CCNC--Dual Eligibles Grant

Beneficiaries and Stakeholders Work Group

December 12, 2011—9:00 a.m. to 12:00 p.m

Conference Room 5—CCNC

Participants: Dennis Streets, Swarna Reddy, Michael Howard, Hank Maiden, Missy Brayboy, Kim Sturkey, Marc Jacques, Alicia Blater, George Smith, Kevin Robertson, David Stone, Patricia Fields, Tonya Peters, Scott Tillbrook,Janet Schanzenbach, Laurie Coker, Elise Bolda, Nidu Menon, and Pat Gerney

Overview of the Project

Overall Goal: To engage persons who are dually eligible and representative community stakeholders in the North Carolina’s Dually Eligible Planning Grant.

Overall Objectives:

  • To provide a way for interested persons to submit ideas for ways to improve the care of persons who are dually eligible and save cost.
  • To provide an ongoing means for interested persons who are dually eligible to submit their thoughts and ideas, views on ways to improve the current system of care and comment on the options being considered/proposed by the Dually Eligible work groups.

Meeting Objectives:

  • Identify 3-4 opportunities within the next 30-45 days to solicit dual eligible beneficiary input and opportunities within the next 30-45 days for local community stakeholder input
  • Identify and strategize other ways to get input (e.g., use of SHIP volunteers for one-on-one interviews with beneficiaries, use of e-suggestion box) especially for engaging the hard to reach
  • Discuss questions and tools that can be consistently used with beneficiaries and community stakeholders
  • Get commitment from specific individuals/organizations to help arrange/conduct input sessions.

The focus of this group is the 284,000 dually eligible persons, most of whom(235,000) are in their own homes in the community, 30,000 are in nursing homes, and about 19,000 are in adult care homes.

Try to engage representative groupsand use this opportunity to reach community stakeholdersgroups already existing in the communities who are working closely with dually eligibles and HHS and have perspective to share about this project.

Core values are to improve care/improve health; improve access, quality, and reliability of the care;and reduce the cost of care for dually eligibles. Do this by building on what North Carolina already has (strengths within the system), and being willing to step back out of those silos to determine the best interests for all of North Carolina. Have a real opportunity. One of 15 states that might be approved to carry out a demonstration of some of the changes we will be proposing.

Elise—laying the ground workfrom the planning efforts, tobe sure we have ways to communicate with beneficiaries throughout, not only during this planning grant, but in the future. Infrastructure that already exists and we will build on.

NC has in place an infrastructure that our proposal builds on and an expectation that the concept of patient centered medical homes will be a piece of the work, along with the informatics center. Another piece of this that we have to be mindful of, is to help people understand the language we are using and understand the concepts.

In terms of beneficiaries’ input if we could have 3-4 significant opportunities to meet with or engage the beneficiaries who would be sufficiently representative of that population. In the next 30-45 days that would help. In terms of populations we need to think about varying ages, sufficiently diverse geography, gender race, ethnicity, functioning, and care settings. We are well aware that this may require some one-on-one meetings. Recently at the conference on aging in Charlotte, North Carolina we held a listening session and then in November, we met with a group at a public housing complex for older adults. These groups helped inform us a little.

We want to identify existing opportunities within the next 30-45 days. It will help to identify existing opportunities, try to reach people through a meeting that is already planned. The other groups we want to reach are community stakeholders -stakeholders -to share information and learntheir ideas.

Populations/Beneficiary Groups

  1. Mental Health
  2. Substance Abuse
  3. Aging
  4. Intellectual/Developmental (DD Council and ARC) work with local affiliates (State—Dave Richards)
  5. Adults with a Physical Disability (State Independent Living Council) CILS
  6. Children (?)
  7. Family Care Givers—Life Span Respite Group (could a message be added to appointment communication—probably not
  8. Tribal Communities

8.

  1. Geography (rural)

Beneficiary--30-45 days—Opportunities

  1. Kevin --Cherokee—SHIP
  2. Bob--Holiday Parties—general community to stakeholders group
  3. Lori--meets weekly for coffee, dual eligibles with chronic illness and mental health—40/50 age group—substance abuse and psychiatric (Winston-Salem area)
  4. Henry - Orange County Master Aging Plan especially in outlying areas; SW’s congregate lunches
  5. Missy—“Gateways” for tribal groups via faith community/churches
  6. Tonya—Senior centers (East)/congregate nutrition
  7. Marc—Club Houses (Triangle Area)

Other Approaches

  1. On-line survey –public comment period
  2. PACE programs
  3. Skilled Nursing Facilities (SNF’s -councils and provider networks)
  4. Adult Care Homes/Family Care Homes
  5. CRC’s (Aging and Disability Resource Centers)

14.

  1. Community Area Ministries
  2. North Carolina Baptist Aging Ministry (NC BAM)

Use of consumer/provider networks to inform of electronic communication

  • Use focus groups in more defining issues
  • Use multiple means—simple language
  • Keep questions simple

Community Stakeholders—broad-based group

  1. CRC’s (Michael) (Tonya)
  2. Community Healthy Carolinians (Missy)—Mary Black—Southeastern Robeson County

Other strategies for input—what already exists from reports—BRFSS survey data, Healthy Carolinians, public health

West / Piedmont / East
Kevin--Cherokee (All groups) / Lori—MH/SA Winston Salem / Tonya-Aging CRC/Senior Center
Charlotte (Aging -done) / Marc Raleigh/Triangle MH/SA--Clubhouses / Missy—Tribal (All Groups)
Marc Gaston ? MH/SA--Clubhouses / Orange Co. (Northern) Aging / Marc Wilmington? MH/SA--Clubhouses

Video shown that describes medical homes from website pcpcc.net, “patient centered primary care collaborative” medical homes video. Reaction to the video was positive. Could be one aspect but other tools will be needed. Need to be mindful that not all locations will have internet access

Reviewed prepared tools and documents to support the community conversations, the suggested Protocol for Beneficiary and Community Stakeholder Sessions, Standardized permission form, suggested questions for beneficiaries and suggested questions for stakeholders, Participant Demographic Summary, Thank You Letter, and Summary/Debriefing Notes for Beneficiary Session were reviewed and discussed. Make two additions to the Participant Demographic Survey as follows: Reason beneficiary is dually eligible, and population group with which beneficiary is associated.

A discussion followed regarding the questions that will be used for beneficiaries and stakeholders as well as language. It was suggested that the questions be reworked completely to those that the beneficiaries will be able to relate to and respond.

Questions and other tools will be reworked and send to the group for review and comment.

The next meeting will be held in January to orient those who will be helping with reaching out to beneficiaries – probably first week of January.Date to be determined.

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