Transcript Oneida County Expanded EISEP

Area Agencies on Aging Preparing for
the Balancing Incentive Program (BIP)
Association on Aging in New York
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Balancing Incentive
Overview
• Federal initiative authorizing grants to States to increase
access to non-institutional community-based long-term
services and supports.
• New York’s BIP grant for $598.7 million requires the state
to expand the NY Connects among them. NY Connects
programs are currently operational in 54 counties
• NY Connects has been designated as the “no wrong
door/single point of entry” as part of the restructuring
plan.
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Balancing Incentive
Overview (cont.)
• New BIP funding will be used to strengthen and expand
the NY Connects Network to be a one-stop shop for long term
services and supports
• BIP requires three (3) structural changes:
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A no wrong door/single entry point system
(NWD/SEP)
Conflict-free case management services
Core standardized assessment instruments
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Background on NY Connects
• NY Connects Current Role
• Most located within Area Agencies on Aging
• Aging-Long Term Care Services and Supports
• Information, Assistance, Screening, and Intake
• Resources Listings for consumers and caregivers
• Referrals for in home visits, assessments, and care plans
• Linkage to community based services and supports such as
case management, home delivered meals, in home personal
care, and social model day care.
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Medicaid Restructuring & BIP
Initiatives laying the groundwork for BIP
• NYS Medicaid rebalancing
• Olmstead
• Managed Long Term Care Transition
• Systems Integration Project NYSOFA; Oneida County: SUNY
Albany Center of Excellence in Aging and Community
Wellnesss
• Balancing Incentive Program BIP
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No Wrong Door System
NWD is a single statewide system of access to LTSS for all
populations and all payers.
The NWD System functions include:
• Public Outreach and Coordination with Key Referral
Sources;
• Person Centered Counseling;
• Streamlined Access to Public LTSS Programs;
• State Governance and Administration.
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NY Connects Expansion &
Level 1 Screens
With the expansion, NY Connects staff will…
• Be trained to provide consistent information about
available services
• Operate in accordance with Standards and Operating
Protocols
• Conduct Level I screens* as appropriate
• *A preliminary functional and financial assessment of
individuals with Long Term Care
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NY Connects Expansion &
Level 1 Screens (cont.)
• Provide application assistance for Medicaid and other
publicly funded programs
• Provide linkages to available services for individuals not
eligible for Medicaid and link those potentially eligible to
a Level II assessment
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Advertising
New York comprehensive advertising strategy is expected
to…
• Create widespread awareness
• Significantly increase in the number of Medicaid recipients
and Medicaid eligible individuals with the roll out of a toll
free number
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Long Term Care Councils
• An important component of the existing NY Connects
design
• Charged with assessing the needs of the community,
identifying priorities to address and developing an action
plan.
• Comprised of local governmental partners, communitybased organizations and service providers, hospitals and
other institutional and community based medical
providers, and consumers/caregivers.
• Under NWD, will expand to include: mental health and
Intellectual Disability and/or Developmental Disability
(ID/DD) networks.
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Sustainability Beyond 9/30/2015
The BIP federal grant ends on September 30, 2015. The Governor’s
Budget released on January 21, 2015 proposed funding to continue
NWD functions from October 1st and into the next State Fiscal Year:
Budget Briefing Book - 2015 Opportunity Agenda - #8. Health Care, p. 108
New York Connects. NY Connects is a statewide, locally based point
of entry system that provides one stop access to free, objective and
comprehensive information and assistance on accessing long term
care services and supports. The Budget provides additional State
funding to maintain ongoing operational support to the New York
Connects program and the "No Wrong Door" initiative as Federal
Balancing Incentive Payments (BIP) funding is set to expire in
October 2015.
The Budget includes funding of $8.2 million in 2015-16 and $18.1
million in 2016-17.
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AAA’s Preparing for NWD
Three (3) Counties models how area agencies on aging
are preparing for the expansion of NY Connects and
restructuring their organization for the “No Wrong
Door” component of the Balancing Incentive Program
• Essex County
• Oneida County
• Erie County
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Oneida
Erie
Essex
NY Three
Connects
(3) Examples
& NWD Implementation:
from Counties with
Varied Populations and Geography
Three (3) Examples from Counties with Varied
Populations and Geography
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Essex County
• Population of 39, 370
• 2nd largest geographically in the State
• Three hospital divide the county naturally into 3
catchment areas
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Essex County
Why “No Wrong Door?”
• Increasing aging population which will increase need for
services
• Increase disabled adults & children needing LTC
• We know our local resources and our local partners vs
regionalizing services
• Opportunity to create more cost effective use of programs
vs institutionalizing an individual
• Consumer satisfaction – Who doesn’t want to remain
home?
• Opportunity to determine unmet needs
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Essex County
Essex County NY Connects (now)
• Strong partnerships
• DSS, area hospitals’ discharge planners, Mental Health, volunteer
programs, local and regional Not-For Profits and other local
governmental agencies such as Public Health and Emergency
Services.
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Taking referrals for varies agencies
Cares Transitions
DSRIP
Medical Home
Long Term Care Council
• Understanding of all programs available
• Constantly a work in progress
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Essex County
• Essex County NY Connects (future)
• Continues Intake and referral
• All staff are currently crossed trained
• Screening
• Expand relationships with local agencies
• Assist ER staff with discharge planning
• Formalize relationships with EMS
• Continue the discussion of PARAMedicine
• Increase Intake and Screening staff
• Continue Case Management
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Essex County
• Add additional components
• Community Mental Health (subcontract)
• Mental Health Workers making home visits w/NYC Connects staff
• Transition when appropriate to Clinical Mental Health Services
• Volunteer Coordinator
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Handyman program
Service dog
Friendly Visitors & Telephone reassurance
Transportation for Social functions
• Engage Baby Boomers
• Attach to the RHIO
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Oneida County
Goals and Objectives of local implementation
• NY Connects will expand to meet the requirements of “No Wrong
Door” (NWD) under the Balancing Incentive Program.
• Restructuring and reassigning NY Connects; HIICAP to create a
fully functioning Aging and Disabilities Center (ADRC).
• Retraining and reassigning various provider staff to perform
telephone information and assistance, initial intake and screens
and enter caller information into client data base at the time of
the call instead of entering data completed by case managers
from hard copy assessment forms. Designated HIICAP and NY
Connects staff will be assigned, trained, and required to complete
the Level one screen
• Designated NY Connects staff will also be trained to provide,
information, assistance, and follow-up assistance for consumers
who are enrolled into to MLTC plans.
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Oneida County
Planning and progress to date
• Planning sessions with HIICAP/NY Connects staff and supervisors
• Laptops for Program Coordinators; Case Managers; Supervisors
• Communication system upgrades are under consideration
• Care transitions Program is being developed and ready for
implementation
• Chronic Disease Self-Management Program (CDSMP) is being
expanded and available in many areas of Oneida County
• On-site training for client data management from PeerPlace
Networks
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Oneida County
Implementation Timeline
• Laptop training for field staff (6/14 to 3/15)
• PeerPlace Training for Case Aide/Data Entry and Supervisors
(6/14 to 3/15)
• Upgrades to Telephone System to support Enhanced NY
Connects/HIICAP Unit (5/15)
• Case Managers Begin Using Laptops Infield (3/15)
• Provider Revised staffing to include (3) LTC Associates;(1)
Program Coordinator (CDSMP); (1) NY Connects Supervisor
(1/15)
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Oneida County
Implementation Timeline (cont.)
• Implement staff training to provide technical support and
guidance during the transition to BIP (6/14-9/15)
• Transition (3) Case Aide Positions to perform telephone I&A, Live
Screening - Reduce Data entry tasks as case managers begin
using laptops in the field (1/15-9/15)
• Enhanced NY Connects/ADRC unit becomes fully Operational
(12/15)
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Erie County
BIP Innovations Grant
Ready, Set, Home
• BIP grant separate from NWD - $738,000
• Ready, Set, Home
• Not specifically NWD
• Growth opportunity
Erie County
Changing the View
• Ready, Set, Home – An Extroverted ADRC model
• Establish a community presence
• Strengthen NY Connects name recognition
• NY Connects Staff are working in and with local
rehab and nursing facilities
• Working to get patients home sooner
• Part of the fabric of the facility
• Not a place to refer patients
Erie County
• Building relationships with MLTC plans providing service in
Erie and surrounding counties.
• Engaging plans on behalf of clients to develop
appropriate care plans
• Working with caregivers
• Establishing and strengthening vendor relationships to
facilitate services and home modifications
• Starting services early
• Relationships with contractors and vendors for home
modifications
Erie County
• Challenges
• Past
• Changing the view within the facilities
• Partner agreements
• Purchasing goods
• Ahead
• Changing the view within the facilities
• Getting to the right clients
• Providing adequate modifications- managing
expectations
Erie County
• Successes
• First client transitioned home days before Christmas
• MLTC plans knowing about RSH. Calling us!
• Housing Connections
• Relief to Families
Erie County
• Positive Results
• Erie County known as a quality provider
• Meeting the need
• Greater Understanding of LTSS
• Pilot Project Medicaid savings estimated at $1,109,724.
• Administrative Support
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Patty Bashaw | Director | Essex County Office for the Aging | PO Box 217,
Water Street, Elizabethtown, NY 12932 | (518) 873-3695 |
[email protected]
Laura Cameron | Executive Director | Association on Aging in New York |
272 Broadway, Albany NY 12204 | (518) 449-7080 | [email protected]
Mike Romano | Director | Oneida County Office for Aging & Continuing
Care | 120 Airline Street, Suite 201, Oriskany, NY 13424 | (315) 798-5456
| [email protected]
Dan Szewc | Long Term Care Coordinator | Erie County Department of
Senior Services | 95 Franklin St., Room 1329, Buffalo, NY 14202 | (716)
858-8526 | [email protected]
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