The South Dakota Association of Healthcare Organizations (SDAHO) is taking part in a legislative summer study to look at sustainable models for long-term care. The committee is comprised of South Dakota state lawmakers and is chaired by state Senator Jean Hunhoff of Yankton and Rep. Taylor Rehfeldt of Sioux Falls.
During the 2023 South Dakota Legislative session, lawmakers approved the summer study that will look at improving our state’s approach to long-term care for older people and those with disabilities. Members of the committee are looking at our state’s current situation and challenges with hopes of developing a 10-year plan that takes into account occupancy numbers, the condition of buildings and facilities, geography and the services provided in addition to workforce needs. Sen. Jean Hunhoff “I want to start out by saying, certainly we’ve had some things happen in the state of South Dakota, closure of long-term care, funding, staffing concerns, certainly a whole listing of items that are I impacting the services we are able to provide for those individuals that need some type of continuum of long-term care services in South Dakota. The intent of this study group is to look at what we have going on in the state and then to do some assessments, analysis and then bring in some resources and then try to identify if there is some type of sustainable model that could be offered that the private sector would be interested in partnering with and continuing those services so that all South Dakotans have access to those services.” Listen here
SDAHO is participating in the summer study, Tim Rave, President/CEO “You are going to hear staffing a thousand times today. Certainly, homes have closed due to financial pressures but a lot of those pressures are brought on by staffing. You can have an Access Critical Long-Term Care facility but if you don’t have the staff to work there or if you must bring travelers in to fill those positions, you can’t make that work. I think there are some things this group should, could look at as we go through this process and look at the high needs areas.” Listen Here
The panel will break into five subgroups focusing on:
- Regulations
- Workforce
- Community-based services
- Infrastructure
- Location
SDAHO’s presentation outlined specific data provided to the association by its members, including a definition on who the patients are utilizing long-term care services and the referral process. SDAHO’s Fiscal Policy Dir. Jacob Parsons encouraged committee as they discuss items in their subgroups, to take a closer look at the referral process and who those people are. “When thinking about your workgroups later today when talking about referrals, it can’t just be association staff and administrators, you really have to think outside of the box and all of those facets of the community that are touching these individuals whether it’s a faith-based organization or psychiatric care. A big thing that gets lost in there is how do nursing homes get paid, who pays for it and as an individual if we all look around the table, we are the ones that will need these services in the future and the majority of us are confused about how we are going to pay for it ourselves.” listen here
Parsons also shared with committee members what the needs and services may look like for future long-term care patients. “When thinking of the resident of the future, a lot of us will need services at some point, so think what your long-term care facilities are like if you have been in them recently. Is that a place you would like to spend what could be your last days? Administrators are telling us that different technologies or tele-medicine will help them provide better care with the staffing that they have. Patients want to have entertainment, similar to a hotel concierge services so they can have transportation to go to an event. Also, transportation services for other things like healthcare that they cannot get in the nursing home.” Listen Here
Long-term care administrators shared other considerations for future facilities including, privacy, a better visitor experience, improved staffing models and on-site or access to financial advisors for the patients and families.
Michele Snyders, SDAHO’s Hospice and Palliative Care Program Manager shared with the committee how palliative care could be part of the solution as the state works on a long-term care plan. “There are about 17 states around the country that are working with their Medicaid office to try and provide more home-based palliative care services. So many of the Medicaid recipients right now have serious needs or disabilities are in a gap, they don’t meet the qualifications under the Medicare definition for hospice, they need more care than what home health can provide, so they are looking at long-term care placement but possibly they could be taken care of at home. Providing some type of definition on what palliative care is and how can it improve quality of care and reduce cost of care as the people involved with palliative care tend to have fewer hospital admissions, are in the ER less frequently, so cost of care go down considerably for people involved with palliative care.” Listen here
When asked his thoughts about the summer study and the impact it could have on the future of long-term care in South Dakota, Rave stated, “In the 20 years I have been part of the process, this is the first time I have seen a holistic approach that covers everything from home health, hospice, palliative care to our hospitals. I also recognize that with all of the stakeholders that have been invited to the table, including SDAHO I am hopeful this collaborative effort will result in long term solutions for the long-term care industry and the people of South Dakota.”
The meeting took place in the South Dakota State Capitol in Pierre and is archived on SDPB. To listen to the full hearing click here. Committee members will return to Pierre June 12, Sept. 25, and Oct. 18. to continue their work.
