Proposal Presented for the Master Plan for Aging (#67)
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
Revise assessment, care planning, and direct care worker training infrastructure to reflect person-centered principles. Adjustments will include convening experts to identify the comprehensive needs of long-term care service recipients, engaging local authorities and resources, and updating assessment tools to consider inclusivity and psychosocial needs.
Justification
The scope of practice for the direct care workforce is based on a medical model rather than being person-centered with a focus on the psychosocial needs of consumers. However, person-centered services are critical to enhancing quality of life for consumers of long-term care services. To promote person-centered services, the State must adequately prepare and empower direct care workers utilizing a training infrastructure which emphasizes psychosocial needs and prevention best practices. Integrating social determinants of health and cultural competency into the revised assessment system will ensure that all consumer needs are addressed and will allow consumers to move across the continuum of care without issue. Overall, these actions will improve health outcomes through the promotion of health equity and enable direct care workers to provide enhanced care.
Full Proposal
To promote the delivery of person-centered, equitable services and supports that encourage health, quality of life, and community engagement while also adequately preparing and empowering direct care workers, the State would establish a revised assessment, care planning, and direct care worker training infrastructure emphasizing psychosocial needs of consumers and underlining prevention services.
- Convene industry experts and consumers and/or their representatives across all settings and populations to identify the current and full needs (clinical, psychosocial, safety, other) of those receiving long-term care services.
- Engage the range of state, local, and private sector agencies in addition to community-based organizations to contribute to a plan for meeting consumers where they are and maximize (both cost and programmatic) efficiency in providing person-centered services.
- Revise the current assessment system to reflect person-centered principles and identify all aspects of non-clinical (including psychosocial/Social Determinants of Health) needs of everyone applying for services. Further, implement a universal system that is implemented and facilitates movement across settings and is independent of payment stream.
- Conduct a review of the revised assessment tool and process to ensure full inclusivity – including language access, cultural competence, and potential biases.
MPA Council Commentary
This proposal is categorized as long-term. Components of this proposal are currently being implemented on an ongoing basis. Relevant State agencies could take further steps to continuously evaluate the comprehensive needs of older adults and engage appropriate stakeholders to identify opportunities for integration of care management to advance person-centered care principles.