Adult Foster Home. Medical Foster Home. What is Home-Based Primary Care? What is a Medical Foster Home Program?

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1 VA Nebraska-Western Iowa VA Nebraska-Western Iowa Health Care System Medical Foster Home Program Where Heroes Meet Angels NWI-Omaha VAMC Health Care System NWIHCS Mission: Honor America s veterans by providing exceptional health care that improves their health and well-being. Adult Foster Home An adult foster home is a family home in which supportive care for compensation is provided in a home-like environment to adults who are frail or physically disabled Medical Foster Home A Medical Foster Home (MFH) is an adult foster home combined with VA Home Based Primary Care (HBPC) to provide non-institutional long term care for Veterans who are unable to live independently and prefer a home-like setting What is a Medical Foster Home Program? A unique partnership of adult foster homes and HBPC It provides an alternative to nursing home placement for dependent, chronically, and terminally ill Veterans unable to live independently What is Home-Based Primary Care? HBPC is comprehensive, longitudinal primary care provided by a physiciansupervised interdisciplinary team of VA staff in the homes of veterans HBPC serves veterans with complex, chronic, disabling disease for whom routine clinic-based care is not effective 1

2 What do MFHs Provide? MFH Program History 24-hour supervision Private or semi-private furnished rooms Medication management Personalized care Homemaker services: laundry, cleaning, etc Meal preparation Transportation Assistance with medical and psychiatric needs MFH was successfully piloted in Little Rock, AK (1999), Tampa, FL (2004) and San Juan, PR (2004) There are 51 operational sites with 322 approved caregivers which had served approximately 962 residents MFH Goals Provides a non-institutional option for Veterans to meet increasing demand for long-term care services Improves quality of life for Veterans Provides longitudinal care in a home to include end-of-life and preventative care Benefits of MFH Provided an alternative to NH care in a less restrictive environment Allows Veterans to choose home environment Less costly than nursing home Offers benefits to caregivers Offers benefits to community Economics of MFH Who pays for MFH? Veteran pays for MFH MFH rates are negotiated according to level of care VA works with Veterans to receive proper level of Comp and Pension, Aid and Attendance benefits Other Veteran income; Social Security Medical Foster Home Caregivers 2

3 Medical Foster Home Caregivers Complete and submit an application and participate in an interview with the MFH Program Coordinator and other staff as needed Demonstrate financial stablity Be at least 21 years of age MFH Caregivers (continued) Recommended to: Complete financial statement Complete FBI criminal background check Provide a minimum of four personal and professional references MFH Caregivers (continued) Physically able to provide the needed care Provide a written backup plan if they become incapacitated, including relief persons Experience as a caregiver, formal or informal MFH Caregivers (continued) Able to communicate to HBPC team any significant changes in the Veteran Willing to accept, participate in, and follow the Veteran s treatment plan Provide care to medically complex Veterans as delegated and supervised by a Nurse Case Manager and/or Provider Caregiver Knowledge, Skills and Education Medical Foster Home caregivers are required to have knowledge and skills in the following areas: Personal care provisions specific to Veterans level of functioning (Activities of Daily Living) Medication management Crisis management and re-hospitalization procedures Provision of supportive and emotional care Caregiver Knowledge, Skills and Education (continued) Nutrition and proper food preparation, distribution and storage Activity and program planning Applicable VA policies Privacy and confidentiality procedures State and local laws and ordinances Fire and safety procedures 3

4 Education Program training will be offered semiannually Additional training can be obtained through appropriate channels, i.e. state/local programs Documentation of the training completed will be maintained by VA Education (continued) HBPC team provides ongoing education on the management of Veterans medical and social needs Topics may include, cultural diversity, ethics, HIPPA, infection control, communication, dementia, personal boundaries and conflicts of interest Medical Foster Home MFH Requirements Must be owned or rented by caregiver and be caregiver s actual place of residence Must be designed, equipped and maintained to provide a home like environment Must be approved by the VA Inspection Team for safety and suitability MFH Requirements (continued) Medical Foster Home Resident Meets National Fire Protection Association Life Safety Codes Must meet state licensure and certification requirements, if applicable Must have no more than three residents receiving care NWI 4

5 Veterans Eligible for MFH Meets HBPC criteria Meets nursing home criteria Received VA medical services within the preceding 12 months Chronically ill with multiple complex medical symptoms Veterans Eligible for MFH Requires assistance and supervision No caregiver available Unable to live independently due to functional, cognitive or psychiatric impairment Able to pay for MFH Veterans Eligible for MFH Role of the Medical Foster Home Coordinator Needs care coordination from multiple disciplines Needs medication monitoring - generally complex regimens Coordinator Wears Many Hats Recruits Medical Foster Homes Inspects and approves homes Processes referrals of Veterans to program Matches patient to home Arranges tours of home, if necessary Assists Veteran with application process for VA pension and Social Security Coordinator Duties (continued) Coordinates VA discharges and placements into homes Conducts announced and unannounced visits to homes 5

6 Medical Foster Home Staff Questions Amy Rosauer, LCSW Medical Foster Home Program Coordinator Kimberly Labedz, MSN Medical Foster Home Program Case Manager Vacant Medical Foster Home Support Clerk Taleen Tatian, M.A. Recreation Therapist 6