Creating Choices to Support Independence: A Consumer-Centered Approach to Long Term Care

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Creating Choices to Support Independence A
Consumer-Centered Approach to Long Term Care
2007 Annual Long Term Care Ombudsman Training
Institute October 18, 2007
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What is NY Connects?

• A statewide initiative that supports the
  development of county level, consumeroriented
  entry points for information about long term care
  and linkages to services that assist individuals
  of all ages with long term care needs

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Goals of NY Connects

• Streamline access to information and assistance
  about long term care services and supports
• Reduce fragmentation within service delivery
• Empower individuals to make informed choices

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Elements of NY Connects

• A trusted resource for information and assistance
  
• For Whom
• Public and Private Pay consumers
• Older adults and people of all ages with
  disabilities
• Where and How
• Connected with the community
• Call center, on site locations, off-site consumer
  visits, website
• Users
• Consumers, caregivers and helping professionals

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NY Connects Core Functions

• Information and Assistance
• Screening
• Public Education

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Local Systems Change

• Long Term Care Councils
• Purpose
• community assessment to determine services that
  are available in the county
• gap analysis
• figuring out solutions that will foster
  seamlessness
• making system recommendations for a
  consumer-centered long term care system

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Why Do We Need NY Connects?
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Changing Demographics Aging of the Baby
Boomers in NY

• NYs general population expected to grow 3
  percent between 2000 and 2015
• Compare to
• Expected growth
• 85 population 56.0
• Minority elders 51.0
• Older adults with 17.1
• impairments

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NYS Aging and Impairment Rate of Growth
Projected Growth in Population and Vulnerable
Elderly Cohorts
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The Long Term Care Maze
Welcome to Long Term Care
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2000 Behavioral Risk Factor Surveillance System
BRFSS)
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National Directions

• New Freedom Initiatives
• 43 States and territories have Aging and
  Disability Resource Centers (ADRCs) designed to
  streamline access to long term care
• Real Choice Systems Change Grants for Community
  Living
• Designed to help states and territories
  rebalance their long term care support programs
  to help people with disabilities or chronic
  illnesses to reside in their homes and
  participate fully in community life

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Shifting/Changing Long Term Care System

• Early intervention and prevention orientation
• Recognition of non-medical in addition to medical
  needs
• Efforts to divert nursing home placements through
  identification of predictors of placements
• Increase in home and community-based care
• Collective partnerships amongst agencies and
  organizations
• Increase in focus on consumer engagement and
  empowerment

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State Medicaid Spending on Home-Based Long Term
Care

49 70 38 44 37 (US Avg) 30 36 23
29 13
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Importance of Informal Caregivers

• 80 percent of individuals 65 with impairments in
  NY receive care from family/informal caregivers.
• 4X the care provided by NYs formal long term
  care service programs!
• NYSOFA established the Family Caregiver Council

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The Cost of Doing Nothing....

• If we do nothing....
• The system will continue to be fragmented,
  contributing to sky rocketing costs.
• Within 10 years, the system will become
  unaffordable and unsustainable!

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NYSOFA and NYSDOHs VISION

• The two agencies envisioned a system for
  individuals with long term care needs that
• Minimizes confusion
• Supports informed decision making and enhances
  choice
• Improve quality of life through early
  intervention and prevention
• Help consumers identify appropriate levels of
  care to prevent institutional care
• RFA released in May 2006.

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NY Connects Status

• 57 Contracts have been
• developed
• 56 Contracts have
• been fully executed
• Madison pending
• Oswego did not apply yet

Fully Executed Contract Developed,
Not Fully Executed Not Applying
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Standard Elements of NY Connects across the State

• Information, Assistance and Screening
• Provides a comprehensive resource listing
• Provides unbiased consumer choice
• Provides necessary follow-up
• Public Education
• Is recognizable in the community
• LTCC
• Works toward local change

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Provision of Information and Assistance

• Based on 3rd quarter data, 50 reported that they
  are providing I and A on long term care options.

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Project Planning Teams in Place

• Planning teams comprised of local government,
  stakeholders and providers have been established
  in all counties.
• Many counties report active planning teams.

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the Long Term Care Council

• Expedites referrals, access and navigation
  through the LTC system
• Enhances knowledge about all LTC services and
  programs
• Provides creative solutions for hard to serve
  consumers
• Provides an all-inclusive representation that
  leads to a broader view of the LTC system
• Promotes systems reform and local problem solving

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Local Elected Official Support Obtained

• Counties reached out to local elected officials
  through informational presentations, kick-off
  events, and invitations to LTCC meetings
• Counties with support from legislature report
  more seamless implementation process

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Relationships with New Partners

• Collaboration with outside agencies
• Hospitals and nursing homes
• Independent Living Centers
• Early Intervention
• 2-1-1

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Public Education Begins

• TV ads for NY Connects
• Worked with a college intern to develop NY
  Connects materials and used a 6th grade class to
  pilot test materials
• Development of promotional items

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Addressing Inefficiencies in System

• Efficiencies and better use of case management
  staff
• DSS caseworkers freed up to do more casework

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Improved Collaboration between Counties

• County planning teams have traveled to meet with
  NY Connects staff in other counties
• Peer to peer meetings
• Expedites innovative practice

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Increased Knowledge of Current Service
Availability

• Gaps analyses
• Increased knowledge of their long term care
  system through cross training of staff
• Lessons learned across aging and disabilities
  populations

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Contact Information

• Stacey Agnello,
• Supervisor - NY Connects
• Center for Human Services Development,
• SUNY Research Foundation
• New York State Office for the Aging
• [phone]