The organization where I gained practicum experience is called VNS CHOICE. It is a long-term care program that is managed by MEDICAID.

Civil Engineer Job Summary
April 5, 2022
Describe the application of a chronic disease model to address this disease at the population level (refer to attached article). Include your rationale for selecting this particular model.
April 5, 2022
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The organization where I gained practicum experience is called VNS CHOICE. It is a long-term care program that is managed by MEDICAID.

Host Organization
The organization where I gained practicum experience is called VNS CHOICE. It is a long-term care program that is managed by MEDICAID. The patients should be sixty five years or older; they have MEDICAID for insurance and have medical conditions or co morbidity that require care management by a registered nurse. Most of the patients have chronic medical conditions and decreased functional conditions that would qualify them for long term care in a nursing home. These patients can however remain safely in the community thus saving costs of having them put in a nursing home. Most of the patients are dually eligible which means that they also have insurance by Medicare.
 
VNS CHOICE is under the direct oversight of a Chief Executive Officer who is also President of the Visiting Nurse Service of New York. VNC CHOICE contributes to an estimated forty one per cent of the total revenue for VNSNY. There is an executive management group that is responsible for various functional domains of the organization’s health plan. The domains are administrative operations, clinical operations, medical leadership and finance. The Chief Medical Officer oversees the administration of medical policy and medical services for the health plan products that VNS CHOICE offers. He also oversees the medical utilization, quality management, grievances and appeals and evaluation of physician reimbursement models.
 
VNS Choice has several strengths; VNS Choice offers a varying range of home health care services which include management of chronic conditions, medical and nursing services. The Hospice Care program provides compassionate and skilled care for people who are at the end of their lives. The hospice services are available to patients who live at their homes, nursing homes or in the residence of VNS Choice. The organization is also home to a national research center where practical problems are solved and research is generated for the purpose of increasing knowledge that helps patients recover from illnesses that are short-term, to manage the challenging chronic conditions and to prepare effectively for advanced illnesses. Innovative research from the Center has enabled the center and attracted large amounts of grants from government and philanthropists. The people who reap these benefits are the VNS CHOICE patients and families.
 
The information generated from the Center’s research is shared with other clinical staff through national initiaves such as the CHAMP Program (Collaboration for Homecare Advances in Management and Practice). The CHAMP Program shares information on geriatric expertise with several home care agencies all over the US in order to promote quality home health care for the older generation. VNS Choice also shares results of research by publishing in professional and peer-reviewed journals, making presentations to students, professionals, the public and policy makers and also to the media to enhance coverage. The current strategy of the organization is to monitor research developments and changes in healthcare as well as changes in the demographics of patients such that patients receive the proper treatment in the setting that the patients prefer.
Working at VNC CHOICE
While working at VNS Choice, I was in the VNS CHOICE Community Care department, where I was reporting to the team manager. The purpose of the position was to provide care management through a process of assessment, planning, facilitation and advocating for options and services that can meet a patient’s health needs. The aim of the position was to maintain the members in the most independent living situation possible while ensuring that health care remains consistent throughout the health care continuum. The position also required close communication and collaboration with the primary care practitioners, family members and the interdisciplinary team.  In the position of nurse consultant, the responsibilities included assessing, planning and providing intensive and continuous management across various settings ranging from home, acute and long-term care settings. It involved developing and negotiating care plans with patients, physicians and families. The nurse consultant assessed the patient’s living conditions, cultural influences and functioning. Other responsibilities included planning for the patient’s care, coordinating this care, assisting patients with daily living activities, providing nursing care, documenting services given, and evaluating  the effectiveness of the plan of care formulated.
 
The work had several tasks associated with it. One of the major tasks was that of direct patient care which involved clinical assessment, administering medications and providing assistance with activities of daily living. This last task involved helping patients to position themselves, to move and lifting or transferring patients with different physical conditions sometimes with assistance and sometimes with out. The assistance could come from family members or paraprofessionals.  Another task related to the health care of the members was transporting the medical equipment and supplies that would be required in delivery of nursing care from and to homes or care facilities and VNS Offices.
 
Participation in outreach activities that are aimed at promoting knowledge of the Program and its services is another task that was carried out by the nurse consultant. Some of the outreach activities included community health screening and in services and coordination of Program activities with those agencies outside the community and with health care providers. Closely related to this task is the development of programs that meet the specific needs of the selected patient population.
 
The major outputs of the position include nursing care plans that contain the nursing needs for the members and the objectives and goals of care. A budget of expected expenditure to indicate responsible fiscal spending that ensures all the necessary services are covered. Documentation of services rendered to the patient and their family is another of the outputs for the position. The documentation is done as per the standards of VNC CHOICE and the regulations of Managed Long Term Care and Licensed Home Care Services. A final output is the development of a program that meets the specialized needs of the patient population.
 
One of the major management actions that were required of

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