New Hampshire Aging and Disability Resource Centers (ADRCs) · 1/13/04 ADRC- Advisory Council Kickoff 1 New Hampshire Aging and Disability Resource Centers (ADRCs) Program Kickoff

1/13/04 ADRC- Advisory Council Kickoff 1

New Hampshire Aging and Disability Resource Centers

(ADRCs)Program Kickoff Meeting

January 13, 2004

To empower individuals to make informed choices and to streamline access to Long Term Supports(LTS)


Meeting Agenda

• Welcome - Doug McNutt• Program Structure, Introductions - Amy Philbrick• Significance of Advisory Council

- Mary Maggioncalda• Overview of ADRC Model – MaryGaye Grizwin• Work Plan Topics, Deliverables, Milestone Schedule

– Laurie Burgess• Advisory Council Processes – Grace Ryan• Wrap Up – MaryGaye Grizwin


Planning Team Roles• UNH – Grant financial mgt, program evaluation, training

– Amy Philbrick - Grant administration, program evaluation– Raelene Shippee-Rice - Caregiver training curricula development, program

evaluation– Andrew Smith - Program outcome measurements (design, implementation

and reporting); data to select and develop pilot sites and for process CQI

• DEAS – Program management & implementation– MaryGaye Grizwin – Program leadership & administration– Mary Maggioncalda – Policy development– Grace Ryan – Operations development– Jill Burke – HCBC waiver integration– Wendi Aultman – Systems development assistance– Laurie Burgess – Technical consultant

Program Management StructureGroup Name

Role Responsibilities Membership Description

PROPOSED Participants/Affiliation

Program Council

Decision making authority on strategic design, policies, budget, implementation plans

Meets quarterly for Program Council Review meetings; Provides guidance on political issues, program viability; indecision or disagreements raised to Commissioner of DHHS

Selected directors & managers of DEAS and sister agencies participating in the ADRC program

Doug McNutt – DEAS Director Jim McCarthy – UNH Dean Health & Human Services Lloyd Peterson – Director of Reorganization Planning MaryAnn Broshek – Division of Financial Assistance Matthew Ertas – Developmental Disability Services Geoffrey Souther – Division of Behavioral Health Jan Paterson – Office of Medicaid Planning Ned Helms – Director of NH Institute of Health Policy and Planning, UNH

Advisory Council

Feedback to Planning Team on program plans and implementation strategies

Meets monthly (or less often after initial Planning Phase) with members of the Planning Team to stay current on program status and provide guidance on specific program issues; Serves as a public advocate for the program through out the state; Works to positively influence strong community support and inter-organization collaboration

Elderly, disabled and caregiver consumers, representatives of advocacy and provider groups, UNH and DHHS policy experts

Ned Helms, David Siress, Susan Lombard,Sandy Ziegra, Don Rabun, Richard Brothers, Joyce Gleason, Dick Chevrefils, Dalia Vidunas, Rene Bergeron, Judith Jones, Rep. Carolyn A. Brown, Pam Jolivette, Lew Feldstein, Kathy Bizarro, Judy Pilloid, Barbara Savatore, Mendon MacDonald, Jim Squires, Clyde Terry, Jim Monahan, Susan Young, John Poirier, Ralph Littlefield, Allan Moses, Lynn Lippett, Sue Staples, Chris McMahan, Keith Thibault, Sandy Thicks, Karen Painter, Nancy Euchner, Sally Carlisle, Gordon Allen, Beth Fitgerald, Rep. Liz Hager, Bev Arel, Members of the ADRC Planning Team (below) See separate list for participant affiliations.

Planning Team

Strategic program leadership, administers grant, develops detailed program plans, manages implementation and rollout

Meets weekly to update project status and track progress against program schedule, discuss issues, establish program plans; Works independently and with key subject matter experts on specific program issues in between meetings; Regularly communicates to a broad audience statewide to develop and maintain a high level of program awareness

ADRC program and grant managers

MaryGaye Grizwin – LTS System Manager, DEAS Amy Philbrick –Senior Policy Analyst, NH Institute of Health Policy and Planning Mary Maggioncalda – Policy Administrator, DEAS Laurie Burgess - Program Consultant, Bailit-Health Purchasing Raylene Shippee-Rice – Professor of Nursing, UNH Grace Ryan – ServiceLink Operations Manager, DEAS Jill Burke – HCBC-ECI Program Specialist, DEAS Wendi Aultman – ServiceLink coordinator, DEAS


Vision: ADRCs Nationwide

• Highly visible in community

• Trusted, unbiased places for public and private-pay individuals

• Single points of entry • Full range of long term

support options and services

• Target audience:– Elderly persons– Younger adults with

disabilities, chronic conditions

– Family caregivers– Persons planning for future

long term support needs– Also, health and LTS

professionals


ADRC Program Goals

• Leadership

• Comprehensiveness

• Quality

• Integration

• Marketing & Outreach

• Adequate funding

• Skilled personnel

• Technology

• Knowledge building


Essential Program Components

• One-stop access (referral) to– All public programs for community and institutional

LTS services administered by Medicaid– OAA programs devoted to LTS services– Any other publicly funded services appropriate for

individuals seeking LTS assistance– Privately funded, community-based resources, services,

and programs


Essential Resource Center Components

• Provide streamlined access to all LTS services through integrated or closely coordinated: – Intake

– Assessment

– Eligibility screening

– Programmatic & financial eligibility determinations


For Clarification…

• The ADRC Model:– Is not an organizational structure

– Does not change program management responsibilities, processes, eligibility criteria, service offerings of LTS programs

– Does not depend on continued grant funding

– Does not replace existing case management activities


NH Grant Award

• New Hampshire Institute for Health Policy and Practice at UNH, in cooperation with the Division of Elderly and Adult Services (DEAS)

• Three-year, $800,000 grant

• Jointly funded through AoA and CMS


New Hampshire Objectives

• A more comprehensive front-end framework to LTS services– Easier access to services– Reduce the fragmentation of Medicaid eligibility

system– Offer a supported decision making model– Encourage personal responsibility

• Improve operating efficiencies & effectiveness


Preliminary NH Strategy

• Develop a strong technology-based infrastructure

• Establish a cross-functional, team-based approach for customer service and operations management

• Integrate ServiceLink, Assessment & Counseling, specific DHHS activities

• Improving quality of referrals to providers


Allocation of Grant Funds

• Develop the technology-based infrastructure

• Integrate the disconnected processes of the existing programs

• Develop staff training curriculum

• Implement quality improvement mechanisms to measure and improve operating efficiencies


Program Development Structure• Program Council – guidance on strategic design,

political issues, program viability; approval on policy, financial, operations issues; program advocacy

• Advisory Council- guidance on ADRC design, development plans, and implementation strategies: operating protocols, process development, performance outcomes

• Planning Team - strategic program leadership, grant administration, detailed program development, and implementation


mgg – 11/21/03

Long Term Support System Transition - Conceptual Model

ServiceLink Audience: Elderly, adults w/physical disabilities, caregivers regardless of financial status; Providers Mission: Providing info, public education, and assistance on long-term support issues and services Service: Needs assessment & supported referrals; Public education Operating Limitations: Limited hours of operation, insufficient # and breadth of topics of education sessions, inadequate attention to audience w/disabilities, inadequate program development

Assessment & Counseling Audience: Elderly, adults w/physical disabilities, caregivers in need of LTS placement or Medicaid benefits; Providers Mission: Uniform, accurate, timely LOC assessments and info on LTS options, Education on LTS planning Service: Clinical NF level of care determinations; LTS counseling & placement assistance; Public education Operating Limitations: Only in four counties, focus on individuals already in NFs, no evidence of NF avoidance, inconsistent standards, some duplication of effort, dispersed management accountabilities, not integrated w/discharge planners nor HCBC

DHHS: (DEAS, DFA, DDS, DBH, et. al.) Audience: Elderly, adults w/ disabilities, caregivers, low-income; Providers Mission: APS and info & assistance on long-term support issues and services Service: Medicaid and SSBG program eligibility & benefits; info & referral, LTS counseling & placement assistance; Public education Operating Limitations: Not integrated w/other programs, target population limited to low income or Medicaid eligible

FUTURE: NH Aging and Disability Resource Center(s) Model

Person-Assisted Information

(telephone, walk-in, home visit)

Technology-Assisted Information (interactive website, related links,

email, resource databases)

Customized Referrals & Connections

Clinical LOC determination, arrangement, care planning, & quality

assurance of Medicaid LTS benefits

Outcomes Measurement; Staff Training, Operations Management & CQI, Public Awareness

HCBC case mgt

CURRENT: Independent Programs

ADRC Legend:

= ServiceLink functions

= DEAS functions; (Contracted or in-house)

= DHHS functions

Local Aging & Disability Resources (Public Supported and Private Pay)

= Funded by ADRC Grant

LTS Planning & Caregiver

Public Education Seminars

Needs Assessments & LTS Counseling

Local ServiceLink Resource Centers

= Providers, Agencies, Resources

Referrals, database updates, resource collaboration, operations CQI

APS Program

& services

SSBG, Title III Programs &

Services

Local hospitals, rehab facilities, nursing homes, and

physicians (discharge planning and service referrals)

DFA financial eligibility processing

Non-profit local agencies

Independent local service providers

National resources

LTC Ombudsman

DBH

DDS DADAPR

Other DHHS agencies


Timetable• Year 1 (October 2003-September 2004):

– Develop operating protocols & standards, database and systems design, staff training curriculum, public education curriculum, public awareness strategy, data collection and evaluation approaches

– Implement pilot in one site• Year 2 (October 2004-September 2005):

– Implement pilot in three additional sites– Evaluate pilots and plan for statewide implementation

• Year 3 (October 2005-September 2006):– Full Implementation– Plan for ongoing operations and quality improvement


Topics for Advisory Council

• Resource Center Staffing • Data collection and analysis • Evaluation Initiation • Pilot Site Selection • Determining the Business Model • Public Awareness Campaign • Info & Referral and Resource Database System • Caregiver Education


Resource Center Staffing

• Team member functions, credentials and determination of caseload standards

• Activities and referral protocols for responding to DBH or DD consumers, families

• Staff training requirements


Data Collection and Analysis

• Data and and approach for projecting the demand on ADRC team members

• Suggestions for additional or other data


Evaluation Initiation

• Appropriate design for data collection approach and program outcomes measures:

– Pre-pilot implementation

– Post-implementation evaluation


Pilot Site Selection

• Proposed pilot site selection criteria and how they’re applied

• Pilot site(s) selected

• Proposed composition/activities of the local pilot implementation teams


Determining the Business Model

• Two guiding principles:– Unbiased management structure

– Long term funding viability

• Pros & cons and details of potential models:– Partially state-owned/partially contracted out

– Fully contracted program


Public Awareness Campaign

• Comments and input on reaching hard to reach populations


Information & Referral and Resource Database System

• System specifications

• System selection

• System implementation


Caregiver Education Curriculum

• Proposed approach for soliciting input from informal and formal caregivers

• Proposed curriculum, rationale, delivery approach

• Long term curriculum development and implementation


Year 1 – Key Tasks• Create/convene planning team, program council and Advisory

Council• Develop specifications for integrated database system and solicit bids

from vendors• Refine conceptual and business model for pilot Resource Centers• Develop pilot evaluation design and conduct baseline measurement• Select pilot sites and convene local implementation planning teams

Select contractor for development and implementation of integrated database system

• Develop training and education curriculum, website, and approach for training and support for formal and informal caregivers for pilot sites

• Implement pilot Resource Center program in selected pilot counties


Year 2 – Key Tasks

• Develop plan for statewide implementation of the Resource Center Program

• Convene implementation teams specific to each of the remaining counties

• Develop training curriculum for Resource Center staff in remaining counties

• Complete formal evaluation of pilots and discuss with Advisory Council, including success of publicity campaign


Year 3 – Key Tasks

• Assess pilot evaluation findings and modify program structure/processes based on lessons learned

• Develop contracts for Resource Centers for remaining counties

• Begin statewide implementation of Resource Centers

• Convene subcommittee responsible for developing plan for ongoing operations beyond grant term


Advisory Council Milestone Planning Calendar

Jan Feb Mar Apr May Jun July Aug SepAdvisory Council Meetings

(1st Tuesday)

Program Kickoff:• Vision, Team,

Roles, Topics, Milestones, Commitment

• PreReads:Overview presentation,Topics for Advisory Council

Topic discussions:• Program

Evaluation

• Operating & staffing model

• Pilot selection criteria

• Data collection & analysis

Topic discussions:• IT strategy

• Business model

• Public Awareness

• Caregiver Education

Planning Team presentations:• IT analysis &

recommendation

• Operating model

• Business model

• Caregiver curriculum

• Public awareness strategy

• Pilot site(s) selection

• Schedule review/adjustment

Planning Team presentations:• Pilot implemen--

tation strategy

Topic discussions:• Pilot

planning

Topic discussions:• Pilot team

• Team training

• IT plan

Topic discussions:• Pilot

readiness• Pilot site

visit• Year 1 Grant

management performance review

Program Council Meetings (mid

-month)

Program Kickoff: same asAdvisory

• Pilot model endorsement

• Pilot Implemen-tationstrategy approval

• Pilot site visit


Meeting Process

• Importance of participation– Valued expertise and experience – Representative of organization or constituent group

• Consistent attendance for continuity– Option to appoint representative with voting ability

• Simple majority vote will carry decisions and dissenting opinions will be noted

• Summaries and handouts available on website


Meeting Schedule

• Focused monthly two-hour meetings –– First Tuesday at 1:00 at Granite State Independent

Living Center• Pre-reads sent by email prior to meeting• Facilitated to allow as many opinions as possible

in designated time– Evaluation form for added comments

• Respect diversity of opinion and person’s right to express their opinion– Allow speaker to finish


Wrap Up• Thank you!• Today’s action items:• Your “homework”

– Review today’s materials and “Topics for Advisory Council Recommendations”

• Next meeting, Feb 3: – Program evaluation – Pilot site criteria– Operating & staffing model– Data collection & analysis


Planning Team Contact List

Questions? Comments? Let us hear from you!Amy Philbrick : [email protected], 603-862-5099Raelene Shippee-Rice: [email protected], 603-862-4715MaryGaye Grizwin : [email protected], 603-271-0541Mary Maggioncalda: [email protected], 603-271-4410Grace Ryan: [email protected], 603-271-0544Jill Burke: [email protected], 603-271-0550Wendi Aultman: [email protected], 603-271-4640Laurie Burgess: [email protected], 781-237-5111

Documents

New Hampshire Aging and Disability Resource Centers (ADRCs) · 1/13/04 ADRC- Advisory Council Kickoff 1 New Hampshire Aging and Disability Resource Centers (ADRCs) Program Kickoff