Preliminary Report of Findings from Consumer and Provider Surveys

1. Preliminary Report of Findings from Consumer and Provider Surveys Based on Responses Received by August 31, 2015

2. Organization of Findings • Overview of Survey Responses to Date • Survey Responses & Completion Rates • Aging/Disability Balance in Survey Responses • Key Themes Related to Plan N Objectives • Accessing Information and Services • Evaluating Service Delivery & Improvements • Reinforcing Balancing Incentive Program (BIP) • Strengthening the No Wrong Door (NWD) System • Leveraging Resources and Fiscal Impact on Services and Consumers • Next Steps

3. Survey Responses Consumer Survey • Total Surveys to Date: 586 • Total Surveys Included in this Analysis: 474 • Completion Rate: 98% Provider Survey • Total Surveys to Date: 690 • Total Surveys Included in this Analysis: 613 • Completion Rate: 97%

4. Characteristics of Survey Respondents Consumers Providers Gender: 80% female Race: 85% white; 4% African American; 3% Hispanic/Latino • Gender: 66% female • Race: 90% white; 4% African American; 3% Hispanic/Latino • 34% Medicare; 18% Medicaid; 25% both; 23% neither • 58% Private Insurance • Receiving assistance or services now: 52% yes; 48% no

5. Counties Represented (Consumers) -Capital Region (4%): Albany, Schenectady -Central NY (11%): Onondaga, Madison, Cayuga -Finger Lakes (30%): Genesee, Monroe, Wyoming, Orleans -Long Island (1%): Nassau -Mid-Hudson(13%): Westchester, Ulster, Orange -Mohawk Valley (2%): Montgomery, Oswego -NYC(11%): Queens, New York, Brooklyn -North Country (5%): Jefferson, St. Lawrence, Franklin -Southern Tier (13%): Broome, Steuben, Tompkins, Chenango, Chemung -Western NY (10%): Alleghany, Erie, Niagara 5% 2% 4% 11% 30% 10% 13% 13% 1% 11%

6. Counties Represented (Providers) -Capital Region (5.6%): Albany, Saratoga, Warren -Central NY (14.9%): Onondaga, Madison, Oswego, Cayuga -Finger Lakes (6.5%): Monroe, Ontario, Wayne, Genesee -Long Island (.9%): Nassau -Mid-Hudson (12.2%): Ulster, Westchester, Dutchess -Mohawk Valley (10.3%): Oneida, Otsego, Fulton, Schoharie, Delaware -NYC (21.5%): New York, Queens, Brooklyn, Bronx -North Country (14%): Clinton, Essex, Jefferson, Lewis -Southern Tier (9.3%): Chemung, Chenango, Steuben -Western NY (4.7%): Erie, Niagara 14% 10.3% 5.6% 14.9% 6.5% 4.7% 9.3% 12.2% .9% 21.5%

7. Types of Agencies Where Providers Work • Twenty-six percent (26%) work in aging organizations • Twenty-three percent (23%) work in disability organizations • Thirty-four percent (34%) work in agencies that serve both older adults and people with disabilities

8. Age Group of Survey Respondents who are Consumers • Survey Respondents over 60 years of age: 61% • Survey Respondents under 59 years of age: 39%

9. Consumers who Self-Identified as a Person with a Disability • Forty-seven percent (47%) identified as a person with a disability • Fifty-three percent (53%) did not identify as a person with a disability

10. Types of Disabilities Identified (N=159) • Vision - 20 • Hearing – 10 • TBI – 5 • Physical – 83 • Spinal cord – 8 • Cerebral palsy – 11 • Mental illness – 28 • Dementia - 6 • Learning disability - 7

11. Major Findings from the Surveys

12. Evaluating Information & Access • To understand issues around information and access, we asked providers about duplication in services across the state and/or agencies • To understand consumer perspectives, we asked about their experience in enrolling in needed services

13. Responses about Information and Access • More than half of providers (61%) reported that there is either not much or very little duplication across service delivery • A high percentage (72%) of consumers stated that they did not find it difficult or confusing to enroll

14. Themes from Questions around Information and Access • Lack of coordination between multiple providers • Lack of communication between agencies • Difficulty in accessing services (especially in the rural areas of the State)

15. Evaluating Service Delivery and Improvements • To understand issues around service delivery, we asked providers how well they thought services were working for their consumers • To understand consumer perspectives, we asked consumers to rate their level of satisfaction with service delivery

16. Responses about Service Delivery • Most providers (88%) believe that services are working well for their consumers • Consumers report that they were either very satisfied or somewhat satisfied with their services in the past year (87%)

17. Themes from Questions around Service Delivery • High satisfaction with services, but many concerns over the lack of services • Concerns about workforce • Quality and turnover

18. Evaluating Barriers, Gaps, and Information about Needed Services • To understand more about service delivery and other statewide initiatives, such as BIP, we asked about: • gaps in services • barriers to providing services • challenges in finding out or getting needed services

19. Responses on Barriers, Gaps, and Information about Needed Services  • Almost all providers (92%) agree that there are gaps in services • Sixty-eight percent (68%) believe that there are barriers to accessing services • More than half of consumers (60%) report that they do not find it difficult to find or get needed services

20. Themes from Questions about Barriers, Gaps, and Needed Services • Knowledge of Services • Hard to know what’s out there • Eligibility Criteria • Strict guidelines • State Level Regulations • Differing criteria and funding

21. Evaluating No Wrong Door (NWD) Initiatives • Questions about obtaining services and confidence in where to get services were asked of providers and consumers to understand how the State’s NWD system is working

22. Responses on the No Wrong Door Initiatives • Providers report that their consumers are very or somewhat concerned about obtaining services (87%) • Consumers report high confidence in knowing who to call or where to go to get services (85%)

23. Themes from Questions about the No Wrong Door Initiatives • Services provided by providers and informal supports are invaluable • Navigating the system is challenging • A single point of entry to alleviate telling stories multiple times and completing different paperwork for each agency would make obtaining services easier

24. Evaluating the Impact if Services were More Coordinated • Providers and consumers were asked if there would be any advantages or disadvantages if aging and disability services were more coordinated in the state of New York • They were also asked if this type of coordination could improve access or quality of services for older adults and people with disabilities and what type of impact this might have

25. Responses on the Impact of More Coordinated Services • More than half of providers (58%) believe there would be advantages to having more coordination among aging and disability services; while 26% believe there might be disadvantages • More than half (60%) of providers are confident that coordinated aging and disability services could improve access and quality of services • Most consumers (70%) believe that state level coordination of aging and disability services would have an impact on their services

26. Themes from Questions on Coordinated Services • More coordination could be good if it leads to more collaboration and less time navigating the system • There is concern over what could be a loss of services & autonomy • People need more information to understand this fully