Illinois Governor's Conference on Aging
Jean Wood
December 11, 2013
Overview of Presentation
•
•
•
•
•
State System Overview
Older Americans Act Services
Managed Care and Health Care Reform
Adult Protective Services
Minnesota’s Aging and Disability Resource
Center
MN Department of Human Services –
Continuing Care Administration
Continuing Care
Assistant
Commissioner
Aging and Adult
Services
Elderly Waiver
Alternative Care
Older
Americans Act
Nursing Facility
Rates and
Policy
Aging 2030
Disability
Services
MN’s Long-Term Services and Supports System
A continuum of services
Older
Alternative Elderly
Americans Care
Waiver
Act
Nursing
Home
66,000
27,000
4,700
31,000
Increasing Need
Percent of total public LTSS funds for
older adults – HCBS vs. institution
EW and AC Impact
• More older adults receive services in Minnesota’s long-term care
programs in their homes instead of going to institutions. In 2007,
almost 58% of older adults in LTC received HCBS. By 2011, the
overall percentage increased to 64.3%.
• The percent of older adults in Minnesota’s that receive HCBS in their
own homes has increased. In 2007, 74.2% of older adults received
services in their own home. By 2011, the percent had increased to
75.4%.
• The percent of older adults with high needs in Minnesota’s on EW or
AC has been increasing. In 2007, almost 60% of older adults with
high needs received services through EW or AC in their own home.
By 2011, the percent was 63.9%.
Minnesota Board on Aging
• Separate state agency
• 25 member governor appointed board
• Administers $24 million in federal funds; $8 million in
state funds; $20 million in local funds and resources
• Designates a statewide network of Area Agencies on
Aging
• Direct service programs:
– Senior LinkAge Line®
– Long-Term Care Ombudsman Program
MN Aging Service Providers
•
•
•
•
•
•
•
•
Nutrition Services: 13
Homemaker: 10
Chore: 33
Transportation: 17
Legal Assistance: 8
Health Promotion: 20
Caregiver Respite: 31
Caregiver Consultation/Training & Education: 20
MN Aging Network
Service
People Served
(FFY 2012)
Congregate Meals
Home Delivered Meals
Chore
49,983
11,383
3,633
Homemaker
Assisted Transportation
Health Promotion
Caregiver Respite
1,296
969
2,933
730
Caregiver
2,685
Consultation/Training & Ed
MN Aging Network Impact
Increase the percent of Title 3 program participants who have
incomes 100-200% FPL to 10% greater than the percent of all MN
older adults at this income level.
MN NAPIS CY2012 Baseline* MN 2010
Census 65+
Population
IIIB 44.14% (n=5,303)
27%
IIIC1 52.73% (n=29,942)
IIIC2 52.54% (n=7,149)
IIIE 47.07% (n=597)
Goal
37%
MN Aging Network Impact
Increase the percent of senior nutrition program participants who
have a high nutrition risk score.
MN NAPIS CY2012
Baseline
Congregate 37.4%
AoA National FFY2011
Comparison
Congregate 19.1%
Home Delivered 68.4%
Home Delivered 51.9%
MN Aging Network Impact
Average number of units per participant that is equal to or greater
than AoA national average.
Congregate
Meals
Home Delivered
Meals
Homemaker
Chore
Assisted
Transportation
Average Units per Participant
MN NAPIS FFY 2011 AoA National
Baseline
FFY2011 Comparison
36.1*
51.4
94.0*
163.3
22.5
27.7
14.9
83.0
37.8
34.4
Role of Managed Care
• Older adults eligible for Medicaid have been required
to enroll in Medicaid managed care since 1983:
Minnesota Senior Health Options (MSHO).
• Currently, 92% of EW participants receive their
services through a managed care organization.
• MSHO integrates Medicare and Medicaid primary,
acute, drugs, home care and other long-term services
and supports as well as Elderly Waiver services the
first 180 days of care in a nursing facility.
Health Care Reform in Minnesota
Connecting health care homes with LTSS
• State certification for health care homes
• CMS Multi-payer Advanced Primary Care Initiative
• ACL Integrated Systems Grant
Developing total cost of care models
• Pioneer ACOs
• Medicaid Health Care Delivery System Demos
Bringing it to Scale
• CMS State Innovation Model Grant
– Accountable Communities for Health
Adult Protective Services in Minnesota
State Policy
• Protect Vulnerable Adults (VA): Safe Services and
Environments
• Defines: Vulnerable Adult/Maltreatment
• Reporting: Required/Encouraged
• Appropriate Cases: Investigation and Protective
Services
30,000+ Reports of
Suspected
Maltreatment of VA
2012
Adult Protective Services in
Minnesota
Lead Investigative
Agencies
Responsible for
Reports:
45% MDH
41% County
14% DHS
Law Enforcement:
Crime Alleged
County: Immediate
Protective Services
Adult Protective Services in Minnesota
Reform 2020: Enhance VA Protections
• State Maltreatment Report Center under DHS
• Web Reporting
• Adult Protection Resource Specialist Staff
• County Grants
• Public Awareness Campaign
Adult Protective Services in Minnesota
Structured Decision Making (SDM) Tool
• 2013 Mandated State-Wide Use
• Minnesota Board on Aging Grant
• All Reports of Suspected Maltreatment Where
County Responsible
• Establishes Consistency in Assessment and Service
to VA’s
Minnesota’s Aging and Disability
Resource Center (ADRC)
Background: Senior LinkAge Line®
Evolving the Service
• MN Board on Aging decision – AAAs
• Statewide uniformity
– Single Brand
– One statewide toll free number
– Upgraded phone system to zip code routing
and then later prefix routing
– Desktop Client tracking system
– Staff training
– Marketing and outreach
20
Minnesota’s ADRC
Making the Shift to a Fully Integrated
System
• It Started in 1999 with a small prescription drug program
• Establish a Comprehensive Statewide Service in 2001 to
prepare for aging of boomers
– Move to a system that does “Information and Assistance” –
not I and R
• Longer Calls
• Higher levels of credentialing of staff
– Development “niche areas” or specialties that fill the gaps
• Helped with Medicare Part D in 2005
• And Now: Care Transitions
Minnesota’s ADRC
But the real keys to our success:
• Branding. Branding. Branding.
• A People not Programs Philosophy which means simplifications
and streamlining for the consumer (not for the programs,
government etc)
• Thinking in a flexible and agile manner and sticking with our
core values
– Be relevant
– Be accessible
– Be ready when the student arrives
• Thinking like a single unit not 7 state units with seven area
agencies – we are one to the consumer
Minnesota’s ADRC
Branding! Branding! Branding!
Minnesota’s ADRC
Branding! Branding! Branding!
• Minnesota Aging and Disability Resource Center
• No wrong door approach
• Four Channels!
–
–
–
–
Phone
Internet
In person/face-to-face assistance
Print
Minnesota’s ADRC
Senior LinkAge Line® 1-800-333-2433
•
•
•
•
•
•
•
•
•
Long Term Care Options Counseling
Transition assistance for private pay nursing home residents
Medicare and other health insurance counseling
Prescription drug expense assistance for all ages
Application and forms assistance
Long Term Care Partnership (2006)
Caregiver planning and support
Health care waste, fraud and abuse
One Stop: State agency related questions, connections to volunteer
opportunities and older workers (Spring 2013)
Minnesota’s ADRC
Disability Linkage Line® 1-866-333-2466
•
•
•
•
•
•
•
•
Disability Benefits
Accessibility/Modifications
Assistive Technology
PCA Services
Transition Services
Accessible Housing
Employment
Awareness/Rights
Minnesota’s ADRC
Veterans Linkage Line™ 1-866-333-2466
•
•
•
•
•
•
•
•
•
•
Veterans Benefits Assistance
Reintegration challenges and referrals
Reintegration with family life
Household finance management
Assistance with mental health and stress disorders
Understanding, maintaining and transferring among benefits
Substance abuse referrals
Housing and homelessness
Job seeking and employment counseling
Understanding education or retraining benefits and options
MinnesotaHelp
Network™
Contact Center
Locations
Minnesota’s ADRC
• Simplified, “Google-style” search capabilities
with a power user version
• Search for services statewide or locally by topic
or keyword
• Save, print and email searches and plans
• Interactive decision support tools for aging,
youth and people with disabilities
• View results charted on a map
31
– Step-by-step
decision making
tool
– Interactive
– Easy to use
– Available at
Minnesotahelp.info
32
Minnesota’s ADRC
Disability Benefits 101 – DB101.org
DB101.org brings together:
•
•
•
benefits information
tools
resources
to make it easier to:
•
•
•
•
•
understand benefits
learn about work incentives
plan for work & set goals
build financial literacy
manage benefits while
working
Minnesota’s ADRC
A system designed to help YOU
…
–
–
–
–
34
easily understand benefits and work incentives
demonstrate to the people you serve how work can be a
solution
better engage people in work planning
• overcome fears and barriers
• explore work as an option
• make informed choices about work
• achieve better employment outcomes
have access to, use and provide consistent messaging and
resources
Minnesota’s ADRC
Print
•
30,000 printed annually
•
Distributed statewide by the Area
Agencies on Aging to Medicare
beneficiaries, caregivers, local
partners and sites
•
2013 – mailing of HCC done to
clinics, hospitals and health care
homes
Minnesota’s ADRC
What is the Return To Community
Initiative?
• Passed in 2009 by State Legislature and is based on research
conducted by the U of MN School of Public Health & the
Indiana University Center for Aging Research which can be
found at this link:
– http://www.dhs.state.mn.us/main/dhs16_148973
• Utilizes the MinnesotaHelp Network™ which includes the
LinkAge Lines (Senior, Disability and Veterans), the website
MinnesotaHelp.info®, and in-person assistance through Senior
LinkAge Line staff and volunteers.
Minnesota’s ADRC
Why is this service important?
• It focuses on private pay individuals
– Assumption is assistance to transition home but then
ongoing follow up in the community will help people
avoid spend down
• Intensive follow-up services are available for people
assisted out of the nursing home
– Also available for those we don’t specifically assist
but who naturally discharge as they are a target
group for follow in the assumptions
• The effort is being evaluated under an AHRQ (Agency
for HealthCare Research and Quality) grant by two
universities.
Minnesota’s ADRC
Experience to Date - Statewide
• Top 3 Referral Sources for CLS Assisted Discharges
– 43% Nursing Homes
– 38% MDS Profile List
– 6% MDS Section Q
• Over 988 consumers directly assisted by CLS who
discharged to community
• Over 900 consumers receiving follow-up in
community
Questions?
Jean Wood
Executive Director
651-431-2563
Jean.wood@state.mn.us