New Plan Items: HCBS, Technology and Residential Care
The U.S. Department of Health and Human Services (HHS) released its first National Plan to Address Alzheimer's Disease on May 15, 2012. The National Plan and its annual updates were mandated by the National Alzheimer’s Project Act, which became law in Jan. 2011.
Several new items in the 2014 update address the provision of home and community-based services (HCBS) to people with Alzheimer’s disease and related dementias.
Other new items explore the role of technology in smoothing care transitions and supporting family caregivers. A number of new items focus on the delivery of services to people with Alzheimer’s disease who live in residential care settings.
Aging Services Providers Take Note
Here are some new items that might be of interest to providers of long-term services and supports:
- Help states provide and sustain dementia-capable HCBS systems. HHS will work with states to help ensure that people with dementia and their caregivers have access to these systems.
- Improve HCBS provided through state Medicaid waivers. The Centers for Medicare and Medicaid Services is conducting webinars and national calls about its final rule on HCBS provided through state Medicaid waivers. These outreach efforts are designed to help states improve the services they provide to people with a need for long-term services and supports, including people with Alzheimer’s disease.
- Improve the dementia capability of the long-term services and supports systems. The Administration for Community Living’s new Alzheimer's Disease Initiative: Specialized Supportive Services project will award grants to help dementia-capable systems provide effective supportive services to people with Alzheimer’s disease who are living alone in the community.
- Assess the adequacy of health information technology (HIT) standards to support persons with Alzheimer’s disease. The Office of the Assistant Secretary for Planning and Evaluation and the Office of the National Coordinator for Health Information Technology will explore new ways to enhance the interoperable exchange of information to support care planning and care transitions for people with Alzheimer’s disease.
- Examine technology solutions to support family caregivers. The Agency for Healthcare Research and Quality is measuring the impact of remote monitoring technology on the efficacy, competence and distress of families caring for relatives with Alzheimer’s disease.
- Enhance the ability of long-term care ombudsmen to support people with Alzheimer’s disease. The National Ombudsman Resource Center will train long-term care ombudsmen to become “Hand in Hand” trainers for nursing home and other direct care staff.
Enhance understanding of state regulations for residential care and adult day health services. HHS will develop a compendium of state policy and regulation as a way to increase understanding about how policies for residential care and adult day health services influence service delivery for people with Alzheimer’s disease.
Using the National Plan to Reduce the Cost of Alzheimer’s Care
The new AFA report contains cost analyses of several new or expanded demonstration programs mentioned in the National Plan.
AFA reports that direct spending for Alzheimer’s disease was approximately $203 billion in 2013. Researchers estimate that by 2050 this level of direct spending will reach $1 trillion if the current care delivery system remains unchanged.
Cost of Care: Quantifying Care-Centered Provisions of the National Plan to Address Alzheimer's Disease suggests that coordinated care programs like the Medical Home, the Independence at Home Program, the Community-based Care Transitions Program, and the Medicare Coordinated Care Demonstration could be adapted so they serve the special needs of beneficiaries with Alzheimer’s disease.
New or adapted demonstration programs are likely to improve care and save money because they focus on prevention, coordination and community-base care, says the report. These programs could save up to $10 billion in care costs by reducing:
- Hospital use among people with Alzheimer’s disease.
- The percent of the nursing home population with Alzheimer’s disease.
- Unnecessary spending on medical services rendered when a beneficiary with Alzheimer’s disease receives care in a medical facility.
By: Geralyn Magan - Published On: Jun 27, 2013Updated On: May 14, 2014