NASUA’s Aging Information Management Systems Study

1. NASUA’s Aging Information Management Systems Study Jim Whaley, NASUA Rob Ficke, Westat Robin Ritter, Westat

2. Overview/Background • Older Americans Act/NAPIS reporting • Accuracy • Burden • Capacity to meet reporting requirements • Use of data • Program operations • Quality Assurance • Accountability • Planning • Management

3. Purpose of Study Identify ways to: • Improve efficiency and effectiveness of reporting • Reduce burden of information collection across multiple funding streams • Eliminate the need for consumers and caregivers to repeatedly provide identifying information to multiple service providers • Reduce expense of reporting systems fragmentation by capitalizing on network economies of scale

4. Process & Methodology • Guided by Project Advisory Committee • Conducted telephone survey of 49 SUAs • Selected 15 states for follow-up survey • Selected 5 states for case studies of best practices

5. Content of Questionnaire • Capabilities & Functions • Technical Aspects • Policies • Computation of client counts Categories of data collected • Satisfaction with information system

6. Capabilities & Functions • Client tracking • Case management • Provider management • Financial management • Summary Reporting

7. Technical Aspects • Hardware • Software • Type of access ─ client server; web-based • How AAAs & providers submit data to the state

8. Categories of data collected • Client vs. summary level • Registered vs. non-registered services • Demographics • Health & functional status • OAA Services • Reason for leaving program

9. Policy Implications • How has SUA standardized collection and reporting of data • How do state government information systems policies affect SUA • Barriers vs. facilitators for information systems development

10. Satisfaction with Information System • Cost • Ease of use and modification • Flexibility • Report generation and ad hoc queries • Customer support • User Training • Documentation

11. Degree of Program Integration • OAA Title IIIB, C1, C2 • OAA Title III D ─ Disease Prevention/Health Promotion • OAA Title III E ─ Family Caregiver Support • Long-Term Care Ombudsman (NORS) • Elder Rights • Senior Community Service Employment • State Health Insurance Programs (SHIP) • Medicaid Home & Community-Based Waiver • Social Service Block Grant • Nutrition Services Incentive Program • Aging & Disability Resource Center funds

12. Criteria for Follow-Up/Best Practices • Vertical Integration: AAAs/providers using same system as SUA • Horizontal Integration: Same software used across multiple funding streams • Unduplicated client counts: Accuracy; based on individual clients • Technology innovations: Bar-coded IDs for client registration • Type of information systems: In-house vs. commercial systems • Diversity: Geographic, urban/rural, single state-PSA

13. Preliminary Findings • Use of information systems at SUA level is in flux • Degrees of vertical & horizontal integration • Use of technology for client registration is minimal • Success with commercial software dependent on tailoring documentation and user training

15. Available funding Cooperation from AAAs/providers Leadership High costs Information systems development mandate Recommendations 79% 72% 67% 63% 31% 14% Facilitators Important to Information Systems Development

16. Barriers to Information Systems Development

17. Special Use Software for Supporting Access to Services • Most SUAs integrate client intake, assessment, and tracking • Separate computer applications often support information & referral/assistance • Only about 1/3 (32%) of SUAs integrate their I & R/A functions within their core MIS

18. Reasons for Separate MIS Systems • Wide selection of I & R/A software products • Superiority of special use I & R/A software • Existence of well-established I & R/A procedures that SUAs are reluctant to change

19. Example of I & A/R Systems Integration • Area Office on Aging of Northwestern Ohio (Toledo) uses Synergy’s SAMS Beacon software in conjunction with its existing web-based consumer information system (Synergy built the interface) • Older persons, their families, and agency staff can use this system to identify community facilities and services to address their needs

20. Implications for ADRCs • Coordinating and integrating service system access software, such as I & R/A, with service delivery applications within state programs on aging is difficult and often does not occur • ADRC information is not being integrated with information systems that support Title III of the Older Americans Act • This suggests that identifying or developing I&R/A computer applications that coordinate and integrate aging and disability program access may be problematic as well

21. Next Steps NASUA Study • Produce and disseminate written report

22. Contact Information NASUA: • Jim Whaley, Director, Center for the Advancement of State Community Service Programs • 202-898-2578, ext. 140 • jwhaley@nasua.org Westat: • Rob Ficke, Senior Study Director • 301-294-2835 • robertficke@westat.com • Robin Ritter, Research Associate • 240-314-5804 • robinritter@westat.com

23. Questions