Draft
Agenda
TUESDAY, SEPTEMBER 11, 2012
HCBS Conference Begins
7:00 a.m. - 5:00 p.m. Registration
7:30 a.m. - 8:30 a.m. Continental Breakfast
8:30 a.m. – 10:00 a.m. Opening and Welcome
Plenary:
Kathy Greenlee
Administrator, Administration for Community Living
Assistant Secretary, Administration on Aging
10:00 a.m. – 10:15 a.m. Break
10:30 a.m. – 5:00 p.m. CIRS-A Training and Certification
Prince William Room
10:15 a.m. – 11:30 a.m. Sessions:
Potomac III & IV ACL/AoA
Washington Room
CMS Intensive – Medicaid 101: Overview of the
Program
Conference Theatre
National Core Indicators: Measuring the
Outcomes of Waiver Services
This session will provide an introduction to the National
Core Indicators consumer survey and will include a
description of the results of the recent round of surveys in
such areas as choice, relationships, health and safety,
community inclusion, and employment. The session will
also include presentations that describe how the outcome
data has been used in states to improve and enhance
public policy and practice. Finally it will include
information about the use of outcome data that aligns
with the HCBS Waiver Assurances.
PRESENTERS:
Chas Moseley, National Association of State Directors of
Developmental Disabilities Services; Valerie J. Bradley,
President, Human Services Research Institute,
Cambridge, MA; Celia Feinstein Co-Director, Temple
Center of Excellence in Developmental Disabilities,
Philadelphia PA, John Martin Ohio Department of
Developmental Disabilities
Potomac I
Effective Delivery of Training to Caregivers
One of the most important aspects of ensuring quality
outcomes for individuals needing long-term services and
supports is ensuring that caregivers are appropriately
trained to provide all the services needed by the
consumer or family member. Unfortunately, training for
both paid and unpaid caregivers is often hard to come by.
Many state HCBS programs provide only limited training
opportunities for the workforce. This session will provide
examples of real-life training programs that work.
Speakers will highlight the program design, training
delivery and curriculum development approaches taken
by two non-profit organizations, a state agency and a
labor-management partnership, and will compare and
contrast approaches to training paid and unpaid
caregivers. The panelists will discuss best practices from
their operational experiences; identify topics that are in
demand and share examples of specific curricula. They
will also address the policy considerations that have
enabled these programs to become successful as well as
provide tips for others seeking to develop training
programs.
MODERATOR:
John Burant, Home Care Director,SEIU
PRESENTERS:
Charissa Raynor, RN, Executive Director, SEIU
Healthcare Northwest Training Partnership; Cheryl
Miller, Executive Director, Oregon Home Care
Commission; Suzanne Miller, President/CEO, National
Family Caregivers Association; Peggy Powell, National
Director, Workforce and Curriculum Development, PHI.
Potomac V
Ending Inappropriate Medication in Long-Term
Care
Inappropriate medication of consumers receiving long-
term services and supports across care settings can take
many forms, including the misuse of psychotropic drugs
as chemical restraints. Session participants will hear from
medical, legal and advocacy experts at the state and
national level on the topic of psychotropic drugs as
chemical restraints. The session will include information
about the dangers of psychotropic drugs (both when used
as recommended and for off-label purposes), signs of
inappropriate medication, enforcement mechanisms and
other ways to reduce psychotropic drug use (i.e. state
laws, informed consent), alternative person-centered
treatments and therapies, resources for help and current
national and state-level efforts to reduce inappropriate
medication of long-term services and supports
consumers.
PRESENTERS:
Claire Curry, Legal Director, Civil Advocacy Program ,
Legal Aid Justice Center; Lori Smetanka, Director,
National LTC Ombudsman Resource Center The
National Consumer Voice for Quality Long-Term Care
Lincoln Room
Medicaid Managed LTSS: Opportunities for
Innovative Program
Design and Diverse Target Populations
Many states are launching or considering a movement to
managed long term services and supports
(MLTSS). Successful MLTSS efforts require the core
elements of strong program design features and
beneficiary protections, strong financial incentive
structures, strong stakeholder engagement and strong
state commitment. While these common elements are
essential to successful programs, MLTSS is not
monolithic. Large states, small states and all in between
can design programs using a variety of Medicaid
authorities to meet specific objectives, to serve particular
populations, and to better integrate care across the acute,
primary, behavioral and long term service continuum.
This session will spotlight two very different programs
which promise to enhance community-based services to
individuals with a wide array of support needs. With
state partners, Mercer will discuss how states can
structure MLTSS programs to provide evidenced-based,
recovery oriented, and community based services for
individuals with mental health support needs – expanding
the array of available services while minimizing costly
institutional or emergent care delivery. In addition, the
session will describe the efforts of another state to tip the
institutional bias within their long term care system and
increase the availability of person-centered community-
based services. While the States vary in their objectives
and the authorities they used to achieve them, the
fundamentals upon which the programs have been
designed are similar, and feature strategic rate design to
provide the incentives necessary for the States to meet
their goals.
PRESENTERS:
Rosanne Mahaney, Director of the Division of Medicaid
and Medical Assistance, State of Delaware; Mary
Sowers, Senior Associate, Mercer Government Human
Services Consulting; Lou Ann Owen, Medicaid Deputy
Director, State of Louisiana; Brenda Jackson, MMP,
LLC; Meredith Mayeri, Senior Associate, Mercer
Government Human Services Consulting
Kennedy Room
Role of Research in Advancing Programs and
Services
With ongoing increases in the number of older workers
and families coping with dementia, the collaboration of
practitioners, policymakers, and researchers is essential.
The purpose of this symposium is to demonstrate the role
of an applied gerontological research center and its
partnerships with service providers and national grantees
to oversee, implement, and evaluate programs and
services for older adults. Specifically, this symposium
will focus on two projects supported by the
Administration on Aging and another project supported
by a Department of Labor grantee. The first presentation
discusses the state-wide replication of an evidence-based
exercise and behavior management program provided to
over 500 dementia caregiving families in Ohio. The
second presentation outlines the partnership of an applied
gerontological research center with three Alzheimer’s
Association Chapters in the implementation of an
innovative family caregiving program in 19 northern
Ohio counties. The third presentation demonstrates the
extent to which human service providers in seven states
were aware and participated in the Senior Community
Service and Employment Program (SCSEP), a training
program for low-income, unemployed older workers in
non-profit organizations. This symposium will discuss
the important role of research in determining the benefits
of innovative and long-standing programs for older adults
and their families.
PRESENTERS:
Heather L.Menne,PhD, Senior Research Scientist,
Benjamin Rose Institute on Aging; Carol J.
Whitlatch,PhD, Senior Research Scientist II & Assistant
Director for Research, Benjamin Rose Institute on Aging;
Farida K.Ejaz, PhD, Senior Research Scientist II,
Benjamin Rose Institute on Aging.
Roosevelt Room
Mental Health
Potomac VI
Senior Hunger in America 2010: An Annual
Report
The report was commissioned by the Meals On Wheels
Research Foundation, prepared by Dr. James P. Ziliak of
the University of Kentucky and Dr. Craig Gundersen of
the University of Illinois. The report is the first in a
series of annual reports on the state of hunger in the US.
It specifically documents the state of hunger among
seniors 60 and older, provides an overview of the extent
and distribution of food insecurity in 2010 and examines
trends over the past decade using national and state-level
data.
PRESENTER:
Peggy Ingraham, Senior Vice President for Public
Policy, MOWAA
Potomac II
Substance Misuse and Brain Injury
The “fingerprint” of traumatic brain injury (TBI) is
damage to the frontal lobes. Addictions are also highly
influenced by neural circuits connecting to the frontal
lobes. Consequently it is not surprising that there is a
high co-occurrence of TBI with alcohol and other
substance use disorders. Of adolescents and adults with
moderate and severe TBI treated in acute rehabilitation,
more than half enter with problems from substance
misuse or actual substance use disorders (SUD). While
initially the injury may provide a deterrent to use, in time
many rehabilitation patients resume use of alcohol and
other drugs, and too many re-establish abusive patterns.
This dual diagnosis is often missed in clinical settings––
both rehabilitation and addiction––and the need to
address both problems via an integrated approach is
ignored in service delivery system planning. In this
presentation the relationship between TBI and substance
misuse will be reviewed, including the relationship
between early childhood brain injury and behavioral
control problems in adolescence and adulthood. The
relative risks of lifetime history of TBI for the
development of SUD will be discussed and data from
several cohorts will be presented. A model for
conceptualizing service delivery system opportunities
will be presented, with emphasis on brief interventions
that have the potential to be incorporated into a variety of
treatment settings. The opportunities for addressing co-
occurring brain injury and SUD in traditional addiction
treatment settings will also be presented.
PRESENTER:
John Corrigan, Professor, Ohio State University College
of Medicine, Department of Physical Medicine and
Rehabilitation
11:30 a.m. – 12.00 p.m. Exhibit Hall opens
12:00 p.m. – 1:00 p.m. Lunch
1:00 p.m. – 2:15 p.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive – Integrating Care: Delivery
Model and Payment Reform
This session will provide an overview of trends for
serving individuals in integrated delivery models,
including health homes, patient-centered medical homes,
ACOs, and managed care models.
Potomac II
ADRCs: The Keystone for a Rebalanced
Community-Based System
Aging and Disability Resource Centers (ADRCs) play an
ever increasing role in the aging network of the future by
coordinating existing aging and disability systems to
provide highly visible, streamlined access to long term
services systems and supports for older adults and people
with disabilities. ADRCs continue to be at the forefront
of key systems change initiatives such as Care
Transitions Interventions, Evidence-Based Disease
Management Programs, Nursing Home Diversion
Programs, Veterans Directed Home and Community
Based Services, Money Follows the Person
(Demonstration) activities and the Balancing Incentives
Program.
The Texas Department of Aging and Disability Services
(DADS) currently partners with 14 local communities to
provide ADRC services. DADS is committed to
expanding the program to 20 ADRCs by the year 2020.
Rapid expansion in an uncertain economic climate has
led to the development of key partnerships, a variety of
funding strategies and increased focus on sustainability.
This session will describe some of the creative funding,
policy and partnership decisions implemented by Texas
to expand and sustain its ADRC Program; including state
unit on aging administration funding, leveraging
Demonstration resources and activities, and additional
local partnerships to prepare for other systems change
opportunities.
PRESENTERS: Patricia Bordie, Manager, Special
Projects Unit, Texas Department of Aging and Disability
Services; Gary Jessee, Assistant Commissioner, Texas
Department of Aging and Disability Services; Marc
Gold, Special Advisor For Policy and Promoting
Independence, Texas Department of Aging and Disability
Services
Potomac V
So Much Need So Little Money
The increasing needs of vulnerable adults and the
overwhelming numbers of reports of adult abuse, neglect,
and exploitation are greatly taxing the budgets and staff
of Adult Protective Services (APS) programs across the
country. Attend this session to learn more about how two
states are managing and improving the administration and
delivery of their APS programs.
PRESENTERS:
Maria Greene, Consultant; Dr.Susan Wehry,
Commissioner, Vermont Department of Aging and
Independent Living
Kennedy Room
A Community of Support – Options Counseling
and Benefits Counseling Supporting Seniors and
Adults with Disabilities
Options counselors and benefits counselors often work
with the same vulnerable population, in person-centered
ways. They share values and often mission. Sometimes
these two functions are shared by one person wearing
“more than one hat”. More often they are performed by
different people who are most effective when they team
together. Yet there are distinctions between the two
functions. When the commonalities and distinct skill sets
and knowledge bases are understood, collaboration and
synergies result that best serve communities, families and
individuals. Let’s learn together, growing partnerships
and skills as we go.
PRESENTERS:
Brandy Bauer, Communications Manager, Economic
Security, National Council on Aging; Sara Tribe,
Katherine Glendening, Aging Services Program Specialist,
AoA/Administration for Community Living
Conference Theater
Addressing Behavioral Health Needs of Older
Adults: Strategies for Enhancing Federal, State,
and Community Partnerships
One in four persons aged 55 and over experiences
behavioral health disorders that are not part of the normal
aging process. As states continue to enhance their home
and community-based service (HCBS) systems,
incorporating services and policies that are responsive to
the needs and preferences of older adults with or at risk
for behavioral health issues is critical. To encourage the
embedding of behavioral health capability into HCBS
systems, the Substance Abuse and Mental Health
Administration (SAMHSA) and Administration on Aging
(AoA) have developed a formal partnership to support
state and community efforts to meet the diverse needs of
older adults with or at risk for behavioral health issues.
The goals of this collaboration are to expand the
availability of evidence-based behavioral health programs
for older adults, with a focus on the prevention of suicide
and substance abuse/misuse, and to support the
development of aging-behavioral health partnerships at
the state and community levels. This session will
highlight progress toward these goals and provide an
array of new resources and strategies that can help states
and communities develop and/or enhance their behavioral
health capability through aging-behavioral health
partnerships.
PRESENTERS:
Marian K.Sheinholtz, Public Health Advisor, Substance
Abuse and Mental Health Services Administration;
Jennifer Solomon, Public Health Advisor, Substance
Abuse and Mental Health Services Administration;
Shannon Skowronski, Aging Services Program
Specialist Administration on Aging.
Potomac I
The Consumer Perspective on Quality Home Care
Members of the aging network advocate for quality long-
term service and supports – but what does this actually
mean to the consumer? In 1985, the National Citizens’
Coalition for Nursing Home Reform (NCCNHR)
released the seminal report, "A Consumer Perspective on
Quality Care: The Residents' Point of View," which
spurred many important policy initiatives and serves as
an important reference for what consumers want and
need from their nursing home experience. In 2012,
NCCNHR - now the National Consumer Voice for
Quality Long-Term Care - has done it again, but this time
for home and community-based services. In this session,
participants will hear about the Consumer Voice’s
recently released report that assesses what home care
consumers want and how they define quality. Speakers
will discuss how the Consumer Voice gained information
directly from consumers, what consumers said and the
policy implications of what consumers believe is needed
to achieve quality long-term services and supports at
home.
PRESENTERS:
Sarah Wells, Executive Director, National Consumer
Voice for Quality Long-Term Care; Robyn Grant,
Director, Advocacy and Outreach , National Consumer
Voice for Quality Long-Term Care;
Roosevelt Room
Innovations in Family Caregiving
Participants will learn about a new model of engaging
and paying family caregivers in the context of a global
waiver (1115), dual eligible initiatives, and managed
long-term care. Family caregivers support programs, and
the engagement of family in consumer-directed care, are
becoming common across states and populations. These
models do not tend to address the highest need
consumers, those who meet or exceed institutional level
of care. Participants will learn from Rhode Island Office
of Health and Human Services and Caregiver Homes, a
provider of Shared Living, about an agency model that
combines payment to family caregivers with extensive
nursing and social work support and an electronic
community care record.
PRESENTERS:
Rachel M.Richards, Vice President, Government
Relations, Seniorlink ; Sharon M. Kernan, RN, MPH,
Assistant Administrator, Center for Child and Family
Health, Rhode Island, Executive Office of Health and
Human Services; Brian McKaig, State Director,
Caregiver Homes of Rhode Island
Potomac VI
The Multi-State Durable Power of Attorney For
Health Care
Legal authority for health care decision making can be a
key to adults remaining in the community. Naming
someone with the ability to make health care decisions
can be easily accomplished using a durable power of
attorney for health care, and now a standardized uniform
form that works in nearly every state is available. This
session will talk about the importance of advance health
care directives and explore various tools, including the
Universal Power of Attorney for Health Care. Attendees
will learn about extensive resources to guide families
with advance health care planning.
PRESENTERS:
David Godfrey, Senior Attorney, American Bar
Association Commission on Law and Aging;
Lincoln Room
Adult Protective Services: Is there a national
system?
With limited funds and growing needs, Adult Protective
Services in all states are struggling to provide protection
for vulnerable adults to be safe from abuse, neglect and
exploitation. The National Adult Protective Services
Association (NAPSA) and the National Association of
States for Aging and Disabilities (NASUAD) conducted a
survey in the spring of 2012. The goal of the survey was
to determine the existing environment for APS in each
state. This information would then reflect the national
picture. In this session, NASUAD and NAPSA will
share the results of the survey and discuss what it means
for delivery of protective services to older Americans and
persons living with disabilities. Many in the field have
expressed interest in a national system for reporting, data
analysis and consistency in policy and operations. This
presentation will share the current environments
commonalities and differences plus facilitate a discussion
on what is working now and what could be possible in
the future.
PRESENTERS:
Rachel Feldman, Policy Associate, NASUAD
Andrew Capehart, Assistant Director, NAPSA
2:15 p.m. – 2:30 p.m. Break
2:30 p.m. – 3:45 p.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Grants, Projects and
Opportunities: Using Balancing Incentive
Program, Money Follows the Person, 1915(i) and
Other Tools to Strengthen HCBS Infrastructure
This session will provide an overview of demonstration
programs and how they can be used and leveraged to
bolster State efforts to provide HCBS.
Conference Theater
CMS Intensive - Psychotropic Medication Use
Among Children in Foster Care
Kennedy Room
Implementing EBP for Family Caregivers
The integration and implementation of evidence-based
programs and protocols into long-term care systems is a
priority for many states to ensure that public and private
sector dollars are being spent effectively and efficiently
with measurable outcomes. Implementation strategies
(intervention selection, hiring practices, data collection,
and evaluation) have proven to be as important to success
of a project as the methods of service delivery. The
Georgia Division of Aging Services and the Rosalynn
Carter Institute for Caregiving has been building a menu
of evidence based services since 2007. This session will
share expertise gained from the successful
implementation of a number of evidence-based
interventions, including REACH II, Chronic Self
Disease Management Program (CDSMP), TCARE,
Powerful Tools for Caregivers, New York University
Caregiver Intervention (NYUCI), and Care Consultation,
as well as planned interventions including Tai Chi and A
Matter of Balance.
By the end of the session, participants will be able to:
Describe evidence-based interventions and how they
might fit the needs of their agency.
Apply implementation strategies to improve agency
adoption and fidelity as well as to ensure expected
outcomes.
Interpret the role of technical assistance in successful
implementation of evidence based caregiver interventions
and statewide dissemination.
PRESENTERS:
Cliff Burt, MPA, Caregiver Specialist, Georgia Division
of Aging Services; Gayle Alston, MS, Director of
Community Initiatives & Caregiver; Gwen Johnson,
MS.RD.LB.
Potomac I
Using the “Q+” Screen to Identify Likely NFTs
Staff often feel frustrated by the time spent trying to
identify likely suspects for returns to the community,
especially among the long-stay nursing facility
population. How can states use existing data to better
focus NFT outreach efforts? How can states use existing
data to prioritize prospective transitionees? This session
will review the research underlying development of the
“Q+” screen developed at the University of Michigan and
will showcase two states, Arkansas and Louisiana, now
using the screen in their NFT initiatives.
PRESENTERS:
Mary James, Research Assistant Professor, University of
Michigan; Robin Wagner, Deputy Assistant Secretary,
Office of Aging and Adult Services, Louisiana
Department of Health and Hospitals; Krista Hughes,
Director, Division of Aging and Adult Services, Arkansas
Department of Human Services.
Potomac VI
Integrating Self-Directed Principles Into
Traditional Personal Care Services
Five years ago the Arizona Long Term Care Services
(ALTCS) Division embarked on a journey to provide
options for self-directed services to the people who are
enrolled in the Arizona Medicaid long term care program.
In response to this effort by the state, a partnership was
formed between Consumer Direct Personal Care, a
private Attendant Care provider agency, and Pima Health
System, a regional ALTCS managed care contractor, to
develop and test a 'hybrid' model of in-home care that
incorporates the principles and values of consumer
direction into a traditional agency-based Attendant Care
service. Medicaid regulations were scrutinized to ensure
that full compliance with all agency-based requirements
was maintained while at the same time integrating the
principles and practices of self-direction into the service.
The proposal was brought forward to the state Director of
ALTCS who endorsed the model as an additional service
option that has since proven to be extremely popular with
ALTCS Members. As a result of this collaborative effort,
the State of Arizona has not only taken a creative
approach to expanding the self-directed service options it
offers, but positioned itself well to pursue the new
Community First Choice Option for self-direction in the
future. The importance of state agencies, providers,
managed care companies and CMS working together for
the purpose of broadening the array of community
services offered, as well as the key decision points at
which to involve service recipients in the decisions that
are being made regarding their care, will be discussed by
the panel during this session.
PRESENTERS:
Heidi Davis, Vice President, Consumer Direct; Jami
Snyder, Operations Administrator for Acute and Long Term
Care, Arizona Health Care Cost Containment System
(AHCCCS); Dan Timmel, Medicaid Long Term Care
Policy, Centers for Medicaid and Medicare Services;
Mike Hanshew, Policy Advisor, Consumer Direct.
Potomac II
Building Sustainable Delivery Systems for
Evidence-Based Prevention Programs: Findings
from ACL’s Process Evaluation of the Chronic
Disease Self-Management Program (CDSMP)
Self-management programs help older adults and
individuals with disabilities learn how to manage their
chronic illnesses and take charge of their health. In 2010,
the U.S. Administration for Community Living (ACL)
awarded $27 million in ARRA funding to 47 states and
territories to establish and expand CDSMP, an evidence-
based self-management program developed by Stanford
University. As federal funding winds down, state units on
aging and state health departments are employing various
strategies to continue offering CDSMP. IMPAQ
International will report findings from the ACL-funded
national process evaluation of CDSMP implementation.
The evaluation included an in-depth analysis of program
data from the 47 states and territories, site visits, and
telephone interviews with states. The evaluators will
highlight state strategies for sustaining CDSMP and
lessons learned for developing viable statewide delivery
systems for evidence-based prevention programs.
CDSMP directors from two states will share their
experiences with delivery system development and
sustainability. The session will conclude with insights
from the National Council on Aging—which provides
technical assistance to ACL CDSMP grantees—on
program sustainability and their plans for future
initiatives to promote evidence-based programs.
PRESENTERS:
Cynthia Woodcock, Senior Research Associate and
Practice Area Lead, Long-Term Care, Aging and
Disability, IMPAQ International LLC; Daver
Kahvecioglu, Senior Research Associate and Practice
Area Lead, Public Health Systems and Services, IMPAQ
International LLC; Holly Korda, Deputy Director,
Strategy and Growth, Systems Research and Initiatives,
Altarum Institute; Lisa Ferretti, Director of Operations,
Center for Excellence in Aging Services, University at
Albany, New York; Marc Molea, Chief, Strategic
Partnerships Division, Ohio Department of Aging;
Donald Post, Manager, Diabetes Prevention and Control
Program, Division of Public Health, Delaware Health
and Social Services; Sue Lachenmayr, Program
Director, Center for Healthy Aging, NCOA; Kristie
Patton, Senior Program Manager, Center for Healthy
Aging, NCOA
Lincoln Room
Improvements and New Horizons in Provider
Monitoring
During this session participants will learn about the
building blocks of effective Home and Community Based
Services (HCBS) provider monitoring and, in particular,
about promising practices being used around the country
that may be considered for use in their own states. Using
a sampling approach, many states have developed a
person-centered monitoring process that combines record
review with interviews with participants and staff to
determine if providers continue to maintain their
qualification to serve individuals with developmental
disabilities. The session will cover how some states are
now better able to discriminate between providers with
low performance, resulting in more frequent monitoring
and scrutiny, and those providers with outstanding
performance, potentially leading to less frequent reviews.
Of particular interest will be information about states that
are posting providers’ review results on their web sites,
and enabling access by individuals and families in order
to increased informed choice of providers.
PRESENTERS:
June Elizabeth Rowe, Human Services Research
Institute; Marion Olivier, Project Director, Georgia
Quality Management System Delmarva Foundation;
Eddie Towson. Director of Quality Assurance, Georgia
Division of Developmental Disabilities, Department of
Behavioral Health and Development Disabilities; Megan
O’Connor, State Office for People with Developmental
Disabilities.
Roosevelt Room
Integrated Care & Opportunities to Expand
Infrastructure with a Focus on HCBS/LTSS
Potomac V
TBI Research: A Public Health Perspective
The Centers for Disease Control and Prevention (CDC) is
collaborating with partners in the field of TBI research to
further understand the consequences throughout the life
course including outcomes associated with TBI
rehabilitation. This presentation will provide an overview
of how the United States (US) Congress has engaged the
CDC to focus research efforts on TBI and review results
from collaborative studies between the CDC and the
Traumatic Brain Injury Model Systems (TBIMS) at the
National Institute on Disability and Rehabilitation
Research. Recent data on the representativeness of the
cohort of rehabilitation patients in the TBIMS
longitudinal dataset have allowed better estimation of the
long-term public health burden associated with all TBI
requiring inpatient rehabilitation in the US.
PRESENTERS:
Jeneita Bell, National Center for Injury Prevention and
Control, CDC, MD, MPH
LCDR, USPHS Commissioned Corps Division of Injury
Response, Centers for Disease Control and Prevention;
Dr. John Corrigan, Professor, Department of Physical
Medicine and Rehabilitation, Ohio State University;
Jeffrey Cuthbert, Research Associate, TBI National Data
and Statistical Control; Dr.Cindy Harrison-Felix,
Assistant Clinical Professor, Physical Medicine and
Rehab, University of Colorado, Denver
3:45 p.m. – 4:00 p.m. Break
4:00 p.m. – 5:15 p.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive -Medicaid and Supports for
Employment
CMS Staff will present on opportunities to support
employment through Medicaid policies, programs and
services. Medicaid Buy-In, State Medicaid Infrastructure
Grant (MIG) activities and employment services will be
highlighted.
Potomac II
Enhancing ABI Waiver Services with Care
Management
Massachusetts Medicaid (MassHealth) administers two
home and community-based services waivers (1915(c)
waivers) for persons with Acquired Brain Injury (ABI).
The University of Massachusetts Medical School
(UMMS), in collaboration with MassHealth and the
Massachusetts Rehabilitation Commission (MRC),
operates these waivers and provides case management to
facilitate transitions to the community for Medicaid-
eligible individuals, with an ABI, residing in a nursing
facility or chronic/rehabilitation hospital. Through
comprehensive person-centered care planning, ongoing
case management, and risk mitigation, 67 ABI
participants have transitioned to the community since
November 2010. Despite rigorous risk mitigation efforts
built into ABI services, there were 146 incidents reported
during a one year period, with 11% of ABI participants
accounting for 110 (75%) of incidents occurring post
transition. These incidents included recurrent falls,
behavioral issues including aggressive and self-injurious
behaviors, medication issues, emergency department
visits, and hospitalizations. In response to these
incidents, as well as to the medical and psychosocial
complexity of this population, UMMS implemented a
care management pilot to enhance clinical resources to
address the ongoing safety needs of this population.
This session will describe the care management activities
employed and will illustrate the impact of these
interventions by presenting aggregate data and specific
case studies.
PRESENTERS:
Kathleen Craven, RN, MPH, Director, Clinical Services
and Supports Commonwealth Medicine, Disability and
Community Services; Charles Sweet, MD, Medical
Director, Disability and Community Services; Amy
Bernstein, MMHS, Assistant Director, Community Based
Waivers, MassHealth
Lincoln Room
Aging, Diversity, and Transportation
Considering the growing diversity of the older population
in the United States, the National Center on Senior
Transportation (NCST) works to address transportation
disparities facing culturally and ethnically diverse older
adults in many communities nationwide. With guidance
from the National Coalition on Mobility Needs of
Diverse Elders, the NCST developed recommendations
for advocates, providers and communities and launched a
grant program, Breaking New Ground, in 2011, to
identify how local communities might partner with
cultural and ethnic groups to remedy transportation
problems affecting diverse elders. The projects brought
together community stakeholders, including older adults
and adults with disabilities and community-based
organizations representing specific diverse populations,
convened focus groups and/or surveyed consumers and
adopted action plans to address identified barriers and
concerns. From their experiences, the projects identified
lessons learned - approaches other communities might
adopt to invite input and better serve diverse consumers.
The workshop will include information about Wichita,
KS? Successful effort to develop sensitivity training for
transit operators and obtain funding to create a Hispanic
Mobility Manager position housed at a Hispanic
Community Center.
PRESENTER:
Virginia Dize, Co-Director, NCST, National Association
of Area Agencies on Aging
Potomac VI
Measuring the Woodwork Effect
Questions have persistently arisen about the extent to
which public spending on home and community-based
services (HCBS) reduces institutional spending.
Advocates for HCBS have consistently argued that
people prefer these services and that HCBS are usually
less costly than institutional care. Critics have countered
that publicly subsidized HCBS services attract a
substantial proportion of qualified individuals who would
not otherwise use institutional care. This phenomenon
has come to be named the “woodwork” effect. At this
symposium, four different studies will present data on the
changes in HCBS use, the concurrent use of institutional
care, the characteristics of HCBS and institutional users
and the net effects on public LTC spending. Comparing
the analyses illustrates the way conclusions can vary
depending on what data sets are used. The findings have
implications for state and national policy.
PRESENTERS:
Dr. Frank Caro, Emeritus Professor of Gerontology and
Editor, Journal of Aging and Social Policy, University of
Massachusetts Boston; Steve Eiken, Senior Research
Leader, Truven Health Analytics ; Dr. Robert L. Kane,
Professor and Minnesota Chair in Long-Term Care and
Aging, University of Minnesota; Dr. Mitch LaPlante,
Professor, Institute for Health & Aging and Dept. of
Social and Behavioral Sciences, University of California
San Francisco; Dr. William G. Weissert, Professor,
Florida State University
Kennedy Room
Integrating Federal Funding Opportunities to
Build a Person-Centered, Participant-Controlled
Long Term Supports and Services System in
Maryland
Maryland’s Long Term Supports and Services (LTSS)
are on the verge of a major systems transformation that is
capitalizing on a multitude of federal initiatives.
Maryland has or is in the process of implementing the
following initiatives: Money Follows the Person,
Statewide Aging and Disability Resource Center
Program, Community Living Program, Veterans Directed
HCBS Program, Options Counseling development, the
Balancing Incentive Program, and the Community First
Choice Option. Implementing these initiatives has
required close cooperation among several state agencies
and stakeholders. This session will discuss how
Maryland is transforming its LTSS access infrastructure
to create a seamless system that meets the requirements
of each of the federal grants and initiatives. This will
include a discussion of the synergies and challenges
offered by trying to integrate all of these programs. The
session will be particularly relevant to states that have
county-based delivery systems in that we will discuss
efforts to apply consistent standards and procedures while
respecting the organizational structures and resource
limitations of each of the counties.
PRESENTERS:
Steven Lutzky, President, HCBS Strategies Incorporated;
Lorraine Nawara, Deputy Director for Community
Integration, Maryland Department of Health and Mental
Hygiene; Stephanie A. Hull, Chief, Long Term Services
and Supports Maryland Department of Aging; Devon
Snider, Money Follows the Person Project Director,
Maryland Department of Health and Mental Hygiene;
Eric Saber, Health Policy Analyst, Maryland Department
of Health and Mental Hygiene; Kristy Michael,
Associate, HCBS Strategies Incorporated
Potomac V
Residential Care Facilities: The Role of Medicaid
This session presents analyses of the newly available
2010 National Survey of Residential Care Facilities
(NSRCF), the first nationally representative survey of
residential care facilities (RCF) serving older people and
younger persons with physical disabilities. The session
will provide an overview of NSRCF findings, an
examination of Medicaid in residential care, and analysis
of the industry in comparison to proposed Medicaid
HCBS regulations. Residential care facilities, including
assisted living facilities, are an important component of
the home and community-based services system. They
provide assistance with activities of daily living, round-
the-clock supervision and room and board, and many
facilities seek to offer homelike settings. In 2010, there
were 31,100 facilities with 733,300 residents.
Approximately, 19% of RCF residents received services
through the Medicaid program, and 43% of facilities
served at least one Medicaid beneficiary.
The Centers for Medicare & Medicaid Services (CMS)
seeks to ensure that Medicaid home and community
based services are provided in an integrated, person-
centered, community setting. NSRCF analyses found
that while facilities providing services to Medicaid
beneficiaries are not too different from non-Medicaid
facilities, the industry as a whole does not meet the CMS
standards articulated in recent proposed rules related to
HCBS waivers.
PRESENTERS:
Emily Rosenoff, Policy Analyst, HHS Office of the
Assistant Secretary for Planning and Evaluation (ASPE);
Angela Greene, Senior Social Scientist, RTI
International; Lauren Harris-Kojetin, Chief, Long-Term
Care Statistics Branch, National Center for Health
Statistics; Joshua Wiener, Distinguished Fellow and
Program Director, RTI International
Conference Theater
Next Avenue
New Partnership Opportunities with Public Media PBS
stations are making a commitment to the 50+ population
like never before through a new online service called
Next Avenue. This service offers new opportunities for
PBS stations to partner with local organizations that
focus on an older population. More than 80 PBS stations
across the country have signed on to, among other things,
provide local information, events and services on the site,
nextavenue.org. In many cases, the station is going
beyond that by partnering with agencies and local
organizations to create television content, host events,
and more. Twin Cities Public Television is a model for
these activities.
PRESENTERS:
Jim Pagliarini, CEO of Twin Cities Public Television;
Judy Diaz, President of Next Avenue; Jean Wood,
Executive Director, Minnesota Board on Aging.
Potomac I
National Center for Elder Abuse
Roosevelt Room
2012 State of the States Survey: Key Findings,
Implications and Considerations for the Future
Each year, the National Association of States United for
Aging and Disabilities (NASUAD) conducts the State of
the States survey to gather information about the status of
aging and disability services throughout the nation. The
findings are in for 2012. What have we learned? Why is
this information important to the aging and disabilities
network? What should the network consider in planning
for the future? What resources are available to help?
PRESENTERS:
Grace Eunhee Cho, Research Assistant, NASUAD;
Diana Scully, Senior Director for State Services,
NASUAD
5:30 p.m. – 7:00 p.m. Reception
WEDNESDAY, SEPTEMBER 12, 2012
7:00 a.m. – 5:00 p.m. Registration
7:30 a.m. – 8:30 a.m. Continental Breakfast
8:30 a.m. – 9:45 a.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive – Medicaid 201: Home and
Community Based Services within Medicaid
This session, which builds upon “Medicaid 101:
Overview of the Program,” will provide an overview of
home and community based services (HCBS) within
Medicaid. Not only will this session provide
invaluable information on Section 1915(c) HCBS
waivers, but it will also provide an overview of the new
tools available for those states interested in enhancing
their HCBS options.
Roosevelt Room
GA Crisis Response System DD
The Georgia Crisis Response System for Individuals with
Developmental Disabilities (GCRS-DD) is a system of
care that is accessed through a single point of entry,
which is the Georgia Crisis Access Line (GCAL). The
GCRS-DD provides community-based crisis supports as
an alternative to institutional placement, emergency room
care, or involvement of law enforcement (including
incarceration). GCRS-DD serves individuals with
developmental disabilities aged 5 years and older in
behavior crisis situations.
PRESENTERS:
Rose Wilcox , Director of Training Services, Dept of
Behavior Health & Developmental Disabilities, Division
of Developmental Disabilities; Eddie Towson, Director
of Quality Assurance, Georgia Division of
Developmental Disabilities, Dept. of Behavioral Health
and Development;
Kennedy Room
Trying for the Flexibility and Fairness in Tough
Times
Two years ago, the Louisiana Office of Aging and Adult
Services implemented an acuity-based resource allocation
method that sets an individual limit on budget/hours of
service based on an individual’s comprehensive
assessment results from the Minimum Data Set Home
Care. The state’s initial impetus to deploy acuity-based
resource allocation was to provide greater flexibility: the
method sets an individual’s budget, and within that
budget allows for more flexible use of and scheduling of
services from day to day and week to week. When faced
with significant budget shortfalls, political pressure to
control rapid growth in state plan personal care, and
issues with waiver cost-effectiveness, acuity-based
allocation also provides a fair way to implement difficult
program reductions. Louisiana’s experience has been
extremely positive, with savings of $2M while serving
5000 additional individuals. This workshop will address
basic concepts of case mix reimbursement, review
Louisiana’s approach to development and
implementation of its payment system, and explore
political pressures for and against implementation.
PRESENTERS:
Mary James, Research Assistant Professor, University of
Michigan; Robin Wagner, Deputy Assistant Secretary,
Office of Aging and Adult Services, Louisiana
Department of Health and Hospitals
Potomac I
Part 1: Introduction to WI ADRC QI Program
“Aiming for Excellence” is a statewide ADRC quality
improvement program in Wisconsin, designed to enhance
operational practices and achieve effective, timely and
efficient services that are customer focused and lead to
increased customers. This model of process improvement
has enabled ADRCs to make significant changes without
the need for additional resources. Unlike other models,
process changes can be made in weeks instead of months
(or years) by engaging in short-term change project
cycles. The model involves customers, energizes staff,
and turns small changes into big results. In one year,
Wisconsin trained more than 140 staff from ADRCs
throughout the state on process improvement. ADRCs
engaged in 47 projects that improved processes and
customer satisfaction. Ten State and ADRC staff have
been trained to be quality improvement coaches, an
essential component for sustainability.
This session would be designed to introduce the audience
to the initiative, by describing how we developed,
implemented and are sustaining the program statewide.
The results of a third-party evaluation of the Aiming for
Excellence initiative will also be shared. The evaluation
results provide a look at lessons learned and the key
components necessary for successful implementation.
The model deployed in Wisconsin has changed the way
we think about our work, about quality, and how we
serve our customers. We would be delighted to share our
experiences so that other states could consider how to
apply a similar approach in their state and achieve similar
results.
PRESENTER:
Carrie Molke, ADRC Quality Supervisor, Wisconsin
Department of Health Services, Office for Resource
Center Development
Potomac II
Best Practices in Lifespan Respite Systems:
Lessons Learned from States and Future
Directions
Lifespan Respite is defined as coordinated systems of
community-based respite for family caregivers of
children or adults regardless of special need. In 2009, the
first twelve state grantees were awarded competitive
grants from the Administration on Aging to build
Lifespan Respite systems to improve access to respite for
all family caregivers. Additional state grants for new or
expanded programs were awarded in 2010-2012. The
first round of grantees have completed their initial three
year projects and have demonstrated best practices in
collaboration across state agencies to maximize use of
existing respite resources and reduce barriers that keep
family caregivers from receiving respite, especially for
the underserved or unserved populations. Many of the
grantees have developed innovative approaches to
marketing respite to family caregivers, developed respite
registries, increased respite capacity through provider
training and recruitment, and developed consumer
directed respite and other models to help families pay for
and find respite. The objectives of this session will be to
educate participants about the federal Lifespan Respite
Program and about best practices employed by states to
successfully implement the program, describe approaches
for encouraging additional state and community
participation and partnerships in these efforts, and
highlight future directions for program implementation.
PRESENTERS:
Jill Kagan, Program Director, ARCH National Respite
Network and Resource Center; Greg Link, Aging
Services Program Specialist, Office of Home and
Community Based Services, Administration on Aging,
U.S. Department of Health and Human Services
Potomac V
The Voice of the Consumer in 1915 (b)(c) Waiver
Cardinal Innovations Healthcare Solutions is a NC public
entity that has piloted a 1915(b)(c) waiver since 2005.
Based on the success of the pilot in savings and adding
additional services, NC is incrementally expanding the
waiver statewide. CIHS is now responsible for 15
counties. With this expansion it was crucial to ensure the
voice of the local consumer was not lost. The Behavioral
Healthcare Organization currently has four locally based
Community Operations Centers (COCs) each with a
Consumer Specialist in intellectual/developmental
disabilities and in substance abuse/mental health as well
as four Consumer/Family Advisory Committees with
representation from all counties and disabilities. The
Office of Consumer Affairs, staffed entirely by
consumers and family members, has evolved to become a
viable model of advocacy, empowerment, education and
engagement of consumers at all levels. The Director of
Consumer Affairs is a Senior Executive, reports directly
to the CEO, and is on equal standing with other
department executives. This model has increased the
organization’s capacity to connect locally with the
individuals and families that are served and provide
outreach to those who are in need of services.
PRESENTERS:
Allison Crot ty , MSW, LCSW, Director of Consumer
Affairs, Cardinal Innovations Healthcare Solutions; Larry
Sw abe, Regional Consumer Affairs Manager, Cardinal
Innovations Healthcare Solutions
Potomac VI
AARP- Across the State LTSS Trends
Demographics, Services, and Spending in Long-Term
Services and Supports (LTSS): What do the numbers tell
us is happening in the states, and how do we make sense
of it all? Come to this session to learn about the most up-
to-date research on LTSS trends in the states from the
AARP Public Policy Institute. Also, hear about the real
life policy implications from state officials.
PRESENTERS:
Wendy Fox-Grage, Senior Strategic Policy Advisor,
AARP Public Policy Institute; Kathleen Ujvari, Research
Analyst, AARP Public Policy Institute
Lincoln Room
MMLTC: What have we gotten into?
Conference Theater
NEARC
9:45 a.m. – 10.00 a.m. Break
10:00 a.m. – 11:15 a.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Coverage Strategies for
Behavioral Health
Potomac I
Oklahoma’s Medically Fragile Waiver Program
This session is intended to give attendees information
regarding Oklahoma's experience with developing and
operating the Medically Fragile Program. The Medically
Fragile Waiver is a 1915(c) Home and Community Based
waiver that was developed in collaboration with the
Aging Services Division of the Oklahoma Department of
Human Services. The purpose of this waiver is to
address the high cost needs of populations that are frail
with chronic physical conditions that require a higher
acuity level of care. This session will address various
components in developing this waiver along with the
criteria and the challenges of serving these individuals.
PRESENTERS:
Princiss Hill, Medically Fragile Program Coordinator,
Oklahoma Health Care Authority; Avis Hill, Waiver
Operations Program Manager, Oklahoma Health Care
Authority
Potomac V
AARP Great Expectations: Healthcare Tasks for
Caregivers
Family caregivers are increasingly carrying out health-
related tasks with little training or preparation. In
December 2011, a national survey of 1,679 family
caregivers was conducted to determine whether they
performed health-related tasks such as wound care and
medication management and administration, the type of
health tasks that they performed, their difficulties in this
area, and their level of stress. Of the total sample, almost
half (50%) of the caregivers were performing some type
of medical/nursing task, and about one-third were also
assisting with ADLs and IADLs, as well as
medical/nursing tasks. This is the first national survey
about this neglected area of caregiving research. This
presentation will review the key findings, including
detailed descriptions of the health-related tasks. The
findings suggest that the conventional ADL/IADL
framework for measuring caregiver responsibilities is
inadequate to capture caregiver responsibilities in the
current health care system. Recommendations for policy
and practice will be offered.
PRESENTERS:
Susan C. Reinhard, Senior Vice President, AARP Public
Policy Institute; Carol Levine, Director, Families and
Healthcare Project United Hospital Fund
Kennedy Room
Building from the Bottom-Up: Integrated
Information Systems as a Tool for Reform.
State infrastructure supporting home and community-
based services has developed over several decades. As a
result, different policy frameworks focused on specific
populations may exist within a single state. New federal
policy initiatives and financial incentives give states an
unparalleled opportunity to streamline Medicaid policies
governing community-based care. Maryland is making
significant high-level policy changes to reinforce its
commitment to person-centered care.
Maryland has embarked as well on an ambitious strategy
to strengthen the system from the bottom up. Building
from existing robust but separate client tracking systems,
Maryland is creating an integrated web-based
information system. The new system incorporates
uniform assessments, creates unified client reports across
waivers, supports care planning, and enhances quality
assurance. Program managers are coming together to
consolidate disparate business processes while
maintaining waiver variations needed by diverse groups
of younger and older persons.
At this session, participants will learn about the vision
underlying Maryland’s system and the analytical
framework supporting it. Speakers will discuss a
collaborative partnership underway that includes the state
Medicaid agency, The Hilltop Institute (a policy research
group), and FEi (a systems design company) to construct
the integrated information system. The session will also
consider the implications of Maryland’s approach for
other states.
MODERATOR:
Donna Folkemer, Director, Long Term Services and
Supports Policy and Research, The Hilltop Institute.
PRESENTERS:
Lorraine Nawara, Deputy Director for Community
Integration Programs, Maryland Department of Health
and Mental Hygiene; Eric Sabel, Health Policy Analyst,
Maryland Department of Health and Mental Hygiene.
Ian Stockwell, Director of Special Studies, The Hilltop
Institute; Andrea Schumacher, Senior Program
Manager, The Hilltop Institute; Nish Thakker,
FEi Systems.
Lincoln Room
The Emergence of an HCBS Policy Lab: The
Vision
The Commonwealth of Massachusetts has cultivated a
dataset that has remarkable potential for informing HCBS
policy development and program design. As a result of a
new partnership between the Massachusetts Executive
Office of Elder Affairs and the University of
Massachusetts Medical School, it is envisioned that this
dataset will be of interest and available to the State Units
on Aging and Disabilities to assist them in obtaining
answers to their policy questions.
The Massachusetts record presently has six years’ worth
of comprehensive experience for 447,000 consumers
participating in 5 different major programs of HCBS
offerings. These consumers are associated to 1.6m
assessments (including clinical eligibility determinations
for the Frail Elder Waiver); 2.6m care plans; 46.6m hours
of personal care and homemaker services; and $1.1b in
delivered service costs. This session will detail how an
“HCBS Policy Lab” is being constructed around this
dataset. Presenters will suggest HCBS policy questions
to which answers will be brought within closer reach by
the availability of the lab. The presenters will explain
how the lab may benefit the policy maker beyond the
Massachusetts borders.
PRESENTERS: Ann L. Hartst ein, Secretary,
Massachusetts Executive Office of Elder Affairs,
Peter J. Tiernan, Director of Administration and
Finance, Massachusetts Executive Office of Elder Affairs
Potomac II
Legal Resources to Keep Clients in the
Community
Difficulty with benefits eligibility, access to stable
affordable housing, establishing and maintaining income,
advance health care directives, abuse and exploitation are
but a few of the reasons that your clients and their
families might need legal assistance to remain in the
community. This session will explore free legal
resources, training, and case consultation services
available to help you and your clients with these and
other issues. The session will focus on resources and
services from the Administration on Aging funded
National Legal Resource Center. Without a home in the
community, HCBS services are not possible and without
legal assistance, some vulnerable individuals and families
lack access to health care benefits, income supports, and
stable affordable housing necessary to have a home in the
community. We will explore the most common threats
faced by vulnerable adults and families and where to find
legal resources and legal assistance to help these clients
realize the goal of community based living.
PRESENTERS:
David Godfrey, Senior Attorney, American Bar
Association Commission on Law and Aging; Omar R.
Valverde, Program Officer, U.S. Department of Health
and Human Services administration on Aging Office of
Elder Rights
Roosevelt Room
Strategic Alliances: Responding to the Changing
Environment for Community Social Service
Providers.
There is no doubt that what we know about community
long-term services and supports (LTSS) is changing. The
dual forces of stat budget cuts and increased demand,
coupled with rapid implementation of Affordable Care
Act demonstration projects, are driving a tectonic shift in
the delivery of LTSS.
The National Coalition on Care Coordination (N3C)
recognized the need for social service providers to
develop a strategy for growing and adapting in the
changing environment. N3C convened a "Strategic
Alliances Workgroup" of experienced aging, health, and
community social service providers, to connect providers
with the health care plans and systems, as well as CMS,
to demonstrate the contribution of social service
providers in the changing LTSS landscape.
N3C will share the progress of the Strategic Alliances
Workgroup, and update participants on how community
social service providers are working with health care
plans and providers to shape the LTSS delivery system.
PRESENTERS:
Robert Blancato, Matz, Blancato and Associates; Brian
Lindberg, Consumer Coalition for Quality Health Care;
Robyn Golden, Co-Chair, National Coalition on Care
Coordination; Pat Volland,Vice President, New York
Academy of Medicine
Potomac IV
Long Term Care Ombudsman: Following The
Transition Home
From long-term care provided in a nursing facility to
long-term care provided in a community setting, the
landscape is expanding giving individuals who are aging
or living with a disability more choices. What happens
during and after the transition? Once in a community
setting an individual may find themselves vulnerable to
issues with providers and often without someone to
advocate on their behalf. Twelve (12) state LTC
Ombudsman programs provide home care advocacy for
individuals living in the community. This session will
discuss the benefits and challenges that face the system
when trying to provide advocacy for persons needing
services in the community. Topics of discussion will
range from national legislation to implementation of
advocacy service challenges.
Proposed 2012 legislation would mandate a state home
care consumer bill of rights, home care ombudsman
office within the Office of the State Long-Term Care
Ombudsman, and additional enforcement of violations of
existing laws. Currently states provide a variety of
advocacy services. This session will inform the
participants on the existing system and the challenges
ahead.
PRESETERS:
Lori Smetanka, Executive Director, National
Ombudsman Resource Center; Deborah Merrill, Senior
Policy Director, NASUAD
Conference Theater
The Confluence of TBI and Aging
The purpose of this presentation is to explore the multiple
issues related to TBI for the older (50+) individual with
the objective that participants will be able to identify
indicators that may impact the older (over 50) individual
who sustains a TBI. By identifying these factors,
attendees may be able to implement actions leading to
preventing a further deterioration in the individual’s
medical condition and the residual functional capabilities
needed to maintain their quality of life.
PRESENTERS:
Sandra J. Knutson, CRC, CDMS, CCM, Principal
Research Analyst, TBI Technical Assistance Center,
NORC at the University of Chicago
Laurie Ehlhardt Powell, Ph.D., Associate Research
Fellow, Western Oregon University; Elizabeth Priaulx;
Senior Disability Legal Specialist, National Disability
Rights Network
11:15 a.m. – 11:30 a.m. Break
11:30 a.m. – 12:30 p.m. Plenary Session
12:30 p.m. – 1:30 p.m. Lunch
1:30 p.m. – 2:30 p.m. Plenary Session
2:30 p.m. – 3:45 p.m.
Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Preadmission Screening and
Resident Review (PASRR): what it is and how to
use it
Roosevelt Room
Veteran Directed Home and Community Based
Services: A Three Year Program Evaluation
The Veteran-Directed Home and Community-Based
Program (VDHCBS), collaboration between the AoA and
VA has been active for over three years. Earlier this year
a comprehensive program evaluation was completed by
the National Resource Center for Participant-Directed
Services at Boston College for the Department of
Veterans Affairs. The components included a survey of
VA Program Coordinators, functional characteristics of
Veterans self-directing and receiving traditional HCBS,
cost data, and Spending Plan and Invoicing information.
While the self-directed population generally had higher
acuity than the comparison group and were nursing home
eligible, the vast majority of Coordinators perceived
VDHCBS to significantly improve the ability of Veterans
to have their needs met, remain at home, be satisfied, and
access services. The findings of this program evaluation
will be covered in detail as will the use of cash
allowances and trends for growth and long term system
rebalancing within the VA.
MODERATOR:
Dianne Kayala, Director, New Initiatives with the
National Resource Center for Participant-Directed
Services
PRESENTERS:
Daniel Schoeps, Director of Purchased Long Term
Services and Supports for the Geriatrics and Extended
Care (GEC) Group of the Veterans Administration,
Department of Veterans Affairs; Ellen Mahoney, DSN,
Associate Professor and Chair, Boston College School of
Nursing; Patrick O’Keefe, MA, Program Analyst with the
National Resource Center for Participant Directed
Services, VA Central Office
Kennedy Room
GA REACH: Implementation and Findings
GA REACH demonstrates a successful community
translation of the REACH (Resources for Enhancing
Alzheimer's Caregiver Health) intervention with a rural
population of 85 caregivers in Georgia. This workshop
describes the challenges and solutions of the
implementation process and details the outcomes of the
evidence based intervention as conducted by the
Rosalynn Carter Institute for Caregiving. Lessons
learned in hiring, training and supporting staff, ensuring
fidelity and participant recruitment will be shared. A pre-
post research design was utilized to measure
effectiveness of the intervention. Statistically significant
results were achieved with demonstration of decreased
depression, decreased burden, improved caregiver health,
and decreased behavioral problems of the care recipient.
Additionally, data analysis of program evaluation reveals
100% of participants reported improved general benefit,
increased confidence in dealing with problem behaviors,
and a better understanding of the disease and the
caregiving role.
PRESENTERS:
Leisa Easom, PhD, RN, Executive Director, Rosalynn
Carter Institute for Caregiving; Gayle Alston, MS,
Director of Community Initiatives, Rosalynn Carter
Institute for Caregiving
Lincoln Room
Measuring Progress in Re-orienting toward
HCBS
Interest in developing alternatives to Medicaid
institutional long-term care (ILTC) has led the states to
implement various approaches to home and community-
based services (HCBS). Since the late 1970s, the federal
government (in particular, the Centers for Medicare and
Medicaid) has invested heavily in social experiments that
offered alternatives to ILTC, primarily focusing on low-
income elderly with functional disabilities judged to be at
high risk for long-term nursing home placement. These
efforts were spurred by the 1999 Supreme Court decision
(Olmstead v. L.C. ) which determined that “unnecessary
institutionalization” was discriminatory, and if people
with disabilities preferred to reside in the community and,
in the judgment of treating professionals their needs
could be met in the community, their wishes should be
respected. Assessing the states’ progress in providing
alternatives has not proven to be a simple task. As the
results of this study show, no single measure tells the full
story. Progress also varies dramatically by population
group, often within states, as well as across states. States
have had less success re-orienting their systems toward
HCBS for the elderly, but a handful of states have been
notably more successful than others. We use person-
level data to describe inter-state variations in Medicaid
long-term care expenditures and service use patterns in
2006 on a range of indicators, not only for all users of
Medicaid-funded long-term care (LTC) services, but also
for sub-populations defined by LTC users’ age and type
of disability. Our research computes measures separately
for the elderly and younger LTC users and, among those
who are under age 65 LTC, separately for those with
intellectual developmental disabilities (IDD) and other,
predominantly physical, disabilities.
At the same time, we also studied people who began
Medicaid ILTC stays, focusing on whether they were
enrolled in Medicaid prior to the start of the stay, and if
so, whether they were receiving HCBS prior to the stay.
We also examined how long they stayed. Separate
analyses were performed for nursing facility stays and for
stays in ICFs/MR.
Since states varied considerably in their progress we also
sought to understand why some states did better than
others. Correlations between the measures and various
state characteristics and program designs were computed,
in an effort to determine what factors were associated
with progress.
Our analysis is not the only one that has been performed.
We discuss our findings, and compare them with those
from an AARP analysis of 2006 Medicaid data. There are
differences between the scope of our study and the AARP
study, particularly in our study’s ability to differentiate
spending and services use for older adults compared to
other populations. In a second study AARP looked at
state long-term systems more broadly, developed a
scorecard consisting of performance on twenty-five
measures, and ranked the states based on their scores. In
contrast, our study focused on identifying state policies
(e.g. state plan coverage of HCBS, consumer direction)
that correlated with greater LTSS spending on HCBS.
PRESENTERS:
Pamela Doty, Ph.D., Senior Policy Analyst, U.S.
Department of Health and Human Services, Office of the
Assistant Secretary for Planning and Evaluation; John
Drabek, Ph.D.Senior Policy Analyst, U.S. Department of
Health and Human Services, Office of the Assistant
Secretary for Planning and Evaluation
Potomac VI
A State Wide Approach to LGBT Inclusion for
Aging Network
The network of publicly funded aging services is
intended to create a baseline safety net for older adults,
with an emphasis on those most socially and
economically vulnerable. Access to these services is
often non-welcoming or non-accepting of Lesbian, Gay,
Bisexual, Transgender (LGBT) older adults. Best
estimates predict that at the height of the aging boom
(2010-2030), the population of LGBT elders will range
from 2 million to 7 million. Greater education and
awareness of this often hidden and underserved elder
population is needed. States have an opportunity to serve
as catalysts to promote and insure LGBT cultural
competency training is made available to the broader
aging network. The Georgia Division of Aging Services
has adopted this role, in addition to creating a systematic
delivery approach. Ability to engage multiple State
agencies and systems including Adult Protective
Services, Ombudsman, Gateway/ADRC staff, and our
Area Agencies on Aging has prompted a state-wide
systems response to addressing the needs of LGBT
elders.
Session Objectives are: to discuss the challenges and
barriers facing LGBT elders, to explain the importance of
the State’s role in creating systematic change and to
define strategies that promote greater inclusiveness
within aging networks
PRESENTER:
Doug Carl, Grant Administrator, Georgia Division of
Aging; Representative, SAGEUSA, National Advocacy &
Policy
Potomac II
Managed Care: Solutions for improving
integration and care/service coordination
Our nation's fragmented health care system poses
significant challenges for Americans covered by
Medicaid. Not only are these individuals at an increased
risk for complex health problems due in part to some
combination of poverty, disability and age, they also are
less likely to be seeing a primary care provider. More
States are now turning to a Medicaid Managed Care
system in an effort to respond to waiting lists and poor
coordination of services while increasing access to HCBS
and providing seamless care coordination of services for
dual eligibles. Managed care organizations (MCO'S)
have effectively addressed the challenges faced by
Medicaid beneficiaries and the costs associated with their
services. The objective of this session is to provide the
audience with a better understanding of the value of
managed care; how it works, how it can increase peoples’
quality of life and provide successful strategies to
decrease the cost of care and services. Additionally, the
audience will learn the types of outcomes that should be
expected of these organizations and how to advocate for
them.
PRESENTERS:
Tom Masseau, Executive Director, Disability Rights
Wisconsin; Timothy Englehardt, director of CMS’
Federal Coordinated Health Care Office; Merrill
Friedman, Vice President, Advocacy, Amerigroup; Mark
Trail, Managing Principal at Health Management
Associates
Potomac V
Elder Abuse: Common, Lethal and Very
Expensive
Elder abuse affects far more older persons than has been
previously assumed; it carries a 300% increased risk of
premature death, and it is costly not only to the victims,
but also to financial institutions and to taxpayers. This
session will present recent research findings on the
prevalence, increased risks and costs resulting from elder
abuse, and current national initiatives to address the
problem, including the Elder Justice Act and
administration efforts. It will also provide a brief
overview of adult protective services.
PRESENTERS:
Kathleen Quinn, Director, NAPSA
Conference Theater
NeuroPharmacology
This presentation will focus on the rationale underlying
the use of centrally acting medications to facilitate
recovery and functional independence in individuals
following brain injury. The roles of neurotransmitters,
hormones and cofactors will be reviewed with specific
attention to those that influence behavior and cognition.
Strategies for medication trials will be discussed as well
as a discussion of the misuse of these agents. Tolerance
difficulties and common side effects will be discussed
relative to their potential to trigger dyscompliance.
PRESENTERS:
Neurorehabilitation Services. Gregory O'Shanick,
MD President and Medical Director
Center for Neurorehabilitation Services
Potomac I
Best Practices in Workplace Eldercare
The National Alliance for Caregiving conducted the Best
Practices in Workplace Eldercare study, commissioned
by ReACT (a coalition of companies working to support
employers and their employees who are family
caregivers). The study consists of 18 organizations, large
and small, in all industry sectors. Best Practices in
Workplace Eldercare identifies current trends and
innovations in workplace policies and practices to
support employees with responsibilities for caring for
older adults (eldercare).
The workshop will look at current trends and innovations
in workplace policies and practices to support employees
with responsibilities for caring for older adults
(eldercare). In addition, the workshop will examine key
benefits to employers, including worker retention,
improved productivity, lower stress and improved health
among workers. These programs are seen also as a plus
for attracting new employees. The hope is that more
companies will provide these types of programs.
After the session, participants will understand today’s
employers to do eldercare programming. In addition,
participants will be able to identify some best practice
models in workplace eldercare, and become better
advocates for employers and caregiving employees.
PRESENTERS:
Gail Hunt, President and CEO, National Alliance for
Caregiving; Drew Holzapfel, Global Commercial
Development, Pfizer
3:45 p.m. – 4:15 p.m. Break with exhibitors
4:15 p.m. – 5:30 p.m.
Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Managed Long-Term Services
and Supports: Structures and Safeguards to
Ensure a Person-Centered Approach to Care
Conference Theatre
Section 811 PRA Demo: New Integrated
Supportive Housing Opportunities
Section 811 Supportive Housing for Persons with
Disabilities is a federal program that assists the lowest
income people with the most significant and long-term
disabilities to live independently in the community by
providing affordable housing linked with voluntary
services and supports. Congress passed major reforms to
the Section 811 program in 2010 with strong bi-partisan
support. The reforms will create thousands of new highly
integrated Section 811 units more efficiently. The FY12
Appropriation Act funded an estimated 2,800 new units
under the new Project Rental Assistance (PRA)
component, the most significant of the program reforms.
The President’s FY13 Budget proposes to expand this
new PRA option to the Section 202 Supportive Housing
for the Elderly Program as well. This workshop will
provide an overview of the new PRA model and how it
can expand supportive housing options for both
populations.
PRESENTERS:
Andrew Sperling, NAMI; Ann O’Hara, Technical
Assistance Collaborative; Lisa Sloane, Senior Associate,
Technical Assistance Collaborative
Potomac V
Advocacy by Ombudsman and APS: How they
Differ
The Long-Term Care Ombudsman Program and Adult
Protective Services both advocate for individuals in long-
term care facilities. How are they different? How can
they collaborate in an effective manner? Join us in an
engaging discussion and hear about best practices for
Ombudsman and APS working together.
PRESENTERS:
Robyn Grant, Director for Education and Outreach,
The National Consumer Voice for Quality Long-Term
Care; Lori Smetanka, Director, National LTC
Ombudsman Resource Center, The National Consumer
Voice for Quality Long-Term Care
Potomac I
Enhancing the Capacity of the Aging and
Disability Network through Online Resources
Attendees will review NASUAD’s newest online
resources available to the aging and disability network
and discuss ways in which online training and social
media can reduce costs while increasing the knowledge
base, and outreach potential of organizations. In order to
provide the aging and disability community with low
cost, high quality training opportunities, NASUAD has
created an online training curriculum that is designed to
be easily accessed by users in the field. This session will
walk attendees through the features of NASUAD’s online
learning center including newly posted trainings on the
Affordable Care Act, Medicare/Medicaid 101 and the
new HCBS Taxonomy. NASUAD has also acquired a
new online clearinghouse of all HCBS research and
materials. This clearinghouse is located at www.hcbs.org
– and is a valuable tool for any professional, from state
directors to consumer advocates. Additionally,
presenters will detail how social media - including
Facebook and Twitter – can be useful tools for reaching
audiences with new and valuable resources. Participants
will engage in discussion about the online resources they
currently use, and those which they need additional
assistance to access.
PRESENTERS:
Sara Tribe, Policy Associate, NASUAD; Rachel Shiffrin
Feldman, Policy Associate, NASUAD
Potomac VI
Low Income Older Workers: A Resource to the
Aging Services Network
Despite recent cuts in funding and record levels of
unemployment among older workers, the Senior
Community Service Employment Program (SCSEP)
continues to provide tens of thousands of low-income
older adults each year with paid part-time community
service jobs. This year alone, SCSEP participants will
work about 10 million hours—about one-fourth of all
SCSEP hours—in the aging services network, including
nutrition programs, area agencies on aging, and others.
This workshop will provide an update on the following:
results of the Department of Labor’s competition for
national SCSEP grantees effective October 1, 2012; a
new SCSEP performance indicator approved in January
2012 encouraging stronger links between SCSEP and
volunteerism; and proposals to repeal or reauthorize
SCSEP (Title V of the Older Americans Act). Finally,
the workshop will highlight promising collaborative
efforts between SCSEP and HCBS providers, based on
recent research by the University of North Carolina
Institute on Aging, Benjamin Rose Institute, and others.
PRESENTERS:
Tony Sarmiento, Executive Director, Senior Service
America, Inc.; Marta Ames, Deputy Director, Senior
Service America, Inc.
Roosevelt Room
Medicaid HCBS Programs and Policies: 1999-
2009
In response to consumer demand, the Supreme Court
decision in the Olmstead case and the New Freedom
Initiative, states have unevenly expanded combinations of
three Medicaid home and community based services
(HCBS) : home health, state plan personal care services
(PCS), and 1915(c) waivers. By 2009, the federal-state
Medicaid program paid for 34 percent of the nation’s
estimated $205 billion total long-term care (LTC)
expenditures while institutional care (e.g., nursing
homes) consumed 55 percent of those expenditures. As
states struggle with budget deficits and the loss of
stimulus money from ARRA, the Patient Protection and
Affordability Care Act of 2010 and its provisions for
continued HCBS growth reflects growing concerns about
the need to preserve and expand Medicaid HCBS and the
need for information on program and policy trends.
This paper draws from a unique national dataset to
present the latest trends in participants, expenditures and
policies for the three Medicaid HCBS programs. While
data for 2009 show a steady increase in participants and
expenditures, these growth rates have slowed since 2001.
Inequities in access to services and limited funds have
also resulted in unmet needs for HCBS. Findings from
the survey of policies such on the programs in 2011 show
that states are increasing the number of waiting lists for
waiver services even as the number of available “slots”
increases. Cost caps such as service and cost limits are
also used in almost half the state plan personal care
programs and almost a third of home health programs.
From this session participants will be able to: (1) identify
trends in Medicaid HCBS participants, expenditures and
policies, (2) understand state responses to unmet needs
and fiscal crisis in terms of Medicaid program trends and
policy, and (3) consider the potential impact on access to
Medicaid HCBS through state policies
PRESENTER:
Terence Ng, Assistant Adjunct Professor, University of
California San Francisco
Potomac II
New Frontier: State Oversight of Medicaid
Managed Long-Term Services and Supports
Medicaid Managed Long-Term Services and Supports
(MMLTSS) is taking the country by storm. A recent
AARP, NASUAD, and HMA report found that the
number of states moving to MMLTSS will double within
the next two years, with 12 states having existing
programs and another 11 with plans for implementation
in 2012 and 2013. What do state agencies need to do to
monitor the performance of MMLTSS programs to
ensure that people receive high quality care? Come to this
session to learn about findings on state oversight from a
recent AARP Public Policy Institute report co-authored
by policy analysts from AARP and Mathematica. In this
session, you will learn about promising practices as well
as red flags as states move toward transforming their
LTSS systems.
PRESENTER:
Lynda Flowers, Senior Policy Advisor, AARP Public
Policy Institute
Kennedy Room
Mental Health
Lincoln Room
The Emergence of an HCBS Policy Lab: The
Engine
This session is in companion with “The Vision” session
which details the construction and availability of an
‘HCBS Policy Lab’. This session is to offer participants
the opportunity to get a ‘use-sense’ as to the utility of the
Massachusetts dataset. Presenters will demonstrate how
the data has been transformed to be ready for analysis.
For purpose of suggesting functionality, presenters will
offer:
-A ‘real time’ picture of all clients being served and
services being delivered by the 30 Area Agencies on
Aging and Aging Service Access Points across
Massachusetts. Participants will be interested in the
nature of information that is immediately available to the
State Unit on Aging executive.
-Demonstration on the capability to integrate and present
state HCBS program information with other datasets of
interest.
-Demonstration on the installation of a program integrity
technique to improve the program monitoring capacity of
the State Unit on Aging.
-Demonstration on the research potential of the lab.
Presenters will share the results of early efforts
attempting to quantify the value of informal supports to
HCBS planning. Presenters will further discuss potential
to develop an ‘HCBS dividend’ analysis.
PRESENTERS:
Ann L.Hartstein, Secretary, Massachusetts Executive
Office of Elder Affairs; Peter J. Tiernan, Director of
Administration and Finance, Massachusetts Executive
Office of Elder Affairs; Sean Rogers, Financial Business
Analyst, Massachusetts Executive Office of Elder Affairs.
4:00 p.m. – 6:00 p.m. Conversation with Regional Administration for Community
Living Administrators
State Directors Only
THURSDAY, SEPTEMBER 13, 2012
7:00 a.m. - 3:00 p.m. Registration
7:30 a.m. - 8:30 a.m. Continental Breakfast
8:30 a.m. – 9:45 a.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Quality and HCBS
Lincoln Room
Assessing Family Caregiver Needs: The New
Frontier
Home and Community-Based Services (HCBS) provided
through Medicaid waivers, enable older persons and
adults with disabilities to remain in their homes and can
support family caregivers. The assessment process for
HCBS is also a key opportunity to assess the caregiving
situation, especially the needs, resources and strengths of
the family caregiver. Where appropriate, the results of an
assessment can be used to connect caregivers with
supportive services. This presentation will present
preliminary findings from a 50-state survey examining
the state of the states in assessing family caregiver needs
within Medicaid HCBS Aged and Aged/Disabled waiver
programs. The process for conducting a caregiver
assessment in Medicaid waiver programs, the types of
questions included to assess caregiver needs, and how the
information collected is used to support family caregivers
will be highlighted. The session will also present findings
from a pilot program in New Jersey designed to improve
the knowledge and skills of family caregivers for
beneficiaries enrolled in waiver programs, following a
caregiver self-assessment. Implications for health care
and social service professionals to better recognize and
support families as partners in care will be addressed.
PRESENTERS:
Lynn Feinberg, Senior Strategic Policy Advisor, AARP
Public Policy Institute; Kathleen Kelly, Executive
Director, Family Caregiver Alliance, National Center on
Caregiving; Sean Coffey, Senior Policy Specialist
Family Caregiver Alliance, National Center on
Caregiving; Aaron Tripp, Policy Analyst, The Hilltop
Institute; Cynthia Woodcock; Senior Research Associate
MPAQ International LLC
Roosevelt Room
“Aha!” Moments along the Options Counseling
Highway
What do “Aha!” moments and the creation of standards
for Options Counseling have in common? This session
outlines Wisconsin’s journey toward development of
Options Counseling standards and highlights the many
opportunities, challenges and “Aha!” moments
encountered along the way. The engagement of ADRC
staff, supervisors, and stakeholders, and their openness to
exploration and learning were essential to the
development of meaningful standards, and to the success
of the project. “Aha” moments shared are derived from
conversations with ADRC customers, staff, and leaders
alike.
PRESENTERS:
Maurine Strickland, Office for Resource Center
Development; Michelle Pike, ADRC of Ozaukee County;
Devon Christianson, ADRC of Brown County;
Laura Neve, ADRC of Northwest Wisconsin;
Charlene Oftedahl, ADRC of Barron, Rusk & Washburn
Counties; Amy Flowers, PhD, Analytic Insight
Potomac VI
Iowa Perspectives on Enhancing the Aging
Network
This workshop will focus on one states effort to enhance
the Aging Network. In 2011, as a result of Iowa House
File 45, the Iowa Department on Aging was mandated to
reduce the number of Area Agencies on Aging in the
state. What followed was, and continues to be, a state-
wide effort to increase support service efficiency, re-
create planning and service areas, and combine resources
to more effectively serve the aging population in Iowa.
This workshop will discuss, in “real-life” Terms, the
intricacies of navigating a process of reorganization
starting with the original legislation, community forum
discussions, and countless meetings between AAA?s and
the various stake-holders within Iowa’s aging network.
All of these efforts complete with many of the bumps
along the way will be illustrated in a forum that will
allow other states, and aging network participants to learn
and prepare for possible reorganization. Regardless of
whether reorganization is eminent in your state or not,
this workshop will provide for opportunities to dialogue
about best practice models, business planning, and other
topics to assist your organization in enhancing services
and supports for your consumers.
PRESENTERS:
Mike Isaacson, Executive Director, Hawkeye Valley
Area Agency on Aging; Donna Harvey, State Director,
Iowa Dept. on Aging; Barb Morrison, Executive
Director, Southwest 8 Senior Services
Kennedy Room
A Participant Direction in a Managed Care
Environment
Bridgeway Health Solutions serves approximately 5,000
members in Arizona’s Long Term Care System (ALTCS)
program. ALTCS covers primary, acute and long-term
services in one integrated program that incorporates
Medicare and Medicaid services and funding in an
approach that is seamless to beneficiaries. In a state
characterized by a rural geography, including some
frontier communities, access to care can be limited. The
focus of ALTCS is to provide the best long-term care in a
home environment. Through ALTCS, home and
community-based service waivers allow Medicaid
recipients to receive funding for in-home care. This
panel will discuss the implementation of participant-
directed home and community-based services in the
managed care environment from the perspective of the
state, managed care organization, advocate, and
participant following a brief introduction to Long Term
Services and Supports in managed care environments.
Audience participation will be encouraged throughout the
panel discussion.
MODERATOR:
Dianne Kayala, MS
Director of New Initiatives
National Resource Center for Participant-Directed
Services, Boston College Graduate School of Social
Work
PRESENTERS:
Kathleen Quinn, Executive Director
National Adult Protective Services Association;
Jami Snyder, Operations Administrator for Acute and
Long Term Care, Arizona Health Care Cost Containment
System (AHCCCS); Rick Frederickson CEO and
President, Bridgeway Health Solutions, a Centene
Company
Potomac II
Technology Enabled Collaboration and
Communication
Recent advancements in technology have the potential to
improve the collaboration and communication within the
Long-Term Care and Home and Community Based
services community. The increased availability and
capability of mobile solutions and collaborative tools
allow individuals, family members, case managers, and
direct service providers the opportunity to interact with
each other in a more effective manner. This increased
collaboration as well as the increased ease of access to
information has the potential to improve the quality of
services and care throughout the community. This session
will address the potential role that technology can play in
helping agencies to increase the level and effectiveness of
communication with various stakeholders, oversee the
management of services more effectively, and drive
towards improved quality of service delivery. Members
of the LTC and HCBS community have already started to
embrace this technology, and agencies have a real
opportunity today to become an active participant and
shape the direction this increased collaboration and
communication takes in the future. We will discuss
potential uses of the technology specific to this
community as well how to prepare for this type of
change.
PRESENTERS:
Meghan Sullivan, Senior Manager, Deloitte Consulting;
Bert Maier, Director, Deloitte Consulting
Potomac I
The TASC Planning Zone: Planning to
Succeed
During the presentation, session participants will have the
opportunity to learn about the Technical Assistance
Support Center (TASC) Planning Zone, a widely
applicable online strategic planning resource which is
available on the NASUAD website and was developed as
a joint project between the Administration on Aging
(AoA), NASUAD, state units on aging, and area agencies
on aging. Participants will gain insight into how to
utilize the TASC Planning Zone in order to
conceptualize, develop, and leverage concise, yet
comprehensive, state and area plans on aging.
PRESENTERS:
Katie Glendenning, Aging Program Specialist for the
Administration on Aging; Rachel Shiffrin Feldman,
Policy Associate, NASUAD.
Potomac V
Can You Hear Me Now?- Advancements in
Emergency Broadcast Alerts and Preparedness
DHS FEMA is progressing in the implementation of
emergency broadcast alerts being ADA complainant.
Come to this workshop to learn what this mean for
people with access and functional needs. In addition,
advice for being better prepared for emergencies for
caregivers and people with disabilities will be discussed.
PRESENTERS:
Maria Greene, Consultant; Dr.Susan Wehry,
Commissioner, Vermont Department of Aging and
Independent Living.
9:45 a.m. – 10.00 a.m. Break
10:00 a.m. – 11:15 a.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive -Open Mike Session
CMS will field questions from the audience on a variety
of topics. CMS staff will be present and respond to
questions. Presenters: CMS CO and RO staff
PRESENTERS:
CMS Staff
Kennedy Room
Implementing a Management Information System
that Supports Key ADRC and Options Counseling
Protocols in Hawaii
Two years ago, Hawaii presented at the HCBS
Conference about their efforts to develop a detailed
strategic plan for building a statewide ADRC system that
meets AoA’s definition of a full-functi
oning ADRC. Last year, the State presented detailed
decision support and other operations protocols for key
business processes necessary to develop a system that
incorporates person-centered principles, while at the
same time ensuring consistency across staff and counties.
During this session we will discuss how the State
collaborated with Harmony Information Systems and
HCBS Strategies to adopt Harmony for Aging and Adult
Services to automate these requirements. The
presentation will include a walkthrough of Hawaii’s new
management information system, including the
embedded interRAI assessment functionality and
automated AoA required ADRC Semi-Annual Reporting
Tool (SART) report, as well as provide, a summary of the
training approach and materials, and lessons learned from
the pilot county, Maui. This session will be of particular
interest to states and other organizations attempting to
streamline and standardize key processes while
maintaining a person-centered process.
PRESENTERS:
Steven Lutzky, President, HCBS Strategies Incorporated;
Hawaii Executive Office on Aging Staff: Wes Lum,
Director, Nancy Moser, Grants Manager, Caroline
Cadirao, Grants Manager
Maui County on Aging: Deborah Arendale, Executive
Director, Mary James, Program Manager –
Implementation Services, Harmony Systems for Aging.
Roosevelt Room
“Sharing the Care” Bringing the Respite Message
from Caregivers to the Community
How to start lifespan respite programs in your state. How
can aging networks utilize Lifespan Respite Voucher
Programs to provide Consumer Directed Services under
the Older American’s Act Programs? Find out about
building capacity through “Sharing the Care”, a
community based approached to providing respite for
caregivers. Learn what UAB surveys tell about what
Caregivers want and need.
PRESENTER:
Julie Miller, Program and Planning Division Chief,
Lifespan Respite Grant Project Director, Alabama
Department of Senior Services
Lincoln Room
A Guide to a Direct Care Career
The presentation will provide an overview of
DirectConnect, a 3 year grant funded by the Department
of Labor that focuses on strengthening the direct care
workforce in the State of NH. Efforts of DirectConnect
include targeted recruitment into the workforce,
improved access to training for direct care workers in the
state and dissemination of best practice briefs regarding
retaining workers in this workforce. Participants will
learn about an industry career lattice that was created
through the grant and how it is being used as both a
recruitment and retention tool in the state.
PRESENTER:
Jennifer Rabalais, Project Director, Institute on
Disability/University of New Hampshire
Business Tools for the Adult Family Home
Provider
In today’s economy nothing is more important in the
operation of a small business than appropriate training
and operational tools. Individuals seeking to become
Adult Family Home (AFH) providers under the Arkansas
Department of Human Services (DHS), Division of
Aging and Adult Services (DAAS) are often located in
rural areas and have no significant business operation
experience. While ample training has always been
available to address health, safety, nutrition and other
caregiver issues, there was no comprehensive tool to
assist interested providers in small business operation
development. DAAS worked with alt.Consulting, a non-
profit community development organization focused on
growing small businesses in rural counties in Arkansas,
to develop a customized toolkit for Adult Family Homes
operation. The toolkit addresses business organization
and start up, human resources, business finances, and
marketing. This presentation traces the development of
the toolkit and its application with new Adult Family
Homes providers.
PRESENTERS:
Ramona Sangalli, Adult Family Homes Program
Administrator, Arkansas Department of Human Services,
Division of Aging and Adult Services
Ines Polonius, Executive Director, alt.Consulting
Potomac I
Supporting Consumers who Transition
This session will focus on the supports consumers need
when transitioning out of a nursing home into a home or
community setting. We will share findings from
consumers who have actually transitioned - hearing what
worked, what didn't, and what could have been done
better. We will also discuss the roles of others, such as
the long-term care ombudsman and transition
coordinators, in supporting the individual. Efforts will be
made to identify and include a consumer who has
transitioned.
PRESENTERS:
Robyn Grant, Director for Education and Outreach,The
National Consumer Voice for Quality Long-Term Care;
Lori Smetanka, Director, National LTC Ombudsman
Resource Center, The National Consumer Voice for
Quality Long-Term Care
Potomac VI
Substance Abuse in Vulnerable Populations
Potomac V
HCBS & Managed Care: Policy & Consumer
Protections
2012 has seen a flood of state proposals to convert HCBS
programs to a managed care model, both in dual-eligible
integration proposals and in Medicaid HCBS waiver
proposals. The proposals assert that the managed care
model can better coordinate care, rebalance state
Medicaid programs away from institutional care and, in
doing so, cut Medicaid and Medicare costs. A danger for
beneficiaries, however, is that cost savings from managed
care will come disproportionately from service denials
and that the social model for HCBS will be
compromised. Based in part on an advocacy toolkit that
the speakers are currently (in March 2012) developing,
the session will consider important consumer protection
issues in designing and then implementing managed care
HCBS programs. One important topic will be care
planning, and the enrollee’s ability to influence or appeal
care planning decisions. Other topics will include
continuity of care, self-directed care, incentives for
rebalancing, and quality measurement. The presentation
will include information on specific states’ programs and
proposals, and will encourage attendees to describe and
discuss developments in their states. Attendees will learn
how to advocate for consumer protections within an
HCBS managed care mode.
PRESENTER:
Eric Carlson, Directing Attorney, National Senior
Citizens Law Center
Potomac II
Community-Based Crisis Intervention for Persons
with Acquired Brain Injury
Over 250,000 Virginians of adult age are living with a
disability as a result of acquired brain injury (ABI).
Behavioral and cognitive issues, the most common
debilitating consequences of a severe ABI (Milders,
Fuchs, & Crawford, 2003), have a significant impact on a
person’s psychosocial adjustment and ability to
reintegrate into the community. In Virginia, there is
currently no publicly-funded option for neurobehavioral
treatment for individuals affected by brain injury. These
individuals are unable to access appropriate behavioral
health services, leading to potential inappropriate
placement in state and local psychiatric facilities, skilled
nursing facilities, or the judicial system. This multi-year
project funded by the Virginia Commonwealth
Neurotrauma Initiative Trust Fund investigates barriers
and potential pathways to appropriate services.
MODERATOR:
Michelle Witt, M.A.L.S., Executive Director, Crossroads
to Brain Injury Recovery, Inc.
PRESENTERS:
Michelle Witt, M.A.L.S., Executive Director, Crossroads
to Brain Injury Recovery, Inc.; Cara Meixner, Ph.D.,
Assistant Professor, Psychology and Assistant Director,
Center for Faculty Innovation, James Madison
University; Cynthia R. O’Donoghue Ph.D., Professor
and Head, Department of Communications Sciences &
Disorders at James Madison University, Harrisonburg,
Virginia
11:15 a.m. – 11:30 a.m. Break
11:30 a.m. – 12:45 p.m. Sessions:
Potomac III & IV
ACL/AoA
Washington Room
CMS Intensive - Community Integration
Initiatives
Potomac VI
Using Home and Community Based Rate
Development and Individual Budget Allocation
Strategies in a Person-Centered System of Care –
Principles Applicable in Both Managed Care and
FFS Delivery Systems
This session will describe strategies states may employ to
develop rate and budget allocation structures based upon
and managed through the use of data and measurement
techniques. The session will further explore, how, in a fee
for service environment or managed care environment,
rate structures and data and information can be used to
contribute to and establish expectations for person-
centered systems of care. With limited resources, more
states are exploring methods to develop payment
structures that both assure efficiency and quality care,
and this session will provide real examples from state
staff and Mercer team members who have supported their
efforts.
MODERATOR:
April Lindquist, Marketing Coordinator, Mercer
Government Human Services Consulting
PRESENTERS:
Tara R. Larson, MA, Ed.S, Chief Clinical Operations
Officer, Senior Deputy of the Division of Medical
Assistance, NC Department of Health and Human
Services; Mary Sowers, Senior Associate, Mercer
Government Human Services Consulting; Brenda
Jackson, MMP; LLC.
Potomac V
Legal Services Developers 101: Furthering HCBS
An often overlooked and even unknown resource in
facilitating home and community based services is the
State Legal Services Developer. Join us to learn: 1)
what a state legal services developer is; 2) What her/his
role under the Older Americans Act is; 3) variations
among states and reasons for those variations; and, 4)
how you can work with your developer to enable delivery
of HCBS.
As one example: If an older person is at risk of losing
her/his home through eviction or foreclosure thus barring
the person from receiving HCBS and potentially leading
to institutionalization, the legal services developer can
help procure legal services to prevent the loss of the
home. Numerous other ways the legal developer can
assist you in enabling successful provision of HCBS and
avoiding institutionalization will be explored.
The panel presentation will highlight the state of
Florida’s approach to developing an integrated and cost-
effective legal services delivery system that targets
priority legal issues impacting seniors most in need. The
Florida model is an excellent example of how legal
services and state developers can assist in enabling
HCBS.
PRESENTERS:
Penelope A. Hommel, Co-Director, The Center for
Social Gerontology; Charles T. Corley, Secretary,
Florida Department of Elder Affairs; Sarah Halsell
State Legal Services Developer, Florida Department of
Elder Affairs; Lindsey Copeland, Director of Policy and
Legislative Affairs, NASUAD
Potomac I
LTQA – Linkages between Long-Term Care and
Acute Care
This session will explore the Long-Term Quality
Alliance's efforts to improve the quality of life for people
receiving long-term services and supports. Learn the
latest on LTQAs work to advance adult-specific key
person and family centered quality indicators and review
case studies of innovative multi-sector coalitions that are
working together to improve care transitions and reduce
avoidable hospitalizations. Attendees will discuss the
importance of consumers and policy makers embracing
and supporting the inclusion of long-term services and
supports as an essential part of the health care system of
the future.
PRESENTER:
Doug Pace, Executive Director, Long-Term Quality
Alliance
Kennedy Room
Addressing the Age Wave: Utilizing the Aging
Network to Engage Baby Boomers in
Volunteerism
The National Resource Center for Engaging Volunteers
in the Aging Network, is a project founded by AoA with
the primary goal of providing technical assistance to
organizations in establishing the national Aging Network
as a leader in civic engagement. As states are looking for
ways to overcome economic barriers while counting to
support older adults, the project also aims to facilitate
enlistment of Baby Boomers in civic engagement.
Presenters will address the national context, goals of the
Center, and the results of a national volunteerism scan
conducted by both NASUAD and n4a. In order to
produce a baseline for the three year grant, a national
volunteerism environmental scan was conducted
(including an online assessment and focus groups) by
both NASUAD and n4a. NASUAD focused on three
national programs: Senior Health Insurance Programs
(SHIPs), Senior Medicare Patrol (SMP), and the Long
Term Care Ombudsman Program, including how each
program is currently utilizing volunteers, especially
Boomers, in the delivery of Aging Network services. n4a
focused its scan on the volunteers within the Area
Agencies on Aging (AAAs) and the barriers and
challenges AAAs face in maximizing the volunteer
experience. n4a will also report on the action plan that
has grown out of a May 2011 Thought Leaders meeting.
The presentation will also describe how the National
Resource Center fits into AoA overall strategy on civic
engagement. The following organizations are grant
partners on the National Resource Center Project: AoA,
n4a, NASUAD and the AARP Foundation.
PRESENTERS:
Karl D. Cooper, Policy Associate, NASUAD; Carol
Cresy, AOA, Tom Endres, n4a
Conference Theatre
Medicaid Managed Long-Term Care Panel
Potomac II
HCBS Taxonomy
Roosevelt Room
New Protocols & Interventions for Early Stage
AD
When persons with Early Stage Alzheimer’s Disease
(AD) are diagnosed they often receive little more
information than the diagnosis itself. These persons with
Early Stage AD have unique concerns that are often
unmet. The Georgia Division of Aging Services, in
conjunction with the Alzheimer’s Association, Georgia
Chapter, and the Georgia Health Policy Center of
Georgia State University, will present findings on new
interventions developed, including driving assessments, a
new clinical counseling protocol developed for persons
with Early Stage AD, and work in progress on an
assessment tool for Adult Protective Services and law
enforcement staff to use in determining whether persons
with Early Stage AD have the cognitive ability to make
prudent financial decisions. By the end of the session,
participants will be able to:
-Describe some of the unique challenges of persons with
Early Stage AD
- Interpret findings from driving assessments for persons
with Early Stage AD and their impact on the person with
AD
-Recognize the key components of clinical counseling
and its effectiveness identified through this project
- Identify the situations in which utilizing financial
capacity tools and training may be beneficial
PRESENTERS:
Ginny Helms, BA Director of Chapter Services & Public
Policy, Alzheimer's Association, Georgia Chapter
Suzette Binford,MA , Family Support Services Director
Alzheimer's Association,Georgia Chapter
Cliff Burt, MPA, Caregiver Specialit,
Georgia Division of Aging Services
Beth Fuller, Ph.D, Senior Research Associate
Georgia Health Policy Center, Georgia State University
12:45 p.m. – 1:45 p.m. Lunch
1:45 p.m. – 3:00 p.m. Closing Plenary
