A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

A presentation for: Warner Pacific CollegeStrategic Management in HealthcareProfessor Christine Tokonitz

Presented by: Karleen AicheleFebruary 4, 2014

Elder Care

A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Availability of facilities Affordability Lack of the quality care Lack in quantity and quality of caregivers

What are the Critical Issues?

Elder CareQUALIT

Y

Abundance of elderly

A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.slidegeeks.com/powerpoint-slides/47236-pest_analysis_business_model_cycle_process_chart_powerpoint_templates/

Political Economic Social Technological

Strategic Analysis

Elder CareQUALIT

Y

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.census.gov/prod/2002pubs/censr-4.pdf (p59)

Population imbalance Population growth U.S.

Political…

Elder CareQUALIT

Y

A desperate need for:

Population elderly Population global?

Percent of Total PopulationOver the age 65

1900-2000(Millions)

Population imbalance Population growth U.S. Population elderly Population global

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.prb.org/ Publications/Articles/2006/ ACriticalWindowforPolicymakingonPopulationAginginDevelopingCountries.aspx

Elder Care

Percent of Total PopulationOver the age 65

1900-2000

QUALITY

A desperate need for:

Source: United Nations Population Division, World Population Prospects: The 2004 Revision (New York: United Nations, 2005)How did we get here?

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.census.gov/prod/2002pubs/censr-4.pdf & http://www.diplomaticourier.com/news/regions/brics/1938-china-s-eldercare-predicament. f

Population interference China/Mao Zedong (Tse-Tung)

Liability for the country China % vs. U.S. %

Political Theory…

Elder CareQUALIT

Y

A desperate need for:

Percent of Total PopulationIncrease1900-2000

Strengthen the population

The U.S. Healthcare/ACAMore interference?

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://rossdawsonblog.com/weblog/archives/2013/04/ critical-issue-will-the-fertility-rate-in-the-developed-world-continue-to-increase.html

Fertility rates 2.1 birth/woman (2.1:1) > 2.1=Extinction

Political/Social Impact

Elder CareA desperate need for:

QUALITY

Fertility RatesUnited States

1925-2009

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.cbpp.org/cms/?fa=view&id=3801

Who funds the elder cost? A depleting youth? Swelling government? Taxation…

Economic…

Elder CareA desperate need for:

QUALITY

Everyone…

Government ExpansionMedicaid Burden

2014-2022

$1,000,000,000,000

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://newoldage.blogs.nytimes.com/2012/07/05/ new-numbers-on-elder-care/?_php=true&_type=blogs&_r=0

Family caregivers Culturally expected China’s new laws ACA?

Social…

Elder CareQUALIT

Y

A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.aarp.org/relationships/caregiving/info-07-2011/caregivers-save-us-health-care-system-money.html

Simply stated….Economic…

Elder CareQUALIT

Y

A desperate need for:

Source: AARP

“Informal” and “Donated”words of our CBO

A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.slidegeeks.com/powerpoint-slides/47236-pest_analysis_business_model_cycle_process_chart_powerpoint_templates/

Technological Social Economic Political

Strategic Analysis

Elder CareQUALIT

Y

A desperate need for:

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Availability of facilities Affordability Lack of the quality care Lack in quantity and quality of caregivers

What are the Critical Issues?

Elder CareQUALIT

Y

Abundance of elderly

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Top 30 jobs by 2020 Technology & Economics…

Elder CareQUALIT

Y

A desperate need for:

The need is known Future workforce

Source: Boston University Medical Center Study (2010) Top 30 fastest-growing jobs by 2020 From http://www.bumc.bu.edu/gms/files/2012/02/Top-30-fastest.pdf

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.census.gov/prod/2002pubs/censr-4.pdf (p59)

Lack of caregivers Imbalance of population

Social Concerns…

Elder CareQUALIT

Y

A desperate need for:

Dependence on insurance?

1800s

Accident Insurance

Medical Insurance

1929

Medicare & Medicaid

1965

1700s

Life Insurance

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Title V Title VII Title VIII

Health Care Workforce

Improving Access to Innovative Medical Therapies

Community Living Assistance Services and Supports Act “CLASS Act”

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Title VIIICommunity Living Assistance Services and

Supports Act “CLASS Act”Establishment of a National Voluntary Insurance Program for Purchasing community Living Assistance Services and Supports in order to:

• Provide individuals who have functional limitations the tools which will allow them to maintain their personal and financial independence and life in the community

• Provide infrastructure that will help address the nation's community living assistance services and supports needs

• Alleviate burdens on family caregivers

• Address institutional bias by providing financing mechanism that supports personal change and independence to live in the community

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Title VIIAdditional facilities to include in the Public Health Service Act (as amended by Title VII of the ACA):• Children’s hospital excluded from the Medicare

payment system• Freestanding cancer hospital excluded from Medicare• Entity that is critical access hospital• Sole community hospital

Improving Access to Innovative Medical Therapies

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Title VHealth Care Workforce

Improve access, delivery to individuals by:• gathering and accessing comprehensive data…including

research on supply, demand, distribution, diversity, and skills needs of the health care workforce

• increasing the supply of a qualified health care workforce

• enhancing health care workforce education and training• providing support to the existing health care workforce

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Geriatric ComponentsGeriatric Components

(financial assistance)

Grant funding opportunities (fellowships) - Short-term incentive focusing on geriatrics, chronic care management and long term care.

Must offer 2 courses each year (minimal/no cost) to family caregivers and direct care providers instruction on management psychological and behavioral aspects of dementia… OR

Develop and include material on depression and other mental disorder common among older adults, medication safety issues for older adults, and management of psychological and behavioral aspects of dementia and communication techniques

$150,000/24 facilities for FFY 2011 to 2014 = $6250

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/

Political…

Elder CareQUALIT

Y

A desperate need for:

Geriatric ComponentsGeriatric Components

(financial assistance)

Geriatric Career Incentive Awards - Monies offered to individuals who foster greater interest among a variety of health professionals in the field of geriatric, long-term cares, and chronic care management

Teach or practice the above for a minimum of 5 years Board certified/eligible in : internal medicine, family practice,

psychiatry, dentistry …(or anything the Secretary deeps acceptable and approves.

Have completed the fellowship Have a junior (no-tenured) faculty appointment at an

accredited school of medicine, osteopathic medicine…$10 Billion for the FFY 2010 to 2013

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.wvahc.org/

Moving Forward

Elder CareQUALIT

Y

A desperate need for:

Dismal future? Two titles still remain Title VIII not completely dead Private possibilities

AVAILABILTY

AFFORDABILITY

QUALITY

QUANTITY

Image credited to: http://blogs.cdc.gov/publichealthmatters/2012/09/emergencies-and-the-elderly/ & http://www.paying-for-eldercare.com/ & http://www.clker.com/clipart-puzzle-pieces-2.html

Conclusion

Elder CareQUALIT

Y

A desperate need for:

Problem solving WHY Two helpful pieces?

DEVISE PLAN

IMPLIMENT PLAN

MONITORPLAN

We are half way there…The future… depends

Elder CareQUALIT

Y

A desperate need for:

References…• Association of American Medical Colleges (ps in the United States. Retrieved January 24, 20AAMS) (2014). Title

VII and Title VIII Reauthorization. Retrieved January 24, 2014 from: https://www.aamc.org/advocacy/ budget/healthprof/150298/t7reauthorization.html

• Baylor Health Care Systems. (2011). Timeline. Retrieved January 15, 2014, from http://www.baylorhealth.com/About/Pages/Timeline.aspx

• Boston University Medical Center (2010). Top 30 fastest-growing jobs by 2020. Retrieved January 17, 2014 from: http://www.bumc.bu.edu/gms/files/2012/02/Top-30-fastest.pdf

• Centers of Disease Control and Prevention, Department of Health and Human Services (2011, March). NCHS Data Brief. Retrieved January 11, 2014 from: http://www.cdc.gov/nchs/data/databriefs/db60.htm

• CNN U.S (2014). Baby Boomer Generation Fast Facts. Retrieved January 11, 2014, from http://www.cnn.com/2013/11/06/us/baby-boomer-generation-fast-facts/

Elder CareQUALIT

Y

A desperate need for:

References…• Congressional Budget Office. Nonpartisan Analysis for the U.S. Congress (2013). Rising Demand for Long-Term

Services and Supports for Elderly People. Retrieved January10, 2014 from http://www.cbo.gov/publication/44363

• Cultural China: History and Literature (2010). Classic of Filial Piety. Retrieved January 19, 2014 from:http://www.cultural-china.com/chinaWH/html/en/37History864.html

• Eldercare Workforce Alliance (2014). Eldercare: How America’s Solution to the job Crisis Can Lead to Better Care for Older Adults. Retrieved January 17, 2014, from: http://www.eldercareworkforce.org/research/issue-briefs/research:america-solution-jobs-crisis-better-care-for-older-adults/

• Gleckman, Howard, Fiscal Cliff Deal Repeals CLASS Act, Created Long-Term Care Commission. Forbes. (2013) Retrieved January 27, 2014 from: http://www.forbes.com/ sites/howardgleckman/2013/01/01/fiscal-cliff-deal-repeals-class-act-creates-long-term-care-commission/

Elder CareQUALIT

Y

A desperate need for:

References…• Indiana University of Pennsylvania (2013). The Eight Largest Faith Grou14, from: http://

www.iup.edu/page.aspx?id=11805

• Kaneda, Toshiko. (2006, January). A Critical Window for Policymaking on Population Aging in Developing Countries. Retrieved January 10, 2014, from http://www.prb.org/ Publications/Articles/2006/ACriticalWindowforPolicymakingonPopulationAginginDevelopingCountries.aspx

• Kurtz, Annalyn (2013, September).Baby bust: U.S. births at record low. CNN Money. Retrieved January 19,

2014, from: http://money.cnn.com/2013/09/06/news/economy/birth-rate-low/

• Long Term Care Options (2014). Elder Care Services. Retrieved January 9, 2014, from: http://www.ltcoptions.com/elder-care-services/

• Martich, Dawn (2012). Affordable Care Act: Titles VII and VII. MCN learning. Retrieved January 17, 2014, from: http://www.mcnlearning.com/news/affordable-care-act-titles-vii-and-viii/

Elder CareQUALIT

Y

A desperate need for:

References…• Nash, Paul (2013, December). China’s Eldercare Predicament. Diplomatic Courier. Retrieved January 16, 2014,

from: http://www.diplomaticourier.com/news/regions/brics/1938-china-s-eldercare-predicament. • Patient Protection and Affordable Care Act of 2010, Title V U.S.C. § 5001 et seq. (2010). Retrieved January 17,

2013 from: Retrieved January 17, 2013 from: http://www.hhs.gov/healthcare/rights/law/title/v-healthcare-workforce.pdf

• Patient Protection and Affordable Care Act of 2010, Title VII U.S.C. § 7001 et seq. (2010). Retrieved January 17, 2013 from: http://www.hhs.gov/healthcare/rights/law/title/vii-improving-access-to-innovative.pdf

• Patient Protection and Affordable Care Act of 2010, Title VIII U.S.C. § 8001 et seq. (2010). Retrieved January 17, 2013 from: http://www.hhs.gov/healthcare/rights/law/title/viii-class-act.pdf

• Ramnarace, Cynthia (2011), AARP Bulletin: Cost of Taking Care of Mom and Dad. Retrieved January 15, 2014 from http://www.aarp.org/relationships/caregiving/info-07-2011/caregivers-save-us-health-care-system-money.html

Elder CareQUALIT

Y

A desperate need for:

References…• Seeking Alpha (2009, September). Nu Skin: Rapid Aging of World Population Portends Strong Future Growth.

Retrieved January 6, 2016 from: http://seekingalpha.com/article/ 162906-nu-skin-rapid-aging-of-world-population-portends-strong-future-growth?source=cc

• Static Brain. (2014) Health Care Industry Statistics. Retrieved January 9, 2014 from: http://www.statisticbrain.com/health-care-industry-statistics/

• The Silver Book (2014). The Growing Older Population. Retrieved on January 19, 2014 from: http://www.silverbook.org/category/3?pageNum=5

• The Theosophical Quarterly, Volume 11 (1915, July). The Sacred Books of China. Retrieved January 18, 2014 from: https://archive.org/details/theosophicalquar11theouoft

• The World Bank: Working for a World Free of Poverty (2013) Retrieved January 19, 2014 from: http://data.worldbank.org/

Elder CareQUALIT

Y

A desperate need for:

References…• United Nations Department of Economic and Social Affairs, Population Division (2013). Ageing[sp]. Retrieved

January 6, 2014, from http://www.bls.gov/oes/ current/ oes399021.htm#nat • University of California, Irvine (2012) Fact Sheet. Retrieved January 21, 2014, from:

http://www.in.gov/isdh/files/Abuse_of_Residents_of_Long_Term_Care_Facilities.pdf• USA.GOV. (2014). Diseases, Conditions, and Injuries Affecting Seniors. Retrieved January 6, 2014, from:

http://www.usa.gov/Topics/Seniors/Health/Diseases.shtml• U.S. Department of Commerce, United Stated Census Bureau, Occupational Employment Statistics. (2012).

Employment by Industry. Retrieved January 6, 2014, from http://www.census.gov/compendia/statab/2012/tables/12s0620.pdf

• U.S. Department of Labor, Bureau of Labor Statistics (2012). Employment Projections: 2012-2022 Summary. Retrieved January 6, 2014, from: http://bls.gov/news.release/ ecopro.nr0.htm

Elder CareQUALIT

Y

A desperate need for:

References…• U.S. Department of Health and Human Services, National Institute on Aging. (2013, October). Growing Older in

America: The Health and Retirement Study. Retrieved January 6, 2014, from: http://www.nia.nih.gov/health/publication/growing-older-america-health-and-retirement-study/chapter-1-health

• U.S. Department of Health and Human Services, (1994). The Economic Impact of Long-Term Care on Individuals. Retrieved January 13, 2014, from: http://aspe.hhs.gov/daltcp/reports/ecoimpes.htm#secVI

• U.S. Department of Health and Human Services, (1999). A National Study of Assisted Living for the Frail Elderly: Results of a National Survey of Facilities. Retrieved January 21, 2014 from: http://aspe.hhs.gov/daltcp/reports/facres.htm

• U.S. Department of Labor, Bureau of Labor Statistics, (2012). Occupational Employment and Wages, May 2012 (Ref No. 39-9021 Personal Care Aides). Retrieved January 6, 2014, from http://www.bls.gov/oes/current/oes399021.htm#nat

• Yale Journal of Medicine & Law: An Undergraduate Publication. (2009, November). The History of Medical Insurance in the United States. Retrieved January 6, 2014) from http://www.yalemedlaw.com/2009/11/the-history-of-medical-insurance-in-the-united-states/