Single Point of Entry/No Wrong Door

This is the third in a series of newsletters produced at the Exchange to provide assistance to our CMS Real Systems Change grantees. This newsletter is produced biannually. Topics include: Physicians’ Role in Determining Level of Care, Nurse Practice Policies for Home and Community Living, ADRC Toolbox, Massachusetts Connecting the Dots, Making Medicaid Work in the 21st Century, Assessment Instruments, HCBS Quality Management Roles & Responsibilities, Family Caregiving, and Housing.

Ohio has been using its Real Choice Systems Change grant to bring people together to consider options to streamline access to information about long term services. A group of county, municipal and private organizations in Ohio are working with state agencies to develop a pilot project. On December 13-14, 2004, policy experts from Rutgers Center for State Health Policy and the National Academy for State Health Policy met with stakeholders to provide information and technical assistance.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. The Compendium will help you learn more about how these grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. Real Choice Systems Change Grantees will also find the Compendium useful to identify other Grantees with similar goals and activities. The fourth edition of the Compendium replaces all previous editions.

This document compares 4 Area Agency on Aging (AAA) models on integrating access and services in CA, MA, OH, & ME. The programs each use AAAs as entryways to senior and LTC services. The sites differ in terms of the primary financing mechanisms and whether the effort was initiated at the state level and disseminated downward or at the local level and worked its way up. This report is 1 of 5 from the series Case Studies from the Aging Network: Health and Social Support Systems Integration.

The Indiana Department of Administration (IDOA) released an RFP for a statewide-automated case management system that included case management, overall tracking & control of cases, person centered planning to formulate & monitor individually centered plans of service, management & control of provider claims, direct linkage to all state systems, outcome-related information, waiting list management to track unmet demands by type of service and individual, & electronic billing to include Medicaid.

This report was prepared to inform the New York City Department for the Aging about other states’ long-term care (“LTC”) point of entry (“POE”) systems. The analysis and case studies in this report focus on the following topics: system structure and integration at the state and local levels, common elements of successful systems, and special features of each POE system.

Despite preference for community-based long-term care, spending & policy is biased toward institutional services. More flexible policies were passed in 1981, when coverage was extended to non-medical services for people who meet criteria. States still must obtain a waiver for community-based services, and the law requires that Medicaid programs provide institutional care. As a result, policymakers face challenges when creating balanced systems that offer access to quality service choices.

The South Carolina ADRC also known as South Carolina Access Plus has developed a number of checklists and surveys to evaluate a variety of program outcomes. The Access Training is an introduction to the program. The Customer Service Training assesses staff opinion on customer service training sessions. The Level Outcome Checklist assesses staff opinion on how well the program is achieving systems-level outcomes. The Progress Checklist assesses staff opinion on collaborating with stakeholders.

This presentation from the November 2004 Gerontological Society of America Conference assesses the progress of 2003 ADRC grantees. The presentation includes the preliminary findings on Stakeholder Partnerships & Input, Business Operations, Streamlined Eligibility, IT / MIS, and Critical Pathways.

This presentation from the November 2004 Gerontological Society of America Conference discusses how the ADRC Iniative will develop a national framework for and implement a single point of entry system in states that will help streamline access to long-term care.