Karen Barno

2012 Legislative Session

2012-01-08T12:26:00.000-07:00

The team at Arizona ALFA is committing to communicating more frequently with our members in 2012. You can also follow Arizona ALFA on Facebook/ArizonaALFA, twitter and our YouTube channel ArizonaALFA.

The 2012 Arizona legislative session is set to begin in a few weeks. I am sure there will be much to blog and report to our members during the next few months. Stay tune . . . .

2011-08-19T11:43:00.002-07:00

From the Desk of: Karen Barno, President/CEO, Arizona ALFA

I find it hard to believe that summer is coming to an end. Does it not seem like yesterday we were at our annual conference? Now we are preparing for our Fall Conference that this year will be a “Legal Symposium” and is at the Black Canyon Leadership conference. The Educational Events committee believed that as assisted living attracts attention with the federal government and state elected officials it was time to discuss the legal issues that arise in assisted living.

Federal Issues:

The NLRB (National Labor Relations Board) is causing many challenges for the business community. Since the Employer Free choice Act was defeated the unions have tried to work through the NLRB. The NLRB is a regulatory board that has “decided” to make public policy decisions that Congress should be appropriately making or worse, establishing public policy that is counter to the direction and wishes of Congress. It should be Congress who determine public policy in regards to workers right to a federally supervised secret ballot election when determine If they wish to be represented by a union. ALFA will continue to monitor this for its members.

Congress has also filed a bill to establish a co-pay for Home Health services. However this co-pay can be viewed as nothing more than a sick tax, falling heaviest upon the sickest, poorest and most vulnerable members of our society.

To gather additional information on these federal bills ALFA has their public policy papers posted to their website, www.alfa.org. Arizona ALFA is an affiliate of ALFA and works closely with them on Federal and State issues.

State Issues:

The Public policy committee is reviewing the 2012 Legislative agenda. The major focus areas will encompass ALTCS reductions, Elder Abuse legislation from the Attorney Generals taskforce and the rules for Caregiver Training.

The ALTCS’s committee, chaired by Karla Averill, is closely monitoring the reductions in ALTC Provider rates and exploring ways to minimize both the amount and impact of these reductions. We have also working closely with a consultant and our lobbyist to develop a plan to demonstrate to the legislature that assisted living is a less expensive, more value driven product than other long term care options.

I have been honored to be a member of the Attorney Generals Taskforce on Elder Abuse. This committee is studying many issues surrounding Elder Abuse and do plan to put legislation forward and I will let you know about the proposed legislation.

The Governors Office on Aging has also formed a Taskforce on Alzheimer’s that we are also a member and will report to our members the outcomes from that committee as well.

The fate of Medical Marijuana has yet to be determined, stand by for further information and we will continue to monitor the situation.

Finally Arizona ALFA is your association, if you have any questions or comments please call me. If there is a program, product or services you would like us to offer let me know so we can continue to serve you!

Karen Barno, President/CEO

Customer service counts

2011-03-21T16:39:00.000-07:00

   Over the weekend I stopped at a large evening event and the parking lot was jam packed. I saw a parking spot and as I waited for the car to back out a large truck cut swooped around me and parked in the spot. The hotel shuttle driver witness what had happened and pulled his cart up next to my car and signaled to follow him. He took me to the front of the parking lot and showed me a space marked - Hotel Employee of the Month. He explained to me the employee of the month was on vacation and he was sure she would not mind me parking in her space.
   With that said he drove off . . .I am sure the hotel will never know what their shuttle drive had done. However when I arrived at work today I asked our conference planner to call the hotel to have them send information to have our conference at their hotel. That one nice sweet gesture will net the hotel over $150,000 in conference revenue.
   That is why customer service matters - you never know who you are helping or who is watching!

Leadership Tips for women

2011-03-17T14:56:00.000-07:00

Frances Hesselbein has long been considered a leader in the not for profit sector. Her latest book provider excellent tips on leadership and how leaders must "carry a large bucket." The book reviews her tenure at the Girl Scouts and the various challenges and opportunities that arose during her time. This book is a must read.

Assisted Living Providers and ALTCS

2011-02-13T15:25:00.000-07:00

During a recent visit with a Senator I was asked the question, “Why don’t more assisted living providers accept ALTC residents?”. I explained that although providers do accept ALTCS it is not as prevalent in AL as it is in Nursing Homes. I offered that with the recent provider rate cuts it is proving more challenging for AL Providers to continue to accept ALTCS. Providers currently accept a much lower rate for the services they provide, and additional rate reductions continue to remain a possibility. This discourages providers from continuing to accept ALTCS.

The continued cuts to ALTCS rates in AL will end up costing the state money, not saving them money. I know this sounds counter intuitive, however for every resident that does not move into Assisted Living, one does move into a Nursing Home. Nursing Homes receive a rate of $100 -$150 per resident day versus the $60 - $90 for assisted living. The argument for not reducing nursing home rates and pushing seniors to live in nursing homes is this: the state receives a match of $3 dollars for every $1 the state spends. However, the state has received the same FMAP for assisted living.

In the end, the State of Arizona pays a higher rate to be in a nursing home. . . . . . . so people have to ask themselves . . . . . .where is the savings?

Senseless shooting

2011-01-08T17:00:00.001-07:00

The state of Arizona should be "showing off" for the tourist in state for the BCS game. Instead the state is coming to terms with an assassination attempt. What is wrong with people, this country is founded on agreeing to sometimes disagree and to compromise. Stop looking at what is broke and start looking for ways we can work together and fix it!

Medical Marijuana in Assisted Living

2011-01-05T15:59:00.001-07:00

The proposed rules developed by Arizona Department of Health Services for Medical Marijuana (MM) have been posted to DHS’s website for public comment. These rules have an emergency exemption so there is an accelerated timetable in the development of the rules.

In the Proposition, Assisted Living and Nursing Homes had a clause that permits Assisted Living Centers and Homes to set their own policies about MM. Each center and home will most likely have a set of policies on what MM will be acceptable.

This clause places a large emphasis on the policy that is developed and followed by the provider. This policy will provide a guideline for managing the use of medical marijuana throughout their properties. Conversely, when DHS surveys the community DHS will review the written policy to ensure that the community is adhering to their policy. DHS will post “example” policies after the rules are completed which will most likely be in April or May 2011.

We will be working closely with DHS to develop these sample policies and will post them to our website as soon as they become available.

As there are many issues to look at in regards to medical marijuana in senior housing, Arizona ALFA will hold discussions over the next few months with our members.

2010-10-12T14:32:00.000-07:00

   Recently I saw the movie, Wall Street- Money Never Sleeps and there was a part where Gordon Gekko was speaking to a group of college students. He said that college students are part of the NINJA generation - No Income, No Jobs and No Assets. That is scary! What has happened to create this? Is it the Baby Boomer generation that caused this?
   When you reflect on the Boomers they have impacted every decade starting with the 60's - free love, drugs, protesting the War and rioting. They went out got married and started to raise their families and entered the 90's with the desire to own a home and secure and excellent job. Which for the most part was accomplished.
   Now here we are entering into a new decade and wondering what impact the Boomers will have on senior housing and the their children's' children? The first group will begin in 2018 so what will happen?
   Will they have saved money to pay for their retirement? What about Medicare will it still be there? How will everything be funded when such a large group enters into retirement. Where will they choose to live? Is that model currently developed and how will they influence senior housing?
   These are questions that must be looked at now by our elected official and everyone effective by Boomers along with the impact it will have on the NINJA generations.

Health care reform

2010-08-21T13:19:00.000-07:00

The White house has sent released a state by state guide on the effects of the Health Care Reform. Here is the link http://www.whitehouse.gov/healthreform/downloads#states to look at your state.

2010-08-20T11:07:00.000-07:00

Great article on the level of satisfaction residents find living in assisted living.
http://newoldage.blogs.nytimes.com/2010/08/06/finding-happiness-at-the-new-home/?scp=11&sq=elderly&st=cse
This is a smaller study size but in some ways mirrors what Dr Wylde has been finding through her research over the past few years. What residents look for when they live in assisted living versus what families look for are usually quite different. Now I agree with the article that Quality of Care is first and foremost in both groups mind and should always be most important. However that is where the similarity end. It is also no surprise that people who live in assisted living are happier than other segments of senior housing. Assisted living was developed on more of a residential wellness model then an institutional model. When people are surrounded by their own furniture and photos that increases their satisfaction. We must agree with the article.

Sunny forecast for Medicare hinges on cuts

2010-08-09T13:21:00.000-07:00

Sunny forecast for Medicare hinges on cuts
This article was in the Arizona Republic last week discussing the viability of Medicare in the future. Interesting how it starts out saying that because of the recent Health Care reform Medicare will be able "stay afloat" for an additional 10 years. However deep in the article it reveals that the research was done using 2010 numbers while not factoring in the "boomers" that will begin to flow into the system in the late 2018. Now is the time to start the discussion on how to deal with the many issues that health care will face over the next 20 years. Most important is how to finance healthcare but there are other issues such as home care, home health, referral/placement agencies, plus a myriad issues that at this time are unknown.

2010-08-06T15:28:00.000-07:00

We are excited to be fast approaching Arizona ALFA's 8th Annual Fall Leadership Conference! This one day fast-paced conference will provide assisted living and long-term care professionals with education, networking, and will put them in front of the businesses they rely on for day-to-day and long-term sustainability. This year we will be adding back the focused tracks offering specific education for Nurses and Executive Directors as well as Marketing/Sales Directors. For more information on the LAST ASSISTED LIVING EVENT OF 2010, go to www.azalfa.org and click on the side-bar tab labeled "2010 Fall Conference". We look forward to seeing YOU there!!

2010-08-06T15:11:00.000-07:00

I have just returned from visiting my mother in Pittsburgh where she now lives. Each day my sister and I would pick her up and take her out to dinner. When we would return a few hours later, yes a trip to the bookstore or clothing store was a required after dinner activity, to drop her off however the same people would be sitting outside. I felt sad because as we would be pushing my mothers wheelchair back into the community I knew that for most of those people no one ever visited. Much less take them out to dinner, or shopping or just a relaxing day outside for a BBQ. I know my mother is lucky to have my sister visit her everyday but sadly many families do not for various reasons.
We are lucky in assisted living to have many activities and group outing however this will never replace a family visit. How can we work together to be families involved and visiting?

Diabetics

2009-08-31T14:58:00.000-07:00

It seems that at least once a day a provider calls about caring for diabetic resident in their assisted living community. I have found however that many providers will not accept a sliding scale diabetic. I am not sure why this occurs. If caregivers are trained properly then there is no reason to not accept this level of care. Therefore if training can not be a reason then it can only be fear . . .fear of the unknown. For example what happens if the residents' insulin spikes high what should the caregiver do? Again if the caregiver is properly trained they will know to check the blood sugar and draw up the insulin amount that the physician ordered. Remember that these same residents lived at home for years with their untrained loved ones drawing up their insulin, in assisted living caregivers are trained professionals.
Arizona ALFA offers diabetic training monthly to educated staff and family members on proper technique.

2009-08-03T14:35:00.000-07:00

Much has transpired since my last post. Most noticeably, the economy has taken a dip (I know, what an understatement!). I am frequently asked what affect the economy has on assisted living. Overall, we are seeing more seniors leave their senior housing apartments to move in with their adult children. This is a way for them to assist family members financially. There is a noticeable rise in the utilization of Respite Care. Respite stays are short term, usually under 30 days, and provide primary caregivers with much needed and deserved breaks. Respite is also a way for the family and potential resident to experience assisted living before committing to the move. Most assisted living communities provide short term respite options. May be a great way to begin the process.

Arizona ALFA 2009 Spring Conference

2009-05-28T12:00:00.000-07:00

The Other Side of Assisted Living

2009-02-18T10:25:00.000-07:00

My mom moved into an assisted living community about a year ago. It has been quite an eye opening experience. I have worked at an assisted living association for 12 years . . . or, since assisted living moved onto the national scene. I have learned many things being on the consumer side. I now spend a large part of my day helping educate other people who are moving their parents or loved ones into assisted living.

There are many things to consider before moving into an assisted living community. The hardest point to remember is your parents may or . . . may not want to move into an assisted living community. They may want to stay home as long as they possibly can … or move in with you. Assisted living is typically needs driven, but don’t wait for the last minute to select a place your loved one could live at for a sustained period of time.

Go and visit different communities before assisted living becomes a need. Heck, most of the communities offer a free lunch and where else can you receive a free lunch?

Make sure that you talk to the residents and staff who work or live there. Trust me, they will tell you anything you need to know to help you make an informed decision.

Karen Barno
President
Arizona ALFA

Arizona Governor Proclaims Assisted Living Week

2008-09-01T09:00:00.000-07:00

Arizona ALFA, the VOICE of assisted living, is pleased to announce that Governor Napolitano has proclaimed September 7 – 13, 2008 Assisted Living week. This is a time to celebrate our residents, families and staff that reside and work in over 2000 assisted living communities throughout the state in both rural and urban areas.

Assisted living in Arizona offers two distinct living styles. The first of the two, assisted living centers, have 11 apartments or more and offer apartment style living. The second option, assisted living homes, have 10 beds or less and are typically located in residential neighborhoods. The only licensing difference between a home and center is physical plant. Assisted living homes have residential style kitchens while assisted living centers have large restaurant style kitchens.

There are three licensing categories in assisted living – Supervisory, Personal and Direct care. Direct care provides the highest level of care in assisted living. Most important to remember is centers and homes are licensed to provide the EXACT same levels of care. Centers and homes follow the same Rules and Regulations set-forth and monitored by the Arizona Department of Health Services.

This week join us as we celebrate Assisted Living in Arizona !

Karen Barno
President
Arizona ALFA