It is a time of reckoning for Connecticut’s private, nonprofit social services.
After two decades of flat or reduced funding from its chief client — state government — community-based agencies are struggling to retain both their programs and the low-paid staff who deliver care for thousands of poor, disabled and mentally-ill adults and children.
Depending on the vantage point, Connecticut’s nonprofit social services sector is viewed as either the best means to preserve the state’s safety net or as the cheapest route to drive down government spending.
Those in the first category — relatives and advocates for the state’s most vulnerable citizens — are waiting to see whether Connecticut will fulfill the program of comprehensive, neighborhood-based care that was envisioned nearly four decades ago when the movement away from institutionalized care began.
Communication breakdown among nurses and doctors is one of the primary reasons for patient care mistakes in the hospital.
In a small pilot study, University of Michigan researchers learned about potential causes of these communication failures by recording interactions among nurses and doctors, and then having them watch and critique the footage together.
Several themes emerged to help explain the poor communication, and both nurses and physicians improved their communication styles, said Milisa Manojlovich, U-M professor of nursing, who defines communication as reaching a shared understanding.
One barrier to good communication is that the hospital hierarchy puts nurses at a power disadvantage, and many are afraid to speak the truth to doctors, Manojlovich said.
A new phase of the state’s Community HealthChoices program kicks in this week, with the end of a safeguard designed to protect the aged or disabled participants against service changes or cuts.
The change comes with some of the 80,000 southwestern Pennsylvania participants in the 6-month-old program still finding shortcomings in the coordination and communication that are supposed to be CHC hallmarks, helping people with health issues get more support to live at home.
“They didn’t fulfill what they promised,” said Theresa Quail, explaining that she has been waiting months for modifications to her home in Richeyville, Washington County, to help her avoid falls. “They said things would be easy and more beneficial for us, but I’ve yet to see any advantages.”
Officials from the state and its contracted managed care organizations have maintained that despite some individual problems with service coordination, transportation and other issues, the program has largely served consumers well since its Jan. 1 debut in 14 southwestern Pennsylvania counties. It required some 80,000 individuals covered by Medicare and Medicaid to pick one of three managed care organizations to coordinate any subsidized long-term care services they might need, such as in-home personal assistance.
Five months after a scathing report found that injuries, serious medical conditions and even deaths of those with developmental disabilities living in group homes often go overlooked, federal officials are responding.
In a four-page informational bulletin issued this week, the Centers for Medicare and Medicaid Services’ Center for Medicaid & CHIP Services said that it “takes the health and welfare of individuals receiving Medicaid-funded Home and Community-Based Services (HCBS) very seriously.”
The agency described its new bulletin as the first in a series of guidance documents it plans to issue in response to a January joint report from the U.S. Department of Health and Human Services Office of Inspector General, Administration on Community Living and Office for Civil Rights.
More efforts are needed to prevent falls among the elderly, especially those just discharged from the hospital, Australian researchers say.
Older adults have a greater risk of falling to begin with. But this risk heightens considerably within the first six months of a hospital release, authors note in Age and Ageing.
More than half of those who do fall during this period suffer serious injury, such as hip fractures, they say.
Exercise interventions, vitamin supplementation and patient education about high-risk scenarios are known to reduce the risk of falling for elderly people in general. But in a new review of previous research, the Australian team found that these strategies were not as effective in older people following hospital discharge.
Two new resources are available for community-based organizations to help with business planning and contracting with health care organizations and payers.
“Fundamentals of Community-Based Managed Care: A Field Guide” from the American Society on Aging is the second in a series of three issues of the publication Generations to focus on how best to build and preserve community-based organization (CBO) partnerships with the healthcare sector, in the interest of helping CBOs survive in the new financial climate, and for addressing the Triple Aim of improving care, improving population health, and reducing costs. This issue also addresses the social determinants of health and the role they play in aging in the community.
A resource guide on pricing from the Aging and Disability Business Institute explores financial contracting and provides guidance to community-based organizations on how to build competitive pricing models for contracting with health care payers. The pricing guide also explains the differences between common types of payment arrangements such as Per Member Per-month (PMPM), per episode, and capitation.
DETROIT — Ford Motor Co said on Wednesday that it was expanding a medical transport service called GoRide in Southeast Michigan, one of several efforts by the U.S. automaker to build new ride service businesses around its Transit commercial van.
Under a multi-year agreement with Michigan healthcare system Beaumont Health, Ford will use Transit vans to transport patients to medical appointments, or from hospitals to home or rehabilitation centers.
Ford already has 15 vans serving Beaumont facilities as part of a previously announced test project and plans to deploy 60 vans by the end of the year, the company said.
Although a growing body of research suggests that social determinants of health—social, functional, environmental, cultural and psychological factors—are intricately linked to health and wellness, our fragmented medical and social services are often underequipped to address these needs. The Ambulatory Integration of the Medical and Social (AIMS) model—developed by the Center for Health and Social Care Integration (CHaSCI) at Rush University Medical Center—integrates masters-prepared social workers into primary care teams to identify, address, and monitor social needs that influence health.
Preliminary evidence indicates that AIMS reduces clients’ emergency department visits, hospitalizations, and readmission rates. AIMS also creates opportunities for community-based organizations (CBO) to develop partnerships with local health clinics to integrate care and promote better health outcomes.
Please join the Aging and Disability Business Institute on April 24 at 1:00 PM Eastern for a one-hour webinar. This webinar will highlight training and implementation support for CBOs interested in replicating AIMS.
Republican lawmakers on Monday told the CMS they are concerned the agency may not be doing enough to prevent patient abuse in skilled-nursing facilities.
In a letter to CMS Administrator Seema Verma, members of the House Energy and Commerce Committee highlighted recent media reports describing instances of abuse, neglect and patient harm occurring at nursing facilities across the country.
“These reports raise serious questions about the degree to which the CMS is fulfilling its responsibility to ensure federal quality of care standards are being met, as well as its duty to protect vulnerable seniors from elder abuse and harm in facilities participating in the Medicare and Medicaid programs,” the letter stated.
Two new grant opportunities from the National Institute on Disability, Independent Living, and Rehabilitation Research(NIDILRR) at ACL have been announced: the Disability and Rehabilitation Research Project (DRRP) on exercise interventions for people with disabilities, and the Rehabilitation Research and Training Center (RRTC) on health & function for people with intellectual and developmental disabilities.
The purpose of the DRRP program is to plan and conduct research, demonstration projects, training, and related activities (including international activities) to develop methods, procedures, and rehabilitation technology that maximize the full inclusion and integration into society, employment, independent living, family support, and economic and social self-sufficiency of individuals with disabilities.
DRRP on Exercise Interventions for People with Disabilities— The purpose of this DRRP is to generate new knowledge about the effectiveness of exercise interventions for people with disabilities.