San Diego Long Term Care Integration Project

1
San Diego Long Term Care Integration Project

• LTCIP Planning Committee
• June 14, 2006

2
San Diego Stakeholder LTCIP Vision for Elderly
Disabled

• Develop system that
• provides continuum of health, social and support
  services that wrap around consumer w/prevention
  early intervention focus
• pools associated (categorical) funding
• is consumer driven and responsive
• expands access to/options for care
• Utilizes existing providers

3
Stakeholder Vision (continued)

• Fairly compensates all providers w/rate structure
  developed locally
• Engages MD as pivotal team member
• Decreases fragmentation/duplication w/single
  point of entry, single plan of care
• Improves quality is budget neutral
• Implements Olmstead Decision locally
• Maximizes federal and state funding

4
Strategies Developed to Support Vision

• Healthy San Diego Plus
• Physician Strategy
• Aging Disability Resource Center

5
Healthy San Diego Plus (HSD)

• MediCal Aged, Blind, and Disabled offered
  voluntary enrollment in LTC Integrated Plan
• Models of care integrated across funding the
  health and social services continuum
• Private entities to contract with State and CMS
  through RFP with local pre-qualification
• Healthy San Diego Health Plus Plans to develop
  program details with consultant resources

6
HSD Update

• Governors proposal/AB 2979
• Supported by
• Medicare Modernization Act (SNPs)
• Budget Deficit Reduction Act (enhancements that
  used to require waivers now available through
  State Plan approval)
• GMC rates tied to SNF ADHC

7
Physician Strategy

• Partner w/physician champions
• Develop interest/incentive for support of after
  office services (HCBC)
• Identify care management resources to link
  physicians/office staff to patients
• Train on healthy aging, geriatric/chronic disease
  protocol, pharmacy, HCBC supports

8
Physician Strategy Update

• CA Endowment Planning Grant report and request to
  fund Implementation
• Finalize/deliver team-building for community care
  management for health and social service
  providers
• Link resources and decision support tools
• Develop, evaluate outcome measures
• Enhance IT infrastructure supports
• Collaborate w/SD-MINE

9
Aging Disability Resource Center (ADRC)/Network
of Care

• Beta testing with
• consumers and caregivers
• community based organizations
• MDs, other providers, Call Center staff
• To develop continuous quality improvement
  program
• Measure behavior changes of providers and
  consumers
• Funding Federal Aging Disability Resource
  Center grant application

10
CaliforniaAging and Disability Resource Center
Grant Program

• Lora Connolly, Director
• CA Department of Aging

11
ADRC Grant Goals

• Promote public awareness of public private LTC
  support options especially among underserved,
  hard-to-reach populations
• Provide Information Counseling on ALL available
  LTC supports
• Help consumers assess potential public LTC
  service eligibility
• Determine programmatic eligibility for public LTC
  programs, including Medicaid nursing home
  eligibility
• Provide short term assistance or care management
• Provide IR
• Help consumers plan for future LTC needs
• Organize, simplify, and ensure one-stop
  shopping for access to all public LTC support
  programs

12
Grant Goals Vision

• Empower individuals to make informed choices
• Streamline access to LTC services
• Assist individuals in planning for future LTC
  support needs
• Resource for LTC professionals others who
  provide services to older adults persons with
  disabilities
• Provide information counseling to private-pay
  individuals

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Grant Requirements--Target Group

• Older adults (age 60) and at least one of the
  following other major target group by Year II
• Individuals with physical disabilities
• individuals with serious mental disabilities
  and/or
• individuals with mental retardation/developmental
  disabilities.
• Individuals with traumatic brain injuries may be
  a targeted group

14
Californias Project Goals

• Identify promising practices in providing
  outreach to reach populations
• Determine viability of physical one stop
  resource centers given states diverse geography
• Identify how web based technology can be best
  employed to support this effort
• Create an environment that fosters tangible
  collaboration between aging and independent
  living services with shared products outcomes.
  

15
Need for Disabled Community Involvement (Ben
Harville)

• National, State, and local needwhy Im here!
• The opportunity revise Year 3 Work Plan to be
  more inclusive of disabled community
• Equal focus on aging and disabilities
• Louis Frick, local ILC Director, will begin
  conversation a little later

16
San Diego ADRC Key Goals (Dr. Mark Meiners)

• Build on existing AIS Call Center
• Build/merge resource database, NOC
• Improve consumer linkages/access to LTC
  information and services
• Outreach to broad community and
  underserved/underutilizing populations
• Complete above with stakeholder input
• Evaluate outcomes develop CQI

17
Specific Activities to Meet Goals

• Surveys
• Call CentersAIS and 211
• Consumers
• Caregivers
• Community-based organizations
• Care management
• Independent Living Center Consumer Advocates

18
Survey Findings

• Survey tool difficulties
• Service directory could be more user-friendly,
  more up-to-date
• need closer relationship w/211
• Too many clicks to get info
• Translations need cultural input
• Needs of different users Call Centers, MDs, care
  managers, consumers, caregivers, et al

19
Response to Findings

• Evaluation leads to
• Call Center input toward enhancements and updates
• 211 collaboration/joint protocols
• NOC enhancements

20
Indicators of Increasing Satisfaction

• More use of web site builder
• Customized site developed for AIS Call Center
• Improved community-wide calendar
• Fall Prevention site ready for feedback
• Increased satisfaction with finding information
  on NOC

21
NOC Enhancements for SD ADRCby Afshin Khosravi
of Trilogy Integrated Resources

• Site wide search powered by Google Enterprise
  Appliance
• 10,000 culturally adopted and hand translated
  Spanish articles
• Medicare section
• Print Search Results
• Call Center Application

22
Practical Suggestions for Local Work Plan(Louis
Frick)

• Joint focus on disabled above poverty
• Join Padres Disability Awareness Day
• Joint involvement of management/goals
• Access Center web site linked on NOC
• NOC as communication tool for ILC clients
• Joint participation in deinstitutionalization
  project
• Outreach w/InfoVan to include disability expert

23
Goals for Lunch Meeting

• Brainstorm potential activities for ADRC in
  support of disabled community
• Decide which are most important to incorporate
  into Year 3 Work Plan
• Prioritize activities of Year 3 Work Plan

24
Current Year 3 Work Plan Activities

• CQI process for database maintenance
• Complete web site enhancements
• Develop My Folder as LTC Options Counselor
• Broad community outreach and education
• Target underserved, underutilizing populations

25
www.sdltcip.org

• Get on LTCIP mailing list for updates
• Attend Planning Committee meetings
• Log onto website for background info
• Call or e-mail input/ideas 858-495-5428 or
  evalyn.greb_at_sdcounty.ca.gov or 858-694-3252 or
  sara.barnett_at_sdcounty.ca.gov