Transcript Slide 1

The State Perspective
Karol Swartzlander and Ed Ahern
California Health and Human Services Agency
STAKEHOLDER INPUT FORUM
East Los Angeles Community College, LA, September 25, 2012
Today’s AGENDA
Part 1: Overview Presentation





Introductions
Changes in Federal Aging and Disability Agencies
How Federal Changes Affect California
History of ADRC Partnerships in California
State and Local Systems Transformations in
California
Part 2:
 California’s ADRC Designation Criteria Review
"For too long, too many Americans have faced the impossible
choice between moving to an institution or living at home
without the long-term services and supports they need. The
goal of the new Administration for Community Living will be to
help people with disabilities and older Americans live
productive, satisfying lives." - Secretary Kathleen Sebelius
Administration for
Community Living
 Federal HHS brings together the
Administration on Aging (AoA), the Office on
Disability (OD) and the Administration on
Developmental Disabilities (ADD)
 ACL oversees federal policies and system
improvements for consumers of any age;
including seniors and people with disabilities.
Administration for Community Living
U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724
| FAX 202.357.3555 | EMAIL [email protected] | WEB www.aoa.gov
The ADRC Vision
“The vision is to have Resource Centers in every community
serving as highly visible and trusted places where people of
all ages and income levels can turn for information and
options counseling on their long-term care needs.”
7
Bringing the Vision to Life
It’s all about building partnerships and making
connections….
New Systems….NOT New Programs
8
2012 ADRC Funding Opportunity
Just the Facts
Part A
•3 Yr Grant Awards
•56 States/Territories Eligible
•Est. Award $2.3 Million
•Up to 8 Awards
Part B
•1 Yr Continuation
•48 States Eligible
•Est. Award $200,000
•Up to 48 Awards
Part A ADRC Funding
Key Deliverables for 8 States (36 Months)
o A final agreement (e.g., MoU, Contract, etc.) between the State Medicaid
Agency and designated lead agency overseeing ADRC Options Counseling
Program to utilize Medicaid funds for certain ADRC functions.
o Statewide coverage of a no wrong door ADRC system serving all LTSS
populations and all LTSS payers.
o Statewide coverage of an Options Counseling Program that adheres to
national Options Counseling Standards including training and certification.
o Statewide agreement and/or coverage for delivering Veterans services
through ADRC.
o Continuous Quality Improvement Plan for its ADRC Options Counseling
Program, consistent with the National Evaluation Framework.
10
ACL Vision for
Role of Options
Counseling
OC Roles
• Veterans
Adminstration
• Medicaid
• Medicare
• Money Follows Person
• FFP
•Balance Incentive
Program
•Managed Care
CA Definition of an ADRC
 An ADRC partnership is a new service delivery
model that provides a coordinated system of
information, referral and assistance for anyone
seeking long-term services and supports (LTSS),
regardless of age, disability or income.
 At the center of an ADRC model is a core
partnership between an Area Agency on Aging
(AAA) and Independent Living Centers (ILC), and
then the broader LTSS network providers.
No Wrong Door ADRC Model
 Each county has a unique mix of health care
and social service supports.
 California’s No Wrong Door approach allows
local ADRC partnerships to build on existing
expertise and infrastructure.
 Rather than creating new services, ADRCs reenvision and redefine how information and
services can be made more accessible to any
consumer.
ADRC Development in CA
2003 – AoA ADRC Grant to Department of Aging
(CDA): San Diego and Del Norte
2006 – CMS Systems Transformation Grant to CHHS:
Riverside and Orange
2007 – AoA ADRC Grant to CDA: San Francisco and
Passages
2009 – ADRC Enhancement Grant to CHHS: San
Francisco and San Diego
2009 – AoA ADRC Grant to State Independent Living
Council (Nevada)
ADRC Development in CA
2010 – Affordable Care Act AoA/CMS ADRC Grants:
Options Counseling and Care Transitions (CHHS)
MFP/ADRC (DHCS)
2011 - ADRC Advisory Committee (CHHS & SILC)
 Participate in the development of a strategic plan
for statewide implementation of ADRCs
 Provide input on ADRC designation criteria and a
formal application process
 Serve as change agents to promote the ADRC model
 Serve as key informants on stakeholder issues
California Vision Statement
Every community in California
has a highly visible, reliable,
universal access point that
provides objective information
to facilitate access to long-term
services and supports.
ADRC Development in CA
2012 ADRC Funding
 Hospital Discharge Planning Grant
 ACL Part B ADRC Grant
 Collaboration with The Scan Foundation
Looking Forward – 2012/2013
 Finalize ADRC designation criteria
 Formalize ADRC application process
 Expand ADRC partnerships and the options counseling
 Developing sustainable ADRC business model(s)
 Support capacity-building of local organizations to
partner with managed care and other organizations
CA ADRC Core Services
1.
Enhanced Information and Assistance
 Call center staff utilize a broader array of information and
provider resources across the aging and disability
provider networks; warm transfers.
2.
Options Counseling
 A person-centered, interactive, decision-support process
whereby individuals are supported in their deliberations
to make informed long-term support choices in the
context of their own preferences, strengths and values.
CA ADRC Core Services
3.
Short-Term Service Coordination
 Coordination assistance for consumers who urgently
need help with multiple services and programs,
generally for 90 days or less and until a longer term
plan is in place.
4.
Care Transitions
 hospital-to-home care transition
 nursing facility transition services
California ADRC Relational Chart
Staff, Advisors, Contractors
CA Health & Human Services Agency (CHHS)
State Independent Living Council (SILC)
2010 Options Counseling & Care Transitions Grants
2009 ADRC Grant
San Diego State
University/Interwork
Project Evaluation
State ADRC Planning
Team
CHHS + Departments
of Aging, Rehabilitation
Orange, Riverside
Passages (5 county)
San Diego & San
Francisco
ADRCs
Mission Analytics
ADRC Advisory Committee
ADRC
Project
Director
Nevada
County
ADRC





Input From
Stakeholders
Public
ADRCs
Subject Matter
Experts
LTSS Industry
Legislative &
Policy Analysts
Operational Model
ADRC No ADRC
Wrong
Door Model
One-stop access from the Consumer’s perspective
Home and Community
Based Services
Options
Counseling
Private
Services
Streamlined
Access
to Information
and Services
Transportation
&Housing
Nursing Homes/
Institutions
Employment
Services
Public
Programs
Health
Promotion
& Nutrition
Strengths of ADRC Partnerships
 An established infrastructure that connects the broad array of LTSS
service providers in a community
 Call centers staffed with Information and Assistance experts
 Consumers streamlined access to the information they need
 Knowledge of the diverse and broadly defined LTSS population
 Databases that include a wide array of provider referrals
 One-to-one Options Counseling that serves to empower individuals and
promote personal choice and responsibility.
 Expertise in transition services (hospital-to-home and nursing facility-tohome)
 Access to skills training, assistive technology, nutrition programs, care
coordination
 Assistance with/ access to Medi-Cal eligibility application processes
The Evolving Landscape of LTSS
Service Delivery Reforms
Budget Adjustments and Resource Limitations
Demographic Shifts in Service Demand
Transformation of LTSS
 National Reforms
 Affordable Care Act, Medicaid Reform
 State Reforms
 Mandatory enrollment of seniors and persons with
disabilities in managed care
 Community Based Adult Services (CBAS)
 Dual Demonstrations in 8 counties
 Medicaid Managed LTSS
ADRCs as the Gateway to LTSS
 Nexus of managed Medi-Cal managed LTSS and
momentum for ADRC partnerships offers a unique
opportunity and challenge
 ADRC Partnerships could offer a gateway to support
dual demonstration efforts and Medi-Cal Managed
LTSS
Community Scan – Potential Buyers
Medicare
FFS/MAP/SNP
OAA
Medicaid
VA Medical
Foundations
Center
ADRC
Employer
Insurance
Plans
Private
Insurance
Employer
Assistance
Programs
PACE
California’s ADRC Partnerships
Imperative to create consistency of:
 Message to the Public About LTSS
 Four Core ADRC Services
 Options Counseling Standards
 Broad Outreach
 Facilitated Access to Public Programs
Considerations for the Future
How can the local organizations work together to:
 Leverage multiple service networks
 Embrace a person and family-centered approach to service
delivery
 Understand and support consumers of any age, any
disability and any source/level of income
 Support effective and efficient transitions back home from
hospital and nursing facilities
 Coordinate with and market services to managed care and
other potential funders
ADRC Designation Criteria
 ADRC Advisory Committee deliberated and
generated draft criteria
 State planning team made changes
 2 Public Forums will generate additional
modifications
 ADRC Advisory Committee will recommend final
criteria to CHHS
 ADRC application process will be available to new
and existing ADRCs
In Conclusion
Relationships
Matters
31
Sales Factoid
National Sales Executive Association
• 80% of sales are made on
5th - 12th contact
80%
10%
5%
3%
2%
• 10% of sales are made on 4th
contact
• 5% of sales are made on 3rd
contact
• 3% of sales are made on 2nd
contact
• 2 % of sales are made on 1st
contact
ADRC Resources
 Communitychoices.info (state)
 TAE-ADRC.org (federal)
 State ADRC Team
 Karol Swartzlander, [email protected]
 Ed Ahern, [email protected]
 Paula Acosta, [email protected]
Additional Resources
 Dual Demonstration, www.calduals.org
 AARP, LTSS Scorecard,
http://www.aarp.org/relationships/caregiving/info-092011/ltss-scorecard.html
 AARP New Report, On the Verge: The
Transformation of LTSS, www.aarp.org/ppi
 TheScanFoundation.org
QUESTIONS???
35
Part II
 15 minutes Break
 Review and Discuss California Draft ADRC
Designation Criteria
 Identify Technical Assistance Needs