Tech For DD

Medication Management

Medication management is often a major obstacle on the path to indendent living for many clients.  Having the right medication, at the right dose and remembering to take it at the right time can require a lot of support, especially if you are taking multiple medications. The most common support for medication management are the pre-poured pill boxes. This is a good organizational tool, but provides no reminders. Newer cell phone apps can be programmed to remind individuals to take their medication, however, these apps do not communicate with your support staff.

I recently came across a recent success in how technology can be used to better support medication management. An individual who currently lives in a supported apartment was at risk of having to move into a more supervised environment. His blood presssure was becoming unmanagable and staff had recently discoverd a stash of blood pressure pills in the closet. The individual wanted to take his medication, but had forgotten, and having forgotten, hid it from his support staff. He began using a MedReady to remind himself to take his medication. The MedReady has the ability to communicate with his support staff if a medication is not accessed within some specified time period. Utilizing the Med-Ready, his blood pressure has remained stable, and he has been able to maintain his current living condition.

The MedReady can be programmed to beep at medication access times. It stops when the medication is accessed. If the medication is not accessed in a reasonable time, for example 2, 5, 10, or 30 minutes, an EMT call center will attempt to make contact with the consumer, and will notify (text or call) the support staff.

Governor Cuomo’s proposed 30-day Amendments to the Executive Budget

OPWDD providers and advocates for the developmentally disabled expressed significant concerns about Governor Cuomo’s proposed 30-day Amendments to the Executive Budget. This amendment authorizes actions to address the loss of federal revenue as a result of modifications to the current Medicaid financing system for developmental disability services. The Governor claims that, “these actions generate $500 million of savings, including $180 million from accelerating Medicaid Redesign Team (MRT) initiatives and delaying investments, leveraging $200 million in current-year under spending to generate 2013-14 savings, and $120 million from a 6 percent reduction to OPWDD Medicaid rates for not-for-profit providers.”

Providers are concerned that budget cuts may reduce the level of care provided to their clients. In addition to budget cuts, providers are concerned that the MRT may include acceleration to a managed care model.

According to the New York Nonprofit Press, NYS Budget Director Robert Megna raised the possibility that the State might consider accelerating the enrollment into managed care of current specialized, high-needs Medicaid populations which are currently carved out of care. “We might have to increase the speed of getting people into managed care,” he said.

These proposed budget changes and probable acceleration to a managed care model highlight the need for providers to evaluate changes to their care. Several States, such as Wisconsin and Mississippi have already transitioned to a managed care model.

Successful providers have integrated technology into their care model. This allows them to maintain a high level of care despite budgetary constraints and do more with less. Focusing on providing staff when needed instead of “just in case” as well as supporting the consumers in developing the skills for more independent  living have been key components of a productive business model.

If the cuts or some percentage of the cuts are enacted in New York adjustments to care models as well as requirements from the state will need to be evaluated for both quality and efficiency.



Supported Independent Living

As many Providers create more independent living options for their clients, technology is becoming an important component of the care plan. Technology addressing cooking safety (stoves), incontinence detectors, medication dispensers, and passive sensors confirming the activities of daily living, help support independence. Clients with the capacity and desire to live more independently, can be supported 24/7, while still performing independent activities that build self esteem and represent meaningful victories for clients long dependent on constant care.