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 email@example.com.
Conversations with Ginny
"The purpose of human life is to serve, and to show compassion and the will to help others." Albert Schweitzer
I want to share with you the great things that our members and others have done over the last month to help us and to help others. Our beloved Harry Haisten worked hard along with his team, Mike McDaniel of Lenbrook, Weyman Perry of Personal Care, Inc. and Tom Bowden of BBT to make our 23rd Annual Center for Positive Aging Golf Tournament a great success. We had a beautiful day of comradery at the River Pines Golf Club and the team from National Church Residences won the trophy. A huge thank you to all who sponsored the tournament, played in it and who worked to make it a success.
As you probably know, LeadingAge Georgia houses the Culture Change Network of Georgia. We recently hosted the CCNG Palliative Care Summit and it opened the eyes of just about everyone present on the need to implement a palliative care program for the older adults we serve. Special thanks are made to the planning committee, the great speakers, GSU and CMS for the grant funded scholarships and to the Debley Foundation, Alliant Health Solutions, Inc. and the Alzheimer's Association for funds that supported the event. If you missed the summit, please read over the articles in the newsletter that highlight the information provided so that YOU can be a bridge to bringing palliative care to those you serve. Providing comfort care is a cornerstone of well-being.
I've read the bios of the individuals we will be honoring at the upcoming Profiles in Positive Aging and you are in for a treat when you meet these folks in person on November 18th at the Atlanta History Center. If you haven't bought your tickets please do so and join in this celebration. Thank you to all of our members who nominated an individual and to those supporting the event. We are still looking for sponsors so contact us if you want to support Profiles -- our signature event.
Our national conference is coming up at the end of the month in Philadelphia. LeadingAge national has done a fantastic job planning this event and the program looks outstanding. If you haven't registered for Georgia Night on Sunday October 28th please register as soon as possible so that you can be with your community!
Our public policy committee has been hard at work and we're doing our background work to be ready for the legislative session. We've got some exciting policy work going on at the national level as well and I'll update you in next month's newsletter. Our nominating committees have done amazing work choosing a slate of officers for LeadingAge Georgia and the Georgia Institute on Aging and the slates will be submitted to our boards for votes later this month.
Thank you for all you do to help others --- LeadingAge Georgia, older adults and your team.
LeadingAge Meeting + Expo
If you haven't registered yet for the LeadingAge Meeting + Expo coming up October 28th – 31st in Philadelphia please register now. The education sessions planned are highly relevant topics with cutting edge information designed to reinforce our passion for what we do and prepare us to help older adults thrive. Some of the sessions that look enticing are: Hospice Deep Dive: The Intersection of Policy, Practice and Partnership; Technology Deep Dive: Shaping the New Health Care Ecosystem; Social Connectedness and Engagement Technologies: Provider Case Studies; Nature Meets Nurture: Designing a WELL Building; Lifelong Learning Through University Partnerships; A New Model of Home Support; Managing Wellness Over Illness; The Slippery Slope Between Functional and Frail in Independent Living Residents; Meeting the Rising Acuity Needs in Assisted Living; and Transition Support: Enhancing Self-Management at a Critical Crossroad.
Click HERE to register
Georgia Night Dinner
Networking with peers and colleagues is as powerful as the exceptional continuing education you'll experience during the LeadingAge annual meeting in Philly. Join us for an evening of delicious cuisine over the beautiful skyline of Philly at R2L Restaurant. Just a few blocks from the convention center, I recommend strolling by the historic City Hall or Union League to take in the rich history before or after you dine with us.
Click HERE to register
Linens are an important, but often overlooked, category when LeadingAge members think about what is available through Value First group purchasing organization. As with every contract members have access to, the goal is to save you money. Are you interested in any of the linen contracts below? Contact your Value First representative today!
- Encompass Group
- Medline Industries
- Phoenix Textile
- Standard Textile
Laundry and Linen Services
- Alsco Laundry and Linen Services
- Angelica Textile Laundry and Linen Services
Request a Cost Study Today!
To submit your cost study request click the following link: https://form.jotform.com/61243365476155
For additional information contact Value First representative Vanessa Ceasar at firstname.lastname@example.org or (404) 421-3956
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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Peachtree Christian Health
3430 Duluth Park Lane
Duluth, GA 30096
Adult Day Services
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for December
December 7 Pearl Harbor Day
December 2 - 10 Hanukkah
December 10 Human Rights Day
December 21 Winter Solstice
December 23 Festivus - for the rest of us
December 25 Christmas Day
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LeadingAge Georgia Public Policy Report
by Tom Bauer, LeadingAge Georgia Policy Advisor
Candidates are campaigning all over Georgia with elections rapidly approaching. As noted last month, the outcome of November elections will likely impact some of LeadingAge Georgia's public policy, issues, especially budget requests and other legislative items which require funding.
The various state agencies have sent their budget requests to Governor Deal During the first week of the General Assembly we will know what recommendations Governor Deal has made, as adjusted by whoever wins the governor's race.
Members and staff of LeadingAge Georgia are members of work groups developing the following issues:
- Medicaid Funded Assisted Living
- Personal Care Home Requirements
- Medicaid Coverage for More Georgia Seniors
The direction of Medicaid issues will be contingent upon whoever is elected governor. One candidate (Democrat Stacey Abrams) favors Medicaid expansion, while the other (Brian Kemp) favors emphasis on private sector involvement and Medicaid waivers.
With regard to personal care homes, the COAGE priority is to "address the growing number of personal care homes with residents in danger and "to improve the ability of the Department of Community Health to impose grater sanctions and provide transparency. COAGE is awaiting DCH's convening of a stakeholders meeting to address the issue in lieu of pursuing legislation. LeadingAge Georgia is monitoring this issue.
Life Plan Communities/CCRCs
LeadingAge Georgia intends to introduce legislation in the 2019 General Assembly to change the name of continuing care retirement communities (CCRCs) to Life Plan Communities (LPCs). The Department of Insurance, which licenses CCRCs, has indicated it has no recommendations for changes to the current law and does not oppose the change of terminology from CCRC to "Life Plan Communities."
Assisted Living Communities
LeadingAge Georgia is currently evaluating the extent of problems which have been expressed concerning the effect workplace staff shortages is having on the ability to treat residents who are near life's end and other chronic medical issues.
Adult Day Services Symposium
October 19, 2018
LeadingAge National Conference
October 28-31, 20018
Philadelphia Convention Center
Georgia Night Dinner at the LeadingAge National Conference
October 28, 2018
Profiles of Positive Aging Gala - Note: Date Change
November 18, 2018
Click HERE for tickets
Annual Business Meeting
December 6, 2018
Information coming soon
Technology & Aging Summit
December 12, 2018
Regsitration coming soon
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What a Golf Tournament!
The 23rd Annual Center for Positive Aging Golf Tournament in Honor of Harry Haisten was a fantastic event. It's hard to believe that Harry Haisten has been willing to lead the efforts for twenty-three years but he's done that for us and we greatly appreciate his time and the energy he puts into this tournament. Harry had help from our members who are incredibly busy in their own businesses but they too worked to make the tournament a success. Our thanks go out to members of the golf fundraiser committee who recruited sponsors and teams along with staff and other members.
National Church Residences took home the trophy for the tournament. We were truly blessed with amazing weather and it was nice to see our members enjoying a game of golf and being together with our mission-based community. We are grateful to our hole sponsors and to everyone who played in the event as well as our volunteers including our new volunteer photographer, Joane Kain. A big thank you to those who donated items for raffle ticket prizes. The golf bags, hats and balls and other prizes were treats for the winners. John Sims of Spring Harbor Life Plan Community took home the biggest raffle ticket prize – the stay at the Marriott on Hilton Head Island. To date, we've raised $19,000 -- just shy of our $20,000 goal. If you still have money to turn in for raffle tickets or team entry fees, please send it in and help us meet our goal. Join me in thanking Harry Haisten and all of our members who gave us such a great tournament.
Harry Haisten, Jr., Co-chair
Tom Bowden, BB & T, Co-chair
Mike McDaniel, Lenbrook
Walter Constantine, Aon
George Tucker, Campbell-Stone Sandy Springs
Mark Lowell, St. George Village
Arthur Levin, Saint Anne's Terrace
Weyman Perry, Personal Care
John Sims, Spring Harbor at Green Island
Kevin Shaw, King's Bridge
Carolyn Roper, representing Glenn Memorial UMC
American Southern Insurance
BB&T Capital Markets
Dixon Hughes Goodman
King's Bridge Retirement Community
National Church Residences
Personal Care, Inc.
Presbyterian Homes of Georgia
Steve Ayers Construction
Wesley Woods Senior Living
Positive Aging Reframing Aging Exhibit was Phenomenal! By Jacque Thornton
Several accolades and testimonials chime in on how wonderful our exhibit to reframe aging inspired the community. 20 of our past our LeadingAge Georgia Positive Aging Image awardees shared their oral history and many joined us to share their wisdom and experiences at the Center for Civil and Human Rights museum on September 25, 2018. As a result, four of our honorees' life sized banners will be on display at the State of the Region breakfast, sponsored by the Atlanta Regional Commission:
Mr. Dosh Jackson, A. G. Rhodes Honoree
Ms. Carolyn Hartfield, AARP Georgia Honoree
Ms. Chung Hee Pai, Briarcliff Oaks Honoree
Ms. Francie Ross, Saint Anne's Terrace Honoree
Colleagues, the Reframing Aging Exhibit was a dream come true and absolutely fabulous to experience! We had 110 attendees from our outreach and 50-60 CCHR guest to tour the exhibit. Because of you and your part to have a spotlight on Positive Aging through the lenses of older adults who have overcome ageism and continue to do extraordinary things in their lives, we have a new vision for this wonderful journey called life as we age.
Kudos to the talented team who labored with me to produce this historical footage that will now live on at the Center for Civil and Human Rights (CCHR) museum for all the generations to read and hear at the Library of Congress through our partnership with StoryCorps Atlanta. Thanks to the honorees who shared their stories, which inspire us all!
Check out the photos and testimonials…
Clik HERE for photo gallery.
Thanks, Jacque for your vision, execution of this exciting event, and opportunity to partner! Congratulations for pulling it off!
Becky A. Kurtz
Manager, Aging & Independence Services
Director, Area Agency on Aging
Atlanta Regional Commission
regional impact + local relevance
Thanks so much for including ARC in the exciting event. All of your attention to detail and planning resulted in a great day and enthusiastic support for rethinking aging. It was a pleasure to partner with you and we look forward to our next opportunity to work together.
Mary Blumberg, ARC AAA
Engage at Every Age Expo was an inspiring community festival for the greatest generations of our time!
2018 Engage at Any Age Expo By Jacque Thornton
Eden Alternative domains of wellbeing informs us of the importance of overcoming loneliness, boredom, and helplessness as we age. The 2018 Engage Expo did just that! It created the environment for adults of all ages and abilities to engage and have a ball doing it! Over 850 attendees convened at the newly named Georgia State University Stadium with a different vision for themselves…"Life-long Wellbeing" through education, writing clinic for new authors, cooking demonstrations, pickle ball, tai chi, music, dance, commemorative celebration of the 1968 US Olympians and 2018 Georgia Games medalists, community artistry and healthy living resource mining. Most of all, we heard from various attendees, that they enjoyed connecting with new found friends who want to do extraordinary things in third and fourth quarter life. LeadingAge Georgia, Georgia Power Company, City of Atlanta Mayor's Office of Constituent Services, AARP Georgia AgeFriendly Atlanta collaborative, Lifestyle Management, Jeremy Cormier Presents, Personal Touch Events, Active Boomers Expo, JenCare, AHF, Sodexo, Ageless Interactions, and Morrison Community Living were amazing community and corporate partners! "It's critically important that people of all ages have a life and interactions beyond the wall of their home. Communities need to both naturally and intentionally have ways for residents and visitors to be involved, to socialize and to learn and to share experiences." ~AARP, Where We Live magazine 2018 | Inspire Community Engagement
The Engage at Every Age Expo was inspired, designed and executed primarily by individuals over the age of 50. The Center for Positive Aging via LeadingAge Georgia are proud of our leadership role in making this event possible as it aligns with our mission of being the trusted voice and source of information you need regarding programs, services, housing options, and products for older adults.
Check out the photos and the buzz is on for a repeat in 2019!
Morrison Community Living Teaching Kitchen Article
By Chuck Trascritti
Morrison Community Living was proud to work with LeadingAge Georgia and AARP at the Engage at Every Age multi-cultural Expo last week at GSU. Chef and Regional Director of Operations Jason Maxwell and his team, Brian White Chef at Canterbury Court, Anthony Stephens Chef at Campbell-Stone and Chuck Trascritti engaged, educated and entertained seniors from the Atlanta area with their Teaching Kitchen concept. They performed 4 sessions all fill to capacity with senior asking questions as they prepared traditional southern far recreated with a health and wellness focus.
Per Chuck Trascritti, “We created Teaching Kitchens to improve resident activity, morale, health and well-being; increase appreciation of cultural diversity through food and encourage intergenerational connections.”
The kitchen is a memory catalyst because it involved so many senses. The sights, sounds, smells and feeling of cooking creates taste memories. The Teaching Kitchen also forms new memories, as residents socialize, try new foods, and learn from tips from the chef.
The Teaching Kitchen is a great way for seniors to reconnect with their own culinary roots. Many seniors no longer cook and enjoy a chance to get back in the kitchen. We give them a fun way to “get their hands in the dough” once again.
The Teaching Kitchen Collaborative is inspired by a ten-year relationship with the Culinary Institute of America and Harvard T.H. Chan School of Public Health. We are proud to be a sponsor and founding member.
Sodexo Top Chef CompetitionBy Heather Katz
Competition Facilitators & Support Team:
Heather Katz, Chris Gibson & Denise Word
Team 1: James Enyart & Jarvis Wright
Team 2: Owen Waston & Greg LeRoux
Both Teams had 60 minutes to create their menu from the mystery basket, prep, cook and plate their salad/soup, appetizer and entree.
Team 2 won the competition!
Citrus shrimp salad
Cajun spiced pork tenderloin medallions
Coq au vin with sautéed Brussels sprouts and candied butternut squash
Citrus & Rosemary infused chicken noodle soup
Mixed field Greens w/ Balsamic Dijon chili vinaigrette
Accented w/ Steamed Brussel Sprouts, red apple
Napoleon Style Pork tenderloin medallions & butternut squash w/ Garlic shrimp cream sauce
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2018 CCNG Advisory Group Meeting Dates & Update
Friday, October 12, 2018 | 9:30am – noon | Location: Alzheimer's Association
Adult Day Services Symposium: Be in the Know
By Ginny Helms
The Adult Day Symposium coming up on October 19th was planned based on the in-put of adult day members and it is chock full of great topics and exceptional speakers. We’ll hear from James Peoples of the Department of Community Health who will talk to us about ways we can work with the brokers to improve transportation challenges. We’ll hear from Catherine Ivy, director of the waiver program for DCH who’ll discuss things we can do to improve referrals from the case managers and to let us know about the changes within the waiver program. Ned Morgens will share information on how adult day centers can be funded through the Medicare Advantage programs. Eve Anthony of Athens Community Council on Aging will educate us on the new Competency Guide for Dementia Care and how to incorporate the information into adult day services. Robin Lacrimosa also of Athens Community Council on Aging will share information on the innovative postcard program that ACCoA clients loved. The meeting will be held at Mauldin & Jenkins located at 200 Galleria Drive, Suite 1700 Atlanta. If you haven’t registered please do so now.
Click HERE to register
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
Service Coordinators (AASC GA Chapter)
Why Service Coordinator Profession Matters
By Kama-C. Oyeshiku-King, Secretary, AASC Georgia Chapter
A resident has questions about their health insurance. A senior needs help with transportation to get to their doctor's appointment. A family member of a resident is seeking information about their mother's recent mental health changes. The administrator needs help setting up an educational program about community safety and how it affects your residents. This is why service coordinators matter.
Service Coordinators, mainly funded by HUD, but also funded by other resources, are an integral part of the housing communities in which they work. They are in place to assist with resources, referrals, and information to assist residents to live and/or age in place, and out of nursing homes. Even though this sounds simple enough, it's not. Service Coordinators are often the "segue" between the administrator and the resident. Working, to ensure that residents are heard and supported. This is why service coordinators matter.
Throughout a single day, servcie coordinators often wear many hats. Whether listening to a resident's latest visit with the doctor or calling to arrange their home delivered meals, working with residents to see if their caregiver is coming today-as they missed the last three days are only a few common examples in the life of a service coordinator. Renewing food stamps or Medicaid, even though their benefits expires today, and they received their renewal letter 4 weeks ago. Responding to an emergency pull cord, to find out the resident is short of breath and needs a familiar and patient face to help keep them calm, while the fire department is there responding. This is why service coordinators matter.
In the next several months, I'll be writing about service coordinators, service coordination, hot topics, ,wellness in our field, and educating others in aging about our profession. Please feel free to connect with me your ideas or questions. Our next AASC Georgia Meeting is: Friday, November 16th in Macon, Georgia. Hope to see you there.
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
Assisted Living Homes: Weigh In
By Ginny Helms
A couple of our assisted living members are telling us that due to current state regulations, residents at end of life are often left in pain until either a family member or a Hospice nurse arrives to administer medications. These regulations are based on the state statute for assisted living homes. We would like to explore this and see if changes are needed. If you are aware of this in your home please contact us and give us details that we can use for addressing policy changes.
Federally Assisted Housing (HUD-Subsidized)
Fannie Mae Calls for Ideas on Healthy Affordable Housing
In response to health risks that are worsened by the presence of toxins and molds in homes as well as inadequate accessibility features, and to spur creative solutions to support low and moderate income households, Fannie Mae has announced a $10 million innovation challenge.
The Innovation Challenge welcomes applicants to propose ideas that respond to one or more of the following problem statements:
- How might we use innovative technology and design to improve affordable homes to better support health, promote overall wellness, or prevent disease and illness?
- How might we leverage finance vehicles to incentivize the creation of affordable homes that promote health and wellness?
- How might we foster design that promotes diverse, sustainable, multigenerational affordable communities in which all individuals can remain a vibrant part of their community through every stage of life?
The deadline to submit ideas is November 1, 2018, at 5:00 p.m. PT. For more information about The Innovation Challenge and to apply, please visit the Innovation Challenge Website
New Report on Low Income Housing Tax Credits
by Linda Couch
A September report from the Government Accountability Office provides a deep look at the Low Income Housing Tax Credit program, particularly total development costs and cost drivers.
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.
HUD Releases Housing Trust Fund Commitment, Expenditure Guidance Regulation
by Colleen Bloom
The U.S. Department of Housing and Urban Development (HUD) has issued guidance for Housing Trust Fund (HTF) grantees, as well as the first report on the status of initial trust fund commitments in 2016 and disbursements.
Notice CPD-18-12 outlines commitment and expenditure requirements, as well as how HUD determines compliance with deadline requirements. It describes how HUD uses data to determine compliance with the 24-month commitment and 5-year expenditure deadlines, and gives examples of the types of documents that do and do not constitute evidence of compliance, and points stakeholders (HUD staff and grantees) to where to find reports and information on grants status.
Home and Community Based Services
Aging Services 2019 Funding Set for Now
by Barbara Gay
Congress marked the beginning of fiscal year 2019 on October 1 by passing H.R. 6157, legislation to fund the Departments of Defense, Labor, Health and Human Services, and Education. This measure, which covers many home- and community-based services programs, was the first Labor-Health and Human Services appropriation to be enacted in over a decade.
The appropriations measure, now law, increases funding for congregate and home-delivered meals under the Older Americans Act. Both programs would see their funding increase by $5 million each over the the $490 million congregate meal programs received for 2018 and the $246 million that went to home-delivered meals.
Life Plan Community/CCRC
3 Words That Life Plan Communities Must Know
A forthcoming publication from LeadingAge will explore the "return to home" provision of the Medicare, Medicaid, and SCHIP Improvement Act. The law's language is a "must-read" for life plan communities and their residents.
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.
Palliative Care - What's Important
By Ginny Helms
Anna Skold, MD, a palliative care physician with Kaiser Permanente who spoke on Innovations in Palliative Care at the Culture Change Network of Georgia summit armed us with a new way of thinking about palliative care. Dr. Skold was adamant that palliative care is about living; not death and dying. She said it needs to be patient centered and ideally, there's an interdisciplinary team of an MD, an RN, an LCSW, a chaplain and a PharmD. Dr. Skold said palliative care is appropriate at any stage of an illness and we need to think of it as an approach to relieving suffering and/or improving quality of life. Dr. Skold's practice as a palliative care physician with Kaiser Permanente focuses on educating patients and their families on the benefits of palliative care, helping them get comfortable with the concept and developing a plan of care that focuses on what is important to each individual. Dr. Skold shared several case studies where patients who received palliative care and had their pain under control were able to do the things that mattered most to them like going fishing and taking the family to Disney. She emphasized the importance of helping both individuals with serious illnesses and their families cope and said that regular chaplain visits help with depression and spiritual distress. She wanted us to know that opioids administered at the end of life do not hasten death and that when dosed correctly they ease pain and shortness of breath. They allow a person to use his or her energy for other things instead of using energy to fight pain or to struggle to breathe. Dr. Skold said she routinely prescribes Miralax because pain medications often cause constipation. She said we all need to pay better attention to preventing constipation which causes discomfort and can be painful. Dr. Skold recommends the Utube video on palliative care. You can view it at: https://youtube.com/watch?v=IDHg76tMHc. We're grateful to Dr. Skold who shared fabulous information and we encourage our members to have team meetings and discuss how to bring palliative care to those you serve.
33rd SNF Cost Comparison Report — An Industry in Transition
By Cory Rutledge
Download our report to benchmark your organization against SNFs nationwide.
In this 33rd edition of the Skilled Nursing Facility Cost Comparison Report, it is clear to see that the skilled nursing facility (SNF) environment is in the midst of a monumental transformation. In last year's report, our data exposed sweeping declines in financial performance, as measured by operating margins, and that trend continues as we analyze the 2017 data. Factors such as lower occupancy, a less desirable payor mix, and a higher cost structure put into question the ongoing financial viability of some SNFs.
A number of other factors are shaping the behavior of SNF operators, including changing referral patterns, the proliferation of Medicare Advantage, narrowing post-acute networks, preparing for the transition to the patient driven payment model, and increased regulatory scrutiny.
Rehab at the End of Life Making the News
By Ginny Helms
A report published by the University of Rochester is causing alarm across the nation. Their study of nursing homes in New York found that nursing home residents are increasingly spending time in rehabilitation during their last days of their lives. The unnecessary rehab stays are thought to be driven by the high reimbursement rates as compared to rates for caring for residents in traditional skilled care. The study showed that the for-profit nursing homes in New York were more than two times as likely to use high to ultra-high intensity therapy than nonprofit nursing homes. Starting October 1, 2019, CMS will implement a new "Patient-Driven Payment Model" which will determine payments based on a patient's condition and health needs rather than on the amount of care provided or the intensity of treatment. More policy changes are needed however in order to fortify resident care and nursing home payment structures. One of our nursing home members said recently that his homes lose $9 per day for residents with Alzheimer's. So, for our part, we'll advocate for nursing homes to receive higher reimbursement rates for the residents with dementia because nursing homes have been being paid less than it costs to care for them. We'll also work to foster better quality of life at end of life through better palliative care programs.
Nursing Home Trailblazers for Palliative Care:
By Ginny Helms
Alliant Health Solutions, Georgia's QIO rolled out a palliative care pilot project this year in order to improve well-being for nursing home residents living with pain and discomfort. Thirteen nursing homes across Georgia joined in the pilot project and staff from two homes shared their experience with participants at the Culture Change Summit on Palliative Care. Jennifer Judson, RN who is the project lead for Alliant led the discussion along with Elise Stafford, LNHA of Coastal Manor and Leigh Thigpen a director of nursing. Elise told the audience that prior to joining the quality improvement initiative she was convinced that her home was providing palliative care but once engaged in the project, she learned that they were not in fact offering true palliative care. Now she is a palliative care champion eager to share how the initiative improves the quality of life for their residents, staff and families. Jennifer Hudson told the audience and that palliative care is appropriate for residents with cancer, end stage renal disease, dementias, end stage cardiac and liver diseases. She shared that Medicare Part B pays for the palliative care consults and that there was a 50% reduction in emergency room visits for residents who had received the palliative care consult versus the rate for residents who did not receive the consult. Leigh Thigpen stressed the benefits of having a palliative care physician involved with resident care. She too said that it benefitted the resident, their family and the nursing home team.
For more information on the presentation at the Summit click HERE. Alliant Health Solutions will present more information about palliative care models at the LeadingAge Georgia annual conference in March.
By Ginny Helms
Did you play Go Fish as a child? If so, you remember the joy it brought as you laughed with your friends and delighted in telling your opponent to Go Fish! Now, there is a game to play that helps individuals have an enjoyable experience as they think about their end of life wishes. Mark Philbrick, RN/MSN, Director of Education for Transitions LifeCare of North Carolina led participants of the Culture Change Summit on Palliative Care in playing the Go Wish game and I encourage you to play it and then help bring it to the older adults you serve. The Go Wish card game card deck provides thirty-six cards with a wish that the player can choose as an end of life wish – like to be free from pain, or to have family members present, or to have their financial affairs in order. When you get your deck, take a look at the cards and then sort them into three stacks – one for cards (wishes) that are very important, one for somewhat important and one for not important. After you've sorted the cards into three stacks, cull the stack of very important cards down to your top 10 most important wishes. Then, put the cards in order of which wishes are most important. Finally, put the wishes on a piece of paper and give it to anyone who may be with you and the end of your life. I did it and was surprised and yet not surprised that the card that says "To be free from pain" was my most important wish. I admit that I realized that I am perhaps a bit of a wimp but I learned at the Summit that when surveyed about end of life concerns, three-fourths of those surveyed said their biggest fear about end of life is dying in pain. So I encourage you to play the game and then help make it available to the older adults you serve. It will take conscious efforts like playing the Go Fish game to truly understand end of life wishes and provide person-centered well-being at the end of life. Mark Lowell, executive director of St. George Village and board chair for LeadingAge Georgia said residents of the SGV well-being committee decided to give the game a try. We'll stay tuned for an update from them to see how they liked it.
Click HERE to order the Go Wish game.
An Ounce of Prevention is worth a Pound of Cure
By Jacque Thornton
This old adage continues to resonate in an age of US healthcare reform from sick care to well care models. As we move into flu, cold, and pneumonia season, it is ever so important that we remain current on all adult immunizations as we age. The National Foundation of Infectious Disease report reveal that an estimated 1 million US adults contract pneumonia each year. Those age 65 and older are at greater risk of death due to this common type of bacteria, pneumococcus. In fact flu and pneumonia were the eighth leading cause of death in the US in 2015. Since 2014, CDC has recommended that all adults age 65 and order received both pneumococcal pneumonia vaccinations, which cover the common strands of the virus that have devastating results. Despite the positive results yielded from the increase in staying current with pneumonia vaccinations by older adults to lessen the occurrence of pneumonia in communities, CDC officials may change it's recommendations. Reliable sources like Bob Blancato, Executive Director of the National Association of Nutrition and Aging Services Programs' recent article raised concern for us here at LeadingAge Georgia. His article informed us "that in the coming months about a dozen experts who serve on the subcommittee of the CDC will make a decision whether to continue to have the current pneumococcal vaccination recommendations stand."
Vaccinations are critically important for older adult population as our immune system changes and declines. In addition, we are experiencing caregiver and nursing shortages throughout the state of Georgia and the United States. Therefore, rescinding the current pneumococcal immunization protocol could adversely impact our workforce in senior living and aging services healthcare settings—potentially causing a rise in unintended exposure to this disease.
I trust that the CDC advisory committee will vote to continue the Pneumococcal vaccination protocol for older adults in the US to mitigate unnecessary loss of lives. Prevention is the most effective way to improve and reduce healthcare costs in the US. Let's advocate to keep our current older adult pneumococcal vaccination recommendation in place to support resiliency in third and fourth quarter life. Our elders are depending on us and good healthcare stewardship is every bodies business.
Update on Medical Cannabis in Georgia By Ginny Helms
Although medical cannabis is legal now in thirty-one states it will be a couple more years before it is available in Georgia says the legislative joint commission co-chairs Senator Matt Brass of Newnan and Representative Micha Gravely of Douglasville. The joint commission has held three of five legislative hearings to allow input on how Georgia should implement dispensing medical cannabis. Following the first hearing we asked the co-chairs what's next in bringing medical cannabis to Georgia and they said it will take more laws and two to three years before we have the laws in place for it to be available in Georgia. Currently, physicians can provide a card that allows for a person meeting the criteria in Georgia's laws to have up to 21 ounces of medical cannabis oil however, there is no legal way to purchase it in Georgia. The good news is that studies in Europe, Canada and Israel show promise of medical cannabis treating pain and anxiety for older adults. The Hebrew Home in New York had similar results with a small trial. We should have opportunity for more trials by the time it is brought to Georgia. A trial is underway in Canada for residents in long-term care homes. Read about the trial here: https://shar.es/a1JcsE.
Administrator - Clairmont Oaks
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Executive Director - The Jewish Tower
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Executive Director - Presbyterian Village, Athens
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Housekeeper - Saint Anne's Terrace, Atlanta
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Service Coordinator - Cathedral Towers
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