Karol Swartzlander & Ed Ahern California Health and Human Services Agency LTSS Advisory Committee

1. Karol Swartzlander & Ed Ahern California Health and Human Services Agency LTSS Advisory Committee March 7, 2014

2. ADRC Overview • History/Overview • Options Counseling • Accomplishments • Barriers/Challenges • 2014 Priorities

3. History 2003- First state ADRC initiative (also first Federal initiative) • Promoted a vision that goes beyond networks serving single populations (aged, disabled) • Embraced collaboration across aging, disability and other service providers • Emphasized the need to help consumers navigate a fragmented and sometimes perplexing array of community LTSS options

4. A history of growth 2006-11 : Systems Transformation Grant 2009-12 : Real Choice Systems Change 2010-12 : Care Transitions 2010-12 : Options Counseling 2010-11 : Tech4Impact 2012-13 : Hospital Discharge Planning Transfer 2012-13 : Scan Foundation 2012-13 : Option B ADRC Grant 2013-14 : Option B + 2013-14: MFP/ADRC Option C: DHCS IA

5. Person Centered System

6. California ADRC Vision Every community in California has a highly visible, reliable, universal access point that provides information to facilitate access to long-term supports and services.

7. ADRCs in California • core partnership between an Area Agency on Aging (AAA) and an Independent Living Center (ILC) • joined by a network of "extended" partners that come together to make system improvements • recognized as sources of comprehensive and trusted, information about the full array of local LTSS options • empower consumers to consider all options, make informed decisions • focus on individual’s personal goals for independence

8. Current Status • Today, seven ADRCs serve 11 counties: Alameda, Nevada, Orange, Riverside, San Diego, San Francisco, Butte, Glenn, Tehama, Colusa and Plumas • Emerging partnerships: Monterey Bay (Monterey, Santa Cruz, San Benito), Santa Clara, Yolo and Ventura

9. CA ADRC Core Services • Enhanced Information and Assistance/Referral • Options Counseling • Short-Term Service Coordination • Care Transitions • Hospital-to-Home Care Transition • Nursing Facility Transition

10. ADRC Options Counseling

11. Options Counseling* • ADRC Options Counseling is an interactive process where individuals receive guidance in their deliberations to make informed choices about long-term supports. The process is directed by the individual and may include others that the person chooses or those that are legally authorized to represent the individual. *ACL Draft National Options Counseling Standards June 2012

12. Vision for Options Counseling • Options Counseling is both the philosophy underpinning how ADRCs interact with individuals, as well as a process that ADRC staff will follow to support individuals and families to consider their options and access the right services and supports at the right time.

13. Essential components of Options Counseling: • a person-centered interview • identification of a goal(s) • identification of desired and available options (including personal, public, and private resources) • a facilitated decision-support process (weighing pros/cons of various options) • assistance to develop an Action Plan that identifies ‘next steps’ • connections to services and supports when requested and • follow-up with the individual to identify changes or additional information.

14. Why are ADRCs Successful Transition Partners? • Knowledge of the diverse and broadly defined LTSS population • Connections to LTSS providers • Person-to-person Options Counseling that includes self-direction, planning and personal responsibility • Expertise in transition services (CTI hospital-to-home and nursing facility-to-home) • Access to skills training and assistive technology, some of which could result in delaying or avoiding higher Medi-Cal costs, and • Assistance and access to Medi-Cal eligibility application processes

15. A Few Lessons Learned • Maintenance of state infrastructure (staff, technical materials, training) essential • ADRC partnership development takes time • ADRCs are successful transition partners • ADRC partnership best practice - third party, objective facilitation of strategic planning • ADRC partnerships that embody mutual respect and focus on the consumer are the most successful

16. Infrastructure Supporting ADRC Expansion in California • State ADRC Program Staff • LTSS Advisory Committee • Technical Guidance and Materials • Options Counseling Training Program • New online community of practice for Options Counselors and MFP transition coordinators

17. Technical Guidance and Tools • ADRC Designation Criteria • Options Counseling Standards • ADRC Designation Application • ADRC Implementation Guide: update in process • ADRC Partnership Planning Guide • ADRC Financial/Business Model • ADRC Business Plan Template • ADRC Business Plan Development Guidance

18. California ADRC Challenges/Barriers • Lack of dedicated (and sufficient) ADRC funding • Start up funding necessary to develop new lines of business (care transitions, VD HCBS, etc.) • ADRCs must educate health plans, Veterans Medical Centers and other potential purchasers about the benefits of community LTSS services • Quality assurance and monitoring • Lack of standardized data to assess full impact of the ADRC initiative • Difficult for some communities to come together. (Lack of interest)

19. CA ADRC Program Priorities 2014 • Encourage and support VAMC/ADRC collaboration • Work with State Independent Living Council to release Request of Application to award modest funds for ADRC development • Apply for new federal funding opportunity! • Transfer of program to Department of Aging (July 2014) • Monitor national ADRC developments (quality assurance and monitoring; long-term sustainability)

20. California’s ADRC Program Priorities 2014 • Collaborate with state initiatives (e.g., Money Follows the Person) • Research requirements for certification for OC • Conduct Options Counseling/MFP Training Program • Formally designate new ADRCs • Promote Use of New Technical Tools: ADRC business plan development guidance; ADRC financial model(s)

21. CHHS ADRC Team and Resource Websites • Karol Swartzlander, karol.swartzlander@chhs.ca.gov • Ed Ahern, edward.ahern@chhs.ca.gov • Paula Acosta, paula.acosta@chhs.ca.gov • Online Resources • http://communitychoices.info (state) • http://www.adrc-tae.acl.gov (federal) • www.thescanfoundation.org

22. Questions?