Longterm Care Options Counseling Whats It All About

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Long-term Care Options Counseling Whats It All
About?
Krista Boston, Director Consumer Assistance
Programs Kelli Jo Greiner, Team Lead
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Its About our Real Challenges

• Human services and long-term care is complex with
  many roles, many providers, and many policy
  challenges
• Difficult to understand
• People want relevant roles and to contribute to
  their community, to work and live independent
  healthy lives.
• When the baby boomers start to hit the system for
  care themselves we are going to have a big
  challenge. The majority have less than 50,000
  in the bank.
• Government programs offer a safety net, but the
  state cant afford large numbers who may need
  long-term care.
• Government tends to produce too much that is not
  accessible and is at a literacy level far too
  high for our users.
• People who need help and their Caregivers, dont
  self identify and they arent likely to as much
  as we wish it.
• There are many sources of information and
  assistance but not all are neutral.
• Generation Xrs and Millenials have high demands
  for technology and we are not prepared.

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Its About our mission and valuesof the
MinnesotaHelp Network Long-term Care Options
Counseling Service

• Simplify the message.
• Ensure a high quality set of services that is
  efficient and effective and
• Responsive
• High level of customer service
• Secure
• Increase access and awareness of our services.
• Be the neutral place for long-term care options
  counseling.
• Dont duplicate what is already out thereBuild
  on what exists, enhance it and fill gaps but
  connect.

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Its About the Strategy

• Build a comprehensive system of information and
  assistance that focuses on getting consumers the
  right information and service, at the right
  place, at the right time.
• Measure the quality of the system to ensure that
  it is relevant.
• Make it NO or LOW cost so it can be sustained.

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Its About the Strategy

• Getting the Right Information and Service at the
  Right Time in the Right Place requires you to
  know your consumers

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And they have lots of different preferencesby
age group
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Source Strategic Directions Group, Inc.
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Source Strategic Directions Group, Inc.
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First Thing Give them right information.

• The right information Depends on the Consumer

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Second Thing At the Right Time
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Third Thing Find out where the right place is

• Places people routinely go to get info
• Physicians/clinics, workforce centers, libraries,
  faith communities, friends and relatives,
  Internet
• Critical decision making points
• Hospital discharge planners, nursing facility
  social workers, county long term care
  consultations
• Intervention points
• Places and times where people might need access
  to decision support and tools on the internet,
  phone or in person.

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Its About a NetworkButwhy a network?

• It builds on our strengths we have the
  technology and we can build it.
• It recognizes our weakness and avoids them we
  arent very good at centralized service delivery,
  local is better.
• It allows for ownership at the local level
  through partnership but,
• Creates a single statewide brand to improve
  access and make the public awareness strategy
  less costly to implement.

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Its About Expertise and AccommodationOur
Channels of Distribution of our product -

• When the Students Ready, the Teacher Arrives
  Link to an Expert
• Telephone/verbal Learner
• In Person conversation Learner
• Print Learner
• Web Learner
• Accessible to all

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Its About the Evolution of the Senior LinkAge
Line
Service of the MN Board on Aging Began in
1993Provided locally by the Area Agencies on
Aging

• Now
• Information Assistance -Link to an Expert
• Multiple complex issues
• Avg call length time 18-25 minutes
• 15,000 people received in person help
• 400 volunteers
• Statewide VoIP network (chat, secure email,
  phone)
• Secure web-based reporting

• In the Beginning
• Information and Referral
• Simple single issues
• Avg call length time est. 3 minutes
• Less than est.1000 people received in person help
• Few volunteers
• Communication across SLL done by email
• Reporting done on paper

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Evolution of the Senior LinkAge Line
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Evolution of the Senior LinkAge LineFace to
Face Assistance Provided by the Senior LinkAge
Line
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Evolution of the Senior LinkAge LineListening
to the people we serve. Modifying our service to
meet the need.

• Dont make me tell my story over and over
• Be the one link for me to get help
• Dont pass me on to someone else
• Dont just give me a phone number and
  disconnect
• I need someone to explain this to me in person
• I want to be helped over the internet
• Send the information to my email address
• To sum it up The right service at the right time
  in the right place

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Evolution of the Senior LinkAge Line Customer
Service

• Excellent Customer Service is the core of the
  Senior LinkAge Line service
• Warm transfers
• 3 way calls
• Call backs by staff
• Follow-up
• Surveys
• Voice mails returned within 1 business day
• In person assistance available statewide

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Evolution of the Senior LinkAge Line Its About
The Expertise

• Local and statewide formal and informal Long-term
  Care Supports and payment options
• Comprehensive knowledge of programs Medicare,
  Medicaid, Waivers, Older Americans Act programs,
  CDCS, Prescription Drug Assistance, Long-term
  Care Partnership
• Use of www.MinnesotaHelp.info
• Caregiver planning, support and training

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Evolution of the Senior LinkAge Line Quality
Assurance and Oversight of the Service

• Comprehensive Standards and Assurances
• Staff have minimum of Bachelors degree in Social
  Work or Nursing
• Training
• 18 hour Core Body of Knowledge training
• 15 CEU annually
• Monthly videoconferences
• Monthly conference calls
• Web based training to be launched soon
• Mandatory Certificate on Aging training from
  Boston University
• Contact Center monitoring conducted by Consumer
  Choices Team
• Surveys
• CCT conducts annual compliance site visits to
  each AAA Contact Center

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Its about the Federal Drivers

• Federal Initiatives
• Choices for Independence
• Keep People Independent
• Reduce Fiscal Pressure on Medicaid and Medicare
• Focus on those services that the Aging Network Is
  Uniquely Qualified to Employ to avoid duplication
• Aging and Disability Resource Center (ADRC)
• Nursing Home Diversion
• Evidence based health promotion
• Greater role for State Health Insurance
  Assistance Program (SHIP)

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Its about how Choices impacts Minnesotans

• Older adults will be better equipped to make
  behavioral changes that will enable them to
  reduce their risk of disease, disability and
  injury
• Consumers of all ages and disabilities as well
  as their family caregivers - will be able to make
  informed decisions about, and more easily access,
  existing health and long-term care options and
• Our citizens who need long-term care will be able
  to remain at home and avoid unnecessary nursing
  home placement, impoverishment, and spend-down to
  Medicaid.

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Its about how Choices builds upon

• National and state level strategies to Modernize
  Medicare and Medicaid.
• The core Older Americans Act programs managed by
  the Aging Network
• A simplified message and reform agenda that has
  been a movement in Minnesota since the mid-90s
  and is now moving to the national level

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Its about the State Drivers

• State Initiatives
• Transitional Consultation
• Return to Community
• Level of Care
• Legislative mandate (2009) for Senior LinkAge
  Line to provide long-term care options
  counseling statewide
• Need will exceed resource capacity planning and
  options counseling are critical

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Its about where Long-term Care Options
Counselinghas already been implemented

• Other states have implemented
• Wisconsin
• Michigan
• Massachusetts
• Indiana
• Rhode Island
• Arkansas
• In some states the Area Agencies on Aging conduct
  the screenings and manage the waiver programs

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Its about knowing what it is

• Critical interactive decision-support and
  counseling process
• Consumers, family members and/or significant
  others are supported in their deliberations to
  determine appropriate long-term care choices
• Determine appropriate long-term choices based on
  the consumers
• Needs
• Preferences
• Values
• Individual Circumstances
• Promote informed decisions about long-term care
  and supports

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Its About Knowing the 3 Key Components

• Long-term Care Support Options Counseling
• Long-term Care Choices Education
• Long-term Care Futures Planning

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Its About Long-term Care Support Options
Counseling

• About the consumer
• Personal Goals and Outcomes
• Personal History, preferred lifestyle
• Functional limitations and capacities
• Financial situation
• Natural Supports

• About the choices.
• Home care
• Community services
• Residential care
• Nursing home care
• Case management services
• Funding Options

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MN Long-term Care Support Options Counseling

• Support Planning
• LTC Choices Navigator at www.minnesotahelp.info
• Assistance with Consumer Directed Community
  Supports
• Managing and Coordinating privately paid services
• Seeking financing options

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Its about Long-Term Care Choices Education

• Definition
• Efforts (including
• verbal information and
• written materials)
• designed to familiarize
• individuals with the
• long-term care basics,
• issues to be considered
• and the range of
• options available in the
• community.

• May be provided in a group or to an individual
  face-to-face, telephone, web
• May include, some exploration of the persons
  values, preferences and circumstances

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MN Long-term Care Choices Education

• Broader component reach many people
• Print materials (kiosks)
• Community outreach
• General information about options available
  locally
• Podcasts
• Topics include
• What is Medicare and what long-term care does it
  cover
• Long-term care insurance
• Long-term care costs and projections

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Its about Long-Term Care Futures Planning

• Definition
• Providing assistance
• to individuals who
• anticipate having long
• -term care needs to
• develop a plan for the
• more distant future.

• For individuals who have no current needs or some
  limited needs now
• Considers age, preferences, values, health,
  availability of informal supports, financial
  resources, and other circumstances

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MN Long-term Care Futures Planning

• Plan for financing long-term care in the future
• Long-term Care Partnership/LTC Insurance/Annuities
  
• Use of limited long-term care Medicare benefit
• Reverse Mortgages
• Debt Management
• When it makes sense to apply for Medicaid
• Advanced Directives

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Its AboutMinnesotas Long-term Care Options
Focus

• Educating, Supporting and Helping Privately
  Paying Minnesotans plan for meeting their
• immediate long-term care needs
• just around the corner long-term care needs
• over the course of time long-term care needs
• And avoid spending down to Medicaid

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Its About Markers of Options Counseling

• The amount of time spent options counseling may
  involve several contacts over an extended period
  of time
• Emphasis on relationship-building, counseling and
  decision support its not just about
  information!
• Development of a personal choices agenda
• Options counseling is a processnot a single
  event.

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Its About When Options Counseling Might Happen?

• When an individual has immediate or short range
  long-term care needs
• After admission to a long-term care facility
• When a family caregiver needs help to continue
  providing care
• When a long distance caregiver has concerns about
  the increased frailty or care needs of a loved
  one
• People are considering (or making) a change of
  residence
• A major life changing event has occurred and
  people need assistance with long-term care needs
• People need help to access publicly funded
  benefits to finance long-term care services
• People need to know how to access private pay
  service options

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Its About Our Tools Robust Client Tracking
System

• Users
• Web Referral is being used by all 7 Senior
  LinkAge Line contact centers across Minnesota and
  their subcontractors. Staff use Web Referral to
  track information about all clients they serve
  over the phone and in person.
• MBA staff use Web Referral to monitor and report
  on the work of the Senior LinkAge Line (SLL)
  statewide.
• Unified Database
• ALL SLL contact centers and contractors are using
  a unified database. This means that any SLL staff
  person in the state can see information that was
  entered by any other SLL staff person anywhere in
  the state.
• The database contains information on over 700,000
  inquiries that have been taken since 2002. Over
  350,000 client records and 69,000 caregiver
  records are contained in the database.

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New Enhancements to Revation
Desktop/Application Document Sharing
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Its About Our Tools Robust Client Tracking
System
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New Enhancements to Revation (Continued)
Advanced Document Collaboration and Revision
Tracking
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New Enhancements to Revation (Continued)
Videoconferencing
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What is MinnesotaHelp.info?

• Service of the MN Board on Aging on behalf of
  State of Minnesota
• 1999 legislative mandate for a long-term care
  database that grew into a larger initiative
• Online at www.minnesotahelp.info since 2003
• A Web-based means of finding information about
  health and human services in Minnesota
• The Web access point for Aging and Disability
  Resource Centers a national CMS and AOA
  initiative

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MinnesotaHelp.info Features

• Simple keyword and topic searching
• Statewide info about local resources
• Special Topics for specific populations
• Award Winning Long-term Care Choices Navigator

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MN Long-term Care Options Counseling needs to
ensure

• People receive full range of options in an
  unbiased, neutral manner
• Consumer Choice
• Availability at home, an agency, hospital, rehab
  facility or nursing home
• Availability to people in all 87 counties of MN
  at the local level in their community
• People who can pay privately are served
• Safety net for public pay long-term care services
  is available for those that need it most

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Questions?

• Krista Boston, Director
• Consumer Assistance Programs
• MN Board on Aging and MN Dept of Human Services
• 651-431-2605
• krista.boston_at_state.mn.us
• Kelli Jo Greiner, Team Lead
• 651-431-2581
• Kellijo.greiner_at_state.mn.us

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MinnesotaHelp Network
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