Maryland Department of Health and Mental Hygiene

1. Maryland Department of Health and Mental Hygiene “Community Options” Development and Implementation of a Continuing Education Seminar

2. Introducing “Community Options: a Discharge Planning Resource Seminar” Created as a forum to bring together discharge planners, experts in public and privately-funded home and community-based services, and HCBS service providers. Attention Discharge Planning Professionals! Introducing “Community Options: A discharge planning resource seminar” EARN CEU’s!

3. Maryland’s Real Choice Systems Change Grant • Maryland Department of Health and Mental Hygiene was awarded a 2001 Real Choice grant for an application entitled “Increasing Access, Service Availability, and Quality in Maryland’s Long-Term Care System.” • Grant goals included: • To increase the availability of attendant care services. • To provide nursing facility diversion through information and assistance to consumers in acute care hospitals. • To assess the quality of waiver services and use that information to focus on quality improvement efforts in the future. • To improve community-based service delivery to children with serious emotional disturbances.

4. Identifying a Need • The need to educate discharge planners about HCBS stemmed from experience with our “Hospital Outreach Initiative”, the Real Choice nursing facility diversion program. • The Hospital Outreach Initiative places local health department nurses in acute care facilities to augment discharge planning for persons at risk of nursing facility admission. • Our nurses became an essential source of information about HCBS for hospital discharge planning staff. • We saw a knowledge gap ranging from basic Medicaid State Plan services to services for clients with more complicated needs.

5. Meeting the Need • We developed a seminar that included presentations and interactive case studies. • We offered Continuing Education Units (CEU’s) to participants. • Social Workers received 6 CEU’s. • Certified Case Managers received 7 CEU’s. • The seminar was free. • To increase interest in the seminar, Real Choice Grant funds were used so that admission and CEU’s were free. • Opportunity for good public relations for Medicaid.

6. DHMH Goals • To develop an effective model to educate discharge planning personnel about HCBS in Maryland. • To pilot the seminar two times. • To develop a model that could be sustained after the grant ends with limited funds.

7. The Target Audience • Our target audience included discharge planning professionals in acute care, long-term care, and community-based settings. • We identified 2 diverse regions in Maryland: • First seminar targeted case managers in Baltimore City and parts of Western Maryland. • Second seminar targeted Central Maryland and counties on the Upper Eastern Shore. • To reach the target audience, we advertised the seminar through direct mailings, ListServs, and word-of-mouth.

8. Private Sector Partnership Johns Hopkins Geriatric Education Center (GEC) • Hopkins GEC has a special geriatric education grant (Title IX grant) and provided support on various levels. • Administrative support, planning support, assistance with identification of speakers. • Handled the CEU process via an agreement with the Institute for Johns Hopkins Nursing. • Hopkins GEC has extensive experience with holding CEU events for health care professionals.

9. Public Sector PartnershipsState and Local Entities • Assistance with planning and/or speakers was also gained through partnerships with the following state and local agencies: • Maryland Department of Disabilities • Maryland Department of Aging • Local Area Agencies on Aging • Local Health Departments • Mental Health Association of Maryland

10. The Seminar Format • Presentations about State-run programs directly from administrators. • All presentations contained key information; including phone numbers, points of contact, and program eligibility criteria. • Information about public and private programs from local-level agencies. • Interactive case studies led by a panel of resourceful discharge planners and program administrators from diverse backgrounds. • Separate resource area with vendors and tables of paper-based resources. • Materials and handouts included copies of the presentations with space for information from the vendor/resource area to create a personalized “resource book.”

11. Agenda – Seminar One Guest Speaker – Spouse of a Medicaid Home and Community- Based Waiver Recipient “Personal Experiences with Discharge Planners and HCBS” Session 1 Maryland Medicaid 101 and Medicaid HCBS Programs HCBS Waiver Services Session 2 Maryland Dept. of Disabilities Programs Session 3 Maryland Dept. of Aging Programs Session 4 Mental Health Assoc. of Maryland on Mental Health Programs Session 5 Keynote Speaker on “Strategies to Stay in the Home” Session 6 Panel Discussion and Clinical Cases *Time was included for lunch, breaks, and for participants to visit the “Vendor / Resource Area.”

12. Seminar One Outcomes and Evaluations • 100 participants were registered. • Wait list established. • 64 people attended with a no show rate of 36%. • 20% of attendees were RN’s, 72% were social workers. • All presentations scored 3.6 or higher on a scale of 1-5 (1 = lowest score, 5 = highest score). State-level administrators received some of the lowest scores. • Most negative comments suggested that the information presented by State-level administrators was too technical and overwhelming. • Interactive case study session was well-received. • 6 vendors participated in the vendor/resource area and roughly 100 paper-based resources were available on unmanned tables. Participants stated they really appreciated this area and the ability to build their own resource reference book.

13. Lessons Learned:Planning the Second Seminar • Due to the high no-show rate, we “overbooked” the second seminar. Charging a nominal fee to secure attendance was considered, but was too difficult administratively. • We decreased the amount of technical information from State-level administrators. • We increased the number of local-level speakers. • We changed the seminar to a more interactive format. • We included more vendors in the resource area. • A web-based database will be created with Hopkins that lists resources presented and suggested resources from participants. Participants of the next seminar were encouraged to share resources to contribute to an online database. • Participants’ knowledge bases ranged from novice to seasoned professional, but most participants really needed basic information about Medicaid.

14. Agenda – Seminar Two Session 1 Department of Health and Mental Hygiene Medicaid 101, Medicaid Home and Community-Based Waivers Session 2 Maryland Department of Disabilities (MDoD) State Plan, MDoD services Session 3 Medicare Part D Session 4 Panel A “Access to Information” • Experts in identifying resources presented information about HCBS and worked through case studies with audience participation. Session 5 Panel B “Community Supports” • Included representatives from mental health and case management agencies. Presentations included various core services. Panelists and audience worked through case studies Session 6 Panel C “Community Living – Affordable and Accessible” • Housing and environmental modification experts, including a home energy assistance program representative, gave presentations worked through case studies. *Time was included for lunch, breaks, and for participants to visit the “Vendor / Resource Area.”

15. Seminar Two Outcomes and Evaluations • 115 participants were registered. • Wait list established. • 78 people attended with a no show rate of 32%. • 11% of attendees were RN’s, 74% were social workers • All presentations scored 4 or higher on a scale of 1-5 (1 = lowest score, 5 = highest score). • 86% of participants felt the information would help them in their practice. • 87% stated they learned new information, but again, there were many comments about participants feeling “overwhelmed.” • 73% stated they would attend the seminar again next year, 20% stated they were unsure. • 91% stated they would pay $25 to attend, 59% stated they would pay $50. • 13 vendors participated and over 100 paper-based resources were available. • The resource binders were again well-received. • One vendor offered to provide some funding for future seminars.

16. Next Steps… • Examine future funding options: • Registration fee • Vendor funding • State funds • Partnership with Hopkins GEC • Restructure the seminar to decrease breadth of information presented or have a two day event. • Continue to assess the needs of the discharge planning community and modify the seminar accordingly. • Plan and host future events.

17. Contact Information Lisa Kelemen, RN, MSN Maryland Department of Health and Mental Hygiene Room 122 F 201 West Preston Street Baltimore, MD 21201 (410) 767-5095

18. This document was developed under Grant No. 18-P-91593/3-01 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. However, the contents herein do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not infer endorsement by the Federal government.