Technical Assistance to Support the Aging and Disability Resource Center (ADRC) Grantees Academy Health 2006

1. Technical Assistance to Support the Aging and Disability Resource Center (ADRC) GranteesAcademy Health 2006 Lisa Alecxih The Lewin Group lisa.alecxih@lewin.com (703)-269-5542 Karen Linkins, The Lewin Group Susan Reinhard, Rutgers University

2. CMS & AoA VISION To have Aging and Disability Resource Centers in every community serving as highly visible and trusted places where people of all incomes and ages can turn for information on the full range of long term support options and a single point of entry for access to public long term support programs and benefits.

3. Research in Support of ADRCs • People do not know who to turn to for information about long term support services • Rosalynn Carter Institute, 2006 and numerous grantee surveys, 2004-2005 • Most think that Medicare will cover long term support needs and do not understand Medicaid is means-tested • AARP, 2003 • Providing the right information, assistance, and access to services at the right time can delay or prevent costly institutionalization • Feinberg, 2003 and AARP 1996

4. AK WA VT ME MT ND MN NH OR NY SD WI ID WY MI RI CT PA IA NJ NE NV OH DE Hawaii IL IN UT CO WV MD VA CA KS MO KY NC TN OK SC AZ NM AR MS AL GA Northern Marianas TX LA FY 2005 ADRC Awardees FL Guam FY 2003 ADRC Awardees FY 2004 ADRC Awardees Louisiana New Hampshire Maine New Jersey Maryland Pennsylvania Massachusetts Rhode Island Minnesota South Carolina Montana West Virginia Alaska Indiana Arkansas Iowa California New Mexico Florida North Carolina Georgia Northern Marianas Illinois Wisconsin Alabama Idaho Ohio Arizona Kansas Tennessee Colorado Kentucky Texas DC Michigan Vermont Guam Mississippi Virginia Hawaii Nevada Washington Wyoming AGING AND DISABILITY RESOURCE CENTER GRANTEES

5. Populations Served PD = Physically Disabilities DD = Developmental Disabilities MI = Mental Illness

6. Pilot Site Operating Organizations Among 54 2003/04 Pilot Sites 25 20 19 20 15 10 4 5 2 2 2 2 2 1 0 County Senior Centers County Health Department County Aging Department Independent Living Centers County Disability Department Statewide primarily through SUA Separate AAA and disability org. County Aging and Disability Depart. Area Agencies on Aging (AAAs)

7. ADRC Technical Assistance Exchange (ADRC-TAE) • Led by The Lewin Group • In conjunction with CMS TA that supports nearly all of CMS System Change grants • Rutgers University, Independent Living Research Utilization (ILRU), National Academy of State Health Policy, National Association of State Units on Aging, and others • Focuses on grant major components/requirements • Also addresses sustainability and scaling up • Relies on multiple sources for knowledge transfer • Uses proven techniques of reinforced learning

8. Functions of an ADRC • Awareness & Information • Public Education • Information on Options • Assistance • Options Counseling • Benefits Counseling • Employment Options Counseling • Referral • Crisis Intervention • Planning for Future Needs • Access • Eligibility Screening • Private Pay Services • Comprehensive Assessment • Programmatic Eligibility Determination • Medicaid Financial Eligibility Determination • One-Stop Access to all public programs

9. The Audience • Primary Audience • 43 state/territory grantees • 62 pilot sites currently and 106 by end of 2006 • Over 1,200 registered website users • Secondary Audience • Policymakers • Researchers • Others interested in access to long term support services and information and assistance • Varying levels of understanding of: • Key grant components • Use of the web and technology

10. Coordinated Knowledge Transfer Framework Knowledge Needs/Materials Refinement Feedback • Information Sources • TA Requests • LTC-TAC Faculty • LTC Experts • State Peers • Research Literature • Grantee Meetings/ • Teleconferences • Listserv Discussions • Web Site • Needs Assessments • Knowledge Development/Synthesis • Issue Briefs • Matrices • Tools • Summaries of • Meetings & Work • Groups • Grantee Progress • Reviews • Knowledge Dissemination & TA • ADRC Website • Weekly Newsletter • Bi-annual National • Grantee Meetings • Monthly All Grantee • Calls • Peer Work Groups • One-to-one TA/ • mentoring • Stakeholders • State Agencies • Aging Network • Disability Community • Indep. Living Centers • Consumers/Families • Service Providers • Program Staff • Private Insurers • Legislators/Regulators • General Public Knowledge Exchange/ Feedback On-Site TA Recipients & Grantees

11. On-site Assistance Listservs Work Groups Individualized Knowledge Standardized Knowledge Web Site Content Teleconferences Needs Assessment, TA Plans National Meetings & Regional Teleconferences AoA, CMS, Experts, TA Collaborative State Expertise Reinforced Learning Process

12. Written Materials • Issue Briefs • Consolidate research and highlight key elements • Make relevant to ADRCs • Provide “real life” examples – bridge research and practice • Try to keep to less than 10 pages • Provide sources for more detail • 25 downloaded 3,762 times • Resource Documents and Tools • Consolidated information for a particular topic • e.g., Information & Referral Software Matrix and Web-based Resource Databases • 70 downloaded 1,662 times • Documents from the field • e.g., RFPs, forms, brochures, MOUs, marketing materials • 344 downloaded 3,487 times

13. Teleconferences • Topics based on grantee needs • Monthly all grantee calls • Average 26 grantees of 43 since Nov; 65 participants per month • Smaller work groups calls • Background materials and/or slides in advance • Use of web-based meeting capability • Expert or state representatives featured • Summary, including questions and answers, posted on website • Monthly calls also recorded and available for future access on the website

14. On-Site Technical Assistance • Onsite requests from grantee or identified need by funders • Support grantees with other stakeholders • Facilitate meetings • Individualized TA needs

15. National Meetings • Permit in-person exchange among grantees • Opportunity for peer-to-peer TA • Tackle issues more in-depth • Reinforce federal messages • Two each year • 1-2 days • Between 100 and 250 attendees • Also send TA staff to other national meetings that grantees attend

16. Other Forums • Online Peer-to-Peer Exchange • 30 topics with 101 posts • e.g., naming the project and customer satisfaction survey • 2,872 total hits • FAQs to Funders • 14 questions and answers • 3,220 hits • Most for single question – 836 on Medicaid eligibility determination • Weekly newsletter • New resources • Upcoming events

17. Feedback Mechanisms • Online surveys for all monthly calls and national meetings • Poor response rate for calls – most=9, mode=4 • Better for national meetings – 30-50% • Possibly because of dinner for two incentive • Funders ask about TA in their semi-annual calls • “In my 20 years of state government services, I have never seen anything so comprehensive and useful as the ADRC technical assistance website” 2005 ADRC project coordinator • Informal mechanisms • TA leads solicit in regular one-on-one calls with grantees • Ask at end of every peer workgroup call • Feedback on format • Topics for future calls

18. TA and Grant Management • Web-based TA Tracking Tool • Record grantee requests and TA responses • Prioritize TA activities • Ensure responsiveness to grantees • Coordinate multiple TA providers • Identify common themes to maximize resources and plan activities • Accountability to funders • Online semi-annual report tool • Grantees submit narrative, check box and outcomes info. • Database allows easy of analysis • Produce reports for internal and external purposes

19. Grantee Baseline & Progress • Sources of information • Baseline from initial needs assessment calls • Progress from • Semi-annual reports, • TA requests and activity related case notes for grantees (TA Tracking Tool) • AoA-CMS Grants Monitoring call notes • Provides information for evaluative efforts

20. Website – www.ADRC-TAE.org • Primary mechanism to disseminate & exchange information • Over 1,200 registered users • Averages 70 visits and 15,000 hits per day • Up from 40 visits and 3,200 hits per day a year ago • Average 2,000 to 3,000 visits and 500,000 hits per month • Built a grantee online community

21. Website – www.ADRC-TAE.org

22. Audience of Implementers – NOT Researchers, sooo … • Know your audience: • Preferred method of receiving information, tech savvy, concerns and challenges • Attract and keep their interest: • Boil relevant research down to the high points • Repeat messages frequently and in variety of ways • Provide a couple (not too many) of resources for more depth • Meet them where they are: • Stage information based on readiness • Monitor what works and what does not: • Solicit feedback constantly, both formally and informally • ACT on the feedback!!! • Try new things: • Keep eyes and ears open for how other successfully teach/support • Experiment with different formats (e.g, consultancies)