Low Medicaid Rates Limit Beneficiaries’ Access to Assisted Living Facilities, Quality Care

More than 700,000 elderly and disabled Americans receive health care in residential care communities, such as assisted living facilities. As the population ages, this number will grow.

A new study by RTI International found that low Medicaid payment rates for services in assisted living and similar settings discourage residential care providers from serving Medicaid beneficiaries, which limits their access to community-based residential care.

The study found that some residential care settings limit the number of Medicaid residents they serve or decrease operating expenses in ways that may also reduce quality of care.

“Medicaid payment rates only cover services in residential care settings; they do not cover room and board,” said Michael Lepore, Ph.D., senior health policy and health services researcher at RTI and lead author of the study. “One of the access barriers is the difficulty that Medicaid beneficiaries have paying for room and board in residential care settings because of their low incomes. This situation dissuades residential care providers from serving Medicaid beneficiaries.”

Residential care settings are community-based homes or facilities that offer room, board and care services, the most popular being assisted living. Compared to nursing homes, these settings often are less institutional and are often the preferred setting.

If Medicaid beneficiaries with long-term service and support needs cannot access residential care settings, then nursing homes may be their only option, ultimately costing taxpayers more money because Medicaid payment rates for nursing homes are higher.

The study, published in the Journal of Housing for the Elderly, found barriers that influence Medicaid beneficiaries’ access to state-licensed residential care include Medicaid reimbursement rates for services, the supply of Medicaid-certified residential care settings and beds, and policies that affect room and board costs for Medicaid beneficiaries.

Researchers examined Medicaid policies in all 50 states and the District of Columbia, interviewed subject-matter experts, and conducted four state case studies informed by reviews of state policies and stakeholder interviews.

“States need to ensure their Medicaid rates for residential care services are sufficient to maintain an adequate supply of these settings and beds available to Medicaid beneficiaries, while also safeguarding quality of care and taxpayer resources,” Lepore said. “Higher Medicaid rates may encourage more residential care settings to serve Medicaid beneficiaries, which may help reduce nursing home use by older adults and people with disabilities and potentially reduce Medicaid spending on long-term services and supports.”

Assisted Living Facilities: Grandpa Is Not Resting On His Laurels!

By Deborah Nguyen

Enjoying Retirement
Enjoying Retirement

While there may have been a time when assisted living facilities were basically a place to send an elderly relative when you simply couldn’t care for themselves any longer, that’s now a thing of the past. Assisted living can now provide access to loads of fun activities, an active social calendar and even opportunities to learn new things. In fact, more and more elderly people are opting for these kind of facilities for their golden years.

Assisted Living: A Brand New Life

While care homes are helpful for those who need a little bit more help or need access to regular medical attention in their older years, they also have excellent benefits for the elderly. Oftentimes older people who live on their own can feel isolated, or become stuck in a rut. Living in a facility such as Chateau Vestavia assisted living, can provide access to all sorts of fun activities, group outings and regular contact with others, making it ideal for any older person.

Social Access

Studies have shown that regular social activity can go a long way to helping to stave off memory loss and even Alzheimer’s disease. Being a part of an assisted living community allows a senior to have access to other peers, especially those who share the same interests. Retirees can join others for group meals, classes and outings to meet new neighbors. New residents will be making friends in no time.

Physical Activity

Keeping fit and physical into their later years can go a long way to keeping a retiree from aging before their time. A healthy weight and regular exercise can keep their heart healthy, as well as prevent the aches and pains that come along with getting older. Many facilities have gyms, pools and staff on site so residents can create their own exercise program. Staff can also give advise on losing weight and staying healthy.

Eating Right

As people age, they may be cooking for one for the very first time in years or they may just not want be bothered with making decent meals. This can be detrimental for their health, and an assisted home can help with that. Many offer group mealtimes, where diners can take in a balanced meal with friends. Apartment-style homes are often equipped with a kitchen, and nutritionists and helpers can offer advice on how to make great meals that will keep people in tip-top condition.

Group Trips

Just because a person is getting older doesn’t mean they can’t get out and about. While many seniors may not be able to drive anymore, assisted living facilities will offer social activities for groups such as trips to go sightseeing, visit national monuments or even to connect with nature. Getting out helps keep the mind stimulated, and prevents elderly people from having that “cooped up” feeling.

The image of the dank, boring care facility is truly one of the past. Today’s elderly clients are more active both physically and socially, and these homes are stepping up to the mark to provide services to match. Be sure to view any home you’re considering fully and ask any questions you might have. Chances are there’s a match for you.

Photo Credit: http://www.flickr.com/photos/doughay/5696872679/

Instigating Change: The Public Perception of Social Work

change 1Over 25 years as an Australian social worker, my experience is that a good proportion of the population relate “social worker” to someone who removes children or someone who butts their nose into other people’s business. Often, it’s perceived that we practice our “stuff” in a government department, hospital to find elderly people nursing homes, or in a child welfare setting to assess family functioning.

How well do we as social workers educate our target groups about the services we provide? What do the general public perceive a “social worker” to be, and whose responsibility is it to promote our profession? Making the choice to create a career out of being a social worker has its disadvantages. After graduation it really didn’t take me long to stop calling myself a social worker. I found it to be a great conversation stopper at social gatherings. “So what do you do?” “I’m a social worker”. Responses ranged from  “oh okay, so you work with dole bludgers” to “oh you’re one of those do-gooders” to “ oh that’s interesting, so what is it that you actually do?”

Social work is a profession. Yet as a profession, it is still battling recognition in both the allied health sector and in the public arena. Historically, we were the charity workers, literally the “do-gooders”, those who gave up their time to help the disadvantaged. Our work was viewed as practical, bandaid, prescriptive, and often linked to churches who traditionally established programs to assist the poor.

Thankfully by the time I attended university in the early eighties, some semblance of a professional identity had been established, albeit still vague to the masses. “Change Agent” was one of the most apt descriptions to me at the time, and one that I use frequently today when explaining what it is that social workers actually do. Also, I was taught the term “change agent” crosses the boundaries of the three distinct areas which consist of casework, group work. and community work.

No, I did not learn how to hand out a welfare cheque to a client. Casework meant one on one counselling intervention to help an individual or family function better. No, I did not learn how to ladle the soup into bowls, and tuck people in at the local homeless shelter. I learnt how to facilitate groups, empower participants, foster mutual goals and maintain enthusiasm. And finally no, I did not learn how to partake in the local Neighbourhood Watch meetings to ensure the safety of the local community. I learnt to focus on community assets as opposed to disadvantages, inspire community participation with action towards change, and advocate on behalf of groups whose disadvantages place obstacles in the way of being heard.

When social workers are viewed as “agents of change”, it does more than just clarify our role to the public. It actually places an obligation back to the profession to ensure positive change happens for our clients. It isn’t enough to sit in the geriatric ward of the local hospital and simply look after the practicalities of a nursing home booking without checking on coping skills. Or to hand someone a food voucher without exploring ways to improve their situation in the long term.  It doesn’t cut it to sit in the office at a community centre booking external hirers and stating boldly you’re achieving something for your community. It’s not enough to sit at the head of the table at a group session and be the perceived expert whilst using psychological jargon only another professional would understand. These methods simply maintain the status quo – they do not inspire change, nor do they empower people to carry out change in order to reach their full potential.

So perhaps we need to look at our own profession and ask ourselves, what is it that we as a group are doing to maximize our profession’s full potential? Why is it that the public perception of our role is still not accurate, let alone widely known?  How do we achieve a better “branding” of the words social work and social worker?

“The general public” are our clients. They’re our target group(s).  There are a whole team of professionals including psychiatrists, psychologists, social workers, social scientists and welfare workers, who aim to empower them to lead more fulfilling lives.   Yet Mr and Mrs Public don’t understand the differences in our qualifications. Our “consumers” actually don’t understand the “service” they’re purchasing, nor the good, the bad and the relevant. They just want “help” or “therapy” or “representation” and more often than not, the term “psychologist” will come to their minds. How do we change this to ensure our clients will understand their choices?

It’s time to make change to the public perception of social work. Clarify our skills in simple, layman’s terms. What is our core business? How do you describe “social work” to your family and friends?  How would you make a visit to a social worker sound appealing or helpful if you had to make a poster to promote our profession?

Start the ball rolling, leave a suggestion below as to how YOU would educate the general public to increase understanding of our skills and start “branding” our profession!

Growing Careers in Social Work

Social work is a field offering a diverse array of challenges and exciting opportunities to improve the lives of individuals in all sectors of society. The jobs in social work and the human services field are considered to be some of the fastest growing career opportunities, with the Bureau of Labor Statistics predicting growth rates exceeding 23 percent in many areas. Some of the fastest growing sectors of the human services field are discussed below.

Case Management

Growing Careers ImageHuman services case management opportunities continue to top the list of growing fields in the social work arena. Professionals taking on these tasks assess individuals to determine their needs and make recommendations of community resources that benefit them. These professionals maintain a relationship with their clients for as long as services are needed, and they constantly reassess to ensure resources remain appropriate and necessary. Case managers work in long term care facilities, with geriatric clients in their homes, assisting children and families in the court system, in hospital settings and with clients in community corrections. The Bureau of Labor Statistics anticipates a 27 percent growth rate in this field between 2010 and 2020, making it one of the fastest growing professions in the United States.

Substance Abuse Counselor

Another growing sector of the human services field is substance abuse and behavioral health. Counselors working in this capacity advise people who are facing addictions. They might work in a hospital setting, outpatient care facility, within the prison system or in private practice. Substance abuse counselors can expect to see a 27 percent growth rate in their careers between 2010 and 2020 according to the Bureau of Labor Statistics. Continued growth in the field of substance abuse and behavioral health counselors is largely due to the transition that managed care insurance companies are making, moving clients away from seeing more expensive psychiatrists and psychologists and toward sessions with less expensive counselors. In addition, as jails seek solutions to overpopulation problems, the criminal justice system continues to sentence drug offenders to counseling rather than jail time.

Health Education

Health education is a third field of human services that is experiencing tremendous growth. The demand for healthy living information continues to escalate, and this is leading to an increased need for professional health educators. These individuals often work in private practice or hospital settings, and they teach individuals about behaviors that promote physical and mental wellness. Corporations are also employing firms that offer wellness services in an effort to reduce employee illnesses and cut down on increasing healthcare costs. According to the Bureau of Labor Statistics, a 37 percent growth rate is expected in this field between 2010 and 2020.

Social Services Assistant

Individuals seeking a more entry level human services occupation might be interested in a social services assistant position. Professionals working in this capacity provide support to social workers and their clients. They assist in locating resources, transporting clients, completing social work documentation and generally providing support to the organization in which they serve. Social service assistants work in a variety of settings, including hospitals, government agencies, nursing homes and non-profit agencies. This is an excellent position for the new graduate, as it provides exposure to the field of social work and additional on the job education. The Bureau of Labor Statistics predicts a 28 percent growth rate in this profession between 2010 and 2020, a higher than average rate when all occupations are considered.

Marriage & Family Therapist

Finally, individuals with higher degrees can consider a career as a marriage and family therapist. This profession requires at least a Master’s Degree, and licensing is required in all fifty states. Therapists assist individuals, couples and families during times of crises, and they empower their clients by recognizing strengths and teaching coping techniques. Many therapists are employed in private practice, but mental health facilities and hospitals also offer positions for these professionals. The growth rate for this field is anticipated to be 37 percent between 2010 and 2020, with continued increases expected as managed care programs show a preference for paying reimbursement to therapists versus more expensive psychologists or psychiatrists.

The opportunities a social work degree presents will continue to see extensive growth well into the 21st century. Graduates should consider the challenges that each area of social work presents, and apply their talents in the area that best represents their individual strengths. In addition, considering positions such as the ones described above helps ensure continued upward career mobility and job security for many years to come.

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