Utah RCSC Summary | advancingstates.org

<A NAME=\"UTRC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">UTAH</H2> <H3>Identified Problems with Utah's Long-Term Care System</H3> <P> <UL> <LI>Lack of access to waiver services and state supported alternative care programs due to waiting lists.</LI> <LI>Difficulty in deinstitutionalizing people with disabilities due to lack of affordable and accessible housing.</LI> <LI>Fragmented long-term care system because service programs have evolved according to categorical funding streams.</LI> <LI>Lack of focus on facilitating deinstitutionalization; waiver programs focus on preventing institutionalization.</LI> <LI>Inability to successfully transition individuals from institutions to the community due to an inadequate supply of community services and supports.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>Variety of long-term care options available for all ages of people with disabilities and chronic illness.</LI> <LI>The state has gained experience in transitioning people from nursing facilities to community supported living situations through the FlexCare Demonstration Project, funded by the Nursing Facility ProjectMedicaid.</LI> <LI>The state's "Plan for the Provision of Long Term Care Services for Seniors" has focused on the provision of community supports to allow elderly persons to remain at home.</LI> <LI>The eligibility determination process screens for mental and physical health risks. Identified risks are then addressed through intervention and treatment services.</LI> <LI>Collaboration of Departments of Human Services and Health through a Long-Term Care (LTC) Coalition to work on problems and forge opportunities for cooperation.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Increase public awareness of and support for people needing LTC services.</LI> <LI>Increase community integration by stimulating the development of enhanced community service and support options.</LI> <LI>Foster systems change through increased inter-agency coordination.</LI> <LI>Increase options for consumer choice and involvement.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Redesign Utah's LTC system to enable children, their families, and adults of any age with disability or long-term illness to choose their residence and their services.</P> <P><STRONG>Goal.</STRONG> Establish intra-departmental and intra-divisional vehicles to increase coordination among state agencies to design and foster LTC strategy implementation.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Establish a Cross-Department/Division Coordinating Committee.</LI> <LI>Study and identify barriers to consumer-directed and person-centered services within each Division's programs through a literature review, consumer-oriented focus groups, and a concept paper.</LI> <LI>Review the feasibility of having case managers, independent of the service provider, available to all people receiving long-term care services in the community</LI> <LI>Enhance communication through partnerships between consumers, state agency administrators and other stakeholders to enable the development of a consumer-responsive service delivery system.</LI> <LI>Support completion of the existing demonstration project of electronic use of the Minimum Data Set for Home Care (MDS-HC) instrument and data base development. This will increase coordination among state agencies through a common level-of-care eligibility tool.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Increase public awareness of and access to LTC information and services.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Review the current sources of statewide LTC service information.</LI> <LI>Establish a centralized 1800 LTC number and a new access point for consumers to link to existing sites by coordinating existing information and referral service providers.</LI> <LI>Establish a statewide Internet LTC interactive Website that will provide information about LTC services available in the State, and how to access these services through the screening and referral process.</LI> <LI>Simplify and streamline the assessment processes for determining LTC needs and eligibility.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Facilitate community integration and residence choice by increasing the capacity of informal caregivers and other supports to provide care.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Use a multi-media campaign to inform the public about caregiver roles in assisting individuals with disabilities or long-term illness to receive support in community settings of choice.</LI> <LI>Develop or identify a series of training modules that teach caregiver skills appropriate to the various stages or levels of care being provided.</LI> <LI>Conduct a series of focus groups with caregivers themselves and community groups that represent caregivers to identify what caregiver support services are most needed, and what problems are encountered in obtaining services.</LI> <LI>Add an additional access point for caregivers to obtain emergency relief from care responsibilities through existing 1800 hot-line services.</LI> <LI>Facilitate the development of peer caregiver counseling programs in each county.</LI> <LI>Work with media to develop public service announcements to encourage volunteers and personal assistance staff to work with consumers with long-term needs.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Increase opportunities for consumer involvement and choice.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Fund and foster self-determination, personal development, and leadership training for Mental Health, Aging, Disabilities, and Medicaid consumers.</LI> <LI>Encourage agencies to support consumers to attend state and national conferences on LTC issues.</LI> <LI>Work with government, community, and private providers to encourage consumer and family participation on policy and advisory boards.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Study and identify barriers to consumer-directed and person-centered services within each Division's programs through a literature review, consumer-oriented focus groups, and a concept paper.</LI> <LI>Support self-determination, personal development, and leadership training for Mental Health, Aging, Disabilities, and Medicaid consumers.</LI> <LI>Provide for a statewide long-term care interactive Website and 1800 number to enable consumers, family members, friends, advocates, or providers to work through what long-term care resources are available, whom they are available from, and how to access them.</LI> <LI>Simplify and stream line the eligibility and assessment process to determine long-term care need and eligibility.</LI> <LI>Develop a multimedia campaign to advise the public about the role that caregivers play in assisting individuals with disabilities of long-term illness to receive support in a community setting of their choice, and enable individuals to identify themselves as caregivers.</LI> <LI>Develop training modules that teach caregiver skills appropriate to various stages or levels of care being provided, develop a peer-counseling program for caregivers, and create a new 1800 access point for caregivers to obtain emergency relief from their caregiver duties.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>The Long-Term Care Coalition included both consumer and provider members. Consumers and providers were drawn from existing Division Advisory Boards or committees, e.g., Aging, Division of Services for People with Disabilities, Mental Health, Centers for Independent Living, and the Arc of Utah.</LI> <LI>A Consumer Task Force will be developed to oversee all Systems Change Grants. Consumer and family members of the Utah Governor's Council for People with Disabilities will comprise the majority of the Consumer Task Force, with two representative consumers to be appointed from the Aging and Adult Services network. Other consumer partners include the Utah Independent Living Centers and the Utah Caregiver Coalition.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P> <UL> <LI>In 1996, the Health Policy Commission established a Long-Term Care Technical Advisory Group (LTC/TAG), co-chaired by the Executive Director of the Governor's Council for People with Disabilities and Equitable Life and Casualty, a representative from the private insurance industry. The LTC/TAG was made up of 16 representatives from state, local public and private nonprofit agencies. The LTC/TAG utilized the recommendations of the LTC Coalition as guidelines for their work.</LI> <LI>The LTC/TAG met regularly and publicly, formed advisory subgroups, reached out to all long-term care stakeholders for input, and commissioned a survey of key players about public policy priorities. The LTC/TAC used the information obtained from the survey to produce a final report in 1999, a set of Principles and Recommendations. These activities were the foundation for future guidelines for RFPs.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P>Consumer partners will work together with the project manager to ensure the projects in the grant remain consumer focused. They will offer advice, direction, validation, input and planning as well as monitoring and evaluation of the grant.</P> <H3>Public Partners</H3> <P> <UL> <LI>Utah Department of Health.</LI> <LI>Area Agencies on Aging.</LI> <LI>Independent Living Centers.</LI> <LI>Economic Development.</LI> <LI>Information and Referral Services.</LI> <LI>Division of Aging and Adult Services.</LI> <LI>Division of Services for People with Disabilities.</LI> <LI>Division of Mental Health.</LI> <LI>Division of Health Care Financing (State Medicaid Agency).</LI> <LI>Division of Health Systems Improvement.</LI> <LI>Governor's Council for People with Disabilities.</LI> <LI>University of Utah.</LI> <LI>Vocational Rehabilitation.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>Bill Walsh and Associates.</LI> <LI>Other contracts will be considered as Grant activities continue.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P> <UL> <LI>Public and private organization members of the LTC/TAG participated in planning meetings and the development of principles and recommendations for systems change.</LI> <LI>Bill Walsh and Associates were contracted to write the grant application.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P> <UL> <LI>Several Divisions from the Department of Human Services and Department of Health will be represented on a Coordinating Committee for the grant. They will research current practices, assist in the development of new resources, offer input and review, collaborate with other state activities related to Utah's projects, act as consultants, and provide expertise related to grant activities.</LI> <LI>The University of Utah is currently in contract negotiations for implementation of project activities.</LI> </UL> </P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG></P> <P>Utah's Work Incentive Project and Centers for Independent Living currently have grant funded projects that are working in collaboration with the Real Choice Grant to ensure inclusion in project activities where appropriate and to avoid duplication.</P> <H3>Oversight/Advisory Committee</H3> <P>The Consumer Task Force will work together with the Project Manager to ensure that Grant activities remain consumer focused. They will offer advice, direction, and validation, will provide input on planning, and will monitor and evaluate the grant activities along with the Project Manager.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>One of the duties of the Project Manager is to monitor progress of Grant activities and ensure that identified goals are achieved. Information to make program adjustment recommendations will be available to the Coordinating Committee. Since Coordinating Committee members already know their Divisions' personnel and decision-making processes, the expectation is that the Coordinating Committee will develop solutions to problems and make suggestions for needed changes.</LI> <LI>The Participatory Action Research (PAR) process is sponsored by the Real Choice Grant and used by Coordinating Committee members. It is designed to keep the cycle of research, action, and evaluation going as the basis for continuous improvement. The PAR process ensures that consumers, providers and evaluators work together to make lasting systems change.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>All resources developed will continue when grant funding ends. It is anticipated that the new resources will be integrated and become a part of ongoing business practice.</LI> <LI>Outcomes will include improved and coordinated service delivery that offers the necessary tools for consumers to make informed choices about all aspects of their care.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>