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DEPARTMENT OF HUMAN SERVICES
NURSING CASE MANAGEMENT
PROGRAM MISSION:
To support and empower individuals and families to achieve and maintain an
optimal level of health and well being in the community through home visits to
adults and elderly persons who are disabled or have multiple chronic illnesses
and live in their own homes.
The program impacts the community
at large by maximizing knowledge of health care issues. Services are designed to prevent unnecessary
emergency room visits, hospitalizations, and premature institutional placement. The following are components of the program:
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Nursing Case
Management provides nursing case management services to persons through
home visits as prescribed by a physician.
The focus is on improving or maintaining the patient's level of
functioning through a comprehensive medical and psychosocial assessment, health
education, monitoring of the patient's medical condition, and coordinating the
provision of needed services in the patient's home. Two major areas of focus are medication management and
nutrition. Joint visits are also made
with Adult Protective Services social workers for an evaluation of critical
medical needs. Consultations are also
provided to the Mental Retardation/Developmental Disability case managers, and
social workers and mental health therapists in Adult Services and Senior Adult
Mental Health.
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Activities of Daily Living supplements
Nursing Case Management services by providing the patient with a bath and
personal care services once a week.
With a focus on prevention, staff emphasizes skin care and home safety, and immediately alerts the
medical staff to any changes in the patient's condition. A fee is charged based
on the patient's income.
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Community Outreach activities include liaison with six area
hospitals for discharge planning; conducting state required nursing home and
community-based care pre-screenings for Medicaid; coordinating the flu
immunization program, including outreach to senior centers and buildings with
elderly residents; and presenting health and wellness programs in the community.
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Nursing Case
Management
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FY 2002
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FY 2003
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FY 2004
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% Change:
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Actual
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Adopted
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Proposed
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'03 to '04
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Personnel
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$488,226
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$582,118
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$628,258
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8%
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Non-Personnel
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118,078
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109,525
|
109,899
|
-
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Total Expenditures
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606,304
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691,643
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738,157
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7%
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|
|
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Fees
|
1,888
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5,500
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2,500
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-55%
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State Share
(Prescreenings)
|
482
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1,328
|
1,120
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-16%
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Medicaid
|
915
|
2,672
|
1,680
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-37%
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Medicare
|
-
|
-
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-
|
-
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Total Revenue
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3,285
|
9,500
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5,300
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-44%
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Net Tax Support
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$603,019
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$682,143
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$732,857
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7%
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Authorized FTEs
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10.8
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10.8
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11.3
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Funded FTEs
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10.8
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10.8
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11.3
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SIGNIFICANT BUDGET HIGHLIGHTS:
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Personnel expenses and FTEs increased as a result of
the reallocation of a 0.5 FTE Human
Service Aide VI from Adult Protective Services within the Division
($19,443). Expenses also increase as a
result of the reclassification of a 1.0 FTE Senior Public Health Nurse
($14,891) and normal step increases.
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Fees, State Share and Medicaid revenues were
decreased ($4,200) to more accurately reflect prior year actuals.
PERFORMANCE MEASURES:
Objective: To provide services to enable patients to maintain or
improve health status or functioning as indicated by at least 90% of patients
demonstrating compliance with medications.
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FY 2001
Actual
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FY
2002
Actual
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FY
2003
Estimate
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FY
2004
Estimate
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FY
2004
Target
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Mission Outcome Measures
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Percent of
patients for whom the nurse prepours medications or prefills insulin syringes
who demonstrate compliance or partial compliance with medications after this
intervention
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92%
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96%
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95%
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95%
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95%
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Percent of
patients with hypertension who maintain blood pressure within established norm for patient 80% of the
time
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86%
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88%
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88%
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88%
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80%
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Percent
of patients identified as obese, underweight, or with unexplained weight loss
who have improved or maintained weight status
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83%
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85%
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80%
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80%
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80%
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Percent of patients in bathing program who have maintained
or improved skin condition
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96%
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94%
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94%
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94%
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94%
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Workload Measures
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|
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Number of persons served in each
program component:
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Nursing Case Management
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432
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425
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450
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450
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450
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Activities of Daily Living
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80
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80
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80
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80
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80
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Percent of patients served with 3 or
more medical diagnoses
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87%
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87%
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87%
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87%
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87%
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Percent of patients who take multiple
medications
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86%
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86%
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86%
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86%
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86%
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Percent of patients who have serious
mental illness
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34%
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32%
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30%
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30%
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30%
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Percent of patients who have 5-10 risk
factors
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83%
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74%
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83%
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83%
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83%
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Percent of patients served who are over
70 years of age
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80%
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78%
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80%
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80%
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80%
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Average number of persons on a waiting
list to receive services
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40
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20
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20
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10
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10
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