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Home Health Options in the VA

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Presentation on theme: "Home Health Options in the VA"— Presentation transcript:

1 Home Health Options in the VA

2 Home Based Primary Care
In place of a clinic visit to a primary care physician (will describe LR model) Interdisciplinary in nature Joint Commission accredited

3 Patient Characteristics (1)
Homebound Frail with chronic medical problems Accepting of care Generally geriatric

4 Patient Characteristics (2)
Avg age is 80 Medical problems avg 12-20 Cognitive Impairment of some degree is prevalent If spouse is caregiver, also frail with cognitive impairment Avg income $20,000 Youngest patient 23---oldest 102 As many as 30 problems

5 Patient “Qualifications”
Meet the characteristics Live in geographic territory Don’t drive Have a caregiver Have a habitable home Safe environment---substance abuse, violent neighborhood

6 Refferals Formal consults Informal consults
Inferred through other needs Self referrals Other patients/caregivers refer

7 Process Evaluation---SW, Psychologist, APN
Needs can be met by team resources Patient agrees to limit outside providers All team members assess the patient Treatment Plan is developed in an interdisciplinary team meeting

8 VA Health Care Team APN RN SW Psychologist Therapist RD Pharmacist
Medical Support Clerk Physician PATIENT/CAREGIVER

9 Medical Foster Homes Piloted in Little Rock---Judy Karklins, LCSW
Adopted as national program Patients must be followed by HBPC Veteran pays for room/board/physical care on a scale according to ADL needs VA vets the homes for safety/suitability

10 MFH (2) Non-institutional care “Age In Place” Family atmosphere
Sufficient Income Same criteria as for HBPC Based on Medicaid Waiver program of Oregon to try and decrease NH placements. Not as regulated as ours---no asso health care team. Money to pay is most often from getting Veteran benefits from filing for pensions---can be private pay Problems occur when only source of income for the caregivers/sponsors. Back ground checks.

11 Fee Services Home Health Aides Skilled Nursing Service Hospice Therapy

12 Process for Fee Service
Order Alert to Community Health Division of HHCS CHN contacts Fee Office for fee payment approval Fee physician approval of care CHN locates agency in Veteran’s area who has availability and faxes orders, pertinent clinical data and fee authorization for payment to agency

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