Wisconsin's Aging and Disability Resource Centers A Simplified System for Accessing Information and Long Term Care May 22, 2001

Alice Mirk WI DHFS2 Resource Centers Services In this new simplified system for accessing information and assistance about community services and long term care, Resource Centers serve the general public through: – Public education – Outreach/Information and Assistance – Early intervention – Prevention – Youth transitional services

Alice Mirk WI DHFS3 Population Based Activities of Resource Centers Marketing Public Information plans Prevention activities with special populations

Alice Mirk WI DHFS4 Series of Protocols for Resource Center Contacts Tailor information for individuals, including: – Intake, to find out what it is the person wants and/or needs. – Information, about programs, services or other community resources including, but not limited to Family Care.

Alice Mirk WI DHFS5 Series of Protocols for Resource Center Contacts (contd.) Protocols for providing access to ongoing services for persons who do not express an interest in Family Care, including: – Assistance: In getting entry level LTC services like snow shoveling, housekeeping, etc. – Referral: To other appropriate resources like congregate meals, transportation, APS, etc.

Alice Mirk WI DHFS6 PAC Protocols Facilities are required to refer individuals prior to admission to all substitute care settings. Resource Centers do a follow-up contact: – 19% go on to explore Family Care – 81% have had their needs met by the Resource Center or chosen other options

Alice Mirk WI DHFS7 PAC Protocols (contd.) Protocols so that, while providing information and assistance: – If the person chooses to explore Family Care, their functional needs would be assessed, and a functional eligibility determination would be made without having to be referred elsewhere

Alice Mirk WI DHFS8 PAC Protocols (contd.) Of persons who have accepted a functional screen to date: – 86% are eligible at NH LOC – 11% are eligible at intermediate level – 3% are not eligible

Alice Mirk WI DHFS9 PAC Protocols (contd.) Protocols so that after the person provides adequate financial information: – MA Outreach occurs and a referral is made to the public economic support unit. Protocols so that if the person decided not to apply for MA, or for Family Care, they again would be offered information, assistance or referral for other available services, including: – Private pay services – Other non-MA services

Alice Mirk WI DHFS10 Resource Center Goals The goal is that the Resource Center would be a clearing house for consumers where information and access to a variety of services, including LTC, could occur simultaneously so that: –Functional eligibility determination could be integrated with other Resource Center functions, including Outreach and Intake Information and assistance LTC options counseling Referral

Alice Mirk WI DHFS11 Resource Center Goals (contd.) – Consumers would not experience Being “handed-off” from one worker to another Being asked the same questions repeatedly – Procedures would be as efficient and cost- effective as possible

Alice Mirk WI DHFS12 Resource Center Goals (contd.) The Family Care Pilot counties have been operating under this model, and: – Most consumers never have to go anywhere; instead Resource Center staff go to their homes; get a better picture of the person’s functioning in their own environment, and the consumer has a level of comfort that makes the sharing of sensitive information much easier.

Alice Mirk WI DHFS13 Resource Center Goals (contd.) – Consumers aren’t on their own in figuring out how to get services; a worker is responsible for facilitating access to the programs and services the person needs and wants – Eligibility determination is done in 2- 4 days (less than 24 hours when needed) – Eligibility information is shared so that a CMO or other service agency doesn’t ask the same questions

Alice Mirk WI DHFS14 Resource Center Experience Long term care in the community is a strange animal!

Alice Mirk WI DHFS15 Being a Resource Center worker requires a varied set of skills: Communication and interview skills Phone interviewing with the ability to assess and reframe as the conversation progresses Ability as a functional assessor

Alice Mirk WI DHFS16 Options counseling is usually not an event, but a process that unfolds over time and results in spontaneous outreach

Alice Mirk WI DHFS17 Sometimes It takes Multiple Contacts ….And the paths are time-consuming and convoluted

Alice Mirk WI DHFS18 In more than four out of five contacts to the Resource Center, the person does not want information about Family Care or other LTC services –They just want questions answered or –They just need information about other community services, or –Referrals to other programs

Alice Mirk WI DHFS19 Sometimes Response has to be Immediate….

Alice Mirk WI DHFS20 And requires high degrees of cooperation between the Resource Center and the Service Agency such as the CMO

Alice Mirk WI DHFS21 Resource Centers can be short term care providers as they assess and arrange for services and help problem solve family situations.

Alice Mirk WI DHFS22 Options Counseling for individuals who have their own resources and have long term care needs is an important part of the Resource Center role.

Alice Mirk WI DHFS23 Current status of Resource Centers in Wisconsin Nine Pilot Resource Centers linked with the Family Care redesign initiative Three were created out of the county Departments on Aging One was created out of combining the county Public Health Department and the Department on Aging

Alice Mirk WI DHFS24 Current status of Resource Centers in Wisconsin (contd.) Two were created from county Social Service agencies Two were created from county Human Service agencies One is split between the county Social Service agency and the agency responsible for Developmental Disabilities Services.

Alice Mirk WI DHFS25 Current status of Resource Centers in Wisconsin (contd.) Number of Resource Center contacts have grown state wide from 4,800 in December of 1999 to A TOTAL OF 68,076 contacts in 2002 In the third quarter of 2002: –14.9% needed basic information on Medicaid, food stamps and other basic resources –29.5% were looking for LTC related services –18.8% were looking for basic info on other services

Alice Mirk WI DHFS26 Current status of Resource Centers in Wisconsin (contd.) 13.9% were referrals to the LTC FS 6.9% were referrals to other public services 8.9% needed short term case management or follow up 3.7% needed a follow up contact from RC staff 2.1% were referred to adult protective services

Alice Mirk WI DHFS27 Current status of Resource Centers in Wisconsin (contd.) 1.1% were referrals to private long term care services 0.3% were referrals to emergency services.

Alice Mirk WI DHFS28 Where do we Go From Here ? Ever growing interest from county agencies to begin the process of evolving into Resource Centers, as they recognize the advantages of a centralized information system for the community Greater collaboration between the county agencies and the community resources results in better services and information to the consumer

Alice Mirk WI DHFS29 Where do we Go From Here ? Recognition that a Resource Center is a business that serves customers and that customer satisfaction is important Recognition for the need for good IT systems to support the concept of a Resource Center that provides the full range of services and good current information for the community.

Alice Mirk WI DHFS30 Intermediate LTC Population Comprehensive LTC Population Why we need Resource Centers? I&A Support as a care giver ?’s on LTC insurance Prevention & intervention Brief interventions after acute care or illness Protective services monitoring Nutrition services 800,000 in WI age 60 and over

Alice Mirk WI DHFS31 Why we need Resource Centers? Intermediate LTC Population Comprehensive LTC Population I&A Support as a care giver ?’s on LTC insurance Prevention & intervention Brief interventions after acute care or illness Protective services monitoring Nutrition services 800,000 in WI age 60 and over Look at the demographics… Explosion of aging population Can’t afford to have this explosion coming through the public system in crisis Need an upstream approach

Alice Mirk WI DHFS32 Wisconsin’s Current Information Technology Initiative A project is currently underway to build a system that would: Allow authorized workers to determine functional eligibility for Long Term Care using Web-based technology Store information in a single data repository that will allow authorized CMO and RC staff to share information

Alice Mirk WI DHFS33 Wisconsin’s Current Information Technology Initiative (contd.) Provide simple and intuitive navigation Present information in user-friendly screens for data entry Provide for context-sensitive help Enable immediate determination of Eligibility, thus reducing wait time

Alice Mirk WI DHFS34 Wisconsin’s Current Information Technology Initiative (contd.) - Sample Screen

Alice Mirk WI DHFS35 WI FUNDING MECHANISMS MA ADMINISTRATIVE FUNDS FOR I & A MA ADMINISTRATIVE FUNDS FOR ELIGIBILITY DETERMINATION MA ADMINISTRATIVE FUNDS FOR IT DEVELOPMENT MATCHED WITH BOTH LOCAL COUNTY DOLLARS PREVIOUSLY USED FOR INTAKE AT THE LOCAL LEVEL AND STATE GPR PREVIOUSLY USED IN THE LONG TERM CARE SYSTEM

Alice Mirk WI DHFS36 Questions ?