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Office of Comprehensive Senior Services, Coursework Example

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Coursework

Formation of the Office of Comprehensive Senior Services

In the last United States Census, it was estimated that there are some 41.1 million people living in this country who are 65 years or older, and that number is expected to reach 72 million by the year 2050; the fastest-growing segment of our population is among the very old, those 85 or older (United States Environmental Protection Agency, 2013, p. 1). With those numbers alone, it is easy to see why services for the elderly are becoming more and more important, including services which help those who need round-the-clock care to find long-term care facilities.  An in an age of budget cuts and belt-tightening, it is also becoming more important to provide these services in as cost-effect a manner as possible.

One way to help with the costs of healthcare is to streamline related services being offered by a number of state departments and programs into one, comprehensive program which will provide seniors who are currently in or considering long-term care facilities.  This paper seeks show how it would be possible to develop and streamline an Office of Comprehensive Senior Services (hereafter referred to as the OCSS) in the state of Arkansas.  The following pages will discuss the offices and departments currently operating in Arkansas which will be integrated into the OCSS, as well as how the change should be coordinated, services and financing issues, and how the integration program could feasibly take place.

Offices and Departments to be Streamlined into Office of Comprehensive Senior Services

The central agency that will be affected by this move to the OCSS  is the Office of Long-term Care, currently operating under the Arkansas Department of Health; it is responsible for the licensing and regular inspection of long-term care facilities in Arkansas (this not only includes nursing homes, but assisted living facilities and adult day care); they also do thorough background checks for the long-term care industry here in Arkansas, oversee and accredit all certified nurses aide (C.N.A.) programs throughout the state and help to determine eligibility for Medicaid for low-come seniors to receive long-term care  services. (Arkansas Department of Human Services, 2013, p.8).

Under the OCSS program, the Office of Long Term Care would retain all these duties, but several other, currently independent, offices and programs would be folded into it.  One of the most important of these services would be the Office of the State Long Term Care Ombudsman.  The ombudsman program is an advocate organization which seeks to represent residents of long-term care facilities across the state, and to help address concerns and complaints on the part of residents of family members and work with the long-term care facilities to implement necessary changes in response to these complaints. (Arkansas Department of Human Services, 2013, p.12).  This is a very important program to help improve the quality of life for Arkansas seniors and will complement the services offered by the Office of Long Term Care itself.

Another equally important office which will be integrated into the OCSS is the Arkansas Adult Protective Services, which deals with allegations of  abuse and neglect of seniors (Arkansas s Department of Health, 2013, p. 13).    The importance of the issues of maltreatment of senior citizens cannot be overemphasized.  The American Psychology Association estimates that 4 million elders in the United States are the victims of abuse and neglect every year, and while most of this maltreatment does not take place in institutions, it is still a serious challenge for the long-term care setting (American Psychology Association, 2011, p. 1). The APS services incorporated into the OCSS would cover both long-term care residents but also of course still be provided to adults who are living on their own or with family members (Arkansas Department of Health, 2013, p. 1).  This would be a integral part of the OCSS, since many adults who are taken out of abusive or neglectful situations do have to be placed in long-term care and having this office as part of the OCSS would ensure greater continuity of care for our most vulnerable seniors.

Because nursing homes are not the only choices available to seniors for long-term care, the OCSS would also incorporate the Living Choices Assisted Living Program, which is the state office which currently helps seniors to find facilities which provide supportive activities of daily living and healthcare services in a residential setting while retaining more independence than they would in a nursing home (Arkansas Department of Human Services, 2013, p. 4).  In a related field, the Adult Day Care Program, which is currently part of the Office of Long-term Care, would also be incorporated into the OCSS: there are many instances in which seniors living in nursing homes or assisted living facilities would also be eligible for adult day care services, and having this program integrated into the OCSS would again ensure a smoother transition for senior clients.

Another important program which would be integrated into the OCSS would be the Elder Choices Program, which helps seniors to delay moving to an institution whether they are at home by themselves or living with family members. (Arkansas Department of Health, 2013, p.6).  Often, many clients who are eligible for the Elder Choices Program do eventually go into nursing homes or assisted living, so once this integration takes place, the transition from at-home to in-facility living should be made smoother for  Arkansas seniors.

Coordination of Change for the OCSS

The coordination of this change would have to begin with a massive staff retraining program so that employees of the various offices and programs now functioning under the Arkansas Department of Health would understand how the new Office of Comprehensive Senior Services would work and what their respective roles would be.  Some positions may have to be streamlined to prevent a duplication of services once the integration took place, but on the other hand many new positions in the local Health Unites would be opening (see section below on how this integration would be implemented for further details) to help offset this.

One of the most important ways in which this change to the OCSS would be coordinated is to have the establishment of an integrated computer system for all of the OCSS services which  could be accessed by all OCSS professionals managing a certain client’s case: in other words, each client would have a detailed health and social history on file which could be accessed whether it was from someone who did protective services or someone assisting the client to find adult day care.  This electronic health record (E.H.R) would help OCSS to improve client care and outcomes by providing easy access to client records by all members of the case management team and provide information on client medical history, social history, current treatment plans and contact information for family members, among other things; all this would help to make the continuity of client care smoother and help to reduce human errors (Office of the National Coordinator for Health Information Technology, 2013, p. 1).  This would make the OCSS more efficient in regards to client care.

Services and Financing Programs for the OCSS

Many of the programs that would be incorporated into the OCSS are currently funded through the Arkansas Medicaid program.  Eligibility for this program is determined by the Arkansas Department of Health’s Division of  County Operations (Arkansas Department of Health, 2013, p. 9) and this would remain true for the coordinated services which would be offered by the OCSS: clients eligible for Medicaid under the former program would still be eligible.

In regards to federal funding, Medicare does not generally pay for long-term care facilities for seniors unless it is for rehabilitative care aimed at allowing the senior to return home; generally, rehab care in a long-term care facility is only covered for up to 100 days, and there are many extra qualifications that the patient must meet (Department of Aging and Adult Services, 2010, p. 8), so the financing for this formation of the OCSS would not be helped by Medicare funds.  However, it would also be possible to apply for a grant from the Center for Medicare and Medicaid (CMS) Research, Demonstrations, and Evaluations: these grants are available for state agencies who currently administer the Medicaid program (such as what OCSS would do) and grants are giving for programs that “expand delivery, access, and quality health care programs” (Federal Grants Wire, 2013, p.20).

With a combination of state and federal funding, clients all over Arkansas who are considering a long-term care facility or who are currently in such a facility, would be provided by the OCSS with the full spectrum of services now offered by the Arkansas Department of Human Services: assistance in choosing and entering a facility, protection from the threat of maltreatment, an ombudsman to advocate for their cares and concerns, access to adult day care or assisted living if needed and information on how to live at home longer and delay entry into a facility.  The only difference would be that these services would now be offered by one office rather than many and this would be accessing these services easier and more streamlined.

How the Integration Would be Implemented

The Arkansas Department of Health currently has County Health Units in all of its counties: these units are largely used to provide healthcare for low-income women and children, (Arkansas Department of Health, 2013, p. 12), but the OCSS could also be given office space in each of  these Health Units so that accessibility would not be an issue in even the poorer, more rural, or more isolated parts of the state.  There would be a central office in Little Rock which would act as a coordinator and administrator for the program statewide, but clients would be able to go to their local Health Unit to meet with an OCSS worker to help determine what long-term care services the clients needs and is eligible for; it would also give families and clients the right to voice their concerns once their loved one is placed in a facility, and provide investigation tools through the Adult Protective Services portion of the OCSS should any problems arise. It would in addition give seniors the tools they need to help delay entry into an institution through the Elder Choice portion of the program and to received day care services if needed as well.

Conclusion

In conclusion, the implementation of an Office of Comprehensive Senior Services would offer Arkansas seniors a more streamlined and multidisciplinary approach to the very important decision of selecting and entering a long-term care facility.  The service the OCSS offers would not stop there, however, but follow the client after entry into the facility and also offer viable alternatives to a nursing home such as an assisted living facility, adult day care, or assisted living at home through Elder Choices.   With our growing aging population, the services that the OCSS could offer are important and will only increase in importance in the future.

Works Cited

American Psychology Association.  (2011). “Elder Abuse and Neglect: In Search of Solutions” Retrieved from: www.apa.org/pi/aging/resources/guides/elder-abuse.aspx

Arkansas Department of Aging and Adult Services. (2010). Arkansas Nursing Home Consumer Guide Retrieved from: www.arkansas.gov/dhs/aging/asmp.html

Arkansas Department of Human Services.  (2013). “Division of Adult and Aging Services” Retrieved from http:humanservices.arkansas.gov./daas/Pages/daas_services

Federal Grants Wire.  (2013). “Centers for Medicare and Medicaid Research, Demonstrations, and Evaluation Grants”. Retrieved from www.federalgrantswire.com/centers-for-medicare-and-medicaids- services-cms-research-demonstrations-and-evaluations.html

Office for the Coordinator for Healthcare Technology. (2013).  “Healthcare IT” Retrieved from www.healthcareit.gov

United States Environmental Protection Agency.  (2013). “Aging Initiative”. Retrieved from: www.epa.gov/aging

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