Environmental hazards like mold, pest infestations, hoarding, inadequate air conditioning, and the lack of a backup generator can profoundly impact health outcomes for vulnerable member populations. And Managed Care Organizations (MCOs) strive to provide more whole-person and comprehensive care, addressing not only the physical but environmental hazards in one’s home has become increasingly important.
However, MCOs face significant challenges in effectively addressing these environmental concerns. The process of accurately identifying hazards and then deploying the necessary resources to mitigate these risks is often complex. At many health plans case managers are often tasked with overseeing these projects. Though deploying interventions for environmental hazards often extend beyond the scope of their traditional role, requiring them to navigate intricate home service projects while also struggling to source reliable vendors. This can lead to significant delays in addressing urgent health hazards.
In this article we’ll dive into three critical environmental risks that are particularly critical to Medicaid recipients—mold exposure, junk removal related to hoarding tendencies, and emergency preparedness through backup generators. We will also unpack why in-home occupational therapy evaluations are an effective way for MCOs to more proactively identify and mitigate these risks.
Mold Remediation
Mold exposure is a significant environmental hazard.
Extended exposure to mold can lead to poor symptoms for anyone but it can be particularly harmful to member’s with existing respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Mold can irritate the airways, cause inflammation, increase mucus production, shallow breathing and coughing.
And for members already on medication to control their respiratory symptoms, mold exposure may cause them to increase their medication, seek additional care and ultimately turns the home environment into a place that is negatively affecting health outcomes rather than providing support.
Though identifying mold problems and detecting symptoms early can often be challenging with most mold growing behind walls or under floors. If left untreated, mold has major consequences for a member’s health with many requiring increased medication, interventions and worsening symptoms. This is especially true for older adults that are often at an increased risk due to decreased immunity and their prevalence of chronic diseases. Nearly 95% of older adults living with at least one chronic condition.
Junk Removal
It’s estimated that 1 in every 40 people in the US have hoarding tendencies.
This behavior is particularly concerning for Medicaid populations, where members often face additional vulnerabilities due to age, disability, or socioeconomic factors. Many members live in homes that are not just untidy, but are actively unsafe due to hoarding. This is why junk removal is about more than just cleanliness. It is a critical intervention to ensuring members are able to live in a home that is both conducive to their physical and mental well-being.
One of the most immediate benefits of junk removal is the reduction in fall risks. Excessive clutter, especially in walkways and common areas, greatly increases the risk of falls. By removing unnecessary items, pathways can be cleared to ensure that mobility aids like walkers and wheelchairs can be used safely. Plus cluttered environments are often breeding grounds for dust and mold, which impact indoor air quality and can severely exacerbate pre-existing respiratory conditions.
In addition, clearing clutter can have transformative effects on a member's ability to leave their home and engage more fully with their community. For many, the physical barriers created by hoarding not only make it difficult to navigate within their homes but also to exit their home. By addressing these barriers, members can more easily participate in community activities and can have great impacts on mental and emotional health.
Backup Generators
Many Medicaid members depend on electrically powered equipment to manage their health. Devices such as oxygen concentrators, home dialysis machines, and electric wheelchairs are vital for safety, quality of life and in some situations survival at home. In the event of a power outage, the absence of a reliable power source can quickly become life-threatening. Backup generators play an important role in these situations, providing an uninterrupted power supply that ensures these devices continue operating smoothly.
And for members with health conditions that make them sensitive to extreme temperatures, such as multiple sclerosis or certain cardiovascular diseases it’s important that they are also able to maintain a temperature controlled environment. Fluctuations in temperature can trigger or exacerbate symptoms and in the event of a power outage a generator can ensure that heating and cooling systems continue to function.
Lastly, it is essential to consider members who depend on multiple, often temperature-sensitive, medications. For these individuals, the loss of refrigeration during a power outage is not just an inconvenience but a serious health risk. Backup generators ensure that medications requiring refrigeration remain effective, safeguarding members' health by preventing medication spoilage.
Comprehensive In-Home Evaluation
So, how can plans identify these environmental factors and take a proactive approach to addressing these hazards in the home?
One effective strategy is in-person home evaluations conducted by occupational therapists (OTs). These evaluations can be an effective way to identify environmental risks that might otherwise go unnoticed for too long.
During an in-person home evaluation, OTs meticulously examine various aspects of the home to identify risks such as poor lighting, tripping hazards, the presence of mold, or inadequate ventilation systems. They are trained to look beyond the obvious and consider the connection between the member and their environment, taking into account specific health conditions and mobility limitations.
In-person evaluations allow OTs to detect potential health hazards that are not always evident to the members or their families. This might include recognizing signs of mold in hidden areas, identifying pest infestations, or noting the accumulation of clutter that poses a risk. Early detection through these evaluations means that interventions can be implemented before these hazards lead to major health complications or emergencies.
OTs also provide detailed documentation of their findings. This documentation is then given to the health plan to help them to track identified risks and ensures that appropriate resources are allocated for the member.
Sourcing Vendors
For MCOs looking to better address environmental hazards having a trusted partner who can deploy these resources is crucial. The process of finding and vetting these vendors, ensuring they meet both quality standards and compliance requirements can be daunting.
Once the appropriate vendors are identified, we facilitate the deployment of these interventions and act as a liaison between MCOs and vendors, coordinating all aspects of the project. This includes scheduling, oversight of the interventions, and follow-up OT evaluations to ensure everything was implemented properly. Our streamlined coordination helps care teams save time and resources, allowing them to focus more on other aspects of a member’s plan of care rather than the logistics of service deployment.
Conclusion
In the homes of vulnerable populations, hidden environmental hazards such as mold, hoarding, and backup power can significantly impact health outcomes. These factors often go unnoticed until they exacerbate chronic conditions or lead to acute health crises. And for high risk populations that are navigating multiple chronic conditions, respiratory issues, weakened immune systems, or mobility restrictions, the stakes are even higher.
Recognizing the critical nature of these environmental hazards, Jukebox Health has taken proactive steps to ensure that our network of occupational therapists (OTs) is thoroughly trained to identify and assess these risks in the home. Our OT network is specifically trained and equipped with the tools to spot these hazards and efficiently report these findings back to the health plan.
To address these identified issues effectively, Jukebox Health collaborates with a variety of trusted vendor partners, capable of deploying interventions tailored to the specific needs of each home. Whether it's remediating mold, removing clutter, installing safety equipment, our approach ensures that interventions are not only timely but also align with the best practices in the member’s plan of care.
For health plans looking to mitigate environmental risks and improve outcomes and are interested to learn more about our OT network and vendor partners, be sure to reach out to our partnerships team at hello@jukeboxhealth.com
