2016 Quarter 1 Managed Care Ombudsman Program Quarterly Report

he Managed Care Ombudsman Program provides various services including education and information regarding managed care plans, services, care and processes, advocacy and outreach on behalf of members, and appeals assistance and complaint resolution for members needing assistance with resolving issues with their managed care plan or navigating the managed care system. This report provides an update on the following items for the first programmatic quarter (April, May and June 2016): • 1st Quarter Overview • Systemic Trends • Community Partnerships and Outreach • Managed Care Ombudsman Program Administrative Update

Dependent Adult Abuse A Guide for Mandatory Reporters, July 2009

“Dependent adult” abuse allegations involve people who are aged 18 or over and are incapable of adequate self care due to physical or mental conditions and require assistance from other people. Dependent adults may be elderly or may have diminished physical or mental capacities that prevent them from meeting their own needs adequately. Researchers estimate that only 1 in 14 incidents of elder abuse actually come to the attention of law enforcement or human service agencies. Elder abuse is one of the most under-recognized and under-reported social problems in the United States. It is far less likely to be reported than child abuse because of the lack of public awareness. Nationally, it is estimated that over 55% of elder abuse is due to self-neglect. Such abuse can happen anywhere … in private homes, at health care facilities and in the community at large. Iowa has an increasing proportion of people who are aged 60 or over. The number of persons 80 or over is increasing more rapidly than any other age group. Iowa’s proportion of older adults in the population exceeds that of the United States as a whole.

The Role of the Long-Term Care Ombudsman, May 28, 2015

Explanation of the role of the Long-Term Care Ombudsman in Iowa

Rights of Residents in Long-Term Care Facilities, May 19, 2015

Explanation of the rights of resident in Long-Term care facilities.

Right of Long-Term Care Residents/Tenants to Participate in Research Studies, November 12, 2015

Explanation of the right of Long-Term Care residents or tenants to participate in research studies. Includes the guidelines for participation.

Office of the State Long-Term Care Ombudsman Visitation & Powers of Attorney memo, February 25, 2013

Explanation of residents' & tenants' rights & Durable Power of Attorney for Health Care

Long-Term Care: An Emotional Journey for Family Members, May 18, 2015

Explanation of moving a loved one to a long-term care facility. Fact sheet designed to discuss some of the common emotions a caregiver may experience when moving a loved one into a long-term care facility & provide some suggestions for dealing with those feelings

Health Care Power of Attorney FAQ, May 28, 2015

Health Care Power of Attorney questions and answers on common questions.

Sexual Expression among Long-Term Care Residents, September 27, 2013

Sexuality among the aging traditionally been overlooked. It is gaining recognition as an important factor in lives of older adults and part of the aging process. Preserving residents' right to freedom of sexual expression in the long-term care environment is important part of the resident-centered care & residents' rights

Minimum Data Set (MDS) Section Q Education: Helping People Return to the Community, February 12, 2014

Explanation of Minimum Data Set (MDS), implementation of Section Q, overview of the program, local contacts and functions, Referral Agency information, role and assistance provided by Long-Term care Ombudsman

Health Care Power of Attorney FAQ, May 30, 2013

Information regarding questions and answers for Health Care Power of Attorney

The Advocate E-Newsletter, January 5, 2016

Although only a fraction of Iowans are Medicaid members, the changes coming to Iowa’s Medicaid system have the potential to significantly impact all Iowans, especially those who are dependent on others for care or assistance with daily activities. That’s because Iowa’s ability to transition to managed care is contingent upon ensuring that Medicaid members have an advocate when it comes to protecting their rights, health, safety and quality of care. Managed Care Ombudsman Program prepares to advocate for Iowa's Medicaid members. Iowa's Office of Substitute Decision Maker provides education, assistance.

Office of State Long-Term Care Ombudsman Map, December 16, 2014

Local Long-Term Care Ombudsman county coverage

Long Term Care: an Emotional Journey for Family Members, January 16, 2013

Many times, moving a loved one into a long-term care facility is a true act of love and unselfishness. If the caregiver and the care recipient cannot leave the house, you have both become very isolated. Imagine mom being able to go outside her door to find someone to talk with. There are activities, meals to be shared with friends, and a barrier free area where she can roam.

Office of the State Long-Term Care Ombudsman: Role in Involuntary Discharges, November 25, 2014

Iowa law requires that a copy of the Notice of an Involuntary Discharge action given to residents of nursing facilities or residential care facilities also be given to the Office of the State Long-Term Care Ombudsman. In addition, the law requires that a copy of the Notice of an Involuntary Transfer/Eviction action given to tenants of an elder group home or assisted living program also be given to the Office of the State Long-Term Care Ombudsman.