Chapter 1. Long-Term Care Today: Turbulent Times by TBd92btU

VIEWS: 4 PAGES: 14

									Chapter 2. Toward an Ideal
          System

   Long-Term Care: Managing
     Across the Continuum
        (Second Edition)


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       Learning Objectives
1. Identify the characteristics of an ideal
   long-term care system
2. Describe what it means for the long-term
   care system to be consumer-driven
3. Identify the roles of formal and informal
   caregivers
4. Define the components of a full and
   uniform assessment of a consumer's
   service needs
5. Discuss the need for incentives for
   providers and consumers                     2
The Criteria for Designing or
Evaluating a Long-Term Care
           System

   • What are they?
   • How were they developed?
   • How are they used?



                                3
Criterion I. The long-term care system should be
based on recognition of the needs, rights, and
responsibilities of individuals. It should:

 Be consumer-driven
 Meet all of the needs of the consumers
 Focus on the individual, recognizing that
  individuals have unique needs
 Respect different cultures and cultural values

                                               4
Criterion I. (continued) Recognition of the needs,
rights, and responsibilities of individuals:


 Promote quality, dignity, and self-
  improvement for consumers.
 Balance consumer rights and
  responsibilities
 Offer consumers a choice of service
  providers and service delivery modalities
                                               5
Criterion II. The long-term care system
should be easily accessible. It should:


Be universally accessible
Be "user-friendly"
Provide care in the least restrictive
 environment
Encourage single-site care availability


                                           6
Criterion III. The long-term care system
should coordinate professional, consumer,
family, and other informal caregiver resources.
It should:

Integrate professional, community, family,
 and other informal caregiver efforts
Evolve from the current medical model to a
 holistic model of service delivery
Involve families in case management and
 care delivery
                                             7
Criterion IV. The long-term care system should be
an integral part of the health and social system, to
promote integration, efficiency, and cost
effectiveness. It should:

Include a full continuum of services
Include a full and uniform assessment
 (initial & ongoing) of the consumer's needs.
Provide emphasis on, and reimbursement
 for, illness prevention efforts as an integral
 part of the overall system
                                               8
Criterion IV. (continued) Promote integration,
efficiency, and cost effectiveness:


Be planned and coordinated to reduce
 fragmentation and inefficiencies
Be based on outcome-oriented
 accountability



                                             9
Criterion V. The long-term care system should be
adequately and fairly financed. It should:

 Utilize public and consumer resources to
  assure universal access to services.
 Provide incentives for consumers to use
  services in an appropriate and cost effective
  manner
 Provide incentives for consumers to self-
  finance their care
                                              10
Criterion V. (continued) Adequately and fairly
financed:

Avoid causing impoverishment of consumers
 and families
Provide incentives for providers to develop
 cost effective measures
Develop payment mechanisms that allow
 efficient providers to adequately compensate
 staff and to allow for appropriate operating
 surplus and/or return on investment
                                            11
Criterion V. (continued) Adequately and fairly
financed:

Operate within the limits of a well conceived
 budget
Provide significant flexibility to enable
 consumers to meet long-term care needs as
 each consumer defines those needs
Be based on uniform financial eligibility
 criteria
                                            12
Criterion VI. The long-term care system
should include an education component to
create informed consumers, providers,
reimbursers, and regulators. It should:

Include community education
Include education for providers
Educate young, healthy persons to better
 prepare them to cope with chronic illness

                                             13
           In Summary:
     The Criteria provide a basis for
  evaluating the current long-term care
system and for developing an ideal long-
           term care system.



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