ADRC-TAE Ad Hoc Call May 31, 2007 ADRC Expansion: Selecting New Pilot Sites. Heather Johnson-Lamarche, MA and VT Sandi Smith, FL

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1 ADRC-TAE Ad Hoc Call May 31, 2007 ADRC Expansion: Selecting New Pilot Sites Moderator: Sharon Zeruld, Lewin Call Attendees: Russ Black, AL Doug Price, PA Sharon Buchert, LA Dennis Dudley, AoA Heather Johnson-Lamarche, MA and VT Sandi Smith, FL Mike Oliver, MA Nancy Field, NJ Lou Ortiz, NJ Ross Grove, IL Deborah Fleming, WY Kelli Killian, AK Alicia Thomas, Lewin Christina Neill, Lewin Barbara Ettner, Lewin Sarah Lash, Lewin Introduction and Announcements Sharon Zeruld The purpose of this call is for grantees to exchange information about strategies taken to expand the ADRC program and specifically, their processes for selecting expansion sites. Grantees are asked to discuss the state role in ADRC program expansion, the role of partners, and the part that the initial pilot site(s) have played, if any. Also, participants are encouraged to address how quality and performance have been incorporated into expansion activities. Louisiana. The Louisiana ADRC project began in 2003 in Lafayette, LA. This site was chosen because it was a strong player in the statewide prescription assistance program for seniors. In addition, it s located mid-state so it s a good central place to have meetings. This grantee was picky about selecting who would be a part of our advisory board and suggested the involvement of a lot of legislators. Currently, that involvement is benefiting them; a bill has been introduced that incorporates ADRCs into the Senior Rx program. This has just passed the House and is expected to pass in the state Senate next week. After the hurricanes, this grantee was able to use disaster relief money to open up more sites and currently have three in total. They hope to be statewide in the coming year through the addition of nine sites for Senior Rx. Most of those sites are Area Agencies on Aging. The new ADRC sites will be evaluated and given funding according to their performance. These performance measures include the number of calls answered, the percentage of those calls from individuals in certain age groups, the number of unduplicated clients served, the help given, and certain referrals. They are also tracking the number of providers that are educated by their local ADRCs. With the performance evaluation, each site has to do well or they ll lose their funding. To get the attention of legislators, they compared the number of clients served in the Louisiana Answers service area with the number of clients served in a given representative s district. In an area of 9 parishes, Louisiana Answers was able to achieve $15 million in prescription drug 6/19/2007 1

2 savings for thousands of clients compared to $10 million in savings achieved by a non-adrc Senior Rx program with twice the geographic area. This lights a fire beneath the state representatives because each one wants to serve their constituency better. Each program has its own regional advisory board. Stakeholders such as hospitals, disability advocates, physicians, and others are involved. Regional boards ensure that those involved have a stake in that program in that region, since there is a lot of variability across the state. Q: How do you assure standard operating procedures? We rely on standards in reporting. We have lists of what the clients are calling to request. That information varies by region, especially in the south where we re involved with hurricane recovery and preparedness. Sites keep track of what sort of help they re giving and submit monthly reports. We ll use that information to generate quarterly reports for legislators. We will have a letter sent to them that highlights activities of the quarter and on the back of the page we ll lay out the year-to-date statistics. We have had some difficulty getting legislators personally involved. They love to be on the Advisory Board in name, but a lot of times they ll send someone from their staff to meetings. Usually they re kind enough to send refreshments too. We appreciate it and we know that we re on their radar screen. In the past we ve held media training events about ADRC issues and the legislators have great attendance then because they like to go on TV and talk about themselves and their region. Q: What are some of your protocols? We return all calls within 24 hours unless it s a holiday. When a client calls, someone answers the phone. If they happen to call in after hours, they have the option to leave a message and a staff person will call them back the next day. Pennsylvania. This grantee is undergoing new site selection in Pennsylvania. They have a committee of state program staff and are involved with disability partners. They have the two existing pilot sites and are using the operating guidelines that these sites have developed, but the grantee will be moving to a more decentralized model which will necessitate changes. The local pilots have looked at their operational policies and determined what has worked best, gathering input from local advisory committees. This grantee has leveraged Massachusetts Interest Survey to see what other agencies in the state might be interested in becoming ADRCs. They are adapting this survey to develop their own version to fit Pennsylvania s program. It s currently going through comments, but the grantee will share it with Lewin in its final version. Massachusetts. As a follow-up to the Interest Survey, this grantee has compiled a formal Readiness Assessment to gauge the availability and interest of sites in a non-threatening way. They preceded the Readiness Assessment survey with a meeting to prime those involved and make it clear that this was the next step. Staff at the pilot site level helpfully suggested that the 6/19/2007 2

3 state send out the Readiness Assessment as questions to guide conversation. One region took it quite seriously and has been meeting monthly since they received it and is preparing a formal response. This Readiness Assessment will also be shared with Lewin. Florida. Florida is unique in that the state legislature has required that all AAAs transition to Aging Resource Centers. As part of these activities, they have developed a readiness review and a timeline for operation. This grantee currently has three pilot programs and the other 8 AAAs are expected to transition to ARCs over the coming months. They will select four AAAs in July to have programs implemented in September and the remaining four will be selected in September to be operational by December. The current sites are assisting the others with technical assistance and developing transition plans. They have also hosted meetings to advise and assist their colleagues. New Jersey. This grantee has two pilot counties and will be expanding to another five. Prior to selecting those five, they examined the Massachusetts and Florida tools and developed their own Readiness Self-Assessment. It was first presented and distributed at the AAA Directors Meeting along with a presentation about ADRC models and expectations. New Jersey s Readiness Self-Assessment takes into account political leadership, local advisory council capabilities, the AAA structure of project management, partnerships with entities like and Centers for Independent Living, organizational capacity, and MIS systems. The factors are rated into the categories of: Achieved, Partially Achieved, and Not Achieved. Six or seven AAAs came forward initially and through this process, two identified that they re not ready yet. It was reportedly good for everyone to be able to see their strengths and weaknesses. A list of interview-type questions helps stakeholders think about how ADRC involvement could be a change agent. Q: Our ADRC program (in WY) isn t based out of AAAs. Are there any states doing an expansion without a single agency behind the effort? NJ: When we first started, one of our concerns was that our Area Agencies on Aging might not be interested. In that case, other nonprofits could step up, like Independent Living branch offices. But, New Jersey s CILs have different funding streams. They re not in every county and they don t consider themselves to be service providers. They are advocacy and support organizations, more of a guide to resources for people with disabilities. AK: All five of our ADRCs are Centers for Independent Living. The state variation in CILs is similar to what NJ described. We partner with other agencies for trainings, like the Older Persons Action Group. The CILs collaborate to create these opportunities. 6/19/2007 3

4 Q: How does that impact expansion? AK: We like to say that our ADRC is already statewide, since we have five regional centers. However, Alaska is large and we could use a few more sites to reach the remote areas of the state. The Assistive Technology Resource Center reaches the entire state through the Centers for Independent Living right now. Q: CILs are funded at a much lower level than agencies that have Older Americans Act funds. What will happen to the Alaska ADRCs when the AoA grant money ends? CILs often struggle with resources and capacity do you have other sources of funding in mind? AK: We hope that the state will pick up the project and provide funding. We have developed a pre-screening tool for the state and CILs to save time and money. But you re right, some CILs are only really funded by ADRC grant money right now. Q: How many states have statewide ADRC programs right now? Lewin: There are 7 states that have achieved statewide ADRC coverage: AK, Guam, IA, MN, NH, NM, and RI. Of these, AK, Guam, NH and RI have multiple physical ADRCs around the state serving regions or counties. IA, MN, and NM are using centrally located call centers and/or websites as a hub for ADRC services statewide. In addition to their statewide call centers, NM and MN also have physical pilot sites in at least one place in the state. Three more states (KY, LA and VA) expect to achieve statewide coverage in the next year to 18 months by opening multiple ADRC sites around the state that will serve regions or counties. FL also plans to have Aging Resource Centers (ARCs) statewide by the end of Q: What other standards have grantees developed? Lewin: Maryland is issuing a RFP to solicit proposals for new sites, and other states may find this a helpful resource with respect to standards. This information will be posted on the ADRC-TAE website when it becomes available. New York is not an ADRC state, but they have a single entry point system called NY Connects. The standards for becoming a site in that system are already posted on the ADRC-TAE website. Discussion of Lewin s Readiness Assessment tool. Barbara Ettner, Lewin: We have been working on a Readiness Assessment tool here at Lewin. We want to develop a web-based application so potential organizations can assess their capacity to perform the core functions of the ADRC. The tool could be used by organizations that are positioning themselves to become ADRCs, used by beginning ADRCs, or used by potential partners. Such a tool could help provide guidance and consistency across locations. The tool will be generic but comprehensive, easy to use, and able to provide immediate feedback to the user. 6/19/2007 4

5 We have a compendium of questions pulled from already developed tools, surveys, RFPs, and other documents. The questions in the final tool will address 8 core domain areas. The tool will also gather user information that can customize the questions based on who is completing the question and what their state s needs are. 6/19/2007 5