Skip to main content

Currently Skimming:

Summary
Pages 1-24

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 1...
... Elderly residents of LTC facilities (nursing facilities, B&C homes, and other group residential homes) are the designated constituency of ombudsmen.
From page 2...
... , that the Assistant Secretary for Aging conduct a study of the state Through a contractual arrangement, the IOM LTC ombudsman programs. carried out the study.
From page 3...
... Funding for LTC ombudsman programs is patched together from multiple sources at the federal, state, and local levels. Most federal funding comes from the OAA.
From page 4...
... systemic advocacy services. Findings Although in some states and locales elements of the ombudsman programs are vigorously implemented, the ombudsman program as a whole has not been fully implemented with regard to the provisions of the OAA that call for ombudsman services to be available and accessible to residents of LTC facilities.
From page 5...
... · The ombudsman program activities of too many states are piecemeal, fragmented, and focused primarily on responding to complaints that relate to individual residents of nursing facilities. These states are not in compliance with the spirit of the program provisions as stated in the OAA; the Offices of the State LTC Ombudsman programs do not function as a whole, statewide, unified, integrated program delivering a range of individual, systemic, and educational efforts.
From page 6...
... However, state ombudsman programs should strive to comply fully with their current mandates before using Older Americans Act resources to serve residents who are younger than 60 years of age. When applicable, the state long-term care ombudsman should coordinate activities and advocacy efforts with other organizations that serve as advocates for nonelderly residents.
From page 7...
... 3.5. The committee recommends that Congress direct the Secretary of the Department of Health and Human Services to implement the statutory provisions set forth in Public Law 102-375 that require a federal Office of Long-Term Care Ombudsman Programs in the Administration on Aging and that Congress explicitly provide an adequate appropriation in the Older Americans Act for the position of Director of the Office of Long-Term Care Ombudsman Programs.
From page 8...
... Without a doubt, most state and local ombudsman programs are subject to one or more of the conflicts of interest reviewed by the committee. Of particular concern to the committee is the prevalence of potential and real conflicts of interest that arise from the structural location of many of the Offices of the State LTC Ombudsman programs.
From page 9...
... These are concepts and approaches similar to those in the quality-of-care field. Not all conflicts of interest can be prevented in the ombudsman programs, although prevention is clearly the preferred method of program administration and the most effective means of assuring compliance with the statutory provisions.
From page 10...
... 4.3. The committee recommends that the Assistant Secretary for Aging establish procedures and resources by which to identify potential conflicts of interest in the areas of loyalty, commitment, and control that are pertinent to the long-term care ombudsman and ombudsman representatives and provide guidance on how to address such conflicts of interest.
From page 11...
... The LTC ombudsman program can justly claim to have improved the system of LTC services. Through systemic advocacy work and educational efforts, the state programs, individually and collaboratively, have brought to the attention of state and federal policymakers, regulatory agencies, and provider organizations a host of conditions that can and should be changed to improve the health, safety, rights, and welfare of LTC residents.
From page 12...
... ; Office of the State LTC Ombudsman Program; Individual Resident Advocacy Services; Systemic Advocacy Work; and Educational Services.
From page 13...
... Thus: 5.2. The committee recommends that the Administration on Aging build upon the committee's proposed set of exemplary, essential, and unacceptable practices to develop and implement an objective method to assess compliance of state long-term care ombudsman programs.
From page 14...
... The committee recommends, at a minimum, that the data system should: . be based on a manageable number of uniform and reliable data items~ach of which has precisely specified, field-tested definitions; making; · be derived from annual statistical reports submitted by state long-term care ombudsman offices that provide information in terms of the data items in the previous point; · include a clear indication of status of complaint resolution from a consumer perspective; · be used to provide feedback to state and local ombudsman programs; · be available for public use to foster research and inform decision · incorporate methods and procedures for continuous revision and improvement; and · be reviewed and updated no less than once every three years.
From page 15...
... Committee members expressed particular interest in the value of all state ombudsmen offices commenting consistently on four specific elements of information, as noted in this recommendation: 5.6. The committee recommends that the Secretary and Assistant Secretary for Aging, Department of Health and Human Services, require that each Office of the State Long-Term Care Ombudsman include in its annual report, in addition to currently required elements, information on and comments about: · the level of awareness of residents, their agents, and other parties regarding the ombudsman program, and the availability of ombudsmen to individual residents; the extent to which the complaints and concerns of residents have been satisfactorily resolved; · the extent to which ombudsmen have provided input into activities designed to improve the overall system of care and services for long-term care residents; and .
From page 16...
... It strongly encourages state LTC ombudsman programs that involve volunteers to maintain paid staff-volunteer ratios at the more robust level of 1:20.
From page 17...
... By triangulating on data from several sources, the committee arrived at the conclusion that resources are not adequate for each state LTC ombudsman program to perform at a level that ensures compliance with even the basic, decade-old mandates of the OAA ombudsman program. In the committee's judgment, 1 FTE paid staff per 2,000 LTC beds is an essential resource standard, and it provides a measure against which the adequacy of resources can be judged.
From page 18...
... 6.1. The committee recommends that by fiscal year 1998 Congress increase the appropriations through Title VII, Chapter 2 of the Older Americans Act for the state long-term care ombudsman programs to an amount that ensures that all state Offices of the Long-Term Care Ombudsman program are funded at a level that would permit them to perform their current functions adequately.
From page 19...
... 6.3. The committee recommends that Congress require that states match the federal funding they receive under Title VII, Chapter 2 of the Older Americans Act appropriations for the long-term care ombudsman programs and that the state match should be no less than 20 percent.
From page 20...
... The Office of the State Long-Term Care Ombudsman program should in turn work with local ombudsman programs and their host agencies to assign fiscal management responsibility to appropriate managers.
From page 21...
... The committee recommends that, if Congress mandates additional responsibilities for the ombudsman programs, then Congress should also provide adequate additional appropriations to the ombudsman program. NEED FOR AND FEASIBILITY OF EXPANDING THE OMBUDSMAN PROGRAM The committee accepts the conventional wisdom that self-advocacy by consumers is the most desirable solution to many of the problems consumers face.
From page 22...
... Specifically: 7.1. The committee recommends that, before any consideration is given by a state to expand its long-term care ombudsman program to serve individuals other than those mandated by the Older Americans Act, the Offices of the State Long-Term Care Ombudsman programs that are supported with Older Americans Act funds fully implement existing mandates for serving older residents of long-term care facilities.
From page 23...
... Based on all this input and its own deliberations, the committee concluded that rather substantial changes in the very nature of LTC are likely in the next decade; it also judged that any ombudsman program will face challenges to adapt and be responsive to changing needs. If the committee's recommendations are adopted—including those related to increasing funding, minimizing conflict of interest, developing and enforcing program compliance, and enhancing the capacity of the ombudsman program to generate information about its activities and their effects then policymakers should be in a better position 10 years from now to make decisions about the desirable evolution of an ombudsman program to meet future needs for advocacy in whatever kind of health care system has emerged in the meantime.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.