Implementation Plan

1. Implementation Plan • Example of a Phase-in Approach • A phase-in approach is suggested below. MAA-ODA, the contractor and Governing Council can identify the exact parameters of each phase during the implementation process. Management checkpoints should be completed two weeks before the start of each phase to ensure that the Resource Center can successfully absorb increases in volume. • The baseline assumption is that each phase will be spaced one month apart. The actual timing and scope of the phases will rely heavily on when Phase I is able to be initiated (i.e., the HCA vs. RFP decision), the volume of clients encountered within each phase, and the ability of the contractor to recruit and hire staff. • Short-term case management through APS should be incorporated in Phase I. Information and Assistance services are going to be minimal until Phase V, as the phone number for the Resource Center will not yet be distributed. Phase I Phase II Phase II Phase II Phase II All Disabled, an Additional Hospital, and two Community Service Groups All Home Health Agency and Community Service Group Referrals Single Hospital and National Rehabilitation Hospital All District Hospitals Full scale operations

2. Implementation Plan • Example of a Phase-in Approach continued • Phase I: Single volunteer hospital servicing the elderly and the National Rehabilitation Hospital. • It is important to service both target populations in the first phase so that the culture and operations do not skew by focusing on one client group at the outset. National Rehabilitation Hospital was singled out by Susan Daniels as a likely Phase I target. Providence Hospital is an example of a possible Phase I facility for elderly clients, as it is medium-sized and does not have an extraordinarily high Medicaid-eligible population base. • Phase II: Service all persons with a physical disability, an additional volunteer hospital, and two community service groups for the elderly. • Servicing all persons with a physical disability is not likely to swamp Resource Center operations, as less than 200 persons from this segment are forecast to utilize the facility annually. Counseling for these individuals is less likely to be complicated by cognitive impairment. • Operations should be smooth enough as a result of Phase I to allow for a large, cooperative hospital to be added to the scope of service. George Washington hospital is an example of a large hospital with a discharge unit that has an excellent reputation. • The community service groups selected should be geographically dispersed from each other and the selected hospitals, if possible. This will mitigate political risk by including all of the District neighborhoods in the early going. Examples of community service groups are the Urban League serving NE and SW Washington, Senior Citizens Counseling and Delivery Services in SE Washington, and Iona Senior Services serving the NW neighborhoods.

3. Implementation Plan • Example of a Phase-in Approach continued • Phase III: Service all elderly clients from District hospitals. • Hospitals are expected to be leading advocates for Resource Center services. Though servicing all hospitals represents an extremely large volume increase midway through the implementation, it can be expected that the existing hospital discharge personnel will be relatively cooperative. • Phase IV: All Home Health Agency and Community Service Group Referrals. • Phase V: Implement full-scale operations. • The final phase includes full hotline operations (this will be the first phase with 24/7 coverage), active promotion of the Resource Center to the community, and reassessment of Medicaid recipients already in nursing facilities. Phase V represents the full implementation of the Operations Model. Of course, continuous process improvement will continue subsequent to this final go-live date.