Respite Care Task Force

Task Force Meeting—September 8, 2015 Christian Living Center, 7000 E. Belleview Ave, Greenwood Village Meeting Summary TASK FORCE ATTENDEES: Brenda Heimbach Cynthia Hansford Kristi Uitich

Linda Ellegard Lynn Robinson Michele Craig

Mindy Kemp Moe Keller Russ Denbraber

Tina Wells Melanie Worley Ryan Zeiger

Task force staff: Lisa Carlson (facilitator) and Barbara Yondorf, Engaged Public AGENDA Desired Outcomes: • • • •

Clarify other efforts that may impact respite care recommendations Provide an update about contracted researchers and their scope of work/timeline Brainstorm the ideal vision for respite care in Colorado Develop and agree on next steps

10:40 a.m.

Welcome, Agenda Review, Ground Rules and Introductions (Lisa Carlson)

10:50 a.m.

Results overview of Task Force member interviews (Barb Yondorf)

10:55 a.m.

Environmental Scan: What other efforts could impact our work? -- Peggy Spaulding and Todd Coffey, CDHS -- Michelle Craig, HCPF -- Kristi Uitich, CDPHE

11:30 a.m.

Research Overview (Mindy Kemp)

12:45 p.m.

Break

12:00 PM

Ideal Vision for Respite Care in Colorado (small groups)

12:45 a.m.

Strategic Goal Areas

1:15 p.m.

Public Comment

1:25 p.m.

Next Steps and meeting evaluation/check in

1:30 p.m.

Adjourn

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MEETING SUMMARY 1. Welcome, Agenda Review, Ground Rules, Introductions—Lisa Carlson Lisa Carlson reviewed the agenda and task force members and members of the public introduced themselves. Rep. Lois Landgraf, co-sponsor of the bill that created the task force, briefly addressed the task force. She acknowledged the very short deadline (January 31, 2016) for the task force to submit its report to the legislature and offered to see if the deadline could be pushed back. 2. Results overview of Task Force member interviews (Barb Yondorf) Barb Yondorf handed out a 2-page document that highlighted the results of interviews with task force members conducted in August. The handout listed the top respite care issues and top suggested strategies for addressing those issues that task force members identified. It also listed possible model programs for Colorado that the task force may want to learn more about. Two model programs were added to the list at the suggestion of task force members: Zach’s Place in Colorado Springs and Adult Care Services in Larimer County. 3. Environmental Scan: What other efforts could impact our work? Staff from the departments of Human Services, Health Care Policy and Financing, and Public Health and Environment reviewed their department’s activities related to respite services. - Todd Coffey, manager, and Peggy Spaulding, program specialist, State Unit on Aging, Colorado Department of Human Services. Mr. Coffey discussed and provided a handout describing the Older Americans Act/State Funding for Seniors Services. Ms. Spaulding discussed and handed out a sheet describing the Colorado Respite Care Program. Michele Craig HCBS-DD and SLS Waiver & Supported Employment Coordinator, Division for Intellectual and Developmental Disabilities, Colorado Department of Health Care Policy and Financing. Ms. Craig explained that the Division of Intellectual and Developmental Disabilities and the Division of Long-Term Services and Supports manage several waivers that provide respite coverage. She described the work of the Community Living Advisory Group and their respite recommendations (e.g., all Medicaid HCBS waivers should include respite support for caregivers, the State should develop respite caregiver trainings, the definition of respite should be expanded to include alternative models, etc.). The Division for Intellectual and Developmental Disabilities is working on the design of a new waiver and that will ultimately consolidate the HCBS-DD and SLS waivers. Their current focus is on service definitions. The report of the Community Living Advisory Group, the recommendation report of the Waiver Redesign Work Group, and a gap analysis prepared by JFK Partners concerning services for those dually diagnosed with intellectual/developmental disabilities and mental health conditions and/or behavioral health needs by JFK Partners will be posted on the task force website. - Kristi Uitich, supervisor for Acute and Community-based Programs, Colorado Department of Public Health and Environment. Ms. Uitich described the role of the department with respect to respite services. The department licenses Home Health and Home Care agencies that provide medical and non-medical direct services that may include respite. It does not license Respite Care Task Force

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individual respite providers or respite services as an individual service. A working group created by HB 14-1360 is developing a plan to eliminate conflicts and gaps between the requirements imposed on CCBs and PASAs for licensure by the Department of Public Health and Environment and the requirements for certification by the Department of Health Care Policy and Financing. 4. Research Overview (Mindy Kemp) Ms. Kemp reported that the Department of Human Services issued a Documented Quote for a study of the dynamics of supply and demand with regard to respite care services in Colorado. As of the September 8, 2015, the department had received three documented quotes. An award announcement will be made by the end of the week. 5. Ideal Vision for Respite Care in Colorado Task force members divided into two small groups to discuss this question: “If we are wildly successful in providing respite care in Colorado, what are the elements that make it so successful?” Then the full task force listed the elements they had identified, grouped them into strategic goal areas (e.g., diverse funding streams, workforce supply and quality, etc.), and said which they thought could be successfully addressed in the short term (1-3 years), medium term (3-5 years) and long term (5-10 years). The results are shown on the next page. 6. Next Steps: • • • •

Get data on respite care provided in Colorado under the Older Americans Act—break down rural/urban, demographics, etc. Post the Community Living Advisory Group report on the task force website. At the next meeting, get a briefing on the gap analysis prepared by JFK Partners. (Michele Craig) Find out more about the workforce training program in Seattle (Mindy Kemp will check)

7. Public comment •

Need to identify who is a caregiver. People don’t see themselves as caregivers. Need to raise awareness--are you a caregiver?

8. Meeting Wrap-up—What worked well? Anything to make it better? •

Need contracted researchers to present at task force meetings.

9. Adjournment The meeting adjourned at 1:10 pm.

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Ideal Vision for Respite Care in Colorado Strategic Goal

Elements

Timeline

Diverse funding streams (need good data to make this happen) • • • • •

Sustainable and adequate funding levels Funding for high-level needs (i.e., provided by an RN) Funding for Medicaid/non-Medicaid alike, those at risk for placement Dedicated funding source for respite care Funding in place for all needing respite (i.e., vouchers, sliding fees, etc.)

Long term Long term Long term Long term Long term

Continuum of services and options • • • • • • • • •

Flexibility in delivery of respite services Emergency and planned respite options Rural areas have same options as urban areas Range of services available Enough multiple offsite facilities for all who need throughout the State Enough diversity of delivery and location of services to give choices Broader range of respite settings (based on need) Have options for the Military Respite has become available in all Medicaid Waivers with choice/options

Medium term Medium term Long term Medium term Long term Medium term Short term Medium term Medium term

PR/awareness • • • • • •

Medical community embraces link between health and respite for caregivers Social media campaign to educate public on respite issues Colorado employers support employees who also are respite care providers Caregivers honored and respected leading to abundant supply Good data to support cost/benefit of respite care Pilot program to demonstrate effectiveness/value of respite care --Strategy preventing out of home placement

Long term Short term Long term Long term Short term Short term

Workforce supply and quality • • • •

Sufficient numbers of providers Well-trained providers Staff qualifications aligned with client needs Staff training is widely available, ongoing, and of outstanding quality

Short term Medium term Short term Long term

Easy access, streamlined process and support • • • • • •

All respite providers have comprehensive intake for continuum of care Broaden criteria so caregiver can be eligible for respite Support informal providers of respite Navigator for caregiver to find way through system Coordinated-centralized single entry point Well publicized

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Short term Short term Short term Medium term Short term Short term 4

• • • • • •

Educate families to understand and accept services Make caregivers eligible for respite under Medicaid Opportunity for follow-up call to check in Respite care meets cultural needs of patient/caregiver Enough diversity to give choices Support informal caregiver arrangements

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Short term Short term Medium term Medium term Medium term Short term

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