Using Geriatric Care Management as an Integral Component to In Home Care

Size: px

Start display at page:

Download "Using Geriatric Care Management as an Integral Component to In Home Care"

Easter Richardson
3 years ago
Views:

What is the main concern of care managers?
What is the goal of Geriatric Care Management?
In what month and year did the Geriatric Care Management Leadership Summit take place?

1 Using Geriatric Care Management as an Integral Component to In Home Care Deborah Newquist, PhD, MSW, CMC Private Duty Home Care Leadership Summit Long Beach, CA January 2011 Defining Geriatric Care Management Geriatric care management is a professional service that assesses a client s needs, arranges for required services (home care, as well as other services) to be given in a coordinated, costeffective manner, and then monitors the services to ensure that they are providing the desired benefit. Geriatric care management complements home care services. Care managers assist families with navigating the health and long term care service systems. 1

(home care, as well as other services) to be given in a coordinated, costeffective manner, and then monitors the services to ensure that they are providing the

2 What Do Care Managers Do? Figure out what is needed (assess) What is really going on? Present options to address needs (plan) Within the framework of values and budgets Arrange services/resources (coordinate) Overcoming resistance Follow along (monitor) Troubleshooting if things go awry Source: White, 2008 Other things care managers can do Attend doctor appointments with clients and ensure optimal service and communication. Keep long distance families and allied professionals updated on how the senior is doing. Make referrals to screened geriatric specialists. Coordinate household repairs and petty cash. Assist with insurance paperwork. 2

(monitor) Troubleshooting if things go awry Source: White, 2008 Other things care managers can do Attend doctor appointments with clients and ensure optimal

3 Care managers can also: Monitor medication regimens. Give emotional support to the senior and their caregivers, including long distance families. Work to reduce risks of injury, burn out, elder abuse and other risks to the caregivers, clients and their families. Coordinate and oversee discharges and transitions of care from bedside to home. Components of care management service Screening Consultation Assessment and care planning Implementation of the plan Ongoing monitoring and management Crises intervention and prevention 3

Work to reduce risks of injury, burn out, elder abuse and other risks to the caregivers, clients and their families.

4 Screening Who is and is not a potential care management client? Clients need to: Have problems that a care manager can help solve. Be able to afford services. Be willing to pay for services. Be comfortable using professional services. Be able to effectively partner with the care manager. Pre qualifying clients Consultation Care managers function to provide: Education Objective expert advice Counsel and support Coaching and guidance Structure, planning, and coordinating Advocacy for clients 4

Be willing to pay for services. Be comfortable using professional services.

5 Assessments Holistic and person centered Rehabilitation ti philosophy h build on strengths th Directed towards reducing risk, mitigating problems, providing enhanced supports, promoting independence, and sustaining quality of life Provides the foundation for the plan of care Care Plans Holistic and person centered Prioritizes iti and guides interventions ti which h may include, but may not, home care services Provides a road map for families Serves as an educational tool Can serve as a marketing tool 5

foundation for the plan of care Care Plans Holistic and person centered Prioritizes iti and guides interventions ti which h

6 Geriatric Care Management Model Team: Older Person Family Members Care Manager A S S E S S M E N T FUNCTIONAL EMOTIONAL PSYCHOLOGICAL MEDICAL SOCIAL ENVIRONMENTAL COGNITIVE C A R E P L A N LEGAL FINANCIAL PERIODIC RE-EVALUATIONS ONGOING CARE MANAGEMENT SERVICES What care management is not Not the same as case management. The payers influence the focus. Not the same a disease management. More than managing the homecare case and providing good customer service. A care plan is not the same as a home care service plan. A nursing supervisor is not the same as a care manager. A staffing coordinator is not the same as a geriatric care manager. 6

management. The payers influence the focus. Not the same a disease management. More than managing the homecare case and providing good customer service.

7 Who Can Do Geriatric Care Management? Clients hire care managers to help them solve problems. They are seeking expert advice. Geriatric care managers need to know about: the bio psycho social issues of aging, available community resources for seniors, financial and legal challenges of aging, g family stresses and dynamics surrounding caregiving, and how to maneuver health care systems. About NAPGCM National Association of Professional Geriatric Care Managers NAPGCM is dedicated to the development, advancement and promotion of humane and dignified care for the elderly and their families delivered by yqualified professionals. NAPGCM is committed to working toward the highest quality of care for the elderly and their families through education, advancement and high standards of professional practice. Started in

surrounding caregiving, and how to maneuver health care systems.

8 Qualifications for Care Managers There is no licensing for care management Certification as first step NAPGCM membership NAPGCM Standards of Practice NAPGCM Code of Ethics CMSA Case Management Society of America NASW National Association of Social Workers ANA American Nurses Association Adding Geriatric Care Management to Your In Home Care Services Why add Geriatric Care Management Services Increased Value Higher Revenues Improved Communication 8

National Association of Social Workers ANA American Nurses Association Adding Geriatric Care Management to Your

9 More reasons to add care management services Many clients and their families need more support than home care alone can provide. Care management provides regular professional supervision and support to the home care staff paid for by the clients. Care management can be a feeder source for home care clients. Care management provides access to more affluent clients who can afford more services. Care management can distinguish you in the marketplace as a high quality service provider. Care management can aid in risk management. How does this differ from what you already do? 1. $$$$$$$$$. (You can charge for it.) 2. Professional service rendered by trained eldercare experts. 3. Ongoing management versus crisis management. (Think of emergency room care versus regular management of health problems.) Preventive approach. 4. More in depth involvement. 5. More holistic involvement. 9

Care management provides access to more affluent clients who can afford more services. Care management can distinguish you in the marketplace as a high quality service provider.

10 Models for Integrating Geriatric Care Management with Home Care The Broker Model of Geriatric Care Management Billed as services are rendered, often on a feefor service approach* (hourly fees). Care manager acts to coordinate home care and other services on behalf of the client. A concierge approach. Care manager as the team leader, supervisor, administrator of each individual care home. 10

Care manager acts to coordinate home care and other services on behalf of the client.

11 The Bundled Care Management Model Care management is included in the home care service package. Services are bundled together. Home care rates are usually higher to incorporate costs for providing care management. A premium service is marketed. Some providers cap the care management and apply fees for services which exceed the cap. The Enhanced Customer Service Model Care management is included as part of the overall home care service package. It is not a billed service. This form of care management should be delivered by a certified or licensed professional. Beware: Many home care companies are now claiming they offer care management but are not using professionals, so in essence, are misleading their clients. Long term care insurance providers will not reimburse these professional services. This form of care management can run afoul of professional approaches if non professionals are used. 11

Some providers cap the care management and apply fees for services which exceed the cap.

12 Billing for Care Management Fees for hourly services and assessments Rti Retainers Recording time accurately Not giving away time Billing in units of time Targeting Care Management Services You know they need care management: If the client or the family is driving dii you nuts. If the family is stressed to the max. If the family can t agree on care options. Long distance families, or busy professionals who cannot be two places at once. Elders with no families who have professionals managing their affairs. Clients with high caregiver turnover. 12

nuts. If the family is stressed to the max. If the family can t agree on care options.

13 Barriers to Adding Care Management Services Does it fit with your agency s culture and established service approaches? Would you need to penetrate a new market and do not want to do that? Addressing the We are already doing this argument. Staff turf issues Would this add a new revenue stream or distract from your core business? Fee phobias Thank you! Call or if you have more questions later. Deborah Newquist, PhD, MSW, CMC President Deborah Newquist Associates debnewquist@gmail.com

Staff turf issues Would this add a new revenue stream or distract from your core business? Fee phobias Thank you!

HOW A GERIATRIC CARE MANAGER CAN HELP

HOW A GERIATRIC CARE MANAGER CAN HELP As a widow living alone, my health problems began interfering with my ability to handle many personal care needs. Without the help of a geriatric care manager I wouldn

Using Geriatric Care Management as an Integral Component to In Home Care

What is the main concern of care managers?

What is the goal of Geriatric Care Management?

In what month and year did the Geriatric Care Management Leadership Summit take place?