Nevada RCSC Summary | advancingstates.org

<A NAME=\"NVRC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">NEVADA</H2> <H3>Identified Problems with the State's Long-Term Care System</H3> <P> <UL> <LI>Lack of single agency responsibility for assessment, referral, and follow-up for families of Children with Special Health Care Needs (CSHCN), and lack of a single entry point (SEP) for community services, making it difficult for families to navigate the state's fragmented system.</LI> <LI>Lack of statewide comprehensive resource planning for CSHCN and no statewide approach to ascertain their medical and social service requirements.</LI> <LI>Systems for collecting, analyzing, and disseminating data on CSHCN are inadequate or nonexistent.</LI> <LI>Inadequate access to CSHCN programs, services, and supports are particularly acute in rural and frontier areas of the State, where specialized care and family-centered services are poorly developed or nonexistent.</LI> <LI>Gaps in private and public insurance coverage for the unique medical care and service needs of CSHCN and their families.</LI> <LI>Persistent shortage of health care professionals, human service workers, and care givers for CSHCN, made worse by a medical malpractice crisis.</LI> <LI>The goal to improve community services and supports for CSHCN competes with other health care issues, public health priorities, and human service programs for limited state funding support. (There is no state income tax.)</LI> <LI>Limited state and local funds for adaptive/assistive technology and equipment for CSHCN and their families, such as electric wheel chairs and communication devices.</LI> <LI>Lack of financial assistance for non-medical needs and services required by CSHCN and their families, such as respite care, transportation, and recreational activities.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>A broad range of services and supports for CSHCN, including specialized clinical services, are increasingly available in the state's two major urban areas, Las Vegas and Reno.</LI> <LI>Targeted case management services, which assure continuity of medical care and related services, are increasingly available to CSHCN and their families.</LI> <LI>Recently passed legislation (AB 513) supports the development of a comprehensive strategic plan for services to persons with disabilities.</LI> <LI>Nevada's underdeveloped public sector permits a greater degree of inter-agency collaboration and access by advocacy groups than is the case in most states.</LI> <LI>Regional networks of organizations and groups dealing with CSHCN issues are small in number, yet represent an important, growing base upon which meaningful, statewide planning and collaboration can be built.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P>Improve community-integrated, family-focused services and supports for CSHCN in Nevada.</P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Produce enduring improvements in the statewide system of integrated community services and supports for CSHCN and their families.</P> <P><STRONG>Goal.</STRONG> Complete a comprehensive, statewide needs assessment of the nature and magnitude of challenges facing CSHCN and their families.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Coordinate project data collection and needs assessment with similar activities undertaken by state agencies and task forces.</LI> <LI>Develop the project's overall action plan and related activities in conjunction with current state strategic planning efforts and the input of CSHCN families and advocates.</LI> <LI>Prepare preliminary report on the major findings of the needs assessment for distribution to the CSHCN advisory council and key policymakers.</LI> <LI>Prepare a final report for distribution to the public, key policymakers, and stakeholders.</LI> <LI>Identify ongoing data collection and systems monitoring strategies, and continue CSHCN needs assessment data collection, surveillance, and interagency collaboration for project Years Two and Three.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Evaluate other states' service delivery models and statewide planning approaches for CSHCN.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Complete data collection and evaluation of other states' service-delivery and resource-planning systems.</LI> <LI>Coordinate analysis of service-delivery and planning-approach evaluation with similar activities undertaken by state agencies and task forces.</LI> <LI>Prepare preliminary report on the major findings of evaluation and disseminate to the CSHCN advisory council and key policymakers.</LI> <LI>Prepare a final report for distribution to the public, key policymakers, and stakeholders , and coordinate data dissemination with the state executive and legislative staff.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Develop a comprehensive set of public policy recommendations, proposals, and strategies aimed at improving community services and supports for CSHCN and their families.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Complete a final report<EM>Strategic Plan for Children with Special Health Care Needs in Nevada</EM>with findings and recommendations based on the comprehensive needs assessment and service-delivery evaluation completed in Year One. Disseminate report to the public, key policymakers, and stakeholders.</LI> <LI>Establish budgetary requirements for proposed changes in service delivery and resource planning for CSHCN, including a request for incorporation into the executive budget.</LI> <LI>Develop legislative strategy and proposals for the 2003 session of the state legislature, including recommendations for regulatory changes, changes in current financing-reimbursement, and related fiscal impacts.</LI> <LI>Establish an overall time frame for achieving the project's goal of a coordinated, community-integrated, and family-focused system of care and support for CSHCN and families.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Establish a Nevada Advisory Council on Children with Special Health Care Needs to guide project activities and serve as an ongoing forum for issues affecting CSHCN once the funding period of the proposed project has been completed.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Identify all CSHCN stakeholders and potential council members. Council members will be selected by the Health Division in consultation with representatives of parent organizations such as Parents Encouraging Parents and Family Ties and the Maternal and Child Health Advisory Board, which includes consumer representation. </LI> <LI>Conduct advisory council meetingsdisseminate the results or outcomes of these meetings to stakeholders across the state.</LI> <LI>Prepare evaluation report on "lessons learned" from the advisory council activities and their impact on real systems change for CSCHN.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Implement a statewide media campaign on issues and challenges facing CSHCN and their families.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Develop a CSHCN Website and CSHCN-related public service announcements and outreach in conjunction with the Nevada Broadcaster's Association.</LI> <LI>Evaluate the statewide media campaign and its impact on real systems change for CSCHN.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Implement three pilot projects to include an urban northern Nevada community, an urban southern Nevada community, and a rural frontier community.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Design and implement three pilot demonstrations based on the needs assessment, service-delivery evaluation, and advisory council activities initiated in Year One of the project.</LI> <LI>Evaluate pilot projects and their impact on real systems change for CSCHN.</LI> <LI>Disseminate findings from pilot project evaluation to key policymakers and stakeholders.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Develop permanent data collection system that allows state policymakers, service providers, advocates, and families of CSHCN to evaluate service delivery models and planning approaches developed in other states and regions on an ongoing basis.</LI> <LI>Develop public policy initiatives, financing strategies, and a long-term strategic plan that provides concrete solutions to the medical care and service needs of CSHCN.</LI> <LI>Implement a statewide multimedia campaign to raise awareness of issues affecting CSHCN and their families and improve outreach.</LI> <LI>Establish a permanent statewide advisory council to guide project activities and serve as an ongoing forum for issues affecting CSHCN once the funding period of the proposed project has been completed.</LI> <LI>Design, implement, and evaluate a three-community demonstration based on the findings of the needs assessment and advisory council activities in Year One of the project.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>The development of this application and the activities described in this proposal reflect the input and deliberation of families and advocates of children with special health care needs.</LI> <LI>The Nevada Advisory Council on Children with Special Health Care Needs will include family members of CSHCN and disabilities advocates from across the state.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>Proposed project activities were developed with the broad, collaborative input of parents of CSHCN and advocacy groups. Consumers were involved as full partners in every step, from the initial meeting to the final product, including developing the initial concept, the goals, reviewing drafts and approving the final product.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P>CSHCN families and advocates will participate with program staff in developing the project's overall action plan and related activities. <UL> <LI>The Advisory Council will help to develop, coordinate and implement the activities identified in the Strategic Plan, and will assist program staff and subcontractors with the establishment of project outcome and performance measures.</LI> <LI>Parents, families, and other CSHCN-relevant stakeholders will actively participate in the development and implementation of the pilot demonstration.</LI> </UL> </P> <H3>Public Partners</H3> <P> <UL> <LI>Division of Health Care Financing and Policy.</LI> <LI>Division of Mental Health and Developmental Services.</LI> <LI>Community Connections.</LI> <LI>Department of Employment, Training, and Rehabilitation.</LI> <LI>University of Nevada School of Medicine Office of Rural Health and Rural Clinics Community Outpatient Services.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>Developmental Disabilities Planning Council.</LI> <LI>Nevada Disability Advocacy and Law Center.</LI> <LI>Nevada Hispanic Services.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P>The application was prepared by a committee comprising the public and private partners listed above and consumers, all of whom had full participation in the process. They attended every meeting, provided input into the plan, reviewed drafts, and approved the final application that was submitted.</P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P>Public and private partners including those listed above will play a major role in the implementation of the project, as it is their services that must be pulled into a seamless system. They will be identified and surveyed and otherwise consulted through the needs assessment process, will provide input through the Advisory Committee, and will have key roles in establishing the sustainability of the project.</P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG> <UL> <LI>The development of a permanent data collection system for CSHCN will be linked with ongoing data collection and planning activities undertaken by the Nevada Department of Human Resources and will be coordinated with similar efforts being developed and implemented by the current Governor's Task Force on Disability.</LI> <LI>The development and implementation of the project's pilot studies will also be informed by the needs and model approaches identified by the Governor's Task Force on Disability.</LI> <LI>The CSHCN Website and related public service announcements and outreach will be developed in conjunction with the Nevada Broadcaster's Association, which has previously collaborated with the State Health Division to create awareness of public health issues and medical care issues affecting vulnerable populations in Nevada.</LI> </UL> </P> <H3>Oversight/Advisory Committee</H3> <P>The Nevada Advisory Council on Children with Special Health Care Need will be established during the first budget year and will include family members of CSHCN and disability advocates from across the state. During the project period, the primary charge of this Council is to guide the development and implementation of activities undertaken by program staff and contractors. At the completion of the proposed project, the Council will provide the foundation for a permanent, statewide forum for advocacy and policy development on issues affecting CSHCN and their families.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>The Nevada Health Division will build CQI principles into the project design to ensure that feedback is incorporated into the project's ongoing operations.</LI> <LI>The success of the statewide media campaign will be gauged by a number of measures including change in the number of website hits, expenditures and case loads in existing programs and services for CSHCN, and the utilization of medical care and social services by the families of CSHCN.</LI> <LI>The Advisory Council will provide corrective feedback and project monitoring during the entire course of the project.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>Initial systems change activities focused primarily on state agencies are likely to yield immediate improvements in community services and supports for CSHCN.</LI> <LI>The Nevada Advisory Council on Children with Special Health Care Need will serve as an ongoing forum for issues addressing community based services and supports for CSHCN once the funding period of the proposed project has been completed.</LI> <LI>Evaluation activities will identify additional resources and/or redistribution of resources to meet the projected service requirements of CSHCN in the coming decades.</LI> <LI>Partnerships between stakeholders, providers, and state agencies that were initiated by the planning and development of the grant application will be developed and expanded and will endure beyond the grant period.</LI> <LI>The recently emerging disability coalition, characterized by a greater degree of cooperation over scarce resources and attention by state policymakers, will be strengthened.</LI> <LI>Inter-agency collaboration on issues affecting disabled persons in general, and CSHCN in particular, will be improved.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide and three demonstration sites (an urban northern community, an urban southern community, and a rural-frontier community).</P>