From the Executive Director
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A Looming Crisis in Long Term Care
My maternal grandmother – Nana – was a central figure in my life growing up. When she was young, she was a talented seamstress who sewed wedding dresses for fancy customers. When she got married, she stayed at home and raised two daughters who were born “during the War.” Once the childrearing was done, her life was largely spent cooking and cleaning and sewing and doing laundry. She was deeply skeptical of my husband when I first brought him home and she discovered that he did all of those things for himself – and often for me too.
She dressed up and put on make-up to go out, and always wore heels until the day she fell and broke her pelvis. That was the beginning of her slow decline. Hypertension, diabetes and several falls plagued her in the last decade of her life. “Don’t get old, honey, it’s hard” was a common refrain.
I’m starting to watch my parents and my husband’s parents go through the same cycle. All three of the parents we have left between us had falls this year. All three of them live alone. The moment any of them becomes disabled – even temporarily – they need assistance.
Vermont is a leader when it comes to caring for people as they age. Through the Choices for Care program, those people who need a nursing facility level of care and who qualify financially for long-term care Medicaid have a choice – they can receive care at home or in a nursing facility or other long-term care facility. A lot of people choose to stay home as long as possible. That’s been good for the people we serve, who keep their independence longer. It’s good for their families and loved ones – most often women – who can remain in the workforce, instead of caring for aging parents. It’s also been good for Vermont’s Medicaid budget. The Medicaid program spends about half as much on people receiving care at home than in nursing facilities.
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On October 31, CMS issued its final rule for the 2020 payment model, PDGM, including rates of payment that go into effect January 1, 2020. The final rule offered some minor tweaks to the payment model and set out 2020 payment rates. The rule includes a 4.36 percent cut (which CMS refers to as a "behavioral adjustment") to home health rates. The cut is meant to offset changes CMS expects home health agencies to make in response to the new model. The rule proposed in July set the cut at 8.01 percent.
The VNAs of Vermont and our national partner the National Association of Home Care and Hospice (NAHC) opposes the cut and has sought federal legislation to stop it. Vermont Congressman Peter Welch and Vermont Senator Patrick Leahy are co-sponsors of companion bills that would require CMS to hold any adjustments until after the model has been implemented and there is data to review, instead of making prospective guesses.
The final rule also included other adjustments affecting home health, including:
- a 2021 home infusion therapy benefit
- several quality measures
- the Home Health Value-Based Purchasing Demonstration program
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Stephen Mills,
Times Argus
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Educational Opportunities
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Materials Available Online
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Home Health Aide/LNA Training Materials
Caring Connection newsletters and support materials are available for your use in supplementing in-house staff training.
Additionally, we offer a few recorded webinar series on specific topics that are pertinent to LNAs, aides and other direct care providers. Here are some examples with the first video in each series unlocked so you and your team can determine if online learning appeals to them:
I
nstructors:
Katherine Vanderhorst, RN, BSN and Amy Craven, PT, MS, DPT from C & V Senior Care Services. They are experts in behavioral health and dementia treatment in home care settings.
Purchase entire series
here
Instructors:
Jennifer Gullison, RN, MSN, COS-C, is the Clinical Director at Cornerstone VNA, Rochester, NH.
Elizabeth DeFeo RN, WCC, OMS, CWOCN, is the Wound, Ostomy & Continence Specialist
Purchase entire series
here
There is no limit to the number of views or staff that can be trained from your agency once purchased.
Other Materials Available Online
Video of classroom session available for purchase
Hosted by NAHC
"Opiods: What You Need to Know" training materials
Compiled by SASH
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Your copy should address 3 key questions: Who am I writing for? (Audience) Why should they care? (Benefit) What do I want them to do here? (Call-to-Action)
Create a great offer by adding words like "free" "personalized" "complimentary" or "customized." A sense of urgency often helps readers take an action, so think about inserting phrases like "for a limited time only" or "only 7 remaining!"
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Webinars and In-person Events
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December 4, 2019
5:30 to 7:30 p.m.
Hosted by OneCareVT
Webinar
Part of the Caring Connections Monthly Aide and LNA series
December 12, 2019
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
December 12 and 13
Renaissance Albany Hotel
Albany, New York
Hosted by Hospice and Palliative Care of New York State
In-person event
Part of the Caring Connections Monthly Aide and LNA series
January 9, 2020
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
January 28 to 30
Revere Hotel, Boston, Massachusetts
In-person event
Part of the Caring Connections Monthly Aide and LNA series
March 12, 2020
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
Part of the Caring Connections Monthly Aide and LNA series
April 9, 2020
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
Grappone Conference Center
Concord, NH
November 21, 2019
8 a.m. to 4 p.m.
Hosted by the Home Care, Hospice and Palliative Care Alliance of New Hampshire
In-person event
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