University of Kentucky College of Social Work的动态

The compromise that birthed Medicare and Medicaid continues to metastasize. Advocates for Medicare could not get Medicare alone and neither could those promoting a program for the poor. So both got together and Medicare and Medicate was the result, but this only happened when certain states demanded and go the ability to limit the costs. NACHC has long noted deficits of costs greater than revenue for Medicaid patient - their dominant patient type at 50%. Now we see the worst result of the compromise - deficit spending, CHCs held hostage by Congress, cost cutting dominating other public and private plans, and the increasing needs driven by populations increasing that are most behind. Teaching CHCs involve residency training in CHC locations - but they cannot help because Medicaid and HRSA payment designs are the major limitation to health professionals, more delivery team members, better delivery team members, and better practice environments (less turnover and turnover cost, etc.)

https://lnkd.in/e2Bd-RB5 A Place to Recover: How #Medical #Respite Programs Help #Unhoused People Heal For people experiencing #homelessness, recuperating after a #hospitalization is difficult. Medical respite care programs can help bridge the gap. Robert Davis ..."How can one rest when lying on a blanket in public is considered a quality-of-life infraction? Where can one heal or recover when medicine and other personal belongings could be thrown away without a moment’s notice? Over the last decade, medical respite care programs have been bridging the gap between housing and health care for people experiencing homelessness. These programs provide private space for unhoused folks who are too ill to recover from an illness or injury on the streets, but do not require hospital-level treatment. Since 2012, medical respite programs have more than tripled in the US, from 43 to more than 145 as of May 2023, according to the National Institute for Medical Respite Care (NIMRC). These programs — typically offered in freestanding facilities, homeless shelters and even motels — exist in 40 states, spanning Washington to Maine and as far south as Georgia and Florida. ... Despite the significant need for medical respite programs across the country, their future growth faces significant barriers. There is a lack of dedicated funding sources for these programs in many states, which can hinder the ability of service providers to expand into medical respite care. On top of that, there are gaps between health care and housing systems that often allow homeless people with injuries and illnesses to slip through the cracks."...

This article provides great insights into the type of work our team in #Michigan is working on and the challenges/solutions in improving the quality of life and care for nursing home residents. In fact, our Coalition works with the entire program mentioned in the article - the Michigan Longterm Care Ombudsman Program –? comprehensively at the state level. ?? Shout out to Salli Pung and Alison Hirschel – both mentioned in the article. The article... ?? Starts out with a story of justice for a grandmother who found love later in life – a story that provides context how important personal preferences and rights are for our aging family members. ?? Examples the type of work and advocating #ombudsman, volunteers and other staff members do to support individuals living in #nursinghomes. ?? Is part of a series, "State of Health," funded by Michigan Health Endowment Fund, who also funds our Michigan team work developing leaders. Such great work and #changeleaders in Michigan who are working together to ensure nursing home residents continue to live their best lives. ?? To Read the Article: https://lnkd.in/enBhVcfd #movingforward #eldercare #longtercare #seniorliving #aging #olderadults #change

Advocating at the Statehouse: St. Francis Center Director of Housing and Supportive Services Jennifer Downey addressed the Health and Human Services committee today at the Colorado statehouse in support of House Bill 24-1322. The committee hearing was chaired by Rep. Lindsey Daugherty. The bill directs the department of health care policy and financing (state department) to conduct a feasibility study to explore the feasibility of seeking federal authorization to provide nutrition and housing services that address Medicaid members' health-related social needs (HRSN). The state department shall report the study's findings to the joint budget committee on or before Nov. 10. The study and report must address integrating HRSN services with existing housing-related and nutrition-related services. The bill requires the state department to seek federal authorization to provide HRSN services no later than July 1, 2025, if seeking federal authorization would be budget neutral. Downey’s comments: Thank you Madame Chair and members of the committee. I am Jennifer Downey on behalf of St. Francis Center. I am the Director of Housing and Supportive Services. St. Francis Center offers a spectrum of services to the unhoused community with the goal of permanent housing. I am honored to have a voice to demonstrate our support of HB 1322. St. Francis Center has demonstrated that housing stability is a key component in overall health. Evidence supports that people with housing stability are able to thrive in other areas of life. St. Francis Center has offered Permanent Supportive Housing that focuses on people who have experienced chronic homelessness and a chronic disabling condition. We have offered this level of housing for more than 15 years. The success stories from this program are endless. Through stable housing and ongoing complex care management, we have been able to house 168 individuals currently. As mentioned, emergency and hospital visits have decreased. Chronic conditions have stabilized. In our housing programs we are able to offer life skills development, substance services, pro social activities all which are health related activities. Housing and food stability are critical and basic needs for the healthcare of the community. Through tenancy support, we could enhance the services already offered that include coordination of care with external medical providers, benefits support, food banks, transportation, just to name a few. I support the critical need for Medicaid to be flexible and focus on the changing and comprehensive definitions of healthcare. Thank you for your time and consideration. See insights and ads Boost post Like Comment Share

This trend has the potential to be a win-win for both healthcare systems and communities. By investing in affordable housing, healthcare systems can improve population health outcomes and reduce costs, while communities gain access to stable and secure housing. #HealthcareInnovation #SocialDeterminantsOfHealth #AffordableHousing #HealthcareCosts #CommunityHealth

In what ways does "place" affect the health of the communities you serve? Explore the idea of spatial justice in this new primer. Let's make sure everyone is in a place that facilitates their health and well-being!

It's an exciting week for BHPN as we launched the new Public Health Primer: Engaging Community Development for Health Equity! The primer was developed through a collaboration between Build Healthy Places Network and the National Association of Chronic Disease Directors (NACDD) to establish mutually supportive collaborations between these two sectors to advance health equity. It emphasizes the importance of resident leadership and provides guidance on how relationship-building can address injustices and promote equitable change in communities. Explore the transformative journey of the new primer ?? https://ow.ly/HivP50QE5e5 #ThoughtLeadership #UpstreamInvestments #BuildingBridges #EquitableChange #EquityInAction #SharedResponsibility #EquitableCommunities #VitalConditions

Having worked in this space for a while it’s great to finally see the NYT piece come out around this topic. It’s exciting to see work be done specifically by Aetna, a CVS Health Company, Kaiser Permanente, Enterprise Community Partners, Mercy Housing, Greater Minnesota Housing Fund and looking forward to study results from Health Management Associates (Center on Budget and Policy Priorities already well ahead in this field). This is important work that fundamentally raises questions about everyone’s top two expenses: housing + health. How are the two financed, and what incentives are at play? Might they work together to improve each other and what errors need to be avoided in order to be effective? #affordablehousing #housing #health #healthcarefinance #housingfinance #hospitals #healthinsurance

#FostercareAwareness What Federal Reforms do you want to see employed? Here are my simple suggestions. Please share any reforms you would like to see enacted. Simple, Logical, Implementable Steps To Reform HHS Protocols Inform families in need about the existence of the appropriate support service(s), help them apply for the service(s), expedite their application, and assign the family a caseworker familiar with the family’s situation and who has knowledge of the program(s) they are currently utilizing to help the families manage their access to the program(s) Staffing shortages need to be addressed across the Department of HHS Increased staffing is needed to ensure the offices/departments/agencies/etc. have the manpower they need to effectively roll out the updated services Training policies and procedures need to be updated throughout the US Department of HHS from the top down (this includes the difficult task of implementing a culture shift from child removals as the #1 solution for solving child neglect to providing support services to the families) One universal HHS website with accurate information that is updated daily, increased accessibility features, available programs based on zip code, direct program contact names and numbers, online application links, application instructions, eligibility requirements, detailed information on the documents needed to prove eligibility, online application assistance via a chat feature, hotline, and contact us button HHS must increase community outreach efforts to include in-person services for those who are unable to complete applications online HHS must actively seek community partnerships to fill gaps in services Every effort must be made to keep nonabusive families together and to provide support services to ensure the families have access to the programs necessary to create a loving, safe home environment When a child needs to be removed from their biological home due to abuse, every effort must be made to place the child in kinship or fictive kin care The current definition of Neglect should be narrowed only to include willful actions of a caregiver to deny a child food, clothing, shelter, medical care, or supervision

Insightful and prophetic words by Michael Maher in the UK 21 years ago (below). The problem has got worse since and is now unsustainable. The same in Ireland as in the UK. Other countries should heed the warning of the disastrous and unnecessary destruction of therapeutic group care and excessive regulation that has also had a massive impact on costs. ? “The private provider that places children on their own is offering a service that few others are prepared to, and for good reason: the stakes are too high: it’s too risky. The level of risk is not intrinsic to the case; it has become so because we have made it so. Such expensive responses, which bleed social services departments dry and compromise their ability to intervene earlier and more positively, are the consequence of the paranoid atmosphere created by the uncovering of all the abuses of the past 20 years… ? … What happens to these young people? Some of them still get referred to therapeutic communities. More of them, however, bypass this sector and are placed in ones or twos in houses over the south of England, maintained through having a staff team, often recruited through agencies, devoted entirely to keeping them ‘safe’, by virtue of keeping them apart from other young people. They have been deemed impossible to live in a group, and the result is that the powerful forces mobilised by group living and group educating are removed – envy, conflict, sexual attraction, adolescent destructive group processes. Their teeth are pulled. When this happens, the chances of moving them onto somewhere where treatment can happen become remote indeed. Treatment is risky, difficult and painful for everyone involved – and often too risky, painful and difficult to attempt.” ? Maher, M. (2003) – Therapeutic Childcare and the Local Authority, in Ward, A., Kasinski, K., Pooley, J., and Worthington, A. (2003) – Therapeutic Communities for Children and Young People, London and New York: Jessica Kingsley Publishers In the last 20 years, I have worked with many services worldwide and have never seen anything remotely like the anti-group + excessive regulation combination that exists in the UK and Ireland. This accounts for some of the cost trend - 1-2 children living in a home - with a care staff team of 10-14 - the home could be 4-5 bedrooms. Masses of time spent on recording details of the work. In some cases, I have seen it deemed necessary that the manager and deputy of the home not be included on the rota - so they can administrate the home that has 1-2 young people in it (80 hours of administration per week!) and 2-3 care staff have to be on the rota. So, 4-5 staff could be in a home with 1-2 children. Mostly, this is imposed by the regulatory system and risk anxiety. Anyone, who is interested in this subject and where your government is contemplating reshaping children's service, will benefit from reading this very well-researched perspective on residential care (reference in comment box)