HCMN 413 Review for Quiz 3
HCMN 413 Review for Quiz 3 HCMN 413
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This 7 page Study Guide was uploaded by Amend on Wednesday August 24, 2016. The Study Guide belongs to HCMN 413 at Towson University taught by Dr. McSweeney- Feld in Fall 2015. Since its upload, it has received 5 views. For similar materials see Services & Housing for the LTC Consumer in Health Sciences at Towson University.
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Date Created: 08/24/16
Review for Quiz 3: HCMN 413 1. What are the four parts of Social Security (OASDI) and what is the relationship between Medicare and Social Security? What population relies extensively on Social Security income in retirement? *SS & Medicare available to all beneficiaries* OASDI = old age, survivor, and disability insurance and Medicare Social Security is a program that the vast majority of Americans participate in during their working years either directly or indirectly through a family status (nonworking husband or dependent children), designed to support Americans with retirement income, and supports survivors after the death of a parent, spouse, and individuals who become disabled; For all ages when needed most SS created in Social Security Act of 1935 FICA (Federal Insurance Contribution Act) provides a system of SS benefits financed through taxes - Population that relies on SS: o Minority beneficiaries w/ SS representing 90% or more of the income of Asians (42), Blacks (49), & Hispanics (55) o Advanced age 80+ beneficiaries SS provides income for 76% & nearly all of the income for 45% of older Medicare is a universal health care program for older persons (65 or older) and persons with special conditions that enable them to be eligible for coverage (endstage renal failure) regardless of age and Americans who have received disability benefits from SS for 24 months & those who are disabled as a result of ALS – do not wait 24 months; part of SS Four Parts: o Part A covers hospitalization; no fees, o Part C covers an optional “Medicare employerprovided health insurance Advantage” Plan that covers A, C & other o Part B covers outpatient care & physician services services o Part D covers prescription drugs o o Medicaid is a federal program implemented by the states and is eligible for poor, indigent & older adults (means tested) - Medicaid waiver programs offer coverage for adult day services, home improvement services & others that support an elder in their own home o 2. What are the guidelines for collecting Social Security benefits (age, covered quarters worked)? What are the guidelines for collecting survivor and disability benefits under Social Security? How are same sex couples and married couples affected by limits in collecting Social Security benefits? o Calculated based on amount of income earned during Ticket to Work program allows SSDI recipients to lifetime work limited hours & still receive benefits Eligible to receive SS benefits after working at least Possible bankruptcy of SSDI program in 2016 due to 10 years & reaching age 66 or above increases in claims Early retirement starts at age 62 w/ reduced benefits Widows/ widowers are eligible to received benefits at of 25% less 60 years or if disabled, 50 years Late retirement will have increased benefits Family benefits are available to: 1960 & later: 67 years old= new retirement age o Spouses who are 62 or older Those born in 1943 or later have payments that are o Spouses who are younger taking care of 8% higher if retirement age delays to 70 child (>16 or disabled) entitled to benefits SS replaces approx. 40% of income a worker earns Divorced spouses claim at 65 if marriage lasted 10 Paid to 10.2 million in 2013 years & exspouse is unmarried 90% of all awards account for disabled workers Defense of Marriage Act ruled unconstitutional: SS Mental health diagnosis primary for 1/3 of recipients now able to pay benefits to eligible survivors & Supplemental Security Benefits were another source partners who are married of income for 1 in 8 recipients 3. What recent action did Congress take to ensure the SS Disability benefit fund would not go bankrupt? Congress took action in October to borrow funds from the Social Security Trust Fund (GI Bill) 4. What is the 4legged stool of economic security, & why is parttime work one of the components of this concept? Social security (social insurance) Private pensions (benefit/ contribution) Private savings (savings accounts, money market accounts, investments, & real estate) Earnings from work/ parttime work savings o OAA program designed to support lowincome elders w/ subsidized employment (SCSEP) o Must be 55 or older and of lowincome o Not likely to be competitive, therefore, rely on the program to supplement their SS payments o Parttime work was added due to the original 3legged stool’s not being enough for someone to live on 5. What types of private pensions do employers offer? (Defined benefit and defined contribution plans) And what are the benefits and limitations of these plans in providing retirement income? Defined benefit plans (oldest): type of pension plan in which an employer promises a specified monthly benefit on retirement that is predetermined by a formula based on the employees earning history, tenure of service & age, rather than depending directly on the individual’s investment returns. Employer promises set payout when employee retires. A stream of periodic payments start when one is at “normal retirement age” of 65, also known as pension or annuity. Defined contribution plans: retirement plan (like a 401K) in which a certain amount or percentage of money is set aside each year by a company for the benefit of the employee (certain amount taken out of employees check per month). There are restrictions as to when & how one can withdraw these funds without facing penalties. Many employers are using defined contribution plans now more than defined benefit plans because they are less expensive to the employer with no long term obligations 6. What section of the OAA covers elder abuse issues? Ombudsman program? - Title VII was modified to create a unified title dedicated to the protection of the rights of older Americans 7. Know the types of elder abuse, frequency of elder abuse, types of individuals most likely to experience elder abuse? Can abuse extend to adults with disabilities? Vulnerable, frail elders are often easy targets or unsavory & exploitative activities Many older adults do not have adequate information to take informed decisions Elder abuse: Physical, Emotional, Sexual, Exploitation, Neglect, Abandonment, & Selfneglect Prevalence estimates between 1 & 2 mil. (About 10%) experience some form of abuse No overarching conceptual framework for addressing elder abuse issues exists Majority of elder abuse cases go unreported (1 comes to light: 23 remain hidden) Majority 89% reported to Adult Protective Services (APS) occurred at home Adult children= perpetrators, older women= more likely to be victims 2004 APS survey reported selfneglect as most common & caregiver neglect as second o 50% more likely to die within 3 years from selfneglect than any other form o Symptoms: poor hygiene, living alone, hoarding, domestic squalor Estimate 1 in 10 older adults in the U.S. experience some type of elder abuse Low & middle income countries experience highest incidence of elder abuse More will be affected due to exponential growth in the older adult population by 2050 National Elder Mistreatment Study: surveyed communitypresiding older adults in U.S. o Rate of elder mistreatment was 10 %to 11%, not including financial exploitation o Majority of the violence is domestic violence, mostly within families o Low social support, or a lack of social connectedness may be a risk factor Native American populations have spiritual abuse: Being denied access to ceremonies the group finds essential/important & being denied access to a traditional healer when sick 8. What is filial piety, and how does this concept impact the prevalence of elder abuse? 9. Filial piety obligations of the family to take care of older & disabled adults; exists within many cultures & countries - Exist in # of states, including MD & PA Require families to take care of their older relatives Not enforced, but case in PA (Pitta case) Example: Korean & Indian populations older adults tend to have high tolerance for financial abuse, as it is common practice for older people to transfer their property & valuables to adult children in hopes that they take care of them as they age 10. 11. What is the Willowbrook case, and how did it impact individuals with disabilities? 12. A case in the evolution of the legal rights of people w/ disabilities to live in dignity arose out of public awareness of the horrific conditions under which children & adults w/ disabilities were living at the Willowbrook State Developmental Center in New York during the 1970s o 6,200 residents were living in buildings o Hepatitis was widespread & several meant to house 4,000 researchers used residents in a study to o Understaffed, overcrowded & underfunded intentionally expose the virus, without o Abuse, dehumanization, & a public health consent, to test effectiveness of vaccines crisis Set precedents for humane & ethical treatment of people w/ disabilities living in institutions Incentive for accelerating pace of community placements for people w/ disabilities, expanding community services, increasing quality & availability of day programs, & establishing right of children w/ disabilities to a public education Led to enactment of legislation: Protection & Advocacy (P&A) System in the Developmental Disabilities Assistance & Bill of Rights Act (1975), Education for All Handicapped Children Act (1975), & Civil Rights of Institutionalized Persons Act (1980) Health Status of Disabled Adults: Study in 2004 in North Carolina Adults w/ developmental disabilities lead more Greater use of tobacco & obesity sedentary lives More chronic health conditions 7x more likely to report inadequate emotional support Similar findings in a 2011 study of disabled adults More likely to report being in fair or poor health 13. How prevalent is elder abuse in nursing homes, and why does it occur? Staffresident & residentresident aggression occurs due to lack of training of staff Complicated when dementia is present –remedies are different Selfneglect issues: estimated that 4% of all older adults fall into this category 14. What is the Elder Justice Act and what did it provide to older adults? What are adult protective services, and in which cases are they provided? The Elder Justice Act (EJA) passed as part of the Patient Protection and Affordable Care Act in 2009 Most comprehensive federal initiative to address elder abuse ever passed Includes $400 mil. Of dedicated funding for: o Adult Protective Services provided to insure the safety & wellbeing of elders & adults w/ disabilities who are in danger of being mistreated or neglected, are unable to take care of themselves or protect themselves from harm, & have no one to assist them o Money to set up Elder Abuse, Neglect, & Exploitation Forensic Centers o Ombudsman Program & training programs for Ombudsmen activities o 15. What is the Federal Ombudsman Program – its purpose (to advocate for resident rights), and types of settings in which Ombudsmen can advocate for residents in Maryland (nursing homes, assisted living, group homes) vs. other states (some states allow Ombudsmen to advocate for individuals obtaining home care services like PA and VA)? What types of activities do Ombudsmen engage in, and what types of individuals who can serve as ombudsmen, etc. o LTC Ombudsman Program works in one state, Washington (PDF) Alaska, Idaho, Indiana, Maine, Minnesota, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, and Wyoming the Ombudsman Program was mandated under state law to provide advocacy on behalf of consumers who receive home and community based care Individuals with the following services have access to LongTerm Care Ombudsman services: o Statefunded home care: AK, ME, MN, OH, RI, VA, WI o Home Health agency services: AK, ME, MN, OH, RI, VA o Older Americans Act home care programs: AK, ME, MN, VA o Adult day services: MN, OH o 16. What is emergency preparedness, and what are the 4 phases of the disaster cycle? (Mitigation, preparedness, response, recovery) **PDF** Mitigation is a public policy issue o Emergency preparedness is the discipline of dealing with and avoiding both natural and manmade disasters, while involving the 4 phases of the disaster cycle in order to lessen the impact of disasters; is a public health issue 17. What is the concept that allows the Federal Government to be involved in emergency preparedness and disaster management? What is FEMA, and what is its relationship to the Department of Homeland Security? o Federalism shared power between the Federal Government and States o FEMA (Federal Emergency Management Agency) agency of the U.S. Department of Homeland Security (DHS); purpose is to coordinate the response to a disaster that has occurred in the U.S. and that overwhelms the resources of local and state authorities. Became part of DHS in 2003 to ensure nation’s first Brought coordinated approach to nation security from responders were trained & equipped to deal w/ emergencies & disasters; natural & manmade weapons Emergency reform Act of 2006 reorganized FEMA & Actively directs its’ “allhazards” approach to provided substantial new authority to remedy gaps & disasters toward homeland security issues included a more robust preparedness mission Joined 22 other federal agencies 2008: Homeland Security published National Response Framework how U.S. responds to disasters 18. Who has the primary responsibility for management of emergencies and disasters? What is the incident command model, and why is it important? Tiered response principle: management of an event remains a local issue unless a jurisdiction’s capabilities are ruined by the event, and local authorities (primary responsibility) request county or state assistance Incident Command Model (Unity of Effort Model): Incident Command System (ICS) Five Functions: command, operations, planning, logistics, and finance/administration One Incident Commander Common protocols for behavior during a disaster= use of a systems approach to coordinate efforts Important: o ICS used for a broad spectrum of incidents, routine to complex, both naturally occurring & manmade, by all levels of government Federal, State, tribal, and local nongovernmental organizations (NGOs) & the private sector o Combination of facilities, equipment, personnel, procedures, & communications operating within a common structure, designed to aid in incident management activities o A model tool for command, control, & coordination of a response & recovery o Provides a means to coordinate efforts of individual companies & agencies as they work toward the common goals of stabilizing the incident & protecting life, property, the environment, & business sustainability o 19. What are interstate mutual aid agreements, and what is the Emergency Management Assistance Compact (EMAC)? Why are these agreements important? o Interstate Mutual Aid Agreements when governordeclared emergencies and disasters cannot be handled with only one state’s resources, other states are allowed to send resources o Emergency Management Assistance Compact (EMAC) a national interstate mutual aid agreement that enables states to share resources during times of disaster, administered by NEMA, the National Emergency Management Association, & consists of a Federal network of mutual aid agreements under EMAC participate all states + DC, Puerto Rico, Guam, & Virgin Islands; seen as an important component of the federal National Incident Management System (NIMS) 20. What is the CMS emergency preparedness checklist for health care organizations, and why is it important? What is a Continuity of Operations Plan, and an all hazards approach to emergency preparedness? o **PDF** & Used by all HCO + nursing homes A Continuity of Operations Plan is an effort within the individual executive departments and agencies to ensure that primary mission essential functions during a wide range of emergencies. An all hazards approach is what the Joint Commission advises all hco take to allow emergency management to always be prepared to prevent, respond to, and recover rapidly from hazardsdoes NOT mean plan for every conceivable situation, just to take preparedness actions o 21. What are key issues faced by veterans with disabilities when they return from war? What types of services should we focus on for this population? o Key Issues: Getting access to healthcare, including behavioral health services PTSD & other mental illnesses (depression) Accessing & having success w/ postsecondary o 1 veteran commits suicide every hour education Drug & alcohol abuse Dealing with housing & financial instability Lack of access to services Lack of understanding from others o Services: Finding employment Dealing w/ a loss of purpose & isolation U.S Department of Veterans Affairs (VA) Long waits to obtain disability & other benefits o Veterans Health Administration (VHA) o Veterans Benefits Administration (VBA) State/Countyfunded programs o 22. What is the difference between shelter in place and an evacuation? How can longterm care facilities help their residents in the event of an emergency or a disaster requiring an evacuation, and what supplies should they have on hand? How can health care facilities and their staff prepare for emergencies and disasters? PDF**** o Shelterinplace the use of a structure & its indoor atmosphere to temporarily separate individuals from an outdoor hazard o Evacuation the action of leaving a place Emergency Management Institute sponsors free FEMA courses (IS 100 and IS 700) CMS Checklist o o 23. What Federal Act must be activated in order for health care facilities to receive funding and special waivers for activities in the event of a disaster, and who activates this Act in each state? o Robert T. Stafford Disaster Relief and Emergency Assistance Act, PL 100707, signed into law November 23, 1988; amended the Disaster Relief Act of 1974, PL 93288. This Act constitutes the statutory authority for most Federal disaster response activities especially as they pertain to FEMA and FEMA programs Governor of each state activates the act o 24. What are guidelines for individuals living in the community regarding emergency preparedness (i.e, what should they have on hand, and how much in case of an emergency or evacuation)? If an older adult or an individual with disabilities uses assistive technology, what should they have on hand in case of an emergency or an evacuation? Be informed Make a communications plan o Create personal support network Build an emergency kit (72 hrs.) o Basic supplies: Water, 1 gallon per person per Plastic sheeting & duct tape to day for drinking & sanitation shelterinplace Food & can opener Moist towelettes, garbage bags Batterypowered or hand crank & plastic ties for personal radio/NOAA Weather Radio sanitation Flashlight & extra batteries Wrench or pliers to turn off First aid kit utilities Whistle to signal for help Local maps Dust mask to help filter Inverter/solar charger contaminated air o Important documents o Finances Get involved within community 25. What are registries, and what are the pros and cons in using them to identify older adults and individuals with disabilities living in the community in the event of an emergency or disaster? Located and assisted quickly in a disaster Give individuals’ name and special accommodations MD does not have registries since it violates others’ rights Other terms: Elder Abuse as defined by the IOM, a violation on older adults’ fundamental rights to be safe & free from violence & contradicts efforts toward improved wellbeing & quality of life in healthy aging; a global issue what constitutes abuse varies across cultures Ageism discrimination against older adults Ableism discrimination against disabled adults Medical Reserve Corps – are a complement to the Maryland State Guard and may be activated in case of an emergency or disaster – 3 in Maryland Emergency = event that exceeds the potential threat of a hazard and requires an immediate response at a local level Disaster = an event involving 100 or more people, with 10 or more deaths Catastrophe = sudden and extreme disastrous event causing upheaval of a community, requires an extensive recovery process that changes the surrounding environment Emergencies are more frequent than disasters Key Agencies for EP: FEMA, CDC, DHS, State Office of Emergency Planning Planning for the Future (examination of nursing homes after Katrina): Eight “preparedness domains” including Integrating needs of nursing homes into disaster planning Using nursing homes as a community resource during a disaster Ensuring materials & supplies are on hand to maintain operation Attending to the diverse needs of patients, visitors, & staff Preparing geriatric protocols for a range of care Mental health strategies Coordinating & planning for transportation Ensuring communications Retirement action or fact of leaving one’s job and ceasing to work
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