San Diego Long Term Care Integration Project

1. San Diego Long Term Care Integration Project LTCIP Planning Committee June 14, 2006

2. San Diego Stakeholder LTCIP Vision for Elderly & Disabled • Develop “system” that: • provides continuum of health, social and support services that “wrap around consumer” w/prevention & early intervention focus • pools associated (categorical) funding • is consumer driven and responsive • expands access to/options for care • Utilizes existing providers

3. Stakeholder Vision (continued) • Fairly compensates all providers w/rate structure developed locally • Engages MD as pivotal team member • Decreases fragmentation/duplication w/single point of entry, single plan of care • Improves quality & is budget neutral • Implements Olmstead Decision locally • Maximizes federal and state funding

4. Strategies Developed to Support “Vision” • Healthy San Diego Plus • Physician Strategy • Aging & Disability Resource Center

5. Healthy San Diego Plus (HSD+) • MediCal Aged, Blind, and Disabled offered voluntary enrollment in LTC Integrated Plan • Models of care integrated across funding & the health and social services continuum: • Private entities to contract with State and CMS through RFP with local pre-qualification • Healthy San Diego Health Plus Plans to develop program details with consultant resources

6. HSD+ Update • Governor’s proposal/AB 2979 • Supported by • Medicare Modernization Act (SNPs) • Budget Deficit Reduction Act (enhancements that used to require waivers now available through State Plan approval) • GMC rates tied to SNF & ADHC

7. Physician Strategy • Partner w/physician “champions” • Develop interest/incentive for support of “after office” services (HCBC) • Identify care management resources to link physicians/office staff to patients • Train on healthy aging, geriatric/chronic disease protocol, pharmacy, HCBC supports

8. Physician Strategy Update • CA Endowment Planning Grant report and request to fund Implementation: • Finalize/deliver team-building for community care management for health and social service providers • Link resources and decision support tools • Develop, evaluate outcome measures • Enhance IT infrastructure supports • Collaborate w/SD-MINE

9. Aging & Disability Resource Center (ADRC)/Network of Care • Beta testing with • consumers and caregivers • community based organizations • MDs, other providers, Call Center staff • To develop “continuous quality improvement” program • Measure behavior changes of providers and consumers • Funding: Federal Aging & Disability Resource Center grant application

10. CaliforniaAging and Disability Resource Center Grant Program Lora Connolly, Director CA Department of Aging

11. ADRC Grant Goals • Promote public awareness of public & private LTC support options especially among underserved, hard-to-reach populations • Provide Information & Counseling on ALL available LTC supports • Help consumers assess potential public LTC service eligibility • Determine programmatic eligibility for public LTC programs, including Medicaid nursing home eligibility • Provide short term assistance or care management • Provide I&R • Help consumers plan for future LTC needs • Organize, simplify, and ensure “one-stop shopping” for access to all public LTC support programs

12. Grant Goals & Vision • Empower individuals to make informed choices • Streamline access to LTC services • Assist individuals in planning for future LTC support needs • Resource for LTC professionals & others who provide services to older adults & persons with disabilities • Provide information & counseling to private-pay individuals

13. Grant Requirements--Target Group • Older adults (age 60+) and at least one of the following other major target group by Year II: • Individuals with physical disabilities; • individuals with serious mental disabilities; and/or • individuals with mental retardation/developmental disabilities. • Individuals with traumatic brain injuries may be a targeted group

14. California’s Project Goals • Identify promising practices in providing outreach to reach populations • Determine viability of physical “one stop” resource centers given state’s diverse geography • Identify how web based technology can be best employed to support this effort • Create an environment that fosters tangible collaboration between aging and independent living services with shared products & outcomes.

15. Need for Disabled Community Involvement (Ben Harville) • National, State, and local need—why I’m here! • The opportunity: revise Year 3 Work Plan to be more inclusive of disabled community • Equal focus on aging and disabilities • Louis Frick, local ILC Director, will begin conversation a little later

16. San Diego ADRC Key Goals (Dr. Mark Meiners) • Build on existing AIS Call Center • Build/merge resource database, NOC • Improve consumer linkages/access to LTC information and services • Outreach to broad community and underserved/underutilizing populations • Complete above with stakeholder input • Evaluate outcomes & develop CQI

17. Specific Activities to Meet Goals • Surveys: • Call Centers—AIS and 211 • Consumers • Caregivers • Community-based organizations • Care management • Independent Living Center Consumer Advocates

18. Survey Findings • Survey tool difficulties • Service directory could be more user-friendly, more up-to-date • need closer relationship w/211 • Too many clicks to get info • Translations need cultural input • Needs of different users: Call Centers, MDs, care managers, consumers, caregivers, et al

19. Response to Findings • Evaluation leads to: • Call Center input toward enhancements and updates • 211 collaboration/joint protocols • NOC enhancements

20. Indicators of Increasing Satisfaction • More use of web site builder • Customized site developed for AIS Call Center • Improved community-wide calendar • Fall Prevention site ready for feedback • Increased satisfaction with finding information on NOC

21. NOC Enhancements for SD ADRCby Afshin Khosravi of Trilogy Integrated Resources • Site wide search powered by Google Enterprise Appliance • 10,000 culturally adopted and hand translated Spanish articles • Medicare section • Print Search Results • Call Center Application

22. Practical Suggestions for Local Work Plan—(Louis Frick) • Joint focus on disabled above poverty • Join Padres Disability Awareness Day • Joint involvement of management/goals • Access Center web site linked on NOC • NOC as communication tool for ILC clients • Joint participation in deinstitutionalization project • Outreach w/InfoVan to include disability expert

23. Goals for Lunch Meeting • Brainstorm potential activities for ADRC in support of disabled community • Decide which are most important to incorporate into Year 3 Work Plan • Prioritize activities of Year 3 Work Plan

24. Current Year 3 Work Plan Activities • CQI process for database maintenance • Complete web site enhancements • Develop “My Folder” as LTC “Options Counselor” • Broad community outreach and education • Target underserved, underutilizing populations

25. www.sdltcip.org • Get on LTCIP mailing list for updates • Attend Planning Committee meetings • Log onto website for background & info • Call or e-mail input/ideas: 858-495-5428 or evalyn.greb@sdcounty.ca.gov or 858-694-3252 or sara.barnett@sdcounty.ca.gov