Service Program for Older People

Integrated Health Care for Older Adults: A Model Partnership

By Nancy Harvey, LMSW Chief Executive Officer, Service Program for Older People

Published in the Fall 2019 Issue Behavioral Health News
http://mhnews.org/back_issues/BHN-Fall2019.pdf

When Sonia was discharged from New York-Presbyterian (NYP) hospital last winter her Care Coordinator arranged for home care, meals, nurse visits, transportation, medical equipment and prescriptions. She went home confident that she would be safe and would receive ongoing care at home as she regained her strength.

Sonia’s Care Coordinator also connected her with Service Program for Older People/SPOP, an independent non- profit behavioral health center in New York City, and encouraged her to meet with a social worker to discuss behavioral health services. Sonia had expressed anxiety about managing on her own and her lack of a family support system. However she resisted the idea of receiving services and the Care Coordinator spent time with her to answer questions and reassure her before introducing her to the SPOP intake staff.

Following a comprehensive assessment Sonia learned that she was eligible for home visits from a clinical social worker and psychiatrist from SPOP based on her diagnosis and her homebound designation (she lives in a third-floor walk-up apartment). She has been  receiving weekly home visits from her therapist and has learned relaxation techniques to manage her anxiety. Most important,  Sonia has not been readmitted to the hospital.

New York-Presbyterian and SPOP are engaged in a unique partnership to make certain that behavioral health care is an integral part of discharge planning and medical care for older patients (SPOP serves adults age 55 and older). The partnership is supported by an Impact Grant through the NYP Performing Provider System, which seeks to improve overall health and quality of life while reducing unnecessary hospital emergency room usage.

Now in its second year, the partnership has been successful in fostering a culture of integrated care within the hospital, with a focus on Medicaid patients. Our Clinic has received referrals from  throughout  the NYP hospital system, and our therapists work with hospital staff and medical teams to coordinate patient care. As a relatively small agency entirely focused on mental health services for older adults, we are able to respond quickly and meet client needs before they worsen. “SPOP’s community- focused expertise in meeting the behavioral health needs of older adults is invaluable to us,” said Brian Youngblood, LCSW, of the Division of Community and Population Health at NYP. “Working together, SPOP and the hospital have expanded access to care for a very fragile population.”

Building a culture of integrated care relies on relationships throughout the hospital system. SPOP and NYP have developed systems to train hospital staff in the basics of geriatric behavioral health and strategies to support a warm hand-off for assessment and services. Psychotherapists make home visits to those clients who are unable to travel for appointments and of- ten engage with family members and caregivers as part of the treatment plan. And because SPOP provides a continuum of treatment – intensive intervention, medication management, weekly therapy sessions, or non-clinical bereavement support – clients receive care that is appropriate to their level of need.

The program has also benefited family members and caregivers. Not all hospital referrals are the right fit for SPOP, particularly when there is cognitive impairment and the client can’t engage in psychotherapy. In one such case, Henry, age 62, called SPOP on behalf of his 87-year- old mother, who has Alzheimer’s disease and who had been referred by NYP. When Henry learned that his mother did not meet the criteria for SPOP services he became distraught. Our intake staff first connected Henry to an agency that could care for his mother, made a call to provide background, and completed a warm hand off. The intake worker then asked Henry if he would like to speak with a therapist with expertise in caregiver distress. Henry was initially surprised – he had been focused entirely on his mother’s needs – but he said he liked the idea is now enrolled for psychotherapy in our Clinic address his own feeling

SPOP and New  York  Presbyterian have developed a model program to care for older adults, coordinate treatment plans, and prevent re-hospitalization rate. Working together, the two organizations have been able to increase their scope of service to care for the whole person – which benefits everyone.

SPOP featured at symposium at New York Academy of Medicine

Nancy Harvey, LMSW, Chief Executive Officer of SPOP, was a featured speaker at the symposium on Innovative Models of Integrating Behavioral Health and Primary Care for Older People at The New York Academy of Medicine on November 20, 2019.

The symposium was co-sponsored by The Coalition for Behavioral Health and The New York Academy of Medicine Section on Healthy Aging.

Approaching the Tipping Point: It’s Time to Re-Think Mental Health Care for Older Americans

By Nancy Harvey, LMSW Chief Executive Officer, Service Program for Older People

Published in the Spring 2019 Issue Behavioral Health News
http://mhnews.org/back_issues/BHN-Spring2019.pdf

The statistics are clear: Older adults are the fastest-growing segment of the U.S. population – in fact, Americans over age 65 will soon outnumber children. Data indicate that older adults are at increased risk for mental health disorders, and elder suicide in particular is a growing public health crisis, especially among men. The need for mental health care is clear, yet the health care community is poorly equipped to handle increased demand and the complex challenges of caring for a population that may be isolated, fearful of treatment, or unsure of how to seek help.

Now is the time for a national conversation about how to meet the growing need for mental health care for older adults. Preventive care and early intervention can save lives, improve overall health and quality of life, increase independence, and reduce unnecessary demand on the health care system. Recent high-profile suicides have shed light on mental illness and suicidality, and hospitals have a strong incentive to include behavioral health in discharge plans to reduce readmissions. The mental health community now has an opportunity to develop creative strategies to serve older adults.

As one of the longest-serving agencies in the U.S. entirely dedicated to meeting the mental health needs of older adults living in the community, Service Program for Older People/SPOP has unique experience in the field. SPOP was established in 1972 in New York City to provide comprehensive mental health care for adults age 55 and older, regardless of financial need, language, or disability. Our founding mission was to treat homebound seniors, and we have provided community-based care and home visits for nearly 50 years.

There is no shortage of mental health providers in our region for adults with financial means and a high degree of medical literacy; however for those who are financially-disadvantaged, homebound, non-English-speaking, or unfamiliar with the health care system, the options are limited. SPOP is often the only appropriate provider for a referral, and we are known for our service to the most fragile and marginalized older adults in the community.

Most important, SPOP has demonstrated that geriatric mental health care saves money. In a recent clinic survey half of all respondents reported decreased usage of hospital emergency rooms since the start of treatment, and nearly 90% reported that they are now equipped to handle daily problems more effectively – outcomes that have a direct impact on health care costs.

“Alice,” age 67, is an example of how SPOP works in the community. “Alice” is homebound due to severe arthritis and at the time of admission was identified as an emergency room “super utilizer” (more than four visits per year). She was diagnosed with an anxiety disorder, and during the weekly home visit with her therapist she worked toward treatment goals of learning to manage anxiety symptoms and develop coping skills and relaxation strategies. Over two years of treatment Alice has made only two emergency room visits, and she recently initiated discharge on the basis of having achieved her goals.

Drawing on our own experience in advocacy, direct service, and fostering strategic alliances, we recommend a broad discussion to explore ways to meet the fast-growing need for geriatric mental health care. Among the topics we might consider are:

• Addressing the shortage of qualified professionals trained in geriatric mental health care, including psychiatrists, nurse practitioners, and bilingual psychiatric social workers, and advocating for Medicare coverage for service at different credential levels (e.g. LMSW vs. LCSW)

• Expanding the use of technology and Medicare coverage for it, particularly telehealth in urban settings

• Creating a clear interface between Medicare and Medicaid for the dual-eligible population

• Educating government leaders and the philanthropic community on the need for funding for geriatric mental health • Advocacy to restore or increase Medicaid coverage for in-home treatment for clients who are disabled and homebound

• Correcting a “silo” mentality and fostering greater coordination between mental health systems and government agencies

A national conversation will be an important first step toward developing a plan to provide care for all older Americans. Strategies to provide service may vary in rural communities, senior residential facilities, or urban settings, but the need is universal: let’s work together to keep older adults healthy, independent, and engaged in the community.

Her Addictions Made Her a Great Fit for the Job

“Gloria Goodson’s career as a counselor began after kicking her own addictions. In retirement, her advocacy continues through volunteer work.”

Click here to read this incredible article and learn more about SPOP in the New York Times.

SPOP Receives 8th Annual Joan H. Tisch Community Health Prize

WINNERS OF THE ANNUAL JOAN H. TISCH COMMUNITY HEALTH PRIZE FOR EXCELLENCE IN URBAN PUBLIC HEALTH ANNOUNCED BY HUNTER COLLEGE

shown left to right:  Laurie M. Tisch, Patricia A. Caldwell, Board President of Service Program for Older People, Nancy Harvey, LMSW, CEO of Service Program for Older People, Jennifer J. Raab, President of Hunter College

 

(New York, NY – November 14, 2018) – Hunter College President Jennifer J. Raab and Laurie M. Tisch Illumination Fund Founder and President Laurie Tisch have announced this year’s recipients of the eighth annual Joan H. Tisch Community Health Prize.  These prestigious awards honor individuals and nonprofit organizations in the New York metropolitan area for distinguished accomplishment in urban public health.  The 2018 recipients are Claudia Aristy (Hunter College ’07), who serves as Director of Children of Bellevue’s Reach Out and Read (ROR) Program a well as the Health Education and Literacy for Parents (HELP) Project; and the Service Program for Older People, Inc. (SPOP), which was one of the first agencies in the U.S. to focus on meeting the mental health needs of senior citizens aging in place in their communities.

Both recipients were honored at a ceremony and reception on Tuesday, November 13 at The Roosevelt House Public Policy Institute at Hunter College.

“We are proud indeed to recognize these urban health heroes,” said President Raab.  “They are perfect examples of the Tisch Family’s extraordinary effort to identify and acknowledge people and organizations that make a major impact on their communities—and who will benefit enormously from these generous $10,000 prizes.  Our thanks again and always go to Laurie Tisch for her innovative spirit and extraordinary generosity—with a special debt of gratitude and affection for Laurie’s mother, the late Joan Tisch, an activist and philanthropist who made healthy living for all New Yorkers both a priority and a passion.”

Said Laurie M. Tisch: “The Service Program for Older People, Inc. and Claudia Aristy have both exhibited their unwavering commitment to serving those in need in our communities. [,” said Laurie Tisch,.  “] My mother dedicated her life to improving the lives of all New Yorkers, and these honorees truly embody her values, dedication, and passion.”

The Joan H. Tisch Community Health Prize honors not-for-profit organizations and individuals for distinguished accomplishment in the field of urban public health. Made possible by support from the Laurie M. Tisch Illumination Fund, the Prize is part of the Joan H. Tisch Legacy Project, which is based at Hunter College, and is a tribute to Joan H. Tisch in recognition of her humanitarian activism in health care and social services in New York City.

Future nominees’ work should focus on improving urban public health in areas such as: reducing health disparities; obesity/diabetes/nutrition; chronic disease prevention and management; environmental health; HIV/AIDS; health problems associated with poverty; healthy aging; mental health; substance abuse and addiction; public health policy and advocacy; and access, financing, and quality of care.

About the Honorees:

Claudia Aristy (Hunter College ’07), Individual Honoree, is the Director of Children of Bellevue’s Reach Out and Read (ROR) Program and the Health Education and Literacy for Parents (HELP) Project at NYC Health + Hospitals/ Bellevue where she is responsible for program administration and training. Claudia also serves as a parent educator in both programs. Her passion for her work inspires staff and volunteers as well as the many professionals and media representatives who visit the programs.

Claudia’s career at Bellevue Hospital began in 2000 as a bilingual Parent Educator in both programs. She has developed all aspects of the HELP Project curricula and was responsible for training bilingual HELP Project volunteers as well as translating and field-testing Spanish language materials. Claudia currently serves on the National Board of Directors of ROR and on the Advisory Board of Leyendo Juntos, a National ROR initiative, and ROR of Greater NY. Claudia has a Bachelor of Arts Degree from Hunter College.

Service Program for Older People, Inc., Organizational Honoree, was one of the first agencies in the U.S. to focus on meeting the mental health needs of older adults living in the community.  Over the five decades since its founding, SPOP has grown from a neighborhood agency serving aging and homebound Holocaust survivors to a city-wide resource and a model for other organizations throughout the country.  SPOP is the only agency of its kind in New York City and serves over 2,000 older adults each year, many of whom are financially disadvantaged and managing age-related or medical conditions.

SPOP is defined by a holistic approach to aging and community-based mental health care. While our primary focus is on patient-centered psychotherapy, our larger goals are to improve overall health and quality of life, address social isolation, and reduce unnecessary emergency room usage.  We connect clients to age-appropriate supports for housing and meals, and our partnerships with hospitals, medical providers, senior centers, and other aging service providers ensure that those working in the field understand the basics of mental health and know how to connect older adults to those services. SPOP’s largest program is a behavioral health clinic for adults age 55 and older, which will provide over 17,000 professional appointments this year.  We make home visits to those clients who are unable to travel and offer appointments at 15 clinic sites in Manhattan and Downtown Brooklyn.  The clinic provides comprehensive psychotherapy and psychiatric services in Spanish, Cantonese, French and other languages.

SPOP is also home to New York State’s only all-geriatric Personalized Recovery Oriented Services (PROS) program for adults with severe mental illness.  PROS provides rehabilitation services and life skills training and has been successful in reducing hospitalizations and teaching adults how to shop, cook, obtain a library card, use a cell phone or computer, and live on their own. Other programs include Bereavement Support, offered free of charge for adults of all ages; Training and Education; and Information and Referral services for older adults, family members, and caregivers.

 Selection Committee for the Joan H. Tisch Community Health Prize:

 Lilliam Barrios-Paoli, (Co-Chair) Senior Advisor to President of Hunter College and the Former NYC Deputy Mayor for Health and Human Services; Harold Holzer, (Co-Chair) Jonathan F. Fanton Director, Roosevelt House Public Policy Institute, Hunter College; Judith Aponte, Associate Professor, Hunter-Bellevue School of Nursing; Pam Brier, Senior Adviser to the President of Hunter College; Joan Grabe, Chair, Hunter College Foundation Board of Trustees and Hunter-Bellevue School of Nursing Advisory Board; David Himmelstein, Professor, Hunter College School of Urban Health; ; Sue A. Kaplan, Research Associate Professor, Department of Population Health, New York University School of Medicine; Ram Raju, MD, Senior Vice President, Community Health Investment Officer, Northwell Health; Dennis Rivera, Public Health Advisor, Hunter College; and Gregory Shufro, Senior Managing Director, Shufro, Rose & Co., LLC.

About Hunter College

Hunter College, located in the heart of Manhattan, is the largest college in the City University of New York (CUNY) system. Founded in 1870, it is also one of the oldest public colleges in the country and famous for the diversity of its student body, which is as diverse as New York City itself. Most Hunter students are the first in their families to attend college and many go on to top professional and graduate programs, winning Fulbright scholarships, Mellon fellowships, National Institutes of Health grants, and other competitive honors. More than 23,000 students currently attend Hunter, pursuing undergraduate and graduate degrees in more than 170 areas of study.  The 1,700 full- and part-time members of Hunter’s faculty are unparalleled. They receive prestigious national grants, contribute to the world’s leading academic journals, and play major roles in cutting-edge research. They are fighting cancer, formulating public policy, expanding our culture, enhancing technology, and more.

About the Laurie M. Tisch Illumination Fund 

The Laurie M. Tisch Illumination Fund (LMTIF) is a New York City-based foundation that strives to improve access and opportunity for all New Yorkers. Founded in 2007 by philanthropist Laurie M. Tisch, the Illumination Fund plays an active role in supporting innovative approaches to the arts, healthy food, civic service and education in order to illuminate strategies that transform our urban landscape. For more information about the Illumination Fund, visit lmtilluminationfund.org.

SPOP Clinic Opens Four New Satellite Sites

In January 2017, SPOP opened four new clinic satellite offices in Manhattan.  The sites are all licensed to provide comprehensive behavioral health care for older adults and their caregivers age 55 and older, including assessments, individual and group psychotherapy, and medication reconciliation.  The program is supported by the New York City Department for the Aging through the Thrive NYC initiative, which seeks to decrease stigma associated with mental health and increase access to service.

The new sites are co-located at Lenox Hill Neighborhood House on East 70th Street; Project FIND/Hamilton House on West 73rd Street; Educational Alliance Manny Cantor Center on East Broadway; and NY Foundation for Senior Citizens Mott Street Senior Center on Mott Street.  Each site is staffed by a clinical social worker and psychiatrist or psychiatric nurse practitioner.  The sites offer treatment in English and Chinese.  To learn more or make a referral, please call 212-272-7120 x 514.

Taking Baby Steps to Get Off the Couch

If there is one thing Elaine Fludgate wants to emphasize, it is that she is not the neediest. Nope, not her. What she is, she said, is the luckiest, the most grateful: She was caught before she actually fell through the cracks.

For 40 years, Ms. Fludgate, 62, has lived on the Upper East Side of Manhattan. Her most recent job was as an administrator for the Kimmel Center for University Life at New York University, where in 2013 she was a recipient of the college’s Give-a-Violet Award for outstanding work. She had a loving partner, Michael, by her side. Ms. Fludgate had a good life.

But everything changed in late 2013, after Ms. Fludgate learned that her partner had liver cancer. She left her job to care for him, helping him until he died in March 2015.

Click here to read the story as featured on The New York Times.

SPOP Welcomes First Lady Chirlane McCray

Service Program for Older People was honored to welcome New York City First Lady Chirlane McCray for a visit on March 2, 2015. Accompanied by Donna Corrado, Commissioner of the New York City Department for the Aging (DFTA), and Caryn Resnick, Deputy Commissioner of DFTA, the First Lady toured SPOP and met with clients, staff and volunteers at the geriatric mental health clinic.

The First Lady was briefed on the strategies that SPOP has used to increase access to mental health care, including home visits for frail seniors, partnerships with senior centers where individuals can receive treatment in a familiar setting that is close to home, bilingual counseling, and recovery-oriented services offered through the PROS program.

Click here to read this story as featured on New York Non-Profit Press.

corrado-mccray-mccandlessDonna Corrado (DFTA Commissioner),Chirlane McCray (First Lady of NYC), and Carolyn McCandless (President, SPOP)

harvey-mccrayNancy Harvey (CEO, Service Program for Older People), Chirlane McCray (First Lady of New York City)

resnick-corrado-mccrayCaryn Resnick (Deputy Commissioner, DFTA), Donna Corrado (Commissioner, DFTA), Chirlane McCray (First Lady of New York City)

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