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The Affordable Care Act and Weatherization – Healthy Homes Programs: Is there a Connection? Carrie Smith, FSL, Chief O

The Affordable Care Act and Weatherization – Healthy Homes Programs: Is there a Connection? Carrie Smith, FSL, Chief Operating Officer. The Affordable Care Act. The Affordable Care Act established…. Where are the opportunities in ACA for healthy homes initiatives. Cost Containment

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The Affordable Care Act and Weatherization – Healthy Homes Programs: Is there a Connection? Carrie Smith, FSL, Chief O

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  1. The Affordable Care Act and Weatherization – Healthy Homes Programs: Is there a Connection?Carrie Smith, FSL, Chief Operating Officer

  2. The Affordable Care Act

  3. The Affordable Care Act established…

  4. Where are the opportunities in ACA for healthy homes initiatives • Cost Containment • Provider ACO’s are forming • Test and evaluate different payment structures, payment reform models • Reduce Medicare payments to hospitals for readmissions • Quality • Pilot programs to evaluate bundled payment models in Medicare and Medicaid programs • Independence at Home demonstration programs to prevent hospitalization and improve outcomes • Prevention and Wellness • Govt to establish a grant program to support the delivery of evidence based and community based prevention and wellness, address health disparities • LTC • New options for home and community based services • Other • Impose additional requirements on non-profit hospitals to conduct a community needs assessment every 3 years and adopt implementation strategy to meet the needs.

  5. The # 1 key to Survival is….. • Diversification of….. • Revenue • Partners • Services

  6. FSL’s Program and Services • Medicare Certified Home Health Agency • Home Care/Personal Care services division • A full service Home Improvement Division (weatherization, minor/major home repair program and handicap accessibility modifications programs) • 4-Adult Day Health Care Centers • Pathways Social Work/Care Management Clinical Team • 17-Licensed Residential Behavioral Health Group Homes • Credentialed Caregiver and Health Care Worker Training Program • Hospital Care Transition Program • HUD and Low-Income and Affordable Senior Apartment Housing Developer and Property Owner/Manager • Community Living Resources division (monitoring agent for DHS licensure division for all Assisted Living homes in AZ)

  7. Potential Activities • Consider adding services such as Handicap Accessibility Modifications to your portfolio • Consider using your intake workers to help enroll people into health exchanges/health plans or help them navigate the system. • Demonstrate to providers you can manage Health and Safety issues in the home (remove hazards such as indoor air quality issues, trip/fall hazards, electrical or plumbing hazards) which may impact the persons ability to live at home and or prevent a hospitalization • Make connections with new partners to your current WAP program for energyefficiency modifications • If their electric bill is less, maybe they can afford their prescriptions?

  8. ACA Partners and Opportunities • Look to partner with newly forming Accountable Care Organizations (ACO’s) • ACO’s take responsibility for cost and quality received by patients and will receive a share of savings they achieve for Medicare. • A hospital readmission can cost on average $12,000 -15,000 per episode. • Think of all the things that can be done to prevent this? Sell yourself to these new organizations.

  9. Other Potential Partners

  10. Challenges - Areas for Change • Application processes • Not uniform • Not one database system for ease of eligibility • Locations and application processes vary by funder, services • Coordination is challenging • Agencies don’t work together / silo system at the federal, state and local levels

  11. What works? • Use current resources to expand services to meet community needs • Dedicated staff • With key knowledge/experience • program space • administration • reputation “Success is when… Preparation, meets opportunity” ZigZigler • Review city/county and state plans • Learn more about Medicaid health plans in your community • Do some research on ACO’s forming in your area • Make the connections to potential partners • Start talking to people • Go out and get it!

  12. Resources • Department of Veteran Affairs – Home Modification Programs • Area Agency on Aging • Division of Aging Services • Medicaid health plans with home and community based programs in your community • HUD programs operated by • State Department of Housing programs • City and County government offices where CDBG funds are used • www.healthcare.gov

  13. Carrie Smith Chief Operating Officer Foundation for Senior Living (FSL) 1201 E. Thomas Rd. Phoenix, AZ 85014 602-285-1800 ext. 142 csmith@fsl.org

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