Event: Office of Community Living Public Forum Transcript- Plattsburgh DISCLAIMER the FOLLOWING

Date: 9/21/15

Event: Office of Community Living Public Forum Transcript- Plattsburgh
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>CART Provider: Standing by.
> All right guys I'm going to get started. I apologize the closed caption is not working. What we are going to do is we will have a transcript and when we post the video we will make sure that it's there. Goo afternoon, my name is Greg Olson and thank you for hangon one second.
> I apologize.
> Good afternoon everybody my name is Greg Olson I'm the executive deputy director of the New York State Office for the Aging. This is our second listening forum for the feasibility study for the office of community living so for those of you that are here I'm sure you received the invitation that describes in a little bit more detail what this process is supposed to get at. The New York State Office for Aging was authorized in the budget that was passed in April of this year to study with our state agency partner and our community partner around the state the feasibility of creating an office of community living with the goal and I will read them to you because they are important with the goal of providing improvements in service delivery and improved program outcomes that would result from the expansion of community living integration services for older adults and persons of all ages with disabilities. And so there is a data collection component that was part of the authorization language in the statute and what we have done in partnership really what CADER has done and I'll introduce them has helped us create a survey that would get at the pieces within the statutory authority that we're supposed to collect. So you probably have no idea what I just said but that's why they're here to kind of walk us through it. There's three phases to this project. One was the distribution of the survey and it went all over the state we had well over a thousand responses and you'll hear a little bit more about that. The second phase is to do these regional forums. As I said this is the second in a series of nine that we're going to be doing over the next two weeks so that you can hear the preliminary results from the survey and have an opportunity for a giveandtake back and forth so we can get some additional information from you based on what the survey respondent said. Then the third thing we are going to be required to do is develop a report and some recommendations on whether or not we want to take future steps in creating an Office of Community Living. So one of the things that happened this morning that I want to just briefly mention before we get into this and then a little housekeeping items are there were a lot of people that had some suggestions that talked about their experiences and I think what I'd like to frame or how I would like you to be thinking about what you talk about today or your responses is if there are good things, if there are problems that you are seeing, how creating a new Office of Community Living would either make that better, make that worse, or have no impact at all. What we want to make sure is that this is very consumer focused. Moving pieces of state government around just for the purpose of moving pieces of state government around doesn't necessarily make sense this should really be focused and driven by what consumers of all ages need. On the housekeeping side we have a limited amount of time for each theme or section, but on our home website, which is or Google New York State Office for the Aging is the ability under each of the themes that you're going to hear today to add additional input if you didn't have a chance to talk during that section or there's something later on that you might have thought about that you wanted to contribute. So I want to thank first of all the office staff that are here, again we just finished one in Albany and got here as quick as we can so apologize for being late. We have a bunch of area on aging director Becky, Crystal Carter, Patty Batshaw who we passed. Without further ado, the folks that are going to help lead us and facilitate are from CADER but Scott Geron and Browan, you're up first give me a look and I'll change the slide. We're looking forward to your participation this is your time to provide us with direction, guidance and advice.
> Great thank you
>CART Provider: I have lost audio.
> Good afternoon, everybody. Thank you all for coming out today so my name a Browan Keith. I am a research assistant professor at Boston University School of Social Work and the Associate Director of CADER. So we were asked to be a part of this project as a nonbiased third party entity to come in and help NYSOFA evaluate the feasibility of creating an Office of Community Living so we've been working closely with an advisory, better, all this technology, so we've been working with an advisory board that was put together for this project some of the folks I think are here, I see one, are you the only one? Any other advisory members. Two. Okay. So groups of people both aging and disability providers, consumers, a wide range of people and they really have been working very closely with us and creating the survey that would represent the needs of this feasibility study as best as possible so I'm going to go over sort of what we did and some of the earlier findings. I can't see the screen, sorry. First slide. So this survey let me just back a little bit. This survey was a mixed method which means that were questions that were quantitative so people were asked questions like how would you rate your services on a scale of 1 to 5 and so it's a real score that people would get that we were able to average across and then afterwards every time there was an open box it would say please give us more information about that. So we have both openended sort of deeper comments and we have some of those numbers that we can get so today you'll be seeing some percentages and some openended themes that came out of the survey and in this audience who here was able to complete the survey or have seen the survey, anybody? Okay, so good proportion of you, great. That's good, this will be familiar to you the way it was created. So the survey really tried to touch on the key themes for plan for part N, and it really focusing on evaluating service delivery and improvement, looking at reinforcing the balancing the incentive programs, strengthening the No Wrong Door system and ways to leverage resources for services and consumers. So the survey responses to date we did this preliminary analysis at the end of August so August 31st, so these numbers are actually now higher but what we're going to be talking about are the results from August 31st. So at that point for consumers we had a total of 474 people that had completed the survey for consumers. We are now up to 715 so 129 more consumers. So again this is you guys are getting things hot off the presses, preliminary results so the purpose is we can add your feedback so this will be different as we move forward and continue to analyze the results. For providers we had as of August 13th, 613 people that had completed and that is now gone up to 777 so we have about 87 more people for that group. Greg said well we were well over 1,000 and more than met our target to getting completion rates which is really outstanding. So the characteristics of the survey respondents for consumers 66% female so a pretty even split whereas providers were 80% female so more female providers. Race, predominantly both with consumers and providers 85% white for providers, 90% white for consumers. Smaller numbers 3% for Hispanic and Latino and 4% for AfricanAmerican. The consumers 4% were on Medicare, 18% on Medicaid and 25% on both and 23 on neither. And 58% receiving private insurance. A lot of these questions are about whether you're currently receiving services or if you were not receiving services would you know where to go. So out of that population 48% are not receiving services and 52 were. So again, a pretty even split. And then in terms of the county's represented, we were again through the commitment to from the advisory committee and from NYSOFA were able to have quite a reach and got quite a few different counties represented for consumers and providers. Consumers you can see that there's a majority seem to be in the Finger Lakes I'm learning this geography very closely in the next couple of days and weeks so that's where we are now. No, where are we now? North Country, right. Finger Lakes is what day comes up? Tomorrow. Okay. So we I think we did a good job in terms of that representation and similarly for the providers same thing, we got a good representation, North Country, there you go 14% so almost the most from here. And then the types of agencies where providers worked, again the role goal that we set out for when we did the survey was to have equal representation we really wanted to be sure that we would have in our ideal vision would be to have as many older adults consumers and people with disability consumers complete this, simply providers that were between both organizations and we were very successful in getting equal representation so that was really an exciting finding for us. So in terms of the types of agencies that people work in, 26% work in aging organizations, 23% work in disability focused organizations and 34% are working in agencies that serve both populations and this number is pretty much stable since August 31st. I think I need to move this because I'm going to whack it. So the age group also has pretty much stayed the same since August 31st we have about 60% of the respondents over the age of 60 and 39 almost 40% under the age of 60 so again a really fairly good split. This one in terms of consumers who have selfidentified as a person with a disability this is now 50/50, it was 47/53 as a person with a disability and 50 did not so again a really great numbers here. Quick analysis on the types of disabilities identified, you can see that there are a range and again I would think that this number probably has changed more now that we have more over 100 more respondents in but we have about 20 from vision impaired, 83 with physical disabilities, mental health issues, learning disabilities so there are quite a few different categories that we were able to capture. So the next part of the presentation is going to be turned over to Scott Drawn and this is really the place where he's going to report out to you on some of the preliminary findings but also your time to tell us what you think and what your feelings are about all of these issues. So I'm going to turn this over to Scott.
> Hi everyone, thanks. My name a Scott, I'm the director of CADER at Boston University and we are really pleased to be helping NYSOFA in this project. I'm going to walk you through some of the preliminary findings that we have received so far based on the analysis of the surveys, and as she mentioned this is really a listening session so we're interested in your reactions to the results that we have, preliminary as they are. We also want you to know that if you are moved to do so, we encourage you to go to the NYSOFA website, there's a way for you to ad additional comments and feedback. We welcome all of your suggestions, ideas, reactions to today's talk or to your thoughts about this project. So let me begin with one of the first part an objective which is really to look at evaluating information and access. And so to understand issues around information and access we ask providers about duplication in services across the state and in agencies that they know. We also wanted to understand consumer perspectives so we asked about their experience in enrolling needed services. I must say this general theme that I'm covering as well as all the others almost every question in the survey or at least multiple questions address each of these themes. What we're doing now is highlighting a couple of the questions that relate directly to the theme but some of the findings or themes that I'll be talking about really come from the analysis of many questions. So in direct response to this issue, more than half of the providers who responded, 61% reported that there is either not much or very little duplication across service delivery and almost three quarters or 72% of consumers stated that they did not find it difficult or confusing to enroll in services that they needed. So that's the those were responses to two of the quantitative questions that we asked. In looking at the, thank you, in looking at the themes that emerged from their responses to the qualitative questions that went along with those, we found a lot more detail about their items so even though a considerable percentage of both consumers and providers did not identify duplication as an issue, when you looked at the qualitative responses these are the themes that emerged. Lack of coordination was a serious issue mentioned by many of the respondents they mentioned a duplication in assessments and applications, they mentioned that there are many case managers working with a single consumer but sometimes or oftentimes little coordination between the case managers. A second major sub theme concerned lack of communication between agencies. Sometimes consumers have multiple providers or agencies that they are working with but the agencies themselves are not communicating well. This is mentioned by both consumers and providers. This leads to duplication in effort and inefficiencies in the use of resources. Finally though, many folks mentioned, many respondents mentioned difficulty in accessing services. This was especially true in rural areas which will be no surprise to you I'm sure but there were most providers and consumers, or at least many based on the responses we received identified access to services in rural areas as a particular issue. A further issue was eligibility criteria which makes it difficult for consumers to access services. At this point I would like to stop and get your reaction and feedback to this theme and also these responses that we've received in our survey.
> Put your hand up and I'll come around you and just remember to talk loud enough that the person on the phone who is hopefully still on the phone can hear us.
> Good for you.
> I am Becky Lacey and the director of home healthcare services. I think what I'm seeing being involved in home care for about 30 years is that there is pretty good coordination I feel between providers in rural areas out of necessity, maybe not perfect but certainly I think we don't seem to have that much of an issue really communicating with other providers. But number 3 is a big issue. There is a great deal of difficulty in assessing services in a rural area mostly because they're nonexistent they're not easy to access a lot of the issues are transportation, in our particular case I'm representing home care home health aids it's a matter of not having enough home health aids and enough funding to be able to higher and retain home health aids. Most of our in particular our agency and most providers rely on Medicaid funds that are based on Medicaid rates. Opportunity aging, Medicaid personal care, those are the greatest part of our revenue. There's very little private care, perse, or insurance base especially for a licensed agency and the rates have not been adequate enough to be able to you know pay the rates that you need to pay for home health aids nurses to attract them and retain them a lot of competition between providers.
> Let me ask you, thinking about the purpose of this project can you think of how an Office of Community Living would affect the issues you just described, would it effect it positively reflect, not sure.
> Not sure. The Office for the Aging does a fantastic job so I think it almost might be repetitive or duplicative to have a separate office of community services. I think the emphasis has to be on the actual services. I find that I've been involved in home care for 30 years and healthcare for 40 something and I've never had difficulty getting assistance or help for clients through the office of the aging. I think it's a pretty good setup because of the care units. I'm not sure what the purpose of Office of Community Living would be. I just you know other than maybe if they combined services for the elderly with services for the disabled. I also happen to be a mother of a severely handicapped daughter so I worked with the OTWBD, those service was that would be the only thing if they wanted to combine but I really feel that it's duplicative and that's not where the effort should be put I think the efforts should be put in the actual services.