February 1, 2016

A Note from the State Long-Term Care Ombudsman:

Last week, pursuant to Iowa Code 231.42, the Office of the State Long-Term Care Ombudsman (OSLTCO) released its Annual Report for Federal Fiscal Year 2015 (Oct. 1, 2014 - Sept. 30, 2015). The report includes information about the programs and activities of the OSLTCO, as well as some fascinating statistics about Iowa's 52,000+ long-term care residents and tenants.

During the reporting period, the OSLTCO visited more than 19,000 individuals living in long-term care facilities while investigating complaints. Most concerns were related to resident/tenant care, but complaints about autonomy/rights, admission/discharge/transfers and financial concerns/lost or missing property were also common. A total of 667 new cases were opened in FFY 2015.

Representatives from the OSTLCO also worked to provide nearly 9,000 hours of advocacy beyond complaint handling in FFY 2015, while Volunteer Ombudsmen stationed at 122 nursing facilities throughout Iowa provided 3,849 hours of service worth $83,716.

Altogether, the Office and its partners clearly made significant strides toward protecting the health, welfare, safety and rights of Iowans residing in long-term care in FFY 2015, and I anticipate we'll make even more progress in 2016 as we expand programming and outreach to reflect the OSLTCO's newly appointed role as advocate for Medicaid managed care members. As always, your assistance and local advocacy efforts help make this work possible, and we appreciate your continued support as we strive to enhance quality of life and care for some of Iowa's most vulnerable populations.

Deanna Clingan-Fischer, JD

Rethinking our role: How last session's legislative mandates are influencing the work of the OSLTCO today

Following the 2015 Iowa legislative session, the Office of the State Long-Term Care Ombudsman (OSLTCO) was directed to expand its scope of responsibilities to help the State better provide advocacy services to health care consumers. 

Taking into consideration the OSLTCO's substantial experience of working to improve the quality of life and care for residents of nursing and residential care facilities, as well as for tenants of assisted living programs and elder workgroup homes, the legislature appointed the Office to serve as the advocate for approximately 57,000 Iowans who receive Medicaid and live in an institutional setting or are covered by one of Medicaid's seven home and community-based services waivers.

Although the State is not scheduled to transition to Medicaid managed care until at least March 1 (pending CMS approval), the OSLTCO has already hired two staff members to oversee the Managed Care Ombudsman Program and has begun to offer information and advocacy services to Iowans in transition, providing unbiased assistance with questions about coverage and issue resolution. When the state fully transitions to a managed care model, the Managed Care Ombudsman Program will also connect Medicaid members to Iowa's legal resource network and help them file grievances and appeals or to request fair hearings.

A second task assigned to the OSLTCO was to lead a workgroup of agencies and consumer organizations to develop a proposal for a Health Consumer Ombudsman Alliance - a statewide consumer assistance program that would provide unbiased information and assistance to Iowans attempting to navigate the complex Medicaid system, obtain and understand coverage, access health services and resolve problems. The workgroup’s Final Report was sent to lawmakers and the Governor in December and detailed five recommendations:

1. Establish a Health Consumer Ombudsman Alliance;
2. Develop a Medicaid Managed Care Information Program;
3. Implement a Statewide Single Point of Entry;
4. Expand the Managed Care Ombudsman Program; and
5. Expand the Current Legal Assistance Network

The legislature has already begun work on the recommendations and we will continue to share updates as they become available. For additional information, please call (866) 236-1430.

Resident-to-Resident Elder Mistreatment in Nursing Homes: Findings from the First Prevalence Study

(2-3:30 p.m., CST)

This webinar, hosted by Consumer Voice in collaboration with the National Center on Elder Abuse (NCEA), will discuss the prevalence of resident-to-resident mistreatment in nursing facilities and teach participants how to identify, prevent and respond to these incidents. The presentation will also provide resources, advocacy tips and information about how individualized care is critical to preventing and responding to resident-to-resident mistreatment.

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