Rhode Island RCSC Summary | advancingstates.org

<A NAME=\"RIRC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">RHODE ISLAND</H2> <H3>Identified Problems with the State's Long-Term Care System</H3> <P> <UL> <LI>Inconsistent access to services with regard to type and severity of disability.</LI> <LI>Lack of care coordination for individuals with multiple needs.</LI> <LI>Lack of information about long-term care services and supports.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>HCBS waiver programs are available.</LI> <LI>Representatives from the aging community, the disabled community, the Center for Adult Health Consumer Advisory Committee, the Long-Term Care Coordinating Council, community providers and nursing facilities representatives developed a Shared Vision for Long-Term Care plan to guide future efforts.</LI> <LI>The Department of Human Services conducted a needs assessment using a Traumatic Brain Injury (TBI) Demonstration Planning Grant.</LI> <LI>The Department of Human Services sponsored a series of Leadership Roundtables on Children with Special Health Care Needs and their families. Leadership is the term used to define families and advocates who help discuss issues pertaining to special needs children regarding their health care needs, behavioral health, dental care and Kati Beckett eligibility. These discussions provided the framework for moving children with special needs into managed care.</LI> <LI>The Living Rite program assists consumer to access services. Living Rite is the concept of reforming the long-term care system in Rhode Island. Its focus includes providing clear and concise information to consumers and policymakers, developing capacity, and coordinating and integrating services. Complete funding for this concept and proposals has yet to be secured.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Expand capacity to provide services.</LI> <LI>Increase informed choice for consumers.</LI> <LI>Improve the integration of health and support services.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Construct enduring system changes that will allow consumers to choose where they reside, and help them access and control needed services.</P> <P><STRONG>Goal.</STRONG> Expand capacity to provide services.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Conduct a survey and needs assessment of consumers across the long-term care continuum.</LI> <LI>Develop training modules for staff working with individuals with behavioral problems who reside in residential facilities such as group homes, assisting living facilities, and housing authorities.</LI> <LI>Provide behavioral specialist consultancy to non-institutional residences. Grant funds will be contracted to help develop training modules and to assist in the training. It is the intention to continue this training after the grant period with either administrative funding or by including the cost in the applicable rate of reimbursement.</LI> <LI>Subcontract with a consultant to produce a work plan that will assist in the assessment of youths with serious emotional disturbances transitioning into the community.</LI> <LI>Track and analyze the demographics, utilization, and outcomes of children accessing residential and community systems of care.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Increase informed choice for consumers.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Develop a Web-based benefits screener and resource directory. A benefits screener will allow individuals to enter information in the a Web-based application that will then screen the information to determine if the individual may be eligible for certain benefit programs and will tell them how and where to apply.</LI> <LI>Host a conference on community services for all populations.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Improve the integration of health and social services.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Develop a service tracking software application.</LI> <LI>Analyze Medicare data to develop acuity patterns of individuals likely to become dually Medicare/Medicaid eligible.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Develop a Web-based benefits screener and resource directory.</LI> <LI>Develop a service tracking software application.</LI> <LI>Host a conference on community services for all populations.</LI> <LI>Conduct a survey and needs assessment of consumers across the long-term care continuum.</LI> <LI>Analyze Medicare data to develop acuity patterns of individuals likely to become dually Medicare/Medicaid eligible.</LI> <LI>Provide behavioral specialist consultation to non-institutional residences, and develop training modules on working with individuals who have behavioral problems.</LI> <LI>Seek consultative services to assist in the assessment of a cohort of youth with serious emotional disturbances transitioning into the community.</LI> <LI>Track and analyze residential and other community systems of care.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>Living Rite Task Force.</LI> <LI>Consumer Advisory Committee.</LI> </UL> </P> <P>Both these groups are made up of consumers, advocates and providers. Their roles are to advise the Department of Human Services on issues, review policy and procedures, and to make recommendations for change. There is no funding since these groups are volunteering. Meeting space and refreshments are provided by the department's administrative funds and are not supported by this grant. <UL> <LI>The Medicaid Infrastructure Grant Steering Committee comprises three representatives (two consumers and one advocate) for the aging population and three representatives (one consumer and two advocates) for adults with disabilities. All are from the public sector.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>The Consumer Advisory Committee participated in Real Choice Systems Change Grant development meetings held by the Department of Human Services (DHS). These meetings solicited input from consumers, advocates and other state agencies. An overview of each of the Real Choice Systems Change Grants was presented at each meeting, followed by a brainstorming session about what to include in the grant application.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P> <UL> <LI>Members of the Living Rite Task Force, the Consumer Advisory Committee, and consumers from the Medicaid Infrastructure Grant Steering Committee will be involved in the implementation, monitoring and evaluation of grant activities, including:</LI> <LI>Provide input in the development of RFPs and be kept informed of each activity's development.</LI> <LI>Assist in oversight of the project and its outcomes.</LI> <LI>Review drafts of reports for comment.</LI> <LI>Assist in the development of the conference.</LI> </UL> </P> <H3>Public Partners</H3> <P> <UL> <LI>Department of Health.</LI> <LI>Department of Elderly Affairs.</LI> <LI>Department of Mental Health, Retardation and Hospitals.</LI> <LI>Department of Children, Youth, and Families.</LI> <LI>Housing Resource Commission.</LI> <LI>Rhode Island Housing, Mortgage & Financing Corporation.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>PARI Independent Living Center.</LI> <LI>Ocean State Center for Independent Living.</LI> <LI>Community Mental Health Centers.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P> <UL> <LI>All the public and private partners participated in focus groups that helped formulate the activities that were proposed in the grant application.</LI> <LI>They reviewed drafts and provided input that expanded the scope of the grant.</LI> <LI>They also were involved in revising and prioritizing activities when the grant allocation was reduced.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P><STRONG>Public</STRONG> <UL> <LI>Each agency will have staff participate as either key project personnel or members of the Real Choices Advisory Committee and will help plan and participate in a conference on services across the continuum of disabilities.</LI> <LI>All of the public agencies will participate in RFP development and some will assist in the evaluation of the RFPs.</LI> <LI>Department of Elderly Affairs will coordinate the activity associated with I&R tracking.</LI> <LI>Department of Children, Youth, and Families will co-coordinate the child-related activities with DHS.</LI> <LI>Department of Mental Health, Retardation and Hospitals will provide technical assistance for the behavioral health activity.</LI> </UL> </P> <P><STRONG>Private</STRONG> <UL> <LI>The private partners will provide recommendations as to what standards and experience contractors should have.</LI> <LI>The Independent Living Agencies and the Community Mental Health Centers will assist in the resource development section of the benefits screener and in recommendations to make the Website user-friendly for adults with disabilities.</LI> </UL> </P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG></P> <P>The Department of Mental Health, Retardation and Hospitals, the Department of Elderly Affairs, the Department of Children, Youth, and Families, the Department of Health, and the Department of Human Services have collaborated on a number of projects in a variety of combinations, including the redesign of children's behavioral health and the redesign of the long-term care system. These partnerships will continue to develop the public policy changes that will ensure the success of the Real Choice Grant activities.</P> <H3>Oversight/Advisory Committee</H3> <P>In order to ensure continued consumer involvement we will establish the Real Choices Advisory Committee. The Committee will include three representatives of the Living Rite leadership team, three DHS Consumer Advisory Committee members, and a representative from each of the five state agencies. This committee will meet monthly to help develop RFPs, review status reports, recommend corrective action if necessary, and advise the project director.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>The Real Choices Advisory Committee will meet on a monthly basis to track progress on goals, suggest alternatives when problems arise and update the other stakeholder groups. Project leads for each of the activities will report the status of their areas to the committee, and any outcome data compiled will be shared with the Consumer Advisory Committee, the Long-Term Care Coordinating Council and with various consumer groups including the Living Rite group.</LI> <LI>The DHS Research and Development Team will act as consultant to the Steering Committee, developing and tracking outcome indicators. This group will provide technical assistance to ensure that information gathered is valid and accurate.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>Consistent access to information through the Web-based system to enable informed choice and admission to the programs that meet their needs and preferences.</LI> <LI>Training modules will provide a continuing means to educate providers and other support systems to accommodate behavioral challenges. The training modules will be made available free of charge after the grant period is ended to agencies requesting them.</LI> <LI>The monitoring of information and referral data will enable state agencies to update and improve CARRE (Coordination, Assessment, Referral, Reassessment, Evaluation) Center I standards and determine whether people are accessing appropriate and useful information. This will lead to enduring change in adequacy and quality of services.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>