Building Alliances For Safer Communities “What’s Working” Webinar Multnomah County Aging & Disability Services Gatekeeper Program Presented by - Lynn Schemmer-Valleau October 2, 2012

OCTOBER 10: Volunteers Win – Area Agency on Aging for Northeastern Vermont, St. Johnsbury, VT (Rural) The Equal Exchange TimeBank, modeled after TimeBank USA, allows members to post a need they seek to fill or search member posts to find qualified volunteers. Volunteers bank their hours served, earning “time dollars” towards a need they may have or to pass on to someone in need; everyone wins! Register today at OCTOBER 11: Louisiana Senior Medicare Patrol – eQHealth Solutions, Baton Rouge, LA (State) This program used newspaper “Letters to the Editor” opportunities to inform high functioning, civically engaged seniors about the Senior Medicare Patrol program and to recruit them for our volunteer corps. The effort doubled the number of volunteers. Register today at Upcoming Webinars

Webinar Instructions Audio options Use your computer speakers, OR Dial in to the conference call All participants are muted “Questions” box Q&A session will be at the end of the presentation, but feel free to submit your questions at any time during the presentation. Click on the “+” to pop out the questions box where you can type and submit your questions.

What we will be covering today: Overview of the Gatekeeper How to develop a programs in your community Key partners Identifying a “hub” and a lead agency Developing protocols Sharing of information with partners Engaging the business community Sustainability Q & A

What is the Gatekeeper Program? It is an outreach effort to identify, refer, and respond to at-risk older adults and people with disabilities living in our community. Gatekeepers are trained: to identify warning signs to call a Gatekeeper Referral number and report their concerns

Why does the Gatekeeper program exist? Linking services with those most isolated in the community is often not successful There are a number of reasons why high-risk older adults are unable, unwilling or resistant to seeking assistance. Negative stigma associated with using “social services” Pride and stoicism Fear of losing control over their life. Shame, suspicion or fear Financial reasons Mental health issues such as paranoia, memory loss, depression Lack of information about what services are available or assistance they may qualify for

Who are Gatekeepers? Gatekeepers are nontraditional referral sources who come into contact with older adults or adults with disabilities through their everyday work or activities and who are trained: to recognize warning signs and red flags that indicate an older adult/adult with disabilities may need some help/support to report their concerns their local Gatekeeper Program The Gatekeeper Model is a great fit with an Aging & Disability Resource Connection (ADRC)

Gatekeeper Structure Can Vary Multnomah County Profile Housed in Type B Area Agency on Aging (AAA) Part of 24/7 ADRC/Helpline Referrals assigned internally to APS and case managers Referrals also assigned to senior center case managers All referrals logged into new ADRC call module and ed to worker & supervisor Program been operational for 25 years in Multnomah County

The Multnomah County Experience Ray Raschko develops the first Gatekeeper Program in Spokane (1978) Human Solutions in Portland started a Gatekeeper Program with three year grant, covering a geographic area of the County (1987) Due to success of the program, absorbed by local AAA and expanded county-wide (1990) Celebrated 25 Year Anniversary (2012) Received Award funding from The Aging Network’s Volunteer Collaborative under the “What’s Working– Effective Practices” program (2012)

Gatekeeper Referrals in Multnomah County FY11/ daytime Gatekeeper referrals received from the community: 66% of the Gatekeeper calls were referred to Adult Protective Services 49% of the calls were for people who were NOT already receiving services

Gatekeeper Referrals By Industry Utility Companies30% Police/Fire/Rescue15% Social Service Agencies11% Anonymous10% Banks/Credit Unions 7% The balance of referrals (27%) come from letter carriers, faith communities, housing managers, transportation providers, concerned neighbors, etc.

Gatekeepers are trained to recognize warning signs, red flags and other reasons to make a referral Any change in normal routine is critical.

Typical areas of potential warning signs are discussed during a training: Communication Financial Caregiver Stress Social Isolation Emotional Health Appearance of the Person Physical Limitations

Warning signs for people in the field are also covered Home needs repair and/or is inaccessible Mail stacked up, old newspapers laying around Strong odors on person and/or in home Yard overgrown and neglected Pets neglected and/or too many pets

What information should Gatekeepers report? Customer’s name Date of birth or age, if known or approximate Address Telephone number A brief description of concerns, observations, what the customer has self-reported or disclosed Gatekeeper’s contact information

Anonymity and Confidentiality This topic is covered during a training. It is an important protocol to address as you are developing your Gatekeeper Program. Anonymous: Gatekeeper’s name will not be tied to the report or shared– total anonymity Confidentiality: Gatekeeper’s name will be kept private to the client, alleged victim, alleged perpetrator, etc but will be on the report for follow up as needed

After the referral is made…what are some things we can do to help? It will be very important to develop a simple and varied list of potential “next steps” and ways that your Gatekeeper Program will follow up once a Gatekeeper has called to make a referral. Gatekeepers always want to know “now what?”

Client Choice Gatekeepers become concerned when they think that the person did not get help…we are not charged with “solving the problem”. It is important to cover the topic of Client Choice with Gatekeepers. As an agency we value client choice We follow up on EVERY gatekeeper referral that is made Does everyone gets help or gets their “issue” resolved? -- NO, they don’t Not everyone WANTS help.

What else Gatekeepers do to help? Donate money – we receive donations through United Way’s Employee Giving Campaign Donate time – some Gatekeepers enjoy volunteering for a community agency Donate resources – Gatekeeper organizations provide in-kind resources like printing or sponsor holiday gift drives

Key Elements of a Gatekeeper Program Identification of partners Establishing a lead agency and a hub Having memorandum of understanding or a working agreement with partners Development of protocols & triage techniques Mechanisms for sharing information

Identification of partners Discuss with key leaders from community. Interested parties generally include: Utility Companies Police/Fire/Rescue Support Programs Banks/Credit Unions Letter Carriers Housing Transportation Can you think of a group in your community?

Lead Agency Hub Establishing a Lead Agency & a Hub Area Agency on Aging ADRC is a great a hub Law Enforcement Community Non Profit Older Adult Mental Health Agency A combined response Lead Agency can partner with another agency for support like training

Memorandum of understanding or working agreement with partners Adult Protective Services Medicaid Senior Centers Advocacy Groups Senior Corps RSVP Program Mental Health Developmental Disabilities

Protocols and triage techniques and sharing information It is important to know how calls will be handled. Some considerations are: Will there be a home visit? What is response time? What do you do with after hours calls? How are calls documented and shared? What information is shared with Gatekeepers? How do your protocols fit with your agency’s confidentiality protocols? How do you ensure consumers don’t “slip through the cracks”?

Protocols and triage techniques Identify the client– are they already being served? If so  connect with their case manager Where can new referrals (people who are not in the system and don’t have a case manager) be sent? Is this an APS issue? Is this a mental health crisis issue? Is this an urgent issue/imminent danger? 911?

Consideration for sharing information How will the various groups share information? Is secure/confidential? Is there a call module with consistent format? Are there back up procedures to ensure that the recipient is not out of the office and the referral sits for several days until their return?

Mechanisms for sharing information Sharing with PARTNERS Internal methodology for sharing Sharing with external partners Secure s/HIPAA considerations Share with mental health call center Determine who you will need to share info with and how it will occur with follow up loop

Mechanisms for sharing information Sharing with the Gatekeeper What can you share back with the Gatekeeper? When is it ok to share follow up information with the Gatekeeper? Must consider client confidentiality

Why this program is important to the business community Helps customers achieve a better outcome Good public/partnership to support consumer Business wants to help but goes beyond their scope of work Peace of mind that consumer will get some follow up Gatekeeper referrals are welcomed – not seen as a “complaintant” Able to provide good customer support while also managing business

Gatekeeper Program Sustainability Identify start up and on-going funding; grants, reallocate existing resources, business community support, etc. Important to have a designated coordinator for the program Regularly communicate your successes Engage your local elected officials

Questions or Comments? Lynn Schemmer-Valleau

OCTOBER 10: Volunteers Win – Area Agency on Aging for Northeastern Vermont, St. Johnsbury, VT (Rural) The Equal Exchange TimeBank, modeled after TimeBank USA, allows members to post a need they seek to fill or search member posts to find qualified volunteers. Volunteers bank their hours served, earning “time dollars” towards a need they may have or to pass on to someone in need; everyone wins! Register today at OCTOBER 11: Louisiana Senior Medicare Patrol – eQHealth Solutions, Baton Rouge, LA (State) This program used newspaper “Letters to the Editor” opportunities to inform high functioning, civically engaged seniors about the Senior Medicare Patrol program and to recruit them for our volunteer corps. The effort doubled the number of volunteers. Register today at Upcoming Webinars