Going Home Plus- Stakeholder Meeting Minutes

Going Home Plus- Stakeholder Meeting Minutes

July 17, 2012

9am- 11am

Queen Liliuokalani Building, 2nd Floor Conference Room

Attending: Madi Silverman, Christy Nishita, Lisa Maetani, Rida Ching, Jackie Hong, Dianne Okumura, Mike Tamanaha, Nancy Moser, Iris Hashimoto, Lou Erteschik, John McDermott, D’Von Auna, Janice Takahashi, Becky Ozaki

AGENDA ITEM / FINDINGS/DISCUSSION / ACTION/FOLLOW-UP /
I.  Introductions
II.  Referral and Identification of Participants
A.  GHP Evaluation Updates
B.  CMS Site Visit updates / Christy Nishita (GHP evaluator) presented project evaluation data.
Issues discussed based on data:
Reinstitutionalizations (RE)
-  Track readmissions within 30 days
-  Track how many go back/stay in to the NF vs. Hospital
-  Track how many RE return to MFP after RE
Lost Medicaid
-  Don’t turn in paperwork
-  Don’t meet level of care
-  Most get retro- eligibility
-  Efforts to streamline, expedite- should make recommendations to Aileen Hiramatsu
-  Other states- SSI eligibility à Medicaid eligibility, an approach to explore with HI
Majority of Discharges to FH
-  High level of acuity, co-morbidities
-  Better matching needed
-  CM responsibility to make sure that caregiver is properly trained
CMS Site Visit for May 1-3, 2012 was postponed
Visit Agenda was reviewed with group / Include in next report:
-Comparisons of #s to benchmarks (per year)
-% of referrals-à discharge
-30 day readmissions
GHP is working on exploring cause of death
-  Acuity
-  Quality of care issue in the home
-  Where were they living- FH vs own home
DHS does follow-up on any suspicious deaths
DHS system is limited in understanding cause of death
-  Not enough quality staff to do mortality review
InterRAI quarterly assessments can also provide more data
GHP to continue to prepare slides and finalize agenda.
III.  Housing Activities / Comments by Janice Takahashi from HHFDC
Review of Section 811 NOFA- provides project-based rental assistance for low-income persons with disabilities
-  Discussion of partnership between HHFDC and MFP
-  Decided not to apply because only 1 developer in Kona responded to the RFI. Too few candidates and limitations in service availability. Typically go through 4 applicants for 1 vacancy
Other issues:
-  If person rents at 62, will not be evicted after age out of program
-  HHFDC would work on a “rent up” procedure on filling vacancies and maintaining a waiting list. The housing project would have to follow this procedure.
-  Housing options for younger persons with disabilities:
o  FHs originally developed as for elderly. FHs didn’t accept younger persons with disabilities, behavioral issues.
o  FH should be a stepping stone to ind- housing, not an apt.
o  State doesn’t have housing options for these younger persons with disabilities who can live independently
Potential Options:
o  Incentives for care homes to accept 1 Medicaid client
o  Option- boarding home model (e.g. Catholic Charities operated elderly boarding homes)
o  Option- Catholic Charities have social worker assigned to senior apt buildings
o  Steadfast housing developer for mental health pop (long waiting list)
o  Co-op building for DD families- closed elementary schools?
o  Public lands development corp- looks at land use
*Note- this is a sign of success for the project: was once in an institution and now in community
HHFDC- Housing Policy Study- conducted every 2 years
-  Key finding
o  Hard to determine how many persons with disabilities are in need of housing?
In process of drafting MOU between DHS and HHFDC so we are ready the next NOFA
Discussion of Seattle conference by Lisa Maetani (GHP) / GHP to see how to work with Housing Policy Study to work on #s
GHP to work with HHFDC on MOU. Look at including DD.
IV.  Outreach and Education/Transition Coordination / GHP discussed interviews with GHP participants. Put video and case summary on website.
GHP would like to partner more w/Ombudsman program to help identify potential participants in the NFs. Ombudsman program has interns. Offer made to use the interns to follow-up on deaths and participate in mortality reviews. / GHP conducted 1 video- will continue to interview 3 other participants
GHP to follow-up with ombudsman group
V.  Quality
a.  QOL
b.  ADRC grant update / Summary of key QOL responses on handout
Update on the new GHP grant with ADRC to:
1.Implement InterRAI assessment tool in foster homes to look at quality issues
- Assessment responses are used to generate Clinical Action Protocols that will be used to identify quality issues and improve service planning
2.GHP to train ADRC to become Local Contact Agency (for any responses in nursing MDS 3.0 assessment in which resident wants options counseling) / GHP to work with ADRC on implementing grant
VI.  Other / 1. Request suggestions for new members. Possible members on neighbor islands to connect by conference call
2. Group asked to think about how we can appropriately incorporate GHP members in the Stakeholder group
Minutes are always posted on the Going Home Plus website : http://www.cds.hawaii.edu/goinghome/
Next Stakeholder Meeting:
January 14, 2013

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