NY Connects State Long Term Care Advisory Council Meeting
Downstate Meeting Minutes
October 30, 2008
In Attendance:Scott Amrhein, Lois Aronstein, Miriam Balmuth, Diane Booker- Aparisio, Patricia Brownell, Elizabeth Munro, Betti Weimersheimer, Wendy DeMartis, Paula Dlouhy, John McGuire, Susan Emanuel, Bruce Darling, Lynn Couey, Jackie Berman, Danielle DeBruce, Rina Kitazawa, Thea Griffin, Gail Koser and Greg Olsen. Via Teleconference: Mike Burgess, Laurie Pferr and Michael Friedman.
- Welcome and Overview - Mike Burgess(Executive Director, NYS Office for the
Aging)& Greg Olsen(Deputy Director, Policy, Research, and Legislative Affairs,
NYSOFA)
- Director Burgess teleconferenced into the Advisory Council meeting and apologized for not being at the meeting in person.
- Laurie Pferr, Executive Deputy Director, also called into the meeting and thanked everyone for attending.
- Deputy Director, Greg Olsen facilitated the meeting and began by introducing the new members of the Downstate Advisory Council Meeting.
- Overview of HEAP/Energy Issue:
Greg stated that NYS received $550 million in federal HEAP funding and as a result, the Governor will provide additional funding to the HEAP program. The increase in funding will allow for all HEAP recipients who pay directly for heat to receive a $100 benefit supplement. - Community Empowerment Conference:
Greg announced the upcoming Community Empowerment Conference in Saratoga on November 12 and 13. Through the conference people will learn statewide and national best practices that will enable individuals to age in place, practices that can be replicated in other areas. At this point, 350 to 400 people are registered up to attend. Greg stated that Westchester is a model in terms of best practices for helping individuals age in place. Mae Carpenter, Commissioner of Department of Senior Programs and Services in Westchester will be the keynote speaker. - State of NYS Budget:
Greg reported that most agencies experienced a 2% cut in April and 6% cut in August to meet the deficit. The NYS Legislature is returning on November 18. The State deficit is growing and there could potentially be a $47 billion deficit by 2011. The budget deficit next year could be $12.5 billion. NYSOFA continues to work to ensure the r core programs remain solid, which includes: SNAP, EISEP, CSE, and NY Connects. These four programs make up the largest part of NYSOFA budget. - Advisory council member, Richard Mollot asked how the Ombudsman program would be affected by the budget cuts. Greg stated that the ombudsman program and other programs such as HIICAP continue to be a priority for NYSOFA. The program is mostly federally funded, but also partially state funded as well. The ombudsman program received an across the board cut.
- NY Connects Program Update - Thea Griffin (Bureau Director, NY Connects)
- Thea Griffin, Director of the NY Connects program, gave an update on the NY Connects program. She reported that on October 1, 2008, NY Connects officially began its third year. Although counties continue to operate at different levels of implementation; they have accomplished much in a short period of time. All with the exception of three participating counties are operational. From July 1, 2007 to June 30, 2008 counties reported more than 100,000 contacts to their NY Connects program (44 counties out of 54 were able to report).
- Counties are focusing on making NY Connects visible and recognizable in the community. Many people are learning about NY Connects through word of mouth and through local human service providers.
- The Long Term Care Councils that have been established by the NY Connects programs are conducting gap analyses and figuring out the barriers to long term care. Gaps identified so far include housing, workforce, caregiver supports, and transportation, among other issues.
- Counties are being creative in their public education activities, using billboards and doctors' offices to promote their NY Connects program.
- Council member, Lois Aronstein of AARP asked if counties were putting NY Connects information on a website. Thea indicated that NY Connects has a website (www.nyconnects.org) that links to county websites and includes county information. Gail Koser stated that NYSOFA will be contracting with a vendor to create a statewide inventory of long term care resources and services. Lois pointed out that AARP has a NY State specific website which may be another avenue to get the word out about NY Connects. AARP also has a bulletin/magazine and in the future some states will be able to have a state specific page in their bulletin. NY will have a page in the AARP bulletin.
- Bruce Darling mentioned that the Division of Housing Community Renewal (DHCR) has information on housing resources. He suggested that groups need to work together to figure out how to consolidate resources. Laurie pointed out that this issue was also raised at the Most Integrated Setting Coordinating Council (MISCC) meeting.
- Council member, Scott Amhreim suggested that NY Connects may want to work with Google to make sure that NY Connects comes up in a Google search.
- Paula Dlouhy of the Rockland County DSS stated that Rockland County has a website for NY Connects. Council member, Betti Weimersheimer of FRIA also recently launched a website and stated that they would like to link to resources as well.
- Thea discussed the NY Connects/Point of Entry Standards. She stated that NYSOFA staff is working with the Centers for Excellence in Aging through SUNY, to provide training on how to provide "quality" Information and Assistance. The training is for both new and experienced I & A workers. The trainings will take place in Albany, Long Island, Geneva, and Utica. Advisory Council members are welcome to attend the trainings.
- Thea also mentioned that NYSOFA staff is finishing up the Building Connections workshops. The Building Connections workshops were designed to strengthen the county programs, and focus on areas such as outreach, LTCC membership, data and reporting. Overall they were well attended and evaluated positively as being relevant and helpful.
- Thea indicated that NYSOFA and staff from the Centers for the Development of Human Services (CDHS) have been working on developing a NY Connects Program Satisfaction Survey. The survey will be pilot tested with several counties. Counties must have reported a certain number of contacts to the program to be eligible for the survey pilot test. Counties will have some discretion on how they will be able to implement the survey.
- Guest presenter, Bruce Darling asked if it were possible for the State to look at NY Connects data based on population (caregivers, older adults, and people with disabilities). Gail indicated that the state has not been looking at data based on population, but that this was a great suggestion. Gail also stated that about 50% of the counties have reached out to the Developmental Disability population. Initially, this population was not mandated to be a part of the NY Connects program.
- Nursing Home Diversion Modernization Grant Presentation (Gail Koser,
Assistant Director of Policy, Research & Legislative Affairs, NYSOFA)
- Gail reported that NYSOFA received the Administration on Aging's Nursing Home Diversion Modernization Grant which began on October 1, 2008. This grant targets the non-Medicaid population; specifically those at risk of nursing home placement and Medicaid spend down (300% of SSI income, $40,000 in assets). NY was one of 14 states to receive the grant.
- Gail indicated that there is a supplemental portion of the grant that focuses on veterans of all ages. The grant provides consumer directed services. Three counties will take part in the grant: Oneida, Onondaga, and Broome. These counties are considered to be fully functional Aging and Disability Resource Centers.
- The grant will take place over an 18 month period. Counties will have to look at existing funding streams and set aside funding to sustain the program once the 18 month period ends. In calculating the budgets, an estimated per person amount was used (approximately $10,000).
- To determine risk for nursing home placement, counties will look at functional and health status, cognitive and mental health issues, and informal support status.
- A member asked what the per person budget amount could be used for. The amount could be used for goods and services. An individual would be screened by NY Connects for the program, referred to the local office for the aging for services and assigned a case manager. The case manager would work with the individual to develop a care plan.
- Members expressed concern that $10,000 may not be enough to pay for goods and services. Greg indicated that $10,000 is an average amount. Some people may receive more funding, while others may require less funding. There is great flexibility in how the money is spent.
- Lois Aronstein from AARP expressed concern about the sustainability of the program. She asked the question of whether communities are stepping up to the plate and creating informal support systems. Greg stated that this was the future of the aging network and that he would send information on Project 2020.
- Diane Aparisio from Westchester indicated that counties participating in this grant may need to invest more money in case management.
- Several other Advisory Council members asked what would happen to individuals taking part in the grant once the grant was over. Gail mentioned that there would be an evaluation of the project by the Centers for Excellence in Aging. Additionally, she mentioned that in terms of sustainability, counties are required to carve out funding to provide services to these individuals.
- Veterans Health Administration:
Gail mentioned that as part of the Nursing Home Diversion Modernization Grant, VHA would be purchasing services, such as case management and home delivered meals, directly from the aging network for veterans of all ages. This project will also take place in the three pilot counties. Veterans will have the opportunity to take part in consumer directed models of care. VHA is very interested in replicating this program. - Bruce mentioned that veterans who become disabled receive cash benefits. He questioned how this cash benefit program would work with the grant. Bruce also stated that NYSOFA also work with the Consumer Directed Personal Assistance Program Association about the consumer directed model and liability issues. Gail stated that NYSOFA was planning to develop a subcommittee on the Nursing Home Diversion Grant.
- Bruce also recommended that NYSOFA should look into pooled trusts to help individuals gain access to Medicaid.
- Opportunities & Challenges to Person Centered Planning and Care (Bruce
Darling, Executive Director, Center for Disability Rights)
- Bruce Darling gave a presentation on person-centered planning. He stated that person-centered planning is more of a process in which the person should come first in the development of an individualized plan, and should be given real choices so they could make informed decisions.
- He expressed that it is important to listen to the person and their needs. He discussed the importance of building a sense of trust with individuals. He stated that people should be allowed to make their own decisions, even it seems risky.
- Elder Abuse Study Update (Dr. Patricia Brownell, Council member and Jackie
Berman, DFTA)
- Dr. Brownell and her guest Jackie Berman gave an update and reported on the goals of the Elder Abuse Study Update.
- Dr. Brownell discussed the Elder Abuse Service System components which can be used to obtain information on the mistreatment of seniors; such as Adult Protective Services, the AAA and their contracted agencies, Law Enforcement and District Attorneys, along with State Representatives of Child Welfare and Public Housing.
- The goal of the survey was to acquire comprehensive data that will indicate the gaps and barriers with this system.
- An interview guide was handed out that was designed to encourage and direct agencies on what type of information should be collected on the mistreatment of seniors, as a standard practice.
Discussion Question:
How do you deal with under reporting of senior mistreatment? Is information not being disclosed about elder abuse?
Ans: Cornell University is doing the study with highly trained interviewers. However, this instrument is being pilot tested to determine its capability to illicit sensitive data. The Study is two- pronged, it includes the telephone survey (facilitated by Cornell) and an agency based survey (facilitated by Dr. Brownell of Fordham). There will also be a separate instrument used for caregivers.- The survey start date is still pending, but will probably begin during the next calendar year.
- The grant funding this project is from the NYS Office of Children and Family Services. It is a 2-3 year grant which is currently in its first year and at the developmental stages.
- Developing NY Connects in NYC What Options Do You Propose? (Advisory Council Members
- Mike Burgess led this discussion by teleconference. He gave a brief synopsis of where the talks between NYC's Department for the Aging (DFTA) and NYSOFA concluded.
- DFTA's priorities are currently centered on its modernization efforts for senior services and expanding the NYC 311 system. As a result, NYC has decided not to participate in NY Connects.
- Director Burgess stated that NYSOFA will still continue to dialogue with DFTA and HRA to encourage them to be participate in the NY Connects program; however he asked the advisory council for some other alternatives to get NYC involved.
Advisory Council Discussion (Q&A)
- Wendy DeMartis, Project Manager from Westchester NY Connects stated the current pros and cons in contracting with 211 to provide NY Connects Information and Assistance. One glitch is the volume of NY Connects type calls that go directly to the Westchester Department of Senior Programs and Services (AAA) and DSS offices instead of 211. As a result, there is no true single point of entry to their LTC service system. However, the public is becoming more aware of their NY Connects program.
- Diane Aparisio added that Westchester has a lot of known networks that the community is aware of. So they are more apt to calling them directly, before calling their NY Connects.
- Richard Mollot (Advisory Council Member) suggested that an RFP should be proposed and private agencies who are already providing LTC services should be selected to manage the NYC NY Connects program. He added that DFTA/HRA had their chance to manage the program, and the State should no longer look to them to provide the service.
- Dr. Brownell (Advisory Council Member) asked if 311 is the same as 211.Gail Koser (NYSOFA) stated that in NYC 311 is the number to call for questions about health and human services in the city. However, 311 is not NY Connects.
- Betti Weimersheimer commented that NYC is very diverse, and doesn't believe that any one agency could address all of the city's LTC service needs. She suggested that perhaps a particular borough should be targeted to pilot the NY Connects program within the city.
- Lois Aronstein (Advisory Council Member) agreed that perhaps the program could be pilot tested amongst the individual boroughs. She stated that negotiations and alternatives should be sought, instead of an all or nothing approach.
- Dr. Brownell asked if NYSOFA can overrule the Mayor's Office and mandate that they participate in NY Connects. Laurie Pferr answered via teleconference that according to the NY Connects standards, counties' participation in the program is strictly voluntary; they have a right to refuse. However, she did encourage looking into other alternatives.
- It was stated that NY Connects is a based on partnerships and trust. And, whatever the plan of action will be in NYC, DFTA and HRA will have to be involved.
- MISCC Update (Greg Olsen, NYSOFA)
- Greg gave the overview on how the MISCC (Most Integrated Setting Coordinating Council) was established and discussed the MISCC sub-committee formation.
- Sub-committees aim to solve problems on critical issues such as housing and transportation.
- MISCC meetings are open to the public and are accessible via webcast and members were encouraged to participate.
- Next Steps and Closing
- The schedule for the next Downstate Advisory Council Meetings will be as follows; February 26, June 30, and October 27, 2009.
- Locations to be determined.
- There was also a request for volunteers for the Nursing Home Diversion Advisory Committee. Council members Michael Friedman and Richard Mollot volunteered.