4th State Units on Aging Nutritionists & Administrators

Conference

August 29, 2006Baltimore, Maryland

Greg CaseCenter for Planning and Policy Development

U.S. Administration on Aginggreg.case@aoa.hhs.gov

Choices for IndependenceChoices for Independence

Using HHS research to empower seniors to take more control

of their health.

PREVENTION

Bringing transparency and choice to long-term care.

TRANSPARENCY

Diverting seniors from nursing home

care and spend-down.

MEDICAID

Helping seniors understand and access

their MMA benefits.

MEDICARE

Consumer Empowerment

Helps individuals make informed decisions about their care options and streamline access.

Community Living Incentives

Gives States more flexibility to help individuals remain at home and avoid or delay nursing

home placement and spend-down to Medicaid. Healthy Lifestyle Choices

Assists seniors to make behavioral and lifestyle changes that have proven effective in reducing the risk of disease and disability.

Advancing the Secretary’s Priorities

Long-Term Care Systems Change

Swift Implementation of the Olmstead Decision An Executive Order – Community-based Alternatives

for Individuals with Disabilities - was issued directing key federal agencies to evaluate and recommend ways to expand community-based services for qualified individuals with disabilities:

– The Department of Health and Human Services has implemented a number of grant programs to assist states in the design and implementation of reforms to promote community living and create a greater balance in long-term care between community-based and institutional support.

Systems Change Vision

Why Single Point of Entry access?

Navigating the long term care system can be confusing and frustrating for persons with disabilities of all ages and their family members

For some, institutional placement occurs due to lack of awareness or difficulty accessing HCBS

To create community-wide systems of services that reduce consumer confusion and build consumer trust and respect by enhancing individual choice and informed decision-making

To breakdown barriers to community based living

Empowering Individuals

South Carolina Lt. Governor’s Office on Aging - 2003

One-Stop Access

One-Stop Access

Home and Community Based Services

Nursing Homes

DiseasePrevention

HealthPromotion

Employment Services

Nutrition Education

Private Services

Public Programs

CMS & AoA Vision for ADRC

To have Aging and Disability Resource Centers in every community serving as highly visible and trusted places where people of all incomes and ages can get information on the full range of long term support options and a single point of entry for access to public long term support programs and benefits.

Components of the ADRC Single Point of Entry Model

Integrated and seamless access to information, assistance and services to long-term care

Meaningful partnerships with Aging, Disability & Medicaid Agencies and stakeholder groups

Investments in MIS that support streamlining data to enhance single entry model

Linkages to critical pathways to institutional care to provide community based alternatives

Working towards one comprehensive assessment and eligibility determination (financial and functional) process

Awareness & Information Public Education Information on OptionsAssistance Options Counseling Benefits Counseling Employment Options Counseling Referral Crisis Intervention Planning for Future NeedsAccess Eligibility Screening Private Pay Services Comprehensive Assessment Programmatic Eligibility Determination Medicaid Financial Eligibility

Determination One-Stop Access to all public programs

ASSISTANCEASSISTANCEAWARENESS

&INFORMATION

AWARENESS&

INFORMATION

ACCESS ACCESS

CONSUMERCONSUMER

Empowering Individuals

ADRC Key Components

ADRC Early Results

Empowering Individuals

2003 & 2004 Grantees

Eight of the 43 ADRC grantees will have state/territory wide service areas by the 3rd year of their grantOver 70% of the 43 grantees are planning MOUs/MOAs to formalize the partnerships between aging network, disability network and Medicaid and nearly 50% have them in place

All Grantees

62 pilot sites currently operating/56 Additional Pilot Sites PlannedThere are over 250 unique partnerships that have developed across the 24 ADRC projects funded in 2003 and 2004All pilot sites have begun implementing activities designed to streamline access to publicly funded long-term care

ADRC Grantees

Partnerships Cut Across Different Types of Organizations

Adult Protective Services, 2%

Employment Org./ Agency, 2%

Transportation Org./ Agency, 1%

Housing Org./ Agency, 3%

Mental Health Org./ Agency, 3%

Social Service Org./ Agency, 13%

Disability Org./ Agency, 12%

Other, 20%

Providers, 13%

Task Force or Advisory Group, 7%

Advocacy or Consumer Group, 10%

Aging Org./ Agency, 7%

Medicaid Agency, 7%

Over 250 Unique Partnerships

New Jersey – 2003 Grantee 2 AAA Pilot sites selected through RFP process

Atlantic County AAA (urban) Warren County AAA (rural)

Initiated new assessment instruments, a computerized universal application and a global budget for both institutional and HCB services.

Developed 12 state planning workgroups: clinical eligibility; financial eligibility; consumer direction; MIS/IT; cultural competency; customer service etc.

Congregate and home-delivered meals seen as primary gateways to LTC services and intake process for nutrition programs fully integrated into ADRC

Massachusetts – 2003 Grantee

Executive Office of Elder Affairs (partnering with Medicaid and Rehabilitation Commission)

Original Pilot, Two urban/suburban counties –Year 3 Expansion, Three additional counties

Serving persons of all ages with disabilities Equal partnership between two well-

established organizations: a AAA and a CIL

Statewide web-based Virtual Gateway allows ADRC to initiate Medicaid financial eligibility

Florida – 2004 Grantee Utilizing AAA to pilot ARCs/ADRCs in two locations across the state to serve

the elderly and individuals with severe mental illness The Florida Legislature passed statutory changes to implement Aging

Resource Centers (ARCs) statewide ($3 million dollars in their FY07 Budget). Established a single administrative structure accessible through multiple

locations (seniors centers, AAAs, housing authorities, mental health centers) Since the co-location of ADRC and Medicaid Waiver staff, the average

amount of time it takes to process a waiver application has decreased from 13.7 days to 3.3 days.

Alaska – 2004 Grantee

Alaska Housing Commission lead entity overseeing ADRC initiative in Alaska

Regional resource centers operated by Independent Living Centers in each of the 5 regions

Targets adults with disabilities of all types Division of Senior and Disability Services will

take the lead in project management this year Develop MIS system for tracking client intake,

assessment, care plans, utilization costs

Virginia – 2005 Grantee

No wrong door approach to expand capacity of existing providers in 3 pilot regions initially and expanding to 9 pilots by end of grant

Private sector partner, Senior Navigator, offers web based I&R database for the elderly and persons with disabilities

More than a dozen various intake and eligibility forms are being analyzed and integrated with the GetCare system to streamline functional and programmatic eligibility

Local power company as partner assisting with funding of pilot sites

Idaho – 2005 Grantee Idaho Medicaid – lead agency – to pilot an on-

line application process at ADRC (where shorter forms will be developed with quicker turn-around times)

ID 2-1-1 CareLine as single point of entry

State level Integrated Access Team will assess consumers referred by 2-1-1 and provide case management

Community Resource Team at the pilot level will ensure client is connected with local resources

Continued Support of the ADRCs

In FY ’06

2003 ADRC grantees (original grant expires in ’06) - opportunity to apply for two-year grants to expand and enhance their efforts to streamline access to long-term supports.

2004 ADRCs - opportunity to apply for two-year Competitive Supplemental grants to support project Replication and Enhancement.

States that have not received an AoA/CMS ADRC grant had the opportunity in 2006 to apply under the “access goal” of the CMS System Transformation Grant opportunity

Comprehensive Technical Assistance

Technical Assistance Resources Website Resource Materials (e.g. Issue

Briefs) National Meetings Weekly Electronic Newsletters Surveys of grantees TA Tracking Tool Reports

Building a Grantee Online Community Monthly Teleconferences/Web

casts Bi-monthly Workgroup

Teleconferences On-line Discussions Electronic Bulletin Board

www.adrc-tae.org