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www.daas.ar.gov Options Counseling in Arkansas Supporting Individuals in Making Long Term Care Decisions Arkansas Aging Conference October 28, 2011
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www.daas.ar.gov What is Options Counseling? Support for Options Counseling Arkansas perspective –Act 516 Federal Perspective –MDS Section Q
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www.daas.ar.gov Long-term Care Options Counseling Defined Long-term care options counseling is an interactive decision-support process whereby consumers, family members and/or significant others are supported in their deliberations to determine appropriate long-term support choices in the context of the consumer’s needs, preferences, values, and individual circumstances.
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www.daas.ar.gov “When it comes to long-term health care, each patient has a unique mix of medical and social needs that must be considered. Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services. ” Dr. Donald Berwick Centers for Medicare and Medicaid Services
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www.daas.ar.gov NEVER BEFORE IN HUMAN HISTORY has our planet contained so many older people— or such a large percentage of them. This has not always been the case. As late as 1930, America's older population numbered less than 7 million—only 5.4% of the population. Just the Facts
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www.daas.ar.gov Just the Facts 14% Population - Percent of Persons 65 and Over
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www.daas.ar.gov Just the Facts StatePercent Florida17.2 West Virginia15.8 Maine15.6 Pennsylvania15.4 Iowa14.8 North Dakota14.7 Montana14.6 Hawaii14.5 South Dakota14.5 Arkansas14.3 Population - Percent of Persons 65 and over
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www.daas.ar.gov Just the Facts Percent 9.5-12.2 12.5-14.6 14.7-16.5 16.7-19.4 20.0-26.8 Population Highest Proportion Over 65 years in Arkansas
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www.daas.ar.gov Just the Facts Life Expectancy in US
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www.daas.ar.gov Just the Facts Percent of People 65 Years+ Below FPL
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www.daas.ar.gov Just the Facts Disability status of the non-institutional population 65 and over Percent 36.5-38.6 39.3-41.1 41.5-44.8 45.7-51.7 59.1-59.1
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www.daas.ar.gov Summary
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www.daas.ar.gov According to the US Dept of Health and Human Services: Health literacy affects the ability to: navigate the healthcare system, including filling out complex forms and locating providers and services share personal information, such as health history, with providers engage in self-care and chronic-disease management Just the Facts Low health literacy
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www.daas.ar.gov Just the Facts Health Literacy Level in Arkansas 56% of adult Arkansans (1.1 million adults) are functionally and/or marginally illiterate Adults 65 or older are more likely to have below basic or basic health literacy skills than those under 65 Source: Peggy Sissel-Phelan, Ed.D
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www.daas.ar.gov Importance of Options Counseling Increase Longevity Increase Poverty Increase Baby Boomers Over 65 with disabilities
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www.daas.ar.gov
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I’ll think about it tomorrow….
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www.daas.ar.gov Consumer Facts Families need individualized support making decisions about long- term services and supports Lots of information is available on-line and from different I&R providers, but it can be complex, contradictory, and confusing Few people plan ahead for long term support needs Information for consumers is often not accessible and at too high of a literacy level
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www.daas.ar.gov Arkansas Response to Options Counseling An Act to Create the Arkansas Options Counseling for Long Term Care –Implemented in 2008 –Must be offered to: An individual or their representative Newly admitted individuals to NHs or AL Level II regardless of payment source All individuals seeking Medicaid reimbursement
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www.daas.ar.gov Form 9571
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www.daas.ar.gov Act 516 Options Counseling Process NH submits 9571 for each new admission Informational letter and brochure with ADRC toll-free number mailed Follow-up call made within 10 working days –ADRC pre-screens for eligibility Not eligible/ADRC counsels on options Nurse makes face-to-face contact –Can complete functional eligibility Referral to Case Manager to comp. LTC app.
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www.daas.ar.gov New Admissions – Act 516
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www.daas.ar.gov MDS assessment is conducted in Nursing Facilities: Federal Response to Options Counseling a standardized, primary screening and assessment tool of health status forms the foundation of the comprehensive assessment for all individuals of long-term care facilities Completed on all residents regardless of payer source
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www.daas.ar.gov MDS Options Counseling Effective October 2010, a revised Section Q identifies individuals who may want to talk to someone about moving back into the community. On admission and with the quarterly and annual assessments, residents are asked if they would like to learn about community choices and supports. If the resident answers yes the NF is required to act on this request through care planning and referral to the designated local contact agency.
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www.daas.ar.gov Findings MDS Options Counseling
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www.daas.ar.gov Findings MDS Options Counseling
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www.daas.ar.gov Findings Options Counseling
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www.daas.ar.gov Findings MDS Options Counseling
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www.daas.ar.gov Service Design (each step directed by individual) Activation Personal Interview Exploring Options - Follow-up Decision Support Link to services Options Counseling Process
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www.daas.ar.gov Opportunity Follow- up Survey to determine –Remained in community –Re-admitted to a facility –Length of time in the community –Services or programs –Satisfaction Level with living situation What’s Next
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www.daas.ar.gov More Information Kris Baldwin Division of Aging and Adult Services 501-682-8509
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