Key Activities of the ADRC Grantees Sharon Zeruld and Lisa Alecxih The Lewin Group

Overview Summary of ADRC Grants Common Elements of Early Successes Key Considerations for Multi-Agency Approach Materials to Share

ADRC Grantees Louisiana Maine Maryland Massachusetts Minnesota Montana 2003 Awardees 2004 Awardees New Hampshire New Jersey Pennsylvania Rhode Island South Carolina West Virginia Alaska Arkansas California Florida Georgia Illinois Indiana Iowa New Mexico North Carolina Northern Mariana Islands Wisconsin

Populations ADRCs Have Chosen to Serve All serve age 60+ 4 plan to serve all disabilities of all ages 4 plan to serve adults of all disabilities AR & IL plan to serve elderly, adults with physical disabilities and adults with developmental disabilities 11 plan to serve elderly and adults with physical disabilities GA plans to serve elderly and adults with developmental disabilities FL plans to serve elderly and adults with mental illness NC plans to serve elderly and a population TBD

AoA and CMS Expectations for Streamlining Eligibility By end of Year 3 – ADRC will streamline access to long-term supports so that intake, assessment, eligibility screening, and programmatic and financial eligibility determinations are integrated or so closely coordinated that the process is seamless to the consumer. Regardless of the configuration, the functions of the ADRC will be coordinated and standardized to ensure that all individuals are provided with uniform information and access to long term support Multiple organizations need to work together to develop common intake questions, assessment tools and eligibility screenings

Nine of the Grants Plan a Multi-Agency Approach Among 2003 Grantees Maine, Massachusetts, Minnesota, New Hampshire, Pennsylvania and South Carolina Among 2004 Grantees Florida, Iowa, and North Carolina Four feature AAA and CIL partnerships Massachusetts, Minnesota, probably Pennsylvania, and SC Two bring together multiple organizations Maine in a collaborative effort New Hampshire in a contractual relationship Two partnered with mental health Florida and Iowa (also includes DD)

Implications of Multi-Agency Approach on Access Function Recommend cross-training for uniform information about available benefits across funding streams and populations Accountability in making referrals to partnering agencies Agreement to reduce the number of steps for applicants for eligibility Sharing necessary information across agencies so customers … do not have to tell their story more than once can contact the trusted resource to get information about status of application

Common Elements of Early Successes: Planning & Start-Up Understand current systems operation Both strengths & gaps Develop program based on shared, underlying values Surrender organizational turf to work as team & put people first Adopt a civic process and develop state & local partnerships Public and private sector integration Leverage other grants Real Choice Systems Change, AoA Family Caregiver, HUD, Medicaid Infrastructure Grants, etc. Determine information needs at the beginning Invest in comprehensive IT systems that support ADRC Very difficult to recreate data not collected retrospectively Leverage other grants – SC is already doing this by building upon earlier CMS Real Choice grant Performance Measurement – be flexible, learn along the way – measure outcomes

Common Elements of Early Successes: Implementation Emphasize performance management & flexibility Staffing Need for cultural competence in both outreach and options counseling Both minorities and disability Recognize needed skills and training of ADRC staff Customer focus Need to develop disability expertise Even when partnering, need common framework Leadership and Commitment Assign at least one staff member that can devote a substantial portion of his/her time to developing the ADRC during the first year

Common Elements of Early Successes: Marketing and Outreach Need to find out how to see ADRC through the consumer’s eyes ADRC planners & staff see things differently than consumers How to ultimately sell the center to the public ADRC name, Website name, Logo and tagline, Brochures Communicate messages that are easy to understand, relevant and actionable What do you want people to do? What is in it for them? Targeted outreach to the most likely consumers Directly – word-of-mouth may be most effective Through referrers -- hospital discharge planners, physicians, pharmacists See June Social Marketing Call materials and recording National Meeting Session Materials

Common Elements of Early Successes: Sustainability Plan for sustainability Institutionalize approach because turnover is inevitable Establish attainable short term goals and objective, but keep sight of the long term goals Use evaluation to: inform decision-making demonstrate performance enable continuous quality improvement See June Social Marketing Call materials and recording National Meeting Session Materials

Common Elements of Early Successes: ADRC Services Program may not offer new services or add staff More about re-aligning infrastructure and orienting staff Focus on streamlining eligibility determination Eliminate inefficiencies Develop protocols for sharing eligibility information Determine need for HIPAA compliance on information tradeoffs between entities Treat options counseling as process, not as event Intervene in critical pathways Collaborating with gatekeepers (individuals and agencies) about ADRC referrals Leverage experience from agencies that serve individuals who can pay privately Eligibility- Communication and collaboration between all local entities involved in eligibility is vital to make process work for consumers. Having written access plans or MOUs between parties is helpful in having common ground to refer back to. IT – takes a lot of time and resources to keep the resource database updated

Key Considerations for Multi-Agency Approach Building trust and common goals Establishing roles and regular working meetings Early and repeated cross-training of staff Primacy of the consumers’ perspective Not having to repeat information IT system or protocols to share information across agencies Minimizing the transfers to other staff Requires knowledge of both systems Simplicity of forms and other requirements Avoiding duplication In roles and responsibilities of staff By developing common intake mechanisms and protocols See materials submitted by MA and NH Also multi-agency workgroup minutes

MA ADRC Implementation/Grant Coordination Organizational Chart Executive Office of Elder Affairs, Elder Services of Merrimack Valley, Northeast Independent Living Program, Mass Rehab Commission ADRC Coordinating Committee Steers all aspects of project towards desired systems change. ADRC Collaborative Team 3 representatives each from CPAB and CB. Responsible for facilitating consumers’ intimate knowledge with the professional experiences of providers on the CPAB. Nominated representatives from CPAB and CB to discuss more in-depth issues related to program implementation. Integrated Intake Team (ADRC Program Coordinator, ESMV Age Info Supervisor, NILP Program Director, NILP Intake Worker) Responsible for effectuating the collaboration or desired integration among the two services communities at the center of this grant. Community Partners Advisory Board (local and state agencies and organizations) Responsible for advising ESMV, NILP, and EOEA on the design and operation of the ADRC. Consumer Board (local elders and persons with disabilities) Responsible for advising ESMV, NILP, and EOEA on the design and operation of the ADRC and sharing intimate knowledge of what works. ADRC Leadership Group Steers all aspects of project towards desired systems change. More expansive group including leadership from ESMV, NILP and State.

Materials to Share: Massachusetts Massachusetts Grant Profile http://adrctae.org/tiki-print.php?page=MassachusettsProfile MA ADRC Overview Chart MA ADRC Implementation Coordination Organization Chart MA Integrated Intake Team Report MA Consultation form and protocol MA ADRC data tracking forms MA Cross-training materials All found at http://adrctae.org/tiki-page.php?pageName=Massachusetts+ADRC

Materials to Share: New Hampshire New Hampshire Grant Profile http://adrctae.org/tiki-index.php?page=NewHampshireProfile SLRC Referral Check-off Form for Hospital Discharge Planners Draft Protocols for Referrals to SLRC by Hospital Discharge Staff Draft Protocols for Receiving Referrals in the SLRC from Hospital http://adrctae.org/tiki-page.php?pageName=New+Hampshire+ADRC

Materials to Share: Multi-Agency Entry Points Peer Work Group Implementing multi-agency entry points peer work group http://adrctae.org/tiki-index.php?page=MultipleAgenciesWorkGroup http://adrctae.org/tiki-view_forum.php?forumId=5