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

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

2. 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

3. 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

4. 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

5. 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)

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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.

14. Materials to Share: Massachusetts
Massachusetts Grant Profile
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

15. Materials to Share: New Hampshire
New Hampshire Grant Profile
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

16. Materials to Share: Multi-Agency Entry Points Peer Work Group
Implementing multi-agency entry points peer work group