2. San Diego Long Term Care Integration Project LTCIP Planning Committee June 14, 2006

3. San Diego Stakeholder LTCIP Vision for Elderly & Disabled n 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

4. 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

5. Strategies Developed to Support “Vision” n Healthy San Diego Plus n Physician Strategy n Aging & Disability Resource Center

6. Healthy San Diego Plus (HSD+) n MediCal Aged, Blind, and Disabled offered voluntary enrollment in LTC Integrated Plan n 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

7. HSD+ Update n Governor’s proposal/AB 2979 n Supported by –Medicare Modernization Act (SNPs) –Budget Deficit Reduction Act (enhancements that used to require waivers now available through State Plan approval) n GMC rates tied to SNF & ADHC

8. Physician Strategy n Partner w/physician “champions” n Develop interest/incentive for support of “after office” services (HCBC) n Identify care management resources to link physicians/office staff to patients n Train on healthy aging, geriatric/chronic disease protocol, pharmacy, HCBC supports

9. Physician Strategy Update n 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

10. Aging & Disability Resource Center (ADRC)/Network of Care n Beta testing with –consumers and caregivers –community based organizations –MDs, other providers, Call Center staff n To develop “continuous quality improvement” program n Measure behavior changes of providers and consumers n Funding: Federal Aging & Disability Resource Center grant application

11. California Aging and Disability Resource Center Grant Program Lora Connolly, Director CA Department of Aging

12. ADRC Grant Goals n Promote public awareness of public & private LTC support options especially among underserved, hard- to-reach populations n Provide Information & Counseling on ALL available LTC supports n Help consumers assess potential public LTC service eligibility n Determine programmatic eligibility for public LTC programs, including Medicaid nursing home eligibility n Provide short term assistance or care management n Provide I&R n Help consumers plan for future LTC needs n Organize, simplify, and ensure “one-stop shopping” for access to all public LTC support programs

13. Grant Goals & Vision n Empower individuals to make informed choices n Streamline access to LTC services n Assist individuals in planning for future LTC support needs n Resource for LTC professionals & others who provide services to older adults & persons with disabilities n Provide information & counseling to private-pay individuals

14. Grant Requirements--Target Group n Older adults (age 60+) and at least one of the following other major target group by Year II: n Individuals with physical disabilities; n individuals with serious mental disabilities; and/or n individuals with mental retardation/developmental disabilities. n Individuals with traumatic brain injuries may be a targeted group

15. California’s Project Goals n Identify promising practices in providing outreach to reach populations n Determine viability of physical “one stop” resource centers given state’s diverse geography n Identify how web based technology can be best employed to support this effort n Create an environment that fosters tangible collaboration between aging and independent living services with shared products & outcomes.

16. Need for Disabled Community Involvement (Ben Harville) n National, State, and local need—why I’m here! n The opportunity: revise Year 3 Work Plan to be more inclusive of disabled community n Equal focus on aging and disabilities n Louis Frick, local ILC Director, will begin conversation a little later

17. San Diego ADRC Key Goals (Dr. Mark Meiners) n Build on existing AIS Call Center n Build/merge resource database, NOC n Improve consumer linkages/access to LTC information and services n Outreach to broad community and underserved/underutilizing populations n Complete above with stakeholder input n Evaluate outcomes & develop CQI

18. Specific Activities to Meet Goals n Surveys: –Call Centers—AIS and 211 –Consumers –Caregivers –Community-based organizations Care management Independent Living Center Consumer Advocates

19. Survey Findings n Survey tool difficulties n Service directory could be more user-friendly, more up-to-date n need closer relationship w/211 n Too many clicks to get info n Translations need cultural input n Needs of different users: Call Centers, MDs, care managers, consumers, caregivers, et al

20. Response to Findings n Evaluation leads to: –Call Center input toward enhancements and updates –211 collaboration/joint protocols –NOC enhancements

21. Indicators of Increasing Satisfaction n More use of web site builder n Customized site developed for AIS Call Center n Improved community-wide calendar n Fall Prevention site ready for feedback n Increased satisfaction with finding information on NOC

22. NOC Enhancements for SD ADRC by Afshin Khosravi of Trilogy Integrated Resources n Site wide search powered by Google Enterprise Appliance n 10,000 culturally adopted and hand translated Spanish articles n Medicare section n Print Search Results n Call Center Application

23. Practical Suggestions for Local Work Plan—(Louis Frick) n Joint focus on disabled above poverty n Join Padres Disability Awareness Day n Joint involvement of management/goals n Access Center web site linked on NOC n NOC as communication tool for ILC clients n Joint participation in deinstitutionalization project n Outreach w/InfoVan to include disability expert

24. Goals for Lunch Meeting n Brainstorm potential activities for ADRC in support of disabled community n Decide which are most important to incorporate into Year 3 Work Plan n Prioritize activities of Year 3 Work Plan

25. Current Year 3 Work Plan Activities n CQI process for database maintenance n Complete web site enhancements n Develop “My Folder” as LTC “Options Counselor” n Broad community outreach and education n Target underserved, underutilizing populations

26. www.sdltcip.org n Get on LTCIP mailing list for updates n Attend Planning Committee meetings n Log onto website for background & info n 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