C ouncils Office of the State LongTerm Care Ombudsman Program Field Representative Kathryn White Why have a council The lives of the residents are heavily controlled by laws rules and policies set by the government and nursing home Compromises in lifestyle become necessary due to ID: 461476
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Slide1
Resident and Family Councils
Office of the State Long-Term Care Ombudsman
Program Field Representative, Kathryn WhiteSlide2
Why have a council?
The lives of the residents are heavily controlled
by
laws,
rules, and policies set by the government and nursing home. Compromises in lifestyle become necessary due to health problems and living conditions. These compromises and controls can make nursing home residents feel their opinions and preferences do not matter. A council gives the residents an active role in their life and a chance to influence decisions that affect them.
http://www.atlantalegalaid.org/fact16.htm
Image 1: Goodwin House Alexdria
Resident
CouncilSlide3
What is a resident council?
Resident Council
-
Resident
councils are organized, self-governing, decision-making groups of long-term care residents meeting regularly to voice
their needs and concerns and to have input into the activities, policies, and issues affecting their lives in the
facility.
http
://
health.mo.gov/seniors/ombudsman/pdf/HowToOrganizeAnd_DirectAnEffectiveResidentCouncil.pdf
Slide4
What is a family council?
Family Council
-
A family council is a self-led, self-determining group of consumers - families and friends of nursing home residents that:
• Works to improve the quality of care and quality of life of the facility’s residents.
• Provides families with a voice in decision-making that affects them and their loved ones.
http://health.mo.gov/seniors/ombudsman/pdf/FamilyCouncils.pdf
Slide5Slide6
http://
ec-online.net/Knowledge/Articles/familycouncil.html
Slide7
Where to start?
Do they want a council?
Are staff and administration willing to help the council get started?
How to introduce members to the council?
How to participate?
Image 2: avoidance300.jpgSlide8
Laws and Regulations
Older Americans Act
Omnibus Reconciliation Act of 1987 (OBRA ’87)
Federal Regulations
State Nursing Home RegulationsAssisted Living RegulationsNursing Home Care ActEnforcementSlide9
Older Americans Act
Every State Required to have a Long-Term Care Ombudsman Program.
The OAA set out specific objectives for maintaining the dignity and welfare of older individuals and created the primary vehicle for organizing, coordinating and providing community-based services and opportunities for older Americans and their
families.
Section. 712. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.(H)(i
) provide for training representatives of the Office; (ii) promote the development of citizen organizations, to participate in the
program; and
(iii
)
provide technical support for the development of resident and
family
councils to protect the well-being and rights of
residentsSlide10
OBRA ‘87
1987 Congress passed the Nursing Home Reform Law as part of
the Omnibus
Reconciliation Act of 1987 (OBRA
87).Established national standards for care and residents’ rights for people in nursing homes.Each resident be provided with services sufficient to attain and maintain his or
her highest practicable physical, mental, and psycho-social well-being.New
federal requirements were
established, including
: a resident assessment process leading to development of
an individualized
service plan,
the right to organize and participate in
family or
resident councils
, the right to be free of unnecessary restraints (
physical or
chemical), and specific requirements for those most responsible
for resident
dignity and
care.Slide11
Federal regulation 42 C.F.R. § 483.15 explains the role of the
resident and family
council:
(c)
Participation in resident and family groups. (1) A resident has the right to organize and participate
in resident groups in the facility.(2) A resident's family has the right to meet in the facilitywith the families of other residents in the facility;
(3) The facility must
provide
a resident or family group, if one
exists, with
private space
;
(4) Staff or visitors may, attend meetings at the group's
invitation;
(5) The facility must
provide a designated staff person
responsible for providing assistance and responding to written
requests that result from group meetings;
(6) When a resident or family group exists, the facility must
listen to the views
and act upon the grievances and recommendations
of residents and operational decisions affecting resident care and life
in the facility.Slide12
State Nursing Home Regulations
OSDH 310: 675-7-7.1 Resident’s Advisory Council
Establish Council
Consist of all current NH facility residents or their designated representative, facility coordinate and assist , and respond to request
No one from facility memberPrivate spaceMinutes prepared/ maintained by staffCommunicate to administrator opinions/ concernsSlide13
Assisted Living Rules
OSDH 310:663-15-1 Residents Rights
Observe all residents rights and responsibilities enumerated under Title 63 O.S. Section 1-1918 (B)
Nursing Home Care Act Title 63 O.S.State Statue 63-1-1918 Rights and Responsibilities2. Every resident shall have the right to have private communication, including…..and meetings of family and resident groups……….
3a (1) Present grievances…….3b The family of residents shall have the right to meet in the facility with other residents’ families.http://www.ok.gov/health2/documents/HRDS%20675%20NHCA%201113.pdf
http://www.ok.gov/health2/documents/LTC%20Continuum%20of%20Care%20&%
20AL%20Rules.pdf
Slide14
Enforcement F-243
State Statue 483.15 © Participation in Resident and Family Group
-organize and participate
-family members meet with other families
-private space-staff/visitors attend by invitation-provide staff personIf one does not exist, determine if residents have attempted to form one but have been unsuccessful; and if so, why.
This requirement does not require that residents’ organize a resident or family group, however facilities must allow them to do so without interference.
http://
www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
Slide15
Enforcement F-244
State Statue 483.15 © (6) When a resident or family group exists, the facility must listen to the views and act upon the grievances and recommendations of the residents and family members concerning proposed policy and operational decisions affecting resident care and life in the facility.
http://
www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
Slide16
By-Laws
Who will
facilitate?
Topic/Guest
S
peakers/ PresentationAgenda
Meeting
Length
Regular Meeting
Time
Goals/
Ground
Rules
Meeting
Procedures
Leadership
Preparation for Meeting
Minutes
Liaison
Confirm Meeting Room/ Refreshments
Image3: clipart_people_desk_meeting_19909_1920x1200.jpgSlide17
Enthusiasm
Participation
and SharingSlide18
Leadership & Structure
Models Of Leadership
Traditional/Town Meeting
-Chair Person/ President, Vice-Chairperson/ Vice-President, Secretary, and
Treasurer.Co-Leaders- Two members share responsibility.
Leadership Committee-several family members share responsibilities, or for first few months then have formal election.
Leadership committee with rotation
Alternating Leader
Representative
-residents bedfast, serving as liaison for other residents.Slide19
Leadership & Structure
Elections
Job Description
Training for Leaders
Term LimitsSlide20
What makes a good leader?Identify
Personal Qualities
Relate to People
Lifetime Learners
Seek AssessmentImage 3: Does it look like what makes up a good leader.Slide21
Duties of Officers
Chairperson/ President
-Presides over meeting, seeing by-laws and procedures are followed, keeping control over meeting, maintaining impartiality, coordinates activities, maintain communication with staff.
Vice Chairperson/ Vice President
-Fill in when chairperson is unable to fulfill duty.Secretary-Taking notes at meetings, recording and maintaining a file of the minutes, maintaining correspondence, and having by-laws handy at meetings in case of questions.Treasurer- Receiving and dispensing funds, maintaining proper financial records, and reporting to the council on status of treasury.
http://health.mo.gov/seniors/ombudsman/publications.php Slide22
Liaison/ Staff Assistant
A facility appointed staff advisor or liaison is required to support the council and respond to written requests/concerns arising from the council meetings. The liaison may or may not be invited to attend the
meeting. In the beginning be clear of the role of the assistant.
http://www.tjaaa.org/resident-family-councils-nursing-homes.aspx
Help to tell families/ new residents
Advise council on changes in facilityExplain the facility's policies and procedures
Help council communicate its questions
Help to book guest speakers
Provide refreshments and make copies
Share information
Educate staff
Enthusiasm
No…No
Planning and running meetings
Speaking on behalf of residents
Selecting meeting times and dates, topics, activities…
Image 4: Runnells
Hospital Staff Members Honored by Resident
CouncilSlide23
Parliamentary Procedure
Robert’s Rules of Order
The Standard Code of Parliamentary Procedure ( formerly the Sturgis Standard Code of Parliamentary Procedure)
Why Do Groups Use Parliamentary Procedure?
To give everyone a chance to be heard
To allow members to participate in an orderly group To establish and maintain order in a meeting
To prevent confusion when discussing club business
To keep things movingSlide24
Opening Activity-Roll call/ name tags everyone becomes acquainted
Read Minutes from last meeting-what has happened since
Receive Reports-discuss needs, concerns, and activities of residents they represent
Unfinished Business- review from previous meeting
New Business-New concerns and ideasResident ConcernsFacility News-information to share from department headsSocial Time-Wind down/ refreshments
Image 6: graphics-agenda-603334.jpgSlide25
Minutes
WHAT: Accurate record made of all happenings at each meeting, who served, facility’s actions in response to concerns of the council.
WHY: Communication tool/sharing outcomes and useful written record.
WHO: Secretary takes minutes or designate someone.
Brief, Legible, and for anyone to understand, typed and copies made for distribution (given to all residents or posted).The name of the person presidingMembers presentWho took minutes
Date and time of the meetingAll items discussed, actions takenDate and time of next meetingSlide26
Formality of Structure
Ensure that the council knows where it is heading and that there is a democratic and fair way for the council to do its work and make decisions.
http
://theconsumervoice.org/uploads/files/family-member/Developing-and-Suporting-Family-Councils.pdf
By-lawsPoliciesSlide27
By-Laws
Written guidelines by which the group operates.
Name
Purpose/ Mission Statement
Membership (criteria)Officers and committees (tiles, responsibilities, terms)Meetings (when and how is conducted)Elections (nomination, procedures)Rules of Order (raise hand, talking stick)
Future AmendmentsSlide28
Policies
Communication with administrator/staff
Communication of concerns to administrator/ staff
Communication with other family members
Communication with residentsHandling individual concernsSlide29
Problem Solving
Will this help improve resident care and residents’ lives?
Narrow down and pinpoint the specific problems
Learning current policy on a facility issue
Learning what laws and regulations requireThe role of the council is not just to identify problems, but to offer ideas and suggestions about how to resolve them.
http://
www.ltcombudsman.org/sites/default/files/norc/issues/Omb-and-Family-Councils-LAFMC.pdf
Image 7: Problem-Solution-Magnifying-Glass-1220488.jpgSlide30
Promoting
Many family councils have active participation of 10% of families of the residents.
http:/theconsumervoice.org/uploads/files/issues/promoting-participation-2012.pdf
FlyerNewsletterMembership FormPermission to Contact Greeter in lobbyMailings
Staff What to say?…………….
Image 8 megaphone.pngSlide31
Ombudsman Role
Yes! Encouragement!
(Yoga instructor from Couples Retreat Movie)
Coach
Educator/ TrainerConnectorMediatorSlide32
Communication/ Meeting
Respect
Trust, Care, and Concern
Good Listener
Observation
Give/ Receive/ Share InformationConfidentiality
Recognition
Patience
Sense of Humor
Criticism
Mistakes
Laugh at Self
People’s Well-Being
Admit not knowing
Alternatives
Praise
(Retrieved from Resident/Family Council folder in Ombudsman Office)Slide33
Communication/ Processing Concerns
Officers having regular monthly meeting with
administrator/
keep
members informed (make an appointment in advance).Allow reasonable time for complaint to be resolved.Hear constructive input/ get all facts.Address small concerns before they become major problems.
Work toward meaningful change, avoid unreasonable demands.Present ideas in a non-threatening way (friendly, but firm).Avoid generalities and exaggerations.
Show appreciation.
Facility clear on the purposes and rights of your council / value of cooperation.
(
Retrieved
from Resident/Family Council folder in Ombudsman Office)Slide34
Obstacles
FEAR OF RETALIATION
LACK OF INTEREST
LACK OF TIME
LACK OF INFORMATIONLACK OF SUPPORT FROM THE FACILITYDISCOURAGED EASILYLOW PARTICIPATIONNOT WANT LEADERSHIP ROLESlide35
Benefits
In-service training
Improve staffing assignments and stopped staff rotation
Survey, improvements to facility
Better service to residents (food, daily care, bathing time, activities, etc...)Grievance Forms at nurses stationStaff appreciation and educational programsBilling/ Delivery issue with pharmacyCouncil put in admission packetOpen lines of communicationSlide36
Resources
How to Organize and Direct an Effective Resident Council: A Technical Assistance Manual of
the Missouri
Long-Term Care Ombudsman Program.
Emmelene W. Kerr. Missouri Long-Term Care Ombudsman Program. This manual covers all aspects of council work – from forming a new council to improving an existing council Written
by a former coordinator in the Missouri Ombudsman Program who draws upon many years of ombudsman experience with resident councils, ombudsmen will find straight forward information
and tips to use when assisting in the formation or strengthening of a resident council.
http
://health.mo.gov/seniors/ombudsman/publications.php
Family
Guide to Effective Family Councils
Prepared by Robyn Grant for The Legal Assistance Foundation of
Metropolitan Chicago and the Evanston Commission on Aging
Additional copies: Kathy Swanson c/o Legal Assistance Foundation of Metropolitan Chicago
111 W. Jackson Boulevard 3rd floor
Chicago, IL 60604
http
://
theconsumervoice.org/uploads/files/family-member/Guide-toEffective-Family-Councils.pdf
Long
Term Care Ombudsman Guide to Developing and Supporting Family Councils
Prepared by Robyn Grant for The Legal Assistance Foundation of Metropolitan Chicago
111 W. Jackson Boulevard 3rd floor
Chicago, IL 60604
http
://
theconsumervoice.org/uploads/files/family-member/Developing-and-Suporting-Family-Councils.pdf
Parliamentary Charts and
Handouts
http
://
www.jimslaughter.com/uploads/OrderofBusiness.pdf
Slide37
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