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2. 9/29/2016 2 Objectives Talk about growth & progress of VD-HCBS Hear from the Chillicothe, Ohio VD-HCBS Program and, ► Experience with VA Choice implementation ► Veteran Directed Care Program Worker Registry ► Music & Memory Program Partnership Provide an Update on VA Choice Implementation and give you the opportunity to share on your progress Closing

3. 9/29/2016 3 VD-HCBS Growth

4. 9/29/2016 4 New & Growing VD-HCBS Sites New VD-HCBS Sites NE IA AAA – Iowa City VAMC Weber-Morgan AAA – Salt Lake City VAMC Mid-Carolina AAA – Fayetteville (NC) VAMC Purchase and Green River AAA – Marion VAMC Bear River AAA – Salt Lake City VAMC Nevada Aging & Disability Services – Las Vegas VAMC Triangle J AAA – Durham VAMC Growing VD-HCBS Sites ADRC of Broward County – Miami VAMC AAA SW IL – Marion VAMC Egyptian AAA – Marion VAMC Caddo AAA – Shreveport VAMC ADRC of Upper Peninsula – Iron Mountain and Milwaukee VAMC Mid-East AAA – St. Louis VAMC Merrimack, Hillsborough, Strafford, Rockingham Service Links – Manchester and White River Junction VAMC Central Texas ADRC – Temple VAMC Bay Aging – Richmond VAMC

5. 9/29/2016 5 Chillicothe (OH) VD-HCBS Vicky Abdella, R.N Director of Community Services Area Agency on Aging District 7, Inc. Keshia King Veteran-Directed Care Program Coordinator Chillicothe VA Medical Center

6. 9/29/2016 6 VA Choice Implementation: VA Internal Process Changes Notification of Veterans Notification/Education/Agreements with providers Transfer process Quick turn around and execution

7. 9/29/2016 7 VA Choice: Area Agency Internal Process Changes Depending on your program operation procedures fiscal changes and work with FMS Provider Agreement Submission & Acceptance Policy and Education Manual Changes for Area Agency staff, Veterans, and workers/providers in the program

8. 9/29/2016 8 Keys to Success with VA Choice & Possible Opportunities If you currently run a VD-HCBS work directly with your VA Coordinator to understand submission and discuss/decide any program changes For any other HCBS programs and VA Choice, Coordinator can direct you or talk with staff in Geriatrics and Extended Long Term Care Possible increases in program census in VD-HCBS

9. 9/29/2016 9 Worker Registries When do you need a registry? How the Chillicothe VA program developed a Worker Registry and why. The impact on your program and Veterans lives Challenges and Successes with the Registry

10. 9/29/2016 10 Assess Need for Registry, Why We Developed Unable to enroll Veterans Rural geography No sustainable or acceptable route to advertise for workers Difficult for public to understand self-directed programs AAA7 anticipated this issue and began working on the registry before program started

11. 9/29/2016 11 Where/How to Start: Our Experience Used published Medicaid Worker Registries from other self-directed programs in the state Traditional Providers Word of Mouth Work Experience Programs in the State Local College/Technical School postings VA Home Based primary Care team Churches Social media

12. 9/29/2016 12 AAA7 Worker Registry Word Document per county we serve ( currently 11) List name and phone number Includes disclaimer

13. 9/29/2016 13 Impact/Challenges/Success with Worker Registries When you can match up the right worker with the right Veteran Quicker enrollment Everyone is Happy! (Workers, Veteran, VA & AAA) Phone Numbers/Keeping Up to Date The longer you have the registry the better it gets

14. 9/29/2016 14 Music & Memory Background Funding Training How identify Veterans to participate Future of program

15. 9/29/2016 15 Music & Memory Background Developed by New York SW Dan Cohen: www.musicandmemory.org www.musicandmemory.org Uses personalized playlists on digital music players to help people reconnect with world around them, growing evidence reduces reliance on ant-psychotic and pain medications National focus has been in nursing homes

16. 9/29/2016 16 Music and Memory Background In Ohio started out in nursing homes over past 2 years Ohio Department of Aging using funding from ACL now bringing to community settings focusing on Veterans First in the country to go into community settings Benefits: improve mood & relationships with caregivers, respite for CG, decrease use of some meds, decreased behaviors

17. 9/29/2016 17 Music and Memory Funding & Training One year grant mostly to receive training and purchase I- pods and music, AAA7 donated laptops AAA7/Chillicothe VA using students and interns to assist AAA7 staff did 3 day webinar training then trained community Hub sites: Chillicothe VA, Adult Day Care, VD-HCBS Program at Chillicothe

18. 9/29/2016 18 Veterans on Music and Memory Identified Veterans who might have dementia, Alzheimer’s, anxiety, depression, PTSD, pain, psychological issues, visually impaired, those in palliative care

19. 9/29/2016 19 Music and Memory Outcomes Before I-Pod: 92 Y.O. Veteran dx Alzheimer’s becomes anxious and upset, often has war time memories. Interacts very little. After I-Pod: Family says have never seen Veteran “come alive” like this. Veteran sings, interacting with family and CM. Says is going to learn all the songs and sing back to CM, wants to slip the CM a check for this gift because he loves it.

20. 9/29/2016 20 Music and Memory Outcomes Before I-Pod: 73 Y.O. Veteran dx with dementia. Family has difficulty with Veteran when time to do personal care and riding in a car. After I-Pod: Veteran using I-Pod when bathing and riding in car. Family says now tasks are not a problem, music calms/relaxes the Veteran. Veteran calls the I- Pod “my little Juke Box”.

21. 9/29/2016 21 Music and Memory Outcomes Before I-Pod: 92 Y.O. dx Alzheimer’s likes to be outside to watch deer and squirrels in yard but often wandered. No interaction with family. After I-Pod: 20’s & 30’s jazz music brought back childhood memories he now talks about his family playing old records on a Victrola. Now voicing wants country blue grass & gospel songs for his “music device”. Sits outside with I-Pod and is engaged in music, does not wander.

22. 9/29/2016 22 Future of Music and Memory Utilized students and interns who are developing a sustainability method for our area (Chillicothe VA) involving donation drives Will be sustained at AAA7 through Employee fund drives Chillicothe VA will receive Community Partnership Award for their efforts in this project

23. 9/29/2016 23 Tracking to VCP Provider Agreements We are asking all VD-HCBS Providers to please make sure your VD-HCBS Ticker entries are up-to-date through May at: https://www.adrc-tae.acl.gov/tiki- index.php?page=vdhcbstickerentryhttps://www.adrc-tae.acl.gov/tiki- index.php?page=vdhcbstickerentry ► If you have questions regarding the VD-HCBS Ticker, are a new user or experience any technical difficulties, please email: veterandirected@acl.hhs.gov with the subject “VD-HCBS Ticker” veterandirected@acl.hhs.gov ► Helpful Tip: The VD-HCBS Ticker Tool has features which can produce tables and graphs demonstrating state and site specific growth.

24. 9/29/2016 24 Tracking to VCP Provider Agreements Signed VCP Provider Agreements for VD-HCBS will be tracked through a VA database If you have not been contacted by your VAMC regarding VA Choice Provider agreements, you should be encouraged to work through your existing contacts for VD-HCBS to engage in conversations to pursue VA Choice Provider Agreements ► Please also email the Veteran-Directed mailbox if you have not been contacted You should expect to be contacted by the VD-HCBS Technical Assistance Team during the summer to track progress towards signing a VCP Provider Agreement, access VCP funding and grow VD-HCBS

25. 9/29/2016 25 Questions?