Supporting Service Coordinators
January 17, 2016 | by Debra Wood, R.N.
As housing plus services models proliferate, more pressure lands on service coordinators. Are we supporting them adequately?
Housing service coordinators have long played an important role in linking residents to supportive services that would allow them to continue to live independently, but as health care delivery becomes more inclusive, management can better support service coordinators as their positions evolve to meet new expectations.
“Service leaders are on the front line, and they need to be well-supported to do a good job,” says Linda Coleman, vice president of resident services at Beacon Communities
in Pleasanton, CA.
Service coordinators serve as advocates and can help residents navigate the health care system, arrange for transportation to appointments and identify resources that can keep the older adult healthier. They provide a link between residents and management and the broader community. They also might be tasked with finding and facilitating podiatry or home health services or exercise programs that will benefit residents.
“The role has grown with the concept from the Affordable Care Act of trying to keep people from repeat hospital stays and working with outside providers and managed care organizations,” says Janice Monks, president and CEO of the American Association of Service Coordinators
(AASC) in Powell, OH. “The service coordinator will manage those partnerships. They also may do more formal assessments. That’s the next level.”Volunteers of America
(VOA), based in Alexandria, VA, has developed a variety of assessment tools for its service coordinators to use to identify residents in need, eligibility for government programs and the residents requiring more supportive services. Research helps the organization determine what residents are at high risk for health problems or cognitive impairment. VOA employs 125 service coordinators in its properties.
“Service coordinators use our housing as a platform to connect residents to health services by building relationships with public and private health care providers,” says Donna Thurmond, vice president of resident services at VOA. “In the future, service coordinators will be more health focused.”
Thurmond hopes research will demonstrate to the Centers for Medicare & Medicaid Services how service coordinators can save health care dollars. Monks says managed care companies already understand the effect service coordinators can have on reducing unnecessary health care costs.A study
by the LeadingAge Center for Housing Plus Services
and The Lewin Group
found that people living in senior housing with an available service coordinator were 18% less likely to be admitted to the hospital than people living in a community without a service coordinator. Alisha Sanders, the center's managing director, indicates such coordination and collaboration could save Medicare dollars for millions of low-income elderly residents.
Beacon Communities has increased the number of service coordinators as its population aged, health delivery changed, and as the housing provider began collaborating with health plans and health systems.
“It’s a completely different level of supportive services,” Coleman says. “Partnering is our vision. We cannot do it on our own.”
VOA also works with outside organizations, which may bring in exercise, balance and other programs designed to enhance residents’ healthy living. Partnerships and collaboration with outside providers help service coordinators achieve the goal of helping residents age in place.
“Service coordinators have an impact on the bottom line and if there is turnover in the building,” Monks says. “They also can prevent damage to apartments. That equates to a positive impact financially. They may not be making money but are saving money.”
For successful service coordination, an organization’s leadership must respect its value and invest in the people who make it happen.
Management can help support service coordinators by having a clear understanding of the service coordinator role and not asking the service coordinator to perform duties that normally fall to management, Monks says. They need to work as a team. She suggests a new service coordinator shadow the manager to learn about that role. And a new manager can shadow the service coordinator, as long as it does not violate the resident’s privacy.
Monks also recommends service coordinators and managers train together on topics of mutual interest, such as bullying, bed bugs, hoarding and active shooters, all hot topics at the moment.
VOA has combined its webinar training so modules apply to both management and service coordination. Both disciplines hear the same message. VOA aims to increase continuity across its system and cross-training will help facilitate that.
“All voices from all departments are important,” says Natasha Ofosu, senior manager of housing quality and training at VOA. “And it helps show how we can work as a team moving forward.”
VOA housing and service coordination networks include people from the other discipline. Together they will problem-solve and look for solutions to residents’ issues. Seasoned coordinators can give new service coordinators ideas and suggestions of things that worked in similar past situations.
“Donna has put a huge focus on peer learning,” says Jessica Meyerson, senior director of research and outcomes at VOA. “We try hard to consult with service coordinator work groups in developing new tools.”
Beacon Communities management supports service coordinators with thorough training about the position, Housing and Urban Development (HUD) guidelines, documentation, and the mission and culture of the organization, Coleman says. She provides new service coordinators with a manual with forms and policies. Coleman also facilitates a retreat for service coordinators near one of its communities and will bring in guest speakers.
Beacon Communities and VOA send service coordinators to the AASC annual conference. The association also offers webinars.
“The training piece is huge,” Monks says. “Service coordinators come across situations and want to know how to deal with them.”
While some things are straightforward, helping service coordinators learn boundaries can prove more challenging, but it is something leadership focuses on for the individual service coordinator, Coleman says. She encourages service coordinators to build relationships with management, maintenance personnel and other staff in the housing community.
Monks also would encourage management to educate service coordinators about their budget and be transparent about financial aspects of the service coordinator program.
“It would help them understand the limits of what they have to work with,” Monks says.LeadingAge Thrive
provides resources to help members better serve seniors and their communities. The 7 major topic areas in Thrive include questions designed to stimulate discussion among your leadership team and board of directors. Thrive also includes resources such as white papers, articles, tools, presentations and business intelligence.
Under the “Workforce and Leadership Development
” section of Thrive, see the resources connected to these questions:
- Do we have a comprehensive orientation program for new employees across all staff levels and settings?
- Do we provide ongoing state-of-the-art training for administrators, midlevel managers, clinical staff and frontline providers across all departments and settings?
- Do we conduct employee satisfaction and engagement surveys, provide employee feedback, and use the data to make organizational decisions?
- Do we periodically assess the level of investment in human capital to ensure that resources are being used appropriately and effectively?
- Do we use evidence-based management best practices (e.g., supervisory training, open communication, empowerment of frontline staff, self-managed work teams, peer mentoring and support) to set organizational priorities, solve problems, improve the working conditions and the quality of the job and minimize turnover and instability in the workplace?
- Do we offer competitive compensation and benefits for staff at all levels and across all settings?
- Do we have specific plans to strengthen our workforce by putting into practice competencies and competency-based training? If so, do you build these competencies into your performance evaluations?
- Do we have a comprehensive cultural competence strategy to support healthy staff-to-staff and staff-to-resident/client relationships and quality service delivery?
- Do we have in place a comprehensive employee orientation program?
Thrive is a LeadingAge member benefit, and access is limited to members. Use the MyLeadingAge login page to log in or create an account.
Visit the Thrive main page.
Providing service coordinators with the tools to successfully perform their jobs is another way leadership can support service coordination. In many organizations, that includes an electronic service coordination record system.
“It documents all of the critical information about our residents,” Coleman explains.
Service coordinators can enter information about each resident’s diagnoses, medical history, medications, ability to perform activities of daily living, next-of-kin contacts and other pertinent data. The information is easily updated as situations change. When a resident starts falling or not eating, the service coordinator can help draw on that information and connect the resident with appropriate support services.
The electronic systems help with compiling the semi-annual reports HUD requires, including demographics and number of services provided. From the aggregate data provided by the service coordinators, management also can determine the affect the service coordination program has had on hospitalizations, nursing home placements and other outcomes.
For owners of multiple communities, the information from the electronic system can prove valuable in improving outcomes system wide. For instance, “The owner can see that 5 people stopped smoking due to a service coordinator’s actions, and ask why we can’t do that in another property,” Monks says.
VOA quality assurance staff and researchers review the reports and use them to enhance the service coordination program.
“We can easily determine if our service coordinators are making the impact we expect,” Thurmond says.
The reports also can demonstrate the value of service coordination and help generate support from managed care or accountable care organizations for wellness or other programs they may be willing to sponsor.
In addition to reviewing reports, management can ask service coordinators about their accomplishments, Monks says, and leadership can recognize service coordinators successes.
“A big part of it is feeling respected, and it goes both ways,” Coleman says.