illinois governor's conference on aging jean wood december 11, 2013
TRANSCRIPT
Illinois Governor's Conference on Aging
Jean Wood
December 11, 2013
Overview of Presentation
• State System Overview• Older Americans Act Services• Managed Care and Health Care Reform• Adult Protective Services• Minnesota’s Aging and Disability Resource
Center
MN Department of Human Services – Continuing Care Administration
Continuing Care Assistant
Commissioner
Aging and Adult Services
Elderly Waiver
Alternative Care
Older Americans Act
Nursing Facility Rates and
PolicyAging 2030 Disability
Services
MN’s Long-Term Services and Supports System
A continuum of services
Older Americans Act
66,000
Alternative Care
4,700
Elderly Waiver
31,000
Nursing Home
27,000
Increasing Need
Percent of total public LTSS funds for older adults – HCBS vs. institution
EW and AC Impact• More older adults receive services in Minnesota’s long-term care
programs in their homes instead of going to institutions. In 2007, almost 58% of older adults in LTC received HCBS. By 2011, the overall percentage increased to 64.3%.
• The percent of older adults in Minnesota’s that receive HCBS in their own homes has increased. In 2007, 74.2% of older adults received services in their own home. By 2011, the percent had increased to 75.4%.
• The percent of older adults with high needs in Minnesota’s on EW or AC has been increasing. In 2007, almost 60% of older adults with high needs received services through EW or AC in their own home. By 2011, the percent was 63.9%.
Minnesota Board on Aging• Separate state agency• 25 member governor appointed board• Administers $24 million in federal funds; $8 million in
state funds; $20 million in local funds and resources• Designates a statewide network of Area Agencies on
Aging • Direct service programs:
– Senior LinkAge Line®– Long-Term Care Ombudsman Program
MN Aging Service Providers
• Nutrition Services: 13• Homemaker: 10• Chore: 33• Transportation: 17• Legal Assistance: 8• Health Promotion: 20• Caregiver Respite: 31• Caregiver Consultation/Training & Education: 20
MN Aging NetworkService People Served
(FFY 2012)
Congregate Meals 49,983
Home Delivered Meals 11,383
Chore 3,633
Homemaker 1,296
Assisted Transportation 969
Health Promotion 2,933
Caregiver Respite 730
Caregiver Consultation/Training & Ed
2,685
MN Aging Network Impact
MN NAPIS CY2012 Baseline* MN 2010 Census 65+ Population
Goal
IIIB 44.14% (n=5,303)IIIC1 52.73% (n=29,942)IIIC2 52.54% (n=7,149)IIIE 47.07% (n=597)
27% 37%
Increase the percent of Title 3 program participants who have incomes 100-200% FPL to 10% greater than the percent of all MN older adults at this income level.
MN Aging Network Impact
MN NAPIS CY2012 Baseline
AoA National FFY2011 Comparison
Congregate 37.4% Congregate 19.1%
Home Delivered 68.4% Home Delivered 51.9%
Increase the percent of senior nutrition program participants who have a high nutrition risk score.
Average Units per Participant MN NAPIS FFY 2011
BaselineAoA National FFY2011 Comparison
Congregate Meals
36.1* 51.4
Home Delivered Meals
94.0* 163.3
Homemaker 22.5 83.0 Chore 27.7 37.8Assisted Transportation
14.9 34.4
Average number of units per participant that is equal to or greater than AoA national average.
MN Aging Network Impact
Role of Managed Care
• Older adults eligible for Medicaid have been required to enroll in Medicaid managed care since 1983: Minnesota Senior Health Options (MSHO).
• Currently, 92% of EW participants receive their services through a managed care organization.
• MSHO integrates Medicare and Medicaid primary, acute, drugs, home care and other long-term services and supports as well as Elderly Waiver services the first 180 days of care in a nursing facility.
Health Care Reform in Minnesota
Connecting health care homes with LTSS• State certification for health care homes• CMS Multi-payer Advanced Primary Care Initiative• ACL Integrated Systems Grant
Developing total cost of care models• Pioneer ACOs• Medicaid Health Care Delivery System Demos
Bringing it to Scale• CMS State Innovation Model Grant
– Accountable Communities for Health
Adult Protective Services in Minnesota
State Policy
• Protect Vulnerable Adults (VA): Safe Services and Environments
• Defines: Vulnerable Adult/Maltreatment
• Reporting: Required/Encouraged
• Appropriate Cases: Investigation and Protective Services
30,000+ Reports of Suspected Maltreatment of VA 2012
Lead Investigative Agencies Responsible for Reports:
45% MDH
41% County
14% DHS
Law Enforcement: Crime Alleged
County: Immediate Protective Services
Adult Protective Services in Minnesota
Reform 2020: Enhance VA Protections
• State Maltreatment Report Center under DHS
• Web Reporting
• Adult Protection Resource Specialist Staff
• County Grants
• Public Awareness Campaign
Adult Protective Services in Minnesota
Structured Decision Making (SDM) Tool
• 2013 Mandated State-Wide Use
• Minnesota Board on Aging Grant
• All Reports of Suspected Maltreatment Where County Responsible
• Establishes Consistency in Assessment and Service to VA’s
Adult Protective Services in Minnesota
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Evolving the Service• MN Board on Aging decision – AAAs• Statewide uniformity
– Single Brand– One statewide toll free number– Upgraded phone system to zip code routing
and then later prefix routing– Desktop Client tracking system– Staff training– Marketing and outreach
Minnesota’s Aging and Disability Resource Center (ADRC)Background: Senior LinkAge Line®
Minnesota’s ADRC
Making the Shift to a Fully Integrated System• It Started in 1999 with a small prescription drug program• Establish a Comprehensive Statewide Service in 2001 to
prepare for aging of boomers– Move to a system that does “Information and Assistance” –
not I and R• Longer Calls• Higher levels of credentialing of staff
– Development “niche areas” or specialties that fill the gaps• Helped with Medicare Part D in 2005• And Now: Care Transitions
But the real keys to our success:• Branding. Branding. Branding.• A People not Programs Philosophy which means simplifications
and streamlining for the consumer (not for the programs, government etc)
• Thinking in a flexible and agile manner and sticking with our core values– Be relevant– Be accessible– Be ready when the student arrives
• Thinking like a single unit not 7 state units with seven area agencies – we are one to the consumer
Minnesota’s ADRC
Minnesota’s ADRC
Branding! Branding! Branding!
Minnesota’s ADRC
Branding! Branding! Branding!
• Minnesota Aging and Disability Resource Center
• No wrong door approach
• Four Channels!– Phone – Internet– In person/face-to-face assistance– Print
Minnesota’s ADRC
Senior LinkAge Line® 1-800-333-2433
• Long Term Care Options Counseling• Transition assistance for private pay nursing home residents• Medicare and other health insurance counseling• Prescription drug expense assistance for all ages• Application and forms assistance• Long Term Care Partnership (2006)• Caregiver planning and support• Health care waste, fraud and abuse• One Stop: State agency related questions, connections to volunteer
opportunities and older workers (Spring 2013)
Minnesota’s ADRC
Disability Linkage Line® 1-866-333-2466
• Disability Benefits• Accessibility/Modifications• Assistive Technology• PCA Services• Transition Services• Accessible Housing• Employment• Awareness/Rights
Minnesota’s ADRC
Veterans Linkage Line™ 1-866-333-2466
• Veterans Benefits Assistance• Reintegration challenges and referrals• Reintegration with family life• Household finance management• Assistance with mental health and stress disorders• Understanding, maintaining and transferring among benefits• Substance abuse referrals• Housing and homelessness• Job seeking and employment counseling• Understanding education or retraining benefits and options
MinnesotaHelp Network™
Contact Center Locations
Minnesota’s ADRC
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• Simplified, “Google-style” search capabilities with a power user version
• Search for services statewide or locally by topic or keyword
• Save, print and email searches and plans• Interactive decision support tools for aging,
youth and people with disabilities• View results charted on a map
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– Step-by-step decision making tool
– Interactive– Easy to use– Available at
Minnesotahelp.info
Minnesota’s ADRC
Disability Benefits 101 – DB101.org
DB101.org brings together:
• benefits information• tools• resources
to make it easier to:• understand benefits • learn about work incentives• plan for work & set goals• build financial literacy• manage benefits while working
Minnesota’s ADRC
A system designed to help YOU …
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– easily understand benefits and work incentives– demonstrate to the people you serve how work can be a
solution– better engage people in work planning
• overcome fears and barriers• explore work as an option• make informed choices about work• achieve better employment outcomes
– have access to, use and provide consistent messaging and resources
Minnesota’s ADRC
• 30,000 printed annually
• Distributed statewide by the Area Agencies on Aging to Medicare beneficiaries, caregivers, local partners and sites
• 2013 – mailing of HCC done to clinics, hospitals and health care homes
Minnesota’s ADRCWhat is the Return To Community Initiative?
• Passed in 2009 by State Legislature and is based on research conducted by the U of MN School of Public Health & the Indiana University Center for Aging Research which can be found at this link:– http://www.dhs.state.mn.us/main/dhs16_148973
• Utilizes the MinnesotaHelp Network™ which includes the LinkAge Lines (Senior, Disability and Veterans), the website MinnesotaHelp.info®, and in-person assistance through Senior LinkAge Line staff and volunteers.
Minnesota’s ADRC
Why is this service important?• It focuses on private pay individuals
– Assumption is assistance to transition home but then ongoing follow up in the community will help people avoid spend down
• Intensive follow-up services are available for people assisted out of the nursing home– Also available for those we don’t specifically assist
but who naturally discharge as they are a target group for follow in the assumptions
• The effort is being evaluated under an AHRQ (Agency for HealthCare Research and Quality) grant by two universities.
Minnesota’s ADRC
Experience to Date - Statewide• Top 3 Referral Sources for CLS Assisted Discharges
– 43% Nursing Homes– 38% MDS Profile List– 6% MDS Section Q
• Over 988 consumers directly assisted by CLS who discharged to community
• Over 900 consumers receiving follow-up in community
