Under a portion of the legislation called the Elder Justice Act, in a section on “enhancement of long-term care,” is a provision for an IT grant program for long-term care to offset the costs of “purchasing, leasing, developing and implementing certified EHR technology … designed to improve patient safety and reduce adverse events and healthcare complications resulting from medication errors.”
The grant funds can be used both for purchasing new computer equipment and software and for upgrading existing computer software and hardware, with e-prescribing technology getting a specific mention. Grants under this provision may also be used for various care-improvement processes not related to technology, including continuing education and on-the-job training to improve the quality of patient care.
The law also directs the HHS secretary to develop “accountability measures” to ensure grant funds are used to improve patient safety and reduce adverse events from medication errors. HHS also must adopt health IT standards for the exchange of clinical data by long-term-care facilities. Grant funds also can be used for staff training. And, within 10 years of passage of the new law, HHS must have “procedures in place to accept the optional electronic submission of clinical data by long-term-care facilities” using those HHS-adopted standards.
Grantees, for their part, are obliged to participate in state, or state-designated, health information exchanges.
One readily apparent problem with the IT grant program is a shortage of funds. While the Recovery Act, also known as the stimulus law, provides an open-ended authorization to create an EHR grant program under Medicare and Medicaid from which an estimated $14.1 billion to $27.3 billion will be spent, the long-term-care funding provision in the new law is authorized at $20 million for fiscal 2011, $17.5 million for fiscal 2012 and $15 million each for fiscal 2013 and 2014. That's a total of $67.5 million to cover IT as well as other long-term-care improvement programs included in the same section of the law. With 15,691 skilled-nursing facilities in the U.S. in 2009, that works out to $4,302 each.
Elsewhere, under the title of "Data Collection, Analysis and Quality," the law requires that HHS, within two years of enactment, ensures that "any federally conducted or supported healthcare or public health program, activity or survey," including long-term-care facilities, collect and report certain patient demographic and healthcare-releated data.
HHS is required by these provisions to ensure “to the extent practicable” that data be collected on race, ethnicity, sex, primary language, disability status and location “at the smallest geographic level such as state, local or institutional level if such data can be aggregated.”
The data are to be used to generate “statistically reliable estimates” based on these data elements “to assess access to care and treatment for individuals with disabilities and to identify locations where individuals with disabilities access primary, acute (including intensive) and long-term care.”
What do you think? Write us with your comments at [email protected]. Please include your name, title and hometown.