Service diversification with a friendly PR twist
Combining referrals, assessments, training
Three years after its formation, one provider's unique spinoff is a booming community resource. Pittsburgh area-based South Hills Health System's senior services division provides an array of programs for seniors, their caregivers, and families, including resource referrals, networking forums, support groups, and education and exercise classes.
More than a hospital-feeding referral system, the division's database houses information on about 500 area providers. More than 9,000 individuals have received information about community resources ranging from independently employed personal caregivers to nursing homes, at no charge to themselves or listed providers.
Donations and grants fund the programs
Formed at the direction of South Hill's board of directors and initially funded by the system, South Hills' senior services now operates with combined employee and community donations and grant monies.
Without similar support, replicating all South Hills' services could be challenging. However, providers may develop program elements using both similar and new funding mechanisms, says Ellen Balber, director.
"Our board of directors wanted to do something for the elderly in our community. We held focus groups of business [leaders], religious [groups], and residents in the community. We discovered there were plenty of services, but seniors didn't understand or know the cost or how to access [the services]," says Balber. "People wanted to know who did what, where," she adds.
The key elements of the program are as follows:
· Community referral database.
South Hills' multicomponent response to its research started with a community referral database. Its goal: to quickly provide callers with specific information about community resources. Seniors or family members place one call to learn of programs and services that address their particular needs.
South Hills uses a different approach to obtain resource information. Rather than receiving written survey responses or conducting telephone interviews, provider relations representatives visit all database-listed providers to obtain detailed information about their services. Their visits garner data not normally provided in a telephone referral service. For example, in addition to providing a nursing home's location, bed capacity, staffing, and rates, the database includes a physical description of the facility and grounds.
Balber carefully points out that the site visit is not a credentialing process. "We include anyone with appropriate credentials and licensure. [The health system's] competitors are our collaborators," she adds.
Problem providers are removed from system
Most database categories have at least three providers, and in most instances, callers receive three or more referrals for each request. Still, South Hills does follow-up on complaints and "removes problem people from the registry," Balber notes.
· Referral user registration.
South Hills registers callers to ensure the referral service works, helping people receive services they really want, says Balber. Within seven days of a routine request for information, a South Hills staff member contacts each caller to assess their satisfaction with both South Hills and the referred service. South Hills does not require registration; it will provide information to any caller, but most people register, she notes.
· In-home needs assessment.
Getting the service you want is difficult if you are not certain or cannot precisely articulate what you need. Recognizing that many times elderly people and their families know they need help but are unable to define their needs, South Hills conducts in-home assessments for some callers. About one-third of registered callers eventually receive a visit, Balber says.
Service coordinators do not provide therapeutic interventions. Their goal is to help identify needs and develop a "common-sense plan" that addresses client requirements.
· Caregiver training.
As South Hill's referral and in-home assessment services matured, staff "developed a relationship with people as we followed [them] over time, [and recognized other community needs]," she says. One such service that surfaced from ongoing client interaction is caregiver training.
Training courses available on varied topics
Many South Hills'-listed providers are independently employed personal caregivers. Although many such individuals may have provided personal care for years, they often have no formal clinical training. South Hills senior services now offers a five-day caregiver training course.
For a $50 fee, participants receive 40 hours' education covering topics such as the aging process, nutrition, signs and symptoms of depression, alcoholism and elder abuse, and the physical aspects of care, including transfers, bathing, and meal preparation. Attendees are "grateful for the education, and it increases their self-esteem," Balber says.
· Caregiver support groups.
Another service that surfaced along the way is caregiver support groups, held on the South Hills campus. Family members providing care to loved ones and independently employed personal caregivers attend group sessions to deal with the frustration, isolation, and emotional toll of one-on-one care.
Participants come and go as their situation changes, she says. Bereavement support meetings are now on the horizon, she adds.
· Provider networking forums.
Ideas for other new services also arise from South Hills' annual community-networking forum. Referral system-listed providers meet to discuss community needs and elder care issues.
· Elder education and fitness classes.
Senior education needs surface from multiple sources, and in collaboration with other agencies, South Hills senior services division now sponsors numerous programs. Examples include long-term care insurance, tax preparation, and driver's education courses.
South Hills senior services division also sponsors numerous fitness classes, charging only enough to cover the instructor's fee. The programs are so popular, Balber is now searching for off-campus sites.
South Hills' full plate of senior services does not come without a cost. The program requires about $350,000 to $400,000 annually, including salaries and benefits for its eight staff members. With today's harsh operating realities, any facility might understandably blanch at spending such amounts on nonrevenue-generating activities. South Hills senior services division owes its existence, thus far, to board and employee contributions. Balber is now focused on expanding program funding, particularly foundation grants.
Although South Hills is not considering such actions, the program could partially support itself by charging community membership fees or utilizing only medical social workers to provide third-party reimbursable in-home assessment services, Balber says.
Insurer funding is the next frontier, she adds. "If a caregiver can keep a spouse at home for three years longer because the person goes to caregiver support sessions, it saves the system money [and should be reimbursable]."
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