports (MLTSS) and related challenges. Our objective is to help members cope with immediate concerns as well as enable them to understand and participate in new program and financing approaches that integrate primary and acute care, post-acute care, and long-term services and supports.
It is highly unlikely our health care systems will ever return to an entirely fee for service model. More than a third of Medicare beneficiaries are now in MA, with much higher penetration in some parts of the country. In states that use MLTSS—right now 41 programs operate in 24 states, with rapidly trending growth—LeadingAge members, and those we serve, have everything to gain by carving out a positive, proactive role in these new systems.
Resources Across the Spectrum
LeadingAge represents organizations across the spectrum of aging services. And, increasingly, these organizations are seeking ways to diversify their services to accommodate more people in different ways.
For example, nursing home members, as well as housing, home health, and other community-based services members, are all telling us that they need tools, information, and support to address the increasing numbers of residents/post-acute care users who are enrolled in managed care. Their residents and clients are enrolling in MA and their states are moving to MLTSS. In addition, PACE programs and others serving individuals who are dually eligible have a strong interest in this evolving marketplace.
The new Center points to ways we can help members, regardless of the services they provide. It's also a place for members to teach and learn from one another.
What will the Center do?
Post-launch, the Center will offer a variety of resources for members at various points in their managed care journeys.
- Materials specially targeted to the characteristics and needs of LeadingAge members to provide basic background on MA and Medicaid MLTSS
- A detailed glossary of managed care terminology
- Fact sheets and issue briefs on a variety of different topics related to managed care
- Webinars and other offerings in the LeadingAge Learning Hub
- Summaries of important articles published by researchers, noting what's relevant for our members
Your Voice in Washington, DC
The Center serves another critical purpose: It is the launching pad for our advocacy work. What we learn and discover from you and others along the way will help inform our policy positions as we advocate for your interests before Congress and the Administration. In turn, we'll continue to provide regular and timely updates to members about current policy developments.
Keeping the Center Alive and Fresh
One key goal of the new Center is to highlight the important role aging and LTSS providers play in modern health care systems. In addition to providing direct services to members, we will frequently add new resources. The Center will be guided by an advisory group of members who have been working with managed care for some time; these members know the challenges and pitfalls and can offer guidance to ensure the Center delivers on its promise.
The Center for Managed Care Solutions & Innovations will be led by Nicole Fallon, vice president of health policy and integrated services.
Once you've had a chance to explore the Center's offerings, take a moment to send us your feedback. We want to ensure that we are meeting your expectations and, ultimately, helping your organization thrive in this increasingly complicated and challenging landscape.
Email email@example.com with questions and comments!