Respite Care Task Force Meeting Summary-‐-‐October 15, 2015 Christian Living Center, 7000 E. Belleview Ave, Greenwood Village
1. Participants Task Force members: Angela Woerner Brenda Heimbach Cynthia Hansford
Kerri Mosinski Kristi Uitich Linda Ellegard
Lynn Robinson Michele Craig Mindy Kemp
Moe Keller Tina Wells Melalnie Worley Ryan Zeiger
Task force staff: Lisa Carlson (facilitator) and Barbara Yondorf, Engaged Public Health Management Associates: Marci Eads, John O’Connor, Chris Armijo, Robyn Odendahl Public: Todd Coffey, State Unit on Aging; Janis DeBaca, Hayley House; Lauren Snyder, Capitol Success Group; Tim Bergman, National MS Society; Meghan Baskett and Jordan Anderson, Easter Seals Colorado.
2. Agenda Desired Outcomes • Review progress to date • Introduce contracted researchers and their scope of work/timeline • Share initial research on best practices • Develop and agree on next steps 2:00 PM Welcome, Agenda Review, Ground Rules and Task Force Member and HMA Introductions -‐-‐ Lisa Carlson 2:15 PM
Review of Task Force Progress -‐-‐ Lisa Carlson
2:25 PM
Follow-‐up on Task Force Information Requests -‐-‐Older Americans Act respite care data-‐-‐rural/urban, demographics etc. (Todd Coffey), and Seattle workforce training program (Mindy Kemp)
2:45 PM
Research Overview (Marci Eads, HMA) -‐-‐Overview of research team role -‐-‐Topics and Methods -‐-‐Progress to date
3:30 PM
Break
3:45 PM
Topics to Discuss (HMACS to share information synthesized to date) -‐-‐Return on Investment and Funding
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-‐-‐Public Relations and Awareness -‐-‐Training and Cultural Competence 4:40 PM
Public Comment
4:55 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 introduced the research study team from Health Management Associates (HMA): Marci Eads, Chris Armijo, Robyn Odendahl and John O’Connor. Review of Task Force Progress
Lisa Carlson briefly reviewed the task force’s progress to date (see prior meeting summaries). Follow-‐up on Task Force Information Request
Mindy Kemp presented information about a workforce training program in Seattle. The nationally recognized program trains home care workers and may be applicable for training respite care providers. Since its inception, the program has trained more than 30,000 workers. Ms. Kemp has a folder of information about the program that people can look at. In response to questions from task force members, Marci Eads suggested the researchers could follow up to find out: • •
How is the program is funded? Does the program train people to work with those needing care across the lifespan?
Research Overview
The Department of Human Services selected HMA to conduct research on a number of specific topics to inform the work of the task force. Marci Eads, Managing Principal, leads the research study team. Ms. Eads began her remarks with a description of HMA and then introduced the members of her team: John O’Connor, Principal, Southern California; Robyn Odendahl, HMA Community Strategies Associate; and Chris Armijo, HMA Community Strategies Senior Associate. Research Study Plan
Ms. Eads reviewed two handouts, “Draft Timeline for the HMA Study” and “Overview of the HMA Study Plan: Topics and Questions, Process and Methods, and Development of Recommendations.” The task force made the following requests:
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Look into the legislative process—what is the best practice for taking this work to the legislature? Look at the whole process, from policymaking through implementation. Be sure to include the Centers for Medicare and Medicare Services. In the Overview document, include interviews with caregivers as well as providers, and interview experts across the country on best practices.
Task force members who have suggestions for people to whom the research study team should speak should forward their names and contact information to Mindy Kemp.
[NOTE: All presentations referenced in the following sections were included in the HMA PowerPoint handout, “Update on Respite Care Task Force Study.”]
Marketing and Awareness, Audience Messages and Communication Vehicles
John O’Connor reviewed the results of HMA’s initial research on marketing and promoting awareness of respite care services. Task force members had a number of comments. •
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Caregivers are on the edge of collapsing. How do we market to them so they realize they are caregivers, can get respite care, and will take action to get it? Often these are people who can’t leave for a minute. We shouldn’t limit our outreach to home caregivers. Family and friends may provide substantial assistance and need respite. Be sure to focus on lifespan issues. With respect to someone with a brain injury, the caregiver who asks for respite services may think this means he/she is saying the situation is hopeless, that taking a break means being a caregiver failure. We need to reach doctors, social workers, hospitals. They can provide information to caregivers on the kinds of help they can get, including respite. Perhaps the most important target group for marketing and public awareness is people who don’t identify themselves as caregivers. It’s important that a marketing/public awareness campaign results in people taking action. We need to reach people before a crisis occurs. They need to know that they can get respite care on a regular basis and there are qualified professionals who can help. Priorities should be prevention and those on the brink.
Other points task force members made included: •
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The Respite Care Coalition already has good materials and videos. The issue is not so much developing new materials as it is getting more providers (especially mental health providers) on the same page, using the same materials. Attention needs to be given to process, collaboration and buy-‐in. Four hundred agencies are signed up with the respite coalition. A website can be powerful because caregivers are at home and use the computer a lot. Invest resources in building a good website rather than, say, radio ads. It’s important to see someone like yourself on the website. For example, sometimes people in rural areas can’t identify with pictures on a website. Make sure ads speak to rural families as well as others. Social media should be a priority.
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Additional areas the task force asked HMA to look into included: •
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Logistical, technical issues—is anyone doing search engine optimization? People should be able to get to a Colorado respite website not only by googling “respite” but also by searching for information on a related question (e.g., “getting a break”) Cost of campaigns Marketing and public awareness addressing the needs of people in rural communities Data on what works—campaigns that reach a lot of people and are cost-‐effective Ways to lead everyone to one website so there is consistent messaging, with links to other sites with additional or targeted information.
At the conclusion of their discussion about marketing and public awareness, task force members emphasized two points: • •
A priority for the group is to better connect the positives of respite to overall health, health care, and health care costs. Respite care needs to be embedded in our care culture. Just as people understand that if these are your needs you go to the ER, they should know that if they need a break they should get respite care services and they know how to access them.
Cultural Competence
Chris Armijo reviewed the results of HMA’s initial research into cultural competence. Following his presentation, task force members had several comments. • •
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Cultural competence includes not only ethnicity but also people with disabilities, etc. Is there a hierarchy of value in this area? What’s the biggest hit we can make? Mr. Armijo suggested that the focus should be on institutionalizing cultural competence; just training people not enough. It may be easier to figure this out using the lens of person-‐centered care. Look at the wants and needs of the individual beneficiary and his/her caregiver—linguistic, physical, economic, etc. Use a person-‐centered model v. trying to help everyone. Start on a mini-‐scale. Providers should not all be lumped together. For example, you could have a person who is white and was brought up in an African American community. One person said her father has Alzheimer’s and almost all of his caregivers are foreigners. Some people don’t seek respite care because they’re not convinced respite care providers can adequately address the needs of the person receiving care, including cultural competence.
Additional areas the task force asked HMA to look into included: • • •
Are there core things related to cultural competency that should be included in all training? Where are most problems with lack of cultural competency? Which groups? What are existing models? Don’t spend resources on developing a new model if we can look at existing models. Ms. Eads said HMA could interview people in other states and see what they’ve done about cultural competency.
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Training
Following his presentation on cultural competency, Mr. Armijo reviewed the results of HMA’s initial research about training respite care providers. Task force comments included: • •
Care competencies are necessary but what about the person with high-‐level behavioral or medical needs? Training and supports should be in place to meet this need. There was some concern expressed over the idea of credentialing and cost of credentialing.
Task force members asked HMA to look into the following: • • •
Is there good research on best practices with respect to training? Are there proven outcomes? What about the cost to providers? What nonprofits or chronic care organizations already have their own training programs for people with specific conditions (e.g., Alzheimer’s, brain injury, MS, etc.)? What are model respite care training programs for when care can’t be delivered in the home because of the complex needs of the person receiving care?
Funding for Respite Robyn Odendahl reviewed the results of HMA’s initial research concerning funding for respite services. Following her presentation, task force members made several suggestions for possible sources of funding in addition to those identified by HMA: • • • • • •
County mill levy funds Shared savings from keeping people out of the hospital Informal networks CCB funds that could be spent on respite services Inclusion of respite care in wellness programs Insurance coverage for respite care
Task force members asked HMA to:
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Talk to recipients in other states to see their satisfaction with services. Funding needs to focus on high quality services that are what caregivers and those being cared for want.
Return on Investment
Ms. Odendahl reviewed the results of HMA’s initial research on the return on investment from respite care. Task force members had several comments. • •
Demonstrating positive return on investment in respite care is the key. We have to demonstrate savings to legislators. Employers need to be convinced of the value of respite care. Employers need education about what respite care is and why they should cover it.
With respect to all of the issues the task force discussed, it was suggested that pilot projects may be the best way to go.
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4. Public Comment
Janice de Baca, made several comments about the HMA presentations and task force discussion. On the question of who you want to reach, priorities should include single caregivers and military families with a spouse overseas. With regard to training, look at the January 2015 PADCO (Parents of Adults with Disabilities in Colorado) interviews with caregivers. On the issue of cost-‐effectiveness, the task force should look into increased mental and physical health care costs of respite caregivers. Faith communities are another good source of respite care, especially in the South. Tim Bergman asked the task force about its definition of respite care. Meghan Baskett asked about adoptive and foster care.
5. Other Business Mindy Kemp informed the task force that its report and recommendations need to be reviewed by the Department of Human Services before it is submitted to the legislature. This means the final report should be ready no later than mid-‐January to give the department adequate time to review the report before it is due to the legislature.
6. Next Meeting Staff will pull together a list of possible recommendations on the topics discussed at this meeting based on the task force’s discussions. HMA will present more of their research results.
Handouts • • • • •
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Agenda Meeting summary, September 8, 2015 Biographies of HMA staff Draft timeline for the HMA study Overview of the HMA study plan: Topics and Questions, Process and Methods, and Development of Recommendations Update on Respite Care Task Force Study (HMA PowerPoint)
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