Presentation by Mike Brett, MD, Medical Director for LIFE Programs, Lutheran Senior Life and Kelly Besecker, Vice President, Sales & Marketing, A-Frame Digital

1. COMBATING THE RISING COST
OF CARE: AGING IN PLACE
Kelly Besecker
Dr. George Brett
March 18, 2013
11:00 – 12:15 pm

2. LIFE Programs
LIFE:
LIFE
Living Independence For the Elderly
(Pennsylvania)
PACE:
Program for the All Inclusive Care of the Elderly
(Nationally)

3. PACE (LIFE): What is it??
 Who: Program for the Frail, Indigent, Elderly
-
Elderly: Eligible for Medicare
Indigent: Eligible for Medicaid
Frail: Eligible for Nursing Home Placement
 Purpose: Keep participants living in their own home
 Keep participants healthy, independent, living in the
community avoiding hospital stays and nursing
home placement
 “Age in Place”
 Holistic Care and Services provided in their home,
and at a Day Health Center
 Multidisciplinary Care
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4. PACE (LIFE) is a HYBRID Program
It’s the Participant’s PROVIDER of
Health Care
And
It’s the Participants’ HEALTH PLAN
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5. L.I.F.E. has Opportunities
for Innovation
Medicaid
Medicare
Revenue
Revenue
(Capitated)
Part A,B,D
Risk Adjusted Capitated
Patient Care
Do what is Appropriate
We make the rules
No “Mother May I?”

6. Typical Participant in PACE
80 Years Old
7.9 Chronic Medical Conditions
2-3 Impairments in ADL’S
39% Live Alone
49% Have Dementia
55% Incontinent
80% Female
90% Live in the Community

7. Framing the Problem
 PACE mission is to keep the frail indigent elderly in their
home and community avoiding institutionalization.
 Want our elders to “Age In Place.”
 PACE is a Managed Care Program
- Medicaid Payment is Capitated
- Medicare Payment is risk adjusted and Capitated
 LIFE Programs in Pennsylvania are not allowed to place their
participants in Personal Care Homes (PCH). Assisted living
costs generally prohibits their use.
 LIFE Participants live independently or live with family
members
 If this is not possible, LIFE Participants must be placed in a
Skilled Nursing Facility (SNF)

8. Solving the Problem
 Housing Authority of Beaver County was building a 24 unit Low
Income Housing Tax Credit Building.
 LIFE Beaver was not permitted to hold long term leases.
- The Lending institution would lose their Tax Credits
 LIFE Participants applied for a lease & added to Waiting List
 Case Management team was transformed into a Task Force
- Nurse Case Managers
- LIFE Center Manager
- Dietary Manager
- Social Service Department
- Medical Director
 Many technologies were researched and 8 were chosen to
present a Passive Monitoring solution for our LIFE programs
 AFrame Digital was chosen. Let’s get into Why?

9. What were we looking for?
 The System must include real time monitoring
 Need a platform that can handle all needs in one
system if possible.
 The check list of features needed included:
- PERS
- Fall Detection
- Location Monitoring – real time
- Activity Monitoring
- Feature rich for future needs, including health data
- Must be research based and tested

10. Our Chosen Technology
 AFrame offered a comprehensive platform that included
everything we were looking for all in one system
 They were research based
 They had an FDA cleared system
 They had an automatic impact detection system that allowed us
to take a proactive approach to falls.
 The plug and play system makes it easy.
 Access anywhere and anytime.
 Participants wear a Personal Help Device (PHD)
- The “Watch” and It really does tell time as well!
 Monitoring done by the On-Site C.N.A.
 It is a Real Time Monitoring system.

11. LIFE Programs and AFrame:
The Present
 July 2011: Friendship Commons, Beaver, PA
 24 Unit Low Income Senior Apartment
 Supportive Housing. LIFE has a C.N.A. there 24/7
 LIFE Beaver Participants using Aframe in 15 of the apartments
 January 2012: Under Our Wing, Butler PA
 24 Unit Low Income Senior Apartment
 Supportive Housing. LIFE has a C.N.A. there 24/7
 LIFE Butler Participants using AFrame in residence in 14 apartments
 August 2012: Francis Farmer Apartments, Beaver, PA
 105 Unit Low Income Senior Apartment Complex
 Supportive Housing. LIFE has a C.N.A. there 24/7
 LIFE Beaver Participants using Aframe in 11 of the apartments
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12. Continuous, Non-Intrusive Monitoring
for Timely and Proactive Interventions
 Personal Emergency
 Automatic Vitals
Response – Panic Button
Collection
 Activity, Wellness
& Location
 Medication
Reminder
 Impact/Fall Detection
 Survey Device
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13. Remote Monitoring System
for Home or Facilities
Wireless Mesh Network
5-Minute Install
Wristwatch
Monitor
DSL or Cellular
Gateway
Other Wireless Devices
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14. Real-time Status and Alerting
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15. Real-time Location and Alert
Resolution
Wellness Indicator
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16. Tablet for Patient Self-Reporting,
Motivation, and Biofeedback
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17. RESULT
 The program saved $2,990 per resident per month
 Now, 15 of the 24 units are occupied by LIFE Beaver County
participants using the applied concepts and technology.
 People were able to live in their own environment and enjoy a better
quality of life. One of our residents was able to get her beloved cat
back to live with her.
 Program has been duplicated by LIFE Butler in low income senior
apartments
 LIFE Beaver has expanded into 2nd Senior Apartment Complex
 New location under development for LIFE Lawrence

18. Individual Home Applications
 AFrame Digital Installations into family homes –
providing safety net
 Affordable Pricing for individual families
 Floor Plans of individual homes
- Multiple family members can check in on loved one
 Alerts sent to designated family member
 Alerts for Wandering if necessary: Peace of Mind

19. LIFE Programs and AFrame:
The Future
 December 2013: Residential Homes in New Castle, PA
 Purchased two three-bedroom homes
 Homes adjacent to each other
 Will locate 6 participants from LIFE Lawrence County there.
 Three participants into each home
 By Regulations, cannot have 4 or more in a home.
 Several will be moved out of Nursing Homes where they
currently reside
 Several will be Participants at high risk for Nursing Home
Placement
 Will have C.N.A. oversee both homes
 Both Homes will be wired with AFrame Digital
 C.N.A. can be alerted even when in the adjacent home
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20. Innovative Care Delivery
 MobileCare Monitor is an
integrated patient health and
safety platform
 Patient-focused promoting
independence and
engagement in their wellness
 Personalized models allows
caregivers to be proactive
and stay ahead of a crisis
 Better care, lower costs and
better outcomes.
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