Licensed Home Care vs Companion Care
I worked with Kathy Livingston, Senior Vice President of Senior Helpers in January 2010, on the newsletters for Senior Umbrella Network of Brooklyn . We spoke several times that spring about how she came to be the co-owner of a Home Care Companion Agency after working in the corporate world, helping franchise owners with their own home care agencies. Kathy invited me to participate in a lecture series at the Brooklyn Public Library, where she talked home care and I talked Patient Advocacy. Then, it was as if Kathy dropped off the face of the earth. She was going through the NYS Department of Health’s process for operating a Licensed Home Care Services Agency (LHCSA). The process took almost two years of full time work.
Last week I sat down with Kathy to ask her how operating a LHCSA has changed the services Senior Helpers offers. “We realized as a Companion Service that many of our clients required a higher level of care than we were able to provide. As a LHCSA, we have two nurses on staff so that we can provide services to people who have more complicated medical needs such as wound care.” Kathy explained, “Legally, we can treat many more people.
I have referred clients to Companion Agencies because they told me they just needed a little help. Sometimes I find that their needs really include medical services, such as actual help in the toilet, not just supervision to get to the bathroom. “People call our Agency and the first thing they want to know is what it is going to cost. That’s the wrong way to decide which type of Agency is right for you.” Kathy tells prospective clients, “The best way for me to help you is for me to understand your needs. As a LHCSA, we have a nurse who determines the level of care required and a Social Worker who coordinates the services for each client and matches them with the appropriate attendant.”
“There are four areas we review before deciding on a care plan, health, social, family and financial.” Kathy told me that resistance is the number one problem she encounters when children think care is required but the parent is not ready to accept the help. “We need to get to speak with the client. Others may think they know the kind of care their parent needs, but we are the experts. We are there to tell the client what they need. A client may insist on an attendant who drives, but that should really be on the bottom of the list of qualifications. LHCSA’s have strict training and quality rules that the Department of Health looks at before approving our license. We also seek Accreditation from the Joint Commissions, which is a periodic external evaluation by recognized experts that provides impartial evidence of the quality of care delivered to clients.”
Kathy recommends the book, Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved one Gets Older, by Mark Lachs,MD. “Our goal is to do the best job possible, and the LHCSA model allows us the opportunity to provide care for people over a long period of time, as they require more or less care.”
Kathy Livingston, Senior Vice President
Senior Helpers
353 West 48th St. New York, NY 10036
646-214-2086
klivingston@seniorhelpers.com
NYS Public Health & Health Planning Council
DOH Commissioner Shah addressed the council on February 2, 2012. He explained that the direction the Department is going is to provide more policy and less services. He said that the Governor’s budget highlights a transition to care management systems, a health insurance exchange which will provide a million people with health insurance, and the state takeover of local government administration, cutting 5500 County and City jobs, while adding 125 State jobs.
The Committee came out with an outline for the recommendations to the Governor for repurposing, streamlining, reforming and reconceptualizing the CON process with an eye on redesigning the public health system and the private health business.
There were about 5 dozen recommendations from statewide organizations, to the Health Planning Committee. To this, the committee has come up with 7 suggestions for review:
1- eliminate CON process for construction project
2- revise the process to facilitate the integration of physical and behavioral health services
3- consider co-location of D&TC’s with Nursing Facilities
4- streamline the process for amendments to CON’s
5- shift to self certification for architects/engineers
6- create a process to account for equipment which has become standard
7- create a timeline for reviews
Additional ideas proposed that require more discussion:
1- broaden the scope of CON to include physician practices that are built solely to avoid the regs
2- established providers should not have to file new 2A’s
3- the process needs to be more proactive, solicit applications, batch
4- strengthen local input/planning
5- It was brought up that there was a suggestion made from the oral health community that dental health should receive more attention and that was considered “not convincing.”
Dancing with the Stars
This is the second time Caryn will be participating in Dancing with the Stars at Ateret Avot, a senior hotel. Last time, Caryn was mentioned in the Ateret Avot newsletter and received flowers and a certificate.
Health Care Planning for NYS
The Committee on Health Planning
The Health Planning Committee advises the Council on need-methodologies, health facility plans, and emerging health care issues. Monitors major health care initiatives and advises the Council on progress and/or problems.
The Committee has taken on the challenge of easing the regulations for some aspects of the Certificate of Need process regarding capital projects. They want to make recommendations to the Governor to eliminate the long period of time it takes for construction projects to go through the review process, to unify reviews that require multiple agency reviews and to raise the financial level of projects requiring review. The Committee is interested in hearing from stakeholders, including payers, that have an interest in
what is needed in their communities.
While they are discussing this, the Medicaid Redesign committee is asking the governor for more resources for the DOH.
The Rewards of Networking
My current client was referred to me by someone I only met once. I don’t know how to thank her, because I never had her card and I didn’t meet her at any official networking site or event. I met her through a client, who was using both of our services. It was just a chance meeting, actually more of an introduction, like “Caryn, this is so and so, so and so this is Caryn.” You can imagine my surprise when I got a call a week later saying that this person had highly recommended me.
I was more than surprised. I was stunned, since I spend hours every day networking online and at meetings and events.
This led me to wonder if other people I know from my networking were getting business from their efforts. I decided to put out a blast asking people if they would be interested in talking about networking. Here are the questions I asked:
1. Do you have occasions to refer clients to other professionals?
2. How do you include referrals in your regular work process?
3. How do you decide which referrals are appropriate for which client?
4. Do you get referrals from other professionals in return?
I thought this might make a good start for a series for the Patient Advocate Institute, where I write to help people who are learning to become Patient Advocates.
The first to answer me was Robert Israel, CLU, founder of Long Island Planning Group. “Making a decision about long term care planning is very difficult. Clients need to consult with attorneys, tax accountants, pension advisors and others. I am often asked for a referral to one or more professionals. I’ve developed a reputation as someone who is willing to answer questions, so most of my referrals come from current clients.” Bob explained in a phone conversation, “I go to networking events, so that I can keep up to date with my referral sources at least once a month.” Bob also has a Refer a Client button on his website.
Ellen Makofsky has been named among the Top 50 Women Superlawyers in the New York-Metro area. She invited me to her office, where we talked about the benefits of belonging to the Senior Umbrella Network, where I am a member and Ellen is President of the Board. Both of us agreed that SUN is one of the best networking groups around because the membership is so diverse and the directory is a tremendous resource. She made a statement that really brought home to me how attorney’s work with their clients. “Every client is unique. At Raskin & Makofsky, LLP, we take the time to get to know our clients and craft a strategy that best suits them. Our discussions with clients must include what they have done in every aspect of their lives and what they hope to achieve in their planning for the future. Our attorneys and staff believe that our duties go beyond tending to our clients’ legal needs to providing them with resources and referrals when necessary.”
David Taub of White Glove Consulting replied by email. “Yes, there are times that I would refer clients to other professionals, whether it be a home care agency, nursing home, assisted living facility or elder law attorney. Based on the situation of my client I determine what other services they are in need of or can benefit from and I would either give them that professionals contact information or complete a referral form and send it to the professional myself. Because of what we do and the type of services we provide, we do have dealings with other professionals on a daily basis and we cross reference clients to each other. We pretty much equally share our referrals with whomever we work together with but if there is a client with a specific situation that will benefit more from one professional over the other (whatever the reason may be) then we will refer them to the more beneficial one.
Our business does get referrals from other professionals as well. We establish referral sources by networking, and marketing our services to professionals that can benefit from them. After we send/receive a 1st referral to/from a professional or company and they experience the real benefit in working together with us, they usually become an established referral source.”
I’ve known Ron Fatoullah, Managing Partner of Ronald Fatoullah and Associates for many years. Most of what I know about elder law comes from Ron’s newsletters and the times I’ve heard him speak. He is a sponsor of Senior Umbrella Network of Brooklyn and until recently, I was a Board Member and still manage their website. We talked in his office in Great Neck. “We were never a jack of all trades. Our firm was founded as an elder law practice, before there was a term elder law.” Ron explained how he talks to clients, “Our initial consultation is over an hour and a half to two hours. We have to read between the lines of what the client is trying to tell us. We ask the client, would it help you to speak to an expert? We routinely refer to Patient Advocates, Geriatric Care Managers and Home Care Agencies to help people with their health care needs.” Ron shared that most of his referrals came from the lectures he gave, especially to other attorneys and to associations such as for nursing home administrators. “Professionals are comforted by knowing that they can get help with questions they have about their clients needs, especially about complicated issues like Medicaid Planning.”
Next, we will ask clients if they believe they received appropriate referrals and how satisfied they are with the referrals they have gotten.
Caryn Isaacs, Patient Advocate
GetHealthHelp.com
347-965-9222
SOURCES:
Robert Israel, Long Island Planning Group
300 JerichoQuandrangle West, Suite 310
Jericho, NY 11753
516-918-3535
risrael@jhnetwork.com
http://liplanning.com
Ellen G. Makofsky, Esq
Raskin & Makofsky, LLP
600 Old Country Road Suite 444
Garden City, NY 11530-2009
Phone: (516) 228-6522
http://www.raskinmakofsky.com
David Taub
White Glove Consulting
1222 Avenue M Suite 409
Brooklyn, NY 11230
P. 718-878-3666 ext. 100
David@whitegloveconsultants.com
http://whitegloveconsultants.com
Ronald A. Fatoullah, Esq
Ronald A Fatoullah and Associates
60 Cutter Mill Road, Suite 507
Great Neck, New York 11021
Telephone: 516-466-4422
rfatoullah@fatoullahlaw.com
http://elderlaw-newyork.com
Bklyn Borough Pres Advisory Committee on Disability Issues runs into Accessibility Snafu
Brooklyn Borough Hall Smells Like Gasoline
A smell of gasoline coming from the elevators caused the meeting of the Brooklyn Borough President’s Advisory Council on Disability Issues to be relocated. Nan Blackshear, Seniors and Disabilities Policy Analyst and Community Liaison, Bklyn BP’s office, put out chairs while attendees waiting in the rain for an hour before being relocated to another building. They really need a portable ramp for these emergencies. The meeting, moved to St. Francis, including refreshments, went off without a hitch.
Health Care Reform Victory
For Immediate Release
Tuesday, November 8, 2011
Contact: Vincent Eng
+1 703 981 6636
media@healthlaw.org
Health Care Reform Victory
Court Upholds Constitutionality of ACA
Washington, DC – The National Health Law Program (NHeLP) welcomes today’s ruling in the United States Court of Appeals for the District of Columbia, upholding the constitutionality of the Affordable Care Act (ACA). The ACA includes a significant expansion of Medicaid, one that will improve access to care for working poor and chronically ill people in particular.
“We are pleased with the court’s decision. The ACA has already improved the lives of millions of Americans,” said Emily Spitzer, executive director of NHeLP. “This decision will help ensure Medicaid coverage and eligibility to over 16 million people.”
In a 2-1 decision, Judge Laurence H. Silberman, affirmed the lower court’s ruling, finding that the ACA’s individual mandate — the requirement that nearly all persons have health insurance — is within Congress’ powers. Notably, Judge Brett Kavanaugh’s dissent disagreed with the conclusion, without taking a position on the merits of the law, stating that the case lacks standing until the law takes effect in 2014.
“NHeLP has been actively involved in implementation of the law and has been carefully monitoring challenges to the ACA in our courts,” said Jane Perkins, NHeLP legal director. “Today’s decision was the second appellate court that upheld the constitutionality of the ACA and it’s becoming clear that the earlier 11th Circuit decision is an outlier in the legal analysis of the law.”
This past August, the 11th Circuit Court of Appeals held the ACA’s individual mandate unconstitutional, but severable from the rest of the law. Judge Silberman’s decision today, however, joins the 6th Circuit Court of Appeals’ decision [Judge Jeffrey Sutton filed a concurring opinion] in upholding the constitutionality of the ACA. The U.S. Supreme Court is considering this week whether to resolve conflicting rulings over the law’s requirement that nearly all Americans buy health care insurance
Sunrise Senior Living Families Get Information
Sunrise Senior Living At Sheepshead Bay Family Day
Judith Grimaldi, Esq. of Grimaldi & Yeung LLP
Judith Grimaldi, Esq ran down the changes in Medicare and Medicaid. Henni Fisher,LCSW, BCD, Alzheimer`s and Aging Resource Center of Brooklyn filled in the blanks and fielded questions. Caryn Isaacs, Patient Advocate discussed how a Patient Advocate can help with decisions when faced with hospitalization, rehabilitation and home care. She introduced special guests Eilish and Ken Natton, who went through the process of getting their home ready for Eilish, who lives with Parkinson’s Disease. Several people from the neighborhood came in to see what Sunrise had to offer. They were treated to live entertainment and wonderful food. The family day health fair which included Sea Crest Health Center and Shore View Center for Rehabilitation and Health Care, Ramps/Lifts for Better Living, Mickey Green, Mutual of Omaha, Visiting Nurses and more was arranged by Anvernette Hanna, Director of Community Relations at Sunrise Senior Living of Sheepshead Bay and Bonnie Nogin, Quality Recreation Solutions.
Donations
As you open your pockets for the next natural disaster, please keep these facts in mind:
The American Red Cross President and CEO Marsha J. Evans salary for the year was $651,957 plus expenses
The United Way President Brian Gallagher receives a $375,000 base salary along with numerous expense benefits.
UNICEF CEO Caryl M. Stern receives $1,200,000 per year (100k per month) plus all expenses including a ROLLS ROYCE .. Less than 5 cents of your donated dollar goes to the cause
The Salvation Army’s Commissioner Todd Bassett receives a salary of only $13,000 per year (plus housing) for managing this $2 billion dollar organization. 96 percent of donated dollars go to the cause.
The American Legion National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Veterans of Foreign Wars National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Disabled American Veterans National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Military Order of Purple Hearts National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Vietnam Veterans Association National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
AGINGICON.COM
Have you lived a life of accomplishment, doing what fulfills
you? Have you reached an age where things are harder to do?
Are you a leader and you know that you cannot do it alone?
Then, you are an Aging Icon.
My name is Caryn Isaacs.
Having been at the helm of developing hundreds of healthcare
businesses and running several multi-million-dollar companies,
my journey includes pioneering a physician-owned HMO and
active engagement in Healthcare Reform.
As a Patient Advocate, my company, GetHealthHelp, LLC,
specializes in crafting solutions that enable Aging Icons to
continue pursuing their passions.
An example is a 98-year-old author, playwriter and poet who is
suffering from fibromyalgia and thought that all her work
would be forgotten. I found a way for her legacy to continue by
publishing them as books and now working on having them
made into films.
If this sounds like something of interest, let’s meet to talk
further.
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