Proposal Presented for the Master Plan for Aging (#125)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Develop mechanisms for individuals to continue or access consistent medical treatment and medications when entering near term rehabilitation post hospitalization, residential settings, or when admitted to long-term care (i.e., nursing homes).
Justification
Disruptions or changes to medical treatment and medications when patients transfer from the hospital to other near term or long-term facilities or enter residential treatment can have detrimental impact on their health and wellness. Individuals have experienced challenges accessing medications (HIV, cancer, Hepatitis, and addiction related medications, etc.) or lifesaving treatments (i.e., dialysis) entering alternate care facilities, due to payment/insurance issues (i.e., medication carve outs) and other institutional policies or practices.
Full Proposal
Provisions must be put in place to ensure that all individuals entering alternate care facilities must be ensured adequate access to consistent medical treatment and medication.
- Develop a statewide standard of care for all residential, near term and long-term facilities to continue medical care and treatment in collaboration with individuals’ primary care or specialty care external providers.
- Develop universal mechanisms for insurance review and coverage of treatment prior to transfer ensuring consistency of care.
- Review regulatory procedures statewide and mandate that all facilities, by law, may not deny admission or access to individuals based on their healthcare needs.
MPA Council Commentary
This proposal is categorized as infrastructure, and is complementary to 6, Integrate Data and Case Management Systems. Policymakers may reference this proposal during the legislative session, as components of this proposal may require legislative action. Proposed first steps for implementation could include the development of interoperable patient and client record systems. This proposal may result in additional State costs which would need to be considered as part of the annual budget process and subject to the availability of resources.