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Policy Initiatives, Issues and Accomplishments
One of CAST's core activities is promoting the development of policy at both the Federal and State levels to advance the use of appropriate Aging Services Technologies to transform the aging experience and enhance care for older adults.
Federal Policy: Health Information and Aging Services Technologies in H.R. 1
CAST's federal policy agenda took a tremendous step forward with the passing of the American Recovery and Revitalization Act (H.R. 1), also known as the stimulus bill. The bill contains health information technology provisions (known as HITECH Act) that aim to create interoperable Electronic Health Records (EHR) by 2014.
CAST and AAHSA's policy teams worked with several Congressional offices and committees, including the Senate Health, Education, Labor, and Pensions (HELP) Committee and Special Committee on Aging, and the House Ways and Means and Energy and Commerce Committees to ensure that the long-term care sector, long-term care health information technologies and aging services technologies are included.
The provisions related to aging services and long term care health information technologies include the following:
- Definition of Healthcare Providers includes skilled nursing facility, nursing facility, home health entity and an open-ended category, "other long term care facility".
- Definition of Health Information Technologies (HIT) includes hardware and software used in the creation of health information, which could potentially encompass telehealth and biometric telemonitoring technologies
- A study on aging services technology proposed by CAST and included in one of the two House IT bills introduced last Congress. This study by HHS will examine "matters relating to the potential use of new aging services technology to assist seniors, individuals with disabilities, and their caregivers throughout the aging process".
- A study to determine if LTC providers, long-term care hospitals, and rehabilitation hospitals, who will currently will not receive incentive payments to encourage the adoption of EHR, will also need incentives to encourage them to implement EHR technology prior to 2014.
- Funding will be available for states in the form of grants and loans to encourage use of HIT. The loans are specifically directed at health care providers that are not covered by the incentive payments, so LTC providers would be eligible for loans. Specific requirements for both the grants and loans are to be developed by states. There are extensive requirements to involve providers as state plans are developed and implemented.
CAST will be following up on available loan and grant programs and will help AAHSA state executives understand the process and work with their states to pursue these opportunities and bring 21st century technologies to long term providers.
- US-based Not-For-Profit organizations (or consortiums) that meet the eligibility criteria can apply to become regional centers to facilitate HIT in rural and other underserved areas.
Next Steps
CAST is trying to ensure that Long-Term Care is included as active partners on the grants to the states and in the national HIT infrastructure; the following are examples of efforts on the national level: Letter to the Office of the National Coordinator, Letter to National Committee on Vital and Health Statistics. Here is a guide with a state advocacy letter template prepared for AAHSA State Affiliates, as well as AAHSA and CAST members. CAST will be following up on available grants programs and will help AAHSA state executives understand the process and work with their states to pursue these opportunities and bring 21st century technologies to long term providers.
Resources
HITECH Grants Program
CAST Federal Policy Contacts
Marsha Greenfield
Senior Legislative Counsel
(202) 508-9488
Impediments to Health IT Solutions
In spite of a continuous spiraling of healthcare costs and reimbursements, it had been difficult to address some core policy issues that inhibit the implementation of cost-effective solutions for our aging services health crisis. Until the advantages of technology-based solution seeking are recognized by policymakers and healthcare professionals, we will not be able to address current problems with a dysfunctional healthcare system in new, practicable and innovative ways.
CAST has articulated seven policy "Impediments" that currently exist, which include:
- Reimbursement for on-site wellness and healthcare systems.
- Federal funding is needed to support the development of technology for pro-active care.
- HUD regulations for senior housing should recognize the need for 'smart' cost-effective housing solutions that allow seniors extended stay in non-institutional environments.
- Cross-state licensure opportunities for nurses and physicians are needed to gain the benefit of opportunities in telehealth, wellness monitoring and remote care management.
- Challenges in a global marketplace.
- Electronic Health Records (EHR) & Personal Health Records(PHR)
- Re-engineer role delineation and scope of responsibilities for doctors, nurses, and other caregivers to maximize use of their skill sets and expand productivity both in clinical and educational arenas.
Download the complete Impediments to the Roll Out of Health IT document that discusses these issues in detail.
Please note that a new website is now available from the Centers for Medicare & Medicaid Services (CMS) concerning Health Information Technology as provided for in the American Recovery and Reinvestment Act of 2009. On this website , you can find information pertaining to the Medicare and Medicaid incentives for electronic health records adoption and important links to related websites at the Department of Health and Human Services.
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