A Healthy Dose of Help
With a quarter of its population over age 60, Florida is home to more seniors than any other state in America. The demand to provide healthcare services to this expanding population in an era so distinguished by diminishing resources and budgetary restraint, coalesces to create a singular situation interspersed with problems and possibilities, all routinely played out among teams of legislators, state agencies, healthcare providers and the patients impacted by enacted protocols. Within that mix of market dynamics and prescribed remedies, one association works to protect the industry’s vitality and venerability.
Beyond its direct impact in the health and wellness concerns of those it serves, the healthcare industry is among the leading economic concerns of Florida by virtue of the fact it represents one of the State’s largest employers. It is estimated that approximately 260,000 jobs are generated through the operation of long-term care facilities (essentially that formerly referred to as “nursing homes”). At any given time, there are as many as 88,000 people employed by a long-term care provider. Some ten years ago, Florida established a moratorium that limits bed counts at long-term operations, which effectively led to a boom in the development of smaller-sized endeavors which are called Assisted Living Centers. These engage the services of more than 40,000 workers. All these numbers combine with another totality in terms of those who benefit from care, thus giving a clearer indication of the massive responsibility entrusted to the Florida Health Care Association in its role as advocate for the health care providers and the elderly patients they serve.
The organization was originally founded as the Florida Nursing Home Association, an initiative created by a family that owned several long-term care centers in South Florida. Following an era of growth throughout the 1950s, principals elected to establish a federation which culminated into the association of today. As Florida’s affiliate of the Washington D.C.-based American Health Care Association & National Center for Assisted Living, the FHCA is dedicated to advancing the quality of services, recognition of those services and the vast variety of matters involving professional development and fiscal security.
The FHCA is comprised by more than 1200 members, with each reflecting either one of the long-term care providers or that of an assisted living center. There are also associate members comprised by the companies typically engaged in servicing these care centers, whether it is as a manufacturer of medical equipment or by way of proving services involving everything from dental care to physical and occupational therapy and more, essentially all that encompasses attending to the needs of the frail and elderly in care facilities. As members represent the plethora of professional backgrounds from so many disciplines of healthcare, the administration of FHCA benefits from engaging leadership from a governing board of directors and personnel whose knowledge and experience is similarly extensive. The extent of that is especially embodied in the example of one executive, LuMarie Polivka-West. As the FHCA’s Senior Director of Policy & Program Development, she has spent her entire career working in healthcare. From serving as Florida’s former Medicaid Policy Chief to directing the licensure requirements that governs providers, Polivka-West took on the role with FHCA after 20 years of working for the state.
Understanding state requirements is critical because, as Polivka-West asserts, “nursing homes are the most heavily regulated operations of the healthcare continuum…there’s strong oversight from state agencies.”
Part of the focus of FHCA is ensuring that their members are not only adequately licensed and trained, but also completely complicit in terms of fulfilling expectations of the state and the patients they serve. In this capacity, FHCA is engaged in all matters that affect the industry. When new legislation is drafted germane to this corridor of healthcare, the FHCA is there providing input, and upon passage, will advise on the interpretation and implementation of the approved guidelines. In this capacity, the FHCA serves the interests of government, the greater community of health care providers and the public at-large.
FHCA’s other primary duty deals with budgeting, especially when it comes to reimbursements. As Polivka-West explains, much of the costs involving elder care is paid for through the auspices of Medicare and Medicaid. Interestingly, as much as two-thirds of Medicaid’s total funding is used to support the frail elderly and disabled, yet these only represent one third of the population eligible for Medicaid – which gives a good indication of costs associated with that care.
Polivka-West affirms, “The public expects good quality care for the most frail, most vulnerable individuals who are cared for in our nursing home… they require 24 hours skilled care.”
She says that whereas these patients were once only seen in hospitals, today they are being discharged into nursing homes. And despite some lingering perceptions, these centers are not destinations to which one goes awaiting inevitable demise, but rather serve more as places of rehabilitation that not only help sustain life, but also enhance quality of one’s life.
In so doing, there are factors that force food for thought. For example, Polivka-West notes some sixty percent of nursing home residents are diagnosed with conditions such as Alzheimer’s Disease and/or dementia. The advent of this statistical reality has necessitated certain change in terms of how care providers function.
Of course, funding issues make for peculiar situations too, especially in light of factors Polivka-West notes as indicating that over the next 20 years, Florida will need an additional 20,000 beds to accommodate demand for care.
She says another “major challenge” will be confronted with the coming new year; one that involves the legislative mandate for an HMO to take over the administration of Medicaid reimbursements, a move Polivka-West says will add “another layer of administrative oversight that is very concerning.”
While a proportion of Florida’s budget will now have to cover costs for implementation of that new layer of oversight, the HMO is also tasked with shaving an additional five percent of existing costs. As this matter continues to be discussed and reviewed between the State and involved agencies, with no clear understanding, as yet, as to how goals will be actualized, Polivka-West predicts that it is likely to generate controversy.
But in this case, as all others, the FHCA will maintain what Polivka-West describes as “a healthy working partnership” with all the players involved – legislators, state agencies and healthcare providers alike. That work is furthered through the efforts of FHCA’s exceedingly capable political action committee that annually advises on any and all matters of initiative.
As Polivka-West observes, “We have people to care for… so we have to target our resources accordingly.” She adds that FHCA will continue to function as “the best spokesperson for the long-term care of the frail elderly and disabled.”
“We represent quality, we represent appropriate reimbursement, we represent expertise in policy making and advocacy… and we represent a business profession that is absolutely necessary to care for our frail elders and people with disability.”
And in so fulfilling that role with the degree of knowledge, expertise and commitment they bring to the table, the FHCA represents something else – the best hope for the future of health care in Florida.