Every day we work with many organizations which are in the process of implementing Money Follows the Person (MFP) programs.   It’s not surprising that each state opts to implement this program a little differently to fit within their organizations and to maximize resources.

While every implementation is unique, each state faces similar challenges and surprises.  We’ve created a list of five things states need to keep in mind when implementing Money Follows the Person initiatives.

1. Who will cover the cost of daily living when the consumer returns to their home and community? There are many costs associated with living at home that are not covered by MFP grants: over-the-counter medicines, toilet paper, cleaning supplies, etc.  Quite often, these costs are not factored into a state’s plan for MFP, but covering some of these costs can greatly impact the success of the program.  One state we work with has added a separate fund for daily living to account for these extra costs.
2. Reporting, Reporting, Reporting – A top priority for CMS, reporting is quite often the most anxiety-ridden element for states.  States need to keep reporting at the top of their minds from the very beginning of the implementation process and build processes and systems that will support accurate and timely collection of data for mandated reports.  Again, each state addresses this differently.  From what we’ve seen, those states that implement a comprehensive database to manage all of the data have the easiest time submitting accurate and timely reports.
3. MFP and Care Transitions Goals Closely Linked – The purpose of both MFP and Care Transitions programs is to successfully transition individuals who choose to live in communities out of institutions.  Given the similarities between the two programs, several states are considering implementing a single system to manage both programs.  Specifically, one system that can track participants in either or both programs that also enables accurate and timely reporting.   By doing this, states can significantly decrease both cost and time required to effectively administer these programs.
4. Scaling Requires Automation – For states that rely on manual, paper-based case management, tracking all the documentation required to successfully manage MFP can be challenging and consumes time and resources better spent on transitioning people back into the community.  States should consider taking advantage of an off-the-shelf system to automate paper-based processes that can be quickly implemented and integrated into business processes.
5. Cross-departmental management may slow progress – MFP was created to assist those with physical disabilities, intellectual or developmental disabilities, the elderly, and others.  This often requires coordination across multiple state agencies and multiple provider agencies, which can slow progress and lead to fewer transitions.  Systems that enhance communications between these agencies will ensure that more people benefit from the MFP program.

Watch this on-demand presentation to learn how states are using technology to rapidly realize the goals of Money Follows the Person.

Actor Noah Wyle, the former star of “ER,” along with 76 members of the grass-roots organization ADAPT (the Americans with Disabilities for Attendant Programs), were arrested this Monday in Washington, DC while protesting proposed cuts in Medicaid – specifically home- and community-based services.

Wyle described his participation in the ADAPT protest as a way “to bring attention to the Medicaid cuts that have been made by many states and are threatened to be made on a federal level.” He and protesters believe that the proposed one-third cut to federal Medicaid spending would reduce home- and community-based services, increasing the need for institutionalization or nursing-home care.

In an interview with CNN, Wyle explained that “to institutionalize a disabled American costs four times as much than to give assistance for independent living. This issue is about civil rights, not about medicine. People who have the ability to live in integrated, affordable and accessible housing should have the right to do so.”

The protesters expressed great concern that they could be destined to rely on nursing-home care due to the shrinking budget for in-home services. “This effort is to end the longstanding bias of the Medicaid system toward institutions and away from community care,” Wyle explained.

To read the full article, visit: http://www.cnn.com/2012/04/23/us/medicaid-protest/index.html

Today we announced OmbudsManager Version 3.0 (OmbudsManager v3.0), an enhanced version of the web-based solution built specifically for nursing home complaint management and federal National OmbudsMan Reporting Systems (NORS) compliance. This new version will enable users to streamline data entry and workflow processes improving user productivity.

New features of OmbudsManager V3.0 include:

• Streamlined data entry and workflow processes
• Enhanced reporting capabilities and filtering
• Enriched User Interface and Usability
• Improved compliance with NORS reporting requirements
• Customer-requested enhancements to application and reports

The Harmony suite of solutions is rapidly becoming the standard for aging services organizations throughout the country. Harmony OmbudsManager is used by over half the state Ombudsman programs in the country for nursing home complaint management.

Learn more about this announcement here.

Today we announced the incorporation of interRAI Instruments into Harmony for Aging and Adult Services SAMS Case Management (SAMS).  This integration will enable our customers to seamlessly leverage interRAI instruments (including the interRAI assessments and algorithms) within their existing workflows to determine eligibility, assess care needs, and create customized care plans.

Through this integration, Harmony will provide our users with an option to incorporate the following interRAI components into their existing workflows directly within the SAMS console:

• interRAI Assessments, including the interRAI Home Care (interRAI HC) and interRAI Community Health Assessment (interRAI CHA),
• interRAI-compliant Data Extract Capabilities
• All 27 Clinical Assessment Protocols (CAPs)/Scales
• Trigger Reports
• Cross-assessment Outcome Reports

interRAI instruments, developed by a global research network, are based on a common language and set of assessment items that are considered to be important in all care settings. By using common measures, clinicians and providers are able to improve continuity of care and integrate care and supports for each individual.

Learn more about this announcement here.

Harmony was pleased to participate in the 2012 Aging Society of America’s – Aging in America Conference last week.

This is a conference we look forward to every year, and with this year’s conference right in our backyard, we were happy to welcome so many customers and friends to Washington, DC.

It’s a highlight of any conference to spend time with so many of our customers at one time.  Thanks to all of our customers for stopping by the booth to say hello.

Below are a few photos from our spot at the conference.

A group of conference attendees taking in a demonstration of Harmony's solutions.

Anthony captivates his audience during a demonstration of Harmony’s Money Follows the Person solution.

A happy Harmony customer

The 2013 Aging in America Conference will be held March 12 – March 16 in Chicago.  We hope to see you all there!

The American Administration on Aging recently released “A Profile of Older Americans: 2011.” The online report examines the demographics of Americans 65 and older. Health and health care, health insurance coverage, caregiving, living arrangements, disability and activity limitations, and income are among the many subject areas explored in the report.

Some notable statistics highlighted within the report include:

• Over one in every eight, or 13.1%, of the population is an older American.
• The population 65 and over has increased from 35 million in 2000 to 40 million in 2010 (a 15% increase) and is projected to increase to 55 million in 2020 (a 36% increase for that decade).
• Almost 3.5 million elderly persons (9.0%) were below the poverty level in 2010. This poverty rate is not statistically different from the poverty rate in 2009 (8.9%). During 2011, the U.S. Census Bureau also released a new Supplemental Poverty Measure (SPM) which takes into account regional variations in the livings costs, non-cash benefits received, and non-discretionary expenditures but does not replace the official poverty measure. The SPM shows a poverty level for older persons of 15.9%, an increase of over 75% over the official rate of 9.0% mainly due to medical out-of-pocket expenses.
• Older women outnumber older men at 23.0 million older women to 17.5 million older men.
• The 85+ population is projected to increase from 5.5 million in 2010 and then to 6.6 million in 2020 (19%) for that decade.

To read the full report, visit: http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2011/docs/2011profile.pdf

In 2011 the first of the baby boomer generation reached retirement age of 65. This milestone has received a lot attention – but the impact that this transition is and will continue to have on caregivers is just now coming into focus.  A recent CNN article reviews the impact that this rapidly growing aging population will have on caregivers.

The U.S. Department of Health and Human Services’ Administration on Aging found that by 2030, the amount of Americans approaching retirement age will practically double. The number of caregivers is sure to rise dramatically as nearly 72 million adults enter retirement.

Adult children are making the inevitable transition into caregivers of their elderly parents. The burden of caregiving can be incredibly stressful and overwhelming. In fact, a survey by the American Psychological Association found that “55% of caregivers reported feeling overwhelmed by the task at hand.” ­­­

In another recent survey, it was found that “Americans caring for aging and chronically ill relatives reported higher levels of stress, poorer health and a greater tendency to engage in unhealthy behaviors to alleviate stress than the population at large.”

Many caregivers devote themselves to their loved ones and end up neglecting themselves as a result. “It’s easy to neglect yourself when you try to be all things to everyone else, but something has to give and it catches up with you,” said caregiver and psychologist Fran Walfish.

Caregivers are often reluctant to ask for help because doing so means admitting that they aren’t able to handle it all on their own. “People feel a lot of pressure, especially in this economy, to not complain or set limits for themselves,” said Walfish. But not asking for help can lead to physical or psychological reactions including heart attack and depression.

Now, more than ever, caregivers need services, such as technology automation, better communication, and support that will allow them to take care of themselves as well as their loved ones.

According to a recent article by The Republic, state officials in Ohio are working to alter the way that health care services are distributed to the 190,000 Ohioans who are both Medicaid and Medicare recipients in order to offer dual eligible individuals a single point of coordination.

Before officials move forward with the proposed changes highlighted in the draft proposal, released Tuesday, January 10, 2011 by Governor John Kasich’s Office of Health Transformation, plans have been made to collect feedback from health care providers, dual enrollees, and relevant advocate groups. They will use this feedback to create a final plan that will then be submitted to federal officials for approval.

Medicaid offers coverage to the poor though state and federal funding, while Medicare supports the elderly and disabled. Medicaid services often include payment for long-term care services, while Medicare will cover costs related to doctor and hospital visits.

Essentially, there is no coordination of care between Medicaid and Medicare. The two systems function independently of each other. According to state officials, insufficient coordination of care has led to “long-term care, behavioral and physical health services being poorly coordinated.” Resultantly, dual eligible individuals end up with worse health outcomes, which inevitably cost the system more.

Greg Moody, Director of Governor Kasich’s Office of Health Transformation, explains that, “As a person moves from one environment to another, there’s nothing about these programs that kind of keeps track of that.”

State officials know that it is this lack of communication that can lead to more costly health services.  For example, “a patient could be discharged from the hospital to a nursing home, instead of less costly, home-based care, because the two programs aren’t talking to each other in the same setting.”

Officials envision the future system operating quite differently. The state will contract with an organization, like an area agency on aging or hospital, to act as a single point of contact. This should help make the system easier to navigate for patients and providers alike.

The initiative will focus on keeping people healthy in addition to treating sickness.

To read more about the proposal in The Republic article, click here.

Effective January 1, 2012, CMS mandated that all HIPAA-covered entities and their business associates were required to switch to HIPAA 5010. Failure to comply with the HIPAA 5010 requirement means agencies and/or providers might not be paid for their services and risk non-compliance penalties from CMS.

Needless to say, this deadline has caused many a sleepless night for many organizations working to be up and running on 5010 before the deadline.

Harmony is pleased to announce that Harmony Financial Management has passed all testing and certification requirements for 5010 HIPAA. Congratulations to all of our Financial Management customers in making the successful transition to 5010 with us!

Congress approved a 2012 budget that leaves many in the aging services community disappointed and concerned about their ability to care for an increasingly aging population with limited funding.  A recent Forbes article, “The Slow Starvation of Senior Services” provides a sobering view of the impact aging services will see as a result of this new budget and highlights the areas in aging services that will take the biggest brunt of the budget cuts (Center for Elder Abuse, the ombudsman program, Meals on Wheels and Eldercare Locator, just to name a few).

The reality we face in this country is that the population is aging at an unprecedented rate.  Services to help this aging population are in greater demand than ever and resources are dwindling.  For aging services organizations, the only way to meet this skyrocketing demand is to secure more funding from different funding sources (a difficult task as funding becomes more and more scarce) and/or to do more with less.

Leveraging technology to automate manual, time-consuming tasks is more important than ever for aging services organizations to increase efficiencies and to provide high quality care to this fast growing demographic.  Leveraging technology solutions that minimize the manual, time-consuming efforts of managing caseloads, service delivery and payment processing will enable organizations to do more with existing resources and meet the demand for high quality long term supports and services.