Aging & Disability Resource Centers

1. Aging & Disability Resource Centers Forming Partnerships with Nursing Homes

2. What is an ADRC? • Will serve all counties by June 2013 • Provides unbiased information on all aspects of life related to aging or living with a disability. • Helps people understand the various long term care options available to them • Helps people apply for programs and benefits • Serves as the access point for publicly funded long term care • - Waiver Program • - Family Care • - IRIS (Include, Respect, I Self-Direct) • - Pace and Partnership • Connects consumers to wellness programs to keep them healthy

3. Options Counseling • Information about the choices you have when making decisions about: • - where to live • - what kind of help you need • - where to receive that care and help • - how to pay for that help • One on one consultation to think through the pros and cons of the options in light of your situation, values, resources, and preferences

4. Functional Screen • Evaluates ADLs • Evaluates IADs • Supporting documentation of medical diagnosis • Meets nursing home level of care

5. Enrollment Counseling • County Availability • - Waiver program • - Family Care • - IRIS • - Pace and Partnership • Prepares Enrollment paperwork and submits

6. MDS – Q A Federal Program • Do you want to talk to someone about the possibility of returning home? • Residents have the opportunity to learn about home and community based services • Residents have the opportunity to live in the least restricted environment • The MDS is to be completed every 90 days • Referrals to ADRC are made online for those saying yes unless there is an active discharge in place

7. Medicare Residents • - ADRC staff do not do discharge planning • ADRC staff will do options counseling • ADRC staff will do future planning • Discharge services set up by nursing home

8. Medicaid Residents • ADRC staff does options counseling • ADRC staff completes functional screen • ADRC staff does enrollment counseling • Family Care, IRIS, Pace or Partnership develops discharge plan with the nursing home staff

9. Private Pay Resident • ADRC staff does options counseling • ADRC staff works with nursing home staff on discharge planning

10. Money Follows the Person • Must have been in the nursing home 90 days or more • - could have been Medicare • - followed by Private Pay • - must be on Medicaid • - must move to home or facility that is 4 beds or less • ADRC submits request to state • Family Care, IRIS, Pace of Partnership does survey of resident

11. Nursing Home Intervention Project • Counties with more than 30% of nursing home beds funded by Medicaid • TMG employee develops marketing plan to encourage relocation out of nursing home • Notifies ADRC of potential resident relocations • ADRC does options counseling in home • IF MA eligible, ADRC staff completes functional screen in home • ADRC staff does enrollment counseling

12. Transition Care • Medicare Discharges – how will your community, hospital, and nursing home handle this?

13. Questions • Judy Rank, Director • Aging & Disability Resource Center of the Lakeshore • 4319 Expo Drive, PO Box • Manitowoc, WI 54221 • judyrank@co.manitowoc.wi.us