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Improving Mental Health Services in Rural Long-Term Care

Background

1. Data indicate that ___________ is the most common mental health condition among both nursing home residents and community-dwelling long-term care recipients.

A. Anxiety

B. Depression

C. Dementia

D. Alzheimer’s


2. National epidemiological data show that most psychiatric diagnoses occur at higher rates across rural when compared to urban settings.

A. True

B. False


3. While evidence suggests that psychotherapy is often the treatment of choice for frail elders, nursing homes rely primarily on one-time, “as needed” medication management consultations with psychiatrists.

A. True

B. False


4. Which of the following is an obstacle that impedes access to mental health care for rural residents?

A. Scare funding.

B. Limited provider supply.

C. Limited transportation alternatives.

D. All of the above.


Barriers to the Provision of Mental Health Services in Rural Long-Term Care

5. In comparison to their urban counterparts, rural providers rely less on the Medicaid program for payment.

A. True

B. False


6. Because Medicaid offers relatively low rates of reimbursement, rural community mental health centers earn less on average per unit of service than do urban providers.

A. True

B. False


7. Independent practitioners and mental health provider organizations are reluctant to deliver off-site services, because such work entails each of the following, except:

A. Requirement of added liability insurance.

B. Inconvenience.

C. Unreimbursed travel expenses.

D. Lost opportunities to engage in billable activities.


8. Where face-to-face clinical contacts are impossible or impractical, telehealth technologies have been used successfully to connect isolated rural long-term care recipients to mental health providers in remote locations.

A. True

B. False


9. Which of the following is a hinderance to conducting mental health interventions via videoconferencing in rural areas?

A. The lack of broadband capacity.

B. Not being able to afford the costs of telehealth infrastructure.

C. Not being able to assemble a workforce capable of maintaining equipment and providing technical support to users.

D. Any of the above.


Prospects for Improving Mental Health Services in Rural Long-Term Care

10. To qualify for participation in the National Health Service Corps program, provider sites must offer any of the following, except:

A. Primary care

B. Dental services

C. Drug and/or alcohol rehabilitation

D. Behavioral health services


11. In order to ensure that the National Health Service Corps could provide useful assistance, rural health advocates should encourage the program to enlist a pool of mental health professionals who are both willing and well-prepared to work with the rural long-term care population.

A. True

B. False


12. Under the revised ACA law, §1915(i), states are allowed to cover which of the following services for any disabled Medicaid beneficiaries in the community?

A. Transportation.

B. Mental health treatment delivered at mental health centers.

C. Mental health treatment delivered at off-site locations.

D. All of the above.


13. Although tele-mental health approaches are cost-effective and acceptable to patients, they are not as likely to improve outcomes as face-to-face clinical contacts.

A. True

B. False


14. All of the following conditions qualify patients for participation in health homes, except for:

A. Psychiatric diagnoses

B. Hospice care

C. Substance abuse disorders

D. Physical illnesses


15. In addition to providing primary care and care coordination, health homes must offer mental health and substance abuse treatment, long-term care, and linkages to community services and supports.

A. True

B. False


Policy Considerations

16. Denial of proper attention to long-term care recipients’ mental health needs:

A. Imposes unnecessary suffering on patients.

B. Reduces the effectiveness of the medical services they do receive.

C. Increases overall costs.

D. All of the above.


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