Long-Term Care

A goal of the Maryland Real Choice grant was to “provide information and assistance to consumer in acute care hospitals to aid decision-making and assist with transitions back to the community.” In 2003, a hospital discharge initiative was used to pay for nurses to work with patients being discharged from acute-care hospital stays. This paper reviews and answers whether there has been any change in discharge patterns from pilot sites to nursing homes relative to the rest of the state.

In laying the groundwork for sustainable improvements in the infrastructure for LTC policy and program implementation, Massachusetts Real Choice grantees conducted an assessment of current Service Coordination practices across State agencies. The research objective was to better understand present service coordination practices among agencies dealing with elderly and individuals with disabilities with the intention of identifying “promising practices”. This report presents the review results.

These reports are reviews of Utah’s long–term care system and waiver programs and provide recommendations for change. The Focus Group Findings focused on non-institutionalized and community based settings. The Long-Term Care paper provides more generalized findings about the structure of Utah’s long-term care system and how to transition forward based on input from stakeholders and administrators, comparisons to other states, and review of current documents and policy.

MA grantees hired an independent evaluator to conduct qualitative assessments of consumers’ experiences at two and nine months of participation. At two months, the successes included connections to community supports and services. Identified challenges included developing and managing an individual budget. Successes at 9 months include increased independence, self-determination, and availability of workers and supports. Challenges included community liaison training and out-of-pocket spending.

The goal of the Massachusetts Real Choice Pilot Project was to increase the quality of life and independence of participant through cost-effective flexible funding. Two pilot projects were developed under the grant to serve adults with disabilities. Attached documents include the pilot project summary, the request for proposals for organizations to participate in the pilot project, methodology of the project, and a descriptive presentation.

The Consumer Planning and Implementation Group (CPIG) was formed as a way to include consumers in the Real Choice Systems Change grant activities. CPIG represents consumers across disability, age, ethnicity, geographic locations, and include community advocates/providers. CPIG provides input on grant activities and provides recommendations to the Collaborative Team (consumers and representatives for Massachusetts’ Real Choice and Independence Plus grants).

During the Spring 2006, a total of thirteen sessions that included key informant interviews and focus groups ranging in size between eight to twelve participants were conducted. The report states several key areas of concern that emerged from the discussions in relationship to Illinois’ Choices for Care program of offering older adults alternatives to nursing home placement. Potential solutions to these identified areas may be found at the end of this report.

Part of the Massachusetts Real Choice grants included community and consumer collaboration and input. The presentations work to introduce how the Real Choice grant aims to work on collaboration, integration collaboration into the pilot project, and review how consumer perspectives were used in the grant. Review the work and ideas on consumer involvement, the pilot evaluation and the consumer experience project.

As part of the Massachusetts Independence Plus grant, the workgroup recognized there was a certain amount of risk associated with individualized budgeting. They devised a “Incident Reporting” System that would document any incidents (such as fall, funding problems, injuries) that would compromise the health of an individual with disabilities being served under the program. The forms were created to assist a future Massachusetts IP waiver and have not yet been adopted

The State of Massachusetts received Real Choice and Independence Plus grants. These presentations describe the projects, their structure, and an overview of grant activities. The goal of the Real Choice grant was to improve the quality and accessibility of home and community-based services available to individuals with disabilities. The goal of the Independence Plus grant was to recreate budgeting so that consumers were able to direct their budget and the services they receive.