San Diego Long Term Care Integration Project

LTCIP Planning Committee

June 14, 2006

San Diego Stakeholder LTCIP Vision for Elderly & Disabled Develop “system” that:

– provides continuum of health, social and support services that “wrap around consumer” w/prevention & early intervention focus

– pools associated (categorical) funding– is consumer driven and responsive– expands access to/options for care– Utilizes existing providers

Stakeholder Vision (continued)

– Fairly compensates all providers w/rate structure developed locally

– Engages MD as pivotal team member– Decreases fragmentation/duplication

w/single point of entry, single plan of care– Improves quality & is budget neutral– Implements Olmstead Decision locally– Maximizes federal and state funding

Strategies Developed to Support “Vision”

Healthy San Diego Plus

Physician Strategy

Aging & Disability Resource Center

Healthy San Diego Plus (HSD+)

MediCal Aged, Blind, and Disabled offered voluntary enrollment in LTC Integrated Plan

Models of care integrated across funding & the health and social services continuum:– Private entities to contract with State and CMS

through RFP with local pre-qualification– Healthy San Diego Health Plus Plans to develop

program details with consultant resources

HSD+ Update

Governor’s proposal/AB 2979 Supported by

– Medicare Modernization Act (SNPs)– Budget Deficit Reduction Act

(enhancements that used to require waivers now available through State Plan approval)

GMC rates tied to SNF & ADHC

Physician Strategy

Partner w/physician “champions” Develop interest/incentive for support of

“after office” services (HCBC) Identify care management resources to

link physicians/office staff to patients Train on healthy aging, geriatric/chronic

disease protocol, pharmacy, HCBC supports

Physician Strategy Update

CA Endowment Planning Grant report and request to fund Implementation:– Finalize/deliver team-building for

community care management for health and social service providers

– Link resources and decision support tools– Develop, evaluate outcome measures – Enhance IT infrastructure supports– Collaborate w/SD-MINE

Aging & Disability Resource Center (ADRC)/Network of Care Beta testing with

– consumers and caregivers– community based organizations– MDs, other providers, Call Center staff

To develop “continuous quality improvement” program

Measure behavior changes of providers and consumers

Funding: Federal Aging & Disability Resource Center grant application

CaliforniaAging and Disability Resource Center Grant Program

Lora Connolly, Director

CA Department of Aging

ADRC Grant Goals

Promote public awareness of public & private LTC support options especially among underserved, hard-to-reach populations

Provide Information & Counseling on ALL available LTC supports

Help consumers assess potential public LTC service eligibility

Determine programmatic eligibility for public LTC programs, including Medicaid nursing home eligibility

Provide short term assistance or care management Provide I&R Help consumers plan for future LTC needs Organize, simplify, and ensure “one-stop shopping” for

access to all public LTC support programs

Grant Goals & Vision

Empower individuals to make informed choices

Streamline access to LTC services Assist individuals in planning for

future LTC support needs Resource for LTC professionals &

others who provide services to older adults & persons with disabilities

Provide information & counseling to private-pay individuals

Grant Requirements--Target Group

Older adults (age 60+) and at least one of the following other major target group by Year II:

Individuals with physical disabilities; individuals with serious mental disabilities;

and/or individuals with mental

retardation/developmental disabilities. Individuals with traumatic brain injuries may

be a targeted group

California’s Project Goals Identify promising practices in providing

outreach to reach populations Determine viability of physical “one stop”

resource centers given state’s diverse geography

Identify how web based technology can be best employed to support this effort

Create an environment that fosters tangible collaboration between aging and independent living services with shared products & outcomes.

Need for Disabled Community Involvement (Ben Harville)

National, State, and local need—why I’m here!

The opportunity: revise Year 3 Work Plan to be more inclusive of disabled community

Equal focus on aging and disabilities Louis Frick, local ILC Director, will begin

conversation a little later

San Diego ADRC Key Goals (Dr. Mark Meiners)

Build on existing AIS Call Center Build/merge resource database, NOC Improve consumer linkages/access to

LTC information and services Outreach to broad community and

underserved/underutilizing populations Complete above with stakeholder input Evaluate outcomes & develop CQI

Specific Activities to Meet Goals

Surveys:– Call Centers—AIS and 211– Consumers– Caregivers– Community-based organizations

• Care management• Independent Living Center Consumer Advocates

Survey Findings

Survey tool difficulties Service directory could be more user-friendly,

more up-to-date need closer relationship w/211 Too many clicks to get info Translations need cultural input Needs of different users: Call Centers, MDs,

care managers, consumers, caregivers, et al

Response to Findings

Evaluation leads to:– Call Center input toward enhancements

and updates– 211 collaboration/joint protocols – NOC enhancements

Indicators of Increasing Satisfaction

More use of web site builder Customized site developed for AIS Call

Center Improved community-wide calendar Fall Prevention site ready for feedback Increased satisfaction with finding

information on NOC

NOC Enhancements for SD ADRCby Afshin Khosravi of Trilogy Integrated Resources

Site wide search powered by Google Enterprise Appliance

10,000 culturally adopted and hand translated Spanish articles

Medicare section Print Search Results Call Center Application

Practical Suggestions for Local Work Plan—(Louis Frick)

Joint focus on disabled above poverty Join Padres Disability Awareness Day Joint involvement of management/goals Access Center web site linked on NOC NOC as communication tool for ILC clients Joint participation in deinstitutionalization

project Outreach w/InfoVan to include disability

expert

Goals for Lunch Meeting

Brainstorm potential activities for ADRC in support of disabled community

Decide which are most important to incorporate into Year 3 Work Plan

Prioritize activities of Year 3 Work Plan

Current Year 3 Work Plan Activities

CQI process for database maintenance Complete web site enhancements Develop “My Folder” as LTC “Options

Counselor” Broad community outreach and

education Target underserved, underutilizing

populations

www.sdltcip.org Get on LTCIP mailing list for updates Attend Planning Committee meetings Log onto website for background & info Call or e-mail input/ideas: 858-495-5428

or evalyn.greb@sdcounty.ca.gov or 858-694-3252 or sara.barnett@sdcounty.ca.gov