Creating a consumer direction program for an area agency on aging
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Creating a Consumer Direction Program for an Area Agency on Aging. The National Association of Area Agencies on Aging Scripps Gerontology Center, Miami University, Oxford Ohio. Choice for Independence. Survey of all AAAs

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Creating a Consumer Direction Program for an Area Agency on Aging

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Creating a consumer direction program for an area agency on aging

Creating a Consumer Direction Program for an Area Agency on Aging

The National Association of Area Agencies on Aging

Scripps Gerontology Center, Miami University, Oxford Ohio


Choice for independence

Choice for Independence

  • Survey of all AAAs

  • Majority wanted more information about Choices for Independence initiatives

  • 48% ranked consumer direction as one of their top technical assistance/training priorities


Designing and implementing a consumer directed program at a aaa

Designing and implementing a consumer directed program at a AAA


Motivations

Motivations

  • Labor shortages in home care

  • Political pressure to spend local dollars or lose them

  • Increased options for older adults and caregivers


Challenges

Challenges

  • Societal values/paying family members

  • Role of case manager

  • Universal concerns about fraud, abuse, health and safety, quality of service

  • Provider concerns


Design solutions to some of the challenges

Design solutions to some of the challenges

  • Care plan costs

  • Limits on who can be hired

  • Agency-wide trainings

  • Implementation team

  • Meetings with provider network

  • Independent evaluation


Consumer direction model

Consumer Direction Model

  • Consumer as employer of record

  • Supports in place

    • Fiscal intermediary

    • Case managers

    • Consumer training

    • Authorized reps


Evaluation of the program

Evaluation of the program

  • Baseline and follow-up information about participants

  • Comparison to consumers who stayed in traditional program

  • Results

    • Consumer profiles

    • Consumer impacts

    • Caregiver impacts


Creating a consumer direction program for an area agency on aging

Characteristics of Traditional and Consumer-directed consumers


Creating a consumer direction program for an area agency on aging

Satisfaction with Choice and Control over Services

for Traditional ESP and Consumer-directed ESP clients


Additional findings

Additional findings

  • Caregivers for consumer-directed participants spend an average of 7 hours a day providing unpaid care

  • Every caregiver said they would recommend the program to others

  • Consumer-directed participants used more of their authorized care plan costs

  • Self-directed participants received nearly 3 times as many units of service as participants in the traditional program


Lessons learned

Lessons Learned

  • Older, more frail and cognitively impaired consumers can succeed in consumer directed services

  • Program serves families

  • Case managers play a key role

  • Program planning and design can preempt some of the challenges

  • Political processes, leading for change within the agency are crucial


Contacts

Contacts

  • National Association of Area Agencies on Aging (n4a)

    • www.n4a.org

    • [email protected]

  • Scripps Gerontology Center

    • www.scrippsaging.org

    • [email protected]


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