Basic HTML Version
Healthcare Journal of NEW ORLEANS
I
NOV / DEC 2013
23
can I fairly get support to those individuals?
But there are ways to do it. Right now in
our developmental disabilities systemwe use
assessments of families’ abilities to provide
supports. And again, it’s a very hard balance
to strike. A family may say, “I can’t do this.”
It’s hard to assess if they really can’t or at this
point are just not willing. We have great fami-
lies, but it’s difficult to have long termneeds,
a child with disabilities, a parent with dis-
abilities, and to provide that level of support.
Editor:
Let’s talkaboutwhereweare intheprocess.
In November, 2012, DHH issued an ROI to bring
somepeople to the table to talkabout theprocess,
but how do you manage the self interest in that
process?Whereareweandcanyoutalkabouthow,
withattempts to improvequalityand lower costs,
youarealsotalkingaboutmaybenegativelyaffect-
ingsomeof theseentities thatareat the table?How
are you going tohandle this politically?
Editor:
When assigning a system, how do you
take into account a specific family structure?
For example some families are more capable
and some aremore willing than others.
Kathy Kliebert:
I think one of the essential con-
cepts of any type of long term care system is
you have to look at the natural and commu-
nity supports. We’re never, as a state, going
to be able to totally provide for the elderly
population or the people with disabilities.
You are never going to have enough sup-
port. So you’ve got to be able to take that into
account and it is very difficult. You have such
a different level of family abilities that are
out there. There are some families that can
clearly provide support and it’s very hard to
then assess objectively what that support can
be. So if you have the same level of acuity as
somebody else, but your family can provide a
lot more support than this other family, how
much better for the family, if we don’t put
people in an institution.
It’s not somuch about transitioning people
out, although we’ll continue to do that, it’s
muchmore about making sure they don’t go
there in the first place if they don’t really need
to. Because once people go into institutional
settings you lose the family ties, you lose those
bonds, you lose those family supports, and
they are very hard to get back, even if a person
is only going in there short term. If they are in
there six months you would not believe the
support systems that are lost. So that’s always
part of our philosophy and will be for this.