HCBS / More Info:Aging and Disability Resource Centers (ADRC): Federal and State Efforts to Guide Consumers Through the Long-Term Services and Supports Maze

Summary

The ADRC program’s purpose is to help people of all ages, disabilities, and income levels more easily access LTSS through single points of entry, make more efficient use of care options, and maximize the services available. This publication provides background on the evolution of ADRCs, their functions and implementation, grants to states, and state and federal evaluation efforts. It also points to selected issues in continuing ADRC implementation.

Author

O’Shaughnessy, Carol V.

Available Files

• Report PDF (1,779K, 30 pages)
• Report Off-site link (30 pages)

Job Opportunities: AoA Affordable Care Act Positions

The Administration on Aging (AoA) has two new staff positions for which it is recruiting that will be involved in the direct implementation of Affordable Care Act activities to help people navigate their health and long-term service and support options through Aging and Disability Resource Centers (ADRCs).  These are full-time federal civil service positions.  These positions will be located at AoA headquarters in Washington, DC.

If interested in applying for either or both these positions, please send your resume and a cover letter to Janell.Miller@aoa.hhs.gov no later than July 9, 2010.

ADRC Care Transitions Program Officer

The ADRC Care Transition Program Officer will provide agency-wide leadership to ensure ADRCs play a visible and meaningful role in supporting the development and implementation of Evidence-Based Care Transitions Models that assist individuals with chronic conditions to transition from hospitals, assisted living, or nursing home facilities back into the community.  The ideal candidate for this position should have a working knowledge of and experience implementing Evidence-Based Care Transitions Models (including the Care Transition Intervention SM, the Transitional Care Model, the GRACE model, and the Guided Care Model) and applying Care Transitions research in hospitals and community settings.  This individual should also have experience collaborating across aging, disability, Medicaid and health networks to oversee grant programs and provide technical assistance for programs that impact the lives of older adults and persons with disabilities of all ages.  The candidate will represent AoA on government-wide initiatives and activities related to Care Transitions, and to support senior level staff on the overall implementation of the ADRC program.

ADRC Options Counseling & Assistance Program Officer

The ADRC Options Counseling & Assistance Program Officer will provide agency-wide leadership to strengthen the role of ADRCs in Options Counseling and Assistance whereby consumers, family members and/or significant others are supported in a person-centered approach to determine appropriate long-term service and support options in the context of the consumer’s needs, preferences, values and individual circumstances.  The ideal candidate for this position should have a working knowledge of and experience implementing consumer-directed options counseling and decision support services, including one-on-one assistance to older adults and individuals with disabilities of all ages and their family members and/or caregivers.  This individual should also have experience: collaborating across aging, disability, Medicaid and health networks; working with grant programs and providing technical assistance for programs that assist consumers to make decisions concerning their long-term services and supports and health care; managing processes and systems that provide streamlined eligibility determination, expedite service delivery and enrollment in publicly funded programs, and care coordination in the most integrated setting.  The candidate will represent the AoA on government-wide initiatives and activities related to Options Counseling and Assistance and support senior level staff on the overall implementation of the ADRC program.

For More Information

For more information on the type of programs and activities the two positions will be involved in, please read funding opportunities B (Options Counseling) and D (Care Transitions) in the AoA program announcement currently available at: http://www.aoa.gov/AoARoot/Grants/Funding/docs/2010/AoA_CMS_Affordable_Care_Act_June_2010.doc.   

Agency pairing with new disability network will benefit both

by Lynn Kellogg

In 1976, my final project to complete an undergraduate degree in social work at Western Michigan University was helping to establish an office of information and support for students with disabilities. The primary paper for my second major in environmental studies focused on recreational planning for people with disabilities. While searching for a job, I served as a volunteer staff member for a state event associated with a White House conference on issues surrounding disabilities.

I had it in my head that work in the field of disability was in the cards. It didn't exactly work out that way - but in some ways it did.

As we age, it's only when barriers to daily activities get in the way that any issues appear. Sometimes people need help with daily chores, or transportation, or housing, or coping with and managing a health condition. Changes in how we do things trigger lifestyle changes, sometime minor, sometimes substantial. We change, we go on. Sometimes we're judged as "different" or feel a difference in people's perception of us.

At a recent Rotary Club meeting, Miss Southwest Michigan presented her platform as a disability rights advocate. Growing up with a brother with Down syndrome had taught her that he was normal. He was happy and functioned well in society. Contending with the judgment of others was what was difficult.

"Disability is a natural part of the human condition. Disability is simply a characteristic of a person. A disability doesn't exist until someone encounters a barrier. It is the environment or culture that needs to be fixed, not the individual with the disability." This is the philosophy of a new organization in town - Disability Network Southwest Michigan.

Sometime in the next few months, new Disability Network Southwest Michigan signage will be added to the Area Agency on Aging's sign at its base of operations at 2900 Lakeview Ave. in St. Joseph. The organization is based at a central office in Kalamazoo and has recently expanded to cover an eight-county area. It now serves Berrien, Cass and Van Buren counties and has co-located its local offices with the Area Agency on Aging.

The new partnership holds great potential. Both organizations have missions of empowerment of the person and advocacy for social change. There are many areas of common interest and expertise. Both organizations strive to have communities that accept and embrace older and disabled citizens by having services and supports in place that make possible staying engaged throughout a lifetime. Both are committed to providing quality information when people seek solutions to barriers they've run up against.

Therein lies the strength of the partnership. Shared information on available resources and common messaging on needed social change strengthens both organizations.

Individuals seeking information on topics such as available resources, assistive technology information, or personal advocacy and support should give Disability Network Southwest Michigan a call. Businesses and community organizations seeking information on Americans with Disabilities Act compliance or home and workplace modification consultations will also find them helpful. The local office can be reached at 985-0111, with a toll-free line - (877) 674-5209 - ringing to the Kalamazoo office and serving outlining areas.

Lynn Kellogg is chief executive officer of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Long-Term Care at (800) 654-2810 or check the website at www.areaagencyonaging.org. The Generations column appears each Sunday in The Herald-Palladium.

HHS Announces Availability of $60 Million in Affordable Care Act Grants to Help People Navigate their Health and Long-term Care Options

HHS Secretary Kathleen Sebelius announced the availability of $60 million in Affordable Care Act grants to states and communities to help individuals and their caregivers better understand and navigate their health and long-term care options. 

Through this opportunity made possible by the Affordable Care Act HHS' Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) will work collaboratively to award funds for an integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.

"The Affordable Care Act seeks to lower health care costs, improve the quality of health care and perhaps most importantly give people more control over their own care. These new grants, authorized under the new law, will help seniors, individuals with disabilities and their families get better quality care and more control. We've also streamlined the process for states and people who rely on these funds," said Secretary Sebelius.

"We know how difficult it can be for caregivers and patients to try and deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where you can get help. These new funds that we have bundled together will help promote better opportunities for coordination of health and long-term supports," said Sebelius.

The purpose of this new grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling, and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs.  AoA and CMS will administer the funding through separate announcements, but will coordinate implementation and monitoring through a single process. 

Some specific areas of focus will include assisting individuals who are under-served and hard to reach with information about their Medicare and Medicaid benefits, helping older adults and individuals with disabilities live at home or in settings of their choosing with the right supports, assisting people transition from hospital or nursing home stays back into the community, and strengthening linkages between the medical and social service systems.

"When it comes to long-term health care, each patient has a unique mix of complex medical and social needs that must be considered when seeking care," said Marilyn Tavenner, acting CMS administrator. "Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services.  Making patients and their families aware of these options will help them make inherently difficult decisions about long-term care.  This integrated program will help families make informed choices and make sure patients have more control over their own care."

AoA and CMS have provided grants to states for several years to develop person-centered systems of information, counseling and access to make it easier for individuals to learn about and access their health and long-term services and support options. This grant program through the Affordable Care Act strengthens and enhances the ability of states to truly integrate the medical and social services care models. 
                             
"AoA's national network of community-based organizations has long served as the central place for individuals and families seeking information and help to address health and long term care challenges.  This collaborative opportunity between AoA and CMS will further strengthen the network's capacity to help people in a more coordinated and comprehensive way in the communities where they live," said Kathy Greenlee, assistant secretary for aging.
                   
Funds will be available to states, area agencies on aging (aaa's), State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs).  Through the grant program, states and local aging and disability programs will receive funds to:

* provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention;
* use additional funds through a competitive process to provide Options Counseling on health and long-term care through ADRCs;
* use additional funds through a competitive process to strengthen the ADRCs role in Money follows the Person program and support state Medicaid agencies as they transition individuals from nursing homes to community-based care; and 
* coordinate and continue to embed tested Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit. 

"CMS and AoA share a long-standing goal of expanding access to community-based care for the elderly and individuals with disabilities.  The Affordable Care Act provides significant resources for state Medicaid agencies and providers to balance the nation's long-term care systems and assure that individuals have a choice of where and how they receive their services," said Cindy Mann, director of CMS's Center for Medicaid, CHIP, and Survey and Certification.

The announcement combines funding opportunities from several provisions in the Affordable Care Act signed into law by President Obama on March 23, 2010, including the Role of Public Programs (Title II, Sections 2403 - Money Follows the Person and 2405 - Funding for Aging and Disability Resource Centers) and Improving the Quality and Efficiency of Health Care (Title III. Section 3306 - Funding for Outreach and Assistance for Low-Income Programs).

These grants also complement President Obama's "Year of Community Living Initiative," which focuses on better serving those individuals with disabilities who need ongoing services and support programs in the community such as those provided by AoA, CMS and other HHS agencies.    

The deadline for applications is: Monday, July 30, 2010.  Grants will be awarded in September 2010.  For more information about this grant opportunity, please visit http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx or www.grants.gov.

To learn more about the Affordable Care Act, please visit www.healthreform.gov
Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

THE FIRST ANNUAL “EXCELLENCE IN ACTION” AWARDS

On Tuesday, February 23, 2010, the Administration on Aging held its first annual Excellence in Action Awards program to formally acknowledge exceptional work performed during the past year by Aging and Disability Resource Centers (ADRCs), Community Living Programs (CLPs), and Veteran-Directed Home and Community-Based Services programs. The awards were presented at the Administration on Aging/Centers for Medicare & Medicaid Service (CMS) 2010 National Grantee Conference entitled “Changing Systems, Changing Lives.”

Eligible nominees were State Units on Aging (SUAs), Area Agencies on Aging (AAA), Centers for Independent Living (CILs), State Independent Living Councils (SILC), Aging Disability Resource Centers (ADRC), Community Living Programs (CLP) and their partners or networks of these programs. Winners demonstrated exceptional commitment, creativity, leadership and success in achieving goals related to the conference theme.” Awards were given in the following categories:

•Changing Systems Award
•Changing Lives Award
•Exemplary Partnership Award

The 2010 Excellence in Action awardees:
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US Administration on Aging Awards more than $32 million for Home and Community-Based Services and Supports for Older Americans and Individuals with Disabilities

HHS Assistant Secretary for Aging Kathy Greenlee has announced more than $32 million to expand and support community-based programs that help promote health, independence and community living for older Americans, veterans and people with disabilities.

“This new funding complements President Obama’s designation of 2009 as the ‘Year of Community Living,’ which supports community living options for all people with disabilities,” said U.S. Department of Health and Human Services Secretary Kathleen Sebelius. “These grants are important investments that will help us strengthen services in the community so that more older Americans and individuals with disabilities can remain in their homes and communities.”

Today’s announcement includes funding for:

Community Living Program (CLP)/Veterans Directed Home and Community Based Program (VDHCBS)
Seven million dollars for AoA’s Community Living Program to fund 16 states to help individuals who are at risk of being admitted to a nursing home to remain at home through the provision of home and community-based services and supports. For the second year, AoA will be partnering with the VHA to offer the VDHCBS program through the Community Living Program.

To learn which states received CLP funding, Click here.

Aging and Disability Resource Centers (ADRC)
Eleven million dollars to 49 states and territories to make it easier for people to learn about and access the full array of long-term care options that are available in their communities. ADRCs are a collaborative effort of AoA and the Centers for Medicare & Medicaid Services (CMS) to support state efforts to implement “one-stop shop” entry points at the community level.

To learn which states received funding and to learn more about ADRCs,Click here.

Alzheimer’s Disease Supportive Services Program (ADSSP)
Ten million dollars for grants to help families caring for individuals with Alzheimer’s disease and Related Disorders (ADRD) in the community. Through the ADSSP, 16 states will receive grants to expand the availability of support services for families who are caring for individuals with Alzheimer’s Disease in the community.

To learn which states were selected and to learn more about the Alzheimer’s Disease Supportive Services program, click here

Community Innovations for Aging in Place
More than $4.5 million for grants to 13 community-based organizations to support a variety of innovative models for providing comprehensive and coordinated health and social services to seniors in the communities where they live.

To learn which organizations were selected for Community Innovations for Aging in Place, click here.

2008 ADRC National Meeting - Agenda and Presentations

The 2008 national Aging and Disability Resource Center meeting took place in October in Boston. Find here the presentations and handouts from the workshops and plenary sessions. Topics ranged from nursing home diversion to quality to information flow and technology. Topics: Nursing Facility Transition; Medicaid; Information Technology; Expenditures; Aging and Disability Resource Center; options counseling; SEP; Governing by Network; Statewide IT/MIS Development; Federal Funding Strategies; Readiness Assessment; Consumer Satisfaction; Serving Private Paying Consumers; Fully Functional SEPs; ADRC/SEP Systems; Hospital Discharge Coordination Strategies;

CMS Funds State Efforts To Increase Awareness Of Home-Based Alternatives To Institutional Care

Seven states today will receive a share of over $8 million in federal grants to increase awareness of home- and community-based long-term care options for people leaving hospitals who otherwise may enter a traditional nursing home, CMS Acting Administrator Kerry Weems announced. The $8.3 million in grants are part of the Real Choice Systems Change (RCSC) grant program, which is designed to help states and territories rebalance their long-term support programs to help people with chronic illness or disabilities reside in their homes and participate in community life. Over $7 million of today’s awards will be used to develop person-centered hospital discharge planning models. These new models for the discharge planning process will place greater emphasis on involving patients and their families in after-care plans, including exploring home-based alternatives to institutional care. Of the states receiving awards today, Kansas, Alaska, and South Carolina will enhance or expand the Aging and Disability Resource Centers (ADRCs) in their states; Oregon and Missouri will develop new ADRCs. The hospital discharge planners will use the ADRCs to tap into community-based resources to use for the discharged patient. Idaho will concentrate solely on developing and implementing a person-centered hospital discharge planning model. An ADRC is a community-based organization that provides information and assistance to people who need social services. An additional $574,613 will supplement grants that were awarded in fiscal year 2007 to Wisconsin and Alaska so they can continue their Person-Centered Planning Implementation programs for another two years. “These awards are a clear sign of the continued commitment of this administration to increase opportunities for home and community-based long-term care services so that individuals who want to stay in their own homes and in their own communities can do so,” Weems said. Since 2001, CMS has awarded 314 Real Choices grants, totaling approximately $284 million to 50 states, Guam, the Northern Mariana Islands, and the District of Columbia . For more details about this and other related grant opportunities, visit www.grants.gov and http://www.cms.hhs.gov/Realchoice. STATES RECEIVING AWARDS Kansas Department on Aging - $1,272,179 Oregon DHS Seniors & People with Disabilities - $1,600,000 Alaska Department of Health and Social Services - $1,237,107 Missouri Dept of Health and Senior Services - $1,598,913 South Carolina Lt. Governor's Office on Aging - $1,224,801 Idaho State University - $800,000 Total New Grants - $7,733,000 Wisconsin Dept of Health and Family Services - $332,746 Alaska Department of Health and Social Services - $241,867 Total Supplemental Awards - $574,613 Total Awards for FY2008 - $8,307,613

H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008

This bill has passed the House and Senate and is now awaiting the President's signature.

Medicare Improvements for Patients and Providers Act of 2008 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for coverage of additional preventive services.

• Provides for gradual elimination of copayment rates for Medicare psychiatric services.
• Places prohibitions and limitations on certain sales and marketing activities under Medicare Advantage (MA) plans and prescription drug plans.
• Requires offering of a range of Medicare supplemental policies.
• Extends the qualifying individual program.
• Provides for application of a full low-income subsidy assets test under the Medicare Savings Program.
• Eliminates Medicare part D (Voluntary Prescription Drug Benefit Program) late enrollment penalties paid by subsidy-eligible individuals.
• Directs the Secretary of Health and Human Services to make grants to states for state health insurance assistance programs, area agencies on aging, and aging and disability resource centers.
• Authorizes the Secretary to award grants to states for increasing the delivery of mental health services or other health care services to meet the needs of veterans of Operation Iraqi Freedom and Operation Enduring Freedom living in rural areas.
• Permits rebasing for sole community hospitals.
• Directs the Secretary to establish a demonstration project for development and testing of new community health integration models in certain rural counties.
• Amends the Tax Relief and Health Care Act of 2006, as amended by the Medicare, Medicaid, and SCHIP Extension Act of 2007, to extend through FY2009 the reclassification of certain hospitals.
• Increases physicians' payments. Revises requirements for and extends the quality reporting system, including incentive payments.
• Directs the Secretary to establish a Physician Feedback Program. Provides for: (1) incentives for electronic prescribing of medicine; (2) expanded access to primary care services; (3) extension of the floor on Medicare work geographic adjustment under the Medicare physician fee schedule; and (4) an accreditation requirement for advanced diagnostic imaging services.
• Revises requirements for Medicare anesthesia teaching programs.
• Makes permanent the exception to the 60-day limit on Medicare reciprocal billing arrangements between two physicians over a longer continuous period during all of which one of them is ordered to active duty as a member of a reserve component of the armed forces.
• Provides for coverage of pulmonary and cardiac rehabilitation.
• Extends increased Medicare payments for ground ambulance services.
• Amends the Public Health Services Act to direct the Secretary to establish pilot projects with respect to chronic kidney disease.
• Revises requirements for renal dialysis.
• Amends title XVIII (Medicare) of the Social Security Act to delay generally until after 2011 full implementation of the Medicare competitive acquisition program for the purchase of durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS).
• Revises such program, dividing its implementation into two rounds, and specifying covered item updates for 2009-2014.
• Directs the Secretary of Health and Human Services to provide for a competitive acquisition ombudsman within the Centers for Medicare & Medicaid Services to respond to complaints and inquiries by suppliers and individuals.
• Provides for phase-out of indirect costs of medical education from capitation rates.
• Revises requirements for MA private fee-for-service plans as well as MA plans for special needs individuals.
• Modifies requirements for quality improvement programs.
• Requires prompt payment of clean claims by prescription drug plans and MA-Prescription Drug plans under Medicare part D.
• Revises the definition of medically accepted indication for drugs.
• Directs the Secretary to: (1) contract with a consensus-based entity for certain activities relating to health care performance measurement; and (2) evaluate and report to Congress on approaches for the collection of data regarding health care disparities.
• Creates the Medicare Improvement Fund.
• Extends the transitional medical assistance (TMA), the abstinence education program, and allotments for disproportionate share hospitals (DSHs) under SSA title XIX (Medicaid).
• Amends the Deficit Reduction Act of 2005 to extend supplemental grants under SSA title IV part D (Temporary Assistance for Needy Families) (TANF).
• Amends the Public Health Service Act to extend special diabetes grant programs.