Ombudsman Partnership with Legal Services: Advocating for Long Term Care Resident Rights
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1 Ombudsman Partnership with Legal Services: Advocating for Long Term Care Resident Rights Lindsay Heckler, Staff Attorney/Legal Liaison Region 15 LTCOP Center for Elder Law & Justice Lisa Newman, Program Director Region 15 LTCOP People Inc.
2 Overview Agenda Center for Elder Law & Justice NYS Long Term Care Ombudsman Program (LTCOP) Region 15 LTCOP The Partnership Benefits and Framework for Growth
3 Who we are: Center for Elder Law & Justice Non-profit civil legal services agency, providing free legal representation in eight WNY counties. Most of our services are limited to seniors (60 years of age and older), but some of our services are available to disabled and low income individuals as well. Mission: To improve the quality of life for our clients through the provision of free legal services. Primary goal is to use the legal system to assure our clients may live independently and with dignity.
4 Long Term Care Ombudsman Program (LTCOP): Overview Established in all states under the Older Americans Act. NY: Office for the Aging State: NYS Ombudsman; Assistant State Ombudsmen, Legal Counsel. Local: 15 Programs, led by program coordinators employed by the region host agency. Region 15: Cattaraugus, Chautauqua, Erie, Niagara Hosted by People Inc.
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6 Hierarchy of NYS LTCOP Congress Administration on Aging State Ombudsman Claudette Royal Program Coordinators Region 15: Lisa Newman Ombudsman Volunteers
7 Mission: LTCOP Overview (Cont.) To protect the health, safety, welfare, human and civil rights of people living in nursing homes and adult care facilities. Philosophy: Resident focused advocacy. Resident is always considered the client regardless of who contacts the program. The certified ombudsman will assist, represent, and intervene on behalf of the resident only with the resident s permission.
8 LTCOP Responsibilities Identify, investigate and resolve complaints made by or on behalf of residents. Provide information to residents about long-term care services. Provide technical support for development of resident and family councils. Advocate for changes to improve residents quality of life and care. Represent resident interests before governmental agencies. Seek legal, administrative, and other remedies to protect residents. Systems change agent.
9 The Ombudsman-Legal Services Partnership Human Services Agency Legal Services Agency
10 Legal Liaison Referrals to CELJ Referrals to Region 15 LTCOP (and other LTCOP regions) Guidance and Research Support: Region 15 LTCOP Staff Region 15 Volunteer Ombudsmen Residents, family, supporters Training: Region 15 in-service presentations New ombudsman certification training presentations Facility training and presentations Legislative Advocacy
11 Region 15 LTCOP Referrals to CELJ Health Care Advocacy Medicare/Medicaid: coverage denials, fair hearings Discharge/transfer appeals Elder Abuse Prevention Financial abuse Consumer Protection Debt matters Scam prevention/recovery Income Maintenance Social Security Overpayments Representative Payee Substituted Decision Making Power of Attorney Health Care Proxy
12 CELJ referrals to Region 15 LTCOP Direct linkages enable full service and promote efficiency. Legal liaison completes Region 15 LTCOP intake/ombudsman request form. Referrals come from many units: Health Care Housing Elder Abuse Prevention Consumer Income Maintenance
13 Systems Advocacy: Educational Initiative 2 Initiatives and Why: 1. Resident Self-Determination/Health Care Proxy Law It is only when the resident lacks the capacity to make health care decisions the health care proxy is activated. Why? Ensure residents have a voice in care. 2. Jimmo There is no improvement standard for Medicare nursing home coverage. Why? Ensure residents have access to care and access to legal assistance.
14 Resident Self-Determination/Health Care Proxy Law Situation: Resident wanted to return home. Resident s health care agent determined it was not safe. Nursing home ignored wishes of the resident; listened to agent. Resident requested new health care proxy. CELJ-Region 15 LTCOP Partnership: Legal Liaison explained the NYS Health Care Proxy Law and steps nursing home must take to trigger the health care proxy to the ombudsman. Legal Liaison supported ombudsman in explaining the law to Social Work and Physician. Ombudsman continued work to ensure staff listened to the resident and efforts were made to prepare for a safe discharge to the community. Legal Liaison connected the resident to the Substituted Decision Making unit.
15 Jimmo: No Improvement Standard for Medicare Coverage Situation: Nursing home states to resident/family therapy services will be cut off because Medicare will not pay for it. The provider uses phrases such as plateau or not showing improvement. CELJ-Region 15 LTCOP Partnership: Goal: keep therapy going! CELJ: ombudsman (and facility) training on the Jimmo settlement. Ombudsman: works with facility to keep therapy going or to get it re-started. CELJ: handles the Medicare appeal.
16 PILOT: Coordinated Ombudsman Response Effort (CORE) Week long Region 15 LTCOP observation of a nursing home utilizing multiple ombudsmen on different days/times. Goal: Improve resident quality of care and quality of life in CMS Nursing Home Compare 1-star nursing homes. How: Increase ombudsmen presence at the nursing home; Identify systemic concerns through a weeklong observation and intake individual resident complaints; Meet with nursing home management to discuss findings; Conduct periodic follow-up visits to the nursing home to verify whether systemic issues are being addressed.
17 The Partnership Promotes Advocacy Identify, investigate and resolve complaints made by or on behalf of residents. Provide information to residents about long-term care services. Provide technical support for development of resident and family councils. Advocate for changes to improve resident quality of life and care. Represent resident interests before governmental agencies. Seek legal, administrative, and other remedies to protect residents. Systems change agent.
18 Forming Partnerships with Legal Services Organizations Partnerships benefit the client! CELJ-Region 15 LTCOP (People Inc.): successful through resource sharing. If unable to enter such a contract, still form the partnership! The partnership may not be as involved, but it is still beneficial. New CELJ Helpline for Monroe, Livingston, & Steuben Counties! Monday through Friday: 9am-11am (844) ; elderjusticeny.org/helpline Free advice on health insurance, consumer credit, powers of attorney, housing, income benefits and more!
19 NYS LTCOP Claudette Royal: State Ombudsman NYS Office for the Aging 2 Empire State Plaza, Albany, NY Contact Information Region 15 LTCOP: Cattaraugus, Chautauqua, Erie, Niagara Lisa Newman: Region Coordinator People Inc. (Host Agency for Region 15 LTCOP) Center for Elder Law & Justice Lindsay Heckler, Staff Attorney/Legal Liaison Region 15 LTCOP x 212 lheckler@elderjusticeny.org
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