Creating Choices to Support Independence: A Consumer-Centered Approach to Long Term Care

2007 Annual Long Term Care Ombudsman Training Institute

October 18, 2007

What is NY Connects?

A statewide initiative that supports the development of county level, consumer–oriented entry points for information about long term care and linkages to services that assist individuals of all ages with long term care needs

Goals of NY Connects

Streamline access to information and assistance about long term care services and supports

Reduce fragmentation within service delivery

Empower individuals to make informed choices

Elements of NY Connects

A trusted resource for information and assistance

For Whom: Public and Private Pay consumers Older adults and people of all ages with disabilities

Where and How: Connected with the community Call center, on site locations, off-site consumer

visits, website

Users: Consumers, caregivers and helping professionals

NY Connects Core Functions

Information and Assistance

Screening

Public Education

Local Systems Change

Long Term Care Councils Purpose

community assessment to determine services that are available in the county

gap analysis figuring out solutions that will foster

seamlessness making system recommendations for a

consumer-centered long term care system

Why Do We Need NY Connects?

Changing Demographics – Aging of the Baby Boomers in NY

NY’s general population expected to grow 3 percent between 2000 and 2015

Compare to……

Expected growth:

85+ population 56.0 % Minority elders 51.0 % Older adults with 17.1%

impairments

56%

51%

17%

3%0%

10%

20%

30%

40%

50%

60%

2000 2005 2010 2015

Aged 85+

Minority

Impaired

Total Population

NYS Aging and Impairment: Rate of Growth Projected Growth in Population and Vulnerable Elderly Cohorts

The Long Term Care Maze

Welcome to

Long Term Care

Who would you call for Long Term Care?

0.40%2%

4.50%

17.20%

21.50% 21.60%

32.70%

ReligiousSupport

AAA Other Self Relative or

Friend

MedicalSupport

Don'tKnow

2000 Behavioral Risk Factor Surveillance System BRFSS)

National Directions

New Freedom Initiatives 43 States and territories have Aging and

Disability Resource Centers (ADRCs) designed to streamline access to long term care

Real Choice Systems Change Grants for Community Living Designed to help states and territories

“rebalance” their long term care support programs to help people with disabilities or chronic illnesses to reside in their homes and participate fully in community life

Shifting/Changing Long Term Care System

Early intervention and prevention orientation Recognition of non-medical in addition to medical

needs Efforts to divert nursing home placements

through identification of predictors of placements Increase in home and community-based care Collective partnerships amongst agencies and

organizations Increase in focus on consumer engagement and

empowerment

State Medicaid Spending on Home-Based Long Term Care

49 – 70% 38 – 44%37% (US Avg) 30 – 36% 23 – 29% 13%

Importance of Informal Caregivers

80 percent of individuals 65+ with impairments in NY receive care from family/informal caregivers.

4X the care provided by NY’s formal long term care service programs!

NYSOFA established the Family Caregiver Council

The Cost of Doing Nothing....

If we do nothing....The system will continue to be fragmented, contributing to sky rocketing costs.

Within 10 years, the system will become unaffordable and unsustainable!

NYSOFA and NYSDOH’s VISION

The two agencies envisioned a system for individuals with long term care needs that:

Minimizes confusion Supports informed decision making and

enhances choice Improve quality of life through early intervention

and prevention Help consumers identify appropriate levels of

care to prevent institutional care

RFA released in May 2006.

Fully Executed

Contract Developed, Not Fully Executed

Not Applying

NY Connects Status

•57 Contracts have beendeveloped

•56 Contracts havebeen fully executed

•Madison pending

•Oswego did not apply yet

Standard Elements of NY Connects across the State

Information, Assistance and Screening Provides a comprehensive resource listing Provides unbiased consumer choice Provides necessary follow-upPublic Education Is recognizable in the community LTCC Works toward local change

Provision of Information and Assistance

Based on 3rd quarter data, 50% reported that they are providing I and A on long term care options.

Project Planning Teams in Place

Planning teams comprised of local government, stakeholders and providers have been established in all counties.

Many counties report active planning teams.

the Long Term Care Council

Expedites referrals, access and navigation through the LTC system

Enhances knowledge about all LTC services and programs

Provides creative solutions for “hard to serve” consumers

Provides an all-inclusive representation that leads to a broader view of the LTC system

Promotes systems reform and local problem solving

Local Elected Official Support Obtained

Counties reached out to local elected officials through informational presentations, kick-off events, and invitations to LTCC meetings

Counties with support from legislature report more seamless implementation process

Relationships with New Partners

Collaboration with outside agencies

Hospitals and nursing homes Independent Living CentersEarly Intervention2-1-1

Public Education Begins

TV ads for NY Connects Worked with a college intern to

develop NY Connects materials and used a 6th grade class to pilot test materials

Development of promotional items

Addressing Inefficiencies in System

Efficiencies and better use of case management staff

DSS caseworkers freed up to do more casework

Improved Collaboration between Counties

County planning teams have traveled to meet with NY Connects staff in other counties

Peer to peer meetings Expedites innovative practice

Increased Knowledge of Current Service Availability

Gaps analyses Increased knowledge of their long

term care system through cross training of staff

Lessons learned across aging and disabilities populations

Contact Information

Stacey Agnello, Supervisor - NY Connects Center for Human Services Development, SUNY Research Foundation

New York State Office for the Aging (518) 474-6096