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NY Connects State Long Term Care Advisory Council Meeting
Upstate Meeting Minutes
October 29, 2008

In Attendance: Michael Burgess, Laurie Pferr, Gail Koser, Marcus Harazin, John Cochran, Ladan Alomar, Donna Andrzejewski, Priscilla Bassett, Patricia Binzer, Laura Cameron, Dr. Michael Cohen, Vincent W. Colonno, Leah Farrell, Janice Fitzgerald, Robin Frank, Maureen Freehill, Carole Gehrig, Jeff Gleba, Lucinda Griffin, Bob Gumson, Dan Heim, Richard Herrick, Lisa Irizarry, Maxcine Johnson, Andrew Koski, Joanne Martel, Phil McCallion, Kathy McMahon, Janet McNally, Lindsay Miller, Pamela Polacsek, Lorraine Noval, Susan Richardson, Nicholas Rose, Melanie Shaw, Aaron Tripp, Ana Winans, Thea Griffin, Art Clark, Jessica Fontaine, Andrea Hoffman, John Lontrato, Gail Myers, Amy Snyder, Erin Verdile, Ingrid Williams, Barbara Diesem-Zimmons,

  1. Welcome and Introductions - Michael Burgess- Director, NYS Office for the Aging
    • Director Burgess opened the meeting with welcoming remarks, introductions and provided an update on NYSOFA programs and activities.
    • Advisory Council members were referred to the minutes from the June 11 SLTCAC meeting and were encouraged to submit any questions or amendments to them to Thea Griffin.
    • The Advisory Council was informed of the upcoming Community Empowerment conference, scheduled for November 12 and 13 at the Saratoga Hilton and City Center. NY Connects will present a combined workshop on Information and Assistance and Long Term Care Councils.
    • The HEAP allotment for 2008-2009 has been increased.
    • The fiscal crisis and the resulting impacts to NYSOFA programs were discussed. The second round of cuts to NYSOFA programs has occurred and more cuts may occur. NYSOFA is working to keep the services whole while being responsive to the challenging fiscal climate. Priscilla Bassett indicated that NYSOFA is to be applauded for advocating so strongly to preserve existing programs and supports. The Governor has invited the legislature back in to session next month in an effort to re-think the State's budget while addressing the deficit which is in the billions of dollars.

  2. NY Connects Program Update - Thea Griffin, Director of NY Connects, NYSOFA
    • Ms. Griffin informed the Advisory Council that as of October 1, 2008 NY Connects is in the 3rd year of operation. NY Connects local programs are at various levels of implementation across the state. In Program Year 2 the focus was on the stabilization and enhancement of program operations. Year 3 will focus on further strengthening the Information and Assistance function and advancing long term care reform through the Long Term Care Councils.
    • She discussed the delivery of I & A, public education and Long Term Care Councils and provided an overview on the number of counties that were operational and conducting these core functions. All but three of the participating counties are fully operational. From July 2007 through June of 2008, there have been over 100,000 contacts to the local NY Connects programs.
    • NYSOFA trainings designed to enhance local NY Connects operations have been l evaluated highly overall and were well attended to date. The Building Connections regional trainings are nearing completion. The Information and Assistance Training developed by NYSOFA and the Center for Excellence on Aging will be offered in four locations around the state.

  3. Evaluation of NY Connects
    1. Caregiver Survey
      Gail Koser, Assistant Director, Division of Policy Research and Legislative Affairs, NYSOFA
      • Ms Koser provided an overview and PowerPoint presentation on the caregiver survey project along with the preliminary findings to the Advisory Council
      • The Council discussion centered on the availability of home health care services and the corresponding priorities for its effective delivery.
      • Respite and transportation services were reported as being the most needed.
    2. Pilot Survey on Program Experience
      Erin Verdile, Sr. Long Term Care Coordinator, NY Connects, NYSOFA
      • Ms Verdile provided an overview of the NY Connects Program Satisfaction Survey and a handout of the Survey Instrument.
      • The project is being conducted in collaboration with the Center for Development of Human Services, an arm of the SUNY Research Foundation.
      • The survey and the process for its administration is currently being pilot tested among 18 volunteer NY Connects programs across the State. Results will be made available to the Council in the spring of 2009.

      Q: Are project staff also considering the implications of individuals who do not agree to participate in the survey, i.e. will non-consenting individuals also be addressed in the Report of Findings? Findings from the consenting population may not be representative of the non-consenting.
      A: Yes, this group is being considered. As with all population based surveys, the population of non-participants must be acknowledged when drawing conclusions from the findings.

      Q: How will the internet surveys be returned?
      A: Individuals choosing to complete the survey on the internet will be sent the web link via email. They will then click on a link that is inside the email message which will bring them to the survey website. There is a built in mechanism for tracking respondents according to their email address.

      Q: Did NYSOFA and the Center for Development of Human Services (CDHS) consider administering the survey by telephone? That is the approach employed by 211 and it is also a computer assisted/teleprompt process which eliminates the use of staff resources.
      A: A staff administered telephone survey was the initial approach considered but was later tabled/postponed due to reported variability in local staff availability and ability to administer the survey at this point in the program. This method will be revisited upon examination of findings from the pilot test of the self-administered format.

      Q: Are other format options being considered to accommodate cultural diversity and also persons with other kinds of disabilities (e.g. visually impaired)?
      A: Yes, these options are being considered for future state-wide implementation of the survey but not for the pilot test.


  4. MISCC Update -Marcus Harazin, Deputy Director, Division of Community Services, NYSOFA
    • The MISCC subcommittee work was highlighted and a handout provided. Marcus indicated the state agencies that are involved in the MISCC. Commissioner Ritter from OMRDD Chairs the MISCC.
    • As with many of the other state agencies, NYSOFA has their own MISCC subcommittee. Their work was highlighted and handouts were provided.

  5. Nursing Home Diversion Modernization Grant (NHDM) - Gail Koser
    • An overview of the NHDM grant and its purpose was provided to Advisory Council members. NYSOFA was awarded the grant from the Administration on Aging to pilot test consumer directed services models for individuals at risk of nursing home placement and spend down to Medicaid. The counties that will be implementing the grant are Broome, Oneida, and Onondaga. In addition, NYS was one of 10 states awarded a Veterans Affairs component for the purposes of identifying veterans of all ages at risk for nursing home placement and providing them with home and community based services, as well as the option to take part in consumer-directed services.
    • The AoA grant period spans 18 months and began on September 30, 2008. The VA component will begin once the consumer directed model is operational in each county and has no termination date.

    Q: Is this grant part of the Nursing Home Transition and Diversion Waiver? How is it related?
    A: No, this is a separate grant awarded to NYSOFA from the Administration on Aging. The goals are very similar, but the NHDM grant is targeting the non-Medicaid population where as the Waiver is for the Medicaid population.

    Q: What is the process for determining eligible recipients? What are income limits?
    A: A standard screening process will be used. Eligible individuals are those with $40,000 in assets and at 300% of the Medicaid level. The first nine months will be devoted to planning and the latter nine months for actual service delivery. It is envisioned that NY Connects staff will conduct the initial screening in all three grantee counties (i.e., PRI).

    Q: Is the package of services adequate and comprehensive to address both medical and non-medical needs? How will medical provider network interact with non-medical to ensure that services are coordinated?
    A: The focus of this grant is on the provision of non-medical supports to those who are at risk of future nursing home placement. The interface between non-medical and medical networks will be addressed throughout the planning period. Members were then invited to participate via sub-committee. Sub-committee members who volunteered included Robin Frank, Richard Herrick, Dan Heim, Andrew Koski, and Melanie Shaw/Bruce Darling.

    Q: Is there an age requirement for eligibility?
    A: Yes, 60 and older for the non-Veteran component. Regarding, supplemental VA component, veterans of any age who meet the screen requirements are eligible.

    Q: How will Veteran's Administration be involved?
    A: The local VA Medical Center (in this case, the Syracuse VA Medical Center) will "purchase" AAA services (e.g., Home Delivered Meals) for eligible veterans of ANY age in the three pilot counties. The Veteran's Salute Program was also offered as a model to reference and become knowledgeable about moving forward with this grant (e.g., Medicare regulations). Program allows $2,000 monthly for at home ADL support services. A veteran's eligibility for other programs offered by the VA will not affect their eligibility for this grant opportunity.

    Q: Is NYSOFA modeling this grant after New York's Consumer Directed Medicaid program?
    A: No, NYSOFA is reviewing various models of the Consumer Directed program.

    Q: How will a functional decline in a formerly eligible grant recipient be detected? What if a person declines to the point where he/she needs institutional care?
    A: A period re-assessment process will be employed.

    Q: Where will you locate potential recipients for this grant?
    A: Existing AAA networks will be used along with NY Connects Information and Assistance staff. With regards to the VA component of the grant, the local VA Medical Center (i.e. Syracuse VA Medical Center) will identify veterans who are eligible for this program and refer them to the aging network. Veteran referrals that come through other channels must first be approved by the local VA Medical Center.

    Q: Will there be an overlap with Medicaid Eligibility Determinations that result from the Nursing Home Transition and Diversion Waiver?
    A: The purpose of this grant is to prevent nursing home placements and spend down. We do recognize the importance and the need for the NY Connects programs and the Regional Resource Centers to collaborate within the three grantee counties.


  6. Next Steps and Closing - Michael Burgess
    • Summary of important discussions from the day.
    • Provided members with tentative dates for next year's meetings, those being:
      February 26, 2009 (this date determined subsequent to the AC meeting)
      June 29, 2009
      October 21, 2009


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