How many hoops do you have to jump through to receive services?

1. Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers How many hoops do you have to jump through to receive services? Initial call or visit to the ADRC___________ ___________ ___________ Basic information Unexpressed needsUrgent needsFuture needs ___________ _______ _______ Comprehensiveassessment ofneeds andexisting supports ___________ ___________ ___________ Assisting people through the hoops may require short-term care management. Is your ADRC equipped to provide this? Options counseling and care planning __________ __________ __________ Eligibility Determination (functional and financial) __________ __________ __________ Implementation“The right serviceat the right time” __________ _________ _________ On-going monitoring _________ _________ _________ 1: Enter entities responsible in the hoops 2: How much “influence” does the ADRC have over each process? (fill in boxes using key on right) 3: Where are the barriers?

2. Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Initial Call for Assistance 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over the process? (fill in boxes using key) 3: Where are the barriers?

3. Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Basic Information (Unexpressed needs, Urgent needs, Future needs) 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over the process? (fill in box using key) 3: Where are the barriers?

4. Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Comprehensive Assessment of Needs and Existing Supports 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over the process? (fill in box using key) 3: Where are the barriers?

5. Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Options Counseling and Care Planning 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over the process? (fill in box using key) 3: Where are the barriers?

6. Entities involved _________________ _________________ __________________ Barriers ________________ _______________ ____________ Entities involved _________________ _________________ __________________ Barriers ________________ _______________ ____________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Eligibility Determination Financial 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over each process? (fill in box using key) 3: Where are the barriers? Functional

7. Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ • Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers Implementation “The Right Service at the Right Time” 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over each process? (fill in box using key) 3: Where are the barriers?

8. Total control (ADRC employees or working MOUs between agencies) • Limited control (Coalition members &/or advisory board involvement) X • No control (Not involved in ADRC planning or implementation) Streamlining Self-Assessment GOAL: Seamless entry into long term supports for consumers On-going Monitoring Entities involved _______________________ _______________________ _______________________ Barriers ______________________ ______________________ ______________________ 1: Enter entities responsible in the hoop 2: How much “influence” does the ADRC have over each process? (fill in box using key) 3: Where are the barriers?