Building Alliances For Safer
Communities
“What’s Working” Webinar
Multnomah County Aging & Disability Services
Gatekeeper Program
Presented by - Lynn Schemmer-Valleau
October 2, 2012
Upcoming Webinars
• OCTOBER 10: Volunteers Win – Area Agency on Aging for Northeastern
Vermont, St. Johnsbury, VT (Rural)
The Equal Exchange TimeBank, modeled after TimeBank USA, allows members
to post a need they seek to fill or search member posts to find qualified
volunteers. Volunteers bank their hours served, earning “time dollars” towards
a need they may have or to pass on to someone in need; everyone wins!
Register today at www.agingnetworkvolunteercollaborative.org!
• OCTOBER 11: Louisiana Senior Medicare Patrol – eQHealth Solutions, Baton
Rouge, LA (State)
This program used newspaper “Letters to the Editor” opportunities to inform
high functioning, civically engaged seniors about the Senior Medicare Patrol
program and to recruit them for our volunteer corps. The effort doubled the
number of volunteers.
Register today at www.agingnetworkvolunteercollaborative.org!
Webinar Instructions
•
Audio options
• Use your computer speakers, OR
• Dial in to the conference call
• All participants are muted
•
“Questions” box
• Q&A session will be at the end of
the presentation, but feel free to
submit your questions at any time
during the presentation. Click on
the “+” to pop out the questions
box where you can type and
submit your questions.
What we will be covering today:
 Overview of the Gatekeeper
 How to develop a programs in your community
 Key partners
 Identifying a “hub” and a lead agency
 Developing protocols
 Sharing of information with partners
 Engaging the business community
 Sustainability
Q&A
What is the Gatekeeper Program?
 It is an outreach effort to identify, refer, and
respond to at-risk older adults and people
with disabilities living in our community.
 Gatekeepers are trained:
to identify warning signs
 to call a Gatekeeper Referral number and report
their concerns
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Why does the Gatekeeper program exist?
Linking services with those most isolated in the
community is often not successful
There are a number of reasons why high-risk
older adults are unable, unwilling or resistant to
seeking assistance.
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Negative stigma associated with using “social services”
Pride and stoicism
Fear of losing control over their life.
Shame, suspicion or fear
Financial reasons
Mental health issues such as paranoia, memory loss, depression
Lack of information about what services are available or
assistance they may qualify for
Who are Gatekeepers?
Gatekeepers are nontraditional referral sources who
come into contact with older adults or adults with
disabilities through their everyday work or activities
and who are trained:
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to recognize warning signs and red flags that indicate
an older adult/adult with disabilities may need some
help/support
to report their concerns their local Gatekeeper
Program
The Gatekeeper Model is a great fit with an Aging &
Disability Resource Connection (ADRC)
Gatekeeper Structure Can Vary
Multnomah County Profile
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Housed in Type B Area Agency on
Aging (AAA)
Part of 24/7 ADRC/Helpline
Referrals assigned internally to APS
and case managers
Referrals also assigned to senior center
case managers
All referrals logged into new ADRC
call module and emailed to worker &
supervisor
Program been operational for 25 years
in Multnomah County
The Multnomah County Experience
 Ray Raschko develops the first Gatekeeper Program in
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Spokane (1978)
Human Solutions in Portland started a Gatekeeper
Program with three year grant, covering a geographic
area of the County (1987)
Due to success of the program, absorbed by local AAA
and expanded county-wide (1990)
Celebrated 25 Year Anniversary (2012)
Received Award funding from The Aging Network’s
Volunteer Collaborative under the “What’s Working–
Effective Practices” program (2012)
Gatekeeper Referrals in
Multnomah County FY11/12
 395 daytime
Gatekeeper referrals
received from the
community:
66% of the Gatekeeper
calls were referred to Adult
Protective Services
 49% of the calls were for
people who were NOT
already receiving services
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Gatekeeper Referrals By Industry
 Utility Companies
 Police/Fire/Rescue
 Social Service Agencies
 Anonymous
30%
15%
11%
10%
7%
 Banks/Credit Unions
 The balance of referrals (27%) come from letter
carriers, faith communities, housing managers,
transportation providers, concerned neighbors, etc.
Gatekeepers are trained to recognize warning signs,
red flags and other reasons to
make a referral
Any change in normal
routine is critical.
Typical areas of potential warning
signs are discussed during a training:
 Communication
 Financial
 Caregiver Stress
 Social Isolation
 Emotional Health
 Appearance of the
Person
 Physical Limitations
Warning signs for people in the field are also
covered
 Home needs repair
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and/or is inaccessible
Mail stacked up, old
newspapers laying
around
Strong odors on person
and/or in home
Yard overgrown and
neglected
Pets neglected and/or
too many pets
What information should
Gatekeepers report?
 Customer’s name
 Date of birth or age, if known or
approximate
 Address
 Telephone number
 A brief description of concerns,
observations, what the customer
has self-reported or disclosed
 Gatekeeper’s contact information
Anonymity and Confidentiality
This topic is covered during a training. It is
an important protocol to address as you are
developing your Gatekeeper Program.
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Anonymous: Gatekeeper’s name will not be tied to
the report or shared– total anonymity
Confidentiality: Gatekeeper’s name will be kept
private to the client, alleged victim, alleged
perpetrator, etc but will be on the report for follow
up as needed
After the referral is made…what
are some things we can do to help?
 It will be very important to develop a
simple and varied list of potential
“next steps” and ways that your
Gatekeeper Program will follow up
once a Gatekeeper has called to make
a referral.
 Gatekeepers always want to know
“now what?”
Client Choice
Gatekeepers become concerned when they think that
the person did not get help…we are not charged
with “solving the problem”. It is important to cover
the topic of Client Choice with Gatekeepers.
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As an agency we value client choice
We follow up on EVERY gatekeeper referral that is made
Does everyone gets help or gets their “issue” resolved? -NO, they don’t
Not everyone WANTS help.
What else Gatekeepers do to help?
•Donate money – we receive donations
through United Way’s Employee Giving
Campaign
•Donate time – some Gatekeepers enjoy
volunteering for a community agency
•Donate resources – Gatekeeper
organizations provide in-kind resources like
printing or sponsor holiday gift drives
Key Elements of a Gatekeeper Program
 Identification of partners
 Establishing a lead agency and a hub
 Having memorandum of understanding or a
working agreement with partners
 Development of protocols & triage
techniques
 Mechanisms for sharing information
Identification of partners
Discuss with key leaders from community.
Interested parties generally include:
•Utility Companies
•Police/Fire/Rescue
•Support Programs
•Banks/Credit Unions
•Letter Carriers
•Housing
•Transportation
Can you think of a group in your community?
Establishing a Lead Agency
& a Hub
 Area Agency on Aging
 ADRC is a great a hub
 Law Enforcement
 Community Non Profit
 Older Adult Mental Health Agency
 A combined response
 Lead Agency can partner with another agency
for support like training
Memorandum of understanding or
working agreement with partners
 Adult Protective Services
 Medicaid
 Senior Centers
 Advocacy Groups
 Senior Corps RSVP Program
 Mental Health
 Developmental Disabilities
Protocols and triage techniques and
sharing information
 It is important to know how calls will be
handled. Some considerations are:
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Will there be a home visit?
What is response time?
What do you do with after hours calls?
How are calls documented and shared?
What information is shared with Gatekeepers?
How do your protocols fit with your agency’s
confidentiality protocols?
How do you ensure consumers don’t “slip through
the cracks”?
Protocols and triage techniques
 Identify the client– are they already being
served? If so  connect with their case
manager
 Where can new referrals (people
who are not in the system and
don’t have a case manager) be sent?
 Is this an APS issue?
 Is this a mental health crisis issue?
 Is this an urgent issue/imminent danger? 911?
Consideration for sharing information
 How will the various groups share
information?
Is email secure/confidential?
 Is there a call module with consistent format?
 Are there back up procedures to ensure that the
recipient is not out of the office and the referral
sits for several days until their return?
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Mechanisms for sharing information
 Sharing with PARTNERS
 Internal methodology for sharing
 Sharing with external partners
 Secure emails/HIPAA considerations
 Share with mental health call center
 Determine who you will need to share info with
and how it will occur with follow up loop
Mechanisms for sharing information
 Sharing with the Gatekeeper
 What can you share back with the Gatekeeper?
 When is it ok to share follow up information
with the Gatekeeper?
Must consider client confidentiality
Why this program is important to the
business community
 Helps customers achieve a better outcome
 Good public/partnership to support consumer
 Business wants to help but goes beyond their
scope of work
 Peace of mind that consumer will get some
follow up
 Gatekeeper referrals are welcomed – not seen as
a “complaintant”
 Able to provide good customer support while
also managing business
Gatekeeper Program Sustainability
 Identify start up and on-going funding;
grants, reallocate existing resources,
business community support, etc.
 Important to have a designated
coordinator for the program
 Regularly communicate your successes
 Engage your local elected officials
Questions or Comments?
Lynn Schemmer-Valleau
lynn.schemmer-valleau@multco.us
Upcoming Webinars
• OCTOBER 10: Volunteers Win – Area Agency on Aging for Northeastern
Vermont, St. Johnsbury, VT (Rural)
The Equal Exchange TimeBank, modeled after TimeBank USA, allows members
to post a need they seek to fill or search member posts to find qualified
volunteers. Volunteers bank their hours served, earning “time dollars” towards
a need they may have or to pass on to someone in need; everyone wins!
Register today at www.agingnetworkvolunteercollaborative.org!
• OCTOBER 11: Louisiana Senior Medicare Patrol – eQHealth Solutions, Baton
Rouge, LA (State)
This program used newspaper “Letters to the Editor” opportunities to inform
high functioning, civically engaged seniors about the Senior Medicare Patrol
program and to recruit them for our volunteer corps. The effort doubled the
number of volunteers.
Register today at www.agingnetworkvolunteercollaborative.org!