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Arkansas Support for Culture Change

Survey Agency

The state survey agency (SSA) and the Arkansas Health Care Association worked on a bill that became law "to amend state law to permit access to civil monetary penalty (CMP) funds for construction of Green Houses (small free standing buildings housing 7-10 elders) to offset such costs as specialized staff training, architects with expertise in designing Green Houses, construction costs, etc.  Three grants for a total of $1,225,000 were awarded to one assisted living facility and two nursing homes in 2009.  The first for-profit GREEN HOUSE® in the U. S. will open in August 2009, and the assisted living GREEN HOUSE® was licensed in January 2009.  The SSA also worked on another bill that became law "to amend state law to permit 'universal workers' in Green Houses. They are currently working on re-writing Arkansas' regulations so that the regulations will not only permit Green Houses but will allow the development of  "Home Style" or small house facilities and will encourage traditional facilities to adopt culture change practices.  Using Civil Money Penalty (CMP) funds, the state survey agency sponsored two major Eden Alternative training opportunities with significant emphasis placed upon GREEN HOUSE® development.  The first of these two events in 2008 used trainers from both Eden and NCB Capital Impact to weave GREEN HOUSE® and small household development into the Eden Alternative curriculum.  CMP funds were also used to fund a paid position to coordinate the Arkansas Advancing Excellence Campaign. 

The Arkansas Accord, the culture change coalition, sponsors "culture change tip sheets" that are posted on the Arkansas Foundation for Medical Care's website, the quality improvement organization (QIO) member of the Accord.  The Accord also sponsors numerous culture change training opportunities with the next one scheduled for July 2009.  Trainers are from all coalition organizations. 

Long-term Care Ombudsman Program

The Office of the State LTC Ombudsman (OSLTCO) began planting the seeds of culture change in 2001 by sponsoring Joanne Rader and Eric Haider as presenters for a one day seminar for ombudsmen and all long-term care stakeholders. This seminar exposed participants to "Bathing without a Battle" and the Culture Change concepts Eric Haider implemented in his facility. As a result, two facilities became Eden Certified homes. In 2002, the OSLTCO sponsored a field trip for one local Ombudsman program to visit Eric's home and brought back a wealth of information to share statewide. That year, the OSLTCO also sponsored a local program to develop and conduct a culture change sensitivity program to all of the facilities in the local area. Since 2003, the State LTC Ombudsman has been an active member and has worked closely with the NHQI Advisory Board, the Arkansas Accord (immediately formed from the St. Louis Accord), Arkansas Innovative Performance Program (A.I.P.P.) Advisory Board, Arkansas Nursing Home Coalition, America Advancing Excellence Campaign, and the Arkansas LANE. The State LTC Ombudsman became a Certified Eden Alternative Associate in 2005. In 2006, as an Arkansas Accord partner, the OSLTCO sponsored statewide regional trainings conducted by Nancy Fox of the Eden Alternative promoting culture change. These trainings were open to all stakeholders and were well attended by over 800 individuals. In 2007, OSLTCO partnered with A.I.P.P. bringing Dr. Susan Wehry for a one day seminar on understanding behaviors, planting the seeds of change in regard to physical restraints and behavior management that enhances culture change. On a statewide basis, LTC Ombudsmen daily work with facilities, families and residents on person-centered care. Since 2003, the OSLTCO has focused on building the Certified Volunteer Ombudsman (CVO) portion of the program in order to provide greater LTC Ombudsman services. These invaluable CVO's (211 at the current time) are able to increase culture change awareness, not only to nursing home residents, but to families and facilities.