Respite Care Task Force Meeting Summary--October 28, 2015 Colorado Department of Public Health and Environment, Building C

1. Participants Task Force members: Angela Woerner Brenda Heimbach Cynthia Hansford Kerri Mosinski Kristi Uitich

Linda Ellegard Meghan Baskett (for Lynn Robinson) Melanie Worley Michele Craig

Mindy Kemp Moe Keller Russ Denbraber Ryan Zeiger Tina Wells

Task force staff: Lisa Carlson (facilitator) and Barbara Yondorf, Engaged Public Health Management Associates: Marci Eads, John O’Connor, Chris Armijo, Robyn Odendahl Public: Cassandra Keller, Colorado Department of Health Care Policy and Financing; Lauren Snyder, Alliance; Matt Chadle, Colorado Department of Public Health and Environment; Jennifer Mellow, Brandebery McKenna Public Affairs; Tim Bergman, Chronic Care Collaborative.

2. Agenda Desired Outcomes  

Review and refine possible recommendations Present and clarify research topics: -- Hot spots in Colorado: maps of respite needs --Informal respite --Access to respite

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Present Region 12 ADRC Respite Subcommittee Work Develop and agree on next steps

1:00 PM

Welcome, Agenda Review, Ground Rules and Introductions -- Lisa Carlson

1:10 PM

Review of Task Force Progress and Possible Recommendations – Lisa Carlson/Barb Yondorf

1:45 PM

Present Research—Marci Eads, Health Management Associates --Hot spots in Colorado: maps of respite needs --Access to Respite

2:20 PM

Break

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2:30 PM

Present Research—Health Management Associates --Informal Respite

2:50 PM

Implications of the Research for Colorado --Given the research, what recommendations should this Task Force make? --Is there any additional information that you need? --Training and Cultural Competence

3:20 PM

Small Groups Report Out

3:35 PM

Region 12 ADRC Respite Subcommittee Work

3:45 PM

Public Comment

3:55 PM

Next Steps and Meeting Evaluation/Check in

5:00 PM

Adjourn

3. Meeting Summary Welcome, Agenda Review, Ground Rules and Introductions Task force members and members of the public introduced themselves. Lisa Carlson reviewed the agenda and ground rules. Review of Task Force Progress and Possible Recommendations Lisa Carlson reviewed the task force’s progress to date. (See Respite Care Task Force Meeting Summary for October 15, 2015). Ms. Carlson distributed a handout, “Potential Recommendations Based on Discussion at October 15, 2014, Task Force Meeting.” Mindy Kemp drafted the recommendations with edits by Barbara Yondorf and additional input from Meghan Baskett and Lynn Robinson. Ms. Carlson noted that the recommendations are in suggested order of importance. She also noted that cultural competency and person-centered care are themes that need to be woven throughout the recommendations. Task force members reviewed the document and made several comments. Investment/Return on Investment. Task force members expressed strong support for a pilot to demonstrate the value in terms of benefits and costs of investing in respite care. The group agreed that a recommendation for a pilot should be highlighted as a freestanding recommendation. One task force member commented that it is important to be specific about where funding needs to go when the task force says that more funding is needed. Training. Task force members discussed the pros and cons of credentialing respite care providers. On the one hand, families want to be assured that respite providers deliver safe, quality care; also, providers prefer having a clear standard for caregiving. On the other hand, there is a concern that credentialing requirements and the cost of credentialing may reduce the pool of respite care

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providers. This is a particular concern in rural areas. The task force asked Health Management Associates to look for creative ways other states are handling this tension. Marketing and awareness. Task force members noted the importance of a central campaign that targets respite providers. Part of the campaign also needs to be outreach to professional workers (e.g., social workers, teachers, etc.) to let them know there’s a central resource for information about respite care and referrals. One caution that several task force members brought up was that respite care shouldn’t be marketed if providers aren’t available. Research Presentations Marci Eads and Jackie Laundon of Health Managements Associates discussed their latest respite care research findings. The findings were included in a PowerPoint handout and presentation, “Update on Respite Care Task Force Study, October 28, 2015.” Topics included informal respite, access to respite and maps of respite needs in Colorado using indicators suggesting counties with a higher need for respite care. Implications of the Research for Colorado--Recommendations Following the research update, task force members broke into two groups to discuss and present to the whole group possible recommendations based on the research findings. The recommendations are listed below. 

Use existing respite programs to develop an outcomes assessment/return-on-investment pilot. o Look at populations in EBD/SLS/CES waivers and study the differences between those who do and do not use respite services. o Use existing data from the Department of Health Care Policy and Financing to pull information on Medicaid clients, matching acuity levels, support needs, etc.

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Use a consistent evaluation tool to assess all respite care programs (e.g., the evaluation tool used by the Area Agency on Aging in Larimer County).

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Identify and ask for respite care funding for high-risk populations to avoid crises. Make this a high priority for funding. o Look at the implications for other systems (e.g., criminal justice, mental health) of crises that could have been avoided had respite care been available and used before the crisis occurred.

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Focus as much on informal respite as formal respite care. This is a major issue in rural areas where the supply of formal caregivers is often insufficient. o Pay informal caregivers. o Remove/do not impose requirements that may discourage individuals from providing formal caregiving in underserved areas, such as a requiring certification or charging for classes.

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Create geographic-area-specific registries to identify local respite care providers.

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Establish a crisis support hotline that caregivers can call to get informal caregivers to come to the home and help.

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Work with Medicaid for more respite credits.

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Use mentors to train informal caregivers. Give them enough information to feel comfortable providing care and to encourage more people to do caregiving.

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Mount a public relations campaign targeting the medical community (e.g., hospitals, medical offices, etc.). Ensure medical providers have access to a central respite care resource that has consistent information for them and allows them to help their patients.

Region 12 Aging and Disability Resource Center (ADRC) Respite Subcommittee Work Erin Fisher, project specialist, Northwest Colorado Council of Governments, representing the Summit County area ADRC, and Rob Dewing, site director, Bristlecone Home Health, joined the task force meeting by phone. They presented an overview of respite services and needs in Summit County (see handout of the same name). They asked for a member of the task force to liaise with the Summit County Respite Coalition to keep each group informed about the other’s work. Tina Wells volunteered, noting that as part of her work for the Alzheimer’s Association she had already planned to connect with out-state groups.

4. Public Comment—there was no public comment. 5. Next Steps and Meeting Evaluation/Check-in   

Mindy Kemp will look into problems some task force members said they had with using the task force’s website and Google Docs. At the request of the task force, Barbara Yondorf will draft definitions of the terms “respite care,” “informal respite,” and “crisis respite” for the group to consider and use in its deliberations and final report. Health Management Associates will present some quantitative data at the next meeting.

________________________ Handouts       

Agenda Meeting summary, October 15, 2015 Potential Recommendations Based on Discussion at October 15, 2015, Task Force Meeting Update on Respite Care Task Force Study (HMA PowerPoint) Maps showing indicators of respite care need by county HMA Respite Care Study Interim Report, October 19, 2015 Respite Overview—Services and Needs in Summit County, October 2015, Bristlecone Foundation

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