DC – One Community for All
2015 Annual Agency Olmstead Goals
FY 14 Goal
FY 14 Achieved
2015 TARGET Goal
100 ( from day supports)
5 (from residential)
DC OFFICE ON AGING
DCOA Quantitative Goal Summary
DCOA has expanded access to community-based long-term supports for individuals in the community through a memorandum of understanding (MOU) with the Department of Health Care Finance (DHCF) to provide a comprehensive interdisciplinary program that organizes, simplifies, and provides “one-stop shop” access to all public long-term care and support programs. The MOU between DHCF and DCOA was signed January 30th, 2015. In addition, DCOA has informal partnerships with Washington Hospital Center Mental Health and House Call Programs, Psychiatric Institute of Washington, DC Long term care Ombudsman office, Adult Protective Services, and Senior Service Network. DCOA has an outreach specialist who facilitates meetings with individuals and/or families interested in transitioning. DCOA’s outreach specialist will conduct fifty-four (54) individual and family meetings.
An ADRC Transition Care Specialist prescreens customers for eligibility, informs individuals about the Elderly and Persons with Disabilities Waiver, and provides transition assistance through options counseling with individuals to create a person-centered action plan that maps out the services and provides guidance of community resources to ensure a successful transition back into the community. The ADRC TCS will conduct 400 pre-screenings.
DCOA Qualitative Summary
Over the past two years DCOA has developed and strengthened its Nursing Home Transition and Hospital Discharge teams by developing standard operating procedures, and increasing its presence in the community. Within the first quarter of FY15 DCOA further strengthened the community transition effort with the addition of five (5) Money Follows the Person (MFP) staff who relocated from the Department of Health Care Finance (DHCF) to DCOA. The five new MFP staff members including one Program Coordinator, three Transition Coordinators, and one Management Assistant. The combined Nursing Home Transition and MFP teams have been renamed the “Community Transition Team”; their intake and referral procedure has been streamlined; and standard operating procedures are in the process of being updated. With full support from both DCOA and DHCF, the MFP team experienced a forty percent (40%) increase in nursing facility discharges in CY15.
DCOA’s community outreach specialist currently conducts weekly outreach events in long-term care facilities and community events to educate families and the public about transitional and supportive services available to District of Columbia residents. The community outreach specialist will conduct ninety-three (93) outreach events.
To expand and improve outreach efforts, DCOA’s ADRC is working closely with DCOA’s External Affairs and Communication unit to improve all ADRC outreach materials. Once completed, ADRC staff will conduct expanded outreach efforts to each nursing facility, hospital, lead agency, and other stakeholders to ensure that District-wide professionals and the public are aware of the scope and resources offered by the ADRC’s Community Transition Team.
Interagency Collaboration & Cross-Training
DCOA is working toward improving disability awareness among its staff by:
1) Scheduling two (2) initial meetings on January 27 and January 29, with Disability, Mental/Behavioral Health, and I/DD sister agencies/organizations: DDS, ODR, RSA, DBH, and the DC Center for Independent Living.
2) Working with these organizations to improve partnership, plan cross-trainings, gain input from stakeholders, and obtain suggestions for creating an ADRC Advisory Committee.
3) Building an active ADRC Advisory Committee which meets quarterly, has program-specific sub-committees/workgroups, and can provide ongoing stakeholder engagement and input into ADRC inclusion of both aging and disability awareness in its practices and programs.
Person-Centered Planning and New Intake Procedure
DCOA is working with the Department of Healthcare Finance (DHCF) and DHS/ESA to reengineer the intake and access system for the Elderly and Persons with Disability Waiver and other Long-term care services. The agencies have spent several months updating the LTC business practices to ensure a person-centered approach in which DCOA staff members assist DC residents in accessing both Medicaid and non-Medicaid services starting with the initial contact through DCOA’s Information and Referral/Assistance Unit. DCOA aims to improve the person-centered process of enrollment in Medicaid programs, while also helping residents to gain a better understanding of the full picture of DC resources offered.
Long Term Care Resources
DCOA promotes awareness of long-term supports by providing Information and Referral/Assistance to approximately 16,000 customers, Options Counseling/ person-centered transition support, streamlined eligibility determination/assistance, eight ADRC sites co-located with District-wide lead agencies, and in collaboration with other DC human service agencies (DHCF- Claudia Schlosberg, DDS Laura Nuss, DBH- Suzanne Fenzel, OVA- Barbara Pittman, DHS) aims to be one of several No Wrong Door entry points for long-term services and supports in the District. To this end, DCOA has published a Long-term Guide and is currently working on translating it into several languages both for publication and for posting on DCOA’s website. The English version of the Long Term Care Guide has been distributed to key organizations across the District and at many outreach events.
DEPARTMENT OF DISABILITY SERVICES
DDS Quantitative Goal Summary
DDS plans to reduce the number of people eligible for supports from DDA who are living in an institutional-based setting by five (5) people in 2015. Those five (5) people will transition to community-based residential settings, where they will receive supports appropriate to meet their assessed needs.
DDS Qualitative Progress Summary
The agency intends to:
1. Conduct twelve (12) outreach activities to inform people with intellectual and developmental disabilities (IDD), their families, advocates, providers, and other governmental agencies about community-based support options.
2. Increase community integration options for people with IDD by reducing the number of people receiving day supports in a congregate setting by one hundred (100) people in FY 2015, as demonstrated by: (1) increased numbers of people engaged in competitive integrated employment; (2) enrollment in Individualized Day Supports, Supported Employment, or Small Group Day Habilitation; and/ or (3) changes to more individualized Active Treatment for people living in ICF/IIDs.
3. Increase the number of qualified providers by four (4) in FY 2015 to meet identified service gaps.
In addition the Developmental Disabilities Administration (DDA) will undertake systemic initiatives to ensure that people in day and employment programs have opportunities for increased opportunities for community integration and competitive integrated employment. Specifically, DDA will: (1) submit waiver amendments to CMS that increase opportunities in the Home and Community Based Services waiver for people with Intellectual and Developmental Disabilities to further opportunities for community integration and meaningful day services by March 1, 2015; (2) Revise its ISP policy and procedure to require guided discussions around employment exploration and most integrated day and vocational services by June 1, 2015; (3) Work with stakeholders to revise its regulations for day and vocational supports by July 1, 2015; (4) Provide training and technical assistance to day and vocational provider organizations on the development of Positive Personal Profile and Job Search and Community Participation Plans by September 30, 2015; and (5) Provide training and technical support to facility-based day and employment readiness programs to improve the quality of those programs and to help those providers plan for future business models that support community integrated services, by September 30, 2015.
DEPARTMENT OF BEHAVIORAL HEALTH
DBH Quantitative Progress Summary
DBH helps individuals transition from Psychiatric Residential Treatment Facilities (PRTFs) into the community. Additionally, it facilitates youth transitions from PRTFs to therapeutic foster homes and other youth-centered community-based settings.
Additionally, DBH facilitates transition for individuals with a stay of one hundred eighty-seven (187) days or more from Saint Elizabeth’s Hospital into the community of their choice.
DBH Qualitative Progress Summary
In our efforts to assist individuals who are transitioning from Saint Elizabeths Hospital (SEH) to community living, DBH has contracted with consumers of mental health services to serve as Transition Specialists. These Transition Specialists utilize their training and lived experience to assist the individuals in care at SEH in making a smooth transition back to community living. To date DBH has contracted with twenty-five (25) individuals to serve as Transition Specialists. In 2015, we expect to contract with six (6) individuals to serve as Transition Specialists.
To support community integration of individuals discharged from institutions, DBH collaborates with other District agencies to offer a session called Family Talk, which is intended to inform parents of PRTF treatment, discharge and community based services. These sessions have been supported by numerous agencies (including DCPS, DYRS, OSSE, CFSA, and DHCF).
DBH also operates a 24hour/7 days a week Access Helpline. The Access Helpline staff is able to link and/or inform callers about the range of community based services available through DBH. DBH also keeps its webpage up to date to inform the community on its supports and services. In FY2014 the DBH Access Helpline received 74,489. The calls are categorized as crisis or non-crisis. Crisis call issues include – calls on primary mental health, physical illness, financial crisis, and substance abuse. Non-crisis call issues include – calls from community service providers seeking authorization to provide a service, or other administrative calls from community service providers.
DEPARTMENT OF HEALTHCARE FINANCE
DHCF Quantitative Progress Summary
In FY 2015, DHCF will enroll 35 people in its Elderly and persons with Physical Disabilities (EPD) Waiver Program and/or Medicaid State Plan home and community-based Personal Care Aide or Skilled Nursing Services who lived in nursing facilities or hospitals for at least 90 consecutive days immediately before enrollment.
DHCF Qualitative Progress Summary
To support its institution to community transition goals, DHCF will:
1. Conduct monthly information sessions for EPD and Medicaid State Plan providers. For this fiscal year, the agency has conducted the sessions every month beginning October 2014.
2. Conduct quarterly information sessions for nursing facilities. One session has been convened to date in the fiscal year.
3. Convene a community fair for disseminating information on the EPD Waiver Program. Planning for this fair is underway.
4. Fully fund the DC Office on Aging’s, Aging & Disability Resource Center (DCOA/ADRC) Money Follows the Person (MFP) Demonstration activities. The MOU supporting this funding for FY 2015 was executed in October 2014. DHCF received a supplemental award of $2.2 million in December 2014 for MFP activities through December 2015. A sustainability plan for MFP funding through the end of the federal Demonstration (2018) will be submitted to the Centers for Medicare and Medicaid Services in April 2015. That plan is under development now with stakeholder input.
5. Develop and utilize monitoring tools for DCOA/ADRC transition activities under the MFP Demonstration. As of February 2015, these tools are under development.
6. Facilitate the implementation of a lottery for thirty-four (34) remaining Housing Choice Vouchers in the MFP set-aside. Long Term nursing facility and/or hospital residents will be selected for these vouchers to be used in the community by September 30, 2015. On January 29, 2015, DHCF issued Transmittal 15-06 outlining conditions of lottery selection. The agency is collaborating with DCOA/ADRC, the DC Housing Authority, and long term care facilities to hold a lottery on March 2, 2015.