Tag Archives for LTCCC

Alliance for Better Long-Term Care Celebrates 25th Anniversary

Published in Pawtucket Times on October 20, 2003

Next Friday, nursing home advocates, state officials, residents and their families and friends along with long-term care providers are invited to North Kingston to celebrate the 25th anniversary of the Alliance for Better Long-Term Care.

With its emergence on the advocacy scene in 1988, the Alliance for Better Home Care (later renamed the Alliance for Better Long-Term Care) has effectively defended the rights o those who can no longer speak for themselves – the elderly who receive care in the state’s nursing homes. Later in the late 1990s, the nonprofit group expanded its advocacy role into the assisted living, home care and hospice sectors. (This would result in the above-mentioned organizational name change).

Back in 1986, a thirty-something Roberta Hawkins had just raised her two daughters, Robin and Cindy. The former facility worker with 15 years’ experience under the belt working at Warwick-based Levitons Manufacturing Co., sought out a new career in human services.  Hawkins enrolled at Rhode Island College to become a  social worker.

At this time, she joined the federally funded program, Volunteers in Service to America (VISTA) “to make a difference.”

Hawkins would later be assigned to assist low-income Rhode Islanders in applying for eligible federal and state benefits. However, poor nursing home care provided at the Rhode Island Nursing Home in Providence would later lead to refocusing of the nonprofit group’s mission, one that would aim to protect the health and dignity of the Ocean State’s growing nursing home resident population.

With VISTA funds and small grants drying up at the beginning of the Reagan years, around 1888, Hawkins’ nonprofit group received funding from the Department of Elderly Affairs to refocus her group’s new advocacy role in the state. The Alliance for Better Nursing Home Care was born.

Hawkins, along with six fellow VISTA volunteers, would later form the staff of the newly created statewide, advocacy group.  Three years later, Hawkins would take over the helm of the group.  Three years later, Hawkins would take over the helm of the group. Ultimately, she would become the sole staffer, with an organizational budget of $ 8,000.  Volunteer staff, consisting mostly of family members of nursing home residents, would help Hawkins formulate advocacy strategy, recruit new members, write and disseminate a newsletter and organize fundraisers.

Twenty-five years later, Hawkins Alliance for Long-Term Care has an operating budget of $ 770,000 with a staff of 14 people and a core group of 40 volunteers.  Several years ago, the Department of Elderly Affairs (DEA) out-sourced ombudsman duties to this non-profit group.

Since its inception, the Alliance for Better Long-Term Care has assisted families in both understanding and choosing the most appropriate care setting to place their loved ones, said Hawkins, in a multiple of care settings – from assisted-living nursing homes or to their own homes, through the provision of home care services.

As the state’s official ombudsman agency, Hawkins and her staff work to educate family members and residents of their state and federal rights.  Care complaints are investigated a resolution mediated between residents and the long-term care providers.

As an advocate, Hawkins testifies on behalf of nursing home residents at legislative and regulatory hearings.

Where does Hawkins go from here?

Hawkins said she looks forward to making  bigger changes in the Ocean State’s long-term care delivery system.

“When delivering services, state agencies sometimes cut people off from the services when they reach a certain age,” like rehabilitation and mental health services, she said.  “That’s totally inappropriate,” she adds.

Hawkins also told All About Seniors she will continue to work toward “putting the home back into nursing homes.” The facility must truly become are a resident’s home, she urged.

Rhode Island’s most visible nursing home advocate also wants to see facility staff adequately paid for the valuable work they perform.

“We must get rid of the staff that do not care about providing good care to the elderly and keep those who really do, by paying them livable wages and providing a good working atmosphere,” she said.

Hawkins has gained the respect of a wide variety of state officials, aging advocates and providers in her 25 years of advocacy.

Lt. Gov. Charles Fogarty, who worked with Hawkins when he was a state senator and as chair of the state’s Long Term Care Coordinating Council (LTCCC), said Rhode Island is fortunate to have such a dedicated and committed advocate.

“We all sleep better at night knowing that she is there for us to advocate on behalf of the thousands of frail and vulnerable elderly in long-term care settings,” he said.

Lucille Massemino, administrator of Charlesgate Nursing Center, a Providence-based 160-bed skilled nursing facility and a former m ember of its board of directors, said she sees Hawkins as a passionate advocate pushing for the quality of life of nursing home residents.

“She is very assertive with administrators, knowing the needs of residents and prodding facilities towards fulfilling those needs,” she said.

Meanwhile, Hugh Hall, president of the Rhode Island Health Care Association has seen Hawkins in action over the past 18 years, working tirelessly for the improvement of Rhode Island’s long-term care services.

“She has lobbied the state legislature for better care in nursing homes [urging lawmakers to pay facilities an adequate reimbursement rate and calling for the state to address a nurse staffing shortage],” he said.

Hawkins said she plans to stay around as long as she is effective and as long as her passion to fight for nursing home residents remains. For the sake of the tens of thousands of Ocean State seniors and young disabled people who need long-term care services, hopefully we’ll see her around advocating on their behalf for a long time to come.

Rhode Island Nursing Homes Scramble to get Dental Coverage for Residents

Published in Pawtucket Times on March 3, 2003

According to Alfred Santos, executive director of the Rhode Island Health Care Association (RIHCA), one company’s business decision has left Rhode Island nursing homes scrambling to bring dental coverage to thousands of nursing home residents.

Over the last two months, Santos has met with state regulatory officials to inform them of this latest health-care access problem.

Here’s the scoop:

Access Dental Care, a major provider of dental services to nursing facilities, announced in a Nov. 4 member to its 40 nursing home clients that it would no longer offer onsite dental care, beginning Jan 1, 2003. The brief memo cited the extreme physical challenge to dental staff who provided dental services to residents outside the normal dentistry setting as the rationale for dropping onsite dental care.

But a nursing home trade group says that there may be a bigger issue behind Access Dental Care’s decision to not provide onsite dental services to nursing home residents.

RIHCA’s Dental Services Committee believes the actual reason for this business decision may well be tied to a low Medicaid reimbursement for dental care services, said Chair john Gage, who also serves as the trade group’s vice-president. Currently, Gage is the administrator at Riverview Heatlh Center in Coventry.

Gage said 80 percent of nursing home residents rely on Medicaid to pay for their dental services. Access Dental Care’s decision to not perform dental services on site will force m any frail, bedridden residents to be transported outside the facility for treatment, causing needless pain and suffering to them, he said.

“With a severe staffing shortage facing many facilities it will be even more difficult to assign a staff person to accompany the resident,” Gage noted.

According to Gage, it’s not so easy for nursing homes to find other providers to deliver onsite dental services. Complicating this health care access issue, Geage said, is HealthDrive’s policy not to contract with any nursing home to only provide dental services.

At press time, state officials from the Department of Health and Human Services were unavailable for comment about this payment issue.

State Sen. H. Elizabeth Roberts

(D-Cranston), who is chairing a subcommittee of the state’s Long-Term Care Coordinating Council (LTCCC) is currently looking at Medicaid issues, said Access Dental Care’s decision to not provide treatment to Medicaid recipients in the nursing home setting only exacerbates an ongoing problem. That Is, low Medicaid reimbursement  keeps low income seniors from receiving the appropriate preventative and restorative dental care they need.

Roberts said, “inadequate Medicaid rates make it hard for dentists to see residents, because the rates are so far below their costs. When combined with the medical complexity of nursing home patients, the low reimbursement is even more of a barrier, she said.

Robert’s LTCCC subcommittee plans to turn their attention to investigating the obstacles that keep dental care from being provided to Medicaid-eligible seniors in nursing homes and in their homes.

Bringing dental services to low-income children and seniors became an important issue to Roberts when care to a young constituent in the Rlte Care program required the use of an operating room for dental work because of severe tooth decay.

This operation could have been prevented with ongoing dental care, she said, noting that it “took the attention of state government to locale a provider who would accept the low Medicaid provider rate.”

Roberts is working to ratchet up the Medicaid reimbursement for dental care and to streamline the payment process through legislation she has recently introduced. The senator intends to bring together the state’s Dental Society and nursing homes to develop a plan to bring dental care to facilities that no longer received onsite dental service.

Robert Hawkins, state ombudsman and executive director of the Alliance for Better Nursing Home Care, agreed with Roberts’ assessment that there has been limited access to dental services in nursing homes over the past couple of years.

Hawkins has been pushing for appropriate dental treatment for nursing home residents for more than 25 years.

“Medicaid-eligible seniors who are mobile can more easy travel to dental clinics, if they can find treatment, especially with the low Medicaid rates,” Hawkins said. “For the old, sick and feeble, why should they have to go to through the turmoil of leaving the facility to get their dental care?

“Lack of access to dental care is a form of discrimination for those unfortunate to be lower-income and on Medicaid, Hawkins charged.

The Medicaid system has always been “penny wise and pound foolish,” Hawkins said. “When you don’t treat a dental problem early, residents don’t eat, they lose weight, develop bed sores, ultimately requiring costly hospital care.

“Can any one remember having a tooth ach all night long with no where to go?,” Hawkins asked.

Susan Sweet, a consultant to nonprofit groups and a longtime elder rights advocate, added there is also a lack of dental care for low-income seniors that extends into the community as well.

“For some reason, dental care is treated in the health care community as less important as other medical care,” she said, adding that reimbursement for dental care has lagged behind reimbursement for other medical care.

So where do we go from here?

Roberts’ plans to bring the state’s Dental Society together with nursing homes to craft a short-term solution is the first step in removing the obstacles of providing dental services to Medicaid-eligible residents. But a more permanent solution is needed.

With Gov. Don Carcieri poised to shortly release his budget, I hope he and the General Assembly counter Medicaid’s traditional “penny wide and pound foolish,” philosophy by increasing Medicaid payments for dental services. An inadequate reimbursement rate will ultimately reduce the needless pain and suffering that dental problems cause in nursing homes across the state.