1. 0 Technical Assistance to Support the Aging and Disability Resource Center (ADRC) Grantees Academy Health 2006 Lisa Alecxih The Lewin Group lisa.alecxih@lewin.comlisa.alecxih@lewin.com (703)-269-5542 Karen Linkins, The Lewin Group Susan Reinhard, Rutgers University

2. 1 CMS & AoA VISION To have Aging and Disability Resource Centers in every community serving as highly visible and trusted places where people of all incomes and ages can turn for information on the full range of long term support options and a single point of entry for access to public long term support programs and benefits.

3. 2 Research in Support of ADRCs u People do not know who to turn to for information about long term support services  Rosalynn Carter Institute, 2006 and numerous grantee surveys, 2004-2005 u Most think that Medicare will cover long term support needs and do not understand Medicaid is means-tested  AARP, 2003 u Providing the right information, assistance, and access to services at the right time can delay or prevent costly institutionalization  Feinberg, 2003 and AARP 1996

4. 3 AGING AND DISABILITY RESOURCE CENTER GRANTEES FY 2004 ADRC Awardees FY 2003 ADRC Awardees FY 2005 ADRC Awardees AlabamaIdaho Ohio Arizona Kansas Tennessee Colorado Kentucky Texas DC MichiganVermont Guam MississippiVirginia Hawaii NevadaWashington Wyoming AlaskaIndiana ArkansasIowa CaliforniaNew Mexico FloridaNorth Carolina GeorgiaNorthern Marianas IllinoisWisconsin LouisianaNew Hampshire MaineNew Jersey MarylandPennsylvania MassachusettsRhode Island MinnesotaSouth Carolina MontanaWest Virginia

5. 4 Populations Served PD = Physically DisabilitiesDD = Developmental Disabilities MI = Mental Illness

6. 5 Pilot Site Operating Organizations Among 54 2003/04 Pilot Sites 19 20 4 22222 1 0 5 10 15 20 25 Area Agencies on Aging (AAAs) County Aging and Disability Depart. Statewide primarily through SUA Separate AAA and disability org. County Health Department County Senior Centers Independent Living Centers County Aging Department County Disability Department

7. 6 ADRC Technical Assistance Exchange (ADRC-TAE) u Led by The Lewin Group  In conjunction with CMS TA that supports nearly all of CMS System Change grants –Rutgers University, Independent Living Research Utilization (ILRU), National Academy of State Health Policy, National Association of State Units on Aging, and others u Focuses on grant major components/requirements u Also addresses sustainability and scaling up u Relies on multiple sources for knowledge transfer u Uses proven techniques of reinforced learning

8. 7 Functions of an ADRC u Awareness & Information  Public Education  Information on Options u Assistance  Options Counseling  Benefits Counseling  Employment Options Counseling  Referral  Crisis Intervention  Planning for Future Needs u Access  Eligibility Screening  Private Pay Services  Comprehensive Assessment  Programmatic Eligibility Determination  Medicaid Financial Eligibility Determination  One-Stop Access to all public programs CONSUMER ACCESS ASSISTANCE AWARENESS & INFORMATION

9. 8 The Audience u Primary Audience  43 state/territory grantees  62 pilot sites currently and 106 by end of 2006  Over 1,200 registered website users u Secondary Audience  Policymakers  Researchers  Others interested in access to long term support services and information and assistance u Varying levels of understanding of:  Key grant components  Use of the web and technology

10. 9 Coordinated Knowledge Transfer Framework Information Sources TA Requests LTC-TAC Faculty LTC Experts State Peers Research Literature Grantee Meetings/ Teleconferences Listserv Discussions Web Site Needs Assessments Knowledge Development/ Synthesis Issue Briefs Matrices Tools Summaries of Meetings & Work Groups Grantee Progress Reviews On-Site TA Recipients & Grantees Stakeholders State Agencies Aging Network Disability Community Indep. Living Centers Consumers/Families Service Providers Program Staff Private Insurers Legislators/Regulators General Publi c Knowledge Exchange/ Feedback Knowledge Dissemination & TA ADRC Website Weekly Newsletter Bi-annual National Grantee Meetings Monthly All Grantee Calls Peer Work Groups One-to-one TA/ mentoring Knowledge Needs/Materials Refinement Feedback

11. 10 Reinforced Learning Process Individualized Knowledge Teleconferences Needs Assessment, TA Plans On-site Assistance Standardized Knowledge Listservs Web Site Content National Meetings & Regional Teleconferences AoA, CMS, Experts, TA Collaborative State Expertise Work Groups

12. 11 Written Materials u Issue Briefs  Consolidate research and highlight key elements  Make relevant to ADRCs –Provide “real life” examples – bridge research and practice  Try to keep to less than 10 pages  Provide sources for more detail  25 downloaded 3,762 times u Resource Documents and Tools  Consolidated information for a particular topic –e.g., Information & Referral Software Matrix and Web-based Resource Databases –70 downloaded 1,662 times  Documents from the field –e.g., RFPs, forms, brochures, MOUs, marketing materials –344 downloaded 3,487 times

13. 12 Teleconferences u Topics based on grantee needs  Monthly all grantee calls –Average 26 grantees of 43 since Nov; 65 participants per month  Smaller work groups calls u Background materials and/or slides in advance u Use of web-based meeting capability u Expert or state representatives featured u Summary, including questions and answers, posted on website  Monthly calls also recorded and available for future access on the website

14. 13 On-Site Technical Assistance u Onsite requests from grantee or identified need by funders u Support grantees with other stakeholders u Facilitate meetings u Individualized TA needs

15. 14 National Meetings u Permit in-person exchange among grantees  Opportunity for peer-to-peer TA u Tackle issues more in-depth u Reinforce federal messages u Two each year  1-2 days  Between 100 and 250 attendees u Also send TA staff to other national meetings that grantees attend

16. 15 Other Forums u Online Peer-to-Peer Exchange  30 topics with 101 posts  e.g., naming the project and customer satisfaction survey  2,872 total hits u FAQs to Funders  14 questions and answers  3,220 hits –Most for single question – 836 on Medicaid eligibility determination u Weekly newsletter  New resources  Upcoming events

17. 16 Feedback Mechanisms u Online surveys for all monthly calls and national meetings  Poor response rate for calls – most=9, mode=4  Better for national meetings – 30-50% –Possibly because of dinner for two incentive u Funders ask about TA in their semi-annual calls  “ In my 20 years of state government services, I have never seen anything so comprehensive and useful as the ADRC technical assistance website ” 2005 ADRC project coordinator u Informal mechanisms  TA leads solicit in regular one-on-one calls with grantees  Ask at end of every peer workgroup call –Feedback on format –Topics for future calls

18. 17 TA and Grant Management u Web-based TA Tracking Tool  Record grantee requests and TA responses  Prioritize TA activities  Ensure responsiveness to grantees  Coordinate multiple TA providers  Identify common themes to maximize resources and plan activities  Accountability to funders u Online semi-annual report tool  Grantees submit narrative, check box and outcomes info.  Database allows easy of analysis u Produce reports for internal and external purposes

19. 18 Grantee Baseline & Progress u Sources of information  Baseline from initial needs assessment calls  Progress from –Semi-annual reports, –TA requests and activity related case notes for grantees (TA Tracking Tool) –AoA-CMS Grants Monitoring call notes u Provides information for evaluative efforts

20. 19 Website – www.ADRC-TAE.org u Primary mechanism to disseminate & exchange information u Over 1,200 registered users u Averages 70 visits and 15,000 hits per day  Up from 40 visits and 3,200 hits per day a year ago u Average 2,000 to 3,000 visits and 500,000 hits per month u Built a grantee online community

21. 20 Website – www.ADRC-TAE.org

22. 21 Audience of Implementers – NOT Researchers, sooo … u Know your audience:  Preferred method of receiving information, tech savvy, concerns and challenges u Attract and keep their interest:  Boil relevant research down to the high points  Repeat messages frequently and in variety of ways  Provide a couple (not too many) of resources for more depth u Meet them where they are:  Stage information based on readiness u Monitor what works and what does not:  Solicit feedback constantly, both formally and informally  ACT on the feedback!!! u Try new things:  Keep eyes and ears open for how other successfully teach/support  Experiment with different formats (e.g, consultancies)