Scan Champions a New Vision of Long-Term Care
Lavery, Joni, Aging Today
Nearly 30 years ago, a group of older citizens, frustrated by lack of access to health services, formed the Southern California-based Senior Care Action Network (SCAN), which eventually led to the creation of the nonprofit SCAN Health Plan, a "Medicare Advantage" HMO serving the needs of approximately 105,000 elders on Medicare in seven Southern Califor- nia and two Ari- zona counties. Those citizens and many others who have worked for decades to en- act long-term care (LTC) reform re- ceived especially welcome news this past April when the SCAN Health Plan announced the new SCAN Foundation. Based in Long Beach, Calif., the Foundation's mission is to advance the development of a sustainable continuum of quality care for elders, and it is an independent phi- lanthropy formed from funds contributed through the SCAN Health Plan.
The SCAN Foundation's primary goals are to find innovative ways to enhance elders' abilities to manage their health and to control where and how they live. The Foundation's board envisions a society where this population receives medical treatment and human services integrated into settings that meet elders' needs and that promote healthy, independent lives. The board recruited Dr. Bruce Chernof, an internist and former director and chief medical officer of me Los Angeles County Department of Health Services, as the Foundation's first president and chief executive officer. The Foundation intends to establish a niche rote - one not filled by any other like entity - that advances development and enactment of LTC policy reform rather than focusing solely on programmatic funding.
THE EXPERTS CONVENE
To get feedback on proposed grantmaking strategies, the Foundation, along with the National Academy of Social Insurance (nasi), convened two groups of LTC experts (see page 2 for access to participant list and experts' findings). Meetings were held in last October in Burbank, Calif., and Washington, D.C. Dr. Chernof and SCAN Foundation leaders asked these experts to identify the primary barriers to providing comprehensive LTC services. Participants agreed that the United States does not have a continuum of care for seniors, is lacking in care coordination - including social services - and uses an outdated model of healthcare financing. They also emphasized me need for new models-for organizing, delivering and financing services.
Nearly all in attendance agreed that mere are no LTC champions presenfly in Congress. One expert mentioned that, due to congressional staff turnover, there is a weak institutional memory on Capitol Hill about past LTC reform efforts. Additionally, mere seems to be lack of political will about addressing LTC issues and including them in general healthcare reform discussions.
Other experts pointed to me caregiving workforce, bom formal and informal, as a barrier to providing comprehensive LTC services. There are not enough trained caregivers in the professional workforce, and most family member caregivers have no special training and need support to help ease the care burden. The number of workers who have expertise working wim older adults needs to increase, along with improved pay and benefits.
The Foundation also sought advice about two of its strategic funding priorities: how to elevate LTC as a state and national priority, and how to develop realistic policy options that would establish and finance a comprehensive continuum of quality LTC Many experts encouraged me Foundation to reframe LTC beyond the definition of institutional care. Policymakers, the press and the public all equate LTC with nursing homes. Whichever way the issue is framed, the proper perspective must include supportive services and include people wim disabilities. "Long-term care isn't just about nursing homes," said Ann Monroe of Community Healtii Foundation of Western and Central New York.
Robyn Stone of the Institute for the Future of Aging Services, at the American Association of Homes and Services for the Aging, Washington, D. …