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Oregon Real Choice Systems Change. 2. Problem: Assistive Technology underused in affordable housing for seniors and persons with disabilities.. Service plans don't consistently address technology implementation apart from durable medical equipmentLow income housing development often doesn't full
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1. Integrating Assistive Technology into Affordable Housing for Seniors and People with Disabilities Gerald Stolp
Tom Keating
Community Housing Section
Seniors and People with Disabilities, Oregon DHS
New Freedom Initiative Conference
March 5, 2007
2. Oregon Real Choice Systems Change 2 Problem: Assistive Technology underused in affordable housing for seniors and persons with disabilities. Service plans dont consistently address technology implementation apart from durable medical equipment
Low income housing development often doesnt fully value and support possibilities of AT and universal design.
Consumers and providers lack awareness about whats available and how to fund it.
Public and private agencies lack capacity to educate and connect consumers to innovative technology that would dramatically enhance QOL
2. e.g. network ready wiring and services, no-step entries,
Even simple ceap things like touch lamps, oversized grips, large button remotes/phones, etc.
What does medicaid pay for? What other state or local grant or loan programs are availablefor accessibility that could also include AT such as environmental control, etc.
MAY WANT TO HAVE EXAMPLES OF RELEVBANT AT AS NEXT SLIDE
GAP perhaps even moreso in care provided under 24 hr and supported living rules. Why?
6000. Total statewide billed to Medicaid for AT under waiver.
WE NEED provider community to be involved in helping us figure out where AT can be better utilized, ways its being implemented that we may not realize.
So we can come with a blueprint for systems change that is practical and useful, perhaps providing specific methods to help with billing.
2. e.g. network ready wiring and services, no-step entries,
Even simple ceap things like touch lamps, oversized grips, large button remotes/phones, etc.
What does medicaid pay for? What other state or local grant or loan programs are availablefor accessibility that could also include AT such as environmental control, etc.
MAY WANT TO HAVE EXAMPLES OF RELEVBANT AT AS NEXT SLIDE
GAP perhaps even moreso in care provided under 24 hr and supported living rules. Why?
6000. Total statewide billed to Medicaid for AT under waiver.
WE NEED provider community to be involved in helping us figure out where AT can be better utilized, ways its being implemented that we may not realize.
So we can come with a blueprint for systems change that is practical and useful, perhaps providing specific methods to help with billing.
3. Oregon Real Choice Systems Change 3 Purpose of Oregon Real Choice Grant Increase awareness and use of Assistive Technology in affordable housing for persons with disabilities of all ages
Collaboration for system change by two Departments of Oregon State Government
Department of Human Services--Seniors and People
with Disabilities
Oregon Housing and Community Services Department
Addresses priority Integrating Long Term Supports with Affordable Housing, in order to:
remove barriers that prevent Medicaid-eligible individuals with disabilities of all ages from residing in the community or in the housing arrangement of their choice.
Addresses priority Integrating Long Term Supports with Affordable Housing, in order to:
remove barriers that prevent Medicaid-eligible individuals with disabilities of all ages from residing in the community or in the housing arrangement of their choice.
4. Oregon Real Choice Systems Change 4 Project Components Provide research-driven policy recommendations for housing and service delivery
Conduct model demonstration activities to implement assistive technology in affordable housing sites throughout Oregon
Develop materials and provide training for consumers, caregivers, and professionals
Disseminate findings statewide and nationally
Gathering information to determine the scope of the problem: Needs, Barriers, Awareness
? Analyzing Housing Department and DD/Seniors Services for policy and rule changes to ensure more systematic assessment and funding of AT needs
? Creating a blueprint for systems change in SPD and OHCS
? Training consumers, service providers, case managers, housing developers, and others
? Publicizing results
? Establishing mechanisms for ongoing change
Gathering information to determine the scope of the problem: Needs, Barriers, Awareness
? Analyzing Housing Department and DD/Seniors Services for policy and rule changes to ensure more systematic assessment and funding of AT needs
? Creating a blueprint for systems change in SPD and OHCS
? Training consumers, service providers, case managers, housing developers, and others
? Publicizing results
? Establishing mechanisms for ongoing change
5. Oregon Real Choice Systems Change 5 www.TechnologyforHousing.org Provides detailed information on project
Resource database
- Assistive technology
- Housing modifications
- Useful links: (e.g. Abledata, Network of Care)
Communication tool
- ListServ
- Discussion forum/Q&A
- Accessible examples/vignettes
When youre doing a web site, you start thinking, does the world really need another web site, but the goal of this site is to be locally referenced, filling a need that based on our pre-development research is unfulfilled, but at the same time providing a broader resource for others around the country.
Since launch in March, weve gotten expressions of interest from people around the country, and some very poignant email from people in Oregon and elsewhere not only of general interest but expressing serious and touching needs for themselves or family members who are elder or who have disabilities.When youre doing a web site, you start thinking, does the world really need another web site, but the goal of this site is to be locally referenced, filling a need that based on our pre-development research is unfulfilled, but at the same time providing a broader resource for others around the country.
Since launch in March, weve gotten expressions of interest from people around the country, and some very poignant email from people in Oregon and elsewhere not only of general interest but expressing serious and touching needs for themselves or family members who are elder or who have disabilities.
6. Oregon Real Choice Systems Change 6
For people without disabilities, technology makes it better;
For people with disabilities, technology makes it possible
Anonymous
7. Oregon Real Choice Systems Change 7 Environmental Control Light switch extension
Remote control of household devices
Computer-based remote control
e.g. lights, appliances, alarms, HVAC
8. Oregon Real Choice Systems Change 8 Activities of Daily Living Reachers
Sock assist
Elastic shoelaces
Button hooks
Velcro
Talking scale
9. Oregon Real Choice Systems Change 9 Alternate Computer Access
10. Oregon Real Choice Systems Change 10 AT Devices are Everywhere Look for everyday items with assistive value. Think curbcuts and door openers
- Voice smoke alarm (KidSmart)
- Migo phone (Verizon)
- Keychain voice recorder (Radio Shack)
- OXO kitchen tools (BB&B)
- Reach extenders (Toys R Us)
- Oversized phones and remotes (RS, Lillian Vernon)
- Christmas tree light remotes (Trim-a-Tree)
- Pill reminders
- Item locators (Sharper Image, Brookstone)
Think Lillian Vernon, Sharper Image. Brookstone
11. Oregon Real Choice Systems Change 11
12. Oregon Real Choice Systems Change 12 Technology for Remote Caregiving Support Integrating home sensor networks and web-based tools to provide data for consumers and caregivers
Examples:
- Providing long distance behavioral support
- Helping consumers avoid victimization
- Monitoring physical health and communicating information to health care providers
- Monitoring environmental changes related to health and safety
- Planning activity schedule with consumer-driven software
Could mention examples such as icontrol, quietcare, homesight, etc.
Remote caregiving
Monitoring
Telemedicine to track diabetes, blood pressure, medication change, compliance monitoring in less supervised arrangementsetc.
Electronic data reporting and record keeping generally
Channel to help support remote and family-based care: hybrid models.
Could mention examples such as icontrol, quietcare, homesight, etc.
Remote caregiving
Monitoring
Telemedicine to track diabetes, blood pressure, medication change, compliance monitoring in less supervised arrangementsetc.
Electronic data reporting and record keeping generally
Channel to help support remote and family-based care: hybrid models.
13. Oregon Real Choice Systems Change 13 Brief Example of Remote Monitoring in Practice Main Components
Consumer-driven activity planning tool:
Picture Planner
X10-based home sensor network
Home automation software
Consumer and caregiver monitoring computers
14. Oregon Real Choice Systems Change 14 Activity Reminder How many people out there have ever had a to do list, done something that wasnt on the list, and after the fact, added it and crossed it out?How many people out there have ever had a to do list, done something that wasnt on the list, and after the fact, added it and crossed it out?
15. Oregon Real Choice Systems Change 15 Some Basic X10 Modules
Passive infrared motion sensor
Wireless transceiver
Wireless computer interface
Door/window sensor
16. Oregon Real Choice Systems Change 16 Apartment Layout
17. Oregon Real Choice Systems Change 17 Activities of Daily Living Web-based Report
18. Oregon Real Choice Systems Change 18 Some Preliminary Results Improved self-management for activity and task completion
Feasible cost effective remote support technology
Caregiver effectiveness increased
Caregiver peace of mind increased
- shower
- middle of the night- shower
- middle of the night
19. Oregon Real Choice Systems Change 19 Questions For consumers: Equal access, better self-management, improved QOL, greater isolation?
For providers: More effective use of staff, improved quality assurance systems and recordkeeping, changes in service delivery?
For families: Better access to real-time info on person of concern?
For developers: Greater options for less restrictive, more integrated housing solutions, or, larger community-based facilities?
20. Oregon Real Choice Systems Change 20 Systems Change Accomplishments Dedicated network wiring in all new housing projects funded by the state housing agency
Inclusion of assistive technology consideration in the revised individual service plan (plan of care) process
Maximizing use of provisions within Oregons existing waivered service options to fund innovative technology
Promoting technology through Fairview Housing Grants
Enhancing caregiver capability through technology in the waivered Childrens Intensive In-Home Support program
1915 C waiver
Enhancing caregiver capability through technology in the waivered Childrens Intensive In-Home Support program
1915 C waiver
21. Oregon Real Choice Systems Change 21 Fairview Community Housing Trust:An Example of System Change Oregon Legislature established a Housing Trust with proceeds from sale of state institution for persons with developmental disabilities
$15,000,000: 5% and all interest can be spent.
Funds grants for housing modifications and equipment for persons with developmental disabilities who dont live in licensed facilities
Can be combined with waivered funds to complete larger projects
Many grants for technology equipment and modifications
22. Oregon Real Choice Systems Change 22 Some Policy and Ethical Considerations Continue to develop ways to enhance access to technology for low-income consumers
Promote strategic use of remote care systems that facilitate better consumer self-management and let caregivers focus efforts on community-inclusion, etc., without supplanting personal contact in the name of cost-effectiveness
Rather than having technology seep in a haphazard way into the lives of people supported by our systems, develop policies to progress in an intentional, strategic, and egalitarian fashion
Ensure that remote support technology is deployed in a way that respects the balance between privacy and support as defined by the consumer
Use Medicaid state plans and waivers to maximize funding for technology
Note Medicaid emphasis on face-to-face billing vs. phone contact and what that implies for remote technology-based support (smart home, email, etc.)
Viability of remote monitoring and caregiver notification technology as a billable service in relation to existing policies regarding billing for video teleconferencing, or telephone-based support?
Note Medicaid emphasis on face-to-face billing vs. phone contact and what that implies for remote technology-based support (smart home, email, etc.)
Viability of remote monitoring and caregiver notification technology as a billable service in relation to existing policies regarding billing for video teleconferencing, or telephone-based support?
23. Oregon Real Choice Systems Change 23 Resources Center for Assistive Technology and Environmental Access http://www.catea.org/quickrefguides/QuickRef.php
Abledata
http://www.abledata.com
Technology For Housing
http://www.technologyforhousing.org/home.php
International Ctr. For Disability Resources on the Internet-wide range of AT and disability info
http://www.icdri.org/Assistive%20Technology/sites_with_information_on_assist.htm
Job Accommodation Network - Free consulting on individualized workplace accommodations
http://jan.wvu.edu
24. Oregon Real Choice Systems Change 24 For Further Info Gerry Stolp
gerald.stolp@state.or.us
Tom Keating
tkeating@eugeneresearch.org