2.50
Hdl Handle:
http://hdl.handle.net/10755/157975
Type:
Presentation
Title:
Community-Based Long-Term Care Services: The Kupuna Care Experience
Abstract:
Community-Based Long-Term Care Services: The Kupuna Care Experience
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Pierson, Charon, RN, PhD, GNP-BC, FAANP
P.I. Institution Name:University of Hawaii Dept of Geriatric Medicine
Title:Assistant Professor
Contact Address:347 N Kuakini St, Hale Pulamamau-9, Honolulu, HI, 96817, USA
Contact Telephone:808-523-8461
Purpose:/Aims: The Executive Office on Aging (EOA) is the designated state agency in Hawaii that receives federal funds through the Older Americans Act as well as additional state funding for serving vulnerable, community-dwelling elders. Through partnerships with the 4 county Area Agencies on Aging (AAA), both federal and state funds are administered to provide designated services. The purpose of this exploratory study was to gather descriptive data through the use of interviews and focus groups on the 4-year pilot project of an EOA-mandated program (called Kupuna Care) of state funding to provide 8 basic home and community-based services for frail elders. Rationale/Background/Conceptual Framework: Between 1990 and 2002, the Centers for Medicare and Medicaid reported an increase in Medicaid spending for non-institutional care from 13.3% to 30.2%, which is reflective of society's shift toward a desire for active, independent living and less restrictive care options. The 1999 Olmstead decision by the Supreme Court provided impetus to this movement; state and federal programs responded by redirecting funds towards support of community-based services. This study builds on previous work by the author that evaluated perceived needs for, access to, and utilization of long-term care services among groups of ethnically diverse seniors and a variety of case managers in Hawaii. This prior research raised some of the questions addressed in this current study related to point-of-entry, dissemination of information, and local governments' assessments of communities' needs. Methods: A total of 9 focus groups and 12 individual interviews (total of 75 people) were conducted with employees of EOA and county AAAs and contracted providers with responsibility for implementing the Kupuna Care pilot program. Recordings of the interactions were transcribed and analyzed using content analysis and additional official documents related to the program were consulted for support and clarification. Results: Six major themes emerged as problem areas: administrative issues within the EOA; administrative issues within AAAs; interagency issues; policy issues; funding issues; and service issues. An underlying theme permeated the majority of interactions related to the "top-down" administrative approach of Kupuna Care. Most participants discussed the solutions to the problems raised in terms of a "culture change" at all levels from providers to the federal government. Implications: This study reinforces the need for comprehensive assessment and planning and rational decision-making in order to provide needed services for seniors, in light of the current fiscal and demographic imperatives faced by federal, state, and local governments. The current climate of consumer-directed programs and consumer demand for alternative care options requires greater collaboration among government and private enterprise. Fundamental issues of trust and collaboration need to be addressed from the outset in order to assure successful programs to serve the growing population of elders.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCommunity-Based Long-Term Care Services: The Kupuna Care Experienceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157975-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Community-Based Long-Term Care Services: The Kupuna Care Experience</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Pierson, Charon, RN, PhD, GNP-BC, FAANP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Hawaii Dept of Geriatric Medicine</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">347 N Kuakini St, Hale Pulamamau-9, Honolulu, HI, 96817, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">808-523-8461</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pierson@hawaii.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose:/Aims: The Executive Office on Aging (EOA) is the designated state agency in Hawaii that receives federal funds through the Older Americans Act as well as additional state funding for serving vulnerable, community-dwelling elders. Through partnerships with the 4 county Area Agencies on Aging (AAA), both federal and state funds are administered to provide designated services. The purpose of this exploratory study was to gather descriptive data through the use of interviews and focus groups on the 4-year pilot project of an EOA-mandated program (called Kupuna Care) of state funding to provide 8 basic home and community-based services for frail elders. Rationale/Background/Conceptual Framework: Between 1990 and 2002, the Centers for Medicare and Medicaid reported an increase in Medicaid spending for non-institutional care from 13.3% to 30.2%, which is reflective of society's shift toward a desire for active, independent living and less restrictive care options. The 1999 Olmstead decision by the Supreme Court provided impetus to this movement; state and federal programs responded by redirecting funds towards support of community-based services. This study builds on previous work by the author that evaluated perceived needs for, access to, and utilization of long-term care services among groups of ethnically diverse seniors and a variety of case managers in Hawaii. This prior research raised some of the questions addressed in this current study related to point-of-entry, dissemination of information, and local governments' assessments of communities' needs. Methods: A total of 9 focus groups and 12 individual interviews (total of 75 people) were conducted with employees of EOA and county AAAs and contracted providers with responsibility for implementing the Kupuna Care pilot program. Recordings of the interactions were transcribed and analyzed using content analysis and additional official documents related to the program were consulted for support and clarification. Results: Six major themes emerged as problem areas: administrative issues within the EOA; administrative issues within AAAs; interagency issues; policy issues; funding issues; and service issues. An underlying theme permeated the majority of interactions related to the &quot;top-down&quot; administrative approach of Kupuna Care. Most participants discussed the solutions to the problems raised in terms of a &quot;culture change&quot; at all levels from providers to the federal government. Implications: This study reinforces the need for comprehensive assessment and planning and rational decision-making in order to provide needed services for seniors, in light of the current fiscal and demographic imperatives faced by federal, state, and local governments. The current climate of consumer-directed programs and consumer demand for alternative care options requires greater collaboration among government and private enterprise. Fundamental issues of trust and collaboration need to be addressed from the outset in order to assure successful programs to serve the growing population of elders.</td></tr></table>en_GB
dc.date.available2011-10-26T20:23:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:23:12Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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