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CertifiedCare Strives To Meet High Demands For Personal Care Aides As Elderly Population Faces Explosive Growth

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CertifiedCare Strives To Meet High Demands For Personal Care Aides As Elderly Population Faces Explosive Growth











CertifiedCare offers family caregivers and Personal Care Aides certification in the area of elder caregiving in “at home” and assisted living institutional environments.


Cleveland, Ohio (PRWEB) January 12, 2012

The desire to “age in place” is a growing trend among the elderly and Baby Boomer generation. Services that used to be solely offered in hospitals are becoming more readily available in the private home, making this possible. With the “age in place” trend paving the way for an emerging professional field called Personal Care Aides (PCAs), CertifiedCare strives to meet the growing demand of PCAs. The organization educates and trains PCAs making elder caregiving safer for caregivers and the elderly population.

Personal Care Aides are one of the top five fastest growing employment areas of our time. According to the Bureau of Labor Statistics, PCAs face a 46% growth rate until 2018. At this rate, roughly 2 million PCAs will be needed to care for the elderly. “We are seeing the impressive growth because of two main factors,” says Dr. Cathleen Carr, Executive Director of CertifiedCare. “The first one being the ever increasing life expectancy due to better healthcare and the second being the aging of the Baby Boomer generation.” According to a CRS Report for Congress, the life expectancy in the United States in 1776 was just 49 years old compared to 77 years in the year 2000. Additionally, all survivors of the Baby Boomer generation will be between the ages of 61 and 79 by 2025, doubling their population in 21 states.

Now, more than ever, individuals are taking on the personal responsibility to care for their loved ones. Providing in home care can be stressful due to several factors, with chronic illnesses being a main one; hence the appeal of a PCA to alleviate some of that stress. In addition, family caregivers spend an average of 22 hours a week caring for loved ones to help ease their burdens. According to a study by the AARP, that burden totals $ 450 billion a year in lost worker productivity, reducing earning capacity and retirement income. This amounted to about 3.2% of the U.S. GDP in 2009.

A PCA alleviates some of this stress by taking care of an elderly loved one and allowing family members to stay in the workforce. It is a PCA’s job is to help people live in the home of their choice equipped with tools and design features that support independence. In addition, they are there to assure that the individual and their caregivers are safe. Personal Care Aides are not Home Health Aides. PCA’s do not administer physically invasive therapies and do not need to work under the supervision of a nurse.

The tasks that accompany the PCA profession are very diverse and with the movement from hospitals to the home, more interdisciplinary than ever before. It is a PCA’s role to provide preventive safety care and wellness assistance, meals, supplies, transportation to appointments and social activities, foster and facilitate connections between family members and the geriatric care team, and more. They are specially trained to work with frail elderly in their homes who are physically disabled or mentally impaired, dealing with a chronic illness or are otherwise unable to care for themselves on their own. They play an integral role in the health and well being of an elder by ensuring that they are taken care of in the absence of family caregivers.

“Now is the time for PCAs to get properly trained in at home eldercare,” says Dr. Carr. “This training makes it easier and safer for everyone involved because of the many daily tasks that need to be handled.” Additionally, certified PCAs can demand higher wages and advance in their field. Such organizations like CertifiedCare offer online classes with 20-100 hours of instruction and certification exams. Specialty areas can include: Legal and Financial, Personal Care and Safety, and Alzheimer’s/Dementia.

Currently there is not enough support to handle the aging population that is coming forward in great numbers. According to the CDC, by the year 2030 the number of people aged 65+ is expected to rise to 71 million. This is an impressive change from the estimated 35 million in 2000. “Due to the expected dramatic increase in the elderly population, the increased difficulties in taking care of them and certification becoming a state requirement, the Personal Care Aide is one of the fastest growing and social employment needs of our time,” says Dr. Carr. “The best time to invest in eldercare education and training is now while we are just ahead of the curve.”

Educational requirements for PCAs vary by employer. Many PCA or family caregiver positions do not require a high school diploma or undergraduate degree, however completion of certification programs is becoming a state requirement. Illinois, Oregon, Arizona and California have laws and regulations already on the books. Other states have legislation pending with more states soon to follow.

CertifiedCare Strives to Meet High Demands for Personal Care Aides as Elderly Population Faces Explosive Growth is part two of a three-part series of topics covered by CertifiedCare.

About CertifiedCare

CertifiedCare offers family caregivers and Personal Care Workers certification in the area of elder caregiving in “at home” and assisted living institutional environments. CertifiedCare created the first online curriculum and training program for assisted living companions that incorporate law, business, and alternative therapies, while complying with the American Medical Association (AMA) Guidelines for elder caregiving. CertifiedCare has worked with over 1,000 caregivers from all over the United States and abroad.

CertifiedCare offers three caregiver certification programs for both family caregivers and professional Personal Care Workers: Basic Caregiving, Advanced Caregiving and Alzheimer’s-Dementia Specialist Certification programs. For more information on CertifiedCare and their programs, visit http://www.certifiedcare.org.

About Dr. Cathleen Carr

Dr. Cathleen Carr is the founder and executive director of CertifiedCare. She is a nationally recognized Eldercare Specialist in the areas of wills, trusts, probate, elder law and holistic health and wellness.

Dr. Carr is a published author on various topics including eldercare, natural health and green living. She is a contributing author to: Examiner.com, Radientlife, Suite101.com, Alternative Health Review, National Diet Institute, BestNaturalHealthDirectory.com, Natural Medicine Ink (editor) and eHealthScience. She also is an herbalist and naturopathic practitioner, where she specializes in therapeutic herbalism and restorative vibrational therapies.

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The Empowered Patient: How to Get the Right Diagnosis, Buy the Cheapest Drugs, Beat Your Insurance Company, and Get the Best Medical Care Every Time

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The Empowered Patient: How to Get the Right Diagnosis, Buy the Cheapest Drugs, Beat Your Insurance Company, and Get the Best Medical Care Every Time

The facts are alarming: Medical errors kill more people each year than AIDS, breast cancer, or car accidents. A doctor’s relationship with pharmaceutical companies may influence his choice of drugs for you. The wrong key word on an insurance claim can deny you coverage. Through real life stories, including her own, and shrewd advice, CNN’s Elizabeth Cohen shows you how to become your own advocate and navigate the minefield of today’s health-care system. But there’s good news. Discover how to

• find a doctor who “gets” you and listens to you

• ask the right questions for the best treatment

• make the most out of a short office visit

• cut out-of-pocket costs for prescription drugs

• harness the power of the Internet for medical issues

• fight back when claims are denied

Combining the personal stories of patients across America with crucial advice on receiving the best possible health care, this guide will enable you to confront an often confusing and perilous system—and come out ahead.

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A Day in the Life of NHSC Mental Health and Behavioral Health Care Providers

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National Health Service Corps Members: A Day in the Life of NHSC Mental Health and Behavioral Health Care Providers
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To learn more about The Carter Center, please visit www.cartercenter.org ES Grant Mental Health Hospital in Monrovia, Liberia, is the sole psychiatric institution for a population of nearly 4 million. Although resources are limited and there are no psychiatrists or psychologists on staff, this small hospital is making a big impact on the mental health of the country. The Carter Center, in partnership with Liberia’s Ministry of Health and Social Welfare, will use Grant Hospital as a training site for mental health nurses and physician assistants to build up much needed human resources for mental health care in Liberia. Learn more about the Carter Center’s Mental Health Program cartercenter.org TheCarter Center, in partnership with Emory University, is committed to advancing human rights and alleviating unnecessary human suffering. Founded in 1982 by former US President Jimmy Carter and former First Lady Rosalynn Carter, the Atlanta-based Center has helped to improve the quality of life for people in more than 70 countries.
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The Health Care Debate And Its Impact On Substance Abuse And Mental Health Services

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With all the heated debate over health care reform, just what was supposed to happen to the often ignored areas of substance abuse and mental health services? At least, a new law that took effect at the start of 2010 will give parity to these services in large employee group insurance plans.

Although these important elements of health services weren’t entirely forgotten in the speeches in Congress and around the nation at public hearings, were they going to receive their proper attention, even as agreement on health care reform remained divisive?

In a Dec. 16, 2009, speech, Health and Human Services Secretary Kathleen Sebelius spoke about the need for mental health and substance abuse services as she addressed health care providers and others near Baltimore.

Sebelius spoke of “the huge opportunity we have in the next couple of years to make some big improvements in the lives of Americans with mental illnesses and substance abuse disorders.”

She added: “There are a lot of changes happening right now that could have a big impact on behavioral health: parity, health insurance reform, the growing popularity of integrated care models, an increased focus on prevention, huge gains in our understanding of the science behind mental illness and substance abuse.”

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Sebelius made no promises, though, leaving future measures for these dual diagnosis treatment services up in the air, but she did stress the need to work together on a solution. “These changes are creating a lot of potential for progress, but we also know that nothing is guaranteed. The integrated care models that spread could have a strong mental health component.  Or they could not.  We might find effective ways to apply some of the research we’re doing.  Or we might not.  In order to get the most out of the next few years, all of us in government, the private sector, and the non-profit world are going to have to work hard to steer these changes in a direction that benefits our friends and neighbors with mental illnesses and substance abuse disorders,” she said.

What was most encouraging about her speech was the recognition of the seriousness of the problem and how common it is. She cited figures that “about one in five Americans will have a mental illness this year” and “almost half of Americans will have a mental illness in their lifetime.”

While health care reform is still up for debate, there is the implementation of the Mental Health and Addiction Equity Act, which Congress passed last year and went into effect Jan. 1, 2010, for employer group health plans with more than fifty employees.

“Thanks to parity, millions of Americans with mental illness and substance abuse disorders will get the care they need.  It’s going to help people afford their medicines.  It’s going to make them less likely to put off important care.  And it’s also an important symbolic step,” Sebelius said.

The law is directed to put mental health benefits on equal terms in many health plans today and applies to all plans subject to the Employee Retirement Income Security Act (ERISA), including self-insured plans.

But just like the debate over health care, more focus is needed on these essential services.

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Taking A Stand – Health Care, Education, And Economy

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I believe with strong leadership, hard work and a dedication to problem solving, we can improve the lives of our society and create a new vision for Northern Virginia.

The Economy

There is an enormous need to improve the economic climate within our communities throughout northern Virginia. Thousands of families throughout NOVA are struggling to afford the expenses associated with life, including childcare. To help families within NOVA I support President Obama’s strategy to expand the child and Dependent Care Tax Credit to help provide relief for parents and care givers. Currently only 35 percent of the first ,000 incurred from childcare expenses by a family with one child and a family with two or more children the first ,000. The credit is not refundable, therefore upper-income families unreasonably benefit while families that earn less than ,000 a year obtain less than a third of the tax credit. I advocate reforming the Child and Dependent Care Tax Credit to ensure low-income families to receive more credit for their child care debuts.

Additionally, it is imperative that we create training programs for clean technologies.

I advocate for additional funding to expand federal job training programs to include green technologies training, like advanced manufacturing and weatherization training. This type of job training program will help fuel our economy and create sustainable green jobs.

I support President Obama’s plan to help expand lending to small business through tax cuts and assistance to community banks. The program is designed to have billion in returned cash for the Troubled Assets Relief Program (TARP) made available to help smaller banks lend to local businesses. Small businesses are the fabric of our economy it is imperative that we provide financial support to create jobs, ignite entrepreneurship and innovation.

Health Care

The Healthcare system in this country is broken and I will fight to fix the system. The United States pays more than any other industrialized country, yet lacks national coverage for all Americans. At the same time, healthcare is inextricably linked to our future fiscal health. Therefore, in order to reduce costs and improve quality for all Americans, three principles must be met in any legislation that passes congress: (1) national coverage; (2) ending insurance company abuses; (3) providing choice and competition in the market.

To meet these principles healthcare reform must contain several different provisions. First, we must find a plan to increase the number of Americans with healthcare. If done properly, it would expand the insurance pool, include more Americans and reduce the costs of premiums. Second, Americans must be protected from the worst insurance company abuses by ending their practices of denying coverage due to pre-existing conditions, capping total coverage, and dropping or reducing coverage when people get sick and need it the most. Additionally, reform should mandate how much of a patient’s premium must go toward their care, as opposed to the marketing, profits and salaries for insurance companies.

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To provide choice and competition into the market reform should include a national exchange, whereby individuals and small businesses can join together to expand the insurance pool for cheaper insurance. Included within this exchange should be a national option. A national option would be non-profit and have the ability to provide comprehensive care for the best price. Including an American option in the exchange would keep private insurers costs from rising and keep them honest.

To keep health insurance affordable our system must shift to preventative care. For example, if more mobile clinics were put in impoverished and rural community’s potential medical issues could be identified early and treated. This would help to combat the high volume of patients visiting hospitals and help reduce cost. Additionally, we should provide tax credits to small businesses to help healthcare become affordable care. To combat the high volume of patients we should provide more mobile clinics in impoverished communities. Tax credits should also be made available to individuals and families that make below the poverty level. Lastly, waste, fraud, and abuse in the Medicare system must be rooted out to keep the long-term stability of our Medicare system for seniors.

Implementing these reforms must be done in order to meet the challenges of our nation. The costs of healthcare are driving more Americans into bankruptcy and making our businesses less competitive to foreign competitors. These reforms would reduce our deficit and begin to get our fiscal house in order. I will be a strong believer in healthcare reform.

Education

Our education system has many issues and in need for solutions to combat challenges that Americans are faced with everyday. Our children are falling behind in comparison to other developing nations. To provide our children with a bright future the United States must be at the forefront of innovation. First, we must support children with special needs and invest in early childhood education, because the period before a child enters into kindergarten is the most critical to their educational development. To attain this goal we must dramatically increase funding for Head Start and other Parent Readiness programs that have proved effective in getting our children ready for their education. Funds must be allocated properly to ensure that classrooms are managed efficiently and effectively.

Second, we must improve our K-12 education system. I talked to many parents across northern Virginia and listen to their concerns about the increasing dropout rate and if American students are being prepared to compete with the world. To achieve this goal, funding must be provided in order to bring technology and up-to-date textbooks into the classrooms. Additionally, we must rebuild crumbling schools and reward teachers based on merit and provide incentives to attract quality teachers. I support the President’s Race To The Top Program and will advocate to reform the No Child Left Behind Act to support schools that need improvement. Additionally, I believe that our school days and hours should be extended, so that our children are getting not only high quality education, but as much education throughout the year as our global competitors.

Third, we must expand access to higher education. The high school education that gave our parents and grandparents a career is simply not enough in today’s fast-developing world. Today, in order to purchase a home, support a family and retire comfortably, a college education is a necessity. Unfortunately, college and other advance training has become unaffordable for many Americans that is why I support expanding Pell grants and tax credits to families to help pay for education.

Expanding these programs will be costly, but they are worth the investment. I believe that government has the responsibility to invest in its future leaders, inventors and communities. We cannot compete globally if we are not developing better products and technologies. Failure is not an option we must improve our educational system, as a member of Congress I will push to refocus our Nation’s effort to strengthening our intellectual capital.

I believe with the right values, dedication, leadership and communication a new vision for Northern Virginia is possible. Let’s make it happen.

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11 Points for Mental Health Care Reform

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Due to greater understanding of how many Americans live with mental illnesses and addiction disorders and how expensive the total healthcare expenditures are for this group, we have reached a critical tipping point when it comes to healthcare reform. We understand the importance of treating the healthcare needs of individuals with serious mental illnesses and responding to the behavioral healthcare needs of all Americans. This is creating a series of exciting opportunities for the behavioral health community and a series of unprecedented challenges Mental health organizations across the U.S. are determined to provide expertise and leadership that supports member organizations, federal agencies, states, health plans, and consumer groups in ensuring that the key issues facing persons with mental health and substance use disorders are properly addressed and integrated into healthcare reform.

In anticipation of parity and mental healthcare reform legislation, the many national and community mental health organizations have been thinking, meeting and writing for well over a year. Their work continues and their outputs guide those organizations lobbying for government healthcare reform. .

MENTAL HEALTH SERVICE DELIVERY

1. Mental Health/Substance Use Health Provider Capacity Building: Community mental health and substance use treatment organizations, group practices, and individual clinicians will need to improve their ability to provide measurable, high-performing, prevention, early intervention, recovery and wellness oriented services and supports.

2. Person-Centered Healthcare Homes: There will be much greater demand for integrating mental health and substance use clinicians into primary care practices and primary care providers into mental health and substance use treatment organizations, using emerging and best practice clinical models and robust linkages between primary care and specialty behavioral healthcare.

3. Peer Counselors and Consumer Operated Services: We will see expansion of consumer-operated services and integration of peers into the mental health and substance use workforce and service array, underscoring the critical role these efforts play in supporting the recovery and wellness of persons with mental health and substance use disorders.

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4. Mental Health Clinic Guidelines: The pace of development and dissemination of mental health and substance use clinical guidelines and clinical tools will increase with support from the new Patient-Centered Outcomes Research Institute and other research and implementation efforts. Of course, part of this initiative includes helping mental illness patients find a mental health clinic nearby.

MENTAL HEALTH SYSTEM MANAGEMENT

5. Medicaid Expansion and Health Insurance Exchanges: States will need to undertake major change processes to improve the quality and value of mental health and substance use services at parity as they redesign their Medicaid systems to prepare for expansion and design Health Insurance Exchanges. Provider organizations will need to be able to work with new Medicaid designs and contract with and bill services through the Exchanges.

6. Employer-Sponsored Health Plans and Parity: Employers and benefits managers will need to redefine how to use behavioral health services to address absenteeism and presenteeism and develop a more resilient and productive workforce. Provider organizations will need to tailor their service offerings to meet employer needs and work with their contracting and billing systems.

7. Accountable Care Organizations and Health Plan Redesign: Payers will encourage and in some cases mandate the development of new management structures that support healthcare reform including Accountable Care Organizations and health plan redesign, providing guidance on how mental health and substance use should be included to improve quality and better manage total healthcare expenditures. Provider organizations should take part in and become owners of ACOs that develop in their communities.

MENTAL HEALTHCARE INFRASTRUCTURE

8. Quality Improvement for Mental Healthcare: Organizations including the National Quality Forum will accelerate the development of a national quality improvement strategy that contains mental health and substance use performance measures that will be used to improve delivery of mental health and substance use services, patient health outcomes, and population health and manage costs. Provider organizations will need to develop the infrastructure to operate within this framework.

9. Health Information Technology: Federal and state HIT initiatives need to reflect the importance of mental health and substance use services and include mental health and substance use providers and data requirements in funding, design work, and infrastructure development. Provider organizations will need to be able to implement electronic health records and patient registries and connect these systems to community health information networks and health information exchanges.

10. Healthcare Payment Reform: Payers and health plans will need to design and implement new payment mechanisms including case rates and capitation that contain value-based purchasing and value-based insurance design strategies that are appropriate for persons with mental health and substance use disorders. Providers will need to adapt their practice management and billing systems and work processes in order to work with these new mechanisms.

11. Workforce Development: Major efforts including work of the new Workforce Advisory Committee will be needed to develop a national workforce strategy to meet the needs of persons with mental health and substance use disorder including expansion of peer counselors. Provider organizations will need to participate in these efforts and be ready to ramp up their workforce to meet unfolding demand.

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What the Patient Protection and Affordable Care Act Means for the Future of Mental Health Care

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The Patient Protection and Affordable Care Act was passed in March of this past year, and aims to improve all aspects of our country’s health services. One aspect that will be much-improved is the area of mental health care.

Insufficient coverage and a lack of programs that educate the public on mental illness have plagued the United States for quite some time. With the passage of the new law, a number of new provisions aim to change the public’s perception of mental illnesses and offer programs and other initiatives to help those who need mental health care. A few of those provisions include:

Improvements to Medicaid (including the expansion of eligibility) that will allow more people to experience the benefits of mental health services
Several new options for people with disabilities
Improve coordination and communication between primary care and mental health services
Much more…

Essentially, what this means is that, over time, individuals with mental illnesses will have access to health insurance that covers mental health and substance abuse services, giving people unprecedented help and cooperation from the government. Other services include prevention programs, new insurance plans for long-term community care, and more.

The Patient Protection and Affordable Care Act also aims to improve health services in the workplace. It specifies that starting in 2014, employers can offer bigger incentives for employees’ positive lifestyle practices or participation in health promotion programs. The PPACA also creates a grant program to assist small businesses to provide comprehensive workplace wellness programs. Grants will be awarded to eligible employers to provide their employees with access to new workplace wellness initiatives.

The grants will be awarded beginning in 2011 with 0 million appropriated for a five-year period. The PPACA spells out that a comprehensive workplace wellness program must be made available to all employees and include health awareness initiatives(including health education, preventive screenings, and health risk assessments) as well as supportive environment efforts (including workplace policies to encourage healthy lifestyles, healthy eating, increased physical activity, and improved mental health).

The improved workplace atmosphere when it comes to mental health awareness is particularly important, as knowledge about mental health is notoriously absent from workplace programs. It has been studied that employees are eager to become more understanding of mental illnesses and ways to treat them, and the Patient Protection and Affordable Care Act aims to accomplish that.

Mental health services will be experiencing a major renovation with the government’s commitment to overall health care reform.  Those with mental illnesses will find it easier to seek help and others will find much more information on mental illnesses to create a better understanding of how mental health services operate. By creating a more cohesive health care system for mental illnesses, our society will not only become more fluid in its operations, but more knowledgeable and, therefore, better for it.

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Treatment Planning for Person-Centered Care: The Road to Mental Health and Addiction Recovery (Practical Resources for the Mental Health Professional)

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Treatment Planning for Person-Centered Care: The Road to Mental Health and Addiction Recovery (Practical Resources for the Mental Health Professional)

“Treatment Planning for Person-Centered Care puts the entire concept of individualized service planning into understandable language for all readers. The authors have captured the essence of active involvement of the persons served in the identification of needs (as well as strengths) and the development of a plan that will address those needs. This book is definitely in concert with and supports the CARF Behavioral Health standards, and would be an excellent resource to better understand how to move towards a person-centered assessment and planning process.”
-Nikki Migas, M.P.A., Managing Director, Behavioral Health Customer Service Unit, CARF. the Rehabilitation Accreditation Commission

“This book encourages the field to turn a very important corner. It clarifies the goals and the processes that Mental Health and Alcohol/Drug systems presently need to focus on: joining with clients to help them enter/re-enter their communities and successfully exit the treatment systems. This book will help practitioners develop the necessary conceptual overview as well as individual components of service plans that will significantly enhance our clients’ chances for real world success.”
-Ed Diksa, California Institute for Mental Health

“The authors take what for many clinicians is irritating paperwork requirement, treatment planning, that is a diversion from their “real” work of therapy and turn it into a valuable tool. By placing the person, the client at the center of planning, Adams and Grieder take the reader step by step through a transforming process. They lead us to re-think whose goals we are trying to achieve in treatment. This book could precipitate many fruitful seminar discussions during clinical training.”
-Eric Goplerud, Ph.D., George Washington University Medical Center

Treatment Planning for Person-Centered Care is a process-oriented book, guiding therapists in how to engage clients in building collaborative treatment plans that result in better outcomes. Suitable as both a reference tool and as a text for pre-degree training programs, the book addresses the entire process of treatment, from assessment through outcome evaluation. The book is relevant to providers in all settings, with a practical approach and case examples throughout.

About the authors: Neal Adams, MD, PhD is past president of the American College of Mental Health Administration and board certified in general psychiatry. Diane Grieder, M.Ed, has over 20 years experience consulting on improved mental health delivery systems. A prologue and epilogue are included by Dr. Wilma Townsend, a leading consumer advocate, consultant, and trainer in the field.

* Enhance the reader’s understanding of the value and role of treatment planning in responding to the needs of adults, children and families with mental health and substance abuse treatment needs
* Build the skills necessary to provide quality, person-centered, culturally competent and recovery / resiliency-orientated care in a changing service delivery system
* Provide readers with sample documents, examples of how to write a plan, etc.
* Provide a text and educational tool for course work and training as well as a reference for established practioners
* Assist mental health and addictive disorders providers / programs in meeting external requirements, improve the quality of services and outcomes, and maintain optimum reimbursement

List Price: $ 67.95

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The Clinical Documentation Sourcebook: The Complete Paperwork Resource for Your Mental Health Practice

All the forms, handouts, and records mental health professionals need to meet documentation requirements–fully revised and updated

The paperwork required when providing mental health services continues to mount. Keeping records for managed care reimbursement, accreditation agencies, protection in the event of lawsuits, and to help streamline patient care in solo and group practices, inpatient facilities, and hospitals has become increasingly important. Now fully updated and revised, the Fourth Edition of The Clinical Documentation Sourcebook provides you with a full range of forms, checklists, and clinical records essential for effectively and efficiently managing and protecting your practice.

The Fourth Edition offers:

  • Seventy-two ready-to-copy forms appropriate for use with a broad range of clients including children, couples, and families
  • Updated coverage for HIPAA compliance, reflecting the latest The Joint Commission (TJC) and CARF regulations
  • A new chapter covering the most current format on screening information for referral sources
  • Increased coverage of clinical outcomes to support the latest advancements in evidence-based treatment
  • A CD-ROM with all the ready-to-copy forms in Microsoft® Word format, allowing for customization to suit a variety of practices

From intake to diagnosis and treatment through discharge and outcome assessment, The Clinical Documentation Sourcebook, Fourth Edition offers sample forms for every stage of the treatment process. Greatly expanded from the Third Edition, the book now includes twenty-six fully completed forms illustrating the proper way to fill them out.

Note: CD-ROM/DVD and other supplementary materials are not included as part of eBook file.

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“Sicko” US Health Care System Revealed in New Patient Rights Survey

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“Sicko” US Health Care System Revealed in New Patient Rights Survey












Denver, CO (PRWEB) May 22, 2007

Patient rights are under siege, as evidenced in a recent survey conducted by the National Institute for Patient Rights (NIPR). NIPR staff compiled the results based on responses from one-thousand randomly selected, former hospital patients who took part in the study. The results of the survey show that, despite billions spent on advances in medical technology, patients daily experience an erosion of their rights “at the hospital bedside.”

Among those responding to essay questions, the following was a typical scenario. A hospital admits a loved one with “complications” (a medical euphemism for “we really don’t know all that’s going on here, but there are several organs involved”). While the loved one rests stable in bed, a line of doctors and nurses seems to form at the door. One after another, doctors enter the room, make a few comments, then turn around and exit. Primary care physicians refer patients to specialists who rely on subspecialists. It seems like each separate organ has its own special doctor.

In the health care industry, this is commonly referred to as “component management.” It suffers from two shortcomings: (1) specialists and subspecialists tend to segregate organ systems at the expense of the whole patient; and (2) it is inefficient, because it inevitably leads to “episodic intervention” where if something happens, you see one specialist for a particular organ system; if something else happens, you see another specialist or subspecialist, and so on.

Episodic intervention leads to uncoordinated care that lacks continuity for the patient and for the patient’s family. Many individual decisions in patient treatment by numerous specialists and subspecialists entail a fragmented delivery system. According to the findings of the NIPR study, this leads to the number one problem in contemporary healthcare delivery: a failure to communicate.

The Top Ten Most Violated Patient Rights:

This failure to communicate is responsible for the #1 spot on the top ten list of violations of patient rights. A full 63% of participants felt that healthcare providers most often violated their right to informed consent. When prompted to explain, many complained about the inadequacy of multiple diagnoses coming from multiple providers. Without a single, complete diagnosis, respondents felt unable to make an informed choice about appropriate treatment options.

The #2 most violated of patient rights was a lack of respect for personal, spiritual, and religious values and beliefs. Participants observed that doctors often failed to acknowledge the unique nature of personal lifestyles in their presentation of treatment options.

A failure to communicate was also the cause of the #3 violation of patient rights, a lack of respect for advance directives. Participants complained about the way in which advance directives are handled by hospitals.

Miscommunication was the cause of violation #4. Despite HIPAA, many participants observed that providers often showed no regard for the privacy and confidentiality of their personal health information. Cell phones were often cited as the main culprit.

Conflicts Abound:

Conflict between “team” and patient/advocate was the cause of #5 on The List. Patients and their advocates have a right to know realistic care alternatives when hospital care is no longer appropriate. Many respondents complained about how they were made to feel when they disagreed with providers about the continued appropriateness of hospital care.

Conflict was also the cause of violations #6 and #7, violations of a right to know hospital rules on charges and payment methods, and a right to review the hospital bill, have information explained, and get a copy of the bill.

Under violation #8, some participants complained about their inability to identify hospital personnel who could help in resolving discrepancies over billing issues or in disagreement between “team” and patient/advocate over treatment.

Medical Mistakes and Records:

Although listed at #9, the violation of a patient/advocate’s right to know the identity and professional status of those who care for the patient contained some of the most poignant responses in survey results.

Quite a number of participants claimed to have suffered significant harm as a result of medical error. They averred if they had had ready access to information about the identity and professional status of their providers, they would have had second thoughts about consenting to treatment.

Coming in at a close #10 was the violation of a right to review medical records and receive an accounting of disclosures regarding health information.

Conclusion:

Despite billions spent on advanced medical technologies such as drugs and devices, patients daily experience an erosion of their most fundamental rights. The rights of patient self-determination and informed consent suffer the most.

Lack of coordination causes anger and frustration among hospital patients and their families by the breakdown in communications. A failure to communicate may not just cause anger and frustration but also unnecessary conflict. Conflict is costly! Finally, miscommunication causes harm when patients suffer underuse, overuse, or misuse as a result of medical error.

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How State Budget Cuts Impact Continuity of Mental Health Care

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Continuity of care between the inpatient and outpatient settings continues to be a challenge. Current hospital payments assume that hospitals are actively involved through discharge and the transition to outpatient settings and advocating for payments for outpatient providers to assist in this process is viewed as duplicative. This undermines mental health care providers’ ability to smoothly transition clients between service settings.

Meeting the credentialing requirements for program services and mental health professionals has posed new challenges. Community behavioral health organizations employ professionals that may not meet private insurers’ credentialing standards (for example, 3 years of post-licensure experience). Community providers have addressed this through contractual arrangements in which quality assurance and supervision requirements substitute for these credentialing standards. Services are billed under a supervisory protocol in which the supervising professional’s national provider identifier is used.

Additionally, some programs offer services that rely on a combination of funding sources such as county, state, and private insurers. In these situations, counties sometimes want to limit private insurance clients’ access to these programs because a portion of the overall program is covered by the county.

Impact of State Budget Cuts on Mental Health Care -

In a dramatic turnabout that may foreshadow dilemmas faced by other states, the governor of Minnesota vetoed funding for the state’s mental healthcare program. The legislature would have extended the program for several months, as a compromise was negotiated to retain elements of coverage for the state’s mental health population – a hospital uncompensated care fund, medication/pharmacy, and “coordinated care delivery systems.” In the system, an accountable hospital-centered program paid a fixed amount to cover about 40% of the state’s mental illness population who elected to participate. As there is no reimbursement for outpatient clinic and all non-hospital services, providers and consumers now are scrambling to seek disability determination or enroll in Medicare type coverage after the six month state mental illness coverage enrollment period ends.

While these cuts are only effective as of June 1, 2010, it is expected that they will result in increases to the uncompensated care burden on hospitals and community safety net providers.

How Do We Minimize The Impact of Budget Cuts on Mental Health Care?

Many not-for-profit membership organizations representing community mental health and other service provider agencies throughout Minnesota have been working in coalition with national mental health groups on advocacy related to the state’s mental health program changes. Initially, advocacy efforts were focused on encouraging the state legislature to vote in support of expanding the state Medicaid program early to receive additional federal funding (as provided for in the national healthcare reform bill). Unfortunately, this proved to be politically untenable in the immediate future; however, a measure was passed to allow the governor to use executive authority to expand Medicaid coverage for mental illness patients.

While being actively involved in this advocacy process is vitally important to the community behavioral health system, national mental health advocacy medicaid organizations and their members are also evaluating ways in which they can optimize their business practices to meet this changing budgetary reality. Among other strategies, community behavioral health providers are working to develop partnerships with community hospitals to reduce the number of avoidable emergency department admissions and ease the transition from the inpatient to outpatient settings, supporting clients through the disability determinations process so they may become eligible for Medicaid as quickly as possible, and raising funds that will help to cover the cost sharing requirements for state sponsored mental health care and the enrolled clients that are unable to pay.

Through this two-pronged approach that includes both advocacy and pragmatic business considerations, it is hoped that the community behavioral health system will be able to develop new cost-effective ways of delivering services that will be well-positioned to withstand funding changes while taking advantage of new opportunities made available through national and state health care reform initiatives.

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