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Home Health Options in the VA

Home Health Options in the VA. 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 . Patient Characteristics (1). Homebound Frail with chronic medical problems

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Home Health Options in the VA

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  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

  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

  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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