Health Care Administration Community Newsletter

Long-term care services involve providing additional services and goods to the vulnerable, such as the elderly and young people who have developed functional incapacities. A sizeable portion of personal care spending in the United States goes into the provision of paid and regulated care services. The government and the private sector have had to create a defined framework and programs that especially address the long-term care services in order to satisfy the interests and demands of this particular group of people. Plans and sophisticated frameworks are designed to help people become self-reliant, independent, financially secure, and truly empowered. Most of the families supported by the long-term care services have poor economic backgrounds and therefore depend on Medicaid and Medicare. The contribution that the two health intervention plans have made in the lives of American people is unforgettable.
Types of Long-Term Care Services
In the contemporary society, the number of individuals in need of the long-term care services is rapidly increasing due to the subsequent increase in the number of elderly populations. The care is not restricted to age, but its demand tends to rise with age, as a person continues to grow old, the more he or she is unable to do some activities by self. According to the US Census Bureau, the number of baby boomers aged more than 65 years is more than likely to triple in about thirty years from now. The persons above this age become so much in need of paid long-term services care for in most occasions women who could have tended to them are more likely in employment positions. Some few years back, nursing homes provided the basis for extending care to these individuals. But with rapidly rising demand, the use of skilled nursing facilitation has expanded to include rehabilitation, short-term and post-acute care (Ansah et al. 105-107).
To ensure the provision of efficient long-term care services in the US rural and urban communities the government through, Medicaid and Medicare has to establish sustainable infrastructure. And as such necessary support to aid in the delivery of care in the rural America include the empowerment of nursing homes, making arrangements for assisted-living, and workforce supply. It also entails training interventions for nurse aides, quality and access to care and availability of services as well as telemedicine (Ansah et al. 108-110).
After the establishment of the infrastructures mentioned above has gotten done, both the government and the paid long-term care service providers embark on the implementation of Medicaid waiver programs, affordable Medicare drug prescription, tax incentives for family caregivers, and facilitation of skilled nursing payment services. All the incentives to improve the quality of long-term services gains their strength from Medicare and Medicaid. The two are the main programs that the US government uses to increase access to affordable healthcare intervention and support services for the disabled adults (Marazzi et al. 187-194).
Medicaid and Medicare take their messages to the people through advertising on the print media and government sponsored advertisements. Many Americans are encouraged to take up health insurances to help cut down the burdens they often experience in accessing medical treatment services. Apart from government-sponsored advertising, private firms offering health insurance services have various ways of meeting and convincing clients to register with them. Several outreach efforts get committed from time to time to enroll older adults who are in so much need of long-term services care.

Source: Florida Agency for Health Care Administration (2013)
Community-Based Programs and Services
It is a special provision for states to develop home and community-based services waivers to help meet the needs of people who very much prefer to receive their long-term care services at their homes rather than in institutional settings. A waiver allows and facilitates the creation of creative and innovative alternatives for persons who very much need care in nursing facilities among participating states in Medicaid. 1991 and before, Medicaid used to pay for the services received by a person living in a particular institution such as a nursing home. However, with the provision of waivers, states that participate in Medicaid can now support and finance services of people being attended to while within the premises of their homes (Ansah et al. 105-113).
Community Health Education Process

Source: University of the Incarnate Word (2017; par.3).
In a bid to respond to adult health care needs, the state started the Adult Day Health Care (ADHC) program to care adults and persons established to have suffered or suffered from chronic illnesses, mental or cognitive conditions. By conventional norms, this kind of individuals could be locked somewhere in care institutions, but through this program, they receive treatment and support while interacting with their close family members so that they do not feel lonely and neglected. Family and friends provide them with the right kind of motivation, mental, physical and emotional support. Medi-Cal beneficiaries automatically qualify to become ADHC participants. Moreover, the service became optional for people to subscribe since 2012.
Beginning 1st April 2012, another program closely related to the ADHC came to place to reform the Medicaid waiver. Community-Based Adult Services is an extensive and elaborative program that has seen more than 250 centers registered across California to restore and maintain optimal capacity for self-care by adults with disabilities who are usually frail. The program is also meant to prevent or delay inappropriate institutionalization of adults with abilities in California State. In a bid to work towards personal independence, the plan stresses on the meaningfulness of partnerships between the family, the participants, and caregivers or the community. All the centers have multidisciplinary teams of professionals tasked to conduct comprehensive assessments and appraisal of the potential participants to determine services they require to individual and specific social and health needs (Stevens et al. 2609-2609).
Older people often get limited on the range of activities they can perform especially by chronic infections such as cancer, arthritis, obesity, stroke and heart diseases which can be prevented. So as to manage the risks and the potentiality of contracting these chronic conditions, the California Area Agencies on Aging organize workshops and seminars to educate the older population to engage in healthy behaviors. These adults are further encouraged to adopt a healthy lifestyle to help reduce the frequency of falls, improving physical and emotional fitness and elongation as well as improvement of the quality of life (Ansah et al. 105-113).
The Californian State Long-term Care Ombudsman program is legally instituted by the federal Americans Act to investigate as well as resolve complaints brought forward by, on behalf of particular residents of care facilities. It, therefore, conducts investigations into the abuse of older persons in long-term care institutions and residential facilities. Residents and even the elderly can contact the ombudsman office to raise concerns about the quality of attention, financial abuse, suspected emotional, mental or physical abuse of residents as well as requesting Ombudsman to be in attendance in resident care meetings. The agency is also tasked with the responsibility of ensuring that all rights of LTC facilities are advocated for and protected (Marazzi et al. 187-194).
Multipurpose Senior Services Program (MSSP) facilities help in providing social and health support services to frail older persons who have been certified to be placed in nursing facilities but wish to continue residing in the community. Therefore, the primary aim of this program is to ensure that necessary arrangements are made to monitor the utilization of community services to help in preventing early institutionalization. One criterion for this service is that it has to be provided at a lower cost than what a nursing facility can charge. Only Medicaid eligible clients aged above 65 years, residing within the MSSP service area, being able to be absorbed within MSSP's budget, and lastly certified for placement in a nursing facility can be covered by this program.
The MSSP program among other services offers the elderly frail persons with adult day care to meet the needs of different adults with psychological, social problems and disabilities. The intervention also engages in giving housing and personal care assistance to adults who require it to maintain independent living. Moreover, older persons have a higher risk of falling more often and hence through MSSP, and such emergencies can be avoided or prevented. Sometimes MSSP clients lack transportation means to social or medical events. Having such as program, these customers get necessary assistance to access community or individual events (Stevens et al. 2609-2609).
Benefits of Social and Educational Programs and Services
Social programs and services help the older adults feel part of the community, realize they are appreciated and so much treasured. These individuals need company and friendship more than any other time. They also want people they can talk to so as to maintain their mental, emotional and physical steadiness. Family and friends and social workers play this role more effectively when the older persons are helped through community-based interventions rather than in specialized institutions. Most of the adults with disabilities are it physical or mental need encouragement, inspiration and motivation not to lose hope but soldier on with life. This will help prevent premature institutionalization as a result of depression and emotional breakdown.
On the other hand, educational programs and services serve to remind or rather emphasize the importance of adhering to healthy lifestyles such as avoiding alcoholism and smoking, regular exercising and good eating habits. Indulging in unhealthy habits will lead to obesity or contraction of chronic diseases like cancer, arthritis, and stroke. The immune system of old people is usually weak and unable to sustain the pressure caused by these chronic illnesses hence causing premature death. In essence, educational services and programs help in reducing cases of premature institutionalization (Stevens et al. 2609-2609).
Sources of funding for social, community and educational services and programs
Long-term care population services are financed majorly by budgetary allocations from the state and federal governments. Every financial year the states and the national government determines the estimated expenditure and allocates certain fund amounts to help meet the needs of the older persons. However, finances from the state and federal authorities do not adequately cover the full cost of offering services. Therefore, the clients also have to pay some fees to access these services. Apart from regular governmental funding, private individuals and corporations partner with LTC institutions and centers offering these services by extending financial aid. In a nutshell state funding, off-the-pocket, grants and private investment and partnerships form the primary sources of money to meet the social and educational programs and services (Marazzi et al. 187-194).
Impact of Reimbursement on LTC
The costs of administering LTC have skyrocketed bearing in mind that the number of beneficiaries and eligible has significantly increased with the rapidly aging baby boomers. As pointed out in the previous section, the primary source of funding for the program is through taxpayer, self, and private funding. However, these sources are not adequate to meet all the needs of the eligible clients. The little the funding the limitedness with which the requirements and wants of the older persons will be satisfied. Increasing funding translates to the improved and efficient delivery of LTC social, community-based and educational services and programs (Stevens et al. 2609-2609).
Licencing Requirements of Programs and Services
All the community-based and social and educational programs and services adopted in LTC have to comply with or have to prove eligibility to California Department of Aging and the Older Americans Act. Additionally, the services offered have to satisfy Medicaid beneficiaries. The California Department of Public Health is responsible for licensing all Adult Day Health Care centers while the CDA certifies them to participate in Medicaid.
Trends in LTC
Due to the expensive nature of accessing LTC services, customers often worry about the fate of paid premiums when the care needed is not provided. As such, insurance providers have come up with new products that provided returns at the expiration of a specified duration. Though this plan is costly, many people have opted for it due to the investment benefits it provides. The other notable trend is the discouragement of institutionalization of the elderly. Some time back, older and adults with disabilities used to be taken care of in nursing facilities. However, the norm today is different as people advocate for community-based programs that allow individuals to lead independent lives. Community-based programs and services help the individuals with disabilities develop socially through close interactions with friends and family hence adopting independence (Marazzi et al. 187-194).
Conclusion
LTC populations need affiliation or to identify to a particular group of people and, therefore, by secluding them in nursing facilities, their socialization rights are limited. They are most likely to develop mental problems, depression or even worse, Post-Traumatic Stress Disorder (PTSD) due to lack of physical and emotional support from families. The community-based programs and services help the older and persons with disabilities to bond with other society members hence boosting their self-esteem. The programs further give them a motivation to improve their levels of independence in almost all aspects of life.












Works Cited
Ansah, John P., et al. "Implications of long-term care capacity response policies for an aging population: A simulation analysis." Health Policy 116.1 (2014): 105-113.
Florida Agency for Health Care Administration. SMMC Long-term Care Provider Webinar: Assisted Living Facilities and Adult Family Care Homes. Web. Jul 30th, 2013. https://www.slideshare.net/AHCAFlorida/smmc-provider-webinar-assisted-living-facilities-and-adult-family-care-homes Accessed on April 29th, 2017.
Marazzi, Maria C., et al. "Impact of the Community-Based Active Monitoring Program on the Long Term Care Services Use and In-Patient Admissions of the Over-74 Population." Advances in Aging Research 4.6 (2015): 187-194.
Stevens, Alan B., et al. "A Model Program of Community-Based Supports for Older Adults at Risk of Nursing Facility Placement." Journal of the American Geriatrics Society 63.12 (2015): 2601-2609.
University of the Incarnate Word. Welcome to the Community Health Education Program. Web. 2017. http://www.uiw.edu/che/ Accessed on April 29th, 2017.




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