SESSION II: Planning and Implementation Plan, Do, Study, Act! The nuts and bolts of launching and building a successful program Gatekeeper state-wide expansion and implementation

Your presenters today Paul Iarrobino Multnomah County Aging & Disability Services Lynn Schemmer-Valleau Multnomah County Aging & Disability Services

Check List for Your Work Plan Key partners-- both internal and external Implementation of an Advisory Council Discussion and decision about structure of the program– identify the Hub, etc. Coordinator position– position description, budget considerations, target hire date, etc Develop an outreach/training plan Develop training materials Plan for program evaluation P lan D o S tudy A ct

Implementing Plan Do Study Act into your roll out of the Gatekeeper Program in your community Plan-Do-Study-Act (PDSA), is an interactive, four-stage problem-solving model used for accelerating change or improving a process. When using the PDSA cycle, it's important to include internal and external customers; they can provide feedback about what works and what doesn't.

Key Partners Identify key internal or community partners Interested parties could include: Adult Protective Services Mental Health Developmental Disabilities APD staff Centers for Independent Living Senior Centers Community Advocates 211 What types of MOU’s or agreements will you need to effectively implement your Gatekeeper program?

Example of a Memorandum of Understanding Example of a MOU with Mental Health

Example of a Memorandum of Understanding Example of a MOU with 211

Advisory Council Members Who are stakeholders in your community? Action Items for the Advisory Council Who will be the point person for trouble shooting problems and bringing together all parties? What will be the process for taking Gatekeeper calls? How will data be tracked? Who will be responsible for follow up? Who will train Gatekeepers?  Implementation of an Advisory Council

Determine Structure of the Program ADRC AAA Centers for Independent Living Advisory Council Senior Centers Option Counselors Adult Protective Services Gatekeepers Case Managers

Coordinator Position Create a position description Budget considerations, FTE status– is there a way to connect this position with other planned training efforts or community outreach activities? Are there other resources that can be leveraged? i.e. build relationship with APS for co-presentations Recruitment-- qualifications, skills and abilities  Volunteer management experience  Public speaking skills  Experience leading an advisory council  Experience with technology and various training platforms  Experience with adult learning principles Think about your program’s activities, outputs and outcomes. What goals will you set for the Coordinator to focus on?

Position Description Good examples of key elements for the Gatekeeper position

Develop an outreach/training plan Think about the “low hanging fruit” in your community– where would it make sense to start doing some training? Use key stakeholders and/or advisory council members as trial runs for presentations and to test the referral system you have set up Use the principles of Plan Do Study Act to further develop your structure and to improve your systems and processes

Develop training materials Brochure  Note: potential for sponsorship from local community for printing costs PowerPoint presentation Handouts Quarterly E-Newsletter Webinars YouTube training videos Train the trainer materials to develop a speaker’s bureau  Keep in mind, all presentations should have capability of being customized to fit the type of Gatekeeper organization you are presenting to.

Example of how training is customized based on industry Easy to customize simply by highlighting the industry

Example of how training is customized based on industry Another easy way to customize a slide…

Example of how training is customized based on industry Use case examples specific to the industry you are presenting to

Examples of one page documents highlighting industry specific Gatekeeper Referrals

Something to consider… Avoid jargon and acronyms when a Gatekeeper calls to make a referral.  Referring to the Gatekeeper as the “complainant” or throwing out a bunch of acronyms… “have you contacted APS?” “Have you checked resources with the ADRC?” “Is this a DV call?” Also avoid jargon and acronyms in your Gatekeeper materials and trainings.  i.e. Referring to AAA… huh? You can tow my car??? What’s an Area Agency on Aging??

Examples of various materials: Text for employee newsletter or church bulletin Do you know an elder in the community who is isolated, has no advocate and may need help or support? If so, please call the Gatekeeper Referral Line in Multnomah County: The Gatekeeper Program enables the local community to identify its own people in need of help. The elders who are referred to the program are the most isolated and have little or no support system to act in their behalf as they experience serious difficulties that compromise their ability to live independently. The role of the Gatekeeper is to simply recognize signs and symptoms that may indicate an older adult is in need of assistance or support and then to make the referral to the proper authorities—in this case, the Gatekeeper Referral Line for Multnomah County. For more information about the Gatekeeper Program, to schedule training or to receive the quarterly newsletter via , contact the Multnomah County Gatekeeper Coordinator at

Examples of various materials: Quarterly newsletter

Examples of various materials: News Release

Examples of various materials: Brochure

Examples of various materials: Poster for employee break room

Plan for program evaluation How will you measure success? Think about your program’s activities, outputs and outcomes Determine what data you are going to collect and how you are going to collect/track it  Trainings/presentations  How many did you do?  How many did your community partners/Gatekeeper Champions do?  How many did volunteers in your speaker’s bureau do?  How many Gatekeeper referrals (RTZ call module)  Where did the referrals come from (industry type)?  How many were issues for APS?  How many were “new” to you… (isolated, not receiving any services/support)?

Examples of various materials: Post training evaluation

Tracking community presentations and training This includes Gatekeeper trainings

Using Data from RTZ to track Gatekeeper Referrals Shows the source of the Gatekeeper referral (pulled from RTZ) and then grouped by industry type

Example of Plan Do Study Act Even though our program is well established there is always room for improvement! Problem: We have two senior centers that share a zip code. The assignment of referrals (including Gatekeeper referrals) for either provider were based on census tract data. The boundary maps were confusing, and with new addresses being added, this caused even greater confusion. There was confusion for ADRC staff as well as the impacted senior centers and other centers and APD offices.

Plan Do Study Act Solution: All parties were in agreement that the policy was confusing and it sometimes caused delay in clients being served. Steps taken:  Met as a consortium to discuss possible solutions.  Proposed assigning new referrals to one agency for each shared zip code. Centers had the ability to reassign after referral was received based on proximity to other assigned cases.  Since there was potential financial impact, the Directors of each agency were consulted and they agreed.  Piloted the change and it was well received. The stakeholders determined there was no need to change this policy any further.

Document to clarify zip code referral issue

Plan Do Study Act Who is responsible for follow up for Gatekeeper referrals? Issue was reviewed and determined to be confusion and barrier to services Met with involved parties to brainstorm ideas for solution Tried out one of the suggestions Success! Clearer understanding of who is to follow up based on geographic boundaries Plan Do Study Act

How to access Gatekeeper materials with the State Unit on Aging On the State Unit on Aging web page  Click on “Gatekeeper Program” on the right side of the page  Scroll down and you will find various resources that have been posted OR  Under “latest news” on the SUA page you will find a list of the latest and greatest that have been posted.

SUA Web Page Click on Gatekeeper Program

Q & A What questions do you have for Multnomah County? Paul Iarrobino Lynn Schemmer-Valleau

Coming soon to a webinar near you… Wednesday, March :00 AM Gatekeeper Sustainability How to build volunteers, provide recognition, develop media strategies & seek in-kind support & additional funding