Healthy-Aging-in-Colorado-Infographic-high-resolution1

Colorado VNA’s Role In Colorado’s Growing Senior Population

By Chris Lee, President and CEO

The State of Colorado is grappling with one of the fastest growing older adult populations in the country. The Colorado State Demography Office estimates [that the] “aging of the younger population, especially the ’Baby Boomers’ …, is forecast to increase the population over 65 by 150% between 2010 and 2030.”[1] The numbers will grow from 550,000 people over 65 in 2010 to 1.2 million in 2030.

Healthy-Aging-in-Colorado-Infographic-high-resolution2

Fortunately, Colorado is not leaving future administrations to deal with the challenges. Our State has created the Strategic Action Group on Aging, in addition to other initiatives, to get out in front of aging-related challenges. The Group’s initial ideas on how to address the challenges associated with a rapidly aging population are detailed in the Colorado Aging Framework, which includes 10 distinct goals that the State aims to achieve. Colorado VNA is a leading partner in the efforts to support the needs of older adults. We are evolving existing services and creating deep partnerships with a variety of stakeholders to position ourselves as a critical provider of older adult services.

In particular, three of the Aging Framework goals directly relate to our work:

  • Goal 3: Strengthen support systems and environments that enable individuals to remain in their homes and communities as they age.
  • Goal 5: Support health care programs and services that provide a continuum of care to Colorado citizens as they age to give individuals the right services at the right time.
  • Goal 7: Promote support for caregivers, including family caregivers, to support citizens as they age

Goal 3 articulates several strategies that are focused on strengthened supportive services for older adults so that they can remain in their homes and communities, one of which “make home-maker services available to support individuals’ ability to remain in their homes as long as possible” is superbly aligned with our current work. Just this past week, I traveled with one of our Certified Nursing Assistant (CNA), Dennis, to visit two of our veterans in their homes. Dennis visits each of these patients several times a week to help with bathing, ensuring that the care plan is implemented, and providing patient and family support. In addition to Dennis, Colorado VNA provides homemakers for these two patients as well. Our homemakers help the patients and families keep their homes clean and safe while also helping with laundry and other household tasks, activities that many of us take for granted even as our ability to conduct them declines with age. Goal 3 seeks to implement similar support functions for those individuals that may not have the resources to pay for private-pay homemakers and/or CNA services. The Denver Regional Council of Governments (DRCOG) has long funded Colorado VNA to provide homemaker services to low-income and vulnerable adults, and Goal 3 seeks to provide even more support to DRCOG and ultimately Colorado VNA.

Senior Living Conditions in Colorado

Goal 5 takes Goal 3 further by identifying strategies to more closely connect homemaker services that are supported by DRCOG to primary care providers. Both of the patients I visited are veterans, and the VA has long understood the importance of connecting skilled nursing and therapy care with paraprofessional care while under physician supervision. Goal 5 seeks to create the same connections between the primary care community and the long-term services and supports (LTSS) community. Additionally, Goal 5 provides direction to study the connection between LTSS and decreasing overall healthcare cost. In summary, the State hopes to answer the question: Do the homemaker services Colorado VNA provides decrease overall healthcare spending, and if so, by how much? To this end, I have been appointed to a guiding committee that will help implement the study that will answer this question.

Healthy-Aging-in-Colorado-Infographic-high-resolution4 smallaAnd finally, Goal 7 seeks to provide more financial support and training for family caregivers as well as other non-family caregivers. Those of you who have cared for an elderly parent know just how difficult, time-consuming, and stressful it is to provide the necessary care to keep your loved one in the home, especially if you must also work outside the home to earn a living.  Goal 7 seeks to find ways to provide more support and guidance for family and friend caregiving. Though not an area we are currently operating within, Colorado VNA has the capabilities to train caregivers, as well as the necessary clinical oversight, to be a viable part of the solution for an expanded family- and friend-based caregiving network. In addition to supporting family caregivers, Goal 7 also acknowledges the need for more expansive wellness services for the elderly, services like our Senior Medical Foot Care run by our Wellness Division.

 

As you can see, there is much change in the aging landscape in Colorado. Thanks to the innovative and compassionate care of our staff, Colorado VNA is well positioned to be a part of an expanded Colorado strategy to respond to a dramatically growing elderly population.

 

 

 

[1] Department of Local Affairs, State Demography Office, July 2012, page 1

 

 

 

Colorado VNA Home Health CareUpdated Services Map

Better Together: Colorado VNA and RVNA Merge Operations, Expand Services

Colorado VNA logo

               Contact:  Kim Howard
                             (303) 698-6517      howardk@vnacolorado.org

 

FOR IMMEDIATE RELEASE

 

Colorado VNA and RVNA Merge Operations, Expand Services

 

April 12, 2016 (Denver, Colorado) – Colorado Visiting Nurse Association (Colorado VNA) and the Rehabilitation & Visiting Nurse Association (RVNA) announced today that they will be merging their two nonprofit organizations as of May 1st  to achieve greater efficiencies while expanding capabilities and services. The decision was unanimously approved by both agencies’ board of directors after several months of negotiations and due diligence.

Both Colorado VNA and RVNA have provided excellent care for decades, and in Colorado VNA’s case for well over a century. Yet the rapidly changing healthcare environment and emergence of large-scale health systems and insurance companies is driving a need for equally large and better clinically-integrated home health agencies.
“Combining Colorado VNA and RVNA into one agency will provide economies of scale in home health not previously seen in Colorado. Together, Colorado VNA and RVNA will create the network and services required to be successful in the changing, and more complex, healthcare landscape,” states Colorado VNA CEO, Chris Lee.

 

Adds RVNA CEO Lori Follett of the merger, “Although RVNA has sustained itself for almost 37 years, this merger will help take our organization to the next level in terms of being able to attract and retain more staff with better pay and benefits as well as operate more efficiently and better serve our clients with technology improvements.”

 

RVNA clinical operations and leadership will remain in the Greeley area, while administrative functions migrate to the Denver headquarters. Patients across the Front Range will benefit from organizational synergies and from a shared commitment to provide the highest quality and most compassionate care.
 
About Colorado VNA
Colorado Visiting Nurse Association (Colorado VNA) is a nonprofit, Medicare-certified home health organization founded in 1889. Its mission is to provide a continuum of health care in the home and community that supports optimal well-being, independence, and dignity. In 2015, Colorado VNA provided more than 220,000 home and community health and wellness touchpoints. The organization’s comprehensive array of health services spans all levels of intensity of care for individuals, communities, and businesses. Colorado VNA has also developed innovative community programs to help seniors age-in-place. For more information, visit www.VNAColorado.org.

 

About RVNA

RVNA, a nonprofit, community-based homecare agency, has been serving Northern Colorado since 1979. RVNA’s mission is to provide exceptional family-centered and compassionate home care solutions to the residents of Larimer and Weld counties, regardless of one’s ability to pay. For more information, visit www.rvna.info.

Moving from home care to home-based services

Photo courtesy of Gretta Blankenship

Photo courtesy of Gretta Blankenship

It’s time to change what we call ourselves…move from thinking of the Colorado Visiting Nurse Association (VNA) as a “non-profit home health care agency” to a “non-profit organization that provides home-based services”. This may seem like a small distinction, but it there are three reasons we should make this change:
1) “Home health care” agencies are defined by outdated Medicare regulations specifically focused on controlling home care as a way to decrease fraud and abuse within a fee-for-service payment environment.
2) Second, there is very little government and/or insurance company reimbursement for para-based services focused on helping patients remain independent in the home.
3) Further, there is very little coordination of care across our various divisions because of the differing ways we are paid for care that we provide.

The Colorado Visiting Nurse Association has begun to think differently about the care we provide as healthcare transitions from a fee-for-service (FFS) payment system to one where healthcare organizations are paid for overall care and health outcomes.
Currently there are many differences between the care provided by each of our home-focused divisions; home health, paraprofessional home services and hospice/palliative. Care provided by our home health professionals is mostly regulated by Medicare and requires patients to be “home-bound” and have a documented needed for care provided by an RN, PT, LPN, etc.

By definition, paraprofessionals are workers who are not qualified or licensed to serve in particular professions but who handle tasks in support of qualified professionals in those fields. Paraprofessionals often work alongside fully qualified professionals, but they also sometimes work more independently, such as in the case of the health care paraprofessionals who provide home visits to the disabled, ill or elderly.

Care provide by paraprofessionals is more proactive in nature and is provided to help patients remain independent in the home, e.g., bathing, shopping, house-keeping, getting in and out of bed, etc. Hospice visits for appropriate patients are similar to home health visits in that hospice patients have to meet strict criteria for admission, i.e. patients must have a terminal diagnosis and patients must have a prognosis of having less than six months to live.

As one can see, there is a big barrier between the care provided by paraprofessionals and home health and hospice; the barrier has to do with the strict Medicare definitions put in place to help decrease overuse and abuse of skilled home health. Bottom line: the way home health services are reimbursed in our country is too focused on decreasing costs and abuse, rather than on improving care for patients.

The good news is that the old ways of paying for the care we provide are beginning to change as Medicare begins to move to paying for the value provided in the home, rather than just for an episode of care. Here is an excerpt taken from the recent U.S. Department of Health and Human Services Report to Congress: Plan to Implement a Medicare Home Health Agency Value-Based Purchasing Program. The report details a summary of Medicare’s view of the problem of fraud, as well as the limited connection between payments and quality of care.

“…the Medicare Payment Advisory Commission (MedPAC), the Office of the Inspector General, the General Accounting Office (GAO), and other stakeholders have raised significant concerns with fraud and abuse in the Medicare home health benefit. While the benefit is designed to encourage teams of skilled professionals to provide patient-focused care to homebound beneficiaries, there is growing concern that the existing payment system does not provide the necessary incentives to provide such high quality patient focused care.”

There is a lot that is changing in healthcare. Care provided in the home is fast becoming of vital importance to improving the health of populations of patients.

– Christopher Lee, Colorado VNA President & CEO, July 13, 2015

New CEO Chris Lee talks to first day at Colorado VNA

My first day at Colorado Visiting Nurse Association

By Christopher Lee, President & CEO

And so begins an exciting new phase in my career…my new role as President and CEO for Colorado VNA. I have been blessed with many exciting opportunities in my career and this one ranks as the most exciting. I am just finishing up my position as General Manager for SCL Home Health Solutions (SCLHHS), which is SCL/Exempla’s home health company. It has been a challenging position, but one that has provided a significant perspective on the complexities of running a mission-based home health organization. I have also learned a lot about the importance and power of partnering with hospitals and payers in order to provide integrated care across the continuum. As I am sure many of you know, health systems and payers have not always thought of non-facility-based care as an important part of the care continuum! Things have changed!

Prior to SCLHHS I was in charge of business development for Good Samaritan Medical Center in Lafayette where I was responsible for helping the hospital grow by expanding and improving various service lines. In addition to business development I ran the medical imaging department for over seven years and was part of the original leadership team that opened the hospital in 2004. It was at Good Samaritan that I learned from some amazing leaders and role models, specifically Beth Forsyth (COO) and Dave Hamm (CEO). Beth and Dave taught me numerous lessons about leadership and the importance of listening to front line and supervisory staff as a way to improve care for patients and increase staff satisfaction. I also spent a lot of time working on and leading performance improvement projects across the hospital. These projects were focused on improving the efficiency and performance of processes in order to make care for patients safer and more efficient.

Throughout my career I have had the support of a wonderful wife and my 12 year old twin boys and 9 year old daughter. They all keep me busy outside of work and fortunately have helped provide work-life balance.  Being able to help drive the kids back and forth between baseball, soccer, track and other various activities keeps me extremely busy outside of work. In addition to family activities I do enjoy taking advantage of what Colorado has to offer by spending time on the trails and roads on my bike as well as logging some miles running to stay in shape. We live in a beautiful place and exploring on foot or on wheels provides a significant amount of inspiration for me to do my best at work.

I hope the above has provided a brief summary of my background and an overview of the perspective I bring to CVNA. I also invite you to see the press release about my new role as additional reference.

Stay tuned for more posts in the future!