Collaborating for a New Tomorrow

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Collaborating for a New Tomorrow
Neil Johnson, Executive Director, MN HomeCare
Association Patricia Jump, President, Acorn's End
Training Consulting
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Future Reality

• The need for services for seniors will triple by
  2050
• There will be 1.3 million Minnesotans over age 65
  by 2030
• Source Long-Term Care Imperative

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Changing Demographics
Source Minnesota Office of Demographer
Estimates of Total Population 2005 2030,
accessed 2006
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Problem or Opportunity?

• Could be viewed as a PROBLEM but we view it as an
  opportunity to
• Restore viability to local communities
• Improve business opportunities
• Expand job growth for all ages

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Opportunity

• 74 of people age 65 and over rated their
  health as good or better
• 80 of seniors over age 65 are healthy (no
  chronic illness or chronic illness that is well
  managed)
• Proportion of people age 65 and over with a
  functional limitation DECLINED by 7 from 1992 to
  2005
• 40 of male veterans (1/2 of whom were over
  age 65) of World War II, Korean War, or Vietnam
  were in labor force in 2007 (Dept of Labor)

Source Older Americans 2008 Key Indicators of
Well-Being, Federal Interagency Forum on
Aging-Related Statistics
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Gifts to the Community
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MHCA Pilot Project What is it?

• Building lifelong communities where seniors
  actively contribute to the vitality of the
  community

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MHCA Pilot Project Based On

• Identification of service and business
  opportunities
• Strong relationships between local providers and
  seniors
• Development of a wide array of accessible
  services
• Focus on healthy communities for all ages
• Strengthening workforce options for all ages,
  including seniors

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MHCA Pilot Project Based On

• Keeping seniors active and healthy in their homes
• Limited reliance on Medicare or Medicaid dollars
• Actively engaging volunteers of all ages
• Reaching out to community leaders to sustain
  local project success

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Project Focus

• All Seniors 65 and over
• All income levels
• All cultural groups residing in their local
  community

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Engagement

• Community-based collaborative
• Seniors actively contributing to their community
• Local business involvement
• Local resource use
• Community leader engagement
• Citizen leader involvement
• Faith-based community inclusion
• Intergenerational mentoring

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Positive Theme

• Seniors contributing to the vitality of the
  community
• Everyone within the community participates
• Continued support to keep people in the community
• Redistribution of dollars back into the community
• Flexible work for seniors
• Volunteer opportunities
• Maximize existing programs to meet individual
  needs

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Basic Elements

• Family education and support
• Person-centered approach
• Advocacy-centered method
• Interdisciplinary team approach
• Active use of volunteers
• One-stop shop for healthy living within own
  community

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Basic Elements

• Navigation through the health system
• Track needs (when healthy ill)
• Promote local resources
• Continued connection to minimize acute episodes
• Expand work opportunities
• Limited use of Medicare Medicaid dollars

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Opportunity for Community

• Develop local support network for seniors
• Business focus on needs of seniors
• Opportunities for seniors to contribute to
  their communities through volunteering or
  part-time work
• Support health and wellness strategies for
  individuals and the community
• Walking clubs biking clubs on-line technology
  to develop community engagement
• Link faith communities with health human service

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Project Foundation Focus on Wellness and
Prevention
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Virtual Center Could Be

• Senior Center
• Home Care
• Public Health
• Block Nurse
• Computer-based
• Other

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Roseville Project

• Prepared by
• Mary Ann Blade, CEO
• Minnesota Visiting Nurse Agency

Roseville Project
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Roseville Project
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Goal

• Keep the seniors of Roseville as healthy as
  possible providing them with a coordinated array
  of services, both traditional and non-traditional
  that will keep them as independent as long as
  possible.
• Utilize current community resources to augment
  and support a new system

Roseville Project
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Task Force

• Representatives of the following organizations
• Senior Council
• School Board
• School Community Education
• Senior Center
• Home Care Agency
• Assisted Living
• Parish Nursing
• The Community

Roseville Project
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Key Components

• 1. Central place where people can call, get
• guidance for service delivery
• 2. Prevention and early treatment of chronic
  illness
• Activity for Seniors
• Exercise
• Social
• Entertainment
• Volunteer activity

Roseville Project
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Key Components (cont.)

• - Medical/Dental
• Yearly check-ups
• Early detection
• - Services that are available to help people
  before they are ill
• Financial
• Chore
• Homemaker
• Nutritional/meals/grocery shopping
• Medication management
• Lifeline
• Community resources
• Foot care

Roseville Project
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Key Components (cont.)

• Acute Chronic Illness (additional
• services)
• Medical/hospital
• Care coordination
• Home Care
• Skilled Nursing
• Home Health Aide
• Therapy Services PT, OT, Speech
• Pharmacist
• Social Worker
• Caregiver support
• Transportation

Roseville Project
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Key Components (cont.)

• 4. Death Dying
• Palliative Care Services
• Hospice Services

Roseville Project
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Financial

• Many of these resources are already being paid
  for or funding raised.

Roseville Project
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Additional Dollars Needed

• Dollars to provide home care services that are
  not paid for by the client, family members, or
  Insurance Companies that do not pay full cost.
  We already have a sliding fee.
• Dollars to provide the care navigation necessary
  when a citizen calls the center.
• I believe 2 full time coordinators are needed in
  the center.
• Between 30,000 - 50,000 is needed to subsidize
  the sliding fee schedule for Home Care.

Roseville Project
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Collaborating for a New Tomorrow
MHCA Pilot Project
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PROJECT PLAN
Project Plan Basics
Seek Grants other investment Monies
Get Advisory Board Input
Inform Key Partners Stakeholders
Determine Project Demonstration Sites
Establish plan infrastructure service delivery
Evaluate Project Effectiveness
Establish Performance Targets/Research
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Project Uniqueness

• Virtual center
• Small, flexible
• Use of volunteers
• Partnership between seniors, business, health
  human services, and community resources

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Project Uniqueness

• Built in connection/monitoring when not part of
  formal health care system
• Centered on local communities - anywhere
• Limited reliance on Medicare and Medicaid monies

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Technology is Key to Success!

• Technology Creates
• Opportunities for

• Seniors
• Businesses
• Communities

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Technology Use

• Smart-home Technology
• Swipe Cards
• Access Individual Health Information Health
  Services Currently Using
• Tele-homecare
• Electronic Medical Record
• Real-Time Database Management

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Advantages for Seniors

• Increased independence
• Improved satisfaction
• Encourage consumer choice, self-directed care,
  engagement in their own future
• Enhance ability to remain at home
• Decreased use of costly health care services
  (emergency rooms, hospitals etc.)
• Build relationships with local businesses
  resources
• Provide ongoing support when not in formal health
  system
• Support family care-giving

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Advantages for Community Businesses

• Increased worker productivity
• Needs of parents are met
• Maintain viable business community
• Actively engage people included in the age wave
• Develop models to keep seniors safe in the
  community
• Community working together to support seniors

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Who Pays?

• Virtual Center initially funded by grants
• Local funding to sustain virtual center school
  district, city/county support, private resources
• Services offered through the use of volunteers
• Private Insurance
• State Federal (minimal)

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Desired Outcomes

• Track community resources used instead of
  state/federal dollars
• Conduct urban and rural pilot projects
• Track re-hospitalization rates
• Monitor client satisfaction rates
• Dollar expenditure tracking
• Use of technologies in-home and clinical

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Desired Outcomes

• Work with public health to enhance health
  outcomes
• Evaluation of existing client relationships
• Beneficial to the client
• Not beneficial to the client
• Analyze relationship between use of resources
  savings
• Project sustainability
• Rapid response to necessary changes

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Case Example

• Situation
• Out-of-control diabetic with frequent ER visits
• Foot wound
• Unable to see well enough to draw up correct
  insulin dosage

• Simple Unconventional Provider Solution
• Provider bought lamp for 19.99 better vision
• No further ER visits

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Case Example

• Situation
• MS client living on 4th floor could not get to
  food served on first floor no refrigerator in
  apartment (one-room apartment)
• End stage renal disease
• Bedsores due to springs poking out of mattress
  and into skin

• Simple Unconventional Provider Solution
• Provider bought new mattress, food small
  refrigerator
• Involved MS Society who helped move client to
  livable apartment
• Client able to die in dignity

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Planning for the Future

• Plan to develop four Pilot Sites
• Large Metropolitan area
• Larger Community, near or outside metro area
• Moderate-sized community in Greater MN
• Smaller rural community in Greater Minnesota
• Looking for home care providers interested in
  committing to this project in their community
• Call MHCA for more information 651.635.0607

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Collaborating for a New Tomorrow
MHCA Pilot Project
Questions