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Embedding a Whole Person Approach into the Emerging System of I/DD Services
Joshua Boynton, CMAA, Managing Director, VERTESS Karen Luken, MS, Disability and Health Consultant June 11, 2018 Raleigh, North Carolina
Embedding a Whole Person Approach into the Emerging System of I/DD - - PowerPoint PPT Presentation
Embedding a Whole Person Approach into the Emerging System of I/DD - - PowerPoint PPT Presentation
Embedding a Whole Person Approach into the Emerging System of I/DD Services Joshua Boynton , CMAA, Managing Director, VERTESS Karen Luken , MS, Disability and Health Consultant June 11, 2018 Raleigh, North Carolina The Gist.. 5 Million
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- 5 Million people live with a developmental
disability (US)
- 741,000 People receiving Medicaid Residential
- 65 + Billion PLUS (not including PH)
- Living with Family Caregivers 3.5mm
- Living with Aging caregivers 900K
- HCBS Wait-list – 400K
- http://kff.org/health-reform/state-indicator/waiting-lists-for-hcbs-waivers/
- http://www.stateofthestates.org/documents/UnitedStates.pdf
The Gist…..
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Th The e Pe Perfec fect t Storm
- rm
Increased Life Span 19 Years in 1930 66+ years today Aging Caregivers – The Woodwork Effect
- 5 million Individuals with IDD
- 635,000 Formal “Out of Family” Residential Care
- 3.5mm live with family caregivers & 900k are
living with aging caregivers.
Class Action Litigation
- (Olmstead, WL Cases 125K people on the WL,
Access to Benefit cases)
Deinstitutionalization
- Demographic/resource dilemma (Growing
demand and shrinking means.)
- Policy Shifts
- Workforce
- Health Disparities
- New Players (i.e. Kansas, Iowa, Tennessee,
NJ, Arizona)
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Nati tion
- nal
al Cou
- uncil
ncil on
- n Di
Disab sabil ility ity – Guid iding ng Principl nciples es for
- r Successful
cessfully ly Enrol
- lli
ling ng Peop
- ple
with th Di Disab sabilitie lities s in Managed naged Care re Plans ns1
- 1. Community Living
- 12. Information Technology
- 2. Personal Control
- 13. Capitated Payment Systems
- 3. Employment
- 14. Continuous Innovation
- 4. Support for Family Caregivers
- 15. Maintenances of Effort and Reinvesting Savings
- 5. Stakeholder Involvement
- 16. Coordination of Services and Supports
- 6. Cross Disability – Life Span Focus
- 17. Assistive Technology and Durable Medical Equipment Quality Management
- 7. Readiness Assessment and Phase in Schedule
- 18. Civil Rights Compliance
- 8. Provider Networks
- 19. Continuity of Care
- 9. Transitioning to Community-based Services
- 20. Due Process
- 10. Competency and Expertise
- 21. Grievances and Appeals
- 11. Operational Responsibility and Oversight
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Pa Paradi adigm gm Shift ift
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Yo You u Ha Have ve the e Key ey…..
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Pu Publ blic ic Sys ystem em Mu Must-Haves Haves
- Core values
- Critical elements
- User-friendly and responsive
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Accountability
- Efficient use of public funds
- Transparent in its processes and outcomes, including outcomes,
evaluation, reporting
- Responsive to deficiencies
- Adherence to core values
- Adherence to contractual obligations
- Adherence to rights of persons served
- Data Sharing and Meaningful Collaboration, including the HIEA
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Access to Care: Expanding Access
- All people with I/DD have access to the health and habilitative care they need.
- Address the Registry of Unmet Needs: decrease the waiting list
- Access to the full array of HealthCare services
- Care Management and Navigation
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En Enga gagem gement ent
- Active consultation with the users of the I/DD system: individuals with
I/DD, families, professionals
- Responsiveness to stakeholder input
- Support to make informed choices
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Cont
- ntinuit
inuity y of
- f Care
are
- Acknowledgement that services to people with I/DD are long-term, often life-
long, and are available continuously
- Transitions are managed seamlessly
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Whole Person Focus
- LTSS are recognized as one part of an array of
services supporting a person’s improved quality of life.
- Social Determinants of Health are addressed as
people with disabilities are also at risk of experiencing poverty, isolation, food insecurity, etc.
- Collaborative Care between I/DD and Primary Care
providers and Specialists
- Services, outcomes and success measures must be
inclusive of the whole person
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Ho How are e ot
- ther
her st state tes s res estructuring ructuring their eir public blic sy syst stem ems s to
- bet
etter ter achie hieve ve whole
- le per
erson son care re in I/ I/DD? DD?
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Personal Perspectives
- If you were in charge what 3 changes would you make?
- What is missing from today’s system?
- How will you know that the “system” is supporting individuals with disabilities
and families?
- “Connecting the dots” and navigating the system is a challenge. What needs to
change so this is easier for individuals and families?
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Professional Perspectives
- If you were in charge what 3 changes would you make?
- What is missing from today’s system?
- How will you know that the “system” is supporting individuals with
disabilities and families?
- “Connecting the dots” and navigating the system is a challenge. What
needs to change so this is easier for individuals and families?
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Re Recom
- mmended
mended Po Polic icy y an and Pro d Process cess Cha hanges nges
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Ex Explore.
- lore. Dream.
- eam. Dis
iscover
- ver…..
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