1

Technical Assistance to Support the Aging and Disability Resource Center (ADRC) Grantees

Academy Health 2006

Lisa AlecxihThe Lewin Group

lisa.alecxih@lewin.com (703)-269-5542

Karen Linkins, The Lewin GroupSusan Reinhard, Rutgers University

2

CMS & AoA VISION

To have Aging and Disability Resource Centers in every community serving as highly visible and trusted places where people of all incomes and ages can turn for information on the full range of long term support options and a single point of entry for access to public long term support programs and benefits.

3

Research in Support of ADRCs

People do not know who to turn to for information about long term support services Rosalynn Carter Institute, 2006 and numerous grantee surveys, 2004-

2005

Most think that Medicare will cover long term support needs and do not understand Medicaid is means-tested AARP, 2003

Providing the right information, assistance, and access to services at the right time can delay or prevent costly institutionalization Feinberg, 2003 and AARP 1996

4

AGING AND DISABILITY RESOURCE CENTER GRANTEES

Guam

Hawaii

NorthernMarianas

AK

MT

ID

WA

CO

WY

NV

CA

NMAZ

MN

KS

TX

IA

WI

IL

KY

TN

INOH

MI

ALMS

AR

LA

GA

FL

SC

WV VA

NC

MD

DE

PANJ

VT

RI

ME

NHOR

UT

SD

ND

MO

OK

NE

NY

CT

FY 2004 ADRC Awardees FY 2003 ADRC Awardees FY 2005 ADRC Awardees

Alabama Idaho Ohio Arizona Kansas Tennessee Colorado Kentucky TexasDC Michigan VermontGuam Mississippi VirginiaHawaii Nevada Washington

Wyoming

Alaska IndianaArkansas IowaCalifornia New MexicoFlorida North CarolinaGeorgia Northern MarianasIllinois Wisconsin

Louisiana New HampshireMaine New JerseyMaryland PennsylvaniaMassachusetts Rhode IslandMinnesota South CarolinaMontana West Virginia

5

Populations Served

PD = Physically Disabilities DD = Developmental DisabilitiesMI = Mental Illness

ADRC Populations

57

20

64 3

0

5

10

15

20

25

All Ages &Disabilities

All Adults withDisabilities

Elderly & PDOnly

Elderly, PD &Other

Elderly & DDonly

Elderly & MIonly

Nu

mb

er o

f G

ran

tees

(4

5 w

ith

2 C

A &

2 I

L s

ites

ser

vin

g d

iffe

ren

t p

op

ula

tio

ns)

6

Pilot Site Operating Organizations

Among 54 2003/04 Pilot Sites

19 20

42 2 2 2 2 1

0

5

10

15

20

25

Area

Agenc

ies o

n Agin

g (A

AAs)

Count

y Agin

g an

d Disa

bility

Dep

art.

State

wide p

rimar

ily th

roug

h SUA

Separ

ate

AAA and

disa

bility

org

.

Count

y Hea

lth D

epar

tmen

t

Count

y Sen

ior C

ente

rs

Inde

pend

ent L

iving

Cen

ters

Count

y Agin

g Dep

artm

ent

Count

y Disa

bility

Dep

artm

ent

7

ADRC Technical Assistance Exchange (ADRC-TAE)

Led by The Lewin Group In conjunction with CMS TA that supports nearly all of

CMS System Change grants– Rutgers University, Independent Living Research Utilization

(ILRU), National Academy of State Health Policy, National Association of State Units on Aging, and others

Focuses on grant major components/requirements Also addresses sustainability and scaling up Relies on multiple sources for knowledge transfer Uses proven techniques of reinforced learning

8

Functions of an ADRC

Awareness & Information

Public Education Information on Options

Assistance Options Counseling Benefits Counseling Employment Options Counseling Referral Crisis Intervention Planning for Future Needs

Access Eligibility Screening Private Pay Services Comprehensive Assessment Programmatic Eligibility

Determination Medicaid Financial Eligibility

Determination One-Stop Access to all public

programs

AWARENESS&

INFORMATIONASSISTANCE

ACCESS

CONSUMER

9

The Audience

Primary Audience 43 state/territory grantees 62 pilot sites currently and 106 by end of 2006 Over 1,200 registered website users

Secondary Audience Policymakers Researchers Others interested in access to long term support

services and information and assistance Varying levels of understanding of:

Key grant components Use of the web and technology

10

Coordinated Knowledge Transfer Framework

Information Sources• TA Requests• LTC-TAC Faculty • LTC Experts • State Peers• Research Literature• Grantee Meetings/ Teleconferences• Listserv Discussions• Web Site• Needs Assessments

Knowledge Development/

Synthesis

• Issue Briefs• Matrices• Tools• Summaries of Meetings & Work Groups• Grantee Progress Reviews

On-Site TA Recipients &

Grantees

Stakeholders• State Agencies • Aging Network• Disability Community• Indep. Living Centers• Consumers/Families • Service Providers• Program Staff• Private Insurers• Legislators/Regulators• General Public

Knowledge Exchange/Feedback

Knowledge Dissemination

& TA

• ADRC Website• Weekly Newsletter• Bi-annual National Grantee Meetings• Monthly All Grantee Calls• Peer Work Groups• One-to-one TA/ mentoring

Knowledge Needs/Materials Refinement Feedback

11

Reinforced Learning Process

Individualized

KnowledgeTeleconferences

Needs Assessment,

TA Plans

On-site Assistan

ce

Standardized

Knowledge

Listservs

Web Site Content

National Meetings & Regional

Teleconferences

AoA, CMS, Experts,

TA Collaborative

State Expertise

Work Groups

12

Written Materials

Issue Briefs Consolidate research and highlight key elements Make relevant to ADRCs

– Provide “real life” examples – bridge research and practice Try to keep to less than 10 pages Provide sources for more detail 25 downloaded 3,762 times

Resource Documents and Tools Consolidated information for a particular topic

– e.g., Information & Referral Software Matrix and Web-based Resource Databases

– 70 downloaded 1,662 times

Documents from the field– e.g., RFPs, forms, brochures, MOUs, marketing materials– 344 downloaded 3,487 times

13

Teleconferences

Topics based on grantee needs Monthly all grantee calls

– Average 26 grantees of 43 since Nov; 65 participants per month

Smaller work groups calls

Background materials and/or slides in advance Use of web-based meeting capability Expert or state representatives featured Summary, including questions and answers,

posted on website Monthly calls also recorded and available for future

access on the website

14

On-Site Technical Assistance

Onsite requests from grantee or identified need by funders

Support grantees with other stakeholders Facilitate meetings Individualized TA needs

15

National Meetings

Permit in-person exchange among grantees Opportunity for peer-to-peer TA

Tackle issues more in-depth Reinforce federal messages Two each year

1-2 days

Between 100 and 250 attendees

Also send TA staff to other national meetings that grantees attend

16

Other Forums

Online Peer-to-Peer Exchange 30 topics with 101 posts e.g., naming the project and customer satisfaction

survey 2,872 total hits

FAQs to Funders 14 questions and answers 3,220 hits

– Most for single question – 836 on Medicaid eligibility determination

Weekly newsletter New resources Upcoming events

17

Feedback Mechanisms

Online surveys for all monthly calls and national meetings Poor response rate for calls – most=9, mode=4 Better for national meetings – 30-50%

– Possibly because of dinner for two incentive

Funders ask about TA in their semi-annual calls “In my 20 years of state government services, I have never

seen anything so comprehensive and useful as the ADRC technical assistance website” 2005 ADRC project coordinator

Informal mechanisms TA leads solicit in regular one-on-one calls with grantees Ask at end of every peer workgroup call

– Feedback on format– Topics for future calls

18

TA and Grant Management Web-based TA Tracking Tool

Record grantee requests and TA responses Prioritize TA activities Ensure responsiveness to grantees Coordinate multiple TA providers Identify common themes to maximize resources and

plan activities Accountability to funders

Online semi-annual report tool Grantees submit narrative, check box and outcomes

info. Database allows easy of analysis

Produce reports for internal and external purposes

19

Grantee Baseline & Progress

Sources of information Baseline from initial needs assessment calls Progress from

– Semi-annual reports, – TA requests and activity related case notes for

grantees (TA Tracking Tool)– AoA-CMS Grants Monitoring call notes

Provides information for evaluative efforts

20

Website – www.ADRC-TAE.org

Primary mechanism to disseminate & exchange information

Over 1,200 registered users Averages 70 visits and 15,000 hits per day

Up from 40 visits and 3,200 hits per day a year ago Average 2,000 to 3,000 visits and 500,000 hits

per month Built a grantee online community

21

Website – www.ADRC-TAE.org

22

Audience of Implementers – NOT Researchers, sooo …

Know your audience: Preferred method of receiving information, tech savvy,

concerns and challenges Attract and keep their interest:

Boil relevant research down to the high points Repeat messages frequently and in variety of ways Provide a couple (not too many) of resources for more depth

Meet them where they are: Stage information based on readiness

Monitor what works and what does not: Solicit feedback constantly, both formally and informally ACT on the feedback!!!

Try new things: Keep eyes and ears open for how other successfully

teach/support Experiment with different formats (e.g, consultancies)