Karol Swartzlander & Ed AhernCalifornia Health and Human Services Agency

LTSS Advisory CommitteeMarch 7, 2014

ADRC Overview

History/OverviewOptions CounselingAccomplishmentsBarriers/Challenges2014 Priorities

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History

2003- First state ADRC initiative (also first Federal initiative) Promoted a vision that goes beyond networks serving single populations (aged, disabled)

Embraced collaboration across aging, disability and other service providers

Emphasized the need to help consumers navigate a fragmented and sometimes perplexing array of community LTSS options

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A history of growth

2006-11 : Systems Transformation Grant2009-12 : Real Choice Systems Change 2010-12 : Care Transitions2010-12 : Options Counseling2010-11 : Tech4Impact2012-13 : Hospital Discharge Planning

Transfer2012-13 : Scan Foundation2012-13 : Option B ADRC Grant2013-14 : Option B +2013-14: MFP/ADRC Option C: DHCS IA

California ADRC Vision

Every community in California has a highly visible, reliable, universal access point that provides information to facilitate access to long-term supports and services.

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core partnership between an Area Agency on Aging (AAA) and an Independent Living Center (ILC)

joined by a network of "extended" partners that come together to make system improvements

recognized as sources of comprehensive and trusted, information about the full array of local LTSS options

empower consumers to consider all options, make informed decisions

focus on individual’s personal goals for independence

ADRCs in California

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Current Status

Today, seven ADRCs serve 11 counties: Alameda, Nevada, Orange, Riverside, San Diego, San Francisco, Butte, Glenn, Tehama, Colusa and Plumas

Emerging partnerships: Monterey Bay (Monterey, Santa Cruz, San Benito), Santa Clara, Yolo and Ventura

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CA ADRC Core Services

1. Enhanced Information and Assistance/Referral

2. Options Counseling

3. Short-Term Service Coordination

4. Care Transitions Hospital-to-Home Care Transition Nursing Facility Transition

ADRC Options Counseling

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Options Counseling*

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ADRC Options Counseling is an interactive process where individuals receive guidance in their deliberations to make informed choices about long-term supports. The process is directed by the individual and may include others that the person chooses or those that are legally authorized to represent the individual.

*ACL Draft National Options Counseling Standards June 2012

Vision for Options Counseling

Options Counseling is both the philosophy underpinning how ADRCs interact with individuals, as well as a process that ADRC staff will follow to support individuals and families to consider their options and access the right services and supports at the right time.

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Essential components of Options Counseling:

a person-centered interview

identification of a goal(s)

identification of desired and available options (including personal, public, and private resources)

a facilitated decision-support process (weighing pros/cons of various options)

assistance to develop an Action Plan that identifies ‘next steps’

connections to services and supports when requested and

follow-up with the individual to identify changes or additional information. 13

Why are ADRCs Successful Transition Partners? Knowledge of the diverse and broadly defined LTSS

population

Connections to LTSS providers

Person-to-person Options Counseling that includes self-direction, planning and personal responsibility

Expertise in transition services (CTI hospital-to-home and nursing facility-to-home)

Access to skills training and assistive technology, some of which could result in delaying or avoiding higher Medi-Cal costs, and

Assistance and access to Medi-Cal eligibility application processes

A Few Lessons Learned

Maintenance of state infrastructure (staff, technical materials, training) essential

ADRC partnership development takes time

ADRCs are successful transition partners

ADRC partnership best practice - third party, objective facilitation of strategic planning

ADRC partnerships that embody mutual respect and focus on the consumer are the most successful

State ADRC Program Staff

LTSS Advisory Committee

Technical Guidance and Materials

Options Counseling Training Program

New online community of practice for Options Counselors and MFP transition coordinators

Infrastructure Supporting ADRC Expansion in California

ADRC Designation Criteria Options Counseling Standards ADRC Designation Application ADRC Implementation Guide: update in

process ADRC Partnership Planning Guide ADRC Financial/Business Model ADRC Business Plan Template ADRC Business Plan Development Guidance

Technical Guidance and Tools

California ADRC Challenges/Barriers

Lack of dedicated (and sufficient) ADRC funding

Start up funding necessary to develop new lines of business (care transitions, VD HCBS, etc.)

ADRCs must educate health plans, Veterans Medical Centers and other potential purchasers about the benefits of community LTSS services

Quality assurance and monitoring

Lack of standardized data to assess full impact of the ADRC initiative

Difficult for some communities to come together. (Lack of interest) 18

Encourage and support VAMC/ADRC collaboration

Work with State Independent Living Council to release Request of Application to award modest funds for ADRC development

Apply for new federal funding opportunity!

Transfer of program to Department of Aging (July 2014)

Monitor national ADRC developments (quality assurance and monitoring; long-term sustainability)

CA ADRC Program Priorities 2014

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California’s ADRC Program Priorities 2014

Collaborate with state initiatives (e.g., Money Follows the Person)

Research requirements for certification for OC

Conduct Options Counseling/MFP Training Program

Formally designate new ADRCs

Promote Use of New Technical Tools: ADRC business plan development guidance; ADRC financial model(s)

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CHHS ADRC Team and Resource Websites

Karol Swartzlander, karol.swartzlander@chhs.ca.gov

Ed Ahern, edward.ahern@chhs.ca.gov

Paula Acosta, paula.acosta@chhs.ca.gov

Online Resources http://communitychoices.info (state) http://www.adrc-tae.acl.gov (federal) www.thescanfoundation.org

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Questions?

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