VA Geriatrics & Extended Care. National Update AGS May 4, 2006. VA GEC. Strategic Planning – GEC, PCS, VHA Budget Marsha Goodwin-Beck Awards Geriatric Research, Education and Clinical Centers (GRECCs) Geriatric Programs – GEM; Geri Prim Care
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AGS May 4, 2006
7. Hospice & Palliative Care
8. Home-Based Primary Care and Medical Foster Home
9. White House Conference on Aging
Strategic Planning: VHA, PCS, GEC
VHA Strategy #1: Continuously improve the quality and safety of health care for veterans, particularly those health issues associated with military service.
Initiative 1.5: Pursue innovations in services to aging veterans that enhance VA capabilities in long-term care, including care coordination and telehealth technologies.
1. Culture Transformation of VA Nursing Home Care Transforming the current culture of nursing home care from a medical model, driven by medical diagnosis and illness, to a person centered culture of care whereby decisions regarding care and treatment involve the resident and are central to the organization and care processes in the nursing home.
2. Enhance access to non-institutional home and community-based services, including care coordination/telehealth. Expand number of VA facilities offering HBPC and MFH, establish a national HBPC satisfaction survey, and conduct national survey to assess hospice and palliative care programs and services.
3. Affirm and support Geriatric Research, Education, and Clinical Centers’ (GRECC) contributions to VHA’s short-, medium-, and long-range plans for addressing the needs of aging veterans. Public Law 96-330 (1980) mandated Geriatric Research, Education and Clinical Centers (GRECCs) to “advance scientific knowledge regarding the medical, psychological, and social needs of older veterans, and the means for addressing them, through: (1) geriatric and gerontological research; (2) the training of personnel providing health care service to older persons; and (3) the development and evaluation of improved models of clinical services for eligible, older veterans.”
4. Align and integrate, where appropriate, chronic care within Geriatrics through a wider care coordination initiative. The VHA definition of Care Coordination is the use of health informatics, Telehealth and disease management to extend and enhance care and case management. The areas of Care Coordination include: General Telehealth (CCGT); Home Telehealth (CCHT); Store and Forward (Teleretinal imaging). The scope of this initiative is to expand care coordination programs, increasing access to specialty care and to non-institutional care across the continuum.
More than $4.3 billion for LTC (increase of $229M)
State Home construction $85 million
State Home per diem $480 million
Excellence in Leadership
Director, St. Louis GRECC
Excellence in Clinical Care Delivery
Nurse Practitioner at Durham VAMC
Updating performance measures
More relevant to VA, VISN, VAMC
Link to strategic plans
Educational, clinical projects
Monthly CME-accredited audioteleconference series beginning 7/06
Annual Reports and Summary Report available at http://vaww1.va.gov/grecc/page.cfm?pg=66
New “Special Fellowships”
All GRECC eligible
Open to non-MDs and non-geriatrician MDs
Request for eligibiilty for NIH Loan repayment Program
Average Daily Census
# of veterans served with v66.7 code
“6 of 9 H&CBC programs at all facilities”
Partnership of Foster Care with HBPC
Alternative to nursing home placement for
- dependent, chronically ill, or terminally ill veterans
- unable to live independently, and
- prefer a family setting for their long-term care.
Average age: 72yrs; Number of major problems: 8
Prominent Dx: Dementia, CVA, Heart Disease, COPD
All eligible for nursing home care
VA finds caregivers; provides oversight and HBPC
Foster care costs – paid by veteran, from VBA
Eligible veterans who:
VA GEC Update
Resolution 48: Ensure Appropriate Recognition and Care For Veterans Across All Healthcare Settings.
Resolution 42: Promote Innovative Models of Non-Institutional Long-Term Care
Resolution 40: Attain Adequate Numbers of Healthcare Personnel in All Professions Who are Skilled, Culturally Competent, and Specialized in Geriatrics.
Resolution 32: Evaluate Payment and Coordination Policies in the Geriatric Healthcare Continuum to Ensure Continuity of Care.
Resolution 34: Improve The Health And Quality Of Life Of Older Americans Through Disease Management And Chronic Care Coordination.