Long-Term Care Ombudsman Services in Indian Country Louise Ryan, Ombudsman Program Specialist, Office of LTCO Programs Tiffany Yazzie, LTCO Program Coordinator, Inter Tribal Council of Arizona Sondra Everhart, State Ombudsman, New Mexico Teresa Teeple, State Ombudsman, Arizona
Overview Overview Long-Term Care Facilities- A Broad Perspective Overview of the Long-Term Care Ombudsman Program Two State Specific Examples: New Mexico and Arizona Next Steps to Interact with Your Long-Term Care Ombudsman Program
Broad perspective Questions for Dialogue Do you have unmet needs for your tribal members who live in long-term care facilities? Do your tribal members who live in long-term care facilities currently have access to long-term care ombudsman services? Do you have suggestions for how ACL/AoA can support development of culturally competent services to tribal members who live in long-term care facilities?
Long-Term Care Facilities (as defined by the Older Americans Act) nursing facilities, board and care homes (i.e. personal care homes, adult family homes), assisted living facilities, and similar adult care facilities.
What Should Residents & Families Expect? Rights A person does not lose their basic rights when living in a long-term care facility Nursing Home residents have a protected set of rights in federal law Every state has different regulations & laws for board & care, assisted living & similar - your Ombudsman is a great resource to explain the standards
Expectations? (some examples) Residents have the right to be free from abuse and chemical & physical restraints To have a care assessment and plan and to participate in one s own care planning Right to privacy and confidentiality of records Right to choice, participate in the community Worship or practice traditions Protections from illegal evictions (in nursing homes)
Facilities on tribal lands Any Medicaid and/or Medicare-certified nursing facility is required to provide residents with access to an ombudsman A CMS (Center for Medicare and Medicaid Services) requirement At least one tribal facility has been cited recently because residents did not have access to ombudsman services Regardless of the CMS requirement, ACL would like to work with tribes to assure that tribal members have access to culturally competent ombudsman services
Long-Term Care Ombudsman Programs seek resolution of problems and advocate for the rights of residents of long-term care facilities. The goal? Enhancing the quality of life, promotion of rights and ensuring care of residents.
Staff and volunteers Each state has one State Long-Term Care Ombudsman The State LTC Ombudsman has the authority to designate representatives Representatives may be staff or volunteers (and are often called ombudsmen ) Nationally, there are: 1185 FTE staff ombudsmen 9,065 certified ombudsmen volunteers 3,320 other volunteers Source: Administration on Aging, FFY 2011
Current Funding States support their LTC Ombudsman Programs through: Federal -- Older Americans Act funds (Title III, Title VII) and other funds (58%) State funds (36%) Local funds (6%) Extent to which these funds are available to tribes depends on tribal relationship to State. Title VI Tribes may use Title VI funds for ombudsman services, the services are to be substantially in compliance with provisions of Title III (Section 614(a)(9) of OAA).
New Mexico LTC Ombudsman Program 3 AAAs in New Mexico Metro, Non-Metro, and Indian 2 NHs on Tribal Land, no ALFs 3 Adult Day Care Centers on Tribal Land State Tribal Collaboration and Communication Act of 2005
Arizona Tribal LTC Ombudsman Programs 2 Area Agencies on Aging that specifically serve tribal members Navajo Nation Area Agency on Aging Inter Tribal Council of Arizona Area Agency on Aging Need for LTC Advocacy 147 SNFs, nearly 2,000 ALFs off reservation 3 nursing homes and an increasing number of assisted living facilities on tribal lands
Root of Concerns Language Hopi: Hopi & Tewa Pascua Yaqui: Yaqui & Spanish White Mountain Apache: Apache Care Touching Body Washing Clothing Cleaning Rooms Food (Farmed to Foraged) Community (Local News) Family & End of Life Choices Advocacy via Education, Mediation and Interpretation
Next Steps Work with your AoA Regional Specialist around use of Title VI funds for the Long-Term Care Ombudsman Program Contact your State Ombudsman to learn about various opportunities to work with the program Most facilities are required to post ombudsman contact information The National Ombudsman Resource Center (funded by ACL/AoA) has contact information for every State LTC Ombudsman and local entities: www.ltcombudsman.org or 202.332.2275 (phone)
Next Steps Create or expand LTC ombudsman services 1. Measure need for LTC advocacy Tribal members have access to LTC facility to remain on tribal lands Tribal members have to move off tribal lands to access a LTC facility 2. Review requirements of funding source(s), such as reporting: Example: Title VI 1 contact = 1 unit of service 3. Identify types of services that can benefit your tribal members Example: Title VI a) Provide information about problems of resident older Indians b) Investigate and resolve complaints made by or for older Indians residing in LTC facilities 4. Identify possible tribal staff that could deliver the service 5. Identify training needs to help staff deliver services successfully a) Locate local resources on or near tribal lands to provide information and make referrals b) Attend an Ombudsman Training to gain basic skills to investigate and resolve complaints of residents 6. If resources are limited, consider a working partnership with the State Ombudsman Office a) COSTS: Contractual Agreements, information sharing, and expense to support staff salary, training and travel b) BENEFITS: Access Title III and State funds, state/regional network, technical assistance and ongoing training
Discussion Topics with your State Ombudsman Family issues End of life needs and choices Care issues (collaboration between facility staff, physician, Tribal healer) Communication tools
Broad perspective Questions for Dialogue Do you have unmet needs for your tribal members who live in long-term care facilities? Do your tribal members who live in long-term care facilities currently have access to long-term care ombudsman services? Do you have suggestions for how ACL/AoA can support development of culturally competent services to tribal members who live in long-term care facilities?
Contact information: Sondra Everhart Louise Ryan Teresa Teeple Tiffany Yazzie Sondra.Everhart1@state.nm.us Louise.Ryan@acl.hhs.gov Tteeple@azdes.gov Tiffany.Yazzie@itcaonline.com