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In 1994, Living at Home/Block Nurse, Inc./Elderberry Institute implemented a national Medicare Demonstration Project that involved designing and piloting an innovative nurse managed health care delivery system based on the Guiding Principles of the LAH/BNP.
The Healthy Seniors Project provided the effective infrastructure for building a consumer-oriented, cost-effective managed care network for elders enrolled in the Project. The Project goals included:
- Promoting an entire community of Healthy Seniors enrollees.
- Developing ongoing trust relationships and continuity of care with seniors.
- Using a client/family centered approach to facilitate independence and autonomy.
- Incorporating preventive, acute and chronic care to serve a broad variety of clients.
- Assessing social, physical and psychological needs to provide whole person care.
- Employing care planning and service authorization to coordinate services cost-effectively.
- Assisting enrollees to access appropriate resources through information, education and referral.
- Demonstrating effectiveness of a community health service system in which nurses are central at all levels.
- Assuring quality care, access for seniors, and cost-effectiveness of the community-based model.
- Providing an alternative model of managed care delivery.
Primary partners in this Project included:
- The Health Care Finance Administration (HCFA), Washington, D.C.
- Living at Home/Block Nurse Program, Inc./Elderberry Institute, St. Paul, MN
- Four Healthy Seniors Communities in Minnesota:
- Cambridge Healthy Seniors-small rural community
- Longfellow-Seward Healthy Seniors-urban neighborhoods
- Nokomis Healthy Seniors-urban neighborhoods
- Owatonna Healthy Seniors-large rural community
- Allina Home Care Service, Minneapolis, MN
Project staff worked from a community office in each of the four communities, providing a single point of access for elders. A service coordinator in contact with a group of local volunteers and familiar with area volunteer services and other seniors programs was available to assist enrollees with non-medical needs. Together with the coordinator, Project nurses (under Allina's license) worked to assess and effectively respond to the needs of elders.
After six years of operation and two Project extensions, the Healthy Seniors Project ceased operation in late 2000, due to reduced payments from HCFA. Each of these sites then transitioned into more traditional Living at Home/Block Nurse Programs.
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