ADRC in Maryland Maryland Department of Aging Evaluator: Stephanie M. Lyon, Ph.D. Center for Health Program Development and Management University of Maryland, Baltimore County Posted 12/6/06

2 Maryland’s ADRC: October 2003 – September 2006  Administered by Department of Aging  Partners: Maryland Departments of Disabilities; Health and Mental Hygiene; Human Resources  Renamed Maryland Access Point (MAP)

3 Maryland Access Point Goals  Design and implement 2 single-entry- point pilot centers  Streamline access to eligibility and services  Establish statewide web-based information system

4 Components of MAP: Development and Implementation of an ADRC  Establish operational components  Build coalitions  Determine policy barriers/changes needed  Develop & implement evaluation plan  Develop & implement pilot centers; streamlined eligibility; statewide web-based information system

5 Strategies for Measuring the Success of MAP  Reviewed ADRC guidelines & data requirements  Consulted with state & pilot staff, Advisory Board, Evaluation Committee, Lewin Group (technical assistance contractor)  Developed evaluation plan  Utilize evaluation data to inform decisions – on-going!

6 Strategies for Measuring the Success of MAP Cont.  Monitoring Development & Implementation Semi-Annual Narrative Reports to AoA/CMS Survey of state & pilot center Advisory Boards Interviews with key stakeholders

7 Strategies for Measuring the Success of MAP Cont.  Measuring Outcomes Semi-Annual Report data from pilot centers Consumer satisfaction survey Survey of Advisory Boards Interviews with key stakeholders Data from pilot centers Medicaid data

8 Semi-Annual Reports  Narratives updated every 6 months Information & referral/marketing Information technology Consumers/staffing Streamlining Critical pathways Project sustainability

9 Semi-Annual Reports Cont.  Pilot center information about partners, contacts, operating organization, service area/budget, staffing, consumer satisfaction  Pilot center utilization data

10 Survey of State & Pilot Center Advisory Board Members  Methodology Brief instrument completed online or mailed March sent to all state & pilot center Advisory Board members No personal identifying information collected Data entered electronically and analyzed 66 surveys sent; 46 (70%) completed; most online

11 Survey of State & Pilot Center Advisory Board Members Cont.  Findings 53% strongly agreed/agreed that goals would be achieved at state level 85% strongly agreed/agreed that goals would be achieved at pilot center level 74% feel Advisory Board represents MAP constituencies

12 Key Stakeholder Interviews  Methodology Stakeholder groups  State/pilot providers & critical pathways  Pilot center staff  State/pilot managers & partner agencies Instruments developed for each group March – June 2006: 48 interviews conducted by student intern Interview notes reviewed & report prepared

13 Key Stakeholder Interviews Cont.  Findings: Accomplishments 2 pilot centers implemented & operating efficiently Facilitated collaborations for systems change & streamlining at state level Success securing funds to sustain MAP

14 Key Stakeholder Interviews Cont.  Findings: Issues Encountered Differential timing of state & pilot activities Difficulties building collaboration Lags in streamlining access & systems change Tensions between disability & aging constituencies Lack of services

15 Key Stakeholder Interviews Cont.  Stakeholder Recommendations Enhance executive leadership at state level Increase collaboration between agencies & between state & pilot centers Expand to include all ages & disabilities Increase marketing & outreach

16 Consumer Satisfaction Survey  Methodology: Short, Timely, Easy to Return Institutional Review Board approval 1-page instrument developed & pilot tested Implemented March 2005 & on-going Weekly sample selected from pilot lists Survey, cover letter, stamped return envelope mailed; internet option available

17 Consumer Satisfaction Survey Cont.  Methodology cont. No personal identifying information Data entered & reported to state & pilot centers, stakeholders, funding agencies 494 surveys (24% of surveys mailed) completed through September 2006 Most surveys returned by mail (not internet)

18 Consumer Satisfaction Survey Cont.  Findings 22% of consumers age 50-64; 73% % contacted MAP for themselves; 33% for someone else 17% requested help for disability-related services 83%-99% positive responses about quality of MAP MAP service timely & information useful 15 said the service needed was not available

19 Pilot Center & Medicaid Data  Provides Demographics & Type of Assistance Requested by Age  Developed format for submission to state  Submitted quarterly or as requested  Medicaid service utilization data for pilot counties available

20 The Case for Continuation  Consumer satisfaction and program data presented to State legislators  Presentations to agencies & other stakeholders  Proposal for continuation to AoA  Results: $250,000 from Governor & Legislature; $400,000 from AoA for 2-year continuation  Goals for next 2 years Implement statewide web-based information system Expand MAP to 4 new centers

21 Evaluation Activities: The Next Two Years  Semi-Annual Reports  Continue survey of consumer satisfaction  Baseline & utilization data from current and new centers  Develop methodology to measure streamlining access  Evaluate web-based information system