<A NAME=\"OHRC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">OHIO</H2> <H3>Identified Problems with the States' Long-Term Care System</H3> <P> <UL> <LI>Workforce shortage.</LI> <LI>Lack of support for informal caregivers often precipitates institutionalization.</LI> <LI>The infrastructure of the current service delivery system does not match supply with demand.</LI> <LI>Lack of consumer self-determination and consumer control over service provision.</LI> <LI>Lack of systems integration, for example, eligibility criteria for various long-term care programs differs.</LI> <LI>Lack of affordable, appropriate housing.</LI> <LI>Lack of a central source for information about the fragmented service delivery system results in lack of knowledge about available resources in the community for those wishing to transition from nursing home to a community setting.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>Commitment to diversion and transition from institutions.</LI> <LI>Continuing commitment to the growth of home and community services. In 1994, the State placed a moratorium on licensing new nursing home and MR/DD beds.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Increase consumer choice and control by providing information about services and supports.</LI> <LI>Improve access to housing for adults receiving community supports and services.</LI> <LI>Promote consumer involvement in state-level decision making on policy issues affecting people with disabilities.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Improve access to community supports, services and housing for consumers.</P> <P><STRONG>Goal.</STRONG> Provide consistent reliable, and up-to-date information to consumers about services and supports available to them, regardless of their point of contact with the formal delivery system.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Develop a Web-based, comprehensive information system that provides information on all benefits and services available for adults with disabilities (No Wrong Door project).</LI> <LI>Identify ways to achieve more uniform access to services and catalog all existing housing programs.</LI> <LI>Provide information and training on the use of the No Wrong Door Internet site targeted at professional agency staff who are working directly with consumers.</LI> <LI>Incorporate data about service quality as part of the No Wrong Door Website.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Increase housing options for people with disabilities.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Collaborate with the state's Systems Change Nursing Facility Transition Grant to support consumers identified for transition.</LI> <LI>Collaborate with public housing authorities to identify available housing.</LI> <LI>Work directly with public and private community service organizations and consumers to resolve housing-related problems.</LI> <LI>Bring together representatives from community services agencies and housing assistance agencies to address system-level issues.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Develop the No Wrong Door project, which will provide consistent information to consumers regardless of where they attempt to obtain services.</LI> <LI>Provide training on the use of the No Wrong Door Internet site to professional agency staff.</LI> <LI>Increase housing options for people with disabilities by working with consumers identified for transition and by working with public housing authorities to identify available housing.</LI> <LI>As part of the No Wrong Door project, identify ways to achieve more uniform access to services and catalog all existing housing programs.</LI> <LI>Work with consumers as well as public and private providers of housing to increase consumer choice.</LI> <LI>Provide ongoing financial support to the Ohio Olmstead Task Force.</LI> </UL> </P> <H3>Consumer Partners</H3> <P>The consumer task force, which is called the Ohio Olmstead Task Force, includes parents of children with disabilities, adults with disabilities, and representatives from the statewide Independent Living Council, the Governors Council on People with Disabilities, the Association of American Retired Persons, the Ohio Association of Area Agencies on Aging, the Ohio Developmental Disabilities Council, and Families for Improved Care.</P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P> <UL> <LI>The Ohio Access process, under the leadership of Governor Taft, sought advice and counsel from consumers and their advocates to develop a policy framework for the provision of long-term care services and supports to people of all ages with disabilities. Consumer input was obtained through a series of public forums and meetings, including the Ohio Access community forums hosted by the Ohio Department of Aging and the Ohio Department of Job and Family Services.</LI> <LI>The Ohio Olmstead Task Force specifically requested that the focus of the revised application be the No Wrong Door project and housing.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P> <UL> <LI>The Ohio Olmstead Task Force will meet at least quarterly to evaluate program successes and to identify barriers that exist to full consumer participation in the project.</LI> <LI>The Ohio Olmstead Task Force will be involved in the development of the competitive Request for Proposals (RFP) for managing entities for each of the Real Choice components. They will also be involved in the evaluation and selection of contractors.</LI> <LI>The Ohio Olmstead Task Force will work with the contractors and involved state agencies in further developing the structure of each of the components and the recruitment of participants.</LI> <LI>Consumers will be involved in the design of the evaluation, will conduct surveys, and analyze data for feedback to consumers, providers, the state agencies and the Ohio Olmstead Task Force.</LI> <LI>Consumers will be involved in the design of the quality assurance model, assisting in identifying outcome measures.</LI> </UL> </P> <H3>Public Partners</H3> <P> <UL> <LI>Ohio Department of Aging.</LI> <LI>Ohio Department of Mental Retardation and Developmental Disabilities.</LI> <LI>Ohio Access agencies include the Governor's office, Budget and Management, and the Departments of Health, Mental Health, and Alcohol and Drug Addiction Services.</LI> </UL> </P> <P><STRONG>Private Partners and Subcontractors</STRONG></P> <P>None selected yet.</P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P><STRONG>Public</STRONG> <UL> <LI>The grant application was a direct response to the Ohio Access for People with Disabilities initiative, a collaboration between the Ohio Department of Aging and the Ohio Department of Job and Family Services. The goals and activities set forth in the grant application are based on some of the recommendations contained in the Ohio Access report.</LI> <LI>The Ohio Access agencies were involved in development and planning for the original Grant application. Staff from the various agencies assisted with project selection and design and wrote the narrative for the application under the auspices of the Ohio Department of Job and Family Services.</LI> </UL> </P> <P><STRONG>Private</STRONG></P> <P>Private partners were not involved in the original grant application.</P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P><STRONG>Public</STRONG> <UL> <LI>Since the grant now has a very specialized focus, the lead agency, the Ohio Department of Job and Family Services (the single state Medicaid agency) has determined to contract with the Ohio Department of Aging to implement the No Wrong Door project.</LI> <LI>Ohio Department of Mental Retardation and Developmental Disabilities will participate on the work group for the No Wrong Door project.</LI> </UL> </P> <P><STRONG>Private</STRONG></P> <P>Ohio Department of Aging will select a private partner, identified through an RFP process, to develop the No Wrong Door Website.</P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG></P> <P>The Nursing Facility Transition Grant project will collaborate with the housing activities of the Real Choice Grant project.</P> <H3>Oversight/Advisory Committee</H3> <P> <UL> <LI>The Ohio Olmstead Task Force will advise the involved state agencies on grant implementation.</LI> <LI>A steering committee has been formed to oversee all the CMS Grant activities (Ticket to Work Infrastructure, Real Choice/Systems Change, and Nursing Facilities Transitions). The steering committee includes two members of the Ohio Olmstead Task Force, as well as representatives from each agency actively involved in Grant applications. Private partners involved in grant application activities are also on the steering committee. To date these private partners include the subcontractors working on the Ticket to Work Infrastructure Grant and the Nursing Facility Transitions project.</LI> <LI>In addition to the steering committee, there is a workgroup for each grant to guide implementation. Members of the Ohio Olmstead Task Force sit on each of the three workgroups.</LI> </UL> </P> <H3>Formative Learning and Evaluation Activities</H3> <P>Ohio Olmstead Task Force will provide input regarding grant activities. Regular and ongoing feedback from the Ohio Olmstead Task Force will be essential to ensure that all projects remain responsive to consumer needs. Where any component needs to be adjusted and improved, the direction for needed improvement will come from consumers.</P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>The No Wrong Door project is structured to produce informational materials that can be used beyond the grant period.</LI> <LI>The addition of a housing coordinator at the state Medicaid agency (ODJFS) will result in ongoing housing for participants in Ohio's Nursing Facility Transitions project and better coordination with state housing authorities. The housing coordinator role will initially be funded by the grant and a plan will be developed to sustain the position beyond the grant period.</LI> <LI>Grant support of the Ohio Olmstead Task Force will result in an ongoing consumer voice in the debate over how best Ohio can restructure its long-term care system. A plan will be developed to sustain the support beyond the grant period.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>