Comment on one of your group member’s tables. Using extra information or more examples, either support or dispute the position of your group member.
We need to approach the issues of long term care and mental health in our Long Term Care sector of our Continuing Care Communities and their impact on the national economy regarding the Affordable Care Act legislation.
Firstly, by 2030 the number of Americans ages sixty-five years and older is projected to exceed seventy million, representing 20 percent of the population (Spetz, et al.2015). Life expectancy remains relatively high, baby boomers continue to age into older adulthood, and advances in assistive and medical technology allow more people with chronic illnesses to live longer and independently in the community (Reaves, 2015). In our own senior communities, we have seen the impact of this trend with our own residents that they are moving in younger and more active. Our Senior Care at home program, allowing older adults to stay in their homes longer has seen tremendous growth in the last year alone. The ACA legislation provides new options for offering home and community-based services through a Medicaid state plan and whom have a higher level of need and permit states to extend full Medicaid benefits to individual receiving home and community-based services under a state plan (Kaiser Health News, 2015).
The impact on our community: Our Continuing Care Community campuses give the resident the ability to start out living in an ordinary apartment then move into an assisted living floor if they end up needing LTC services. Our Residents pay hundreds of thousands of dollars in an entrance fee and thousands per month. The resident pays a high price for housing but gets a promise of access to care for life, even if the residents lose their assets. Our senior communities comprise of mostly white, higher socioeconomically status and we need to diversify our resident population. Our residents are living longer and running out of funds which in turn they are relying more on Medicaid and Medicare benefits. Right now, we have 40% of Medicaid beneficiaries. Our surrounding area of Cleveland is very diverse. The growing people of color elderly population are in poorer health and are likely to face a greater need for LTC services later in life (Shi & Singh, 2022). These factors pertaining to minority groups present new challenges for us to deliver LTC services. We need to make our senior communities and programs affordable and accessible to all.
The impact on our health system at large: The impact for LTC for the aging population is overwhelming, Even the rest of developed world also faces aging –related problems and challenges in providing adequate LTC services for their populations (Shi & Singh, 2022). There has been a trend away from institutional care toward home and community-based services. Medicare and Medicaid Services have provided incentives to states to encourage greater use of those services. Medicaid policies could have great influence over future patterns of long-term care utilizations, since Medicaid provided 62 percent of $211 billion spent in 2011 on long-term care in the Us (Spetz, et al, 2015). And this trend will continue to grow as the need for LTC grows.
We can capitalize on this by:
Establish the Community First Choice Option in Medicaid to provide community-based attendant supports and services (Kaiser Health News, 2015). Continue to expand on our Senior at Home program. Expand our Nurses and Nurse aids to travel out into the community to give older adults care.
Connecting patients in the community with our emergency response system.
We need to develop more community outreach program funding to bring these services to our diverse community. We need to fit the needs of different individuals and address their changing needs over time to be comfortable aging in place.
Reaching out to our Foundation and Community Partnership stakeholders to market and fund for Senior at Home programming.
Create a stronger volunteer base of individuals who can help shop, clean, pay bills.
This can be potentially damaging: Creating a larger workforce will be a challenge on its own. As the elderly population becomes more diverse, this will affect workforce demand. We may not get the workforce we need to make these outreach programs get off the ground. Occupations anticipated to experience the highest growth rates are counselors and social workers, home health and personal care aides (Spetz, et al, 2015).
Secondly, we need to approach the issue of Mental Health. Mental disorders are common psychiatric illnesses affecting adults and present a serious public health problem in the U.S., suicide has been the ninth leading cause of death in the United States (Shi & Singh, 2022). Barriers to access mental health care are prohibitive costs of services and shortage of available mental health professionals (Shi & Singh, 2022).
The impact on our community: An estimated 25% of older adults have depression, and anxiety disorders. Mental health disorders are frequently comorbid in older adults, occurring in conjunction with common chronic illnesses such as diabetes, cardiac disease, and arthritis (Shi & Singh, 2022). There is also a growing prevalence of dementia and caring for these patients has become a major focus in our facilities.
The impact on our health system at large: Patients with mental health issues tend to die earlier, have more medical illnesses, and receive worse medical care. Managed care providers have expanded their services to include delivery of mental health care. Many state and local governments have also contracted with managed care organizations to manage their full health care benefits packages, which include mental health and substance abuse services for their Medicaid enrollees (Shi & Singh, 2022). Previously, Medicare charged beneficiaries more for outpatient psychiatric treatments but in 2008 Congress passes a law that gradually reduced the copayment for those services from 50 to 20 percent. Medicare Part A covers mental health services if you’re admitted as a hospital inpatient (Medicare.gov 2023).
We can capitalize on this by:
Keep residents connected to the outside world and with the community.
Use our Wellness stakeholders to create programming specific for mental health and dementia.
Explore technology and how they can be utilized to reach our in-house residents as well as our Senior at Home beneficiaries.
Educate and train our workforce to be well equipped with residents with dementia.
This can be potentially damaging: Again, we must address our workforce. We need to continue with our community partnerships and hospital partnerships stakeholders to capitalize on the variety of professionals who provide mental health services such as psychiatrists, psychologist, social workers, nurses and counselors.
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