Community Choices: Connecticut’s Aging & Disability Resource Centers

1. Community Choices: Connecticut’s Aging & Disability Resource Centers ADRC Update for Long Term Care Planning Committee March 13th, 2012

2. Aging and Disability Resource Centers in Connecticut AoA/CMS 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. What is the ADRC? • Nationally - an “ADRC” is an Aging and Disability Resource Center. • In Connecticut the acronym is already used for “Alcohol and Drug Recovery Centers.” • Therefore, to the public we refer to ourselves as “Community Choices.” Community Choices

4. Locations & Service Areas • South Central: Center for Disability Rights & Agency on Aging of South Central CT • Western: Independence Northwest & Western CT Area Agency on Aging • North Central: Independence Unlimited, North Central Area Agency on Aging & CCCI. • **Southwestern: (“ADRN” Opened October 20th, 2011) Southwestern CT Area Agency on Aging & Disability Resource Center of Fairfield County. • **Eastern: (“ADRN” invitation extended Jan. 6th, 2012) Disability Network of Eastern CT, Senior Resources, & CCCI **Currently no federal funding available

5. Who Community Choices Can Support • Older Adults • Persons aged 18 & over living with Disabilities • Caregivers • Those who want help in communicating their needs • Those who want to plan for future long term care needs • Those who want help navigating a complex system of federal, state & local programs

6. How Community Choices Can Support…. • Community Choices offers: Options Counseling, Short Term Care Management, Care Transitions, Application Assistance, Decision Support, Follow-Up, Long Term Care Planning, Benefits Screening, Information & Assistance, and Case Consultation. • Community Choices can connect consumers to the following types of services: Adult Day Care, Disability Services, Elder Abuse Prevention, Employment Assistance, Financial Assistance, Housing Assistance, Equipment Assistance, In-home Services, Legal Services, Transportation, Nutrition, Mental Health & Substance Abuse Services.

7. Community Choices Community Choices Service Categories: • Information & Referral • Options Counseling: 3 types: Long Term Support, Employment, Benefits • Assistance: Application, “Urgent & Emergent Situation Response,” Planning for Future Needs, and Decision Support. • Follow-Up • Advocacy (for individuals) • Short-term Case Management or “Short Term Support” (Long Term Support being piloted) • Care Transitions • Case Consultation

8. Our job is to give people the tools they need to choose the right path for themselves.

9. Oversight Structure Statewide ADRC Committee: • ADRC Operating Protocol Workgroup • ADRC Planning Workgroup • ADRC Training Workgroup • ADRC Private Pay Workgroup • ADRC Marketing Materials Workgroup • ADRC Data & Outcomes Workgroup North Central ADRC Workgroup • North Central Community Choices Council Western ADRC Workgroup • Western Community Choices Council South Central ADRC Workgroup • South Central Community Choices Council Evaluation: • UConn Center on Aging – historical ADRC partner since 2007

10. Brief History of ADRCs in Connecticut The Aging Services Division Hosted Connecticut's First ADRC Planning Meeting in June 2007 and invited all parties with a possible interest to the planning event.              • Greg Case, from the Administration on Aging and Carrie Blakeway of the Lewin Group presented on ADRC models, their variations, successful partnerships and lessons learned from around the country.   • By the conclusion of the meeting a wide array of topics were covered as they pertain to the inception of ADRCs in Connecticut. • Next, The Aging Services Division applied for and was selected to receive funding from the Administration on Aging for the Nursing Home Diversion Modernization grant. 

11. Multiple Funding Streams • 2009 ADRC Grant • 9/30/09-9/29/12 $683,910 • Medicaid Infrastructure Grant • MOA w/ BRS 1/1/10-12/31/11 = $281,454 • Affordable Care Act Funding: • ADRC Options Counseling Grant • 9/30/10-9/29/12 = $500,000 • ADRC Evidence-based Care Transition Grant • 9/30/10-9/29/12 = $400,000 • MIPPA II Grant • 9/30/10-9/29/12 = $228,862 (ADRC only portion) • ADRC Nursing Home Transition & Diversion Grant • 9/30/10-9/29/12 = $448,500. MFP controls & operates. • Substantial additional In-kind contributions and leveraging of other funding sources

13. ADRC Options Counseling Grant • Part of a National effort to define “Options Counseling” and what it entails • Staff training focusing on: person-centered planning, motivational interviewing, active listening, cultural sensitivity and long term planning • Development of Long Term Support Options Consumer Guide, brochure, & long term care planning tools • New consumer satisfaction survey just for consumers who receive Options Counseling • Development of Cost Savings / Value of Benefit Calculator

14. ADRC Care Transition Efforts • Tasked with implementing a care transition model with the ADRC for the purpose of reducing unnecessary hospital readmissions. Tammy & Joyce - Care Transition Coaches

15. MIPPA II Activities include: -Outreach, Education & Application Assistance for: • Medicare Part D Low-Income Subsidy (LIS) • Medicare Savings Program • ConnPACE (prior to program changes) • Medicare Preventive Benefits changes resulting from Affordable Care Act Partners: NAMI-CT, INW, CDR, AASCC, SWCAA, WCAAA, Senior Resources

16. ADRC Nursing Home Transition & Diversion Grant • Grant funding = for the purpose of having the Money Follows the Person Program become well-connected to ADRCs for the implementation of the Minimum Data Set 3.0 Section Q changes set to begin 10/1/10. • Connecticut’s MFP program applied for and oversees this grant.

17. In-kind Funding Streams / Additional Leveraging of Funds • CMS - SHIP • AoA – Title IIIB – I&R, Title V - Older Workers • Rehab Act Title VII Parts B & C, Ticket to Work • Agency Partners – fund raising / in-kind, community grants • New – ADRC Sustainability Initiative Pilot: • Sliding Fee Scale – cost sharing • Educational Offerings • Membership Appeal • Potential for seeking funding from the private sector including hospital partners, insurance companies **Items listed represent only a small sample of leveraging

18. Community Choices 5 Year Plan & Budget Highlights: • Statewide ADRCs that are “fully functional” • In 5 years have care transitions activities statewide in 28 Hospitals including 55 Care Transition Coaches • One .5 FTE responsible for outreach & marketing • One 1.0 FTE responsible for training • 10 Community Choices Counselors statewide • Technology, training, admin. support staff, marketing material needs • Year-by-year layout of new partners & mutual activities **All items are based on available funding

19. Future Connections with Medicaid • Medicaid Elder Waiver & CHCP • Other Medicaid Waivers: DDS, DMHAS • “Duals” (Medicare/Medicaid Eligible) Grant • Money Follows the Person • Medical Care Homes • BIPP – Balancing Incentives Payment Program • Funding for providing Medicaid presentations / application assistance

20. Future Connections with Other State Agencies / Partners • One measure of ADRC success = # of formal connections to other State Agencies & partners. • Community Choices can only provide “seamless” service delivery if they are well connected. • Actively working on expanding formal connections. Ex. VDHCBS, CTCDD, Connect-Ability, CDSMP, hospitals, 2-1-1 and more • Availability of resources complicates this effort.

21. How Does Community Choices Help Consumers with Long Term Care Needs? • Long Term Support Options Counseling • Encourage Planning for Future Needs • Coaching consumers on managing chronic conditions so they can age in place • Screen people for available federal, state and local benefits, provide application assistance, follow-up, and advocacy • Helps people navigate a complex system of services & supports • Staff utilize & provide updates to, and directs independent consumers to state’s Long Term Care Supports & Services website • Assists with overall rebalancing efforts

22. How Does Community Choices Help the State of Connecticut? • “No-Wrong-Door” / Single Entry Point model ensures consumer access to needed social service programs and supports. • Working across “specialty” (aging, disability, employment, Medicaid, agency) ensures consumers do not “fall through the cracks” resulting in stronger public image for state. • Applications & Redeterminations submitted to DSS by ADRC staff are completed fully & accurately = time savings for DSS staff and the consumer. • Presentations & Outreach on multiple federal and state social services and programs. • Potential long-term cost savings to federal, state, and local government with investment in ADRCs.

23. Considerations for the Long Term Care Planning Committee General Rebalancing & Community Choices: • ADRCs support efforts to rebalance the long-term care system in CT, shifting expenditures toward community care, with savings to the state • Please continue supporting ADRCs and the established infrastructure to assist CT residents with: • Care Transitions (across settings: community, hospital, SNF, etc.) • Assessments & Long Term Care Options Counseling • Long Term Care Planning & Decision Support • Benefits Screening & Case Consultations

24. Questions: To contact Community Choices – dial: 1-800-994-9422 Website: www.ct.gov/communitychoices Resource Database: www.ct.gov/longtermcare Margaret Gerundo-Murkette, MSW Social Service Program Manager – Aging Services Division Connecticut Department of Social Services 25 Sigourney St. Hartford, CT 06106 (860)424-5322 Margaret.Gerundo-Murkette@ct.gov Jennifer Throwe, MSW, CIRS-A Statewide ADRC Coordinator (860)424-5862 Jennifer.Throwe@ct.gov