Trisha Chadduck, MSW, LICSW Hospice and Palliative Care Program Coordinator Loni Larson, MSW, LICSW Medical Foster Home Program Coordinator Glenda
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1 Trisha Chadduck, MSW, LICSW Hospice and Palliative Care Program Coordinator Loni Larson, MSW, LICSW Medical Foster Home Program Coordinator Glenda Trochmann, MSW, LICSW Women Veterans Program Manager & Mental Health Social Work Supervisor
2 Objectives Describe the differences between hospice and palliative care and the benefits connected with them Explain unique programs available for enrolled Veterans of different eras Review new programs and services Provide an opportunity for discussion and specific questions
3 What is Palliative Care? Medical care provided by an interdisciplinary team focusing on relief of suffering and support for the best possible quality of life for Pts. facing serious life threatening illness and their families. National Consensus Project To palliate: to come along side, to comfort
4
5 Disease Trajectory
6 Hospice vs. Palliative care 6 mo. Or less life expectancy as determined by 2 MD s VA will pay 100% for home hospice care with a contracted agency No co-pay for service VA will pay contract nursing home if on hospice No limitation of life expectancy Co-pays apply Will not pay for nursing home if on palliative care
7 Hospice Resources Community Hospice Care Hospice Contract Nursing Home Bereavement Services
8 Community Hospice All enrolled Veterans are eligible for VA paid community hospice care. Veterans may chose to use Medicare or other insurance to cover hospice care with no effect on their VA benefits. Payment mirrors Medicare
9 Hospice Contract Nursing Home Veteran MUST be enrolled in VA system Veteran/family must desire this level of care Must be followed by community hospice care Must be deemed Hospice eligible by VA provider Fargo VA Community Living Center (CLC) is first site of choice for inpatient hospice. Must be placed in Nursing Home under contract with the VA
10 Hospice Contract Nursing Home Placement Currently the VA has Hospice CNH beds in: Jamestown (Ave Maria, Eventide Hi-Acres) Garrison (Benedictine Living Center) Larimore (Good Samaritan Center) Minot (Manor Care Health Services) Mayville (Luther Memorial Home) Fargo (Rosewood on Broadway, Villa Maria Healthcare, Bethany) Valley City (Sheyenne Care Center) LaMoure (St. Rose Care Center) Dickinson (St. Luke s Home) Detroit Lakes (Emmanuel Nursing Home, St. Mary s Nursing Center) Battle Lake (Good Samaritan Center) Bemidji (Nielsen Place) Twin Valley (Twin Valley Living Center) Crookston (Villa St. Vincent) ** Cannot use contracted nursing home in Glen Ullin, Stanley or Hallock**
11 Bereavement Services Phone call/bereavement assessment Support group and resource referral Assistance with death benefits information Supportive mailings for 1 st year Bi-annual Memorial Service
12 Death Benefits Most Veterans entitled to Burial Flag Military Honors Headstone and Markers Burial in state or national cemetery Some Veterans entitled to burial allowances Funeral, plot and transporting of body Survivor benefits
13 Contact Information Hospice and Palliative Care Clinic ext Trisha Chadduck, LCSW, MSW Hospice and Palliative Care Program Coordinator ext
14 Unique VA Programs and Other Non-VA Veteran Resources
15 Extended Care Programs Community Living Center (CLC) Respite Care Contracted Home Health Services Adult Day Health Care Contract Nursing Home Care
16 Community Living Center (CLC) Interdisciplinary medical and nursing care, basic and skilled, as well as care for veterans with chronic stable conditions, those requiring rehabilitation or short term specialty services, respite care, or those who need comfort and care at the end of life. Goal to restore the resident to maximum function.
17 Respite Care Care in our CLC, 30 days per year Can also occur in the community Goal to provide relief from the physical and emotional burdens associated for caring for veterans at home CLC Unit Manager ext
18 Home Care Skilled Home Care is contracted with agencies. Includes consults for OT/PT/Speech & Social Services Usual benefit starts with 12 visits a year Have to be enrolled in Primary Care with the VA. Respite in the home through home health agency May have Co-pays, (probably $15.00 each visit) Check with Business Office, ext
19 Adult Day Health Care (ADHC) Therapeutic outpatient day programming based on the medical model in a group setting for veterans at risk for nursing home care. VA has Contracts with facilities in MN and ND to provide these services. Veterans allowed so many hours or units per month.
20 Contract Nursing Home Care (CNHC) Providing care in a community skilled nursing home facility under contract with the VA. Eligible veterans, screened to require nursing home care may utilize this benefit. **Eligible veterans are needing nursing home for service connected disability or are service connected 70% or higher. Or 60% service connected and Permanent and Total disabled (P&T) also called Unemployability- determined through VBA
21 Contract Nursing Home Placement Veterans who are 70% or more SC, need NH placement for an SC condition, or are deemed unemployable by a VA provider are eligible for VA CNH placement. Currently the VA has CNH beds in: Jamestown (Ave Maria, Eventide Hi-Acres) Garrison (Benedictine Living Center) Larimore (Good Samaritan Center) Minot (Manor Care Health Services) Mayville (Luther Memorial Home) *Glen Ullin (Marian Manor Health Care)* *Stanley (Mountrail Bethel Home)* Fargo (Rosewood on Broadway, Villa Maria Healthcare, Bethany) Valley City (Sheyenne Care Center) LaMoure (St. Rose Care Center) Dickinson (St. Luke s Home) Detroit Lakes (Emmanuel Nursing Home, Oak Crossing) Battle Lake (Good Samaritan Center) *Hallock (Kittson Memorial Healthcare)* Bemidji (Nielsen Place) Twin Valley (Twin Valley Living Center) Crookston (Villa St. Vincent) **Those facilities that are bold are not available for hospice contract placement**
22 Home Based Primary Care Program (HBPC) Provides comprehensive, interdisciplinary, primary care in the home of veteran with complex medical and social conditions. Primary focus of HBPC is longitudinal care for complex chronic disabling disease. Interdisciplinary care team involved in care. Veterans must be enrolled in VA healthcare system Must live within a 50 miles radius of the Fargo VAMC. COMING SOON HBPC will be adding a team to the Bismarck region which will cover a 50 mile radius of the Bismarck CBOC
23 Other Specialty Programs Caregiver Support Program OEF/OIF services Mental Health Services
24 Caregiver Support Program VA offers a wide range of services for Caregivers of eligible Veterans of all eras (e.g. support groups, linking to resources, education about caregiving, etc). Additional services, including a monthly stipend, are available for eligible Veterans who were seriously injured in the line of duty on or after September 11, 2001.
25 OEF/OIF program Combat vet clinic Social work assessment, nursing, physician exam Case management Groups Outreach
26 Mental Health Services Social Work Therapy (individual & group) Case management Psychology Therapy (individual & group) Psychiatry Psychotropic med management Nursing Case management Addiction Counselors Substance Abuse Treatment Program
27 Mental Health Programs Military Sexual Trauma Suicide Prevention Program PTSD programming (groups & individual) Numerous evidence based therapies (e.g. CPT, PE, ACT, CBT) Homeless Program, including HUD-VASH Inpatient psychiatric unit (10 beds) Mental health walk-in clinic Variety of group offerings (e.g. anger management, social skills, DBT, pain management)
28 Military Sexual Trauma (MST) MST refers to sexual harassment and sexual assault that occurs in military settings. MST services include counseling (individual and group), primary care Every veteran is screened for MST No fees for services related to MST
29 Healthcare for Homeless Veterans Description of Services: Shelter, clothing, food, medical care, psychiatric services, substance abuse treatment, transitional rehabilitative housing, and permanent housing programs. Programs: Shelter Outreach, Grant/Per Diem Rehabilitative Housing, Veterans Justice Outreach, and HUD-VASH permanent housing programs. No fees
30 Veterans Justice Outreach (VJO) Works with local law enforcement and courts to provide eligible veterans with the treatment they need Veterans may be appropriately diverted from arrest into mental health or substance abuse treatment
31 HUD-VASH Housing Program Assists homeless veterans and their families in finding permanent housing Section 8 Housing voucher decreases out-of-pocket expenses for the veteran Mandatory Case Management Offered in Fargo and Grand Forks
32 Women Veterans Program
33 New Programming Home Based Primary Care at the Bismarck CBOC Medical Foster Home
34 MEDICAL FOSTER HOME
35 MFH 2004
36 MFH 2010
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38 National MFH Initiative by the numbers as of 12/31/2012 1,722 - # MFH Veterans served # of Medical Foster Homes 555 # of current MFH Veterans 9 # OEF/OIF Veterans to date 145 # of current P1a Veterans in MFH (28%)
39 WHAT IS A MEDICAL FOSTER HOME?
40 MEDICAL FOSTER HOME A Medical Foster Home (MFH) is an adult foster home combined with VA interdisciplinary home care team such as VA HBPC (Home-Based Primary Care) to provide non-institutional long term care for Veterans who are unable to live independently and prefer a family setting.
41 VA Medical Foster Home Program Merges adult foster home with VA Home-Based Primary Care (HBPC) program. Person in community takes dependent Veteran into their private home, as MFH caregiver MFH caregiver provides daily personal assistance and supervision for up to three Veterans VA HBPC provides comprehensive medical care and management; caregiver education VA MFH Coordinator provides oversight Veteran pays for MFH
42 Eligibility Veteran must be enrolled and receiving care from a VA, or has received care within the preceding 12 months Veteran meets nursing home level of care but prefers a non-institutional setting Have care needs that can be met by MFH and HBPC Unable to safely live independently due to functional, cognitive or psychosocial impairment
43 The Veteran s family/support system is not able to provide supervision or personal assistance Agrees to MFH placement with HBPC as primary care provider MFH s will be within 50 mile radius of Fargo
44 MFH Goals Veteran Choice Home setting Personalized Care Affordable Primary Care in the Home Increased Satisfaction VA Non-institutional long term care option Utilizes veteran benefits Partner with Community Ensures quality care Cost effective
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49 Call Loni Larson, MFH Program Coordinator , ext 4394
50 Other Veteran Resources Vet Centers MN and ND Veterans Home County Veteran Service Officers Veteran Service Organizations (e.g. DAV, DVA, VFW) ND National Guard Outreach Job Service North Dakota Veterans Employment Team
51 Thank you!
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