Creating Choices to Support Independence: A Consumer-Centered Approach to Long Term Care 2007 Annual Long Term Care Ombudsman Training Institute October 18, 2007

What is NY Connects? A statewide initiative that supports the development of county level, consumer–oriented entry points for information about long term care and linkages to services that assist individuals of all ages with long term care needs

Goals of NY Connects  Streamline access to information and assistance about long term care services and supports  Reduce fragmentation within service delivery  Empower individuals to make informed choices

Elements of NY Connects A trusted resource for information and assistance For Whom: Public and Private Pay consumers Older adults and people of all ages with disabilities Where and How: Connected with the community Call center, on site locations, off-site consumer visits, website Users: Consumers, caregivers and helping professionals

NY Connects Core Functions  Information and Assistance  Screening  Public Education

Local Systems Change Long Term Care Councils Purpose community assessment to determine services that are available in the county gap analysis figuring out solutions that will foster seamlessness making system recommendations for a consumer-centered long term care system

Why Do We Need NY Connects?

Changing Demographics – Aging of the Baby Boomers in NY  NY’s general population expected to grow 3 percent between 2000 and 2015 Compare to…… Expected growth:  85+ population 56.0 %  Minority elders 51.0 %  Older adults with 17.1% impairments

56% 51% 17% 3% 0% 10% 20 % 30% 40% 50% 60% Aged 85+ Minority Impaired Total Population NYS Aging and Impairment: Rate of Growth Projected Growth in Population and Vulnerable Elderly Cohorts

The Long Term Care Maze Welcome to Long Term Care

2000 Behavioral Risk Factor Surveillance System BRFSS)

National Directions  New Freedom Initiatives 43 States and territories have Aging and Disability Resource Centers (ADRCs) designed to streamline access to long term care  Real Choice Systems Change Grants for Community Living Designed to help states and territories “rebalance” their long term care support programs to help people with disabilities or chronic illnesses to reside in their homes and participate fully in community life

Shifting/Changing Long Term Care System  Early intervention and prevention orientation  Recognition of non-medical in addition to medical needs  Efforts to divert nursing home placements through identification of predictors of placements  Increase in home and community-based care  Collective partnerships amongst agencies and organizations  Increase in focus on consumer engagement and empowerment

State Medicaid Spending on Home-Based Long Term Care 49 – 70% 38 – 44% 37% (US Avg) 30 – 36% 23 – 29% 13%

Importance of Informal Caregivers  80 percent of individuals 65+ with impairments in NY receive care from family/informal caregivers.  4X the care provided by NY’s formal long term care service programs!  NYSOFA established the Family Caregiver Council

The Cost of Doing Nothing.... If we do nothing.... The system will continue to be fragmented, contributing to sky rocketing costs. Within 10 years, the system will become unaffordable and unsustainable!

NYSOFA and NYSDOH’s VISION The two agencies envisioned a system for individuals with long term care needs that:  Minimizes confusion  Supports informed decision making and enhances choice  Improve quality of life through early intervention and prevention  Help consumers identify appropriate levels of care to prevent institutional care RFA released in May 2006.

Fully Executed Contract Developed, Not Fully Executed Not Applying NY Connects Status 57 Contracts have been developed 56 Contracts have been fully executed Madison pending Oswego did not apply yet

Standard Elements of NY Connects across the State Information, Assistance and Screening  Provides a comprehensive resource listing  Provides unbiased consumer choice  Provides necessary follow-up Public Education  Is recognizable in the community LTCC  Works toward local change

Provision of Information and Assistance  Based on 3 rd quarter data, 50% reported that they are providing I and A on long term care options.

Project Planning Teams in Place  Planning teams comprised of local government, stakeholders and providers have been established in all counties.  Many counties report active planning teams.

the Long Term Care Council  Expedites referrals, access and navigation through the LTC system  Enhances knowledge about all LTC services and programs  Provides creative solutions for “hard to serve” consumers  Provides an all-inclusive representation that leads to a broader view of the LTC system  Promotes systems reform and local problem solving

Local Elected Official Support Obtained  Counties reached out to local elected officials through informational presentations, kick-off events, and invitations to LTCC meetings  Counties with support from legislature report more seamless implementation process

Relationships with New Partners Collaboration with outside agencies Hospitals and nursing homes Independent Living Centers Early Intervention 2-1-1

Public Education Begins  TV ads for NY Connects  Worked with a college intern to develop NY Connects materials and used a 6 th grade class to pilot test materials  Development of promotional items

Addressing Inefficiencies in System  Efficiencies and better use of case management staff  DSS caseworkers freed up to do more casework

Improved Collaboration between Counties  County planning teams have traveled to meet with NY Connects staff in other counties  Peer to peer meetings  Expedites innovative practice

Increased Knowledge of Current Service Availability  Gaps analyses  Increased knowledge of their long term care system through cross training of staff  Lessons learned across aging and disabilities populations

Contact Information Stacey Agnello, Supervisor - NY Connects Center for Human Services Development, SUNY Research Foundation New York State Office for the Aging (518)