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Department of Health and Social Services Division of Services for Aging and Adults with Physical Disabilities. Joint Finance Committee Hearing Fiscal Year 2012 Bill Love Division Director Thursday, March 3, 2011. Division of Service for Aging and Adults with Physical Disabilities. - PowerPoint PPT Presentation
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Department of Health and Social Services
Division of Services for Agingand Adults with Physical Disabilities
Joint Finance Committee HearingFiscal Year 2012
Bill LoveDivision Director
Thursday, March 3, 2011
Division of Service for Agingand Adults with Physical Disabilities
The mission of the Division of Services for Aging andAdults with Physical Disabilities is to maintain and improvethe quality of life for Delawareans who are seniors or whoare at least 18 years of age and have a physical disability.
The Division is committed to providing services thatmaximize independence through individual choice, enabling persons to continue living active and productive lives, and to
protecting constituents who may be vulnerable or at risk.
Delaware Health and Social Services
Overview & AccomplishmentsAgency Snapshot• Staff: 883 includes Nurses, CNA’s, Planners, Contract & Program
Managers, Case Managers, Fiscal & Administrative staff (includes long-term care facilities)
• Total Budget: $79.9 M (approximately 50% of funding for community programs is federal)
• Service delivery is a partnership between DSAAPD and contracted providers
• Over 30 providers are used for direct service delivery• Client assessment, case management and program oversight,
provided by DSAAPD, are vital to service delivery • Funding: State, Social Services Block Grant, Medicaid, Older
Americans Act, Health Fund (Tobacco)
Delaware Health and Social Services
Overview & Accomplishments
Adult Protective Services Delaware Senior Medicare Patrol Nursing Home Transition
Case Management Information & Assistance
Delaware Money Management Nursing Home Care
Adult Day Services Congregate Meals Medical Transportation
Adult Foster Care Day Habilitation Personal Care
Alzheimer’s Day Treatment Delaware Kinship Navigator Personal Emergency Response
Assisted Living Home-Delivered Meals Respite Care
Assistive Devices Home Modification Senior Comm. Service Employment
Attendant Services Housekeeping Specialized Medical Equipment
Cognitive Services Legal Services Support for Participant Direction
CARE Delaware Joining Generations
Delaware Aging and Disability Resource Center (ADRC) Medicaid Waiver for the Elderly & Disabled
Services Provided by DSAAPD Staff
Services Provided by Contractors
Programs Provided by DSAAPD Staff in Coordination with Contractors
Delaware Health and Social Services
Population Growth
0
50000
100000
150000
200000
250000
300000
350000
400000
2000 2005 2010 2015 2020 2025 2030 2035 2040
Age 60+
Age 75+
Age 85+
The size of the age 60+ population began to spike dramatically around 2005 and will continue to expand steadily for the next 20 years. The age 75+ population will climb noticeably by the year 2015. The “oldest old” population, age 85+, most in need of critical care services, will nearly double between 2005 and 2020, then double again by 2040. By 2030, Delaware is projected to have the 9th highest proportion of persons aged 65+ among all states.
The size of the age 60+ population began to spike dramatically around 2005 and will continue to expand steadily for the next 20 years. The age 75+ population will climb noticeably by the year 2015. The “oldest old” population, age 85+, most in need of critical care services, will nearly double between 2005 and 2020, then double again by 2040. By 2030, Delaware is projected to have the 9th highest proportion of persons aged 65+ among all states.
Overview & Accomplishments
Delaware Health and Social Services
Long Term Care Expenditure Patterns
Institutional Bias in Delaware…
Costs for institutional care
Community care costs
Institutional Bias in the US…
Delaware ranks 38th among all states in the percentage of long-term care dollars spent on home and community based services.
Delaware ranks 38th among all states in the percentage of long-term care dollars spent on home and community based services.
Costs for institutional care
Overview & Accomplishments
About 66% of long-term care dollars are spent in facilities.
About 87.5% of long-term care dollars for aging and physical disabilities are spent in facilities.
Community care costs
Delaware Health and Social Services
Overview & AccomplishmentsPriority Initiatives
Delaware Health and Social Services
Overview & Accomplishments
• Facilitates access to information and services
• Delaware Model– Call Center (information, referrals, case assignments)
– ADRC website
– Core Services: information and awareness; options counseling; service access; care transition assistance
– Designated Local Contact Agency (LCA) for nursing home transition
– Discharge planning (partnering with Christiana Care)
• Federal priority and a magnet for grants and funding
• Working toward “fully functioning ADRC” model to include all disabilities
Aging and Disability Resource Center (ADRC)
Delaware Health and Social Services
Overview & Accomplishments
1. Focus on system reform opportunities
• Money Follows the Person and Nursing Home Transition programs
• Transition/discharge planning best practices
• Pre-admission screening–deflecting nursing home admissions (facilitating access to community-based services)
• Independent assessment of current residents of five DHSS facilities
• Long-term care reform options under Affordable Care Act
• Rapid response team
Rebalancing Long-Term Care
Delaware Health and Social Services
Overview & Accomplishments
2. Expand access to home and community-based services
• Aging and Disability Resource Center (ADRC)
• Consolidation of three Medicaid Waivers– Increased opportunities for self-direction and person-centered care– More service options– Streamlined service access– Administrative simplification– Increased efficiencies
Rebalancing Long-Term Care (continued)
Delaware Health and Social Services
Overview & AccomplishmentsOrganizational Restructuring
Delaware Health and Social Services
Overview & Accomplishments
• Integration of three Long Term Care facilities (State-operated)– Smooth transition for staff and residents
– Integration of facility service functions with DSAAPD operations
– Deflecting admissions and transitioning individuals to the community
– Comprehensive assessment of each resident
– Ensures access to community-based supports for all long-term care residents
• Transfer of Long Term Care Ombudsman Program (LTCOP) and Adult Protective Services (APS)
– Phased-in transition to Office of the Secretary
– Enhance service model for constituent services in Delaware
– Increase visibility of these services
Organizational Restructuring (continued)
Delaware Health and Social Services
FY 12 Governor’s Recommended BudgetBase Adjustments
• 35-14-01– The addition of $750K in General Funds to replace Social Services Block Grant funds lost in
past years
Structural Changes
• 35-14-01– Transfer Long Term Care Ombudsman Program and Adult Protective Services salaries and
positions to the Office of the Secretary
• 35-14-20– Transfer, salaries, positions, and related operating costs for the Delaware Hospital for the
Chronically Ill (DHCI) from the Division of Public Health
• 35-14-30– Transfer, salaries, positions, and related operating costs for the Emily P. Bissell Hospital
from the Division of Public Health
• 35-14-40– Transfer, salaries, positions, and related operating costs for the Governor Bacon Health
Center from the Division of Public Health
Delaware Health and Social Services
Thank You.