introduction 2020 call for presentations · behavioral health services care transitions chronic...

Thank you for your interest in presenting at LeadingAge Michigan's 2020 educational events.Our Annual Conference & Solutions Expo will be held May 17-20, 2020 at the Lansing Center inLansing.Our Leadership Institute will be held August 12-14, 2020 at the Grand Traverse Resort in TraverseCity.To have your presentation considered for the annual conferences or other 2020 educationalprograms, please complete the following online presentation submission.

Suggested content areas for next year’s programs:Accountable Care OrganizationsAdult Foster CareAging Services Provider Collaboration & PartnershipsAging Services State & National UpdatesAssisted LivingBehavioral Health ServicesCare TransitionsChronic Disease ManagementCyber SecurityDementiaFair HousingHome and Community Based ServicesHomes for the AgedHousing UpdatesHuman TraffickingInnovative InitiativesIntegrated Models of CareLeadershipManaged Care and Integrated CarePACEPain and Symptom ManagementPayment & ReimbursementQuality Assurance Process Improvement (QAPI)SNF Regulations and Interpretive Guidance

Introduction

2020 Call for Presentations

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Strategic PlanningTeam BuildingTechnology to Advance Care & EfficienciesTransformational LeadershipWorkforce & Staffing

All presentation topics creatively focused on aging services trends and innovations as well aslearning from previous experiences will be considered. All information pertaining to your presentation must be included in this online submission. If youhave any questions, please email [email protected] call the Association at (517) 323-3687.

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Presentation Information


1. Presentation Title:*

2. Presentation Length:*

60 Minutes

90 Minutes

120 Minutes

3. What type of presentation are you looking to provide?*

Education Session (Breakout)

Keynote

4. Typically LeadingAge Michigan does not pay honorariums or expense reimbursement for educationsessions. If this is a keynote proposal, what is the requested fee?

*

5. Content Level:*

Beginner

Intermediate

Advanced

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Other (please specify)

6. Presentation's Target Audience:*

Nursing Home Administrator

Executive Director

Director of Nursing

Social Worker

Dietary Staff

Activity Professional

Direct Care Staff

7. Describe how this session relates to long term senior living and health services administration.*

8. What is the problem in practice or improvement to be addressed by this learning activity?*

9. Session Description:(50 to 75 words maximum; used for marketing materials)

*

10. What is the learning outcome of this educational activity? Participants will be able to:*

11. List main point #1 to be covered in this presentation. (Must be stated using an action word such as:define, identify, describe, state, recognize, examine, explain, discuss, demonstrate, review, assess,summarize, list, etc.)

*

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12. List 3 bullet points that summarize the content to be presented that meets what you described in mainpoint #1

*


*


*


*


*

Identify the Domains of Practice in one or more of the categories below that will beincluded in the content of this presentation (Note you don't have to choose one from eachcategory, just what applies to your presentation)

17. Customer Care, Supports & Services

18. Human Resource

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19. Finance

20. Environment

21. Management and Leadership

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Primary Presenter


Primary Presenter Information

22. First Name*

23. Last Name*

24. Credentials*

25. Current Position/Title*

26. Organization/Employer*

27. Mailing Address*

28. City*

29. State*

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30. Postal Code*

31. Telephone*

32. E-mail*

Degree 1

Major area of study 1

Institution 1 (Name, City,State)

Year Completed

33. Education (include basic through highest held degree) - If a category does not apply please put "NA" inthe field.

*

Degree 2



Year Completed

Degree 3



Year Completed

34. Education (include basic through highest held degree) - Please tell us about any additional degreesheld.

35. Please provide a narrative bio to be used for marketing materials and the presentation introduction.*

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36. Describe your relevant professional experience, continuing education, or other information that qualifiesyou as a presenter or subject matter expert of the educational content for this session.

*

Commercial Interest, as defined by ANCC, is any entity producing, marketing, re-selling, or distributing healthcare goods or servicesconsumed by or used on residents/patients, or an entity that is owned or controlled by an entity that produces, markets, re-sells ordistributes healthcare goods or services consumed by, or used on, residents/patients. Nonprofit or government organizations, non-healthcare-related companies, healthcare facilities, and group medical practices are not considered commercial interests.

37. Are you employed by or do you represent any commercial interest organization?*

Yes

No

38. If yes, what is the company name?

39. Is there a potential conflict of interest related to your presentation?*

No

Yes

If yes, describe potential conflict

40. Over the past 12 months, have you or your spouse/partner had a financial relationship with acommercial interest whose products or services may be relevant to the educational content that you willplan/present for this activity?

*

Yes

No

Name of CommercialInterest Organization

Relationship(s) withOrganization

Related Product/Service

41. If yes, please provide the details of the relationship below

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42. Do you agree to ensure to the best of your ability that content for this educational activity is evidence-based or based on the best-available evidence, is presented free from bias, and does not promote theproducts or services of any individual practitioner or organization?

*

Yes

No

43. Are there any co-presenters for this presentation:*

Yes

No

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Co-Presenter #1


Co-Presenter #1 Information

44. First Name*

45. Last Name*

46. Credentials*




50. City*

51. State*

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52. Postal Code*

53. Telephone*

54. E-mail*

Degree 1



Year Completed


*

Degree 2



Year Completed

Degree 3



Year Completed



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*



Yes

No



No

Yes



*

Yes

No





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*

Yes

No

65. Is there another co-presenters for this presentation:*

Yes

No

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Co-Presenter #2


Co-Presenter #2 Information

66. First Name*

67. Last Name*

68. Credentials*




72. City*

73. State*

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74. Postal Code*

75. Telephone*

76. E-mail*

Degree 1



Year Completed


*

Degree 2



Year Completed

Degree 3



Year Completed



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*



Yes

No



No

Yes



*

Yes

No





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*

Yes

No

87. Are there any co-presenters for this presentation:*

Yes

No

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• I understand that a fee will not be paid and that I am responsible for all travel-related expenses forthis presentation, including conference costs such as meal and hotel reservations.

• I understand there will be a registration fee if I attend any sessions on a day when I am notpresenting. A discounted registration rate will be offered to any presenter wishing to attend the fullconference.

• I understand my assistance and completion of planning documents will be required in thecontinuing education application process.

• I understand promoting a company, service or product during the presentation is strictlyprohibited.

• I understand this presentation must be free of bias.

• I understand I am giving approval for the content of this session to be presented.

• I will inform my co-presenter(s) of these policies.

• If accepted, I understand that it is my responsibility to submit all forms, handouts, and othermaterials to LeadingAge Michigan in the time frame specified.

Applicant's Responsibilities


88. I understand and agree to the above mentioned responsibilities.*

Yes No

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89. Electronic Signature: Please enter your full name below.*

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Thank you for submitting a presentation proposal.

All proposals will be reviewed by association staff and peer professionals on the following criteria:the timeliness of subject matter; practical applicability to aging services providers; type ofpresentation methods and style; the presenter’s qualifications, and the presentation’s overallquality. Proposals that are incomplete or do not accurately follow the proposal guidelines will bedisqualified. LeadingAge Michigan reserves the right to request modifications to a proposal fromthe presenter(s) before a final decision is made.

Thank You


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introduction 2020 call for presentations · behavioral health services care transitions chronic...

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